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Today we are on our to welcome Dr. David usum for

0:47

a lecture on keep the Harmony and pass the

0:50

gravy a talk on conflict resolution.

0:52

Dr. Houston is a professor of radiology Vice

0:55

chairman and Associate Dean at Johns Hopkins.

0:58

He has published over 300 scientific papers and is

1:01

the author of neural Radiology the requisites the case

1:04

reviews series and Radiology business practice had

1:07

a succeed he is also the former president of ASMR.

1:10

We are grateful for Dr. Usum and his

1:13

support of MRI online and for serving as our Neuro Imaging

1:16

subspecialty advisor, we have learned so much

1:19

from you.

1:20

At the end of the lecture join Dr. Yusum in a Q&A session where

1:23

he will address any questions you may have on today's topic. Please remember

1:26

to use the Q&A feature to submit

1:29

your questions we can get to as many as we can before a time is

1:32

up with that. We are ready to begin today's lecture Dr. Yousum.

1:35

Please take it from here.

1:37

Thank you very much. Hopefully you're seeing

1:40

my screen which says managing and mediating conflict and

1:43

we will be talking about this non-radiology topic

1:46

today.

1:49

And I'm going to start by talking

1:52

about something called difficult conversations. This

1:55

is a wonderful book that I recommend to all of you

1:58

by Douglas Stone Bruce Patton

2:01

and chiliheen from the Harvard negotiation project. What

2:04

I'd like to do is to summarize some of their major points

2:07

as part of our discussion about

2:10

how to have a difficult conversation about conflict to

2:13

begin with we'll just ask a polling question

2:16

of the audience and hopefully all of you can

2:19

participate how often in a week. Do

2:22

you have a difficult conversation one that

2:25

is potentially a conflict. So go

2:28

ahead and answer where that would be number one never one

2:31

to two times a week three to

2:34

five times a week six to ten

2:37

times a week or 11 to 20 times a week.

2:40

So go ahead and putting your answer. I just like to

2:43

say that it's here in Denver, Colorado

2:46

or Evergreen Colorado where I am, it's 10

2:49

Them and I've already had two difficult conversations in

2:52

my family. The first was

2:55

who was going to go out and do the shoveling when

2:58

it's minus 10 degrees Fahrenheit. And

3:01

for those in the Celsius world that's minus 23

3:04

degrees outside my door and my wife

3:07

and I had a difficult conversation and ultimately my

3:10

90 year old mother-in-law with

3:13

bilateral hip replacements was was sent out to do the

3:16

to the shoveling and the other question was

3:19

which hatch should I wear we had a difficult conversation about

3:22

that. So looking at the results from the audience about

3:25

50% said one to

3:28

two per week another 41% said

3:31

three to five and then we had a healthy five

3:34

percent who said never very good.

3:38

Well, let's talk about the framework of a difficult conversation

3:41

as it was laid out by Douglas Stone

3:44

and the Harvard negotiation project. They talk

3:47

about three levels of a difficult conversation. The

3:50

first is the event. It's actually the facts of

3:53

what happened. The second part is the feelings that

3:56

those elicited and the third part which is really quite

3:59

important is what does this difficult conversation

4:02

say about yourself image your identity.

4:07

So let's talk about the event. A lot

4:10

of times the facts of the event are more

4:13

complex than either person perceives. We

4:16

we don't know what's happening on the other

4:19

side of the conversation or the other side of the

4:22

conflict and these include some hidden data that

4:25

might not be there different relationships that we're

4:28

unaware of the ramifications of the of

4:31

the difficult conversation and what the

4:34

other person's motivation, you know during the

4:37

Trump Administration we had this term use

4:40

that that there are alternative facts, you

4:43

know, we sometimes ridiculate that one person's

4:46

perception of what happened might be completely different

4:49

from another person's perception of what happened. It's not

4:52

really absolutely clear. What the correct.

4:55

Perspective is when you're coming into a difficult conversation.

4:59

The second piece is the feelings and

5:02

this is your reaction to being in

5:05

an uncomfortable position of conflict

5:08

and the feelings

5:11

really sometimes are what's driving the level of

5:14

Engagement in the difficult conversation. So

5:17

both parties may have feeling and we don't know what the

5:20

emotional state is. You know, it's often said when you have teenagers not

5:23

to get into a conversation with them unless

5:26

you know that they are not hungry that they are

5:29

not sleepy and that they're not having a fight with one of

5:32

their friends at school. So you have to

5:35

know what the background emotional state is of the person and then

5:38

also you need to know their level of Baseline emotional

5:41

intelligence. It may be that some people

5:44

are just more gifted at understanding the

5:47

complexities of a difficult conversation and other people

5:50

haven't really put that energy to on to

5:53

that knowledge base. So the Baseline emotional

5:56

intelligence

5:59

As I said what we often do not talk about in the

6:02

framework of a difficult conversation is what

6:05

does this?

6:08

Difficult conversation need to ones self-image

6:11

in other words. Why am I so

6:14

getting so outraged about this? Why am I

6:17

getting so emotional? It must be because something about this is touching

6:20

a very important core principle for

6:23

me and the Douglas Stone and and

6:26

that group talk about three domains that are the

6:29

major identity domains. They are am

6:32

I competent and am I a good radiologist? Is

6:36

this a question about my competency as

6:39

a physician as a an engineer

6:42

as a counselor? The

6:45

second is am I a good person. Am I

6:49

doing the right thing or am I being accused of being

6:52

an evil person and doing the wrong things and the third thing

6:55

the third competency is am I worthy of love

6:58

in other words. Am I a good enough person that

7:01

other people want to engage with me and if there

7:04

are conversations that

7:08

in my competency question whether I'm a good person or

7:11

a bad person or question whether I am a worthy person that

7:14

to engage with other people in a loving relationship. That

7:17

is those make it a

7:20

very emotional state.

7:23

So this is from the book from difficult

7:26

conversations and I just want to

7:29

highlight some of the potential issues that

7:32

it becomes a head-butting battle versus one. That's

7:35

a learning conversation when we talk about the facts when

7:38

you're in a head-budding or just you know, just fighting you

7:41

want to convince someone that you're right and that they're

7:44

wrong. Whereas if you're in a learning conversation that

7:47

allows emotional growth your goal

7:50

is to share what you know, understand the other's point of view and how

7:53

the actions and intentions contributed to the result of

7:56

the conversation similarly on the feeling side. If

7:59

you're in the mode of just a fight then you're

8:02

gonna avoid talking about your feelings unless you've been

8:05

hurt and then if if you have been hurt then

8:08

you just open up with full guns blaring and you know, get very high

8:11

strung about it in a learning conversation where

8:14

you're there's growth of emotional intelligence. Your

8:17

goal is to address and acknowledge your feelings without being

8:20

judgmental about the other person or your own.

8:23

Oceans judging yourself about your emotions and finally

8:26

on the self-image side in this situation

8:29

where it's not going to be a good result. The goal

8:32

is to protect yourself image at all costs and not allow

8:35

yourself to be exposed to any doubts about

8:38

your identity. Whereas in the

8:41

growing conversation for emotional intelligence. The goal

8:44

is to understand how the situation affects both parties

8:47

and to keep an open mind.

