When Yes Means NO - Conflict Avoidance

You are having a staff meeting and discussing how your dental hygiene team could improve patient education by increased use of intra-oral photos for patient education.  Rather than just dictate that a certain number of photos are expected every day you have chosen to ask your entire team for ideas on how to achieve this goal.  You begin by explaining that we learn better and comprehend more when we use visual means of communication.  You ask the team for their experiences of how a photo helped someone take ownership of an issue we had been explaining verbally in the past.  You then go around the room asking each team member whether making more photos makes sense.  Everyone says yes.  At next month’s staff meeting the photos in hygiene have increased by only one per cent.
What is the problem? 
Did we really get total staff buy in?  Everyone said yes when polled.  Why no follow through?  Is everyone avoiding conflict?  The doctor wants this so why should we point out the problems associated with implementation?  If the assistants and business staff are not truly a team with the hygiene staff they see this as a non-issue.  The photos don’t involve any effort for them.  So, who cares?  If they have not taken a true ownership interest in the practice they don’t grasp that the photos are a part of the reason they have a job and a paycheck.  The hygiene team may grasp the value for education but not like the extra time involved due to the photo system used in the office.  The staff has to feel that they can push back without fear of repercussion when they do not see things the same way that the doctor does.  However, as the business owner/professional it is not unfair to ask those who disagree to also offer a solution from their point of view. 
 How do we know conflict avoidance is in play?   If someone – especially the doctor - proposes a change and there is no discussion, just quiet nodding of heads with no eye contact, you should smell a skunk.   Change is difficult.  Most of us don’t like it, especially if it is not our idea.   Rather than stating that more photos in hygiene were needed.  Perhaps the doctor could have just pointed out the issue of how more intraoral photos would help the patients and the practice and asked for ideas.  After discussion the group might have come to a consensus on how to create a better educational experience.  (There is a near 100% probability that more photos in hygiene would be part of the solution.)  The ideas could then be written down and the team – and doctor - held accountable for implementation.  Would this take longer?  Absolutely.  Would it be more likely that something good will happen?  Yes. 
This approach requires more patience and trust on the part of the doctor.  It also builds trust among all the team members and the doctor.  This sort of exercise is also good barometer for the doctor to determine whether the staff has true buy in to the practice.  You will quickly see whether everyone is engaged or not.  If there is someone who is clearly unwilling to have any input it is time to have a quiet chat with that person to understand why they feel unable to contribute as a part of the team.
A great resource for implementing this strategy can be found at Mike Scott’s website - www.totallyaccountable.com/
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