EP46 | Building Trust in the Process with Karl Pister

If you work in healthcare, you already know this. Conflict is everywhere. In the OR, in labor and delivery, in committee meetings, between physicians, nurses, administrators, and teams that are all trying to do the right thing.

But here's the problem.

Most of us were never trained to handle conflict well.

We learned procedures.

We learned Diagnostics, but we didn't learn how to navigate the moments when 2 professionals strongly disagree. That's why I developed the SPARK framework. SPARK stands for stop, pause, ask, don't assume, reflect and respond, and create a path forward. It's a practical system designed specifically for high-stakes healthcare environments. Through keynote talks, residency workshops, and Spark Masterclasses, I teach physicians, nurses, and healthcare teams how to turn destructive conflict into productive conversations that strengthen teams and improve care. If your hospital, residency program, or medical conference is looking for a speaker on conflict, Communication and leadership in healthcare.

I'd love to work with you.

You can learn more in the show notes because in medicine, conflict is inevitable, but handled well, it can make teams stronger.

In every operating room.

In every ward, in every clinic, and every team meeting, a silent battle brews. Conflict, negotiation, identity. Welcome to the Scalpel and Sword podcast, where I, Dr. Lee Sharma, physician and conflict analyst, explore the hidden negotiations behind modern medicine. Let's trade burnout for boundaries and learn the art of healing with precision and power.

Hello, my peaceful warriors, and welcome to the Scalpel and Sword podcast. I am your host, Dr. Lee Sharma, physician and conflict analyst. And I want to ask you a question. If you are a new leader in healthcare, or if you're somebody who's been in healthcare leadership for a while, how do you feel about conflict? Does it frighten you? Do you try to avoid it? Or do you see it as a pathway to improvement, to understanding? And is there a way forward through conflict that can actually build trust? And I am so excited today because I feel like our guest is really going to help us get into answering those questions. Today we have on the podcast Carl Pister. Carl is the founder and president of The Coaching Group, an executive coaching and organizational consulting firm. He has over 34 years of experience in coaching, training, and counseling with a focus on the healthcare sector since 2008. He got his bachelor's in Spanish, his master's in social work, and a master's in marriage and family counseling, all from Brigham Young University. He is certified by the International Coach Federation as professional certified coach and is also certified by the John Maxwell Team. His expertise includes conflict management, mediation, executive development, employee relations, and leadership. He also is an experienced podcast host. He hosts the podcast, the Healthcare Leadership Excellence Podcast, and he shares insight on leadership, communication, emotional intelligence, and conflict resolution. Carl, I'm so glad you're here. Welcome.

Well, thank you so much. It's good to be here. Looking forward to our conversation.

I know, me too. So you've been working with healthcare leaders for a really long time. What were some things you noticed right off the start that you really felt that healthcare leaders struggled with regards to conflict?

One thing I've noticed is that just because you have a lot of initials after your name does not mean That you're qualified or trained in conflict. And many times people are so intelligent that they're given a sort of a free pass throughout school. Johnny is super smart. He got a 2400 on the SAT. He's socially awkward, but we're not— we'll just give him a free pass instead of pulling him aside and helping him learn the emotional intelligence skills. That are so important in conflict leadership. And then in medicine, I've seen a tendency because Jane Doe is a super good neurosurgeon, she will be a great section head. And that's a pretty big jump there.

That's true.

She can take apart a brain and put it back together brilliantly, but she cannot say a phrase without insulting people. That's not fabricated stories. Those are real.

Oh, 100%. And I think it is so interesting because it's so prevalent in healthcare that people who are perceived as being quote unquote high performers, you know, they see a lot of patients, they do a lot of procedures, they bring in a lot of resources to the institution. And so we are more likely to look the other way. And I think it's also interesting that you've seen those people really promoted, that, you know, they've actually been introduced into leadership levels just because they were these high performers. And so when they do things like this, when they clearly do not have that insight into how their communication is affecting other people, we tend to smile and nod and say, just, that's how they are.

And dealing with a situation right now where An excellent surgeon in his subspecialty was interviewed by an organization. None of the people were impressed by him. He rubbed people the wrong way. He was very aggressive. No one wanted him. And yet, because he was a very high producer, they brought him on anyway. And somewhat of an administration pat on the head saying, well, you'll just learn how to work with him. And it's such a trust busting. And I'm not throwing admin under the bus. We have revenue targets to meet, but boy, when you're bringing in a toxic person into the worksite knowingly, it's so short-sighted.

