The Art of Difficult Conversations: How Mastering Conflict Can Make or Break Your Physiatry Practice

Are You Avoiding the Conversations That Could Save Your Practice?

As a physiatrist and business owner, you signed up to restore function and improve lives—not to navigate endless difficult conversations.

Yet, here you are…

• Dealing with staff members who aren’t meeting expectations.
• Struggling to address patient compliance issues without damaging rapport.
• Trying to negotiate contracts with insurance companies that don’t value your expertise.

Every time you avoid these conversations, your practice, profits, and peace of mind suffer.

Most doctors were never taught how to manage tough discussions without draining their energy. Instead, they:

• Procrastinate and let resentment build.
• Explode in frustration after holding it in too long.
• Give in to demands to avoid conflict, at the cost of their business.

But what if you could handle difficult conversations with confidence—without the emotional exhaustion?

Let’s dive into the six-step framework that will help you protect your practice, your profits, and your peace of mind.

1. Prepare in Advance: The Key to Staying in Control

The biggest mistake? Going in blind.

Whether it’s a staff performance issue, a demanding patient, or negotiating a better contract, preparation gives you the upper hand.

• Get clear on the main issue—what exactly needs to change?
• Identify your ideal outcome—what’s the best possible resolution?
• Plan for resistance—what objections or pushback might you hear?

Preparation = confidence. Confidence = control.

2. Stop Catastrophizing: Assumptions Will Drain You

Ever find yourself rehearsing a difficult conversation in your head, convinced it will go terribly?

That’s called catastrophizing—and it’s a fast track to stress and inaction.

Instead of assuming the worst, stay open to possibilities:

• What if they actually respect your feedback?
• What if this conversation leads to a better work culture?
• What if setting boundaries makes your practice run smoother?

Your mindset going in will dictate how much energy you lose.

3. Listen Actively: The Secret to Unlocking Cooperation

Too many doctors focus on what they’re going to say next instead of actually listening.

The solution? Active listening.

• Maintain eye contact.
• Repeat key points to show understanding.
• Let the other person speak before responding.

When people feel heard, they become less defensive—which means less resistance and less stress for you.

Pro Tip: Try using “Tell me more about that” to encourage open discussion without tension.

4. Say “I”, Not “You”: Avoid Instant Defensiveness

Want to shut down a conversation before it even starts?

Start with “You never…” or “You always…” and watch the other person go on the defensive.

Instead, shift to “I” statements:

• “You never listen to my recommendations!”
•  “I feel frustrated when my medical advice is ignored.”

This keeps emotions in check and opens the door to real change.

5. Acknowledge Disagreements Without Losing Ground

Not every conversation will end in agreement—and that’s okay.

But respecting another person’s perspective makes them more likely to respect yours.

Try these phrases:

• “I see where you’re coming from, and I appreciate your perspective.”
• “I understand this is important to you. Let’s find a solution that works for both of us.”

Acknowledging their viewpoint doesn’t mean you have to agree—but it will keep the conversation productive.

6. Mastering Difficult Conversations Will Protect Your Energy

Difficult conversations are part of running a profitable practice. The more you avoid them, the more energy you lose.

• When you address issues early, you prevent them from snowballing into bigger, costlier problems.
• When you communicate clearly, you build a team and patient base that respects your expertise.
• When you set boundaries, you create a practice that works for you, not against you.

The most successful physiatrists aren’t afraid of difficult conversations—they master them.

Are you ready to have the conversations that will transform your practice?

Let us know in the comments if you’re committed to protecting your energy and profits!