No matter how in tune you are with your colleagues, at some point, you’ll find yourself in conflict and needing to have a difficult conversation. In my leadership roles at VUMC and elsewhere, I’ve had plenty. Here are some strategies for making these conversations less stressful and coming out with a win for all sides.

First, what is a difficult conversation? Of course, it’s anything hard to talk about. Self-esteem of one or both parties is often at risk, and important issues are at stake. Often, when you’re having a difficult conversation, you care deeply about the other person or people. These conversations can center on a host of issues that may involve misunderstandings, assumptions, a clash of values, or a perception of unfair treatment. Some examples in science include:

• A postdoc skips regular meetings with the group leader. The leader lets it slide, and then the postdoc attempts to publish on their own.
• Authorship order and inclusion is not established early.
• Trainee projects and roles aren’t clearly defined, leading to conflict instead of cooperation.
• Someone in the lab isn’t doing their fair share of work.

When an issue like this arises, you have a few choices for responding. You can remain silent—but silence can take an emotional toll, and the issue can simmer until it explosively erupts. You can respond immediately—but then your response may become confrontational and/or unproductive. Or you can respond later, giving yourself time to think, but there is some risk with waiting too long.

Take a deep breath. Ask yourself these questions:

• What is the importance of the issue and the relationship?
• How does it make you and the other person feel?
• What does this say about me and my identity?
• What do I really want?
• What do I want for others?
• What do I want for this relationship?
• Is this something I can possibly resolve with the other party, or will we need help?
• What are the options?

Each difficult conversation is really three separate conversations: 1) What happened? 2) How does it make the people involved feel? 3) What does this say about our identities?

“What happened” is often a matter of perspective. Consider the picture to the right. Just because the person who thinks the number is a six is correct doesn’t mean the person who thinks it’s a nine is wrong. Both have their own perspectives. Assigning blame early is rarely productive.

Many people are reluctant to talk about feelings at work, but avoiding any discussion of how an incident made you feel can cause you to miss some important underpinnings of the conflict. How each party feels has implications for their identities. If someone is concerned about being perceived as a bad person, it’s hard to have a productive conversation.

Curiosity helps immensely in these situations. Try to set aside your preconceptions and learn more about the situation. Some things you might say:

• Tell me more about…
• My point of view is different. Can you help me understand…?
• Help me understand your intent when you said/did…
• What were you feeling when…?
• Let’s figure this out together

Listen to learn, not just to respond. Bring empathy and grace for yourself as well as the other party. Acknowledge that impact often does not equal intention (and vice versa).

Here’s an example of this process in action: Imagine you are a radiologist like me. You’re performing an ultrasound on a pregnant person and a medical student is with you. You can’t find the fetal heartbeat, and the mom, knowing something is wrong, starts to cry. The medical student rushes from the room.

You could assume the student is uncaring about their patients. You could even say this to the student. But if you listen to learn, you might instead say, “I noticed you left when the patient started crying. Can you help me understand what was going on?” And you might learn that the student had a miscarriage three weeks ago. The initial assumption no longer makes much sense.

Stay curious and aim for the most respectful interpretation of others’ behavior. Let that curiosity lead you in these interactions and frame these conversations.

I am a certified Leadership and Performance Coach and have mentored and coached over 130 physicians and other individuals. Having a curious and open mindset is essential to coaching. I have published multiple peer-reviewed papers and have given national invited presentations on mentorship and coaching. My mission is to help physicians, scientists, and other individuals achieve personal and professional growth and fulfillment. Please feel free to reach out to me at Lori.deitte@vumc.org if you are interested in learning more.

Some of the information in this post comes from Crucial Conversations by Joseph Grenny, Kerry Patterson, Ron McMillan, Al Switzler, and Emily Gregory, and Difficult Conversations by Douglas Stone, Bruce Patton, and Sheila Heen. Check them out for more tips and strategies to make these kinds of conversations go well.

About the Author

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Lori Deitte, MD

About Me

Clinical radiologist, certified leadership and performance coach, physician leader, and experienced faculty development educator. My mission is to help physicians, scientists, and other individuals achieve personal and professional growth and fulfillment.