In this podcast episode, Mike Sacopulos interviews Laura Hills, D.A. Dr. Hills is well known for her programs, books, and articles, and notably, has been the staff development columnist for The Journal of Medical Practice Management since 1998. Her newest book is, The Problem Employee: How to Manage the Employees No One Wants to Manage.
My guest today on SoundPractice is Dr. Laura Hills. She has had a distinguished career of more than 40 years as an educator. Her passion is to teach professionals how to build better relationships, communicate more effectively, and to lead others. She's certainly well known nationally for her books and articles. She has been writing for the Journal of Medical Practice Management since 1998. And most importantly, she is the author of the recently published, The Problem Employee: How to Manage the Employees No One Wants to Manage.
In the preface, you say that you've been writing about healthcare management for 40 years. You also explained that though you started in healthcare marketing and in fact published your very first book on that subject that you shifted your career to focus on staff development and leadership about 25 years ago. Tell me why the change in focus?
Dr. Laura Hills:
Well, I began in marketing because it was a very hot topic in the 1980s. I was a writer looking for information about marketing because it was so new in the professions and I couldn't find what I was looking for. So, I wrote my first book then and it put me on the map. I had great success speaking, coaching, consulting, and I was doing wonderful work.
But what happened over a period of years is I started to see a pattern emerge. I could bring patients into an organization through marketing. But I could not keep them there. Patients would come and go. I found, very often, there was a problem in the patient's experience that turned the patient off. Many times it had to do with the staff members.
They didn't like what happened at the front desk. They didn't like the way someone in the back talked to them. They felt rushed. They were kept waiting because of circumstances but no one told them what was going on. And so, I would advise my clients that they needed to address those issues or else we could put a revolving door on the front door.
And not just patients, but employees too, who were fed up with the workflow and the problem employees. But I found the managers resistant because they hired me to do marketing. Marketing was a lot more fun. It's a lot more fun to think about bringing new patients in rather than dealing with the problems of patient dissatisfaction or problems with the people you've employed.
I had an opportunity to get to know Dr. Marcel Frenkel who was the editor of The Journal of Medical Practice Management. He suggested that I begin a column for the journal on staff development. And that's when I really found who I'm supposed to be. I was very successful with marketing but I'm much more of a people person. And though it's not as sexy a topic as marketing. I found that this is really what I cared–developing people. And I never looked back. I started there and I went deeper and deeper. So, for well over 20 years now, that's been my focus.
Excellent. And I'm not so sure I agree with you on the not so sexy. Some of the most interesting stories I've ever heard are about problem employees. Let's talk a little bit more about the book because you certainly do a deep dive into the problem employee.
Don't you think that it's more than a little maddening for the healthcare executive to have to spend his or her time and energy working with problem employees? Shouldn't we just expect employees to show up and do the job that they're hired for without causing us so much grief?
Dr. Laura Hills:
Well, I will say it can be maddening and it can easily become maddening if you allow it to be. So, yes, we're human. Nobody enjoys seeing people behave badly and having to deal with that. But it's also you ask the question shouldn't we expect people to do their jobs. I took a quote right out of my book that I felt addressed that so clearly that I asked to for it to be on the cover and the quote is this, "Wouldn't it be great if you never had a problem employee, but we must be realistic, if human beings are involved there will be problems."
So, to expect that you won't have problems is not realistic. You will, because you have human beings and they come in the door with all that they bring from their life before you knew them. They're dealing with life outside of the workplace. And they're going to bring that in sometimes too. And they're flawed. They're human beings. They're going to have things about them that you would prefer sometimes that they don't.
You have a choice to respond emotionally or to respond strategically. And that is why I wrote this book because we can all tell our water cooler stories and pull our hair out. And it seems totally crazy sometimes, but we need to come back to earth and have a strategy for dealing with the inevitable problem employees.
After 2020 Dr. Hills, you have my vote. I agree with everything that you have you said. Now, in looking at your book, which is extraordinarily well done, The Problem Employee, you cite a lot of different reference material. I counted North of 175 sources. Does this for people that are listening fall into the scholarly work category?
Dr. Laura Hills:
I would say it does not. I do have a background in scholarship. I published an academic book that had more than 300 sources, but this is not empirical research. This is not written in the typical style of a scholar. It has a very how to do it, step-by-step focus.
What I would say that it is, is me serving not only from my experience, but as an aggregator of best ideas. I cast a wide net to learn as much as I could about the subject of problem employees and pulled from that what I felt were the best ideas, the best resources, and put them into this one volume. So, it is very well researched, and you will find a lot of sources, but it's going to read like a how to book.