8:51

So we're going to play a little game along here. And

8:54

what I've put in is a really simple conflict that

8:57

most of us may have experienced in

9:00

a similar situation. So we're going

9:03

to start with Pat Pat asked for time off to present

9:06

at a society meeting. I'd like

9:09

time off the clinical schedule to present my ultrasound of

9:12

the Achilles tendon work at the ultrasound meeting

9:16

the request came back from the supervisor Lee.

9:21

That the time off was denied as insufficient justification

9:24

for the days off the days

9:27

you want off are not ideal and I cannot approve

9:30

of your request.

9:32

So Lee is seen the supervisor has

9:35

seen to be presenting on a similar topic ultrasound

9:38

of plantar fasciitis at the same meeting. So

9:41

the here is our here is our

9:44

Facts of the conflict what happened?

9:48

So as we get into this, we're going to

9:51

talk about five sort of pet peeves of your presenter

9:54

Dr. Youthsom here.

9:56

And they are in 10 verses impact blame versus

9:59

contribution personal visitor situational good

10:02

versus better decisions and right versus

10:05

married. So let's start with intent versus

10:08

impact. What happens is that you know

10:12

Lee has a

10:15

I'm gonna go back Pat. Okay Pat asked for

10:18

the time off. The request was denied what happens

10:21

generally is that the request was denied

10:24

is in the public sphere. But what is in the private sphere

10:27

that we cannot see is the intent of

10:30

Lee in

10:33

refusing to allow Pat to go to the meeting.

10:37

What we also cannot see is the impact of

10:40

that decision.

10:41

on Pat

10:43

when Pat finds out that the

10:46

request has been denied.

10:49

So unfortunately in this private realm we

10:52

tend to make this make assumptions.

10:56

So from least standpoint the decision

10:59

to

11:00

deny, the request was because

11:04

Pat had has an R1

11:07

do that same week.

11:09

and

11:10

Pat want to redirect the priorities of

11:13

Lee from presenting at

11:16

a meeting to the very important thing

11:19

for their Pat's career, which is to get an R1 Grant.

11:24

So this is not seen in the interaction. This is in the

11:27

private realm on the other hand. We have

11:30

Pat's reaction that by

11:35

Refusing to allow me to go to the meeting.

11:38

This person is sabotaging my career and

11:41

trying to hold me back and hold me down and

11:44

therefore this leads to Pat's anger.

11:47

So unfortunately these things are not.

11:50

told to each other all we have in

11:53

the public spheres that the request was denied and part of

11:57

the event discussion is

12:01

pulling these facts out what actually was

12:04

happening once these facts are

12:07

Aligned and are in the open and the

12:10

public sphere then it will lead to some resolution

12:13

of that conflict. Oh, lee was

12:16

actually looking out for my career by worrying about my

12:19

ro1 submission and was trying

12:22

to be helpful in prioritization as opposed to

12:26

being that b and and screwing up my career.

12:31

The second piece second pet peeve. This is pet peeve

12:34

number two from the use of world is blame versus

12:37

contribution. It's amazing how just using

12:40

different terms can lead to a different atmosphere

12:43

of

12:45

The conflict so if we say okay Pat,

12:48

what was your contribution to the

12:51

conflict versus?

12:54

It's your fault Pat.

12:57

So by asking the person how they contributed to

13:00

the

13:01

difficult

13:03

position in in the conversation you can change

13:06

it from a blame.

13:09

To a positive thing which is contribution. So in any

13:12

difficult conversation, there are components that each person brings to conflict so

13:15

you can say here was my piece in

13:18

the misunderstanding here and our difficult

13:21

conversation. I could have let you know that my intention was

13:24

just to fly in and fly out in one day

13:27

so that way I could get right

13:30

back into my or one submission and it

13:33

really wouldn't take any time off from what I from the

13:36

time I was spending

13:39

putting together the grant

13:41

Lee could have said I should have told you that my concern was about

13:44

your R1 submission that week. So my contribution

13:47

from standpoint of Lee is I didn't tell

13:50

you about why I was doing this and I didn't give you my reasons. That

13:53

was my contribution to the

13:55

To the difficult conversation and

13:58

Pat could have said well I should have

14:01

told you that my intention was not to decrease my

14:04

prioritization on the Orem but I'm just going to go, you know one day

14:07

back and forth.

14:09

So you asked the question, what could I have done differently? What

14:12

was my contribution here in this conflict? What

14:15

could I have done differently and and own your piece

14:18

of it and contribute and and offer that

14:21

to the other person, you know.

14:23

That this was you know, I might have handled this

14:26

a little bit differently if I was aware of

14:29

what was going on.

14:31

The third pet peeve is making

14:34

it personal versus situational, you

14:37

know, too often. We immediately go

14:40

and attack the person themselves as soon

14:43

as you start talking attacking the person themselves, you know,

14:46

all that identity stuff starts happening and my competent, you

14:49

know, am I a good person am I worthy of love? So

14:52

if you say you are a nasty piece

14:55

of you know, whatever that is

14:59

a lot different than talking about the situation so address

15:02

the event without judgment do

15:05

not impune the other person's character. So

15:08

Pat could have said, you know your current response

15:11

in the email made me feel unheard and

15:14

unappreciated when I ask for the time off.

15:18

as opposed to

15:20

Lee you're a cold be yeah you and

15:23

Lee could have

15:26

said I think that priorities prioritizing your Grant over

15:29

a paper presentation was essential rather

15:32

than saying something like you have poor judgment

15:35

again, it's a personal attack with

15:38

you have poor judgment or you're a cold be as opposed

15:41

to the situation.

15:45

Your response in the email made me feel

15:48

unheard or prioritizing the grant was

15:51

essential.

15:53

And we always talk about using the I statement. So this

15:56

made me feel unheard. It's it's what

15:59

I felt and that's what's important.

16:02

So don't go personal.

16:04

Keep it to that specific act that

16:07

the individual did and you may be critical of

16:10

the ACT. But as soon as you start being hypercritical of

16:13

a person you're going to make that situation much

16:16

worse.

16:19

The fourth of my pet peeves is

16:22

this sometimes you're in a situation. We have

16:25

two options a good decision and maybe

16:28

a better decision but they're both good you

16:31

and I and talking would say yeah, you

16:34

know going out to the society meeting and presenting your

16:37

work is a very good thing that's great for your career.

16:40

It happens that.

16:42

Submitting your Grant on time and getting

16:45

funded for an R1 is a better thing for your

16:48

career. They're both good. It's not like one's a

16:51

bad decision and one's a good decision. They're both on

16:54

a grade of good to better.

16:56

So a lot of times we lose sleep over. What

16:59

should I do? Should I should I go and visit my mother in

17:02

Florida or should I work

17:05

on my book The you know,

17:08

both are great decisions. They're both up great options and

17:11

recognize that you're not making a

17:14

bad decision. You're just choosing among good decisions.

17:17

So don't beat yourself up about this. I agree

17:20

that presenting the work of this Society meaning is worthwhile getting

17:23

funded through the NIH isn't even more valuable.

17:27

to your career

17:29

So it's good and better.

