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. In general, the ability to create and sustain effective relationships with staff and patients falls directly on your shoulders. And if done correctly, it will become your most valuable currency.


In any office, there are times when someone grates on someone else’s nerves. 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 report they leave a job was conflict with a coworker or a manager.

Office conflicts are normal and inevitable. What’s the solution? You have the ability to instill trust and confidence within your staff. 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. Before you speak, be clear about the message you want to send. Your office staff plays an invaluable role in your life. With their combined effort and your positive reinforcement, you will have the peace of mind to concentrate on your patients.


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 is 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.

The following powerful tools will help you with office politics:

A) Listen

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.

Schedule a time to sit down with first your office manager and then your staff. Have a roundtable discussion where everyone has the chance to speak his or her 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.

A good beginning would be to meet with your office manager at least once every 2 weeks and your staff once a month. These meetings don’t have to be lengthy, but they do have to be considered sacred time—don’t change the day or time once things take off unless, of course, an emergency comes up. Canceling meetings sends a loud and clear signal that you had something more important to do than to talk with your staff.

B) Giving and Receiving Feedback Graciously

You can model the importance of getting and giving feedback by frequently asking for it and giving it. 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.

You have to be willing to listen before you can really hear others. Humans are not born with an ability to give and get feedback graciously—it is a learned behavior.

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. It took a lot of courage on their part to come forth.

C) 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.

D) Conflict Resolution

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. 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.

Confrontation Tips

  • Always check your intentions. Is it geared toward problem solving and goodwill?
  • Timing is everything. Ask permission to give feedback.
  • Always have “tough talks” in private.
  • Be clear about the issues and their impact on behavior.
  • Before the conversation comes to a close, get a specific agreement about what will change.

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. 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. This is your office, and you are the boss. Deliver your message with respect and sensitivity. 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.

E) 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.

F) Watch E-mail Correspondence

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

Use e-mail only to set up a time to speak face-to-face or at least voice-to-voice. Interoffice e-mail should be used only for dispensing information, not dialogue.

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) 739-0098 or