When this happens, because we are sort of consciously introducing this conflict element into the system, like we have now introduced an element Where unfortunately we're setting us up for a negative culture, a culture that may breed conflict, that's not going to be a culture that lends itself to improvement or to insight. Can you raise the awareness of these people in these leadership positions to the way they're interacting and the lack of positive culture that this produces?

You can. And it's complicated. It's complicated because unless you have senior leadership, because many times, as you're aware, we've got the admin dyad, we've got the clinical dyad. And unfortunately, we've had a swing in medicine to where now the admin dyad many times tells the clinical side, you just do your clinical work and we'll take care of everything else. And you can't run silos like that. So the only way Dr. Jones knew, let's just say he's a surgeon. We won't say a subspecialty and he's a high producer. Unless administration takes a strong role, it will be a toxic environment. I just interviewed a gentleman who used to be president of Dallas Methodist, Britt Barrett. And Dr. Barrett, he's a PhD. But he flipped that hospital from being one of the worst places to work in Texas to one of the best, not voted by himself, but by outside. And he told a story. I was in a lecture of his a couple of months back and then had him on the podcast last week. And he said, you know, at first I didn't think I could get away with it, but as CEO, I guess I could. And during physician new hire orientation, doctor, What he would do is come in and welcome people, but he would be very blunt and say, if you're a whiner, a loser, or a jerk, I will hunt you down and you will not be with us anymore. He said you could see HR in the back, just, you can't say this. And he thought, well, I can't, but it worked. I don't care how good you are. If you are toxic to the rest of our employees, You do not belong in this hospital. And that's the support you need, or else the surgeon will come into coaching and will pretend to cooperate because he doesn't want to lose privileges, but will then go right back to it. And you'll see a repeat over years until someone says, no more specific metrics, et cetera. Usually though, we wait till it's too long.

That is such a powerful insight because I absolutely agree with you. When we have physicians that are in these situations that are clearly generating toxic environments, we tend to look the other way until we have some type of HR disaster. Somebody has witnessed or seen something that X physician did, and now we're going to HR, we're complaining about what happened, or there's a bad clinical outcome. Something catastrophic has happened clinically. And the tragedy with all of these situations is that we don't have administrators like the CEO of Dallas Methodist that was able to set a boundary very early on for what the expectations were. So he's not waiting until we have a train wreck. He is going ahead and being proactive about what those expectations are. And I think what's so interesting about that, and I agree with you on this 100%, Is that because doctors have letters behind their names and because we do these jobs, people are hesitant sometimes to set those boundaries for us. I always love to share the story of my dad, who was a general surgeon, who, when I was in residency after graduating, I was doing OB-GYN, so I was in an operating room a lot. And he told me when I was a very young resident, it's like, look, if I ever hear about you throwing instruments. Yelling at people in the operating room or acting like a butt. If you do that, even after I'm gone, I will come back and I will haunt you. You do not act that way in an operating room. And so like what the CEO did for these doctors actually was done for me by my father. And he set those rules for me. And anytime I'm in an operating room, he's with me and I hear his voice.

Mm-hmm.

In an operating room, if you're the surgeon, you act like a gentleman or a lady. You don't act a fool. And what's so interesting about that is that I feel like I get better buy-in from the staff that work with me. People in general say, oh gosh, we're really happy we get to work with you today. And that's beautiful because you want that. But also I get to hear what all the other surgeons are doing. They tell me, they tell me the conflicts that happen. I get to hear that.

Yeah.

And occasionally, sometimes I am consulted to mediate or help a troubled physician that I've already heard the story. I already knew what happened to this person. And now this person's coming to me saying, hey, I'm getting called to peer review, or this is happening. Can you help me? Can you talk me through this process?

Yes.

So it's really interesting that there are people who are now being proactive about helping physicians. Avoid getting to this place. If you are fortunate enough, let's say you've got someone who's approaching you for coaching and they're not asking you for coaching because they're in a bad spot. They're asking you for coaching because they literally want to be better. How do you start that process with them?

