DIFFICULT CONVERSATIONS WITH COLLEAGUES

1. DIFFICULT CONVERSATIONS WITH COLLEAGUES DONALD BACHMAN MD FACR METROWEST MEDICAL CENTER FRAMINGHAM MASSACHUSETTS DEPARTMENT OF PSYCHORADIOLOGY* * I WISH

2. LOTS OF CONVERSATIONS ARE DIFFICULT

3. WHAT MAKES A CONVERSATION DIFFICULT • ANYTHING WE FIND HARD TO TALK ABOUT • WE FEAR THE CONSEQUENCES FOR OURSELVES OR THE OTHER PARTY • WE CAN’T PREDICT THE OUTCOME • OUR SELF-ESTEEM IS THREATENED • OUR EMOTIONS GET IN THE WAY

5. SOME DIFFICULT CONVERSATIONS • TELLING A CO-WORKER THEY MADE A MISTAKE • ADMITTING THAT YOU MADE A MISTAKE • DEALING WITH AN IRATE CLINICIAN • CHALLENGING THE JUDGMENT OF A REQUESTED EXAM OR PROCEDURE YOU FEEL IS INAPPROPRIATE • APOLOGIZING FOR BAD BEHAVIOR

6. THREE UNDERLYING CONVERSATIONS 1. WHAT HAPPENED? Who is right or wrong? Are the facts interpreted differently 2. WHAT FEELINGS ARE PROVOKED What is being said is often not what we feel 3. HOW IS OUR IDENTITY AFFECTED What our conversation means to our self-image Stone,Patton &Heen DIFFICULT CONVERSATIONS

7. DIFFICULT SUBJECT MATTER • SENSITIVE ISSUE SUCH AS AN ERROR • EMBARRASING TOPIC • CONSEQUENCES FOR YOU OR OTHER PARTY POTENTIALLY UPSETTING • WADING INTO SUBJECTS WHERE YOU ARE LESS KNOWLEDGABLE THAN YOU SHOULD BE

8. WHO ARE YOU TALKING TO? • SOMEONE YOU DON’T LIKE OR TRUST • SOMEONE WHO YOU KNOW IS SENSITIVE, DEFENSIVE, UNREASONABLE OR VINDICITVE • SOMEONE YOU REALLY LIKE AND MIGHT OFFEND • SOMEONE YOU DON’T KNOW • A PERSON WHO COULD RETALIATE

10. WHAT’S YOUR PERSONALITY? • OUTGOING OR INTROVERTED • CONFRONTATIONAL OR COMPLIANT • EMOTIONAL OR DISPASSIONATE • ANALYTICAL OR INSTINCTIVE • ARE YOU CONCERNED ABOUT YOUR OWN COMPETENCE, GOODNESS, WORTHINESS (EVERYONE IS!)

12. HOW TO MAKE IT EASIER • ACCEPT THAT THERE IS NO DIPLOMATIC WAY TO THROW A GRENADE • ACKNOWLEDGE YOUR FEELINGS, BUT DON’T LOSE YOUR TEMPER • DEVELOP YOUR BATNA (BEST ALTERNATIVE TO A NEGOTIATED AGREEMENT)

13. “GETTING TO YES” METHOD • AVOID POSITIONAL BARGAINING • SEPARATE THE PEOPLE FROM THE PROBLEM • FOCUS ON INTERESTS, NOT POSITIONS • INVENT OPTIONS FOR MUTUAL GAIN • INSIST ON USING OBJECTIVE CRITERIA FISHER AND URY GETTING TO YES

14. “GETTING TO YES” METHODDEAL WITH THE EMOTIONS • RECOGNIZE AND UNDERSTAND THE EMOTIONS ON BOTH SIDES • ACKNOWLEDGE THEM AS LEGITIMATE • ALLOW THE OTHER SIDE TO VENTILATE • DON’T REACT TO EMOTIONAL OUTBURSTS • DO NOT EMULATE UNCONSTRUCTIVE BEHAVIOR

15. ALLIGN YOUR INTERESTS

16. GETTING PAST NO • “GO TO THE BALCONY”- FOCUS ON THE PRIZE, NOT GETTING MAD OR EVEN • STEP TO THEIR SIDE - DEFUSE THE ANGER • DON’T REJECT - REFRAME • BUILD A BRIDGE • MAKE YOUR ADVERSARY A PARTNER Ury GETTING PAST NO

17. A FEW HINTS • DON’T LOSE YOUR TEMPER,YOU WILL ONLY REGRET IT • TAKE NOTE OF OTHERS WHO NEGOTIATE DIFFICULT SITUATIONS WELL • PRACTICE YOUR DISCUSSION SKILLS,ESPECIALLY IF YOU FIND IT HARD • DON’T GET DRAWN IN, TAKE TIME TO COMPOSE YOUR RESPONSES • DON’T BEAT YOURSELF UP

18. KEEP YOUR HEAD

19. HELPFUL REFERENCES • Fisher R and Ury W GETTING TO YES Penguin Books 1991 • Stone D, Patton B and Heen S DIFFICULT CONVERSATIONS Penguin Books 1999 • Patterson K, Grenny J, McMillan R and Switzler A CRUCIAL CONVERSATIONS McGraw Hill 2002 • Ury W GETTING PAST NO Bantam 1991