Unresolved conflict

Feb. 1, 2013
As a veteran dental hygienist, I've seen a great deal of conflict in the dental office.
A mediator can turn in-office turf wars into a stable, productive work environment


As a veteran dental hygienist, I've seen a great deal of conflict in the dental office. While disagreements and differences are uncomfortable, nerve-racking, and unsettling, the results are not always bad. Let's characterize conflict. Conflict occurs when the ideas, interests, or behaviors of two or more people or groups clash. The clash can be a minor exchange of words ("You're crazy. I'm not going to clean that up.") to a power play ("That isn't my job.").1 Conflict has many causes. Sometimes it results from different values, other times from poor communication. It could also result from selfishness, a personality disorder, evil intent, or scarce resources.

Conflict is unhealthy when it is avoided or approached on a win/lose basis, with one side the winner and one the loser. It's also been my experience that most people want to avoid conflict, hoping that everyone will settle down and the problem will go away. But conflict management styles that are aggressive (win/lose) or avoidant (see no evil/hear no evil) are ineffective.

However, when handled properly, conflict can motivate a team toward positive growth and change. Positive conflict can be very useful when a healthy team is focused on finding ways to resolve a problem in the office.

Based on the work of Wilmont and Hocker (1998, Interpersonal Conflict), there are five conflict styles that we can use at home, work, or with our families.2

  • Avoidance
  • Competition
  • Compromise
  • Accommodation
  • Collaboration

Avoidance --This style can be useful if the relationship is short–term, unimportant to the person, if the person needs time to "think on their feet" before responding, or if it's a minor issue. However, most conflicts are not resolved through avoidance, and will reappear later with more force. Avoidance can give the impression that you don't care enough about the person or issue to engage in the conflict, and can reinforce the impression that dealing directly with conflict is harmful.

Competition -- This style works when the relationship is short-term or people are competing in games and sports. It can be appropriate when quick, decisive action is needed, such as in an emergency. Competition can be harmful to relationships by reducing the negotiation to win or lose. It can also escalate the conflict, or encourage passive-aggressive tactics from the other party. Solutions are seen as win or lose.

Compromise -- This style can be less time consuming than collaboration. It is often used when other methods have failed. It works best when solutions are short-term and both parties feel this is the most reasonable approach. Compromise can become an "easy way out" and result in modified gains and losses. It is seldom received as win/win. When power balances are unequal, it can be seen as giving up. Interests are met to the fullest extent possible.

Accommodation -- This is very useful if preserving the relationship is more important than resolving the issue, or if the issue is more important to one person than the other. A disadvantage is that the desire for harmony can supersede the needs of the accommodating party. Creative problem solving is reduced. One person's needs are met more fully than the other's.

Collaboration -- This style preserves the relationship as well as the needs of both parties. There is a high value placed on integrative solutions. Collaboration demonstrates that conflict resolution can be productive and creative. This style can be the most time-consuming conflict resolution process. If investment in the relationship is low, the time and energy may not be worth the outcome. This favors those with a high degree of verbal communication skills that can be used to manipulate or set up a power imbalance.

Considering how closely everyone in a dental office works together, all of these styles are used. There is no denying that in the short term, a dental team can be in conflict and still be smiling and greeting patients, addressing patient concerns, and fixing teeth. In the long run, however, dental teams that are bickering, gossiping, and in conflict are neither sustainable nor productive in human and financial terms.

The team feels the tension while they are working, and patients sometimes sense the tension as well. Some people are nervous about dental offices and procedures, even under the best of circumstances. When the office itself provokes anxiety, some patients may go elsewhere. Bottom line — unresolved conflict costs money.

In 2006, I had an opportunity to facilitate a workshop in personality types and conflict. Two doctors, an office manager, three hygienists, two front desk workers, and three assistants were embroiled in bickering, backstabbing, and gossip. Their behavior was a response to the conflict management style of the manager, whose philosophy was "the beatings will continue until morale improves." The excessive, punitive control over the team produced absenteeism and turnover. Production suffered with holes in the schedule, cases dropped off the books due to lack of communication, and the team's focus was on turmoil instead of their duties. Could this scenario be playing out in your office?

Imagine there are two employees in a dental office who each earn about $35,000 per year. In the last two months they have been engaged in a disagreement. On average they each spend about two hours a week of their time gossiping, enlisting other team members to one side or the other, telling their stories, and reliving an event. Doctors and team leaders think this is an insignificant matter and leave it to the team to "work out." This is a costly mistake. What most likely started out as a petty issue has spread and caught up the entire office in the scuffle. Front against back, hygienists against assistants. Everyone feels the underlying, and sometimes overriding, rumble.

