Elephants in the Room

I like elephants; especially the new one at the Baltimore Zoo who is very wrinkly and cute. I've seen their art work, especially that of a certain 7 or 8 year old who can actually do a rather impressive self-portrait.

I think they are hard workers, heavy lifters, and find joy in simple things - much like the picture I posted in an earlier blog.

But, what do you do when there is an elephant in the room that everyone ignores? You know, that uncomfortable odd feeling, when everyone is having a conversation in their head about it - or making snide remarks in their head about it. You can see it in the look that they give each other as the presenter tries to ignore it, yet it's the most obvious thing that no one wants to talk about.

I'm working with a client who has a HUGE elephant in the room, and they will not address it. While meeting with them the other day, I asked how it got to a point where the inmates were running the asylum, and they really didn't have an answer.

Most of the physicians are creating a hostile work environment in their practices with this client, yet when they are spoken to about their behavior, they threaten to leave, and take all of their patients with them. See, they are really good clinicians, and they serve their patients well, but they just can't work with their co-workers. If they were to leave, they would financially cripple my client.

My client has tried many interventions with the physicians, and they refer to all of the customer service pleasantries as "crap". And, if the coworker can't handle their behavior, they need to grow a thicker skin. Which is kinda funny, as in reality, the physician is having a hissy fit like a 3 year old, because they aren't getting their way.

Where I sit, I get to see both vantage points of the story. Most people will tell you that they like their doctor, they are very nice and concerned about their well-fare, and would recommend their doctor to others. Which can very well be true. However, I get to see the "God complex" that most of them have, and the arrogant personalities that really hinder the work environment. I don't know how it happens, but somewhere between their first residency and their first placement, they lose their heads.

Let me give you an example... my client has countless ones, but this should move the story along nicely. There is a Medical Associate who has 15 corrective actions against them. This means they were written up, not given a verbal warning, but written up over 15 times for tardiness, dress, unprofessional behavior, incorrect processing of files.. the list goes on... but the Manager cannot fire them because the doctor likes the Medical Associate and how the Medical Associate types up their notes. When trying to move the MA to another position for a better fit, the doctor had a temper tantrum and refused to see patients for the rest of the day... which equaled a loss in revenue. So, what does the client do?

They call my department in to teach the Managers how to better handle poor performers. They have them read Good to Great, which tells them to fire the people on the bus who aren't helping them drive it in a direction. And also tells them to find what they do well, and focus all of their attention on that.

Yet, they can't do that. Because if they fire the poor performers to make room for the right people, they would lose 1/2 their practices and the physicians would go along with it.

I mentioned to them that there will always be a new book. Ten years from now, there will be a new program. But they will continue to have the same problem with not being able to get to "great" because of the huge elephant in the room that no one wants to address. Let me take that back, the managers want to address it - it's the bane of their existence - yet upper management doesn't know how to handle it.

We talked at great length about this on Monday, and the only option that would try would be to re-evaluate their compensation plan and bonuses for the physicians. They don't have performance reviews or 360's as part of their development plan for them, and to begin that process as well. But by making behavior part of the compensation process is a good start.

In the meantime... I'm working on a course in coaching and feedback which will help the managers deal with performance as it happens, and not wait 6 months later for a performance review.

My head hurts....