New Attending dealing with conflict

[unicornssong]

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Hi All

So I just started a new job fresh out of residency at a completely new hospital. Like others have said, the new learning curves are steep - I have to learn new faces, new policies, totally new ways of doing things. Unfortunately it's recently also meant learning all new conflict resolution.

So anyways, for a little background, I've been at this job for about a couple of months along with the monthly meetings - and there is a single attending that is brought up time after time as not a team player, actively frustrating, always seems embroiled in some conflict, constantly complaint etc etc. While I've essentially managed to stay out of it up until now, he's finally stepped on my toes a few times and I'm starting to hit my limit with him. They are either over things that are minor (in my opinion ie he doesn't like note my format or he thinks they're too long or I have spelling mistakes or I forgot to write I titrated down prednisone etc) to policy items (we signed out over secure messaging at my residency, here every single patient including that social admit is done on the phone apparently in great detail). I welcome advice on how I can improve but sometimes the way the messages come across are very pointed- "I don't like the way you do this". "You should really know we do things this way here", " You need to conform to the system". I've tried to keep my replies neutral and positive, but they're starting to grate on my last nerve - enough so that if this continues, it is highly likely I will opt not to renew my contract.

As a resident, conflict resolution was very straight forward. Conflict with your attending - suck it up. Conflict with your resident - talk it out/teaching point +/- chief resident at a pinch. While everyone else seems to just ignore him (this is not unique to me), I cannot and will not accept working in a job where its acceptable to be a complete jackass. Nevertheless, I'm going to be stuck working with him for the next couple of years and would very much appreciate your experience and wisdom on how to deal with people like this without creating a conflicting work environment (and the medical director is aware).

 

[rokshana]

Hi All

So I just started a new job fresh out of residency at a completely new hospital. Like others have said, the new learning curves are steep - I have to learn new faces, new policies, totally new ways of doing things. Unfortunately it's recently also meant learning all new conflict resolution.

So anyways, for a little background, I've been at this job for about a couple of months along with the monthly meetings - and there is a single attending that is brought up time after time as not a team player, actively frustrating, always seems embroiled in some conflict, constantly complaint etc etc. While I've essentially managed to stay out of it up until now, he's finally stepped on my toes a few times and I'm starting to hit my limit with him. They are either over things that are minor (in my opinion ie he doesn't like note my format or he thinks they're too long or I have spelling mistakes or I forgot to write I titrated down prednisone etc) to policy items (we signed out over secure messaging at my residency, here every single patient including that social admit is done on the phone apparently in great detail). I welcome advice on how I can improve but sometimes the way the messages come across are very pointed- "I don't like the way you do this". "You should really know we do things this way here", " You need to conform to the system". I've tried to keep my replies neutral and positive, but they're starting to grate on my last nerve - enough so that if this continues, it is highly likely I will opt not to renew my contract.

As a resident, conflict resolution was very straight forward. Conflict with your attending - suck it up. Conflict with your resident - talk it out/teaching point +/- chief resident at a pinch. While everyone else seems to just ignore him (this is not unique to me), I cannot and will not accept working in a job where its acceptable to be a complete jackass. Nevertheless, I'm going to be stuck working with him for the next couple of years and would very much appreciate your experience and wisdom on how to deal with people like this without creating a conflicting work environment (and the medical director is aware).

key is that you said you work WITH him, not FOR him...how you write your notes is for you to decide (and CDI, but that is another issue)...follow policies as you need to and ignore him (or just say thank you I'll remember that piece of advice)...and if you do choose to not to renew your contract, let your director know why

 

[chicagochildpsych]

You aren't a resident anymore, politely ask him if you are in violation of any written hospital policy. If the answer is no, remind him you are a fully licensed board certified physician who has the ability to practice independent of his recommendations.


Sent from my iPhone using SDN mobile app

 

[justin1390]

You aren't a resident anymore, politely ask him if you are in violation of any written hospital policy. If the answer is no, remind him you are a fully licensed board certified physician who has the ability to practice independent of his recommendations.


