Fight! But Stop Before the Nosebleeds

Not a day goes by that we don’t hear about the benefits of diversity. Diverse opinions and perspectives provide well-rounded conversations, multiple points of view, better vetting of ideas, and a richer, more robust final product. Or that’s what we like to believe. But what I find in the real world is that while diversity often happens, more well-informed discussions do not. How can we be creating a more diverse workplace, yet still not be reaping the benefits of the diversity we hope for? Well, it’s simple really—it all comes down to conflict. And I’m not thinking that too much of it is getting in our way; what I am seeing is that not enough conflict comes up in our work lives and as a result, diversity of perspectives is essentially silenced. The diversity we seek doesn’t seem to make it from the human resources annual report to the conference room table.  Something needs to change! 

While some of you may like conflict, many people say that they do not–and I have witnessed that a number of people who work in healthcare do not. They like to please people–to make people better and comfortable–and they carry that desire out of the patient exam room and into the meeting room. That desire for peace, harmony, and agreement costs us all. For example, it is estimated that 25% of employees say they have called in sick to work to avoid conflict (“The Real Cost of Workplace Conflict” by Entrepreneur Jennifer Lawler June 21, 2010). 

Some of us can engage in personal conflict and we take pride in our ability to manage personal or familial conflict. Yet we hate confronting it at work. Others hate conflict everywhere. It is seen as devastating or destructive, or at best as an unnecessary irritant. Why? There are so many reasons for this. Some of us were taught through our early conflict models–through the observations, we made of others who share our race, skin color, gender, or religion–powerful and often indirectly stated opinions about the need, desire, or even safety that comes from avoidance of conflict. Patrick Lencioni, in his book 5 Dysfunctions of Team, points out that lack of conflict is often based on an absence of trust. This, in turn, prevents us from fully engaging in conflict, keeping us from weighing in and therefore costing us the ability to truly buy in, which he then links to the next dysfunction–an ability to commit to decisions. Conflict is a critical piece in the precarious Jenga game of management team health. One push too far and the whole thing could tumble. And since no one wants that, we avoid the push. 

As a result of this avoidance of conflict, we miss out.  Conflict is great and it’s great for us to get to the best outcomes. It’s great for our teams, it’s great for our discussions, it’s great for our team dynamics. and I’d even go so far as to say that it enlivens those who engage in conflict for the purpose of getting the best result and the most diverse and dynamic discussion possible. 

How to Encourage Healthy Conflict

So, how do you help your team get started engaging in healthy conflict? And how do you protect those who are beginning to come out of their conflict-avoidant shells so they do not get bowled over in a meeting by that one person on the team who seems to have very thick skin and is happy to engage in conflict, or who sees pushback as a game? The answer is… very carefully.  Teams that do not yet know how to use healthy conflict to their advantage have to be moved forward carefully and together as a unit. Certain team members cannot get too far ahead or they risk squelching those who are still learning. 

Five Steps to Begin to Engage in Healthy Conflict. 

