1. Kendall L. Stewart, MD, MBA Betsey Clagg, RN, BSN June 20, 2005
Preparing Managers to Deal with Difficult People Some Practical Strategies1,2,3 A Presentation for the 2005 OHA Annual Meeting
Kendall L. Stewart, MD, MBA
Betsey Clagg, RN, BSN
June 20, 2005
1Thank you for attending this session.
2We intend to make practical points that you can put to use in your professional lives.
3Please let us know whether we succeeded on your evaluation form.

2. Why is this topic important?
Difficult people are everywhere.1
Dealing with them is a challenge for everyone, but these folk are particular challenges for organizational leaders.
SOMC leaders believe this is the most significant challenge they face in their professional lives.
Most of us don’t deal with difficult people very well.
We could do better, and we could prepare our managers to do better.
This presentation will suggest a number of practical strategies that will help you prepare your managers to deal more effectively with these “Phantoms of the Workplace”
After mastering the information in this presentation, you will be able to
Describe how difficult people sometimes behave,
Explain how that behavior “makes” your managers feel,
Specify how those feelings compel your managers to react,
List three practical educational strategies that will assist you in preparing your managers to deal more effectively with difficult people.
1I get the biggest kick out of dealing with snobs, particularly big-city snobs. Being from Portsmouth, I
get such opportunities all the time. An executive from Columbus liked my tie. A psychiatrist from
Cleveland was appalled that someone from Portsmouth would be appointed Chair of the OPA Ethics Group.

3. What are some successful strategies for preparing managers for dealing with difficult people?
Acknowledge the extent of the problem.
Ask managers how difficult people behave.
Ask managers how difficult people “make” them feel.
Ask them how unpleasant feelings incline them to react.
Encourage more realistic expectations.
Detail practical strategies for dealing more effectively with difficult people.1
Design and deploy effective educational activities.
Engage managers in the learning process.
Arrange for opportunities to practice effective confrontation.
Focus on changing the manager’s behavior.
Promote team learning across departmental lines.
Document educational effectiveness.
1I was trying to teach one of my male patients to be more romantic. I know what women want.
I explained Hallmark™ cards to this man. You know what he did?

4. What percentage of the problems SOMC leaders face are “people” problems?
SOMC Leaders Focus Group, September 9, 2004

5. How do the difficult people at SOMC behave?
They are negative.
They avoid conflict.
They are manipulative.
They are pot-stirrers. They are selfish.
They won’t take responsibility for their behavior.
They are arrogant.
They are disrespectful.
They fall back into old behaviors.
They are passive-aggressive.
They are demanding and impatient.
They deny their behavior.
They disregard policy.
They are unmotivated and lazy.
Rank ordered by SOMC Leaders Focus Group, September 9, 2004

6. How do difficult people at SOMC “make” managers feel?
Anxious
Confused
Defeated
Defensive
Desperate
Determined
Detached
Disengaged
Disappointed
Embroiled
Frustrated
Helpless
Impatient
Inadequate
Ineffective
Intimidated
Mad or angry
Nervous
Overwhelmed
Powerless
Resentful
Scared
Sick
Stressed
Tired
Apathetic
Uncomfortable
Unmotivated
Withdrawn
SOMC Leaders Focus Group, September 9, 2004

7. How may these feelings compel managers to react?
Behave aggressively
Become arrogant
Counterattack
Seek out others who will commiserate
Condescend
Become defensive
Become guarded
Grovel
Minimize the problem
Become moody
Become obsessive
Placate the troublemakers
Protect the victims
Ruminate
Regress to defensive inflexibility
Behave rudely
Scheme
Seek affirmation of their perceptions
Indulge in tantrums
Ventilate destructively
Withdraw
SOMC Leaders Focus Group, September 9, 2004

8. What are some successful strategies for dealing with difficult people?
Label them.1
Neutralize them.
Describe them.
Predict them.2
Inform them.
Involve them.
Ignore them.
Convert them.
Avoid them.
Expose them.
Circumvent them.
Use them.
Persuade them.
Confront them.
Rehabilitate them.
Discourage them.
Ridicule them.
Isolate them.
Punish them.
Extrude them.
1It is critical to tell people “how.” I suggested that leaders use the mental image of a yellow sticky note.
2We waste a lot of time hoping difficult people will change. People don’t change much. I recently took my
wife to Hawaii to celebrate our 30th anniversary. We got out “The List.”

