Insights From Our Editors

Getting Comfortable With Conflict

Dr. Fishbein some of her team are all smiles (no conflict) in NYC for Vision Expo East. Dr. Fishbein says that hard conversations become easier if you go into them with a plan.

Dr. Fishbein (second from left as you look at photo) and some of her team are all smiles (no conflict) in New York City for Vision Expo East. Dr. Fishbein says that hard conversations become easier if you go into them with a plan.

Creating a strategy for the conversations you dread

By Bethany Fishbein, OD

In my last column, I talked about the importance of direct communication.

Some feedback I got was, “I get it and understand that’s what I’m supposed to do, but I hate the thought of actually doing it!” Many optometrists consider themselves to be non-confrontational and avoid what they perceive as conflict at all costs.

Healthy conflict is critical to organizations, and handling conflict is part of life for optometrists – and not just for those who own practices. Whether or not you’re the practice owner, as the doctor, you’re often the one asked what to do when a patient shows up 20 minutes late for an appointment, questions fees at the front desk, or is disrespectful to one of your team members. As an employed doctor, you may be frustrated with a team member, practice manager or practice owner.

“Grinning and bearing it” only leads to increasing frustration, sometimes to the point where it becomes intolerable. I have spoken to optometrists who are questioning whether they should look for new jobs or sell their practices. They feel they can’t continue in their current situation, but haven’t tried to change it because they never learned the skills and tools to do so.

Getting more comfortable with conflict, and being willing to have tough conversations, is critical to the success of your practice. I can’t guarantee that you will get your desired result 100 percent of the time, but you will get a result every time, and know that you gave your best effort to improve the situation before deciding to make a change and move on.

Preparing beforehand will help you feel more confident going into the conversation, and increase the odds that the message is received in the way you intend and will get a positive result.

Here is the strategy I often use to coach people through a conflict conversation.

Get It All Out

The first thing I ask clients to do when they’re wondering how to approach a high-stakes conversation is to take a few minutes to share with me what they really wish they could say, without worrying about using the “right” wording, being politically correct or having any fear of how the conversation will be received by the other person. You can do this with a friend or colleague, or even in a journal.

Use “you” as if you’re talking directly to the person, and don’t hold back. You’re in a safe space, and it’s helpful to vent a little and get an unfiltered view of the real situation at hand.

Consider what might happen if you said it exactly the same way to the person you’re having conflict with. Most likely, they would be angry, defensive, fight back or clam up completely – so the next steps help you refine the message into something that will be more positively received.

Address the Impact, Not the Individual

Talking about the impact of the problem is a way to address the issue without the person feeling blamed or judged.

Consider the difference in the response you’re likely to get if you say, “These jobs have been sitting here for days!” and “We are having an issue with patients not getting their glasses when we promise, and at least part of it is a delay in when they’re being sent out. How can I help you get these done every day?”

Or between, “Doc, you need to get here on time!” and “As the manager, I’m really struggling to enforce on-time arrival with the staff when they see you come in late every day, sometimes after your patients are here. Can we talk about solutions?”

Be On The Same Side

Let’s say you have an associate who spends a long time with patients.

If you say, “You take way too long with patients,” you’re likely to get denial, explanation, excuses, defensiveness, or an empty promise to try harder with no real change.

Instead, try something like, “Most patients are in the office over an hour before they leave the exam room, and our optical team has noticed more patients taking Rxs because they don’t have time to look at glasses. Help me understand what’s going on, so we can figure out how to fix this.”

This simple sentence puts you and your associate on the same side of the table against the issue of patients not getting to the optical, rather than pitting the two of you against each other. You’re not having a confrontation– you’re working together to solve a problem.

It may take a few practice rounds to get really comfortable with what you’re going to say. The conversation shouldn’t be scripted – so it’s worth practicing, to make sure you’re starting the conversation with a message and tone that will be well-received and productive.

Be Open, Not Over-Prepared

The opening to the conversation is really all the preparation that’s required.

It’s tempting to try and work through all of the potential scenarios that can happen next, and have answers ready for anything the other person might say – but that involves a lot of time and effort preparing for something that may not even happen.

I’d encourage you instead to share your concern… and then stop talking. Wait for the other person to speak, and when they do, actively listen. If you’re preparing your response in your head before the person is even finished, you aren’t actively listening to what they’re going to tell you. Be open to their perspective. They might say what you expect, but you might be surprised and will often learn something you didn’t know about yourself, your process or your business.

Create a Plan

Ideally, leave the conversation with a plan. This may be a plan for complete resolution of the problem – or might just be some next steps to take. Make sure you and the other person in the conversation are aligned, and agree on what the next steps are. Include a timeline for follow-up, and follow through on any commitments you make to the other person.

Practicing these steps will set you on a path to turn previously intimidating conflict into healthy discussions that help you solve problems and move things forward in your practice and in your life.

Bethany Fishbein, ODBethany Fishbein, OD, is a co-owner of two practices in New Jersey, a practice management consultant and certified executive coach. She can be reached at

To Top
Subscribe Today for Free...
And join more than 35,000 optometric colleagues who have made Review of Optometric Business their daily business advisor.