What a great question. And I'll just go back 3 hours working with cardiac intensivist client today. Superb gentleman. I've known him for about a little over a year. on another project, and his organization sees him as a potential high performer. And I don't have, Doctor, a templated approach. What I do is get talking with them enough and get inside their circle enough that then they start sharing what their concerns are. And I've been on Morning rounds in this gentleman's unit, and we had just a great conversation today, and he shared some insights with some real emotion, and it was just so marvelous to see him open up so much. And this was our first session, and we'll go from there. Another item that I'd like to mention, just piggybacking off your comment about trust. I was working with a cardiac surgeon years ago, and I think it was like our 5th session. And he said, Carl, when are you going to start coaching me? And I'm usually a little more filtered than this. And I said, I'll start coaching you when you start trusting me. And you could see I kind of caught him off guard. And he said, what do you mean? I said, you don't trust me. You haven't opened up at all. And he said, well, you don't understand my world. What's it gonna take for me to understand your world? Well, you gotta come into my world. So I knew the director of surgical services really well, and she gave me the whole list of shots that I needed to be able to get in the OR.

Mm-hmm.

And I was able to observe 2 open heart surgeries, one 6 hours, the other 7 hours. And for a medical rookie like myself, I will never forget those 2 days. I was in the birdcage at the top of the bed, literally 3 feet from this heart. And to watch him lead the choreography of a well-orchestrated surgical staff. At the end, he said, well, Carl, what do you think? I said, doctor, all I can say is it's choreography. After that, the coaching took off. And even after the coaching was formally over, I'd get occasional texts from him saying, I'm kind of stuck here. Do you have 5 minutes? It sounds sappy perhaps, but it's all about relationships and trust. Once people have that, even highly stellar educated people, they're still people. And people, in my view, open for debate, People run best when they feel understood and they know someone has their back.

100%. And when you were talking earlier, you had made a comment about the administration side, the clinical side, and how siloed that can be. I think that's a big part of why physicians not only have difficulty with conflict, tend to be more conflict avoidant. Is because our educational system has really siloed us. That, you know, everything that leads to being a physician is your personal grades when you're in college, your personal grades when you're in medical school, your performance solo as a resident, which will lead you to getting either the job or the fellowship that you're looking for.

Yes.

Your personal performance as a physician that will lead you to Getting more patients or doing more procedures or whatever it is that you choose to do. And so we're asking people who live and work in this very isolated world to learn how to trust and especially build relationships that are built on trust in the professional arena. And it's such a hard skillset for us. We're not good at it. And it's something that unfortunately also, I think, leads to our difficulties in dealing with conflict because as you said very beautifully, Conflict resolution starts in relationships and relationships start with trust. And if we're already having problems with the bedrock, this is clearly why we have problems with conflict. So I love the fact that you took the time because you did, you had to take the time. And I've been in the operating room for 7 hours. That's exhausting. That's tiring. And you're sitting there all day, even though it's a really cool thing to watch. I mean, that takes some stamina. So I'm really proud of you for doing that because that's not easy. And then to have that person look at you and really feel like you were willing to take that step to have that insight into his world. I mean, that's why it meant so much to him. And I'm sure that's why he still calls you because that meant a lot to him that you were willing to do that.

And the sad thing for me, doctor, because he was a lightning rod individual and I would hear people speaking poorly of him. And of course I couldn't divulge it. I had a coaching relationship with him, but I knew from the conversation that they hadn't taken the time to build the bridge with this person. And I'm a conflict leadership junkie and I get daily feed from the Project on Negotiation at Harvard. And so many times it's trying to get people to get from the adversarial conflict approach To, you know, there was an article the other day, is it okay to have small talk before a negotiation? And they said, absolutely, because the more connection you have, the higher the possibility of a good outcome.

Yeah.

And this is in hardcore business negotiation, not trying to get 2 sides in a collegial environment to see eye to eye. That would be Blatantly obvious, but it was impressive that even when you're talking dollars and cents and contracts, the more you have the other person's purpose and interests in mind, the better it's going to go. So it's not a warm fuzzy approach. It's truly what is going to work to get almost in a selfish way. You don't do it for that reason, but my chances of getting what I want in a mediation skyrocket when I'm concerned about what you want. And the interesting thing is, Dr., we are hyper about best practice in medicine. You can get peer-reviewed negatively for not following best practice. Yet we think and use our own ideas and approaches in conflict and relationships when there are very well-established best practices. by the research of what works, but because it's a relationship and I've got my biases, I'll do what I want and expect a good outcome.