As with all workplaces, dental offices are filled with people with unique personalities, communication styles, and backgrounds. Conflicts will naturally occur. The problem isn't that conflict exists, it's how the office deals with those conflicts or what happens when they're not resolved. The impact of unresolved conflict in the workplace can be devastating to the parties involved, to partners and the team, to patients, and to the practice as a whole. Left unattended, a simple conflict can cost the practice thousands of dollars in lost time, inefficiency, turnover, and patient frustration. This is astounding!

While every dental professional knows that such workplace conflicts affect productivity and morale, the exact, very real money drain caused by office drama is not as obvious.

CPP Inc., publishers of the Myers-Briggs Assessment and the Thomas-Kilmann Conflict Mode Instrument, commissioned a study on workplace conflict. They found that in 2008, U.S. employees spent 2.8 hours per week dealing with conflict. This amounts to approximately $359 billion in paid hours (based on average hourly earnings of $17.95), or the equivalent of 385 million working days.3

So, yes, that is plenty of time spent gossiping, defending turf, striking back, recruiting people to one side or the other, planning defenses, and navigating the drama.4 More importantly, it is time taken away from the day-to-day business needs, patient care, lab work, and responding to patient requests. Basically, no one is getting the job done.

This might be amusing if it were being played out elsewhere, but it's not when it's happening in your office. It impacts the entire team, you, and your image as a professional.

So what's an office to do? Avoidance promotes turnover and escalating conflict, which are expensive emotionally and financially. Realistically, it is difficult, if not impossible, for people who are warring to come to peace without some outside help. A mediator could be just the solution to help the team get back on track to productivity and focus on the job.

A mediator provides a forum and atmosphere for communication where parties gain understanding, become understood, and work together to explore options for resolution.

What is mediation?

Mediation is a way for people in dispute to exercise their choices and discretion and to regain a sense of control. It is a means by which everyone can be an active participant in the decision making process, and have direct involvement in determining the solution. In the informal setting of mediation, the parties have the opportunity to express their emotions and realize their true interests. This opportunity is the first step to easing emotional turmoil. Instead of having a decision forced on the parties by someone else (win/lose), mediation provides the forum for the parties to craft their own decisions. Once they reach mutually acceptable agreement, the parties are able to end the emotional turmoil.

Mediation is a structured process, according to "The Essential Guide to Workplace Mediation" by Nora Doherty and Marcelas Guyler. Although mediation is informal, there is nothing haphazard about it. It is a structured staged process that is clearly designed to facilitate and direct people from point A to point B, from deeply felt negatives of conflict to new agreed outcomes and constructive changes.5RDH


1. Controlling the Costs of Conflict Page 6 K. A. Slaikeu and R.H. Hasson)
2. Wilmont and Hocker, 1998, Interpersonal Conflict)
3. (2008). Workplace conflict and how businesses can harness it to thrive. CPP Inc.
4. lawler, J. (2010). the real cost of workplace conflict. Retrieved from http://www.entrepreneur.com/article/207196
5. Doherty, N., & Guyler, M. (2008). Essential guide to workplace mediation & conflict resolution. rebuilding working relations. kogan page limited.
6. (2012). Advantages of mediation. Retrieved from http://www.osc.gov/adrabout4.htm
7. Bolton , R. (1979). People skills. how to assert yourself. New York: Simon & Shuster Inc.

The Benefits of Mediation
  • Mediation offers a rapid resolution. When parties want to get on with their business and their lives, mediation may produce rapid results. The majority of mediations are completed in one or two sessions.
  • Mediation is confidential. The mediator will not disclose any information revealed. The sessions are not tape recorded or transcribed. At the conclusion of the mediation, any notes taken during the session are destroyed.
  • Mediation is private and voluntary.
  • Relationships are preserved. Many disputes occur in the context of ongoing work relationships. Mediated settlements that address the interests of all parties often preserve working relationships in ways that would not be possible in a win/lose decision-making procedure.
  • It is a foundation for future problem solving. After mediation, if a subsequent dispute occurs, parties are more likely to use a cooperative forum of problem solving to resolve their differences.6

Sharon Dolak, RDH, and Alternative Dispute Resolution Specialist, graduated from Montgomery County College of Dental Hygiene in Pennsylvania in 1981. She lives in Keller, Texas, with her three sons and has been practicing clinical dental hygiene for the last 12 years with Dr. Rebecca Lauck and Dr. Jay Corley at Blue Stone Dental. She is certified in Myers-Briggs Personality Assessment, Strong Interest Inventory Assessment, and is a life coach. In 2006 she received her certification in mediation from Texas Woman's University, and advanced her skills and certifications to include mediation, arbitration, and workplace mediation, earning her the title of Alternative Dispute Resolution Specialist from Mediators Without Borders. Her professional mission is to promote respectful and positive dialogue between parties in conflict. She can be contacted at sharondolakmediation.com, [email protected], or (817) 781-7910.

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