Latest / It’s All Your Fault: High Conflict People / Healthcare Conflict Solutions: Managing Hospital Tensions in High-Stress Environments with Dr. Jeff Stuart
Transcript
- Speaker 1 (00:05): Welcome to, it's All Your Fault On True Story fm, the one and only podcast dedicated to helping you with the most challenging human interactions, those involving someone with a high conflict personality. I'm Megan Hunter and I'm usually here with my co-host Bill Eddie, but he's off on an airplane today, so it's just me. But we wish Bill some very safe travels and he'll be back next week. We are the co-founders of the High Conflict Institute, which is based in kind of jointly in Arizona and San Diego, California, where we focus on training, consulting, coaching, educational programs and methods both for people in their professional life and in their personal life with conflict influencer.com. Speaker 1 (00:58): So welcome back to our ever so faithful listeners and to any of you new listeners out there, what we talk about is high conflict and what to do about it. There's a lot of people that talk about difficult personalities and difficult people talking about it is one thing, but actually having some solutions is critical and that's the key and that's what we're all about solutions. So today I'm really excited to be joined by a very special guest. We're going to talk about conflict in the healthcare world. I don't know if there's any conflict, what we're going to find out in this half hour from Dr. Jeff Stewart. So welcome Dr. Stewart. Speaker 2 (01:39): Thank you. Speaker 1 (01:40): Really happy to have you on. So Dr. Jeff Stewart is a medical doctor and also has interestingly an MBA, which we share jointly, which is cool. That's an interesting combination. Dr. Stewart is the co-founder of Resolve Conflict. Do you pronounce it? Resolve conflict? Speaker 2 (01:58): Yes. Resolve conflict with the cute little RX at the beginning. Yes. Resolve conflict. That's just the logo. But yes, Speaker 1 (02:04): I love it. I love it. And an experience and experienced physician executive whose roles have included leadership of a private medical group, medical director and board member of multiple surgery centers and three years as the Chief medical officer of Washington Healthcare System in Fremont, California. His three decades of medical practice and leadership including services hospital, CMO through the pandemic, have given him extensive experience in operational planning, creating communication strategies, really important and mitigating conflict in high stress, unpredictable settings. We're going to have to talk about that. He's completed mediation training at the Center for Understanding in Conflict where he also participates in an ongoing professional development for mediators and through High Conflict Institute he's become a conflict influencer to help manage high conflict people who blame and kind of disrupt system and also studied professionalism at the Vanderbilt Center for Patient and Professional Advocacy and is currently becoming an ICF certified coach through the surgeon masters based also in San Diego. Dr. Stewart is a board certified anesthesiologist and holds that MBA from the Wharton School of Business. That was a lot. It's a lot. So welcome to our podcast. Speaker 2 (03:26): I'm tired just thinking about it or what I was thinking is people must be thinking he must be fairly old. He is certainly been around for a while. But no, I appreciate that introduction. I'm really happy to be here. I mean as we've met obviously and I undertook the training with you and really found that as a valuable adjunct to other work I've done and certainly relevant. And I guess as far as the real Jeff Steward, the real Jeff Steward is somebody who's been the physician for a long time, kind of fell into leadership positions as many of us do in healthcare that end up in these positions. And what I should stop and mention first is the real Jeff Stewart is a father and a husband of course I have two incredible daughters I know with you host from San Diego. Obviously it's a very navy kind of town, but she's in the Navy and in the submarine right now as we speak. Speaker 2 (04:20): So we'll say some prayers for her. And I have a younger daughter as well who's just starting medical school, which is kind of a little bit of what kind has really motivated me to kind of take some of this work even to the next level beyond I was doing frankly. And my wife is also part of our resolve conflict team. She's an attorney and family mediator herself. Learned as much from her as anybody. So that's the family side. I guess the real just Stewart professionally I was, as I said, many doctors just kind of going my way getting through medicine and at a pretty young age for a physician in our early thirties fell into some leadership roles. What happens with physicians who I guess you'd say those of us who care about people in the overall organization, we end up getting a lot of things thrown our way. I don't think that's unique to medicine but certainly has given me a career of a pretty varied experience and perspective. As you mentioned, I did go to business school along the way. Speaker 1 (05:23): In your spare time? Speaker 2 (05:25): Time, yes. Honestly, when I did that I didn't really know exactly where I was going with it at that time I was running my medical group and foresaw the benefits of it. But really I'd say over the last maybe 20 years as I evolved in the leadership really became interested in communication and teamwork and why it was compromised in many situations and what we could do to improve it. And that's kind of became my area of interest. And the real Jeff Stewart also has very bad timing because as I evolved through