99. Case: Discussion with Staff on New Scheduling

You are the manager of an outpatient clinic that serves patients from throughout the Maritimes.  Many of these patients travel for their appointments and are trying to minimize time away from work, so after a discussion with the Patient Feedback team the decision is made to open the clinic on Saturdays and Sundays on a trial basis.  It is also hoped that this will reduce wait times for appointments.  You must tell your team about this change, which you suspect will be unpopular.  How will you structure the conversation?

In addition, you need to determine a fair process for deciding who will take the weekend shifts.  Some of your staff have children, while others do not.  Several staff members have other commitments on the weekends, such as sports teams and volunteer work.  You want to approach the conversation about staffing in a way that won’t create resentments between colleagues and are wondering how to do that.

You’re the only dietician working in an outpatient clinic and you’ve got an 8-year-old child as well as a parent whom you’re caring for at home.  You’ve caught wind of a plan to open the clinic on weekends and you’re angry because you know that you will be required to work weekends, and this will reduce the time you have with your family and increase costs for caregiving.  What are you planning on saying as you go into a meeting to discuss these changes?

Discussion Questions:

  • How did your response to the case shift when you read about it from a different perspective?
  • What do you see as the most important values for each person involved in the conversation?
  • What are the ethical concerns raised by this situation?
  • Are there aspects of decision making that could have been handled differently to reduce the likelihood of having difficult conversations?
  • What sorts of supports might help this difficult conversation to go well?


Danigelis, A. 2010. How to Communicate Employee Expectations Effectively https://www.inc.com/guides/2010/08/how-to-communicate-employee-expectations-effectively.html

Gooch, K. 2018. 7 healthcare leaders on conducting difficult conversations with peers. Becker’s Hospital Review, Published September 28, 2018. https://www.beckershospitalreview.com/hospital-management-administration/6-healthcare-leaders-on-conducting-difficult-conversations-with-peers.html

Forbes Coaches Council. 13 Ways Managers Can Initiate Tough Conversations With Employees. Published September 28, 2018. https://www.forbes.com/sites/forbescoachescouncil/2018/09/28/13-ways-managers-can-initiate-tough-conversations-with-employees/#196674672d9e

Hampbley, C. Managing Difficult Conversations with Practice Staff. Physicians Practice, February 9, 2017. https://www.physicianspractice.com/staff/managing-difficult-conversations-practice-staff

Ontario Medical Association.  Managing Your Medical Office Staff – An HR Guide for Physicians. Section C: Motivation and Retention. https://www.oma.org/wp-content/uploads/1_managingyourmedicalofficestaff.pdf