Managing Conflict: Bridging the Generational Gap

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Managing Conflict Bridging the Generational Gap

• David A. Novis, MD
• MGMA Annual Meeting
• Las Vegas, NV
• October 2006

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What I can share with you30 Years Experience
with Resolving Conflicts

• Business
• Managing partnerships
• Boards of Directors
• Hospital Administration
• Medical Director
• Chief of Pathology
• Hospital Medical
• Executive Committee
• Trustee

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Agenda

• Generational Profiles what are they are what do
  they mean?
• Getting in and out of conflict
• Weaving in generational considerations
• Problems submitted from floor

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Practice ManagersWhat difficulties in your
practice bring you here?

• Impasse in resolving conflicts?
• Unrelenting trans-generational friction?
• Placed in no win situations?
• Delegated responsibility w/o authority?

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Situations Influencing Conflicts and their
Resolutions

• Generational
• Gender
• Religious/racial
• Upbringing
• Education
• Experience
• Other

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Generational ProfilingA new phenomena?

• "The young people of today think of nothing but
  themselves. They have no reverence for parents or
  old age. They are impatient of all restraint.
  They talk as if they alone knew everything and
  what passes for wisdom with us is foolishness
  with them. As for girls, they are forward,
  immodest and unwomanly in speech, behaviour and
  dress.
• Socrates

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Generational Profiles
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Generational Composition of Total Workforce
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Generational Composition of Physician Workforce
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Matures/TraditionalistsThe Elders
Background environment World War II, Depression
Heroes MacArthur, Eisenhower, FDR
Characterized by others Loyalty, patience, conformity, sacrifice
Sense of Self Hard work climbing the ladder Success Tenure Authority
Quote In my day, we built this practice on
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BoomersOutgoing Leaders
Background environment Civil rights, Woodstock, Viet Nam
Heroes Kennedy
Characterized by others Competitive, workaholic, climbers
Sense of Self Personal development teamwork success
Quote DRGs, cook book medicineit wasnt supposed to be like this.
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Generation XersIncoming Leaders
Background environment Watergate, Challenger explosion
Heroes none (do not recognize authority)
Characterized by others Slackers, cynical, short term goals
Sense of Self Loyal to people not companies Self reliance capre diem success
Quote Ill need 6 weeks off when my child is born
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Millennials/Generation YSoccer kids
Background environment Oklahoma bombing, 9/11, Internet, Laptops, cellulars
Heroes Pop stars
Characterized by others Coddled, aimless, need constant stimulation, communication, reinforcement,
Self Group oriented and postpone career
Quote Like, we have to work for our money? Our parents told us anything is possiblebut deprived us of social skills.
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How is profiling commonly employed?

• Marketing campaigns, corporate strategies
• Stereotypical judgments racial profiling
• May promote conflict

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Generational ProfilingA shortcut to resolving
conflict?

• Profiles characterize generations--not
  individuals
• Individuals and problems are unique
• People may think that the roots of their
  differences are generational (not unlike sexism
  and racism)

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Issues that may appear to be based on
generational gaps

• Investment portfolios
• Call schedules
• Work schedules
• Income requirements
• Retirement buyouts
• New member equity
• Succession

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Learning from my mistakes

• Succession
• Equity
• Mission (Quality)
• Operations (POC testing)

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Conflict.How did we get ourselves into this
mess?

• Fail to anticipate the inevitable
• Fail to perceive conflict
• Perceive conflict, but ignore it
• Try to resolve conflict but fail
• See Diamond, Jared. Collapse (London Penguin,
  2006).

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Fail to anticipate a problem before it arrives

• New problem--No experience
• False assumptions
• Example Equity
• Assumed competence in all areas
• Assumed entitlement of new associates
• See Diamond, Jared. Collapse (London Penguin,
  2006).

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Fail to perceive it when it does arrive

• Slow trendcreeping normalcy
• Dont want to perceive it
• Example Succession
• Want to believe associates will grow into the
  job
• See Diamond, Jared. Collapse (London Penguin,
  2006).

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Fail to try and solve it

• Denial
• Rational (Selfish) behavior
• Example Mission (Quality)
• Fail to embrace common goals
• Fail to appreciate conflicting goals
• See Diamond, Jared. Collapse (London Penguin,
  2006).

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Try to solve it and fail

• Values clash, vary or change
• Put tactics before strategy
• Short term vs long term goals
• Narrows solutions
• Example POC Testing
• Fail to seek compromise solutions
• Diamond, Jared. Collapse (London Penguin, 2006).
  
• Tuchman, March of Folly (New York, Random House,
  1984)

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Strategies of Conflict Resolution

• Anticipate the inevitable
• Harness conflict for growth
• Avoidance may not be the best strategy

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Strategies to Harness ConflictWhat Younger
Generations May Not Know

• Get the right people on board
• Strategy First.
• Then Tactics
• Collins, Good to Great (HarperCollins, New York,
  2001).

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Get the right people on board

• Consider ALL skill sets
• Understand everyones personal niche
• passion
• expertise
• skills and limits
• Points to areas of need
• Hire, Train or outsource

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Get the right people on board

• Creates infrastructure
• Develops recognized champions
• Determines need for experience vs. fresh ideas

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What skills do you need?
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Strategy first

• StrategyTacticsLocationRoute
• Example Department staff meetings
• Tactics firstReluctant, narrow, short term
  solutions
• Strategy first lasting, broad long term
  solutions
• Develop a corporate mentality
• Opens the door to a family of tactics

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Strategy first

• Establish a mission
• Fixate on outcomes (the vision)
• Establish a strategic plan
• Develop a corporate mentality
• Opens the door to a family of tactics

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then tactics

• Alignment
• Cultivate Trust

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Alignment Instill Corporate Culture while
maintaining sensitivity to individual needs

• Understand everyones needs
• determine walk aways
• real vs. articulated needs

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Cultivate Trust

• Require vulnerability
• Tolerate mistakes and shortcomings

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Real vs Articulated IssuesDont debate smoke
Articulated Real
Da Vinci Robotics Da Vinci Robotics Da Vinci Robotics
Pro Improve Care Undermine SurgiCenter
Con Expensive Tie up OR
Point of care testing Point of care testing Point of care testing
Pro Faster TAT Control
Con Poor QC Precedent
Double reading surgical biopsy specimens Double reading surgical biopsy specimens Double reading surgical biopsy specimens
Pro Better Quality Anxiety over errors
Con Expensive, ? TAT Anxiety over being rushed
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Consider all the possible solutions

• Not getting slides on time?
• Need more histotechs or a better work flow?
• Not getting reports out on time?
• Need more typists or a better work flow?

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Summary

• Define conflict
• Determine needs and walk-aways
• Real Issues vs Articulated issues
• Place in context of mission, vision and outcome
  measurements
• Consider all possible solutions
• Action Plan with outcomes (may need more
  information)