medical staff leadership and the varied roles you described, I took the chief medical officer job six months before the pandemic. So that was quite eyeopening when that all went down originally, but also was the most I've ever learned in my life and what brought me to the resolve conflict and this really interest in the conflict realm more specifically really was everything before that experience. Speaker 2 (06:25): But that experience really kind of brought everything to the forefront. Obviously a time of intense anxiety and pressure and the resulting difficult interactions. But my co-founder was resolved conflict Paul, Dr. Paul Netters was a cardiologist, was at the same time holding a CMO role at another community hospital. And we had lived together, we were residents in a previous life where critical training and then he and I just started commiserating and brainstorming. But along the way we kind of found this common interesting path to really be interested in communication and why it failed and really kind of focused around difficult communication and then the inherently conflict ridden world of healthcare, which we had experienced, we'd experienced in a way where we were often the one sent in to mitigate the conflict. Originally very ill prepared to do this learning under fire if you will. But it did motivate us together to get some of this additional training really we started researching conflict in healthcare specifically over time and it really all with respect to the real Jeff Stewart, it's interesting, 30 years in practice I feel like now. And I take a lot of pride in being a good anesthesiologist and I still do work, but really I feel like the real Jeff Stewart is what Jeff Stewart's doing now is really kind of dedicated and passionate about helping physicians and everybody really, especially on the front line in healthcare, live a smoother existence and what's just a really challenging atmosphere all the time, but especially over the last five years. And my sense is it's only going to get more so Speaker 1 (08:12): Yeah, sadly. So our services are much more in need than ever before and it will continue to grow. Speaker 2 (08:20): Yes, Speaker 1 (08:21): I had an experience just a couple of days ago while it was for my mammogram and the gal who was giving me the mammogram said, I don't even remember how it came up, but she was kind of disgruntled with what she does and she was very efficient. So I think I was complimenting her and her efficiency and she's like, well yeah, I really like this but I don't like the patients. And she said, went on to say she Speaker 2 (08:47): Not a great idea to usually say that to a patient from my, Speaker 1 (08:51): And it was just after the mammogram ended, so that was good news. But she said she just previously worked for the company that sold the machines, the mammogram machines. And so she'd only been doing this role as I guess, I dunno if it's tech or whatever the proper title is for a year and she said, forget it, I'm out of here. It's too difficult. People are yelling at me and it's just become so challenging that just I'm not going to do it anymore. So she's going back to sales and it's really unfortunate because she's good at what she does. So I guess I'm really curious about what you experienced. I imagine pre pandemic there was plenty of opportunity for conflict, but just like you already said about the last five years since the pandemic conflict has increased and we have heard that across the board, every single phone call and we take at high conflict institute for training consultation, whether it's in healthcare, education, law, customer service, every single one says that conflict has really increased in the last five years. There's not one that said stayed the same. So in your experience, what was that experience like as the CMO? Right at the beginning of the pandemic, Speaker 2 (10:17): I was prepared from a understanding the lay of the land conflict wise going in and hospitals being an inherently conflicted place, but basically day to day in the hospital, the way we describe, and this is with all due respect to people who are actually fighting in combat and things like that, but a hospital can be an analogy of a war zone essentially. I mean there is life and death going on there and every area is kind of its own battlefield, what you're describing kind of in an x-ray outpatient area, they have their own pressures, a lab where they do heart procedures, does the operating room does. So everything's bubbling in the hospital to begin with. And then you through upon that the stress of the pandemic, which just kind of rose the temperature for everybody in general. And there was an element of fear and anxiety that was even Rainier than there was before, which really made the situation very ripe for conflict and problems. Speaker 2 (11:22): And I think I was very blessed I think to work with the CEO and within our organization that we recognized almost immediately that we couldn't communicate as we had pre pandemic and that as difficult as things were, and we had some initiatives already going underway to try to develop more collaboration between this is what I was helping with physicians and the administration and nursing. So we did have a little bit of that set up, but we realized that we really needed to get out in front of a lot of these issues and I think we were successful in that by really stressing transparency and communication and openness and availability to communicate with people what's really kind of counterintuitive, as crazy as everything was during the pandemic and basically just what was happening, how stressful that was for everybody. Difficult conversations took place and I don't think it was some of the motivation