It is at this point that Dr. Gaillour acknowledges the reticence of many physicians to confront other people. He goes on (as someone who coaches physicians) to recommend a set of questions which physicians might engage that further the dialogue and provide constructive confrontation (McKinna and Pugno, 2006, p. 162). He has identified what is often referred to as a confrontation script (Bergquist and Mura, 2011, pp. 227-239):
“Many physician leaders squirm at the thought of ‘confronting’ colleagues about inappropriate behavior. Focus on the behavior, not the person. Be aware of any bias you may harbor because of behavior style differences between you and the other person. Speak frankly, without anger or judgment. Don’t settle for simply ‘d fusing’ such situations – seize them as opportunities to help others achieve their full potential. Here is a seven-step discussion format I often suggest to the clients I coach:
- Describe the observed or reported behavior and the effect it had on others.
- Probe for additional information.
- Probe for acknowledgment of the event and the effect.
- Suggest or request a new behavior.
- Ask for agreement.
- Encourage the person to develop skills to address the behavior in the future.
- Agree on next steps for follow-up.
Authentic leaders are respectful, honest communicators, and help others communicate effectively as well. By communicating and collaborating, leaders help others overcome challenges and achieve results.” Francine R. Gaillour, MD, MBA, FACPE, Internist, Founder and Director of Creative Strategies in Physician Leadership™]
There are many process-based interpersonal and group tools and strategies that help to create and maintain effective team functioning. These include the cluster of communication tools involved in Active Listening (Bolton, 1986; Bergquist and Mura, 2011) and strategies that encourage the generation and integration of diverse perspectives—such as those associated with Bohm dialogue (Bohm, 2004).
In agreement with Dr. Gaillour, I propose that the fundamental feature of any effective team process is centered on the engagement in dialogue. As Ken and Mary Gergen (2004) proclaimed, “truth is only found within community.” More specifically, they would suggest that truth is found in trusting relationships: “constructivism favors a replacement of the individual as the source of meaning with the relationship.” Even more to the point, truth is found in dialogue – and disagreement. There is an insistence that we respect and learn from other people: “one is invited into a posture of curiosity and respect for others.” Of greatest importance is the respect we show for the distinctive expertise which people from all backgrounds bring to the dynamic construction of a desirable future. According to Ken and Mary Gergen (2004), a constructivist framework:
“is . . . likely to favor forms of dialogue out of which new realities and values might emerge. The challenge is not to locate “the one best way.” But to create the kinds of relationships in which we can collaboratively build our future.”