Well, I think that people will find that to be helpful. Now, in fairness, there are a few other books out there on the marketplace that they deal with problem employees, but none of them that I found focus on employees in the healthcare sector. What else sets your book apart from others that people might find on this topic?
Dr. Laura Hills:
The other books that I am aware of, talk about problem employees as though you're dealing with one thing. The giant world of problem employees. And they speak about a strategy that you would apply to all problem employees. Now, certainly there are some things that you will do in common, no matter who the person is and what the problem is. That's what I focus on in part one in our book.
It is a step-by-step through the kinds of things most leaders are already aware of that you want to talk about observable behavior and not jump to conclusions that you want to document everything very carefully. You want to provide multiple warnings. And a lot of books do the same thing. They talk about those subjects.
But what sets this book apart from the others is that it doesn't believe, and I don't believe, that there is a cookie cutter, one size fits all approach to managing problem employees. That they are not all the same and that they require different strategies.
Dr. Laura Hills:
That's why what I did in the book is provided 17 different types of problem employees and go deeply into each one because they are not the same understanding what makes them tick, and what's going to be most effective in that case. And I haven't hit upon another resource that does this in this depth.
Let’s talk about 17 specific types of problem employees. For instance, there are chapters in The Problem Employee on managing a bully or slob, the prima donna, a pessimist, drama queen or the gossipy person. Wouldn't we use the same basic management approach with every type of problem and employee. And if not, maybe tell me where that analysis is gone wrong on my part.
Dr. Laura Hills:
Well, there are some things in common that you're going to focus on, for instance, that you're looking at observable behavior rather than conclusions, that you would draw about what someone is doing. And documentation is very important. But it's very important as well to understand that a bully bullies for particular reasons that have maybe nothing to do with an employee who for instance, is taking part in a click or who is lazy or who is a slob. These are very different types of behavioral problems motivated by very different reasons.
And so, the premise that I put forward is that it's extremely helpful to understand why people do the things that they do and get to the source of the behavior. That will give you the best data about what to do about it. Then you can tweak, you can adjust your approach depending upon what you find out further from the person. But that if you just took a blanket approach and dealt with them all the same way, you're not going to be nearly as effective.
That makes sense. I think I've waited as long as I can for a story of really bad behavior. So maybe you could tell us what you believe is one of the more challenging of the 17 types of problematic behavior. Illustrate with a story and give us some kind of background on that. Because some must be more difficult to deal with than others. I would assume.
Dr. Laura Hills:
I would say that the most difficult employee to deal with is the one in front of you right now. And what one client's difficult, another one won't. For instance, you could have somebody in one case who has no problem dealing with a bully, let's say. They understand what bullying's about. They don't personally get upset.
I worked with a leader who had a lot of difficulty because one of the employees disliked her and this leader truly wanted to be liked. I would say this was a problem with her leadership is that she wanted to have everyone love her. So, it bugged the heck out of her that this problem employee didn't like her. It distracted her from her own leadership.
So, I don't think that's a horror story necessarily, but it illustrates my point that who the person doing the managing is matters just as much as what the particular problem is. They're all leaders come in different sizes, shapes, and forms, and we all have our bugaboo about what's going to drive us crazy and it's not going to be the same for you or for me or for the next person. It's whatever your hot button is, your Achilles Heel. Maybe you've had a personal experience with something, and it bugs the heck out of you much more than another type of problem that you might encounter.
Well, it's a good point that there are two parts to the equation. Multiple ways for things to go awry. So, in The Problem Employee, you stress the importance of not jumping to conclusions about problematic behavior that is being observed. Do you think healthcare leaders often do that?
Dr. Laura Hills:
Of course, they're human. If they try not to, we all try not to, but it's a human tendency to draw conclusions. And I think it's probably in our DNA to do that because in some primitive form, it was what kept us alive to jump to a conclusion. That looks like an enemy. I better run. That animal is going to eat me. I better go. Right?
So, I think it's in us to do that and we have to use strategy to overcome it. And it's extremely important that we do because when we see a behavior, we may think what is going on is what is in our head. And it may have nothing to do with our story. Let me give you some examples. Let's say you have a diva, a prima donna and it's driving you crazy. This person's is acting so superior. So self-centered so confident, cocky, downright insulting.
So, you jump to the conclusion. Well, this person really thinks he is superior, but the reality is the person may actually be doing those things because of a lack of confidence. Or another example, let's say you've got someone who comes to work disheveled, looking sloppy. Has a sloppy desk, sloppy work habits, leaves dirty coffee cups in the sink in the break room, is a slob. So, you jump to the conclusion, this person doesn't care at all about other people or himself. He's oblivious.
