Dysfunctional behavior masks any attempt to accept accountability
Dorothy Garlough, RDH, MPA
The blame game was happening big-time in the office. It all started with the doctor requesting that Jen, his hygienist, do a referral on a patient with an advancing periodontal condition. Jen was having one of those days, where every patients’ needs were complicated and required more time and energy than usual. She was feeling the stress of already being 40 minutes behind schedule with two more patients to see before lunch. Jen needed her lunch hour because she had booked an appointment with her bank that she couldn’t afford to miss. The little voice inside her head was screaming, “Great. I’m already behind and now I have to do a referral!”
Jen handed the chart to the front desk administrator, asked the receptionist to tag the chart for a referral, and get the chart back to her. She planned to write it up at the end of the day. Because the office manager happened to be at the front desk, she and the patient had a brief conversation about the wait time before the patient could get an appointment with the specialist.
But the receptionist was also having one of those days where too much was going on. Usually calm, collected, and in control, this wasn’t her demeanor on this particular day. Things had already gone awry with demands coming from both patients and staff. She seemed to be putting out fires at every turn, multitasking like crazy, and yes, was a little distracted because her little one was sick at the babysitter’s. The request from Jen got lost in the chaotic shuffle.
Three weeks later, the patient phoned the office and demanded to speak with the doctor. The patient had not heard from the specialist, and to him this confirmed that the office was incompetent. The patient was clearly angry, and neither the business administrator nor the office manager could appease him. It was not the first time the patient had experienced incompetency from the office, and he was threatening to change dentists and take his family of six with him. In addition, he said he’d broadcast the office’s screw-ups to his extended family and workplace.
The doctor was livid that this crisis had occurred. He targeted Jen’s oversight as the breakdown, and Jen in turn blamed the receptionist and office manager. They in turn blamed everyone else, pointing fingers at anyone but themselves.
The blame game was in full swing and it felt like a merry-go-round with no one bailing out of the dysfunctional behavior of distancing themselves from the crisis. No one was taking accountability for the loss of a six-member family from the practice. Everyone was focused on playing the game to perfection, scuttling to be cleared of any wrongdoing. Solutions were not even touched upon.
There is something attractive in others who own their mistakes with no excuses, who make sincere apologies and right their wrongs.
Who was to blame?
According to Professor Heather Domsky, PhD, and her team of researchers, as cited in an article by Susan Krauss Whitbourne, PhD, “People who share the same intent are equally blameworthy. Intent of actions or non-actions matter and should hold more weight than outcome, but research shows that people are swayed by outcome more so than by intent.” The research revealed five reasons people play the blame game.1
1. Blaming others is reactionary and defensive—When we blame others, we take attention away from our own possible contribution to the failed issue. This defense mechanism helps us save face and retain a more positive self-image.
2. This reaction is seen as an attack—This destructive tactic is like a battle (me against you), and I feel I’m in the stronger position by hurting you.
3. Humans are not good at understanding motivations for others or their own behaviors—People are often inaccurate in attributing why others behave as they do. Neither are people particularly self-reflective. Therefore, misjudgments about intent and outcome are common.
4. Blaming others is the easy way out—Lack of self-awareness blinds us to our own contributions to bad situations. This lack of looking at our role enables us to remain unchanged, which is easier than self-transformation.
5. People lie—It’s easy for people to blame someone who’s not around, even when they know they’re at fault. They figure that it won’t be discovered that they knocked over milk in the staffroom refrigerator and didn’t clean it up. They might blame it on a coworker and hope that their lie isn’t discovered.
In the example of the bad day, everyone held the same intent—the doctor, hygienist, office manager, and receptionist. Their intent was to care for the patient. Therefore, they were all to blame and everyone should have been held accountable. As it was, they looked like cowards to the patient, and incompetent ones at that. It’s important to guard against playing the blame game because it will ensure that teams do not develop a culture of blame, which can lead to the demise of patient care and the business.
An example of success
Dentistry is not the only profession where the blame game is played. It happens in every industry, with results that are telling. One strong business leader, Carlos Ghosn, recognized the lack of accountability before he took on his role as CEO of Nissan in 1999. Ghosn orchestrated the Renault-Nissan alliance, which earned him the name of “Mr. Fix It.” He’s recognized as an astute business leader worldwide. Under Ghosn’s stewardship, needed changes were made to Nissan.
He notes that when he took over Nissan, there was an entrenched culture of blame. “If the company did poorly, it was always someone else’s fault. Sales blamed product planning, product planning blamed engineering, and engineering blamed finance. Tokyo blamed Europe, and Europe blamed Tokyo.”
There was a financial bleed for which no one was taking accountability. A blame culture had taken hold, and Ghosn recognized that this needed to shift, starting with him. He publicly announced that he would resign from Nissan if he failed in his objective. He told the world to “Judge me,” and he was willing to be held accountable for the entire project.2 Amazingly, the objectives were reached a year ahead of schedule.
Unlike other games, the more often someone plays the blame game, the more often the person loses. In an office environment, patients become angry and relationships disintegrate. In my example, had each member of the team chosen not to play the blame game and taken accountability, it is very likely they would not have lost the family of six from the practice. All the energy and creativity they used to avoid accountability could have been spent on recognizing how breakdowns occur and then finding a solution so it wouldn’t happen again. Owning up to the fact that they failed as a team and as individuals could have freed up energy so that creative solutions could have been discovered.
The greatest breakdown occurred with the doctor. He did not accept the accountability of the transaction. He played the blame game and assured the patient that the staff would be reprimanded. He wanted nothing to do with a failure to care for the patient and took no responsibility. This was a mistake, because as the leader, he was ultimately responsible. Furthermore, a leader sets the tone for accountability in any organization. If the leader shirks responsibility, his followers will do the same. Accountability needs to be modeled.
There is something attractive in others who own their mistakes with no excuses, who make sincere apologies and right their wrongs. An immediate call to the periodontist, along with accountability displayed and not hiding from the truth, could have not only satisfied the patient but also possibly turned him into a raving fan. He could have walked away saying how he liked how things were handled, and that his needs had been met. Isn’t that why dental professionals exist?
Dorothy Garlough,RDH, MPA, is an innovation architect, facilitating strategy sessions and forums to orchestrate change within dentistry. As an international speaker and writer, Dorothy trains others to broaden their skill-set to include creativity, collaborative innovation, and forward thinking. She recognizes that engagement is the outcome when the mechanisms are put in place to drive new innovations. Connect with her at [email protected] or visit engagingteams.com.
1. Whitbourne SK. 5 reasons why we play the blame game. Psychology Today website. https://www.psychologytoday.com/blog/fulfillment-any-age/201509/5-reasons-we-play-the-blame-game. Published September 19, 2015. Accessed February 23, 2018.
2. Ghosn C. Saving the business without losing the company. Harvard Business Review website. https://hbr.org/2002/01/saving-the-business-without-losing-the-company. Published January 2002. Accessed February 23, 2018.