9. What approach did we use in designing the educational activity?
Leadership Development Team
Strategic Value Leadership Conference
Learn and share tools and techniques
Promote team learning across department lines
Problem-oriented learning
Focus on changing behavior – (indicators)
Effective presenters
High energy level

10. What strategies did we use to engage managers?
Purposeful – useful strategies
Brevity
Humor
Storytelling
Informal setting
Provide food
Make it Fun
Theme - “SOMC Productions”
Attention span
Food, fun connected to theme – keeps energy up

12. What did we consider in designing our role play exercise?
Not a favorite method of learning
Non-threatening, “safe” environment
Reinforce classroom theory
Realistic scenarios
Clear expectations of outcomes
Heterogeneous vs homogeneous groups
Planned “debriefing” (processing)
Adults do not like to feel incompetent, be embarrassed
Realistic, real – life scenario’s. Recommend develop your own – tap into personal experience of your managers
Did groups both ways – the mixed group was more effective plus had the added bonus of leaders who do not normally work together – building relationships

13. How did we engage the participants in the activity?
Theme - Getting into “character”
Triads: manager, employee, observer roles
“Scripts” for manager, employee
Observer role
Fully engage in activity – realistic
“Back stage” areas
Large group discussion
Encouraged least experienced to take the role of the manager – reminded this was a “safe” place to practice
Encourage the employee’s to be more difficult

14. What was our approach to processing the role play experience?
Completed a reaction form
What happened?
How did you feel?
Based on your feelings, what did you do?
What was the reaction?
What might have been done differently?
“Interviewed” individuals
Captured “best practices”
Applauded their acting debut
Individually completed a form (manager, employee and observer) this allowed them to capture their thoughts and assisted in the large group discussion
Used two scenario’s – read through both of these prior to beginning the discussion
Used a Barbara Walter’s approach to interviewing the “actor’s” and observers. : role played, strategy used, expected, consequences, timeframe, successful, done differently, body language, emotional aspect
Best practices
Sandwich discussion
Everyone participated – animated discussion
“advised one another”
Not setting consequences identified as a weak area

15. How did we document the effectiveness of the education?
Completed an evaluation immediately following the course
Asked for a commitment to deal with a difficult person within 60 days
Reported on their experience and completed a follow-up evaluation in 60 days
Measured the percentage of those who applied the learning within 60 days
We asked managers to estimate the percentage impact this educational experience had on their actual leadership performance.
Predicting behavior was the most helpful strategy

16. What results did we see?
Attendees’ mean assessment score was 4.73 compared to previous mean evaluation scores of 4.5, 4.61, 4.54, and 4.56 following similar SOMC leadership workshops.1
Written comments were overwhelmingly positive.1
71-percent of attendees applied their learning within 60 days.2
Managers estimated their leadership performance had changed by 32.5% due to this education.3
Predicting behavior was the most helpful strategy
1Workship evaluation
2The return rate for the 60-day follow up survey was 30-percent.
3American Society of Training and Development assessment tool

17. Where can you learn more?
Stewart, Kendall L., et. al. A Portable Mentor for Organizational Leaders, SOMCPress, 2003 S
Stewart, Kendall L., “Physician Traps: Some Practical Ways to Avoid Becoming a Miserable Doctor” A SOMCPress White Paper, SOMCPress, July 24, 2002
Stewart, Kendall L. et. al, “On Being Successful at SOMC: Some Practical Guidelines for New Physicians” A SOMCPress White Paper, SOMCPress, January 2001
Stewart, Kendall L., “Bigwigs Behaving Badly: Understanding and Coping with Notable Misbehavior” A SOMCPress White Paper, SOMCPress, March 11, 2002
Stewart, Kendall L., “Relationships: Building and Sustaining the Interpersonal Foundations of Organizational Success” A SOMCPress White Paper, SOMCPress, March 11, 2002
Please visit to download related White Papers and presentations.

18. Southern Ohio Medical Center The SOMC Medical Care Foundation, Inc.
How can we contact you?
Kendall L. Stewart, M.D.
Chief Medical Officer
Southern Ohio Medical Center
President & CEO
The SOMC Medical Care Foundation, Inc.
th Street
Portsmouth, Ohio 45662

19. Director, Staff Development Southern Ohio Medical Center
How can we contact you?
Betsey Clagg, R.N., B.S.N.
Director, Staff Development
Southern Ohio Medical Center
th Street
Portsmouth, Ohio 45662

20. Southern Ohio Medical Center
What questions remain?
Southern Ohio Medical Center
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