17:33

pet peeve number five

17:35

demanding that you are right versus

17:39

Married, so this this relates to

17:42

the relationship, you don't want to

17:45

destroy the relationship in your effort to be

17:48

right all the time. That's kind of damaging to

17:52

a long-term relation. Sometimes being right winning

17:55

the argument or not as important as preserving the

17:58

relationship. I'll give you a different example. There is

18:01

an individual at Johns Hopkins one of

18:04

the neurosurgeons who insists that Moyamoya syndrome

18:07

should not be used in the same.

18:10

Categorization as Moyamoya disease in

18:13

that it has to be a bilateral process and sometimes you

18:16

know, we disagree about the Imaging

18:19

findings and getting a fight with this neurosurgeon. It

18:22

doesn't pay, you know, because we want him to

18:25

continue to send us angiogram CTA MRA

18:28

conventional arteriograms, and we're just going to destroy the relationship. So

18:31

it's not worth even bringing it up just use

18:34

the term that he likes in conference rather

18:37

than

18:39

repeatedly picking at that scab about this

18:42

particular pet peeve of the neurosurgeon.

18:45

So if you you know sometimes you

18:48

know, the relationship is is worth preserving

18:51

and and so Pat might say if you think that you can prepare

18:54

for the grant while taking the two days off that we

18:57

could stew then I approve so.

18:59

instead of

19:01

basing this on whether it's right

19:04

or wrong base it on the importance and the

19:07

value of maintaining the relationship between the mentee

19:10

and the mentor or it's sometimes

19:13

you know, if your spouse or your boyfriend

19:16

girlfriend, whatever it may be your significant

19:19

other is a particularly, you

19:22

know has a particular pet peeve about not eating Italian

19:25

food. You know, why bring

19:28

up let's go out for you know

19:31

pasta tonight.

19:33

so that's my sort of summary of the

19:36

difficult conversations by Douglas Stone the next

19:39

Reference that I would like to point to you is a book

19:42

by a Carrie Patterson called crucial conversations and

19:45

he defines a crucial conversation as

19:48

one where the stakes are very high.

19:51

Opinions are going to vary and emotions run high. So this

19:54

emotion thing is again a common

19:57

theme with difficult conversation the second layer of

20:00

the conversation.

20:02

He says that the choices when you're dealing with a

20:05

crucial conversation our threefold you can avoid them.

20:09

You can face them and handle them poorly or you

20:12

can face them and handle them. Well, and obviously he's

20:15

making the case that by reading the book you're going to

20:18

be able to handle them. Well, so

20:20

let's do a pulling of the audience.

20:23

In these crucial difficult conversations highly

20:26

emotional. What do you generally do?

20:29

Do you generally number one avoid them?

20:32

Do you handle them but kind of poorly?

20:35

Do you handle them? Well?

20:38

Or it depends on the day. I'm having.

20:42

So tell me your your personal assessment.

20:45

Do you run away from these conversations and

20:48

say, you know this I don't want to get involved. Let me

20:51

out of here. Do you handle them poorly? Do you

20:54

handle them well, and you know pretty successful but dealing

20:57

with conflict and crucial conversations or

21:00

you know, it depends on how well mine

21:03

how I woke up in the morning. So let's see the results

21:06

of the poll. So about 55% says

21:09

it depends on the day. I'm having 23% say

21:12

I avoid them very good. So I

21:15

this gets to the background emotional state,

21:18

you know, if you woke up in the

21:21

morning had a fight with your dog and your cat

21:24

and your parakeet and get into work

21:27

already riled up. It may be that it depends

21:30

on the day you're having how well you're going to be able to tolerate a

21:33

crucial conversation with a colleague at work. So

21:36

there is that, you know that piece and

21:39

that piece remember is invisible to

21:42

Other person it's not in the public sphere.

21:45

It's in the private sphere. So how you're coming

21:48

into the crucial conversation is something that

21:51

needs either to be brought into the public or you

21:54

have to explain that this is you know

21:57

where I'm coming from.

21:59

So these are the steps that

22:02

carry Patterson and I'll put to having a

22:05

successful crucial conversation. First

22:08

is to create a pool of shared sincere

22:11

meaning through dialogue and

22:14

this in part is the facts of the conversation

22:17

and also is about

22:21

sincerity in in having a relationship with

22:24

the person that you're on engaging in the conversation. Make

22:27

sure you know what you want going into

22:30

it. So this requires some thought about what are

22:33

my goals in going into this conversation? And then

22:36

we have this thing that we we refer

22:39

to in business school, which is the bat

22:42

and a

22:45

b a TNA stands for best alternative to

22:48

a negotiated agreement. If this conversation goes poorly,

22:51

what's my alternative? What

22:54

where do I go from there important to

22:57

have that in your mind and to improve it so that way, you

23:00

know, the stakes aren't so high as high for

23:03

you detect silence or violence.

23:06

This is one of the themes of crucial conversations and that is

23:09

that if you're in a conversation the other person

23:12

starts clamming up and all of a sudden is no longer

23:15

engaging with you. That's a bad sign it

23:18

mean it probably means that they're withdrawing because

23:22

They're at threat or they're losing

23:25

their ability to communicate with

23:28

you on a healthy way and that

23:31

may lead to violence and

23:34

by violence. We're not

23:37

necessarily talking about physical violence, but that angry conversation

23:40

the yelling

23:43

the screaming and just losing it is is

23:46

what we're talking about with violence. So it may

23:49

be that silence is a Prelude to violence. But

23:52

either way you're going to look for this in the

23:55

conversation if it starts to happen, you go back off

23:58

and recreate a common space

24:01

with the other person. So you want to maintain Mutual purpose and

24:04

respect at this point if you detect silence or

24:07

violence speak, but also listen remember that

24:10

from Stephen covey's Seven Habits

24:13

of Highly Effective People. One of them is seek first

24:16

to understand then to

24:19

be understood so ask a lot of questions.

24:22

Listen to the responses convert agreements into action

24:25

plans. Once you have an agreement, make sure that you

24:28

that this leads to an action plan to be accountable for

24:31

your part of that action plan. So by Mutual

24:34

purpose, they're saying that we're going we're looking for

24:37

a common outcome that we can agree on is a positive

24:40

thing by having mutual respect. We're going to have dialogue.

24:43

I'm going to listen I'm going to speak I'm

24:46

going listen. I'm going to speak it's not going to just be me

24:49

overpowering you in violence. If you will and the

24:52

at-risk behavior is when the person just

24:55

sort of stops debating surrenders makes accusations gets

24:58

offended or insulted Etc.

25:01

So safety is important part of

25:04

a crucial conversation. You want to make sure that it's not getting to

25:07

the point where the relationship is now at risk if

25:10

that happens. It might be appropriate to

25:13

ask for a timeout and say, you know seems like it's getting a

25:16

little bit heated. I think we both need time to sort

25:19

of think about where we're going with this and what our

25:22

goals are. Maybe we should read, you know

25:25

read.

25:27

Engaged tomorrow right recognize what's going on

25:30

step out of the content temporarily change gears

25:33

Etc.