But you don’t know that. You don't know what's really behind the behavior. Maybe there's a reason that the person looks the way he does, or she does. That has nothing to do with whether he cares about it. So, when we jump from behavior to conclusion, of course we make mistakes, and we miss opportunities to turn things around. That's how we operate.
So, we have to fight that tendency within ourselves and pull out what's happening and look at it in the light of day and use strategy, use reason rather than emotion and not jump to the conclusions.
Well, that certainly sounds like great advice. What's the biggest mistake that you see managers making when dealing with a problem employee?
Dr. Laura Hills:
I'd say the biggest mistake by far is not taking action. Doing nothing. Most will tell you, "I started to have a little feeling in my gut that things weren't right, but I thought it would all just go away, or I thought the employees should work it out between them and things escalated from there." That that is a common scenario. So, they don't step in.
And the second most common is they step in but not soon enough. They let the problem fester and grow out of control. If they had come in sooner, they made have been able to completely quash it or they may have been able to turn it in a new direction. It's hard because it requires you to confront people and sometimes, they react badly when you do. And it's also uncomfortable especially about the more personal behavioral traits that you see in people.
I mean, could you imagine having to sit someone down and say, "There's something about your appearance we need to discuss." Or "You've been sharing information about others and I've overheard the following." It's very uncomfortable to do it for many people, understandably so. And once you have that confrontation, the moment where you bring the problem to the fore, you have to be ready for whatever the heck happens at that point.
And the person may respond in any number of ways. They could become angry. They could clam up, they could deny it. They could blame someone else. They can cry. These things all happen, and you have to be ready. And you're in there by yourself, usually, dealing with this. That is typically how it is unless you are going to confront as a group which is not how it should be done.
That's an intervention. Right?
Dr. Laura Hills:
Yeah. That's an intervention. So here you say, "Can we talk in private?" You close the door, you sit down, and you have to now say, "I have observed the following." And be ready for whatever happens. So, a lot of people just don't want to do it. They don't. So, they let things understandably. They hope it goes away and it rarely goes away. Let's just say that.
In the book, you include a bonus feature at the end of each chapter. Can you tell our audience a little bit about that?
Dr. Laura Hills:
Yeah, sure, Mike. What happened as I was working on this book is I focused a laser pointer on the problem employee, what you need to do, that's our subject. But every now and then I find some other angle, something else about the topic that didn't quite fit within the chapter that I was working on, but it was really good.
So, I decided to come up with a bonus feature so that I provide my readers with just a little sweet, extra something that enhances their understanding or gives them a different way to apply what they've just learned.
For example, some of the chapters end with a tool. I talk about how to do things step by step, what works, what doesn't work. But here is an actual tool. For instance, the chapter on bullying has an anti-bullying policy as the bonus feature. So, you can use it if you don't have one or compare it with the one you are using, and it gives you something concrete rather than just how to.
The chapter on the low morale employee gives you games you can play with your employees to increase morale. If you have an employee who is distrustful, trust has been breached, I provide a quiz that allows you to assess trust in your organization and your own trustworthiness. And if you are managing someone who has sloppy habits, I give you a bonus feature that is how to establish a culture of tidiness, not just with this one employee, but with everyone who you're managing.
I also, sometimes in the bonus feature, give you a tip or some guidance to share with other employees dealing with the same problem employee. For instance, if you have a lazy employee that no doubt affects everyone around him or her. So, I have a bonus feature for you to share with the other employees on how to deal with the problem employee. So, they don't get work taken from the lazy employees’ plate and put on theirs. There's a typical strategy of someone who's lazy is to get other people to do their work. How do we resist that?
If you have a gossip, how to extricate yourself from someone who's trying to share gossip, if you're working side-by-side with that person or a clique is forming and you're being recruited for a clique or you're dealing with clique behavior, what do you do? Who should you report it to?
I also have a few bonus features that are more personal development for the reader. For instance, one is the chapter on the drama queen. What if you start to see a little of yourself in the description? Well, I have a bonus feature about how to stop yourself. If you find yourself slipping into that behavior. How to stop being a drama queen.
If you're going to manage a pessimistic, gloomy, cynical employee, that's one of the chapters, the bonus feature is, I think it was 10 strategies so that you don't get brought down by the relentless pessimism. You're doing self-care in that case. And then I also have a few bonus features about what to do when the problem is not an employee you manage, but a colleague or your boss who is doing the behavior.