was the same, some was this extra stress I was talking you about. Speaker 2 (12:29): But what was interesting is people were more open even though the same conflict was there, and I know you may not expect me to go there with this answer, people were willing to deal with things in real time because we had to. And when we would deal in real time to get onto the next thing, it was obviously as you know, much more effective and beyond that after the initial kind of stir of everything, because again, I'd like to give us some credit, but just generally I give our whole hospital medical staff and nurses and administration credit and I do think we were a little bit unusual. That's why I really enjoyed talking about it. You were in these meetings where people were willing to listen to everybody. And I'd like to say that it was because we all became collaborative and we understood that the concept of letting everybody speak, even going all the way to the idea of mining for a conflict to get different opinions and building trust so we can do that. Speaker 2 (13:27): I don't know that that was the motivation honestly, but I think the motivation was nobody really was so confident in what they knew to do. So everybody was more open about listening to everybody and we would have to turn things over quickly. So yes, the whole temperature rose from the pandemic and it caused a lot of internal stress with everybody and organizational stress. But I actually think the way organizations survive was by being able to manage relationships in this kind of timeframe a little bit more proactively than they had. What's disappointing is a whole nother, and I'm not saying it was easy by any stretch, but I do think that's something I noticed and Paul noticed as well. And I'm not saying every day I got in the middle of some pretty intense things, but I think that what happened was there was just this mechanism, you couldn't dwell on it. Speaker 2 (14:23): Everybody was freaked out about the next thing that was coming and the sadness of I was really under, I guess, I dunno, I couldn't be naive at my age I guess, but maybe I could. But just under the illusion that all this great kind of experience that I described and I'm hoping it makes sense it all, as soon as the pandemic kind of yielded a little bit, we held that amped up stress time. And I think this gets back to what you're saying, that amped up, everybody's running hot and yet we lost that kind of immediate motivation where we had to problem solve to fix things. So from some stuff I've learned from you from high conflict and student, otherwise to me it was like what was going on during the pandemic maybe was definitely more stressful to a degree, although day to day in a hospital can be just as stressful as a day during the pandemic. But because we were in problem solving mode, it's like we couldn't stay in that amygdala area quite as long. We didn't have that luxury and nobody and we had to move on. Once things got better, everybody was still amped up, but there wasn't that need to solve the next problem anymore. And I think that is all built on itself along with just the evolution of various other pressures in healthcare. Speaker 1 (15:39): Yeah, that's pretty fascinating. I am thinking about healthcare professionals in particular are going to be probably more on high alert to get things done anyway and maybe spend less time thinking, even having time, particularly during the pandemic to get into conflict with each other. It's just go, go and always in that what can we do, what can we do mode? The conflicts that I heard about up during the pandemic from healthcare professionals mostly centered around traveling healthcare professionals. Speaker 2 (16:13): And that's a unique group for sure. And it was a financial sort of windfall for these folks being able to do this mean just as an aside. So I mean I think they benefited from that, but I think it's always harder for somebody coming into an organization and especially under those circumstances I would think there's little either bitterness or jealousy and then just like we're doing our thing here and you're coming in and so that makes sense to me that they would feel that way and they didn't have the relationships built before they just kind of dropped in there. Speaker 1 (16:47): Yeah, that's exactly it. That was kind of where my head went. Every new relationship, it was just like a Petri dish for new relationships. You move to a new facility, a new hospital, there's always going to be as an MBA student forming, storming, norming and performing. And so that forming stage is usually we're a little suspicious of each other or we're on our best charming behavior and then you gradually get into storming just to try to figure out, it's that opportunity to figure out how to have relationships, how to get along and how to build trust. And ultimately that will in most people build trust. So you get to the norming stage and maybe fairly quickly in a hospital environment to a performing stage, but with someone with a high conflict personality, which is slightly different. I think once they get to that storming stage, they kind of stay there. So I am really interested in your thoughts on that. Speaker 2 (17:54): That makes sense to me. And we certainly have some examples of that had some examples that during the pandemic it was consistent though with the same high conflict folks that were in that category beforehand and afterwards. But I think the relational piece of healthcare in general as opposed to mediating a discreet issue, and it's similar to what you and Bill your work with in divorce is that you're going to have to have, if there's kids or any kind of thing, I guess you're connected, you're going to have an