Dr. Mayer’s newest customer service article available in Healthcare Executive magazine

Posted by BestPractices on September 16 2010

Below is the latest customer service article in Healthcare Executive magazine by Dr. Thom Mayer, Founder and Chairman of BestPractices.  “Dealing With B Team Members” was published in the SEPT/OCT 2010 edition of the magazine.

Dealing With B Team Members

Holding up a mirror can have a positive effect on them and the organization.

Thom A. Mayer, Founder and Chairman, BestPractices, Inc.

The legendary former CEO of Southwest Airlines, Herb Kelleher, was the driving force behind an airline consistently rated as the best in the industry in customer service. A clever business reporter once asked him, “If you had to make a choice between making your employees or your customers happy, which would you choose?”

Kelleher didn’t hesitate, answering, “My employees! If we make our employees happy, they will make our customers happy.” Simple advice, but how do you do that?

In a previous column, I discussed the importance of getting the “why” right before mastering the “how” of service excellence. The “why” of satisfying your customers is about understanding that all successful and sustainable service excellence initiatives are founded on the principle of making the job easier for our employees.  Simply stated, if it doesn’t make the job easier, it isn’t really customer service.

The A Team versus B Team example illustrates this point. A Team members exhibit positive, proactive and compassionate behaviors in their daily work, which make it a joy to work with them. The B Team members are precisely the opposite—negative, reactive, constant complainers—they devastate staff morale. They are Nurse Ratched, Dr. Cranky and Administrator Scrooge. By all estimates, we spend the vast majority of our problem-solving efforts as leaders cleaning up the messes they so systematically create in our healthcare systems.

Everyone knows who they are— except them. They truly don’t realize the havoc they leave in their wake and, indeed, believe they are bastions of excellence. If they knew how they are perceived, they would change on their own. Clearly that hasn’t happened, nor will it, unless leaders take action to deal with B Team members and their behaviors.

The most important step for leaders is to hold the mirror up to B Team members. We have to show them what their behaviors and attitudes are doing. Doing to whom? The most obvious answer is “the patient and his or her family.” After all, they are the customers, right? To adapt Herb Kelleher’s logic, however, it is even more important to show B Team members what their behaviors are doing to us—the other members of the healthcare team. This is a nonintuitive— or perhaps even counterintuitive— insight, but it is nonetheless a critical one. Holding up the mirror to the B Team members must, therefore, focus on developing ways to show them how their behaviors eviscerate team morale. But how do we start this process?

How to Counsel the B Team

Be clear and concise. Far too often healthcare leaders and managers are too vague in how they counsel B Team members. Here’s an example of a manager counseling a B Team member. (This is probably occurring somewhere in a hospital even as you read this.)

“Well, thanks for coming in to see me. How’s the family? Everything going well for you? I’ve been talking to some of the staff and we were just kind of thinking that things could be going a bit better and were hoping that you could help us make things better through your actions, because when things go better, people feel better, and then things actually get better. And because feeling better is what we all want, I hope you can help us on this journey toward better! Well, thanks for coming in and give this some thought.”

What did this manager just say? Most people would say, “Nothing!” The B Team member comes out of that discussion with no earthly clue as to what was said or what he or she is supposed to do differently.

Start by knowing what you are going to say before you say it. If possible, write down the words you will use to open and close the meeting. The message must be clear and concise. Don’t exchange pleasantries. This is not a social interaction. Come prepared with the facts, particularly examples where employees have documented specific behaviors at specific times with specific effects.

Developing an “A Team Culture” is essential—so your staff understands the traits of excellence exemplified by the A Team, as well as the demoralizing effects of B Team behavior. Part of the culture is encouraging staff members to communicate examples of A Team and B Team behaviors. Allow them to communicate these examples to you in whatever fashion they are most comfortable, whether verbally in person, via voice mail, or by e-mail or letter. (My experience is that voice mail is most often an easy and confidential way of communicating, whereas e-mail is more time-consuming, requires more concerted effort and is too easily forwarded, resulting in breaches in confidentiality.)

Encourage your staff to also report on how the B Team behavior made them feel when it occurred and what A Team behaviors might have prevented the problem. Act on the information quickly. Celebrate A Team behaviors in a public way.  Praise them for their excellence.

When meeting with B Team members, the following format, which I learned from a friend and mentor, Robert Strauss, MD, is one that is extraordinarily effective.

“When you do ‘X,’ it makes others feel ‘Y.’ Try ‘Z’ instead.”

But what are X, Y and Z? Simple. “X” is the B Team behavior. “Y” is the specific way the B Team behavior makes others on the team feel and interferes with the culture of excellence to which we hold ourselves accountable. “Z” is an A Team attribute or behavior that can be used instead. Here’s a simple example.

“When you show up late (the B Team attribute), it makes others feel angry, frustrated and taken advantage of (the effect on the team). Try setting your watch ahead or leaving home 15 minutes earlier than you need to (A Team attributes).”

As you can see, holding the mirror up to the B Team members can be done in a concise, focused and noncontroversial fashion. Notice there is no mention of the manager’s authority or the staff member’s insubordination. It isn’t about that; it concerns the effect on team members and how we can make their jobs easier. This is at the core of moving B Team members to the A Team. Over time, don’t be surprised

if your staff begins to use this language themselves. It usually isn’t long until the best of your A Team folks start dealing directly with the B Team—by holding up the mirror.

Give B Team Members a Mentor

These mentors are quintessential A Team members—people admired by your staff for their grace, dignity and the equanimity they bring to work daily. Have them work together so the B Team member can see the A Team attributes at work as well as the impact these attributes have on other team members.

Finally, have the courage and the conviction to replace B Team members who simply refuse or cannot make the transition to the culture of the A Team. For the good of staff members, the team and the organization as a whole, we must begin to aggressively deal with the B Team members. Oh, and don’t be surprised if Nurse Ratched, Dr. Cranky and Administrator Scrooge actually do move to the A Team and tell you how grateful they are that someone finally held up the mirror to them.

Dealing with B Team members isn’t easy, but it is much easier than ignoring how their behavior affects your staff. It is extremely gratifying when your team says, “What did you say to Dr. Cranky? He’s a completely different person!”

Editor’s Note: Thom Mayer, MD, is author of Leadership for Great Customer Service: Satisfied Patients, Satisfied Employees, published by Health Administration Press. For more information, visit

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