Conflict Resolution 

 

Inevitably, from time to time, coworkers experience strife  and conflict. Conflict interferes with establishing rapport  and cooperation, which are essential in the workplace. However, at times, conflict can be a positive experience if it  resolves issues of disagreement in an appropriate manner.  The policies and procedures manual is a valuable tool  when beginning to resolve issues. The manual should state  clearly what standards are acceptable in all areas and with all  employees of the facility. 

 

Conflicts happen when miscommunication or misunderstanding of the message occurs. If someone offers a feedback  or criticism, do not argue with the person or become defensive. Simply say, “Thank you for your thoughts,” and continue with what you were doing. 

 

Conflict also can stem from prejudices or preconceived  ideas. Medical assistants should be aware of their own tendencies in this area and be careful not to act on them or let  them affect their relationships with others.

 

 

Problem Solving and Critical Thinking 

 

Regardless of the type of practice, communication is vitally  important to keep conflict to a minimum, establish a positive environment, and provide quality health care. Problem solving and critical thinking are necessary skills for  health care workers. Problem solving is a way of looking at  a problem and ultimately arriving at a decision. Box 5-3  offers helpful steps for problem solving. Most problems  have more than one solution. Weighing all the factors  involved and evaluating the results will help later with  other problems. 

 

Critical thinking (Box 5-4) includes the ability to think  imaginatively, solve problems, visualize situations, learn  new information, and think logically. Both problem solving  and critical-thinking skills are important concepts to employ  before trying to resolve any conflict. Box 5-5 illustrates the  steps in conflict resolution. 

 

Communicating with Superiors 

 

In dealing with your superiors, as with your coworkers, communication should be kept positive. If conflicts do arise and  you need to speak with your superior, choose an appropriate  time or ask for an appointment to discuss the matter. Be direct and to the point, and do not promote any gossip you  may have heard. If you have been given an order to do something and need clarification on how to complete it, ask for  help. Most supervisors would rather be asked a question  than have you perform a function about which you are not  clear. Show initiative in your daily work. If a task needs to be  done, volunteer to do it without being asked, as long as it  falls within your job description. Too often, staff members  are busy keeping score of which employees do more or less  work as compared with others. 

 

Loyalty to Your Employer 

 

You represent your employer or physician every time you  speak to a patient or caller. You must support the physician  and the physician’s reputation in every instance. In your  position, you may become privileged to personal information about your employer. Under no circumstances, whether  inside or outside the office, should you discuss that personal  information. It is perfectly acceptable to state, “I really can’t  answer that,” or “I’m sorry, but I don’t know,” in response to  a patient’s or other staff member’s questions. 

 

A loyal employee protects and defends an employer when  other employees engage in negative conversation. See

 

 

 

***BOX 5-3 | Steps for Problem Solving

• Recognize that a problem exists. Recognition may result from a feeling, observation, or conversation with others.
• Describe the problem, and clarify what the basic issue or question is and the factors that affect it.
• Identify alternative methods of resolving the problem. Any alternative method should be considered, even if is not immediately seen as practical. 
• Consider how the method or solution will affect those involved.
• Choose the best method for resolving the problem, and implement it.
• As the plan is being put into effect, evaluate the results and adjust the method if necessary.

 

**BOX 5-4 | Elements of Critical Thinking

• Ask questions. • Define a problem. • Examine evidence.  • Avoid emotional reasoning.  • Analyze assumptions and bias.  • Avoid oversimplification.  • Consider other interpretations.  • Tolerate ambiguity.  • Think about your own thinking.  BOX

 

**BOX 5-5 | Steps in Conflict Resolution

• Communicate your needs in simple terms. • Know when to express your feelings. • Do not assume you know the other person’s feelings.  • Look at the issue from the other person’s perspective.

 

 

COMMUNICATION AND PATIENT  RIGHTS 

Every patient has the right to privacy and confidentiality.  Any information about a patient is considered privileged  information. 

