Dealing with difficult personalities and managing conflicts within an orthopaedic practice can be a sensitive issue that is often unavoidable. These situations are not limited to internal staffing issues but may also arise from interactions between staff and patients. The following five tips can be helpful in managing conflicts.

1. Speak in a calm and respectful tone.
   Take notice of when a situation begins to escalate and conflict arises. Remember to speak slowly and with confidence. Lower the volume of your voice to capture the attention of the individual. When people are required to lean into or engage more closely with the speaker, they are more likely to focus on the conversation.
2. Engage and show empathy.
   Thoughtful questions can begin to mitigate a conflict. Acknowledge how the other person is feeling by saying, “I understand that you are concerned about your bill” or “I understand your frustration …”
3. Disengage when necessary.
   Remember that no one is required to engage in abusive or disrespectful conversation. If someone becomes irate or goes beyond the bounds of polite disagreement, the best action to take may be to end the conversation or postpone it until tempers have cooled.
4. Take a deep breath.
   Take time to gather your thoughts and relax. Some situations should not be handled immediately. When both parties are frustrated and situations begin to escalate, it may be time to just agree to disagree and return to the discussion at a later time. When such a situation occurs with a patient, it may be best to defer the answer to the practice manager or another physician. Offer to follow up with the patient after investigating the situation further.
5. Be professional and caring.
   When dealing with a difficult staff member, it is best to address the matter privately or ask a manager or supervisor to mediate. Ask permission to provide constructive feedback and offer an alternative solution to the conflict.
   When dealing with a patient, move the discussion to a private area. Importantly, do not embarrass the individual or put him or her on the defensive.

Cindy Bracy is the manager, practice management affairs, in the AAOS department of electronic media, evaluation programs, course operations, and practice management. She can be reached at bracy@aaos.org