ongoing relationship. So that's a very different kind of situation, which is basically the situation of conflict I guess at work, usually any workplace, but especially in healthcare, and I think these people were put in a position where they had no relationships and they're coming into already, there's no time for the norming already in this stressful, nobody's willing, there's not the usual downtime in the coffee room break. Everybody had to be secluded. So I think it's hard that practice of travel nursing is really challenging in the first place. I mean most of the nurses that do that are excellent nurses because I think you have to be kind of be able to manage that. But it's really challenging if you don't know anybody and it's a stressful situation, there's going to be a conflict and then you will have no basis of understanding the people you want to communicate with Speaker 1 (19:27): Or have that rapport and trust already established with them that you kind of give them a break, give 'em a little pass. They've just come from a shift of two days and two nights or something. Right? Speaker 2 (19:38): Or at least you're comfortable addressing it with them if something else goes on. It's not like you're a stranger so to speak. Speaker 1 (19:45): So what do you find in healthcare leads to the biggest conflicts? Is there a common theme? Is there a common level or department? Speaker 2 (19:55): There's definitely common themes that I think go throughout the organization and there's research on this that basically you have a lot of conflicting priorities in the hospital. A nurse's priority may be to get this task a done, A doctor's priority may be to see a patient now, but he's got 10 more patients to see. So if their priorities intersect while she's trying to do something and he's in a hurry, there's a conflict. And it's even beyond that. I mean if you get to the administrative medical staff higher level, there's different priorities of different people in organization. I think that's probably clear with everybody. A big one in healthcare is ambiguity of roles and poor communication. People feel like they know what their job is, but they don't really know often. And I'm talking globally about the organization, not like a physician to physician necessarily, but even though that can happen as well, they're not sure where their job ends and somebody else's begins often within certain context of the hospital in the operating room. Speaker 2 (20:55): Everybody works kind of as a unit together. But as I was mentioning earlier, there's all these different areas. So once you get out of that unit, you wouldn't think it'd be a big unit, big differentiator from the operating room to the recovery room. And it's a whole different group and the communication between those two resources right next to each other is often really poor based on probably having poor policies and nobody's fostering the communication. And then your limited resources in the hospitals is a real big one because there's so much going on there and not everybody can have the resources at the same time. It's certainly a big source of conflict for physicians in between physicians. Again, an operating room example would be one doctor wants to use an operating room and the other doctor wants to use it and the doctor either gets to use it, the other guy says that he makes more money for the hospital or this or that. Speaker 2 (21:50): And so that's a real challenge. It's a challenge in clinics within a hospital as well. And then just what's really kind of brought things up even more over the last decade or so are operational pressures and different operational pressures for different people in the hospital. Doctors may have an operation, just as an example, doctors may have an operational pressure where they're paid by the number of surgeries or procedures they do or the number of patients they see. Somebody in a more managerial kind of financial role is going to have an operational pressure to keep costs down while the doctors are doing that. So just by definition they're going to clash. And then a couple others real briefly, this is not, shouldn't be too brief, but power and hierarchy historically in the hospital has been in place in a way that everybody understood and respected. But as things evolve, especially over my career, there's much more of a team approach. Speaker 2 (22:49): I mean we need to do that for the efficiency aspect of healthcare. We also need to do it for just quality. And as healthcare changes to what's called more value-based model where instead of getting paid for an episode of care that you're getting, hospitals are getting, or services are getting one kind of bundled payment for everybody. There's more pressure than ever to have good teamwork and be able to work together. This in and of itself isn't a problem, but evolving to that from a situation where the power was imbalanced and there was a lot of hierarchy, getting physicians especially come into this type of thinking is really challenging. And people just may have different values about things. I mean I was involved in this would be the easy to understand example could be end of life care where some of the nurses or more theologians who sometimes work at the hospital could have opinion on something and a doctor who's equally dedicated to patient care could have a different take on and often do on what the right path is for the patient and the patient's family of course, I mean, so this is what I've described. Speaker 2 (24:04): These kind of factors are really kind of internal to the hospital, but as you see, they kind of sprout out an affect patient care. Your example is great when somebody's really frustrated. I'm sure there were a lot of these factors