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An article by Anke Sommer

How susceptibility to burnout leads to conflicts and ‘stupid’ behaviour

Doctors en route to healthy collaborations with colleagues and employees (conflict managements as a support mechanism).

Unresolved conflicts in interpersonal relations can lead to burnout and stress-related illnesses among doctors. What’s worse: it isn’t just the work relationship that suffers but the people affected by it also start losing their minds.

After all, conflicts obliterate rationality and devastate finances. Afterwards, it is often the case afterwards that those involved can no longer recognise themselves in their actions and are shocked by their blind behaviour. They consider their actions to have been rash and ‘stupid’.

This loss of rationality not only costs you your health, it also weakens capital at the practice, clinic or hospital: in short, at the workplace.

Practice shows that conflicts in work relationships are closely linked to doctors’ excessive everyday workloads.

This knowledge is commonplace, so why do those affected stay in these destructive conflicts for longer than is healthy and risk burnout?

There are reasons for this

Practically no one wants to be associated with the interpersonal disruptions in professional collaborations. A conflict is nothing more than a breakdown in the interpersonal relationship. This occurs regardless of the type of relationship, i.e. irrespective of whether it is a private or professional relationship. The cause of the disruption no longer has anything to do with the consequences that emerge later. This is similar to the conflict itself. How it came about may be an interesting topic, but it is irrelevant as far as tackling the consequences is concerned. Right now, the only thing that’s relevant is identifying the facts that have led to the conflict and disruptions.

‘Outing’ oneself is still regularly seen as a weakness. It results in tabooing and maintenance of a widespread strength-sapping phenomenon.
Conflicts and their resulting disruptions never go away on their own. If you leave them, they destroy everything, including our understanding of controlled behavioural patterns. This explains why conflicts give rise to irrational behaviour such as ‘finishing off’ an important business partner, a line manager or an employee, or behaving rudely towards a patient, even if you personally accept the negative consequences of such behaviour.

Conflict resolution: learning from large companies

Large companies tackle conflicts differently to the way small and medium-sized businesses have been doing up to now. This is due on the one hand to experience and size, and on the other hand to the recognition that there’s nothing to be gained by maintaining a conflict. Most people assume that this is because of the financial means that have to be provided for it, but they are only half right. Some small companies have also recognised that it isn’t the intervening to tackle the conflict and its related disruptions that costs money, but rather staying in the conflict situation itself.

Team buildingRecognize adverse processes in your team and dissolve them while having fun and joy in shared adventures. You can learn here how this works.... Read more, conflict resolution at management levels as well as among team leaders and employees, coaching sessions to tackle conflicts and bullying potential, and the facilitation of group processes have long been part of the established range of methods to support interpersonal workplace relations.

This is based on experience. The more functional the collaboration, the more services will be rendered in a healthy, energy-saving way. This protective and preventive strategy is reflected in company profits.

Doctors aren’t immune to being worn down by stress and conflict

Physicians are confronted with and treat their patients’ illnesses on a daily basis. They recognise when ailments become psychosomatic, which illnesses are triggered by stress and when they start to disrupt the mind-body balance.

However, if a workplace conflict remains unresolved at one’s own practice, in a hospital or clinic, or in pharmaceutical companies, then it also wears the doctors down.

The burnout rate for doctors is increasing. In stress cycles, communication among each other is also always affected. This may also explain the increase in the conflict rate among physicians.

Stress creates the basis for conflicts. It allows aggression levels and thus also irrationality to grow.

And yet doctors prefer to suppress, ignore and skip over an existing conflict rather than getting stuck in and resolving it, with the result that the conflict then creates regular disruptions that are constantly making their way into the workplace and, just like a virus, contaminating healthy communication left, right and centre. The potential for stress has again increased and the climate for potential burnout has been created.

Description of a (job-related) conflict within a group medical practice

Dr B. appears to be an extremely pleasant doctor, but you can see the stress and the lack of rest and recuperation in her. Her speech sounds rushed and restless. She works non-stop and has already been experiencing serious relaxation and sleep problems for more than 1.5 years.

Her practice is running very smoothly, but the costs are too high for her alone and there is a problem with patient flow. She also has no stand-in periods and the reassurance that she can simply go on holiday without having to close her practice. This is why she’s always on the lookout for a second doctor for her practice despite the fact she’s had lots of trouble with all her professional partners in the past.

Dr B.’s medical centre has been designed and developed as a group practice. She has already tried working in partnership with both male and female colleagues. If you look at the practice books, you can see that Dr B. has been running the centre for more than 15 years but the second doctor always moves on after four years at the latest.

Most of her professional partners don’t stay longer than two years. Dr B. says that none of them have been able to make the jump into her successful practice. She says that the joint waiting room is almost always full, just that most of these patients belong to her. Patients regularly ask her why none of her colleagues stay. People often also find the second doctor unfriendly and irritable.