25:36

And then the other piece is making sure

25:40

that you're asking questions and not

25:43

just making declarative statements. It's important

25:46

to understand the other person's point of view as

25:49

to hear their facts and their story and then listen to

25:52

it. So I I you know, I want to hear what was

25:55

going on from your side when I

25:58

rejected the request for the meeting attendance.

26:03

What was going through your head? What were you thinking

26:06

Etc so being inquisitive?

26:11

so again

26:13

the one of the main themes of crucial conversations is to

26:16

recognize when their other person

26:19

is going into silence or when

26:22

that person is getting so upset that

26:25

there's the risk of violence and intervening at

26:28

that point by either stepping back or

26:31

you know, listening a little bit more carefully putting

26:34

the emphasis back on the other person so that

26:37

way they have the opportunity to give their share of

26:40

the of the

26:42

perspective

26:46

the next thing that I alluded to in the run-up to

26:50

this

26:51

Seminar was the Thomas kilman

26:54

conflict mode inventory. This

26:57

is something that as part of my training as

27:00

a myers-brigg career counselor. And

27:03

then again as a trainer as

27:06

a trainee for mediation in

27:09

the court system, we learned about the Thomas

27:12

kilman conflict mode inventory and how

27:15

to administer and explain it. So unfortunately, it

27:18

is something that is copyrighted and

27:22

the people Ken Thomas and Ralph

27:25

kilman and the Myers Briggs Association own

27:28

the rights to it. So I can't administer the

27:31

test to you without going through their

27:34

system. I did point to the website where

27:37

you can take this inventory this

27:40

this 30 question choice.

27:45

Questionnaire in order to understand where you

27:48

are as far as your preference for

27:51

dealing with conflict and I recommend it there is

27:54

a paper copy version of it that you can get through

27:57

the mbti the Myers-Briggs type inventory site for

28:01

$22.95 or you

28:05

can go online.

28:07

On a site that Ralph kilman owns and

28:11

do the online survey. Unfortunately that is

28:14

more expensive at $45. But if you're

28:17

interested in this topic, you want to have a little bit more emotional

28:20

intelligence so that you're Baseline emotional intelligence

28:23

is a little bit more sophisticated. I would

28:26

recommend that you take the tki the

28:29

Thomas kilman inventory. So these two gentlemen are

28:32

were professors of management at the University

28:35

of Pittsburgh and this dates back to 1974. Okay. So

28:38

here it is created in 1974 this

28:43

Survey that was done and they reported the

28:46

Norms out for the first I think

28:49

was like 30,000 people who answered the

28:52

survey.

28:54

and then

28:56

after 30 years

28:58

did an additional over 30,000 people

29:01

and did a really assessment of what the

29:04

Norms are as far as the different

29:07

types of responses to

29:10

conflict and you'll see these in just a moment.

29:13

The tki has been translated into 30 languages.

29:17

and they've had International samples

29:20

with thousands of individuals from

29:23

different countries and they've done normalization of

29:26

the values for these different countries because

29:29

it is true that how someone in

29:32

southern Africa might be

29:36

Respond to conflict might be different based on cultural norms

29:39

than someone in Northern Asia, for

29:42

example, so there are some differences across cultures.

29:48

So, how do we deal with conflict? What is our

29:51

base? What is our fallback position in how

29:54

we deal with conflict and the way the different

29:57

ways that Thomas and kilman described

30:00

include compromising which

30:03

is basically meeting in the middle.

30:06

Avoiding which is basically saying, you

30:09

know, I really don't want to engage in this. I'm out of here. I'll

30:12

wait until this.

30:15

resolves on its own

30:18

collaborating

30:20

which is when people get together in a

30:23

respectful way and try to synergize and

30:26

make a

30:27

resolution that is even better than

30:30

individual.

30:32

preferences

30:34

and competing

30:37

and with competing we're talking about, you know,

30:40

winning is the ultimate goal.

30:43

the fifth way of

30:46

Addressing or dealing with conflict is accommodating which

30:49

is kind of like a lose win

30:52

situation where you give in?

30:56

Because you don't want to deal with conflict and

30:59

you just want to please the other

31:02

person and you end up taking heat for

31:05

that the problem with accommodating. By the

31:08

way is that after you accommodate an

31:11

accommodate and accommodate and give it and giving and given ultimately there

31:14

is a level in which you start to

31:17

get a little bit frustrated and unhappy with

31:23

Giving in all the time. So if you're

31:26

you know a spouse and sisal no

31:29

Italian food and you've gone out to the

31:32

restaurants for three years and you who have

31:35

this passion for spaghetti and meatballs. Haven't

31:38

had spaghetti meatballs out at the little literally

31:41

restaurant for three years that 50th

31:44

time that you asked. Hey, you know, how

31:47

about going out for Italian food on Friday night

31:50

the 50th time you asked you get a little resentful that

31:53

you've

31:54

You've gone to Chinese food. You've gone to Afghan food.

31:57

You've gone to French food. You've gone to Mexican

32:00

food. You've gone to Thai restaurant. It's three

32:03

years now and I've given in each

32:06

time and not going to an Italian restaurant in Little

32:09

Italy Baltimore. Yeah, it builds

32:12

up. So that's a problem with accommodation. I mean you think that

32:15

accommodation is good for relationships, but people get resentful

32:18

when they're accommodating all the time.

32:21

So let's talk about the tki the Thomas kilman inventory.

32:24

This is these are 34th choice questions are actually

32:27

yes, no questions or preference questions and based

32:30

on the

32:33

answers to the questions it categorizes your

32:36

level of

32:38

dealing with conflict in terms of competing.

32:42

collaborating compromising avoiding

32:47

and accommodating

32:50

and very much like the Myers-Briggs type

32:53

inventory in which we talk about people that are introverts or

32:56

extroverts those who are

33:00

sensing or innovating or thinking

33:03

or feeling or judging or perceiving there is

33:06

not a right or wrong.

33:09

Way of handling conflict in fact

33:12

what?

33:14

The tki really?

33:16

Teaches us probably is that being flexible

33:19

in how you respond in

33:22

different conflicts?

33:25

Is probably the best mode but let's look at what we're

33:28

talking about from the standpoint of the Thomas kilman

33:31

conflict mode inventory. So there

33:34

are two scales that Thomas and

33:37

kilman refer to one is assertiveness.

33:41

And one is cooperativeness.

33:48

Those people that are most assertive.

33:52

Include those that are in the competing and collaborating group.

33:55

They

33:57

If they're not cooperative and they're assertive

34:00

we put them into the competing group. They're not going

34:03

to work with you. They just want to win at

34:06

all costs.

34:08

And they will just stop on the competition, right? So

34:11

they're not very Cooperative those people who are

34:14

assertive and cooperative.

34:17

Tend to be those that fall into the collaborating group

34:20

they speak their mind, but they're

34:23

willing to listen as well and cooperate

34:26

in group and work towards a successful.

34:30

Solution that includes all the different

34:33

parties, so that's collaborating.

34:37

at the midpoint of assertiveness

34:40

And cooperativeness is though are those people that are in

34:43

the compromising group? These are people that are willing

34:46

to sort of split the difference, you know?

34:49

Yeah, I'd like to get more but

34:52

I've gotten something and therefore.