involved and they were open with you about it I guess because on the way out. But it does trickle down to patient care and that's really my interest is the people that are most important that we can support with and it affects their wellness. And then their outcomes are the providers. And I include doctors and nurses, the frontline providers and not ignoring administrators and then the patients themselves. And I think if you, I'm a big advocate of keeping the patient in mind and it usually drives you to do the right thing, but that's easy to say when I'm here talking less easy when doctors and nurses are going at it in the hospital. Speaker 1 (24:58): Yeah, yeah. I remember being in the emergency room with one of my kids once had some injury in soccer or something and I heard a doctor and a nurse just fighting it out. And it's not very comforting I guess to a patient who is in need of their care to hear that kind of thing. And I'm sure that's quite unusual, but I mean healthcare in the hospital setting has to be such a high stress environment compared to other environments. There is so much at stake and just very recent experience. And we have a family member who's recently spent some time in the hospital. And so my husband and I spent quite a bit of time with this family member and kind of seen the whole plethora of professionals who come across, come into the room or are in different treatments and things and it's a lot, it's a big village that takes care of patients and so many wonderful people and they have to work harmoniously and they have to be in sync and there has to be those communications and the ambiguities have to be out of there. Speaker 1 (26:12): So when does it fall apart? Just one minor example was we have a patient who's in pain and ringing the bell for pain meds and no one's coming, no one's coming and ring again after 10 minutes or so and still no one comes. And in this particular instance when the nurse came, the patient was in the bathroom and he overheard a from the nurse about I get here and you're in the bathroom and he's in pain. And now you have somebody who's probably really busy, a nurse who's extremely busy and doing their best to get to the room and help the patient. And you have a patient that's in pain has been waiting and now here's what they consider to be a smart remark. Right now you have some conflict and in the best of circumstances that's going to be tricky. But if you have someone who has higher anxiety and maybe is displaying some traits of high conflict, and I observed this in this incidence where when he came out of the bathroom, got back in the bed, then it was the nurse saying, well, it's time to go to your appointment. Speaker 1 (27:31): And he said, no, it's not for another hour. And they said, no, it, it's now. You remember me telling you that 10 minutes ago. It was just kind of like I have to be right. And it was kind of said in that way, I kind of have to one up you and let you know. I did tell you that. And to a guy that's sitting there in pain, he's not going to receive that well. But I can imagine from the nurse's perspective, believe me, I admire the hell out of any medical professional. I think the work you all do is incredible. But in that moment, did we make the conflict bigger or did we make it smaller? Speaker 2 (28:11): Oh, well, clearly we made it bigger. We had no empathy for the patient. And what I'm thinking about as you're saying that is, and again I'm going to even go out and say the vast majority of nurses would not deal with that way. And even if they were frustrated, they'd understand that an empathetic approach to the patient is really part of being a good nurse obviously. And I think what it all draws back to, again, in my opinion, just it connects to what you're discussing though, is a complete lack of preparation and training for the people working on the front lines in healthcare of how to communicate with people. We can't expect them to have to do your high conflict institute course work. But there is data out there and there's kind of anecdotal experience where even some basic training awareness of how to approach people can go a long way. Speaker 2 (29:10): And I know the little bit of training, we've done a few trainings and the little bit of training we did at my hospital, people just really enjoyed it. And they were like, wow, it brings it to top of mind again, you're not going to change somebody overnight. And there are people, you I and others that are interested in this developed skills and many of us doing this probably have just a natural skillset that kind of is augmented by what we've learned scientifically and otherwise. But everybody can learn some skills. And I know that from working with the doctors when they were going to deal with people, people either a difficult patient but also with respect to colleagues in administration and otherwise if they were dealing with a conflict and I could coach them a little bit how to approach it, it always went much better than if they went in blindly as if they would even simple things that I know I'm guessing your audience are quite familiar with and the basics. Speaker 2 (30:18): And you wouldn't explain it maybe in the conflict language, but maybe though if somebody comes at you like this guy is and you go back at him defensively, then you're making the conflict bigger and it's just going, going, going, going. But if you somehow just know that by giving a little empathy, and I mean I love from my training, the whole ear statement thing, which I found is vastly useful, even beyond high conflict personality people themselves, even like a little mnemonic or training like that, I think you would cut these kind of incidents at a given hospital if they don't have