Why Your Practice Needs Rules (Even When Coworkers Are ‘Family’)

You’ve heard the expression “You can choose your friends but you can’t choose your family.” Very true.

Maybe like mine, your family has a grouchy ole “Uncle Pete,” the ultimate contrarian who makes us crazy because he insists on disagreeing with everything. Well, I remember Uncle Pete whenever I give a lecture on customer service. That is because I talk about how important it is to treat all patients as if they were members of your family and then I say, with emphasis, “That is, as long as they are members of your family that you actually LIKE!” The comment is usually followed by a roar of laughter. The audience understands that while Uncle Pete may be our family’s secret, they all recognize this surly relative.

That got me to thinking about family relationships as it relates to our work environment. It really hit home recently when I received a call from someone (Gale), who explained that she had just about enough of her work family.

Gale loves her job but explained that her coworkers’ constant chatter throughout the day was becoming more and more of a work distraction. Her coworkers were often on their cell phones or gathering as a group in the hallways, talking about their private lives or the previous night out, loud enough for patients to hear and comment about. Gale didn’t feel it was professional or appropriate, but when she tried to approach them on her own, she got the evil eye and cold shoulder.

Gale finally decided to go directly to the office manager for help. The manager claimed to be aware of the behavior and explained that she tried to stop it in the past by prohibiting cell phones during clinic hours. Realizing that the policy was ineffective (as there were no consequences), the manager then spoke with the doctor requesting permission to remind staff of their rules of conduct. The doctor refused, explaining she wanted the practice to function as one big family and felt that reprimanding staff did not encourage family unity. The manager’s hands were tied and he dismissed Gale’s complaint by saying, “I tried to handle this. In the big scheme of things, it is really not a big deal so let it go and we will avoid conflict.” Needless to say, the chatter continued as did the patient grumbles. Gale decided to get outside advice.

As she relays the details to me, my mind keeps shifting between her story and a recurring incident involving our 3-year-old grandson. His mother comes to pick him up after spending the day with us. He knows that when she arrives, it is time to leave.

However, he instead goes into diversion mode in an effort to prolong his visit. It never fails. (“I have to finish my milk. I can’t find my shoes. I don’t want to put my jacket on. I need to watch the end of Spider Man.”) Hearing him go on and on, his mother caves, every time. “OK,” she says. “I’ll just wait until you’re ready.” What? Three years old and already he has learned that he can win by challenging Mom’s instruction? He deflects and mom gives in to avoid conflict.

Sound familiar? Avoid conflict? No consequence? Even though Gale’s coworkers were older than my grandson (chronologically) and should know better, they are also learning that there is no disadvantage to overlooking the rules.

Rules are made for a reason. They create a certain expectation of behaviors and actions, whether at home, in society or at work. At home, the rules are generally spoken. At work, it’s a little more formal with established rules via an employee manual or the “Practice Rule Book.” The minute that Gale’s boss deferred putting an end to the staff’s unprofessional behavior, she relinquished management control to them and all rules went out the window. By doing nothing, she basically condoned their actions and allowed negative behavior to continue. Maybe the doctor felt that disruptive chatter was “not a big deal,” but just like our 3-year-old, human nature will continue pushing the policy envelope.

Gale faced two choices at this point. One, she could offer her resignation and find a more enjoyable work culture. Two, she could make a last-ditch effort to have an honest conversation with the doctor herself and explain how the current situation is negatively impacting their patients.

The idea of wanting to develop a “family culture” at work is admirable. Let us face it though. Even families have rules and guidelines. Didn’t you have adult/parent ground rules in your family? We sure did and if we broke the rules, we faced punishment in the form of no TV, no car or being grounded for a week. Worst case scenario? Verbal reprimand from ole Uncle Pete.

At the end of the day, when people cross professional boundaries and break rules, there are no firm guiding principles to distinguish between acceptable and unacceptable behavior. On the other hand, having certain professional rules in place encourages an environment where everyone is able to function more effectively and act more politely. It creates a more satisfying experience for everyone.