Effective communication can have a significant effect on client satisfaction.

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1 ESSENTIALS OF COMMUNICATION: COMMUNICATION STYLES, NEGOTIATION, & DIFFICULT CONVERSATIONS Amy L Grice VMD, MBA Amy Grice VMD MBA LLC Virginia City, MT, USA Objectives of the Presentation: Exploration of these topics will provide a hands-on, accessible understanding of the fundamentals of communicating under stressful circumstances. Beginning with a determination of the participants communication styles, this presentation continues with a comprehensive look at successful negotiations, and finishes with a look at how to manage difficult conversations. You will gain a new comfort level with these difficult skills. The Importance of Effective Communication Equine practitioners often have a more complicated web of communication than veterinarians working in other fields. There are multiple players that may need to be communicated with individually, and many different channels by which to reach them. In addition, there is a wide variation in the amount, type and nature of the information desired by these parties. It is not always clear who the decision-maker will be, or which party is financially responsible. Documentation of communication in the medical record therefore becomes critical. At a minimum, communication about a patient with a stakeholder sets expectations, involves a two-way flow of information, and provides a clear explanation of examination findings, recommendations and next steps. In emergency situations, excellent communication is essential. Emotions are high because emergencies are unexpected, throwing people off balance. They may be distressed about their horse s pain or suffering, and have no idea of what to expect. Will their horse die? Will the horse be permanently disabled? What will it cost? The attending veterinarian must remain calm, take charge of the scene, and focus on the patient s needs while keeping the people at the scene safe. This requires the ability to exhibit leadership and communicate effectively. Clients often have no way to assess the clinical and technical skills of their horses doctor, and consequently often judge their veterinarian s competency by his/her effectiveness at communicating. Communication skills are a component of emotional intelligence. Emotional intelligence can be improved through training and develops over a lifetime. Role playing is an excellent method of improving communication skills. The key elements of effective communication include nonverbal communication, open-ended inquiry, reflective listening, and empathy. Effective communication can have a significant effect on client satisfaction. Communication Styles Communication styles include avoidance, compromise, accommodation, competitive, and collaborative. By determining your preference for a certain style, you can gain greater awareness of the effect it has on your conversations.

2 Those with a strong preference for avoidance dislike confrontation and disagreement. They are often quite diplomatic, which can be very helpful in heated discussions or in negotiations. However, their needs may not be met. People with a low preference for avoidance have a high tolerance for assertive or even aggressive conversation, but are often seen as lacking tact or being overly confrontational. A compromising preference makes people eager to find an agreement that will close the discussion or negotiation quickly, so they often grasp the first fair solution that presents itself. Seen as friendly and reasonable, they are vulnerable to making choices without adequate factfinding. In contrast, people with low compromising preference often have strong principles and passion and are subject to standing on principle when common sense dictates otherwise. Because of this, they can be seen as stubborn and irritating. Those with a high accommodation preference generally have strong skills in relationship building and enjoy helping solve others problems. While they can excel in resolving conflict and in negotiations, they can be vulnerable to competitive counterparts because they sometimes place more value on relationships than warranted by the situation. In contrast, those with low accommodation preference often focus on being right and can have difficulty seeing other perspectives. They may be seen as stubborn, unreasonable, and/or uncaring about others feelings. When people have a high competitive preference, they like to win, and enjoy discussions and negotiating as a contest. Unfortunately, they often have a style that is dominating and can damage relationships. In negotiation, they are highly skilled, but often focus only on the tangible aspects of bargaining, leaving out intangibles like a future relationship with their counterpart. Those with a low Competitive preference value fairness and trust strongly. They are generally seen as non-threatening and easily can gain trust. In some situations they will be at a disadvantage because they don t wish to compete. Individuals with a high collaborating preference enjoy solving tough problems through conversation and work hard to find the best solution. Because they have a strong wish to build consensus, they may fail to gain their share of resources in a tough discussion, and are vulnerable to competitive negotiators. Those with a low collaborating preference prefer a more controlled, detail oriented process because they may lose clarity and focus in the seeming chaos of a group setting. Becoming comfortable with recognizing, working with, and practicing other styles is important. Depending on the situation in which you find yourself, your style may help you be more successful, or could be a source of weakness. Self-awareness can help you mitigate the negative effects and capitalize on the positive. Negotiation When most veterinarians think about negotiation, they think of bargaining with a salesman over the price of a new digital radiology unit. In truth, negotiations take place continually in life: between business owners and employees, veterinarians and horse owners, parents and