any of that training, which most don't down to a minuscule amount. You'd always have the high, I mean I'm sure there's high conflict personalities in nursing as well, but the default I think would be we'd move the needle on that. And I'm really passionate about, and I know you are too, about some providing training and I know some places do the crucial conversations, things like that for the nurses. There's a huge paucity of that for doctors, not much at all. And this should start when they're in nursing school and medical school and then it's like there, it's not even addressed at all. So I think it's just really interesting to me, really where my mind goes these days is, wow, just a little preventative medicine would really help. But nobody wants to do preventative medicine. Speaker 1 (31:45): I know know I'm totally with you on that. Yeah, if we could get this in the schools even better, just learning four big skills, how to check yourself, right? Little self-awareness, how to have managed emotions, what that means and what unmanaged emotions looks like, what extreme behaviors are and how to have moderate behaviors and what all or nothing thinking is and how to have flexible thinking because like you said, conflict is increasing and it's going to continue to increase and we have to be prepared for this. There's health insurance costs are increasing here, coming up in a couple of months here in the US for a lot of people. And it's already very difficult for a lot of people to pay for their healthcare and meet the deductibles. And Speaker 2 (32:34): Yeah, there's pressure, there's pressure everywhere. And it certainly funnels a hospital, an ER or anywhere in a hospital I should say, is really a reflection of what's going on in society. You could go to five emergency rooms and get a pretty good sense of the pressures that people are under if you start talking people there about as real as it gets. Speaker 1 (32:55): That's a good cross section society number one and a reflection of what's going on. And one thing I've been thinking about recently is as society divides politically, ideologically, we seem to be losing this concept of a shared reality. We may not like the reality, but we could kind of share the view of it. And it seems that's disappearing. And I think that's in all areas. And I can imagine in healthcare, I've read some stories and reports of people who didn't want to, were a bit reluctant or hesitant to provide services for someone of maybe a different political party or something along those lines. And I'm sure that's really rare, but I can imagine rare that it might influence or impact some things, but it's probably more just day-to-day negativity. Yeah, Speaker 2 (33:57): There's enough day-to-day pressures and I mean those categories kind of broke down there and there's always multiple of those several categories. There's multiple factors affecting any particular situation. And I think that especially now because of what we've been talking about, it's even more important for people to be aware of this. And I think beyond what we've talked about, I think you also might be aware that the incidents of violence on healthcare professionals from patients is at a level it had never been before. And I know people sometimes find that hard to believe, but I lived it. I wasn't a victim. I haven't been a victim. I've had some patients that are angry, but again, I'm a little better equipped to deal with that than many. But a close colleague of mine basically was punched by a patient's wife and it was, Speaker 1 (34:57): Oh dear. Speaker 2 (34:58): It was just kind of wild. Speaker 1 (34:59): My son works in an emergency department and has told me a lot of stories, and his name is Michael and his colleagues call him Big Mike because when there's someone who's misbehaving and getting a little rowdy, they call for Big Mike because he's six three and he is a big strong guy. Speaker 2 (35:18): No, every ER has a big Mike do, Speaker 1 (35:21): But, Speaker 2 (35:22): And every operating room usually has a big mike too. Speaker 1 (35:25): Interesting. Interesting. Yeah. Yeah. That's good. So you were in the conflict influencer certification, so you had to listen to me during on and on for a long time in those courses. Was there anything, yeah, I'm so happy you were in there. Was there anything in there beyond your statements that you've mentioned that changed maybe the way you approach conflict or just human dynamics? Speaker 2 (35:53): Well, I think just sort of being able to have a mindset instead of like, oh wow, this is a really difficult doctor on the spectrum. Developing an understanding of really the difference between somebody who's truly a high conflict personality and the implications for how to deal with them. I think I had without labeling people that way, dealt with these kind of people in different ways and made me maybe doing it more correctly with one, not less correctly with the other. And as I was reflecting on the definition of a high conflict personality, it's really interesting because I could see people retrospectively that fit these categories and why maybe I had more success with one versus the other, but I really got a lot out of this idea that you can, and I know things are fluid. And I actually just listened earlier today to the podcast because I was really interested in about high conflict personality being situational, it canopy situational versus I think that was a pretty old podcast. Speaker 2 (37:04): But versus just pattern. Pattern, yeah, pattern, thank you. But what I realized having put my experience together with this definition, that it's really important to realize that because especially in a hospital, because trying to get past something so you can