At VitalSmarts, we talk a lot about creating a sense of safety in high-pressure, high-stakes conversations.
In fact, after thousands of hours of observation and research, we found that the ability to create safety is THE determining factor of success in crucial conversations. No matter how big or small the issue is, when you make the other person feel safe, you have a 97 percent chance of succeeding in the conversation.
Isn’t that incredible?
It’s a great concept, but beyond all the theory, how do you actually do it?
Safety = Mutual Respect + Mutual Purpose
About 12 years ago I was working with a healthcare company that had 75 small, rural hospitals in the midwestern United States. One day I called the director of Human Resources with whom I’d been working, but his assistant answered.
When I asked to speak with the director, the assistant said, “No.”
So I asked if she could take a message. Again, she said, “No.”
“Help me understand what’s wrong,” I replied.
After a long pause, she told me, “He died.”
I gasped, “Oh no — that’s horrible! I’m so sorry to hear that! When things are worked out, have someone give me a call.”
“Fine, but it could be a while,” she replied.
Surprisingly, the next day, their chief legal counsel — the head attorney for the whole firm — called me.
She informed me, “We won’t be replacing the head of HR for a while — maybe even a year. In the meantime, I’m going to step in and be head of HR.”
This surprised me. Have you ever heard of a head attorney acting as HR Director? I hadn’t!
So I asked, “Why are you doing this?”
She said, “Well, I’ve been trying to handle a problem through HR for a year and haven’t been successful. I sit in court regularly and hear our organisation under attack. I feel extremely nervous because I believe in each of our 75 hospitals, we have at least one physician who needs to retire and hasn’t. So before we bring in a new head of HR, I need to hold some serious conversations, or what you call ‘Crucial Conversations’.”
This was the situation:
- The attorney’s primary concern was the company, its liability, and the patients.
- She’s working toward outcomes that benefit everyone, but the necessary conversations to get there will be high stakes.
- As she works to purge the hospitals of doctors who should no longer practise medicine, she may be accused of firing loved physicians in small towns and denying doctors the privilege to work.
- Lawsuits and bad publicity are seemingly inevitable.
Realising the risks, we talked about how to have these crucial conversations and the two essential tools she’d need to bring: mutual respect and mutual purpose.
Fortunately, she had some personal experience as well.
She told me, “When I was a little girl, my dad was a physician in a small town. He always said he’d retire at age 55. But he didn’t. In fact, he didn’t retire until 70. It wasn’t that he didn’t want to retire earlier — he couldn’t. In small towns, there’s not always someone to take a doctor’s place. And these small town physicians are taking care of people they’ve known for years. We may have more mutual purpose in the room than you may realise.”
As she met with these physicians, she’d first show mutual purpose. She’d tell the physician, “At corporate, we’re putting together a programme. We’ll bring in 3-4 young physicians for you to interview. If you find the right match, we’ll finance this young physician to buy your practice, then you can retire. Want to join us?”
Virtually all of the physicians were in! They found mutual purpose that quickly!
Now, what about the issue of doctors committing malpractise against their patients? Was there anything left to respect?
It turns out there was.
Respect is like a glass half-full or half-empty. We can always find something to disrespect about anyone. Yet if we look carefully, we can also find something to respect.
She had immeasurable respect for what these physicians done for the town and for how they were trying to help their patients now.
To show her respect, she brought a token of the company’s appreciation — a check for $500 written in the physician’s name to the charity of their choice to honour their years of service to the community.
Most physicians immediately pulled out their checkbooks and matched it. Some families raised additional funds (up to $20,000) to donate in honour of these physicians.
Consequently, the physicians retired with the mutual respect of both the company and their communities.
Throughout this whole process, one thing never changed: the content of the conversations was still difficult.
The physicians needed to stop practising quickly. Often there were tears, but there weren’t lawsuits and negative news stories.
These Crucial Conversations were successful because they were built on mutual respect and mutual purpose.