34:56

I'm going to take upon I

34:59

will I will.

35:01

Accept this compromise. So they're in the middle of assertiveness and

35:04

cooperativeness.

35:08

Usually we talk about compromising in terms of the car salesman,

35:11

right? So when you go to the car salesman that you

35:14

know, they give you the price for the car and they say, you know, the car

35:17

costs fifty thousand dollars. And you say

35:20

well, you know, I went to another dealer and I they offered

35:23

it to me for forty thousand and you're sort of thinking in

35:26

terms of well, maybe I can get it for 45,000 in the

35:29

Midway portion and you have this back and

35:32

forth about well, I maybe I can throw in the next year of

35:35

warranty but I still 150,000 and you say

35:38

well, I'm not interested in a warranty because I already have you know

35:41

insurance that covers this Etc and there's this back and

35:44

forth and back and forth you get somewhere in the middle.

35:48

In that category of not assertive

35:51

and also not cooperating resides

35:54

those people who prefer avoiding conflict.

35:57

So they're not

36:00

speaking up. They're not speaking their mind. They're not putting their

36:03

per their perspective and what they would like.

36:06

They're just walking away. So these are not a

36:09

certain people and they're not going to cooperate with everyone else. They're just

36:12

gonna walk away from the conflict. And again, I'm using

36:15

terms that unfortunately tend to have some emotional

36:18

charge them as if it's judgmental, but

36:21

there are situations where you want to avoid the

36:24

conflict and not engage because

36:27

the consequences of engaging

36:32

are horrible I'll give an example you're walking

36:35

down the street of East Baltimore on Wolf

36:38

Street and a

36:41

person comes over to you with a gun and says

36:44

give me your wallet.

36:46

Well, are you going to engage that person

36:49

say well I'll give you half my wallet or let's talk

36:52

about this. You know, why don't we go to the restaurant and I'll

36:55

buy you a dinner because it looks like you're hungry and you know you want

36:58

to avoid conflict. So you simply throw down

37:01

your your wallet and walk away and not engage.

37:04

That's probably a good decision in East

37:07

Baltimore.

37:09

Okay, and then the fifth group

37:12

I kind of explained with regard to

37:15

accommodating that's these are people who are not assertive. They're

37:18

not speaking their own mind they're giving in

37:22

And they're listening to the other person when they

37:25

give in so the other person so that they're engaged with

37:28

the other person. They're just not

37:31

insisting on their own what they really want. You

37:34

know, I really want Italian food

37:37

finally, you know, but I'm not going to

37:41

State my mind as much I'm just going to cooperate with

37:44

the other person say okay fine. Yeah, I like

37:47

Chinese food, too.

37:50

So these are the scales that we have with regard to

37:53

the five types of individuals and when you take

37:56

the tki you get a score for each of these

37:59

different.

38:00

categories

38:05

and again, the the scales are assertiveness the

38:08

extent to which you will satisfy your own concerns, not the

38:11

other persons and cooperativeness the extent to

38:14

which you try to accommodate the other person. So we're

38:17

going to pull the audience some of

38:20

you may have taken the inventory based

38:23

on.

38:25

you know my

38:27

My posts about going to

38:30

the tki site so some of you may know

38:33

already. But what would you say based on your level

38:36

of assertiveness and your level of cooperativeness that

38:39

you would basically be

38:42

most like what will be your dominant way you

38:45

handle conflict. Would it be competing collaborating compromising

38:49

avoiding or accommodating?

38:53

So go ahead and

38:55

I'd like to see from the audience standpoint where most

38:58

of you would expect to.

39:01

Be as far as your dominant style. Would you be competitor

39:04

collaborator compromiser avoider or

39:07

accommodator?

39:10

so, let's see how the audience thinking

39:13

so 42% are

39:16

saying collaboration and

39:20

the next highest I guess is accommodator.

39:23

And 21% said a compromise and then

39:26

we have avoiding and competitor.

39:29

So

39:33

Here, let's pull the audience. Once again. What

39:36

do you think is the dominant style for Radiologists?

39:41

so in the Radiology

39:43

Profession. What do you think is the

39:46

dominant style for radiology, and

39:49

I know this for a fact because I've given

39:52

this test 200 if not thousands of

39:55

Radiologists. So this comes from personal experience.

39:58

Do you think that Radiologists tend to be competitors collaborators

40:01

compromisers avoiders or commentator?

40:04

Let's go ahead. What do you what do you think?

40:09

Let's see the results and

40:12

people put collaborator first

40:15

and combinator second.

40:19

So I would tell you that in my experience in giving

40:22

this test over 80% of Radiologists

40:25

score out predominantly avoiders.

40:31

They avoid conflict.

40:36

and

40:37

I think it's partly because we are in kind of a service

40:40

oriented.

40:42

Profession where we are providing a

40:45

service both to the patient customer as well as our referring

40:48

referral base and we don't want to

40:51

antagonize our referral base.

40:54

So think about this, how often have

40:57

you been looking at a studying on?

41:00

Oh my God, why did they order this? This is totally unnecessary.

41:03

It's redundant.

41:06

A lot of times personally, but how often

41:09

do you then contact?

41:11

The referring Physicians say why did you order this?

41:14

You know, you just ordered a CTA three hours

41:17

ago and now you're ordering an MRI of the exact same body

41:20

part, you know, we tend to Radiologists

41:23

tend to avoid conflict. They don't want to

41:26

bring it up with the referral base because that's

41:29

our bread and butter, right?

41:31

So I would tell you that about 85% of the

41:34

Radiologists when they when you score them

41:37

out. They have a dominant avoiding.

41:41

All right next.

41:43

Surgeons, so I've given this test to

41:46

surgeons plastic surgeons general

41:49

surgeons ENT surgeons, maybe not

41:52

thousands but hundreds of Surgeons. What

41:55

do you think is their dominant style would they

41:58

be competitor collaborator compromiser avoider or

42:01

accommodate a surgeon?

42:04

And we're lumping plastic surgeons

42:07

ENT surgeons and general surgeons together.

42:12

That may or may not be fair.

42:15

All right, so

42:17

competitor 91% you know,

42:20

it's true. It's true. It's not at 90% They're

42:23

usually at 70% competing as

42:26

their dominant way of doing with.

42:29

Conflict and you know you what you

42:32

hear about sometimes the way surgeons act in

42:35

an operating room on for whatever

42:38

it's worth. It does reflect the way they kind

42:41

of think about things. Let's take another profession.

42:45

Pediatricians okay. So pediatricians.

42:48

I've only given it twice to a Pediatric Group.

42:51

So my numbers are in the dozens not hundreds,

42:54

you know thousands of Radiologists hundreds

42:57

of Surgeons dozens of

43:00

Pediatricians. What do you think is the dominant

43:03

style for a pediatrician would

43:06

it be competing collaborating compromising avoiding

43:09

or accommodating?

43:14

pediatricians

43:17

Okay, so we have collaborating compromising

43:20

and accommodating. So in general the

43:23

pediatricians.

43:26

Show up in this Cooperative category.

43:29

They're usually collaborators or

43:32

a combinators. They do listen to

43:35

the other people's point of view and they're

43:38

kind of split in their level of assertiveness.