take care of patients and you can't get past something with a high conflict personality if you start asking 'em why they feel this way or how they're feeling. And so I thought it was really cool to be able to, and I'm somebody who's dealt with these kind of people for years, and it just made so much sense to me what you were describing, and now having it kind of reflexively, I think it really helps me to try to categorize, even if I can't exactly like I alluded to a few minutes ago, even if it's, I feel like this is a situational high conflict episode here, I can use some of your skills, but generally the value of having this definition really has helped me deal with some physicians and just my approach in general. Speaker 1 (38:14): Good, good. Oh, that makes me happy. Of course I know Bill as well. Yeah, it's like you said, not labeling, it's identifying what people need. It's different operating system. I need to feel respected to feel okay so you can get the best work out of me. So it doesn't mean we let people trump on us and Trump on others in the operating room or wherever, but it's just that we're going to give respects and set limits and set limits and set limits and just keep that momentum going. And I don't think I really talked about momentum back when I recorded the conflict influencer certification, time to rerecord one of these days. But I find that momentum is important and you can only have the momentum in the conversation to kind of control the conversation. And that's also a new word I'm using. I didn't use that, the control word in the past, but I think we kind of have to control or manage the conversation, influence the conversation with momentum. Speaker 1 (39:21): So how do we do that? We drop in the skills. We're getting data from the person constantly. I'm really angry that you did this or he or she did this. Okay, person's upset. Maybe they said, I didn't feel respected, I felt disrespected. Okay, there I go. I need to give you some respect now let's keep moving on. And it's that momentum I find lately that if you know the skills, how to set limits, how do you use your statements, how to shift people into what I now call cop actions, choices, options and proposals, then you got it. You just keep that momentum going and you're not stuck and you're not searching around and blank like, now what do I do? And in those moments, that's usually when we revert back into what we would do with everyone else that would work with everyone else and isn't going to do that so much and probably backfire here and make the conflict bigger. So such a, I think it saves so much time, number one, and so much stress, it really cuts down on the stress because you're now not feeling like you're on your heel just backed into a corner. And instead now I'm managing this, I'm not getting upset. I have no need to get upset. This isn't about me. I can just stay cool, calm, keep the momentum going through the skills and move along. Speaker 2 (40:49): No, really having any kind of framework, yours is obviously excellent and I like it a lot. I think gives people the ability, and this is what I really am interested kind of instilling in nurses and doctors in training that while conflicts is inevitable, it's going to be emotional, but you can learn to deal with it and you want to be able to approach it all problem solvers in healthcare, you want to be able to approach it as a problem to be solved, not an emotional avalanche that's going to overwhelm you. And it's not by, I mean you're kind of discussing it, it's not by it fact you don't feel the emotion. Can you manage the emotion? Can you think about it in a way where you've developed some skills that you're confident in using and so that every time this happens or something happens where you can utilize these skills, it's not like, oh my God, what am I going to do? Speaker 2 (41:50): And I think I have a really interesting perspective on that because a lot of, I think the skills I developed under fire, even though I had them over years, it would take so much out of me because I wasn't managing as well on the inside. So I really couldn't believe that that piece what's taught by, again, your approach and many to be able to manage yourself and then view it as a problem to be solved. I think if we can even just get people to realize at the start of their career that they're going to deal with this. So you got to figure out a way to solve a problem. It's just kind of like as an intern, you're going to have to draw blood from somebody. So you might be anxious about it, but you're going to do it a hundred times and you're going to figure out how to do it. So I like getting the problem solving as I know you do, problem solving, brain going and any way to do that I think is cool. Speaker 1 (42:43): And I'm thinking as you're talking about as healthcare professionals, you all are doing so much to address the body's physical needs and target it exactly what they need without judgment. It's just, okay, needs a blood transfusion, do it go. And it's kind of the same here, but when our emotions are involved or we're hooked or we don't like someone or we're stressed out, we're anxious. It could be a little bit tricky, but once you start doing it and you get used to it, as you know, it does make your own life so much easier and it increases patient care. Speaker 2 (43:18): I'm just passionate about all this kind of work. I think as I already spoke about it's effect on wealthness and just culture as far as everybody working and burnout is such a big problem for everybody. The cost of conflict growing versus shrinking. Again, it's focused on the medical staff side, results in all these things called judicial reviews and lawyers are involved and probably could have