That's, I think that's, it's so beautifully put that we really do think that not following some type of systemic approach to conflict. And when I say systemic, having faith in the process.

Mm-hmm.

One of the guests that I had on the podcast, and I think this has been about a month ago, Javi Morin, who Is a PhD JD at the University of Tennessee Memphis College of Medicine, and she teaches conflict resolution to healthcare professionals. And she and Kimberly Best, our mutual friend, who is a friend of the podcast, does this class with her. And one of the things that Javi said in terms of being a mediator, and it just has really stayed with me, is that we are the guardians of the process.

Yes.

That we are the ones who understand, just like you said, How important these processes are, that we really embrace and understand that doing these specific things to transform conflict and build trust in relationships really do work. And so what we are doing as we are walking into these situations is making sure we are preserving as much as possible this process. And you are now introducing people, you are introducing healthcare professionals and physicians who have no idea how conflict resolution works, you are introducing them into this process and then you are making sure that they feel safe and understood within it.

So true. Yeah, I could not say that better. And the magic thing is that process is solid in its results. There are steps that you don't violate. Just as I'm sure in a surgical procedure, A becomes before C before D, if I got the alphabet right there. What I was saying though, and it has to be followed.

Yeah.

When I'm going into a mediation in a couple of weeks and there's one person in the room that is all about, let's leave the past behind and move forward, and it's, yeah, that would be step 3, but you can't get to step 3 until you hit 1 and 2, and you've got to get 1 or 2 or 3 is surface. It's what they call false harmony and it explodes on you later. And you wonder why that mediation didn't work. Gotta follow the principles. Love that point.

Yep. No, absolutely. One of the things that I love, so I have been all up reading your blog and listening to your podcasts. And I have really enjoyed doing that. And one of the models you talk about for building that perspective, seeing, trying to introduce into your own thought process, maybe the way somebody else looks at this situation, is the idea of the prism.

Yes.

Tell us what that means and describe to us how using this prism imagery really helps us get insight into what other people In this conflict with us are thinking.

Prisms aren't too common anymore, but here's this light that's around us all over the place and it looks white. And yet a focused beam of light through a prism delivers a rainbow breakout of individual light bands. And unless we understand those bands and the ordering of those bands, And the filter, and let's use a prism as a metaphor for a person's filter.

Absolutely.

Unless we really know what that filter is like. And it's always a humbling process because at first you're thinking, how did you get that rainbow outta that light, for heaven's sakes? Yet if you step back and then you hear, humblingly so, A trauma or a bad experience or a childhood experience. And suddenly you're thinking, oh my goodness, how could I have been so short-sighted as to criticize that rainbow? And some people say, well, Carl, that's great, but— and this is the fatal phrase— we just don't have time for that in the worksite. And Keith addressed that in his book, 7 Habits. I paraphrase, we never have time to do it right this first time, but we will always be forced to make time the second time to do it right.

Mm-hmm.

And so because I am laser focused and I need this key performance indicator done by the end of the first quarter, which is 21 days away right now, and Carl, I understand you have some feelings on this, but we've gotta get it done. The chances of that working well are coarse. Carl may be very cooperative for 21 days, but each day that I'm checking off toward my KPI, I'm also digging a hole of resentment because you didn't listen to me. I wasn't asking for anything more than a concern to be understood, yet you just blew right by me, Mr. Boss. And so that— Was I gave you your KPI on March 31st, like you wanted to. And when the headhunter calls me the next day, chances are I'll talk a lot more openly about jumping. And we don't connect between resolving conflict well and employee retention. And we look at our bottom lines and we think, oh my goodness, we lost $1.1 million in this area. But we can get rid of Surgeon John Doe in a heartbeat. And, but did you look at the recruiting costs that it's gonna take to replace Surgeon John Doe? Especially if it's a high subspecialty, that's gonna cost usually about $1.2 to $1.5 million.

Yep. That you saved.

And you can never recover for 2 or 3 years. what Surgeon Doe would have generated because you didn't take the time to do X, Y, or Z with it? Really? And you're concerned about your budget. Now I'm sounding really snarky and sarcastic, but it blows me away that people can't see the connection.