43:42

But they are good at talking to the

43:45

parents and hearing their perspective about what's going on

43:48

with the child. I think that that may be

43:51

why that they are they tend to be a Cooperative group.

43:54

They want to work together with the with the parents

43:57

and with the environment with the with the school system

44:00

to affect a positive outcome.

44:07

All right, um, how about your administrator the

44:10

administrator? That's supervising you

44:13

I'm not talking about your physician Mentor

44:16

your physician lab Chief. I'm talking about the

44:19

personal on the business side of your practice be it

44:22

in private practice or in Academia the

44:25

you know, not not necessarily the chair but

44:28

the the business administrative person. What do

44:31

you think?

44:33

They turn out to be so this is

44:37

This is a situation where I've only done this once with non-physicians

44:40

in the business administration. So we're talking

44:43

about a group of 12 to 15 administrator.

44:46

So not a big sample size personally.

44:51

Let's see what they say.

44:53

So the you guys are saying competitor at

44:56

43% and compromiser 15

44:59

coverage. My the my experience

45:02

with them has been that they've they've been predominantly compromising. You

45:05

know, they they tend to take the Middle Road. They

45:08

they don't demand as much they're

45:11

willing to find the middle ground.

45:17

Okay, so I just want to you've heard

45:20

me use some terms and I just want to make sure that

45:23

the terms that I'm using.

45:26

reflect the different types of response to

45:31

Conflict. So Middle Ground tend to be a compromisers.

45:35

Stand up for your rights tend to

45:38

be competitors 50/50. Those are

45:41

compromises. They're they're willing to take the midpoint bipartisan.

45:44

That's collaborating and

45:47

you know.

45:49

I'll just open this up maybe to it a chat question. Why

45:52

is it that we

45:55

don't just all be collaborating with

45:58

that's supposed to be the best way right? We're cooperative

46:01

and we're assertive and you know, we're working with

46:04

the other groups.

46:06

Why doesn't why don't we all go to collaborating?

46:12

Anyone want to give a chat response to why don't

46:15

we all just spend all the time in chatting?

46:19

Not Jack Jack and collaborating.

46:23

Um, let's see whether I have an answer from anyone each

46:26

situation requires a different type of decision making not

46:29

have the time very good. That was alarisa poramini.

46:33

Yes, the issue is that

46:36

when you try to get people together to collaborate

46:39

the decision-making takes a lot longer because

46:42

you're having to get all the parties together. You have

46:45

meeting after meeting after meeting. I had a chairperson John Lewin

46:48

who was you know, in my

46:51

opinion one of the best chairpersons, I've worked with he always

46:54

convened the committee got every all

46:57

the people together it

46:59

Months to sometimes come to a decision about something

47:02

and sometimes we missed the opportunity because we

47:05

were too busy in conversation and collaborating committee

47:08

and it was like too much committee. So there

47:12

is a negative about collaborating it

47:15

and you know, sometimes you just want the leader to

47:18

just make a decision.

47:20

Even if it's someone arbitrary, right?

47:24

So that's bipartisan. So

47:27

yeah, you go to Congress and let the Republicans and the

47:30

Democrats try to work it out takes a long time. Sometimes they

47:33

don't even work it out and it falls apart postpone those

47:37

who tend to be people who are avoid right damn the

47:40

torpedoes full steam ahead competitor.

47:44

Self-sacrifice that's the accommodator the

47:47

person who's willing to be in a lose win

47:50

situation. I love I lose the other person

47:53

wins, but you know, that's my style

47:56

is to give in and and be so nice to

47:59

everybody and just, you know, take take one

48:02

for the team, right accommodating.

48:05

Given, so those would be the accommodators

48:08

as well withdraw avoiders.

48:12

other

48:14

terms Alternatives when you're seeking

48:17

Alternatives, you're generally collaborating.

48:21

Split the difference compromisers selfless. Well

48:24

that tends to be the accommodating people but it's

48:27

not necessarily a good thing righteous competitor cautious

48:30

avoider problem solving

48:33

collaborator kill them with kindness accommodator

48:36

two heads are better than one collaborating

48:39

might makes right.

48:43

competing

48:44

So when you look at the scores for people and the

48:47

Norms, you can see that when you

48:50

look at us versus International sample, there

48:53

aren't that many differences between the US

48:56

Norm Sample versus

48:59

the international Norm sample. And what we

49:02

what you see is that with regard to the

49:05

middle range of the scores that

49:09

most the the most common

49:13

Value here is going to be at the

49:16

six to nine compromising and the least common

49:19

is going to be the four to six accommodating and three

49:22

to six competing. So these are the normative

49:25

data and from that you can

49:28

see where you stand as far as Norms. Are

49:31

you in the central 50% It is

49:34

true that there are differences across gender. And

49:37

that is that women tend to

49:41

be less likely to compete. These are

49:44

the percentile medians then men.

49:47

And they're more likely to compromise, but

49:50

if you look at the commentings a lot of times people say,

49:53

oh, you know, the women are going to accommodate and given to the minutes are

49:56

that that's not necessarily true. They're at

49:59

the same percentile avoiders same men and

50:02

women and collaborating same men

50:05

and women. So the differences are the competing in the compromising actually.

50:10

So, um, we're running out a little bit time. So maybe we could

50:13

do this relatively quickly, which is the ideal best

50:16

conflict mode for something like climate

50:19

change or working on the Paris Accord. What would

50:22

you say would be the best?

50:24

Style for that would it be competing collaborating compromising

50:27

or avoiding or accommodating? The

50:30

next one is?

50:34

a policy of China versus an intellectual

50:37

property

50:39

what would be the best what would you think would be the best conflict mode for

50:42

doing with China and their

50:45

stealing of intellectual property from American

50:48

businesses

50:50

the filibuster rule in Senate, which says that

50:53

You need 60 votes in

50:56

order to break a filibuster a

50:59

a stalling tactic in the Senate.

51:02

What do you think is the best conflict mode for that?

51:05

military support for Ukraine

51:09

What would be the best situation for

51:12

how much Military Support should we

51:15

give to Ukraine and the voting right

51:18

right sax, which allows improved

51:21

access to the voting

51:24

system in America, generally.

51:28

in support of

51:31

underrepresented minorities and lower-income individuals as well

51:34

as

51:37

you know people who

51:39

have delays and getting their vote in because of

51:42

their overseas or in the military Etc.

51:45

So what which is the ideal conflict mode? So we'll let

51:51

will just make a couple comments here

51:54

climate change when it's an international Court in my

51:57

opinion. This is something that requires collaboration. You're

52:00

never you can't just push it through the Biden policy

52:03

about China intellectual property. Well, if you are in that

52:06

business in high tech, you're pretty strong

52:09

you're having don't hold back, you know, no holds bar.

52:12

We need to you know demand and

52:16

and punish China if they're stealing our

52:19

intellectual property. That's a competitive piece the filibuster ruin

52:22

Senate.

52:24

That might be something you just kind of avoid because without

52:27

the votes of 60 in one party. It

52:30

ain't going anywhere. So to bring it up again and again

52:33

and again.

