Your staff needs an attitude adjustment, or you have a really cranky, non-compliant patient. You know you should step up to the plate and say something, or the behavior will continue. So why don’t you? Because you’re like most of us… you’d rather set your hair on fire than face a confrontation. In this presentation you will learn techniques to use to approach confrontation with an open heart and an inquiring mind, and will find that the difficult conversations are interesting, fun, and yield results.  Give examples of confrontations that you have avoided in the past, and the deleterious effect of non-confrontation  Describe confrontations that you have embraced, that lead to better than expected outcomes  Exercise techniques and skills to embrace confrontation in your practice  Create your culture of friendly confrontation for your office and develop an implementation strategy

1. Embrace the Tiger:
How to Enjoy
Difficult Conversations
with Your Staff & Patients
Patricia L Raymond MD FACP FACG
Rx for Sanity, Norfolk VA
RxForSanity.com

2. If we don't change,
we don't grow.
If we don't grow,
we are not really living.
Growth demands a temporary
surrender of security.
~ Gail Sheehy
Learners agreement
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3. The Sylvia Technique
Don’t Mirror, Harmonize
Whiplash
Avoidance/misdirection
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4. A appeaser is one
who feeds a crocodile –
hoping it will eat him last.
~Winston Churchill
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5. Carefront- Judith Briles
“When you ________, I felt ________
because _______ . Was it your intent
to _______?
STOP: Wait for response
In the future, ________ .
If there isn’t a change, _______ .”
Scripted confrontation
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6. 1. How do you feel
about confrontation?
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7. Interactions with others
often described as attacks
• Heart broken
• Butt kicked
• Ego bruised
• Stabbed in the back
• Crushed
• Stepped on
• Left hanging
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8. How do you feel about confrontation?
• Hunker Down
• The more I ignore things, the
bigger they get.
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9. Embrace the Tiger
Return to Mountain
~Tiger Form
Tai Chi, Nam Hoa Temple
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10. Conflict = Danger + Opportunity
Potential
Pictogram, p95 qual confront
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11. When women are depressed
they eat or go shopping. Men
invade another country. It’s a
whole different way of
thinking.
~ Elayne Boosler
Women p96 UN
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12. Bonobos verses Chimpanzees
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13. No One and
Nothing
is against me.
Car cuts you off in traffic, 2 A phone call
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14. 10 years private practice in a group
No One and
NothingGI Fellowship PGY 2-3
GI Fellowship PGY-1
is against me. Internship/Residency in Internal Medicine
Medical School
Chemistry Major- hate being in a lab by myself!
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15. Do people– your spouse, children, colleagues,
staff, patients, friends, strangers in the street-
hold a measure of your well-being hostage?
How comfortable are you with conflict?
What kinds of situations put you on the
offensive?
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16. 2. Chart your
past confrontation history
(PCH)
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17. What have you done to avoid conflict?
How do you avoid or prevent conflict?
What kinds of situations put you on
the offensive?
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18. Do your obstacles have a theme?
Have your obstacles made you
stronger/wiser, or do you keep
doing the same thing over and
over?
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19. Insanity:
doing the same thing
over and over again
and expecting different results
~ Albert Einstein
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20. 3. Recast conflict
as a blessing
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21. Eye of the Storm
•Peace, calm, clarity, stillness.
•Experience the storm without
resisting or fighting it.
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22. “All crises
were not meant
to be managed.
Embrace the chaos.”
~Susan Elizabeth Phillips,
Breathing Room
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23. Recast your life experiences
Choose to see it differently
Be present in the moment
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24. 4. Next Confrontation
-Did your sphincters tighten?
-Keep trying to see conflict as blessing,
potential, opportunity
-If that doesn’t work…
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25. Pull up
your big girl panties,
& deal with it!
~ A cocktail napkin
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26. Courage is
like a muscle.
We strengthen it with use.
~ Ruth Gordon
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27. Time to embrace the tiger
-Ones you initiate
-Ones that are thrust upon you
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28. Embracing the tiger: Ones you start
• First, get centered
• Second, establish who you are
wiling to be in the moment
• Select three, and if you can get the other
party to commit to three…)
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29. Select three states of being
• Alert • Generous
• Appreciative • Gentle
• Attentive • Grateful
• Clear • Joyous
• Compassionate • Kind
• Courageous • Loving
• Creative • Open
• Empowering • Present
• Enthusiastic • Receptive
• Flexible • Supportive
• Focused • Truthful
• Vulnerable
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30. Embracing the tiger:
Ones that are thrust upon you
• Cultivate non-resistance
• Martial arts, yielding
• Don’t tense up!
Resistance is futile.
Non-resistance is fertile.
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31. Embracing the tiger:
Ones that are thrust upon you
• Only two sentences for you:
Tell me more.
What do you need?
~or~
What’s missing for you?
Mom work excuse
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32. LISTEN!
“attend to them with the ear of your
heart…”
~Prologue, Rules of St. Benedict
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33. The Chinese character for "listening
attentively"
• Consists of five characters:
- the character for ear
- for standing still
- for ten
- for eye, and
- for heart and mind.
• Listening attentively means:
"When in stillness, one listens with the
heart. The ear is worth ten eyes."
-- Zen Master Dae Gak, "The
Practice of Listening"
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34. Now, Choose your next tigers!
• If you had a magic wand, and
could wave it over your
staff/patients/colleagues and get
them to do any one thing
differently, what would you choose
and why?
• If the people in your office were
singing a blues song about their
job, what would they be singing
about EXACTLY?
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35. It was a high counsel
that I once heard
given to a young person,
"Always do
what you are afraid to do."
~Ralph Waldo Emerson
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36. You may be disappointed
if you fail,
but you are doomed
if you don't try.
~ Beverly Sills
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37. RxForSanity.com

38. III
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39. I am not afraid of storms,
for I am
learning how
to sail my ship.
~ Louisa May Alcott
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40. Pull up
your big girl panties,
& deal with it!
~ A cocktail napkin
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