Yeah. And what's so crazy about it is that's so prevalent in healthcare. $90,000 to replace a nurse, one nurse. Half a million dollars to replace an academic physician, $1.2 million to replace a subspecialist surgeon. You know, the numbers are there. And I love how you said, because I think this is a very common issue with conflict, is because again, we don't like it. We're scared of it. We don't see it as a potential transformative experience. We see it as something that we need to get rid of as quickly as possible. And so how do you get rid of it as quickly as possible? Like you said, you skip steps. You skip this idea of communication, of humility, of reducing defensiveness, of trying to see somebody else's perspective, trying to feel how people feel seen. You skip right to, okay, we're good, but we're not good. We might be nodding, we might be smiling, but we're not good. And we don't find out that we're not good until ex-surgeon leaves. Until an entire floor of nurses leaves. We don't realize we're not good till then. And at that point, the damage is done. We've already had the conflict that's decimated our system. And it's this idea of, there's a quote, and I'm not sure if this was on your blog, but I loved this so much, that conflict doesn't need to go away. It needs to be useful. And I loved that so much using the idea that we're not trying to get rid of it as soon as possible, that we're literally trying to use it to illuminate. When you are talking about conflict or you're working as a mediator, do you find a lot of people who are conflict avoidant?

Oh, yes. A couple of quick examples. I'm working with a labor and delivery unit years ago, and they were really doing well. And so I just asked them, As we go into next meetings, what would you like to learn as we do team development? And one of them says, I'm not too good at conflict. I've only been in 4 delivery rooms because we have 4 children, but I think most labor and delivery nurses have no problem going toe to toe with the world to advocate for their patient. They are steel-toed as they should be.

Yeah.

And so I thought, Wow. I never would've guessed that labor and delivery nurses were conflict averse. And so there were 13 of them around the table and I said, does anyone else have those? And 11 hands went up.

Yeah.

2 weeks ago, I'm dealing with a unit, brilliant nurses, and one of them says, I hate conflict. And so we did a couple of scenario role plays and they were taking notes as if it was wisdom from heaven. And it wasn't, it was just me talking, but it was, oh, could you repeat that again? Because I like that phrase. It was Conflict Resolution 101. And these are advanced nurses, no rookies in the room. And yet no one, they've been put in high conflict situations with absolutely no training on how to handle something. It happens for them every day. The nice thing is it's exciting to see the enthusiasm for learning this. I hardly have anyone saying, no, I really don't want to learn conflict resolution. No, they are lining up for it.

Yeah. And I think that's one of the things, and one of my things that I've talked about with Kim Best, and because of her in large part, I've realized that those of us who are passionate about working about conflict in healthcare, It's a big small world. There's a lot of us who are working in this space because we understand the importance of it. And I think what's happening now is you're seeing more and more professionals, administrators, residency program directors who understand how important it is for all of us to have these skill sets. I did a talk with a residency program this past weekend and they were first and second year residents. And I sent out surveys. I always do this before doing these talks because I'd love to know what's going on with them. These are anonymous surveys. But I really want to know what the culture is like for them. And I think what's really interesting about this is clearly they've all been around it. They've all witnessed it. They've all seen what conflict can do and they've all seen the negative effects of it. But one of the questions I always ask is, did you get to see or be a part of anything that you saw positive come out of that conflict? But they don't get to see it. They don't get to actually witness anything positive. And so the idea that something positive can come out of it, I think is a really big aha moment for a lot of people who are curious about conflict in healthcare.

And I think it just goes to your point that you mentioned with that one expert, was it at Vanderbilt that you mentioned working with him to help people see how powerful it can be when again, the process is meticulously Apply. And then because what I've seen with my physicians and the ones that I've interacted with, they are data-driven. They are brilliant individuals. And when they can see that this isn't just kind of a warm fuzzy concoction, but there is this and this step to it, and that it really does bring people to the table, as your colleague mentioned. You know, we facilitate the process.

One of the things that you talk about also in your blog, or one of the blog posts that I love, was talking about the 3 types of conflicts that leaders in healthcare especially, but I think all leaders need to learn to manage. And those 3 different types of conflicts are tasks, relationship-based conflicts, and value-based conflicts. Tell us the difference between those 3 and maybe ways that you have helped people learn how to approach each of those.

