Office politics and staff morale

“I’m a physician with a staff of five, and we are having problems with interpersonal conflicts and office morale. Help!”

This is one of the more common calls I receive in my work. If you were the physician making that call, I’d naturally assume that your office has grown and that you’ve added new employees, and hopefully one of them is an office manager.

Most physicians focus on medicine in school and rarely find the time to take a course in how to manage an office staff. But as those of you already in practice know, a fully operational, efficient, and smooth-running office takes work and skill to accomplish. Generally speaking, the ability to create and sustain effective relationships with staff and patients falls directly on the physician’s shoulders. And if done correctly, it will become his/her most valuable currency.

As you face yet another year of new challenges and more likely a few of last year’s unresolved dilemmas, here are some invaluable tools to help you create an office where employees thrive in an environment geared toward peak performance.

Personality Differences

It’s a given in any office that there will be times when everyone grates on someone else’s nerves. But keep in mind that when interoffice relationships stagnate into tension and hurt feelings, it affects the entire staff and rears its ugly head in the form of decreased productivity, absenteeism, and high turnover. The No. 1 reason people reported they left a job was conflict with a co-worker or a manager.

So, now that we know that office conflicts are normal and inevitable, what’s the solution? The answer lies with you, the physician. You have the ability to instill trust and confidence within your staff. In turn, they will nurture one another, which will ultimately bring structure and calm to your office, to your patients, and to you!

Your job is to create an office environment where conflict resolution is the norm—where disputes, grievances, misunderstandings, and hurt feelings are not ignored but addressed before they undermine the relationships among your staff.

Laying the foundation for a friendly and structured office is less about “control” and more about “influence.” Keep in mind that everything you do and say sends a message. So, before you speak, be clear about the message you want to send. Remember: You can catch more bees with honey than with vinegar. Your office staff plays an invaluable role in your life. With their combined effort and your positive reinforcement, you have the peace of mind to concentrate on your patients. Without a functioning team for a staff, office life becomes a daily boxing match; one worker pitted against another, with you in the middle, stressed beyond words, trying to initiate peace and increase efficiency.

Office Protocol

The relationship that you have with your office manager is key. She or he is your right hand in this effort and is in the trenches daily with your staff—as well as with your patients. It’s vital that your office manager be on the same page as you when it comes to values and vision for your office. Two qualities to look for when hiring an office manager are polished communication/people skills and brilliant coaching techniques. The relationship with your office manager needs to be nurtured. That means you must find the time to spend quiet time alone discussing what really goes on in your office.

Now let’s address some powerful tools that will help you with office politics.


People have a strong need to be heard, understood, and most important, taken seriously. Therefore, it makes sense that asking for a change in behavior from someone who hasn’t even been given the opportunity to speak his/her mind is a waste of their time and your energy.

The greatest gift you can offer your staff and patients is for you to take the time to carefully listen to what they have to say, with an earnest intent to understand their concerns. The ability to listen and concentrate on what another has to say is a learned response that begins immediately when you stop talking and offering advice.

Get the ball rolling in the communication department by scheduling a time to sit down with first your office manager and then your staff and have a round-table discussion where everyone has the chance to speak their mind. Make eye contact with everyone, especially when they are speaking; and if someone seems to be hanging back and not sharing with the group, politely draw them into the conversation by asking them a question or offering them time to address a concern. This is no time for a monologue by anyone—especially not you. Although it’s important that you maintain a position of leadership throughout the discussion, listen more than you speak.

Ask clarifying questions, and intermittently take time to summarize in your own words what you think you have heard. While the discussion is in progress, put your office on hold. Forward phone calls, turn off pagers and cell phones, and don’t allow paperwork on the table to be shuffled while others are speaking. Total concentration on what’s being said is the name of this game. You could begin the meeting with, “Staff, on a priority level, what’s the most important topic we should address first?”

Setting Up a Schedule

A good beginning would be to meet with your office manager at least once every two weeks and your staff once a month. If your office manager is a new employee, or if your staff keeps growing or changing, make it more often.

These regular staff discussions are important and should not be taken lightly. Schedule them into your daybook just as you would any other important meeting These meetings don’t have to be lengthy, but they do have to be considered sacred time; so make it a point not to change the day or time once things take off—unless, of course, an emergency comes up. One way we build trust is by keeping our word. Canceling meetings sends a loud and clear signal that you had something more important to do than to talk with your staff.

When I conduct meetings and retreats for medical staff, a regular concern seems to be, “We hope the physicians will come.” Retreats and meetings are excellent opportunities to get others to collaborate with you on different avenues you can implement to make your office more effective.

