Prepare For and Address Difficult Conversations

Kathleen Ruby, PhD Washington State University

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Prepare For and Address Difficult Conversations

No matter how well we hire, train, manage, or lead in our veterinary practice, issues that require difficult conversations must often be addressed. Do these situations sound familiar?

  • A colleague’s work is suffering, and you suspect it is the result of problems at home.
  • A star technician’s negative attitude toward a new associate has the whole team on edge.
  • A client has called to report poor communication and what she considers substandard care.

Related Article: 6 Steps to Successful Negotiation

Challenging conversations have 3 elements: stakes are high, opinions vary, and emotions run strong.1 Most of us fear initiating these conversations, but when challenges occur, it is time to talk.

Step outside of your perspective and view the situation objectively.

First, prepare! You are about to embark on an exchange involving strong emotions. Preparation is essential to give you and your colleague a fighting chance to have a productive discussion rather than a battle. If you don’t prepare, unaddressed feelings may leak, blow up, or cause the conversation to shut down.2

Related Article: New Boss? Negotiating Mutual Agreements

Dr. William Ury, who has written several books on conflict resolution, suggests taking time to “go to the balcony” before every difficult conversation.3 Sit quietly, check your emotional state, and look at the issue at hand as though you were an outside party. Step outside of your perspective and view the situation objectively. Consider the facts, not assumptions, fears, or judgments.

Listen and seek to understand, not judge

Now you should be ready to initiate the conversation. Invite your colleague to talk at a time convenient to you both. To begin, provide an objective overview of the situation and ask your teammate to share his or her story:

“You have had several late starts and 3 absences over the past 2 weeks, which has caused some staffing difficulties. Can you tell me why this is happening?” 

These communication tools will help you stay focused during this exploration phase2:

  • Ask open-ended questions
  • Acknowledge feelings
  • Summarize and paraphrase as the story unfolds
  • Monitor your body language
  • Manage your emotions

Related Article: Dealing with Another Doctor’s Mistake: What to Say

When your colleague finishes her explanation, summarize what you have heard and check for clarification. Next, relay your story using facts, data, and possibilities rather than assumptions. For example:

“I’m talking to you because I am concerned both about you and the practice. In addition to the issues mentioned earlier, I have seen you talking on your cell phone between clients and you appeared agitated and upset afterward. I am concerned that our clients can see this frustration. I am wondering if something is interfering with your job?

Giving her the opportunity to clarify her situation changes “what is wrong with you?” to “what is happening?”2

Managing emotions in a difficult conversation takes preparation and skill.

Mutual understanding is the goal

You cannot move a conversation in a problem-solving direction until the other person feels understood.

The next phase is problem-solving. Discuss your ideal outcome, invite your team member to do the same, create steps that meet both your concerns, and commit to action.4 Make sure to set a time to review if the proposed solution is working. Always thank your teammate for her commitment to solving the problem.

Having a difficult conversation takes courage. Managing emotions in a difficult conversation takes preparation and skill. Don’t forget to congratulate yourself for stepping up to this challenge!

12 Steps to Success


1.Crucial Conversations: Tools for Talking When Stakes Are High, 2nd ed. Patterson K, Grenny J, McMillan R, et al—New York: McGraw-Hill, 2012.  
2. Difficult Conversations: How to Discuss What Matters Most, 2nd ed. Stone D, Patton B, Heen S, et al—New York: Penguin Books, 2010.
3. Getting to Yes: Negotiating Agreement Without Giving In, 3rd ed. Fisher R, Ury W, Patton B—New York: Penguin Books, 2011.
4. Fierce Conversations: Achieving Success at Work and in Life, One Conversation at a Time. Scott S—California: Berkley Trade, 2004.
5. Handling difficult conversations. Stone D; Management Consulting News;; accessed July 2013.

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