3 children. Anytime a decision requires input from more than one person, negotiation is involved. Because these types of decisions are very common, developing skill in negotiation is an essential element of effective communication. Negotiation is defined as a process during which two or more parties attempt to resolve their differing interests. There are several characteristics common to all negotiations, whether they are between warring countries or simply between a parent and child. They are: 1. Negotiation occurs between two or more parties. 2. The parties have a conflict of needs, desires, or interests that needs resolution. 3. Parties negotiate by choice, voluntarily, because they feel they can gain a better outcome than by simply accepting what the opposing party is offering. 4. Negotiations require both parties to move from their opening positions in order to reach an agreement. 5. The parties prefer to negotiate rather than: fight; sever a relationship; have one party dominate and the other capitulate; take their dispute to a higher authority for resolution. In addition, when there are no rules or laws to guide resolution, or when parties choose to bypass those rules, negotiations will often occur. 6. Successful negotiation manages tangibles as well as intangibles. Conflict Resolution and Difficult Conversations Conflict resolution is a way for two or more parties to find a peaceful solution to a disagreement among them. The disagreement may be personal, financial, political, or emotional but it arises from two parties having different needs or desires. Many people fear conflict or avoid it at all costs. They may have difficulty recognizing the legitimacy of others needs that conflict with theirs. Being willing to examine the conflict in an environment of compassionate understanding can result in creative problem solving, team building, and improved relationships. When a dispute arises, often the best course of action is negotiation to resolve the disagreement. Conflict arises from differences between two parties. Disagreements can be over values, motivations, perceptions, ideas, desires, and/or behaviors. But a conflict is more than just a disagreement. It is a situation in which one or both parties perceive a threat. Conflicts often trigger strong feelings because a there is a threat to a core need. These core needs are to feel safe and secure, to feel respected and valued, and/or to continue to have a strong relationship. Conflicts continue to fester when ignored. Because conflicts involve perceived threats to our well-being and survival, they stay with us until we face and resolve them. We respond to conflicts based on our perceptions of the situation, not necessarily to an objective review of the facts. Our perceptions are influenced by our life experiences, culture, values, and beliefs. Conflicts trigger strong emotions. If you aren t comfortable with strong emotions or are unable to manage your own emotions in times of stress, you won t be able to resolve conflict successfully. Conflicts are an opportunity for growth. When you re able to resolve conflict in a relationship, it builds trust. You can feel secure knowing your relationship can survive challenges and disagreements.

4 Healthy Responses The capacity to recognize and respond to the things that matter to the other person Calm, non-defensive, and respectful reactions A readiness to forgive and forget, and to move past the conflict without holding resentments or anger The ability to seek compromise and avoid punishing A belief that facing conflict head on is the best thing for both sides Unhealthy Responses An inability to recognize and respond to the things that matter to the other person Explosive, angry, hurtful, and resentful reactions The withdrawal of approval, resulting in rejection, isolation, shaming, and fear of loss of personal or professional relationship An inability to compromise or see the other person s side The fear and avoidance of conflict; the expectation of bad outcomes Successfully resolving conflict depends on your ability to manage your stress, control your emotions and behavior, pay attention to the feelings being expressed by others, and be aware of and respectful of differences. The most important information exchanged during conflicts and arguments is often communicated nonverbally. Nonverbal communication is conveyed by emotionally driven facial expressions, posture, gesture, pace, tone and intensity of voice. Emotional awareness helps you to understand what is really troubling other people, and understand what is really troubling you. It helps you stay motivated until the conflict is resolved, communicate clearly and effectively, and influence others to a maximal extent. If you ignore feelings, and insist on finding solutions that are strictly rational, your ability to face and resolve differences will be impaired. Planning before a difficult conversation can help it to be as successful as possible. By thinking through all the possible responses of the other party, you will be better prepared. So before having a difficult conversation, ask yourself what outcome you really want. Stop assuming the worst and acting in ways that confirm your story. Instead, ask yourself what the other side of the story might be. Ask yourself what role you might have played in the situation. As a part of thinking through your plan for having a difficult conversation, distill all of the behaviors that illustrate the problem into a statement of the real issue, as you see it. Think about the conversation as a negotiation, and what is most important to you. Invite the other party to a private safe space at a particular time, but be prepared to have the conversation immediately. Most people dread difficult conversations and want to get them over with as soon as they are invited. During the difficult conversation, remember that effective negotiation includes aiming for mutual gain, genuinely caring about others outcomes, and valuing a future relationship. You

5 need to focus on what is in common rather than on differences, interests (the why ) rather than positions (the what ), meeting the needs of all parties, open exchange of information between sides, and an enlargement of the pie through innovative ideas. To do this most effectively, start with the facts, and then describe the gap between your desires/expectations and reality as you see it. Share your story and then listen to theirs. Ask clarifying questions, and seek to understand their perception of the situation. Listen with curiosity, an open mind and open heart. Listen and look for what is felt as well as said. Make a fair resolution of the conflict the priority rather than winning or "being right". Focus on the present and avoid bringing up past grudges. When the difficult conversation is drawing to a close, brainstorm options that meet the most important of each of the party s needs. Agree on a plan of resolution and determine if there are missing details or unresolved issues that will need to be addressed. It is important to stay flexible. If other issues come up, consciously decide whether and when to address them. Agree to check back in at a predetermined time to be sure both parties are satisfied with the resulting resolution. Not every conflict needs to grow legs or be resolved. It is important to pick your battles, be willing to forgive others, and know when to let something go. Summary Understanding of the fundamentals of communicating under stressful circumstances allows you to have better outcomes with clients as well as employees. With an awareness of your communication style, you become a more successful negotiator, and can manage conflict with new confidence. Approaching difficult conversations with an open mind, genuine curiosity, and a desire for mutual gain yields better results. Through reflection and planning, resolving conflict can become much easier. References/Suggested Reading Douglas Stone, Bruce Patton & Sheila Heen, Difficult Conversations: How to Discuss What Matters Most, Penguin Books, 2010 G. Richard Shell, Bargaining for Advantage: Negotiation Strategies for Reasonable People, Penguin Books, 2006