52:34

To change the filibuster rule

52:37

when you don't have the 60 votes. It's not worth

52:40

it. You might as well just avoid that military support for

52:43

Ukraine. Currently. We're having a little bit of a debate that potentially

52:46

with the new Congress. They may decide not

52:49

to support the Ukrainian work

52:52

with Russia as much this is

52:55

something that probably getting to a compromise where

52:58

there is a middle ground where both the Republican

53:01

side the Democratic side the Hawkeye side. The pacifist side

53:04

can find a middle ground where they're supporting Ukraine. Sometimes

53:07

that comes out in

53:11

In humanitarian support as opposed to

53:14

military weaponry for example, and then the

53:17

John Lewis Voting Rights Act. Again. This is a something that

53:21

You know probably is going to require a collaboration.

53:26

So I want to end in the last couple minutes paying

53:29

respect to a former professor

53:32

at Johns Hopkins who

53:35

recently passed away in December of 2018. But

53:38

I attended some of his some of

53:42

his seminars he wrote a

53:45

book called choosing civility or the civility solution and

53:48

these talks about how

53:51

we interact with each other when we're in conflict and

53:54

I just want to point out he made he gave

53:57

10 rules for a civil interaction one

54:00

is to pay attention to the other person to

54:03

acknowledge that person and their perspective to

54:06

think the best of people assume the

54:09

positive don't think the worst of them even if they're not

54:12

of the same political persuasion or

54:15

religion or you know view on

54:18

abortion, whatever it may be but assume that

54:21

that people have positive intentions

54:24

Listen without interrupting and I thank you for doing that today be

54:27

inclusive and welcoming other

54:30

people and and this you know how many universities

54:33

and businesses talk about diversity and

54:37

inclusion and having a

54:40

wide swath of

54:43

the population is part of their business, but then don't

54:46

have actual policies.

54:48

that encourage that and I'm I'm thinking in

54:51

terms of Visa policies for example for international

54:54

individuals and how

54:59

Or at the border, for example, so being inclusive welcoming

55:02

other other people. I think that

55:05

is giving lip service is one thing having actual

55:08

policies is another thing. So those are the

55:11

first five rules the sixth rule is to speak kindly and

55:14

he gives examples of you know, how to talk in Conflict

55:17

where it's not

55:19

in your face and aggressive don't speak ill

55:22

of others that's very important that you're not a gossiper and

55:25

you know talking about people behind their back except and

55:28

give praise.

55:30

Respect the no and this is

55:33

very important.

55:36

In saying no and respecting the other person's

55:39

a view and not pushing

55:42

it and again respecting others opinions.

55:45

And this is a book that should be

55:48

required reading for all Humanity choosing civility.

55:52

So with that I will open up for the question and answer

55:55

session. I've given you pieces from difficult conversations by

55:58

Douglas Stone the Harvard negotiation project. I give

56:01

you my five pet peeves and how to

56:04

address them crucial conversations from Carrie

56:07

Patterson and the silence versus

56:10

violence and looking for that and how to reopen the conversation. Sometimes

56:13

just take a break from it.

56:15

I explained the Thomas kilman model and

56:18

perhaps you will take that and understand yourself have that

56:21

emotional intelligence about what your Baseline is for how

56:24

you respond to conflict? And then Pierce forney's

56:27

ten rules about remaining civil

56:30

in managing and median conflict and

56:33

hopefully this will help you over the holiday weekend when you're in

56:36

a situation where it might be a difficult conversation or

56:39

crucial conversation with the family member or friend or

56:42

a colleague at work and make it

56:45

a better New Year. And with that I will

56:48

go to the chat and or

56:51

the cumber the question and answer

56:54

and see whether there's looking at the chat to see whether there's

56:57

any questions when young people right they

57:00

don't get appreciated enough on that that may be true.

57:03

We may discount one

57:06

of our biases are unintentional biases

57:10

maybe that we don't respect the

57:13

youth and their opinions as much.

57:15

As we would once they read a reach adulthood

57:18

as if at age 18, you know suddenly they have all

57:21

the emotional intelligence to make good decisions.

57:26

Let me go to the Q&A here. How do

57:29

you resolve when your boss is forcing you

57:32

to take new Privileges and basic Interventional procedures as

57:35

in thyroid finding aspiration parasitesis starting to

57:38

and you are refusing since you have not done those procedures in

57:41

20 years. I say I am not confident in

57:44

those procedures and said well you're going to lose your position there.

57:47

So this this is one

57:50

of these situations where you have to ask yourself if this

57:54

a fundamental issue in my

57:57

life that I'm going to stand

58:00

up for it. If that is the case. Then you are you

58:03

would go into competitive mode just like intellectual property might

58:06

be for businesses.

58:08

If this is not that critical and issue for yourself,

58:11

you may seek a solution

58:14

that may be on the compromise saying to

58:17

the chair, you know, I don't feel like I

58:20

am competent to do this currently. Will

58:23

you support me going to get additional

58:26

training at and why you

58:29

at University of Florida gains, but wherever maybe so

58:32

that that way I can feel comfortable

58:35

doing the procedures and not potentially.

58:41

Jeopardizing a patient safety, for

58:44

example, so you may want to negotiate on

58:47

those situations or if

58:50

you don't have another option for

58:53

a job and this is the only job you have because they're holding

58:56

something over top of you

58:59

or your financial situation is you may have to go into

59:02

a combination mode and say okay I'm going

59:05

to do it.

59:06

I'll do the best I can and you

59:09

know at that point you may end up talking to a colleague about.

59:13

You know proctoring you on those procedures until

59:16

you were comfortable but going into a combination

59:19

mode. So that depends on your quote unquote batna your

59:22

best alternative to a negotiated agreement.

59:26

I had to compromise and ask for training but I

59:29

still felt bullied. Well, when you look at that

59:32

feeling bullied you may with emotional

59:35

intelligence say, you know this person

59:38

on the tki is kind of a competitive.

59:41

That's the way they deal with conflict and I

59:44

have to recognize that some people

59:47

are going just beat you down and demand be demanding

59:50

and having recognized that maybe

59:53

you can accept it better or you can look at strategies for

59:56

how to deal with the competitor and that's part of the tki that

59:59

Thomas killing evaluation process. So it

60:02

may help you to understand. This is just the way

60:05

they handle conflict. They're going to be strong and

60:08

not cooperative.

60:10

How does one who is more collaborative in nature when it comes to handling issues,

60:13

but who is new in the group rally for and

60:16

represent the other more experienced odor avoiding

60:19

types in the group to make meaningful change for them. So, you know,

60:22

it is true that Radiologists in

60:25

general tend to be introverts and they tend to be avoiders. And

60:28

sometimes it's that back door

60:31

coffee machine talk among

60:34

people that you can rally the

60:37

people and get enough people together to sign

60:40

a joint statement or is

60:43

an email together because they're not willing to speak

60:46

out because they're introverts or they need extra time

60:49

or they tend to be avoiders. But you know that they

60:52

are feeling the same way. So sometimes what you have to

60:55

do is sort of do the back door negotiation with

60:58

people one-on-one in

61:01

order to develop a

61:04

Collaborative resolution to this to the problem.