The irregular patient flow alone is leading in the first half of the year to an extremely unpleasant atmosphere between Dr B. and the new person. The conflict resolves itself differently, depending on the partner.

Dr B. says: “I’ve seen it all, from raging and swearing in front of a full waiting room, slandering and badmouthing me to my practice team, being rude to my patients, month-long delays in the payment of agreed charges up to threatening letters from my practice partners.” Summing up the experience, she says: “I’m not giving up my patients for the sake of peace and quiet. With all the work and conflicts, I barely have the strength left to manage the practice confidently. I no longer have the patience and strength to deal with my partner’s problems.”

Disruptions can lead to illnesses

The percentage share of crises that appear in connection with business partners is high.

In specialist circles, people assume that around 50 per cent of those affected also suffer health problems. They develop and suffer from symptoms such as migraines, asthma, deafness, abdominal hyperacidity and heart attacks. People often fail to make the link between these symptoms and the conflict.

The conflict always has an impact on the work atmosphere, so the problem extends outwards, in the case of a medical practice to the patients. This is also the case if the disruptions triggered by the conflict are ignored or skipped over.

The people affected in the above example are part of the picture of a disrupted, divided practice.

‘My patients and your patients’, unequal treatment of patients by the employees of the respective partners, and authority conflicts among staff are just some of the features of a divided practice. In such cases, the conflict is a cost item for the entire practice, irrespective of whether it’s a group or joint practice. In the long term, it makes either part of the workforce sick or at least one of the co-operating doctors seriously so.

Similar conflicts between colleagues take place in hospitals and clinics, just that the disputes are influenced more by the hierarchical conflicts that are common in these environments.

Differentiate between conflict and disruption!

The problem is that many mediation and negotiation processes produce results that don’t take the existing problem into account. Negotiations are conducted on the basis of facts, often without really identifying them. It’s a bad thing if the conflict starts being analysed in terms of psychology and becomes focused on the behaviour of individual people, as it means that the conflict will become increasingly personal without ever being resolved and released of all emotions. In most cases, the disruption in interpersonal relations that has occurred is repeatedly ignored, as efforts are made to remain objective, so at most the interpersonal level has been objectively cleaned up.

In my role as coach, I have all too often noticed that even this interpersonal level becomes psychologized and tackled in terms of personal shortcomings.

Unfortunately, disruptions never go away on their own; they have to be cleaned up. This is a golden rule from crisis management.

In Dr B.’s case, the disruption has continued for years. If a partner physician joins the practice, he or she immediately inherits the problem. The aggression that Dr B. encounters time and again is merely a symptom of the existing fault. Dr B. is transmitting the problem, and the longer this situation continues the more she will herself become a disruption, despite doing everything for the sake of her work.

The disruption is deeper than the facts. If ‘only’ the facts are dealt with then the disruption still remains. It survives as part of Dr B.’s behaviour and is thus carried forward. And in Dr B’s case, it is leading directly towards burnout.

Dr B. also didn’t see the job-related conflict. At no point did she consider that the lack of any differing specialisation between both partners could lead to the first step being taken towards a success community. This is exactly what the start of a job-related community should look like.

She also failed to see that analysing her partners in psychological terms is of no help when it comes to neutralising the conflict’s disruptive power. In short, she interpreted the situation in terms of others’ incompetence, thereby excluding any objective change in the practice’s overall environment. Nor did any of her partners recognise this substantive problem.

This comes as no surprise. If fact, it’s very normal. The more you’re affected, the less you see why.

Emotions are stronger than intellect

The popular saying gives it straight: conflicts make you blind. If one day you find yourself being put through the mill, the reactions of third parties, if indeed you allow them, may show you what’s actually going wrong. You only ever change, however, if at some point the situation become so painful that there’s really no other option left open to you – or if the consequences of the conflict are driving you slowly but surely insane.

At this point, we have long since lost control of our minds.

A strategy for everyday work life is required

Whether as a line manager, partner or colleague, take responsibility for disruption-free relations.

If you follow this premise then you’ve already achieved a great deal by preventing burnout and assuming self-leadership.

In order to be able to foster more successful work relationships, you need a strategy that can withstand everyday life and equips your co-operation or work relationship with the mechanisms for success.

If you are a line manager, then ensure disruption-free relations with your staff. Nurture them. Team building helps to consolidate reliability in the term in a relevant way. A joint event welds things together. Use conflict resolution measures if disruptions are emerging in the team dynamic. Workplace bullying must not and should not be permitted on any level.

As far as conflicts in co-operations are concerned, if you are yourself involved then you need to clean up the relationship as soon as either you or your partner are behaving in a anti-business way. At this point, the loss of rationality has already begun and this destructive force usually doesn’t stop itself, or it does so too late, i.e. when it has already started damaging the business.

Employees can help with relevant tip-offs, e.g. about the need to monitor the consequences of the conflict. In this way, you can show your boss and line-manager in an impersonal way that action is needed, even if your boss is part of the conflict.

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