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Dealing with difficult people in the GP practice – Employees

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One of the key skills for the GP practice manager is dealing with difficult people. Most commonly, these will be either practice employees or patients. There are similarities in the best way to deal with both, but there are also some fundamental differences. In this first part of two blog posts about dealing with difficult people in the GP practice, we'll look at what types of difficult employees you may encounter, the problems they could cause your practice, and how to deal with them.

Why are some employees difficult?

For the most part, a difficult employee displays the behaviours which cause so much angst and friction because it is these behaviours that have worked for him or her (or someone else) in the past. It's kind of like a screaming child: the child screams because he or she knows that doing so will produce a positive result: a sweet or an extra half-hour to stay up and watch television.

What are the potential consequences of having difficult employees?

If an employee gets his or her own way by displaying negative behaviours, then not only will that employee continue to use the same tactics, but other employees will also be affected. As a manager, you need to make tough decisions. You also need to be fair. Kowtowing to one employee who stamps their feet and not doing likewise with a second will provoke more unrest among the troops and accusations of favouritism.

If you don't deal with a difficult employee quickly, you could find that staff morale falls, productivity slides, and employee turnover rates rise. These things are bad for patients, remaining staff, and are likely to lead to extra scrutiny and poorer ratings on CQC inspections, especially under the area of practice leadership.

What types of difficult employees will you encounter?

There are several different types of difficult employees, and knowing what these are will help you form the strategies to deal with them. Here are the five most common:

1. Mr (or Mrs) Negative

Negative employees hate change, are unwilling to contribute to practice evolution, and will resist new policies and procedures. Their negativity will quickly spread, and you'll often find a negative employee ‘converting' others in hushed conversations at the water cooler.

2. The egotist

Not a team player, and always looking out for number one, the egotist will destroy team spirit from the inside. Often a control freak, he or she will keep important information to himself or herself. When he or she calls for help, it's usually because the proverbial has hit the fan.

3. The victim

This is the employee who is never at fault. There is always a reason for something going wrong, and it is never caused by the victim. He or she shuns accountability, and places blame elsewhere. Eventually, others won't work with him or her and you'll only be able to give him or her menial tasks.

4. Mr (or Mrs) Angry

The angry employee is irritable, and loses his or her temper regularly. He or she could bully others, and unpredictability of temperament leads to difficult working relations.

5. Sicknote

When you have a large project on, or need all hands on deck, sicknote will conveniently go missing. He or she will throw a sickie, or simply be too busy with other tasks to help. They're probably disillusioned with work, will be difficult to motivate, and their poor performance leads to others having to do extra work.

How to tackle a difficult employee

As the practice manager, you'll need to formulate a plan to deal with a difficult employee and then put it into action:

Work out what to do

Evaluate the situation and try to discover if there is an underlying cause for the poor behaviour – especially if it is out of character.

Only act on facts, not hearsay. You'll want to act quickly and decisively, but don't do so on a wing and a prayer. It could be that you are part of the problem, so be aware of your own faults and behaviours, too.

With the facts gathered, plan how to tackle the problematic employee. While verbal and written warnings are tools to be used, you'll gain more respect if these can be avoided.

Discuss poor behaviours with the employee

Talk about the attitude and behaviour issues with the employee, and do so with another person present if possible. Your objective is to tackle the behaviour, and not the person. Ask if the employee has issues at work, with colleagues, or at home. When you discover the root cause of behavioural problems, you'll be able to plan a course of action with the employee to get him or her back on track.

Use positive language and avoid accusation. For example, instead of saying, “I've noticed that when you're sick, it's always on a Friday,” try saying something like, “At the end of a hard week, everyone wants to go home as early as possible. We really need everybody to pull together on a Friday.”

Ask if there is any training that could help the employee overcome their difficulties. It could be that they need extra help with a new system and have been afraid to ask.

Don't be judgemental, but do be a good listener

Make sure you give the employee plenty of time to respond. You'll learn nothing by lecturing, and everything by listening. Ask open-ended questions that require more than a one-word answer.

Confirm what the employee has said by repeating it back to them.

Be prepared to find a solution without knowing the cause.

Understand that one chat is probably not enough

Having got the ball rolling towards improved behaviour, you'll need to continue the good work. Schedule regular sessions to iterate the required behaviours, and to pat the employee on the back for improvements made. Encouragement rather than castigation is the order of the day.

Sometimes you'll need outside help

The underlying problems that have caused irrational and out-of-character behaviour could be beyond your scope of expertise. This is when the employee needs your support the most. Don't be afraid to admit that any help needed requires a particular capability. You're not a bereavement or relationship councillor, but this may be exactly what an employee needs. No matter how often we repeat the mantra never to mix personal and professional, there are some issues that bear their weight heaviest when we least expect or want.

Be prepared for the extreme

Despite your best intentions and efforts, it may be that the employee is simply a bad fit in the practice. In such cases, it is always best for both parties to part company. Whichever type of difficult employee it is that needs tackling, do so quickly. The longer you leave a bad apple in the basket, the more likely he or she will disaffect your other employees.

Next time, we'll look at how to deal with difficult patients. For now, please feel free to contact us and tell us about how you succeeded in turning around a difficult employee – your experience could prove to be the strategy that another practice manager needs right now.

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