I strongly recommend that such meetings be facilitated by an outside person so you have the chance to fully participate in the discussions. Have a minimum of one or two such gatherings every year.

How to Ask For—and Graciously Receive—Feedback

Giving and receiving useful feedback is a learned skill from which you and your staff coul
d benefit.
You can model its importance by frequently asking for it and giving it. Here are some examples of ways to ask for specific feedback from your staff:

• “What is the one behavior you would like to see more or less of in me?”

• “What one dimension of my leadership behavior would you recommend I change?”

• “What is the one thing I could do differently that would make your job easier?”

Asking for feedback is the first step. Receiving it well, and in a positive manner, is another story. Always make sure to clarify the feedback you have received by asking questions that will help the other person be specific. And in your own words, summarize back to that person what you think you have heard—before you respond.

Be willing to “try it on”! Don’t go into automatic defense mode or outright reject the information because it doesn’t fit your image of yourself. Even if it is delivered awkwardly and is hard to hear, a point or two might be made that you could consider looking into. After all, none of us are perfect—not even you! Always thank the person who gives you the feedback. Remember: It took a lot of courage on their part to come forth.

Be Generous With Acknowledgments

Most of us are acknowledgement-starved in the workplace. Don’t just focus on what’s wrong. Look around to see what seems to be working. And when employees go above and beyond what might be considered their job, take time to tell them verbally how appreciative you are. Kind, thoughtful words go a long way toward building employee loyalty and trust.

Dealing With Issues and Conflicts

Although hiding your head in the sand might seem like an alternative, it’s not—especially for those who want to avoid confrontation at any cost. The time will come when you must have a face-to-face with a member of your staff who can’t seem to stay on the same page with everyone else. Maybe several staff come to you to complain about your office manager or one of your partners. Tough communication talks with an “offender” aren’t always comfortable, but nevertheless they have to be done to address and deal with issues as quickly as possible.

 Hoping the complaint will go away or that the “offender” might get the message some other way does not work. Unresolved issues or tensions increase an already difficult situation. If a staff member is abusing office policies (like coming in late), delivering inferior patient care, or causing interpersonal conflict, you or the office manager must address the situation as soon as it comes to your attention. Your failure to address performance problems makes you lose credibility with the rest of the staff.

Conflict resolution, constructive confrontation, and performance management are skills that you can learn even if you are a conflict avoider. A coach or facilitator can work with you to conduct a dialogue and/or teach you and your staff skills to bring about more constructive communication. Keep in mind that this is your office and you are the boss. You have every right to ask others to change their behavior if what they are doing is interfering with your needs, your staff’s needs, or excellent patient care.

Most people want to do a good job. Unfortunately, some are simply unaware of their behavior’s impact on others. Feedback is a gift of compassion when delivered with respect and sensitivity. There is no anesthesia for the pain of a tough conversation—but the potential payoffs are huge.

Confrontation Tips

• Always check your intention. Is it geared toward problem-solving and good will?

• Timing is everything. Ask permission to give feedback.

• Always have “tough talks” in private.

• Do your homework. Be clear about the issue’s and behavior’s impact.

• Make a specific request.

• Before the conversation comes to a close, get agreement about what will change.

Avoid Gossip

Gossip is a normal social phenomenon. As a leader, it is imperative that you do not feed or participate in negative gossip about a patient or another staff person. People judge your character by how you talk about those not present. Encourage others to take their concerns directly to the source.

Watch Email Correspondence

I am often called to facilitate workplace wars that started with an email conversation that went south. Since 80% of human communication these days is nonverbal, an email recipient has to guess the sender’s tone, body language, and emotions. Therefore, email is a very incomplete form of communication.

Conflict avoiders tend to use email to deliver feedback and deal with sensitive issues. But by hiding behind email, they often create more conflict than they avoid. So be brave, and use email only to set up a time to speak face-to-face or at least voice-to-voice. Interoffice email should be used only for dispensing information, not dialogue.

No amount of interpersonal magic or skill will fix every situation. Sometimes the best solution is to know when to call for help from an executive coach! Here are a few questions to ask yourself as to whether or not your communication skills could use a bit of help:

• What professional relationships do I want to improve, and how can I make that happen?

• Who would benefit from my undivided attention at work?

• Who needs to hear my appreciation or thanks?

• What is the conversation I’ve been unwilling to have with _________ that, if I were willing to have it, might make a big difference in our working relationship?

Janet Ott is a former psychiatric nurse practitioner who serves as an organizational coach, facilitator, and educator to professionals. Her specialty helps others create thriving business and personal relationships. She can be reached at (360) 758-7247; via email at [email protected], or visit