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The art of managing 'difficult' people in general practice

Understanding colleagues' personality types, strengths and weaknesses can help you manage difficult people in meetings and other types of problematic behaviour.

It is Thursday lunchtime and time for the weekly management meeting. You have had a productive morning and are feeling calm and positive.

By 2.30pm, you are walking dispiritedly to the car park. The meeting felt like a waste of time. One partner talked over everyone else and had a lot to say. Another said absolutely nothing at all. A third denied ever having received any papers for the meeting and was therefore unable to make a single decision unless pressed. The fourth agreed with everything everyone said and you know she’ll corner you tomorrow and complain about several of the plans which were made. This happens every single week.

Subjectively, it may well feel as if everyone is simply being difficult and intentionally obstructive. Everyone, that is, apart from you: you are reasonable, calm, fair and balanced, have excellent listening skills and always respect the rights of others.

Objectively, this may well be the case, but will not be the whole story. Working closely with others in a small team demands that we make the effort understand our colleagues and put mechanisms in place to mitigate the impact of their (in your eyes) difficult behaviour.

Improving understanding

A wide range of tools is readily available to help our understanding of colleagues' behaviour, in various forms from online psychometric questionnaires to face-to-face training. Most of these tools classify personality types into groups and describe their characteristics and many go on to describe how one personality type may interact with others.

Some are based on Jungian psychological types, such as Myers-Briggs Type Indicators. Other models look at how individuals prefer to learn (Honey and Mumford) or how they function in a team (Belbin). What they have in common is that they all help deepen our understanding of the behaviour of ourselves and others. 

If you have identified that your practice team would benefit from some reflection about personality types in order to improve inter-personal understanding, what steps can you consider?

  • Undertake some background reading and training in one of the personality tools. This may benefit you as an individual both in terms of your own development and in terms of feeding back into the practice. It may also count towards your learning plan.
  • Identify a small group in the practice and try out an online personality quiz. Ask everyone to print off the analysis, think about it, and then look at the impact of the results in an informal manner. This should feel like a bit of fun, not a witch-hunt. Typically, team members who have not experienced this type of activity before will find it interesting – you may find that you stimulate a lot of discussion in reception. 
  • Invite a trained facilitator into the practice to look at the team’s composition in terms of personality types and advise on a constructive way forward.

Difficult behaviour in meetings

In terms of managing difficult behaviour in meetings, the role of the chairperson is crucial. The following are the most common types of behaviour requiring skilful management:

Behaviour type Characteristics Managing the behaviour

The introvert

  • Quiet
  • Good at: listening, watching, analysing and absorbing information.
  • State at the beginning of the meeting that you would like equal contributions from everyone present.
  • Ask them directly to say what they think.
  • Ask them to give their views first.
  • Make it clear that their contribution was helpful.
  • Recognise their previous experience.

The extrovert

  • Poor listener.
  • May speak too much; interrupt or speak over others.
  • Likes the last word.
  • Gets the discussion going.
  • State, at the outset, that you want equal contributions from everyone present.
  • Establish 'listening to what others have to say' as a ground rule.
  • Encourage self-monitoring as a ground rule.
  • Actively stop the talking by saying: ‘that’s really helpful; let’s hear from some of the others.’

The optimist

  • Supportive and positive about all topics, dislikes tough decisions and saying ‘no’.
  • Over-commits.
  • May say what they think others want to hear rather than what they really feel.


  • An ally.
  • Make sure they are on board with an idea before the meeting if you feel you will need support.
  • Check they are saying what they really mean.
  • Discourage over-commitment by recognising their existing commitments and looking for someone else to take a share of the work.

The fence-sitter

  • Uncomfortable about making decisions.
  • Finds it difficult to move forward in the discussion.


  • Ascertain why they are not ready to make a decision about an issue.
  • Make sure all information on agenda items is distributed in writing and in good time before the meeting.
  • Ask what they think the most important aspect of the decision is for them.

The pessimist

  • Sees the negatives in everything.
  • Will deflate discussions.
  • Quick to state negative opinion without listening fully to options.
  • Explore the validity of their negative opinion – identify possible barriers. 
  • Remind them the point of the meeting is to find better ways of doing things.
  • Encourage them to listen to others’ views.
  • Stick to evidence, not opinion.
  • Ask others to comment on the potential problems and to suggest solutions.

The comedian

  • Makes jokes and lightens the atmosphere.
  • Can say things that are not helpful and may use humour to undermine others.
  • Check whether there is a truth hidden in the joke and discuss it.
  • Move back to the purpose of the meeting.
  • If the behaviour is harmful or unhelpful, speak to them separately before or after the meeting.

The deviator

  • Takes the discussion off at tangents often into areas of personal interest.
  • Takes the meeting back to discussions that have already been resolved.
  • Makes leading remarks about sensitive topics.
  • Manage the situation by saying ‘we need to stick to the topic in hand’ and summarise where you had got to.
  • Tackle leading remarks with a direct question: ‘Is that something you would like us to put on an agenda for a future meeting?’ 


The mediator

  • Good at defusing conflict with either humour or clarification.
  • Fair, calm and consistent.
  • Looks for common ground.
  • States own opinion calmly and assertively.
  • Move the discussion back to them to see how they see the situation

The creator

  • Good at generating ideas.
  • Imaginative.
  • Good at initiating thoughts and suggestions.
  • This person will come up with ideas but will not be strong on detail or on making it happen.

The co-ordinator

  • Sticks to the topic.
  • Has a good sense of overall direction.
  • Inclusive style.
  • Not strong on creativity.
  • Good at goal-setting, making decisions, well-organised.
  • Does not deviate from the topic.
  • This person is also a useful ally at a meeting
  • Use them to help the group clarify its thinking and remain objective

Source: based on Meetings Management, The Productive Leader, NHS Institute for Innovation and Improvement

Other types of problematic behaviour

Behaviour we perceive to be difficult, or downright rude, aggressive or manipulative, is not confined to meetings. From time-to-time, practices will find they have a persistent malicious gossiper, a work-shy team member, a grumpy and negative partner, or a bully in their midst.

Behaviour of this kind always impacts negatively on the whole team and the quality of work or service to patients. It does not improve if you ignore it. In these circumstances, courage, consistency and assertiveness are called for on the part of both the practice manager and the GPs.

  • Hold regular one-to-one meetings with all staff members, so you are aware of issues as they arise and not after the event.
  • Expect high standards of behaviour from everyone and demonstrate these yourself.
  • Tackle problems actively when they happen by talking to all involved and finding a solution. This may involve facilitated meetings and conflict resolution.
  • Use the practice’s disciplinary and capability policies as a structure for managing persistent unacceptable behaviour, taking advice as appropriate if the situation may lead to dismissal. See below for resources on Medeconomics that can help with this.

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