been managed early on with the conversation as somebody was trained. And beyond that, the effect on people being able to work together as a team and really being able to be the best they can possibly be, can't happen if they can't manage their emotions talking to each other especially, and I mean healthcare is not the only one, but especially in healthcare, and then the patient suffers. So I just think to me, it's crucial that we somehow get the word out as we're doing the importance of these skills and getting people these skills. And if we could just get leadership to be aware of them more, I think. Because what I'm also finding is, I mean if the leadership is engaged at whatever level and they have interest in doing this, it really can benefit their staff or the entire, whoever's under their organization. Speaker 1 (44:36): And the bottom lines across the board, I think. Speaker 2 (44:38): Yeah. Oh yeah. Well, right. I alluded to the cost efficiency, less medical, I mean bad communication. As you know, there's a lot of data out there beyond that really accounts for, I don't know, a significant percentage, 10, 20% of all medical errors. And I mean, I've seen that when people can't manage their emotions or manage conflict or there's a high conflict personality that's not been addressed correctly, you talked about momentum, it's negative momentum, it's an avalanche momentum, and then everything breaks down and care suffers. There's no doubt about it. Speaker 1 (45:12): And I think about some folks that I've worked with in the healthcare profession that we can't forget about. They have a personal life too, and things are going on sometimes at home or in health in their own family or divorces or kids with a drug problem or all the things that all of us deal with. And yet we expect you to come and take care of us in this very intense setting, using complicated everything to the outside world. Everything you do is very complex. So I just want to give that shout out to all healthcare professionals that the work you do is incredibly respected by the rest of us that have to rely on you. And number two, we're just recognizing that you have a life too. And so some days of course, you're going to come in with some stress. So it goes both ways. As patients, we should come in with respect and with compassion for those who are helping us. And you don't have to come with anything special from either perspective other than just stay calm, check yourself, use your statements to help deescalate people, whether they have a high conflict personality or they're just stressed out because they're in a difficult circumstance. Speaker 2 (46:30): No, and in leadership, just back to one more point where I really building off what you just said, but also going back to what I saw, the value of putting a framework or definition around what is a high conflict personality is what you're describing can result in a situational episode for somebody who does not have a pattern of high conflict personality, they're going through a divorce, this is happening, something horrible happened to one of their kids. And if you're in leadership in roles like I had, you're going to deal with that person differently than the person who has a pattern who is truly disruptive and disruptive physician even in that category. So I think it's really valuable to be able to delineate that. There are plenty of people that can fall into situational, I mean, I'm a human being, I'm sure that has happened to me too, but it's not a pattern. Speaker 2 (47:29): They'll have remorse about it and things like that, and they'll want help. They'll want to know how they can be better. And then you're going to deal with them one way and you're going to support them and it'll probably really help them to deal with things in the future. And they're going through a difficult time. And then the person with the pattern, you're going to deal with them a different way where you're just going to try to get them to focus on what needs to be done so the organization is not affected and patients aren't affected. So that's another, I just want to throw that in because that was really interesting. Side thought I had was you were speaking. Speaker 1 (48:03): Yeah, and that's perfect place to end this. I think that was just very elegant and brilliant. That was exactly it. So thank you Dr. Stewart for being here. Thanks for taking the Conflict Influencer certification. I was real honored to have you in that course, and I'm sure we'll have lots to talk about in the future and wish you a lot of success. Your website is Speaker 2 (48:29): Www.rxsolvesrxsolveconflict.com. Speaker 1 (48:35): Alright, well we'll put that link in the show notes down below. So everyone go visit his website and feel free to reach out to him. And I am just, again, very grateful to have you on and I'm sure we'll have you back to pack out more. Speaker 2 (48:49): Thank you for having me. Speaker 1 (48:57): Thank you all for listening. Again, we have those links down below. If you're looking for training, consulting, or anything to do with high conflict, whether it's in your business, professional life, or in your personal life, come see us@highconflictinstitute.com or conflict influencer.com for the personal stuff. In the meantime, keep practicing and learning the skills, be kind to yourself and others while we all try to keep the conflict small and find the missing piece. Speaker 3 (49:28): It's All Your Fault is a production of True Story FM Engineering by Andy Nelson. Music by Wolf Samuels, John Coggins and Ziv Moran. Find the show notes and transcripts at True Story fm for high conflict institute.com/podcast. If your podcast app allows ratings and reviews, please consider doing that for our show.