1. Decide to go after conflict. You need to propose the notion of healthy conflict improvement to your team. You will have to decide to proceed and make sure that the team is aware that this is a goal. This allows those who like conflict to see that their role is to help bring their colleagues along. It also prepares the hesitant for the exercises that are about to come. This conversation must be coupled with an explanation as to why conflict will be helpful. Team members have to know that their temporary discomfort can bring them happiness if they stick with it.
2. Build team trust. This is sometimes done in hokey ways, like through trust fall exercises, and to be clear, I am not suggesting those. Physical trust does not necessarily beget mental and emotional trust, although they can work together. Trusting team members mentally and emotionally requires some vulnerability and understanding. Some build trust through conversation. Our team uses a series of vulnerability-based questions in order to build trust. This helps us all open up about the way we think, how we feel about goals, and how our various upbringings might have impacted our trust and conflict style. These types of questions do not require sharing embarrassing high school antics, but they do require more depth than a simple work-only discussion. Creating a safe place to have these conversations is important. You might know that you have succeeded when team members share, and others make comments such as … “Ah, I had no idea about x, y, and z, I feel like I know you so much better.”
3. Raise the stakes to create occasions for conflict to emerge. There are many reasons for us to feel passionate about our professional goals, but healthy conflict will require a focus on a professional goal that we all share. For example, Gina getting a promotion to Operations Director is not a goal we all share. However, getting all patients seen on the day they call is something all of us can feel very strongly about. This is an example of ensuring that everyone has a stake in the goal at hand. Malcolm Gladwell, in his article, “The Innovation Myth,” talks about the virtues of “threat” and “constraint” to the creative process. No manager is a stranger to threat and constraint–they are everywhere. If we can identify and harness threat and constraint, and run toward them rather than trying to bury them, then maybe we can make something great happen.
4. Grow the discussion…Carefully.  When faced with threats or constraints, teams with trust and a common goal often speak passionately to work through the problem to a successful conclusion. That professional passion, if nurtured, can inevitably lead to differences of opinion. That’s when the magic can begin.
   A well-facilitated discussion that encourages all conflicting opinions to be heard can do wonders.  In order to have that conversation, a group may need to agree to some ground rules, such as only one conversation at a time, no use of extreme words (“your department never…”), no personal attacks, no sidebar conversations (keep everyone focused and passionate about the same conversation or else you have fragments and conflict will often go underground), and everyone gets a chance to share. I have seen teams set timers to allow all voices to be heard, call on quieter members of the team before more vocal team members are allowed to pose a retort, or even pass an object around so that only the person holding the object can speak and has the floor until passing the object to someone else. Whatever the technique that suits your team, don’t expect that healthy conflict conversation will happen just because we are all adults. Adults start wars, and adults can be pretty childish sometimes. Assume the best intent, but stack the deck for success by clearly setting the ground rules.
   Another way to build the discussion is to put a moratorium on words like no and but. Encourage team members to start their thought with phrases like “what I like most about what has already been shared is…. AND I want to add…” These are just a few techniques that can be used to grow the conversation. This step can often seem like the most daunting part of the process, but it does get easier with time and practice.’
5. Soft-land the conflict. In order to soft-land the discussion, everyone needs to leave with a clear understanding of what was agreed upon (for teams new to this, people will not forget those areas where opinions differed from their own). Write down what was agreed upon and then plan to come back to hash out some of the unresolved areas. The best conclusions are ones that can provide the team some traction and movement toward solving the problem. If you do not get to any solutions, then I would argue that the threat and constraint are not strong enough, or interpersonal trust is lower than previously believed and you’ll need to go back to steps 1 and 2. Arrive at some conclusion and then agree to move on to the decision. The ability to arrive at a conclusion can help a team feel successful and can encourage more healthy conflict.

A key part of a soft landing is being on guard for what happens after the meeting, which may undo the good work from steps 2 and 4. Sometimes follow-up discussions involve conversations that undermine peers, colleagues, or others. Typically people won’t tell you that they are having conversations that undermine the healthy culture you are trying to build, you’ll have to listen for those destructive words and watch for those harmful behaviors.  Additionally, for a successful soft landing, one must ensure that an exacerbation of biases or discrimination doesn’t take place as a way of penalizing someone who shared an unpopular opinion, even though conflict and sometimes unpopular opinions were explicitly requested.

When Conflict has Gone Too Far

What most worry about when they begin to dream of a more conflict-healthy team is the inevitably destructive knock-down drag out that will make everyone miserable. While it’s possible, I don’t see this very often in healthcare. It’s the worst possible fear, but it rarely happens because it’s so very far from the norm. And we don’t change quite as quickly as we might like. Managing the discussion well (see #4) and ensuring a soft landing to the conflict discussion help keep conflict in the healthy range. In the event that conflict goes too far, the facilitator and the most senior team member will have to work diligently to support the team, to make apologies if necessary, and to get the team back on track.

Having seen healthcare leadership teams work to engage in conflict as much as I have has taught me one thing: beware of the quiet danger lurking under subtle conflict more than the overt conflict. It is much more likely that team members who did not “get their way” or who did not share the goal will 1. talk badly behind someone’s back, 2. fake support of the decided action and do nothing, or 3. sabotage the hard-fought solution. This often causes more destruction and harm than someone speaking too aggressively or “going too far” in a healthy conflict discussion.

Dare to push the envelope in your work discussions; then you can really win and revel in your diverse perspectives. Coleman Associates is committed to making healthcare work better. If we can help your leadership team to work better together, please contact us.