 

Privacy 

Privacy is the health care industry’s term for what is commonly known as confidentiality. All patients have the right  to have their personal privacy respected and their medical  records handled with confidentiality. Your treatment and  concern for the patient reflect the physician’s high standards  of care. The human dignity of each patient must be preserved regardless of the patient’s socioeconomic background,  race, age, nationality, sexual orientation, or gender. HIPAA,  as previously mentioned, was passed in 1996 by Congress.  The Privacy Rule, which is part of HIPAA, provides for the  federal protection of health information. This rule, although  protecting patients’ privacy, also allows for patients to have  better access to their medical records and to have more control about how and to whom the information can be released.  HIPAA designates as protected health information (PHI) any  facts that, if revealed, potentially could be used to identify  the individual. PHI includes the following data elements: 

• Name
• Address
• Phone numbers
• Fax numbers
• Dates (birth, death, admission, discharge, etc.)
• Social Security number
• E-mail address
• Medical record numbers
• Health plan beneficiary numbers
• Account numbers
• Certificate or license numbers
• Vehicle identifiers, serial numbers, and license plate numbers
• Device identifiers and serial numbers
• Web Universal Resource Locators (URLs)
• Internet Protocol (IP) address numbers

 

This means that none of this information can be given out  by any means (electronic, paper, or orally) for any reason  without the consent of the patient. The patient gives consent by signing a copy of the medical office’s notice of privacy practices (NPP). The NPP is provided before all  new-patient visits and is generally updated once a year with  established patients. Although the office must make a good  faith effort to obtain the patient’s signature, it is not mandatory. The NPP consent covers any information necessary for  treatment, payment, and operations (TPO). For any other  purposes, the patient must provide a written authorization  that identifies the type of information to be released, the  name of the recipient, and the length of time it for which it  is valid. If you are in doubt about whether to release personal  patient information, do not do it. Always make sure that you  have obtained the appropriate authorization. 

 

Family members can pose special confidentiality problems. If a patient brings a family member into the examination room with them, you might presume that they are  giving informed consent to share information with that family member. However, it is prudent to have the patient sign  a form specifying with which family members or friends the  office personnel may discuss the patient’s case. Domestic  violence victims may be intimidated into allowing their violent perpetrators to come to the office with them. A wise  medical assistant may ask the significant other to leave the  room for a few minutes so the assistant can assess whether  the patient is safe at home. It is important to let patients  know that they can exclude family members from the discussion of their health if they wish. 

 

Advising Patients 

As a medical assistant, you are the physician’s representative.  Because you are part of the staff, wear a uniform, and assist  with treatments, patients may view you as an authority figure. The physician advises the patient on a course of treatment or procedure based on the examination and diagnostic test results. You are not permitted to offer your opinion  about the physician’s diagnosis, discuss the course of action  the physician has set forth, or tell the patient what you  would do in her position. Those opinions are beyond your  scope of practice and could put you and the physician at risk  of being sued. If asked by a patient, “What would you do if  you were me?” you must not offer advice. Explain to the  patient that the physician will be pleased to review the  course of action and answer any questions and that you will  be happy to arrange for that meeting. A medical assistant  giving advice to a patient could be construed as practicing  medicine without a license and is a punishable offense in  most states.

 

Patient Decision Making 

Patients who have received bad news from the physician or  are faced with difficult choices do need help to come to a  decision. Your role is to listen empathetically to the patient,  ask reflecting or clarifying questions, and make clear the  information the physician has related to help the patient  come to a decision on a course of treatment. For example,  Mrs. Santos has been told by the physician that her breast  biopsy was positive and a mastectomy is recommended as  soon as possible. When the physician leaves the room, she  asks you what she should do. Your response should be, “Mrs.  Santos, you seem upset about having to have a mastectomy.  What concerns you about the procedure?” If she asks what  you would do in her circumstances, you can explain again in  simple terms what the doctor has said. You may also obtain  approval from the physician to suggest to the patient that  she seek a second opinion. Sometimes patients are so nervous  in the presence of a physician that they do not hear information correctly. It would be permissible to give Mrs.  Santos written information about the procedure, offer to  bring her concerns to the physician, and encourage her to  call back once she is home if she has more questions.