You noted those in, as strange as it might seem, order of difficulty.

Okay.

Tasks are pretty easy because it needs to be done. You're wanting this, you're wanting that. Let's find out the interests and let's bring it together. I'm simplifying it, obviously. Relationships, because, and one of the best books on relationship mediation is Difficult Conversations by a trilogy of authors, Stone, Patton, and Heen, out of the Project on Program on Negotiation at Harvard. As it centers around some pretty personal things. Am I a good person? Am I seen as good? Am I seen as competent? Am I seen as lovable? And you start messing around with that and you're starting to get into the high parts of the hard drive. Those hit close to home. So that's more difficult. If you really want to walk into the field of landmines, it's about values because values are truly our hard drive. We see this now in Carl's opinion here in our highly polarized society. Where someone says X and I feel Y, it's a value. Instantly I go after them because they threaten me to my very core. And I think that's where we need to go in reverse. Many times I think we overlook the role that values play in our day-to-day work. And when those values are assaulted because unintentionally, I've just not run into too many people that wake up wanting to destroy my life. They're unaware of their impact, but still, when one of my values is threatened, I can become very claws out really fast. So that's where, again, to your colleague at Vanderbilt's point, where we need a process to say, no one's assaulting. We're talking, we're respecting. Carl, tell me why that is such a closely held value for you. And you have Carl talk in an arena where no one's crossing their arms or rolling their eyes or shaking their head or scoffing under their breath. And sometimes we have to be really clear with people because you and I have both— Well, I didn't say anything. Well, you verbally, you didn't, but every inch of your body was saying that you felt that this person was just this close to being very despicable. So don't tell me you weren't talking. And to set up those guardrails, I just had this in a large mediation the other day where I had to send out— it turned out to be, not that I've ever over-talked things, doctor, but it was a 5-page document of This is what you can do and this is what you can't do on Tuesday night. Because one of them had said, well, we'll try to be civil if we can. And it's, oh, please, you know, you are a board-certified physician. You can probably decide if you're going to be civil or not.

Yeah.

So giving them the ground rules so that the values didn't become the issue, but how to resolve the And that's huge.

That's so awesome. The idea of guardrails, of we are very clear and focused on what we're in conflict about because it's so easy for us, right? When we have, let's say, one specific issue that we are really working on and trying to understand what everybody's perspective is, but somebody else wants to, and I've seen it happen in meetings and you have too. Where there's one issue that's being talked about and all of a sudden somebody's across the table going, I don't trust you. I've never trusted you. And now we're starting to flip the script. And I have seen people start to kind of devolve into that defensive mode of now this is a personal attack and I'm going to defend it. And at that point to say, okay, we are now losing what we are here to talk about. We need to return back to our actual issue and then. When the mediation is over, okay, we have come up with a working solution for this issue. And then to go to the side and say, we probably need to have a separate discussion about the relationship conflict that just happened here. But that's not happening today. We are going to do that and we're going to keep these issues separate. But I think as human beings, we get into conflict, we naturally start pulling in these other issues for multiple reasons. And you've seen it happen.

Yeah.

We don't understand that there is a way to approach conflict that actually can preserve and enhance relationships. And one of them is actually knowing what you're in conflict about.

Absolutely. And you said something that's really important is to have the strength as a leader to extend the time of resolution. I call it the tyranny of the timeframe. We have a tense issue here and we have till 4 o'clock, so we need to get going on it. And it's okay, so that it's been bothering me for the last 10 millennia. I have 10 minutes to tell you about it and resolve it.

Yeah.

Versus the leader that says, we're in the thick of it, folks. And to your point, we're not going to be able to talk about everything today, but we are going to be able to do X, Y, and Z. And it just relaxes the room.

Yeah.

Yes, absolutely. There is something that occurs when you can guide people into this discussion of this is what we're doing today. I do think it creates a safer space to have discussions, but you're not dismissing anybody's concerns at all.