So, for instance, if you can manage a childish employee, but what if you have a childish boss, how do you deal with that without getting fired? What do you do with that situation? The same with, if you have a micromanaged employee and how do you stop having the person need so much management? What if you have a micro-managing boss? That's a bonus feature.
I have to say, you caught me totally off guard with a bonus chapter that you have in The Problem Employee. And that was on managing the star performer. In first glance, it seems like that's hardly a problematic employee. Why did you decide to include this chapter in the book?
Dr. Laura Hills:
Well, it isn't part of the 17 problem employees. That's the bonus chapter. And certainly, it's not a problem to have a star performer. We want that. Right? But they require a little extra care and feeding. And if they're not managed well, they can create inadvertently problems with the rest of the team.
So, it's a delicate, lovable, desirable employee to have, but you have to be very careful. So that chapter delves into how to keep that employee motivated. Because if you're always performing at a high level, you don't want them to burn out. Right? And you want them to stay and find new challenges with you.
So, you want to keep them motivated. You want to encourage and reinforce them, but you don't want to inadvertently encourage them to become prima donnas. And then how do you deal with jealousy and mistrust from other employees?
Because that star is setting the bar high, and the others may say, "Really, did we need that? We didn't need someone making us all look like we're mediocre." And so, the goal of course, is to bring everyone up. But realistically, there is going to be some resentment. How do you not fall into teacher's pet type of behavior that encourages that.? You're right, Mike, it is not a problem employee. And I'm very clear about that in the book. It is not as simple as it may seem to manage the star performer. Especially if that person is so outshines everyone else.
I can understand that. And I think that's useful information and worth people thinking about. And that gets me to readers of your book, who do you think is going to find this book to be most useful?
Dr. Laura Hills:
Well, the simple answer is anyone who manages one person, because as long as human beings are involved, there will be problems remember. But I would say this beyond whether you're managing someone now who's causing a problem. That's certainly a book for you, but if you're going to be managing other people as a component or the main thrust of your career, this is a book for today, but I wrote it also for tomorrow because you may not have all 17 problem behaviors to deal with right now. And I sure hope you don't, but if you stay in your career long enough, my guess is ultimately some of them in this cast of characters is going to show up and you're going to have to deal with it. So, you have this book on your shelf or in your Kindle, and you can turn to it.
As well, if you are in a position of having direct reports, who manage employees, this is a resource you can share with them when they come to you and say, "I just don't know what to do about this relentlessly gloom and doom employee I have, she's bringing everyone down." You have a resource.
So, the book is for someone who actively has a problem right now, or who is committed to a career on managing employees or direct reports who do. It gives them a strategy because the truth is, Mike, most of the time, you're in it alone. You're there trying to figure out what to do. All eyes are upon you. When you have a problem employee, you're not the only one who knows it. Everyone who works with that person is acutely aware of what is going on. And all eyes are on you. And you have to know what is going to work with this person and how can I protect my organization.
Very, very useful. We're almost at the end of our time together, but I have one last question and perhaps it will show my cynical nature, Dr. Hills, but is it really worth the time and effort unpleasantness to try to turn around a problem employee or we just be better off cutting our losses and moving on. I know it's not pleasant to think about, but give me the cost benefit analysis on this one?
Dr. Laura Hills:
It's very expensive to replace employees. It takes time, it takes money, it takes effort, and it's a distraction for everyone else. There's lost productivity. And so, if there's a chance that you can bring this person back in line, it's worth taking it from the point of view of wear and tear and finances and so forth.
There's also every time you fire someone, there's risk of wrongful discharge to whether warranted or not. And so, anything you can do to keep an otherwise good employee or a formerly good employee to bring them back is worth reasonable amounts of time and effort on your part. But that's the key. At some point, it's over, you don't go on and on forever trying to bring someone back. And we do talk about that in the book as well. That there's a strategy of multiple warnings, but not forever warnings.
You're going to cut it off. And at some point, you aren't going to cut your loss. Some people cannot be brought back. And after you give it a reasonable amount of effort, you've documented everything. You've given them opportunities. Yeah. You're going to cut them loose, but it is definitely worth some effort. And that's what this book is about. What is the effort you should be giving it? What's going to work? What's not going to work, because that's in there too.
And give it a real honest try before you say, "Okay, it didn't work." So yes, the answer is, I know it would be tempting to just say, "You out." But this is an approach that doesn't open up a lot of risk to the organization and can potentially bring people back. It does by golly work.
Well, we will leave it at that with you being the voice of reason and moderation in this, which I think is very much needed across the board. My guest has been Dr. Laura Hills. She is the author of the newly published The Problem Employee: How to Manage the Employees No One Wants to Manage. Thank you so much for being on SoundPractice.