The Top 3 Defensive Reactions That Can Derail a Collegial Intervention

Collegial interventions are not likely to be at the top of your list of favorite things to do. In fact, most healthcare leaders dread them because they can so easily go badly. However, avoiding these difficult conversations is a recipe for a future disaster. 

Here are the top 3 most common defensive reactions you are likely to encounter in a collegial intervention, along with some tips on the best ways to respond: 

  1. Blaming: In our 20 years of experience working with hospitals, we’ve found blaming to be the most common reaction from a defensive physician. After all, it’s human nature to protect one’s self-image, and the easiest way to do that is to say that the problem was caused by someone else. For example, “Look. If Smith would just be competent, then I wouldn’t have to act this way. Anyway, with her attitude, she got me angry. You should be talking to her.”
  2. Defending Quality: When blaming doesn’t work, the next thing a defensive physician may do is defend their actions based on a passion for quality, and you may even find them engaging in a little hyperbole. For example, “I was only pointing out these problems because I care about quality, and I’m not going to sugarcoat my complaints.”
  3. Deflection: The third defensive reaction is based on shifting the focus of the conversation to something else. For example, “But you’re missing the real problem. I’ve been over the vascular trays with the nurses time and time again, but these problems never get fixed. Nothing ever changes. You should be focusing on Dr. Dishonest and Dr. Incompetent. They are the real problem, and nothing has ever happened to them, right? Why am I being singled out?”

Luckily, we’ve found the following strategies to be effective for all three of the most common defensive reactions. We’ll use the following defensive reaction as an example: 

  • “Look. If the Nurse-Manager would just fix the problem, then I wouldn’t have to act this way. Anyway, with his attitude, he got me angry. You should be talking to him.”
  1. Partial Agreement: Ok, so you may be right that someone needs to fix the problem…
  2. Refocus: AND…remember that we’re here to talk about you and your behavior.
  3. Explain for Clarification: You are responsible for your own reactions. 

If you would like to get access to the 8-minute “Six Steps for a Successful Collegial Intervention” video (at no cost), just use the form below and we’ll send you the link. In the video, we will start with how to request the meeting. Then, we’ll do a deep dive into starting the meeting, setting expectations, and responding constructively to several “defensive reactions” designed to throw you off. 

Request the Collegial Intervention Video

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