In fact, you're giving them a rare window to let them know that for the first time, probably ever within their corporate life, That they're going to have a real opportunity to resolve a problem. Because we surface skim all the time because we just KPI meeting time, et cetera. One thing I suggest to leaders is when they're really diving in, just have a listening session. John, tell me what the problem is. And just take notes for that meeting and then tell John, you brought up some really good points and I want some time to think those through so I can respond better. Could we talk on Thursday about this? And it just, whoa, Carl or John or whoever's running the meeting, he's serious about this. Now you have to do it on Thursday if you've said Thursday, but they're used to the Well, John, thank you for your comments. Now let me tell you what I was thinking before you started talking, but I'll pretend that I'm thinking your points are important. And I'll tell you the decision I made before I supposedly wanted your opinion, and then we'll all be happy and we'll move forward. No, no, no, no, no, no.

And that happens all the time. That happens all the time. There was so much that I learned looking at your blog and listening to your podcast. But you do use this quote, and I think to me, what you just said, it just absolutely frames it. Hearing what's behind the silence.

Oh yeah.

Actually listening to what people say, but listening to what people don't say and having the ability to sit there, actively listen and listen in such a way that you find messages beyond what people are saying. What people say is important, but sometimes what they don't say is more important. And if we're able to hear that, that's gonna make us more powerful in the process.

And one of my professors in graduate school said something that stuck with me for decades. The person who is most nervous talks first. And there's so many times I learned this from a great mentor. And many times I'll write it across my ever-present yellow pad are the letters W-A-I-T, which is wait. And it also means, why am I talking? Because it's silence and I'm paid to resolve things, so I better be saying something wise instead of, Carl, just let the silence do its powerful work of bringing out what really needs to be said. And it is so hard to do. And the payoff is astronomical, but I have to write it at the top of my pad, even after all these years, because it's not natural to be quiet.

That's beautiful. Well, thank you for sharing that because I'm going to start doing that. Because that's really cool. That understanding of the power of silence, of stepping back, of letting other people talk, of really actively listening in the process. That is incredible. Carl, if you had one thing that you could pass on to physicians in leadership or physicians who just want to be better leaders, if you could give them one piece of advice, what would it be?

It would be to pay attention to the power of what we overlook all the time, and we mentioned it already. It's the power of strong listening, to truly put aside your biases. In whatever form they show up, and just listen and take notes. And that's all you do. You don't need to express your opinion. You just need to truly hear the other person and do what they call looping. Come back with them. Now, Carol, did I get this right? You said this. I want to make sure. It seemed like this was important to you. Did I get this right? that right? And then stop the urge to pontificate on what you think would be a good point. Then just dig in again. And Carl, you mentioned this. Why is that so important for you? Because it sounds like it really is a key item for you. You will see walls drop amazingly. And I was joking with someone earlier today on our podcast recording that so many times when I talk about listening and Oh yeah, we do that well already. I've got that. Oh, what's step number 2? You hear because you have 2 ears that are functioning, but listening is not hearing. Listening— Steve Covey's, his 5th principle is seek first to understand, then be understood. He would give a role play where he would, until the person could tell him that she felt that he could advocate for her as well as she could for herself. He had not listened appropriately. And I've always thought, what a gold standard.

That is awesome. And that is amazing instruction. Carl, if people want to reach out to you, or if they want to know more about the coaching group, how would they do that?

We're on LinkedIn under coaching group and under Carl Piester. There we have a YouTube channel that we opened up last July, so That's open. It's Coaching Group Inc. And you'll find us there. My website is coachinggroupinc.com. If people want to get ahold of me on a cell phone, it's 503-381-8705. So always happy to talk and any situation that I can add value on, happy to do that.

You have definitely added value for us today. So thank you so much for being here. Thank you for sharing your wisdom. Thank you for encouraging us to be good listeners, to actually understand that conflict can be transformative, to not skip steps in the process, and to be guardians of that process because the process works, and to encourage us to embrace it. Thank you so much.

It's been a pleasure to talk with you today. Thank you so much.

And for all of our peaceful warriors who have joined us today on The Scalpel and Sword, until next time. Be at peace.

Every episode is an invitation to speak, to negotiate, to choose. I'm Dr. Lee Sharma. Join the dialogue by subscribing to Scalpel and Sword. Until next time, peaceful warriors, may your choices be sharp and your voice be even sharper. This podcast is a reflection of lived experience and research in conflict resolution. The Scalpel and Sword is not intended as medical or legal guidance. For personal matters, please consult a qualified professional.