Sent from my iPhone using SDN mobile app

But let me caution by saying that in doing so you need to be careful not to burn other bridges. The art of conflict resolution is a political one fraught with alliance building, rapport, and personality fortitude. He has been there longer than you, and whether or not he's a bit of a pinhead, he has workplace tenure you do not. You also don't know what kind of connections or who he has in his pocket.

I used to work in some very ego-heavy fields before entering the medical field, and I'd advise remaining tactfully curt with him, honestly. If you MUST say something, I would advise him that luckily, you are a great learner always striving for efficiency and personal self edification, and while always conforming to hospital policy, will always look for better and more innovative ways to accomplish work, and you'd be happy to go over the rationale of why you do what you do. And that's what defines an OK vs a great provider. If you want to be a bit more passive-aggressive to get him to back off, I always like the good old: "Because unfortunately many providers become stuck in a stagnant system of personal preference, and if there's anything the last few years of health care has illustrated, it's that health care is a moving target requiring constant adaptability."

Objectives met:
1. Everything there make you look like a cutting edge provider, and at the very worst a bit of a smart-ass
2. There's no direct emotionally charged words exchanged
3. You have implicitly rendered him: un-innovative, inefficient, and a sheep to the industry

 

[staup640]

But let me caution by saying that in doing so you need to be careful not to burn other bridges. The art of conflict resolution is a political one fraught with alliance building, rapport, and personality fortitude. He has been there longer than you, and whether or not he's a bit of a pinhead, he has workplace tenure you do not. You also don't know what kind of connections or who he has in his pocket.

I used to work in some very ego-heavy fields before entering the medical field, and I'd advise remaining tactfully curt with him, honestly. If you MUST say something, I would advise him that luckily, you are a great learner always striving for efficiency and personal self edification, and while always conforming to hospital policy, will always look for better and more innovative ways to accomplish work, and you'd be happy to go over the rationale of why you do what you do. And that's what defines an OK vs a great provider. If you want to be a bit more passive-aggressive to get him to back off, I always like the good old: "Because unfortunately many providers become stuck in a stagnant system of personal preference, and if there's anything the last few years of health care has illustrated, it's that health care is a moving target requiring constant adaptability."

Objectives met:
1. Everything there make you look like a cutting edge provider, and at the very worst a bit of a smart-ass
2. There's no direct emotionally charged words exchanged
3. You have implicitly rendered him: un-innovative, inefficient, and a sheep to the industry

^^^ This is intelligent advice. I've been a hospitalist for about 6 years in a couple of prestigious academic institutions. Usually, the people you describe get fired eventually if they haven't earned significant clout in the hospital system already. If they have, you may be out of luck and have to learn to deal with him.

My advice: try as hard as you can to ignore him. Let him give you whatever advice he wants, accept it politely, and then move on while internally ignoring him. Every place you will work... academic, private, whatever... will be political so be aware of this. Try not to become a problem yourself. I would say I ignore about 10% of my colleagues. I draw the line when something is affecting patient care directly and when that happens I try to resolve it with them directly instead of talking to their superiors. If that doesn't work, and it's still affecting patient care, I talk to their superior. But anything as far as personality - I ignore as much as I can.

 

[deleted480308]

just make sure you are flawless in your following of protocol if you are going to start (or finish) a pissing match. Your crap should be spelled right and you should be signing over properly and documenting meds right. He may be a jerk, but if he's right about something, correct it.

Ignore him on the opinion stuff.

 

[QofQuimica]

I find that the best way to deal with know-it-alls like this is to "apprentice" yourself to them. If you look at what's really going on here, this guy wants to be recognized as an expert. And if he's a senior or even mid-career doc, then he probably does have some decent tricks and tips he can pass along to a noob like you. So pick something he's better at than you are and that you'd legitimately like to improve at, and then ask him for his help/advice. All of a sudden, you go from being adversarial to having him on your side, because now he likes you and has a vested interest in mentoring you. Seriously, it works. Try it.