61:07

How do you how do you deal with a toxic work environment? So

61:10

it depends what toxic means if it is

61:13

a violent work environment a disrespectful work

61:16

environment. I'm working on my Batman. I'm looking

61:19

at what are my best Alternatives in

61:22

those negotiated agreement if this is inherent

61:25

to the environment and it hasn't changed in

61:28

years Etc. It's just the way it is that this

61:31

institution or this private practice or this VA whatever

61:35

it may be your setting I want to

61:38

look at what my alternatives are. This is a great time to

61:41

look for Alternatives because we have a shortage in

61:44

Radiologists and physicians in general. So you might want to

61:47

look at that if that's the case if it if it

61:50

is remediable able to

61:53

be improved then you might want to look at what is the source of

61:56

the toxicity. Is it a single individual at the

61:59

top is it a pervasive culture is it

62:02

and

62:04

Australia and and again this this requires some of

62:07

that negotiation and Rowing the people and having not

62:10

just a single voice but a lot of people who work

62:13

together and come to the person

62:16

in charge and say, you know, we're in

62:19

a situation where this business administrator is making very difficult for

62:22

us to you know, receive reimbursement for any

62:25

of our expenses and we as

62:28

a group want to talk with you about what changes could be me.

62:31

how to deal with a manipulative and over smart colleague

62:34

who does not work

62:37

again, there's strength in numbers.

62:40

So I would try to get a group together that could

62:43

address this but you you

62:46

gonna look at you know,

62:49

which which of these Styles should I go with here? You know

62:52

are we just going to accommodate to this person allow them to continue

62:55

on and one anointing and do the lose win situation.

62:58

Are we going to talk to the person individually and

63:01

say, you know what, we need

63:04

to talk about this and and work to a solution.

63:07

That's a 50/50 split the difference, you know.

63:10

You know will will accommodate you and allow

63:13

you to have more time on the schedule and MRI rather than

63:16

CT, but in return we expect you

63:19

to be respectful of the other people who are having to do more procedures and

63:22

and you know

63:25

CT rotations and they may get a different

63:28

bonus for example, so you're working towards that I want

63:31

to do a clinical exercise for a month. I believe that my

63:34

boss felt shame since I did it outside of his Department.

63:37

He purposely gave me hard time to take time off. What should

63:40

I do?

63:42

So I don't know whether your facility has something called a sabbatical

63:45

program where you actually have time to improve your

63:48

skill set. I would think about this very hard and

63:51

what you're trying to do is create a win-win situation. If I

63:54

go outside the institution for

63:57

additional training, I will come back

64:00

with a new capability that the

64:03

department needs and wants

64:05

if I go outside the institution for this time, I will

64:08

defer on my compensation and

64:11

do this on my own expense if you know, so you're

64:14

trying to find, you know, make it a win

64:17

for the other person. Also, you know,

64:20

if I if I do this, you know, I'm going

64:23

to be able to now do ultrasound guided ablation of

64:26

these you fallopian tube. We don't have that

64:29

capability. Currently. I will bring back something really

64:32

good for the Department that we can grow boss stays

64:35

home. When snow and I see days I think that stocks

64:38

that we all drove into work.

64:41

On this one. I would probably be an avoider is this

64:44

a you know, first off how often does it happen in

64:47

a year that the bus does not

64:50

come in because of the snow is this really a

64:53

an important issue that you want to

64:56

bring up, you know and potentially injure

64:59

the relationship. So I'm either going to

65:02

avoid and not bring this up for or company. Um

65:05

camera. I know I'm over time should I keep going or

65:08

Right there with yeah, that's completely up to

65:11

you. If you'd like to you can finish off the questions we have on the docket right now and

65:14

then we'll be good. Okay, the competitor does not

65:17

feel the need to read and listen about managing complex.

65:20

Always the same type collaborators try to learn

65:23

and develop strategies and the Gap does not seem to feel well. Unfortunately,

65:26

that is true. Yes. I'm in there are

65:30

times when the competitors are just going to stick their

65:33

heels in and be demanding

65:36

what I find is over the

65:39

course of time the people who are constantly competitive

65:42

and and don't care as much about relationships, right

65:45

because they're not collaborative. They're not dealing with

65:48

relation. They tend to not be successful

65:51

over the course of time. It may take a

65:54

long time and other people make excuse me may suffer

65:57

along the way.

65:58

but if I could give an

66:01

example and

66:03

Excuse my political persuasion being coming

66:06

out but for example Donald Trump.

66:08

He Revels in Conflict. He actually

66:11

seems to enjoy it. He likes having that

66:14

level of you know energy and Buzz

66:17

around him over the course of

66:20

time. I'm not sure what actually make him more

66:23

happy to always be competing and trying

66:26

to win it all costs as opposed to

66:29

you know changing his tune on

66:32

certain topics, so

66:38

The collaborators try to learn and develop strategies, that's

66:41

true and they become more emotional intelligent and over the

66:44

course of time when they choose which

66:47

conflicts to collaborate in

66:50

if they're good at collaborating then they

66:53

tend to be more successful and also happier. I don't

66:56

believe that Donald Trump is a happy necessarily a

66:59

happy person always feeling like yes to

67:02

win and beat the other person that that's there's a

67:05

burden to being a constant competitor in my

67:08

opinion. Hope my bosses is reasonable gets

67:11

to raise Dr. You some I am not perfect. I have

67:14

lots of conflicts that I get into

67:17

with colleagues with family members with

67:20

my mentees. Um, I try

67:23

to be emotionally intelligent and sympathetic.

67:26

But I make mistakes all the time in the piece is

67:29

that blame versus contribution? It's not

67:32

that it's my fault. It's that I contributed

67:35

to the misunderstanding and the

67:38

conflict in this way. I see my peace. I was

67:41

in a bad mood. I was stubborn about it, and I

67:44

didn't give you

67:45

A fair chance to State your case, and that

67:48

was my piece.

67:50

What was your piece? What was your contribution and we

67:53

say what was your contribution? It's it's better than saying, you know,

67:56

what was your fault or what did you do wrong contributions a

67:59

good word? It's like yeah, I want to contribute. Yeah, I want to

68:02

say this is my contribution here. Here's my piece.

68:06

No, one is perfect and awareness is key to development. I believe

68:09

we're at the end of the questions answered

68:12

and we'll end with shamas comment that

68:15

no one is perfect, and we all have growth potential.

68:18

Thank you very much for participating so

68:21

readily with me and I hope

68:24

that in some ways that there's some few pearls that

68:27

you've got now this talk that will help you manage conflict

68:30

better and be a happier person. Thank you

68:33

very much Dr. You some thank you so much for your life for

68:36

today and thanks to all for your participation and our new conference a

68:39

reminder that you can access the recording of today's conference and

68:42

all of our other previous name conferences by creating a free

68:45

MRI online account. Be sure to join us in the

68:48

new year on Thursday, January 5th at 12:00 p.m. Eastern

68:51

time for a lecture with Dr. Khan on vertebral argumentation

68:54

past present in future. You can

68:57

register for this lecture, and we're online.com and follow

69:00

us on social media for updates and reminders on future and

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conferences. Thanks again and have a great day.

69:07

Bye-bye everybody.