by Dr. Andy Roark, DVM
I have a friend who dreamed of doing a veterinary residency. During her internship (a one-year program which, for some, serves as vetting for residencies), my friend — like a lot of first-year doctors — struggled with insecurities and doubts. She didn’t want to “get anything wrong,” and she dealt with that by frequently asking for advice, input, and reassurance on her cases.
Nine months into her internship, when she requested letters of recommendation for residency programs, she was called into a meeting. With difficulty, her advisor told her this habit of constantly seeking input and reassurance had been driving her mentors crazy and causing them to question her competence. They would not be writing her a letter of recommendation.
My friend was devastated. Once she was told how her actions were being perceived, she changed her behaviors and forced herself to become a much more self-sufficient doctor. She told me the lesson ultimately made her more self-reliant and a much better and more confident clinician. She never did that residency, but she says she’s OK with that now. Her one frustration is that she wasn’t told her behavior was hurting her until it was too late.
Sometimes we need to tell people things that aren’t easy to hear. Unfortunately, veterinary medicine has this nasty habit of attracting really nice people. That’s why, as a group, we often put these conversations off again and again. The result is that we end up having tough conversations with people we care about and want to help long after we should.
If we are going to have to talk to someone about a behavior that is hurting them, the best thing we can do is have the talk early — before the behavior becomes ingrained or the damage becomes career-limiting — with kindness and compassion.
So, how do we do that? Here are 6 steps to take:
- Choose the time and location –
If you’re frustrated or angry, now is not the time. It’s better to be two days later having the conversation than immediately after an event but with strong emotions seeping into your words. Talk in private at a time when you can smile about the problem.
- Start with open-ended questions –
Productive questions may sound like: “How do you feel things are going in the exam room?” “How do you like working with Dr. Haskins?” or “What went well and what could have gone better?”
When we start the conversation with a general inquiry, usually one of three things happens:
- The person reveals awareness that things aren’t going well and gratefully asks for advice.
- The person provides insight into his or her motivations, goals and reasons for taking the approach he or she has chosen.
- The person says “Great!” and reveals that he or she is oblivious to the problem.
Regardless of how the person responds, don’t argue or refute what he or she is saying. This is purely a listening exercise. Your chance to respond comes later.
- Re-state the person’s position clearly and with compassion –
Statements like: “So, you’re feeling good about working with Dr. Haskins but sometimes get frustrated that she won’t let you do things you’ve been trained to do. Is that correct?” can be hugely helpful in making the person feel heard, understood, and cared about.
If the person feels everything is going well, you might say something like, “I’m glad you’re feeling good about this. The other technicians seem to like you a lot and you’re fitting in well. The one thing I’ve noticed is that sometimes it’s taking more time than usual to get appointments set up for the doctors. Have you felt that way?” The goal here is to kindly state the person’s position as you see it and ask him or her to clarify or verify that position so that you have a starting point to work from.
- Point out commonality –
Discuss everything you both agree on. The truth is that you and the person you’re talking to probably agree on just about everything. There’s just a few specific points that you see differently. Put everything you agree about up front to set a positive and team-oriented tone for the critical part of the conversation.
You may use statements like: “I know it gets crazy up at the front desk and that the ringing phones can be hard to deal with when clients are walking in…” or “You are an excellent technician and your patient care is fantastic. You are right to prioritize that.”
- Share what you have learned –
Remember, this is someone you care about — you don’t want this person to feel personally attacked or unfairly judged. One of the best ways to avoid this feeling of judgment is to bring up anything that you learned during this discussion.
Statements like, “I didn’t realize you felt such pressure” or, “I hadn’t heard we were having problems keeping that product in stock” may help to reinforce the idea that you and the person you’re talking to are on the same team.
- Respond with criticism –
After you’ve chosen the time and place, asked questions to understand what’s going on and this person’s perspective, restated what you heard, pointed out the things you agree with and shared anything you learned from the person, and only after, can you give the person the feedback that is needed and/or respond to points that the person made with which you don’t agree.
Success in delivering criticism is largely determined by the steps leading up to the actual feedback. Once it’s time to deliver the news, however, it’s best to deliver it clearly and directly so it’s understood. You’ve come too far to deliver mixed messages now. Use specific examples and avoid speaking in generalities. End by asking for a change in the behavior.
Statements of criticism might sound like: “When you come in late 5 out of the last 10 days, it gives people the impression that our team isn’t important to you. Can you change this behavior?” or “When you interrupt the veterinarian while she’s talking, it confuses pet owners about who they should be listening to. Can you make sure to avoid that going forward?”
Criticism can be scary. Most of us have been hurt by it at some point or another (usually when it was poorly delivered) and we don’t want to inflict that sort of pain on others. The truth, however, is that if you really care about someone, giving them feedback in a kind and compassionate way may be the most generous gift you can offer.