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Gina W. Ore, Founder & CEO, Passion for Patients

How Incivility in the Workplace Negatively Impacts the Patient Experience

By Gina W. Ore
Founder & CEO
Passion for PatientsTM

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Original Publish Date: October 10, 2017

It was the first – and the last – time I went to this doctor. When I walked in, not only did I feel like I was assaulted, I felt like I was doomed.

All I wanted was an annual check-up! So when I approached the reception desk and felt the tension that was so obvious and conspicuous, I experienced a huge let-down followed by a deep sense of apprehension. I caught the tail end of a discussion between two women in scrubs that was loud and getting louder. While they did not mention a name, they gestured towards the receptionist; I gathered their ‘discussion’ was about her. I couldn’t hear the entire conversation, but I clearly heard “Well, she’s always doing that!”. That confirmed my suspicion.

Conflict between and among staff members always impacts service delivery and ultimately patient care. It was very clear that some members of the ‘team’ were having a conflict and I knew that my experience was going to be affected. After all, how can the staff focus on the patient if they are busy defending themselves from the office bully?

The atmosphere was not what I expected; it was so uncomfortable and intimidating that I almost walked out. I had waited several weeks to get this appointment so I wasn’t going to reschedule it just because a couple of employees couldn’t get along.

Humilated and uncomfortable with the conversation between the bickering employees, the receptionist stared at her computer as she mumbled “Name?” and handed me a clipboard. I accepted the clipboard and started to fill out the forms. I then realized that I had already completed these forms and submitted them using the patient portal. I mentioned this to the receptionist and she snapped “We’ve been having trouble with that portal so you’ll have to do them again.” I could hardly hear what she was saying as she was visibly upset as she wiped away her tears.

I was aggravated by her behavior but I also wanted to comfort her as she was clearly struggling. It was obvious that this young woman at the front desk was being bullied by abusive co-workers. It was affecting her work as well as the atmosphere in the office.

I was also frustrated and resented that my time in this doctors office was impacted by bickering employees. There was little professionalism and my confidence in the practice handling something as simple as an annual check-up was completely gone.

Today, the phrase for the behavior I witnessed is Incivillity in the Workplace or sometimes Workplace Bullying. This is a very costly issue – not only as it relates to employee turnover and performance, but also as it relates to dissatisfied patients who leave the practice.

Some studies have shown that two-thirds of those who resign from their jobs do so because of some form of incivility in the workplace. Additionally, workplace bullying contributes significantly to increased absences of staff and reduced or unacceptable performance.

There is no justification for a workplace that tolerates incivility and bullying. Harrassment doesn’t just happen, it is allowed to happen. It starts like a tiny cancer and spreads so quickly that it seems to come from nowhere.

Like many cancers, incivility may have a microscopic origin and can spread until it infects the entire workplace and the organizational culture itself. Organizational leadership may overlook that microscopic origin and may not even realize that there are specific symptoms of the beginnings of incivility. Leaders may even be “carriers” without knowing it.

When workplace incivility infects a medical practice, patient care always suffers. Incivility in the workplace often results in mistakes being made in patient care. It has even resulted in the death of patients because of errors being made in diagnosis, treatment, and follow up.

Just as early diagnosis and intervention is a critical component of cancer care, it is also a critical component in combatting incivility in the workplace.

Establishing a zero-tolerance approach to incivility is a necessary component of that early intervention. Implementing a zero-tolerance policy toward incivility through empowering the staff is most effective in developing a cohesive work team. Constructive peer-pressure is the best way to ensure the effectiveness of that zero-tolerance policy.

Incivility in the workplace can also be addressed with professional help in communication techniques. There are specific behaviors that are categorized as incivility in a working environment. Simply identifying those behaviors and putting labels on them goes a long way toward addressing this common problem in a medical office.

As dangerous to an organization as this incivilty cancer is, it is also terribly contagious. It can metastasize into the entire culture of the organization and can result in workplace bullying becoming the standard and acceptable behavior. It can also result in a hostile environment and even litigation. It’s hard to imagine that all of these potential problems may quickly grow from “accidental communication”.

Accidental communication is a label that we at Passion For Patients™ place on a simple misunderstanding. It is quite common for misunderstandings of any size and at any level to be left unresolved. After all, many will go to great lengths to avoid confrontation with co-workers and especially with bosses. When this happens, it is not unusual for “accidental communication” to grow and grow until it negatively affects the entire workplace.

Some medical practices are paying more attention to the “check out” process. They make sure that patients have their follow-up instructions, prescriptions, and future appointments. Unfortunately, all too often patients encounter the same deficient interpersonal skills while checking out as they did when checking in. Assistants staring at computer screens rather than establishing eye contact are commonplace. The check out process is frequently seen as routine rather than as an opportunity to make a positive last impression.

After a disappointing visit to a doctor’s office, patients can now take advantage of the same technology that so often negatively affects their medical visit. They can now go online to record their satisfaction (or dissatisfaction) with their doctor visit. Many who author on-line reviews report that they are satisfied with their doctors but very unhappy with the office staff and the experience. Patient satisfaction scores are available for all to see. And studies show that a majority of patients check patient satisfaction scores before choosing a doctor.

Medical practices that do well with patient satisfaction are often very interested in learning what they can do to improve an already good performance. Many of those practices that don’t do well aren’t interested in improving. In some cases, they think they are doing well. In still others, they don’t believe a solution is available to them. At this time, some doctors are unable to see a clear correlation between patient satisfaction scores and insurance reimbursement rates. But the time is coming when lower patient satisfaction scores will hurt the bottom line of a practice in more ways than simply losing patients.

Fortunately, training on identifying the symptoms and cures for incivility enables practice managers and other healthcare leaders to facilitate early intervention for incivility.

Passion for PatientsTM Workshops provide on-site training and specific techniques on how to empower the workforce to remain free of the cancer of incivility. Contact us at www.passionforpatients.net to learn more and to schedule a consultation on how to resolve any incidents of incivility that may already be present, or on how to keep it out of your workplace.

After all, medical professionals can care for patients, so it is important to remind them to care for each other.