The Quality Corner show welcomes back Vibhuti Arya, PharmD, MPH, FAPhA and Professor at St. John's University's College of Pharmacy and Health Sciences for a discussion on interpersonal conflict and how that relates to healthcare.
Podcast Host Nick Dorich, PharmD, PQS Associate Director of Pharmacy Accounts, chats with Arya about different types of conflict and how connections are formed through these conflicts.
Discussion revolves around internal boundaries and external relationships and the conversations that form from these interactions.
Vibhuti Arya on previous episodes:
SDOH
Improving Data and Storytelling for SDOH
The Quality Corner show welcomes back Vibhuti Arya, PharmD, MPH, FAPhA and Professor at St. John's University's College of Pharmacy and Health Sciences for a discussion on interpersonal conflict and how that relates to healthcare.
Podcast Host Nick Dorich, PharmD, PQS Associate Director of Pharmacy Accounts, chats with Arya about different types of conflict and how connections are formed through these conflicts.
Discussion revolves around internal boundaries and external relationships and the conversations that form from these interactions.
Vibhuti Arya on previous episodes:
SDOH
Improving Data and Storytelling for SDOH
00:00:00:21 - 00:00:20:24
Vibhuti Arya
And I tell you, the beautiful part of that, you know, this this kind of idea of kind of QAing the or QIing whatever the question is that like, should we find ourselves here again, it really helps you look through a lens of how could we tackle this? What are the things in the process that need to look and feel differently?
00:00:21:01 - 00:00:56:20
Vibhuti Arya
And then you start thinking, okay, well, I got this piece, I got that piece. I'm not I'm not okay with that piece. That's just not my style or that's not what I do. You know what Nick does? Let's get Nick in the mix, right? You can start building these connections and building the relationships and building the bridges that I think a lot of times people don't take the opportunity for because conflict carries with this such this heaviness and this, like, negative association, you know, so so there's identifying and inviting people to look at conflict a different way has been like, you know, kind of like the passive resistance, like it's like a chef's kiss when
00:00:56:20 - 00:00:59:06
Vibhuti Arya
that happens.
00:00:59:08 - 00:01:24:08
Intro
Welcome to the Pharmacy Quality Solutions Quality Corner Show where quality measurement leads to better patient outcomes. This show will be your go to source for all things related to quality improvement and medications and health care. We will hit on trending topics as they relate to performance measurements and find common ground for payers and practitioners. We will discuss how the platform can help you with your performance goals.
00:01:24:10 - 00:01:58:04
Intro
We will also make sure to keep you up to date on pharmacy quality news. Please note that the topics discussed are based on the information available at the date and time of reporting. Information or guidelines are updated periodically and we will always recommend that our listeners research and review any guidelines that are newly published. Buckle up and put your thinking cap on the Quality Corner Show starts now.
00:01:58:06 - 00:02:19:19
Nick Dorich
Hello Quality Corner Show listeners and welcome to our podcast where we discuss medication use and how to utilize pharmacists to improve health outcomes. I'm your host Nick Dorich and hopefully fingers crossed this episode is live coming to you also as a video cast for the first time, we often record over video but only get to use the audio, but hopefully you get to see our smiling faces this time.
00:02:19:19 - 00:02:42:14
Nick Dorich
Fingers crossed that it's working for today's episode. We're going to jump right into our conversation for this topic and we're going to introduce our guests. It is a returning guest to the podcast, and previously we have had her on to discuss social determinants of health, to talk health equity. But today we're going to talk about some different items that relate to leadership in health care and about a word that most people don't like to deal with.
00:02:42:16 - 00:02:49:09
Nick Dorich
But before we get into that, we're going to introduce our guests. So, Doctor Vibhuti Arya, welcome to the show. How are you doing today?
00:02:49:11 - 00:02:54:09
Vibhuti Arya
Thank you so much for having me back. I'm really excited for our conversation today.
00:02:54:11 - 00:03:11:09
Nick Dorich
Excellent. So the beauty I know you folks have listened to your episodes on the show before, and we'll probably link or reference to those past episodes in the show notes here so that people can go back and listen to them. They're already two of our most listened episodes of the show, but hey, it's great messages. More people should hear it or hear it again.
00:03:11:15 - 00:03:23:17
Nick Dorich
But Vibhuti, Do you mind giving us an introduction so you know who you are, what it is that you do in your day job as in your experience as a pharmacist? And really, because I know this is important to you as someone that works in public health.
00:03:23:19 - 00:03:52:00
Vibhuti Arya
Yeah. So I am a public health pharmacist. I teach actually at Saint John's University, my alma mater. I work with the New York City Health Department as my practice site. So students who come on AP rotations, they rotate with me as a public health policy and management elective. And really it's about integrating pharmacies and pharmacies into public health initiatives, particularly early in our most medically underserved areas are priority areas where we try to improve health equity and dismantle structural racism is a feat.
00:03:52:02 - 00:03:58:23
Vibhuti Arya
So that's kind of what I do is looking at integrating pharmacy into public health practice but really through the lens of equity.
00:03:59:00 - 00:04:16:12
Nick Dorich
Excellent. Well, that's that's a big job and somebody has to we all have a part to play in helping to achieve that. But thank you for taking some time out of your schedule and away from the main responsibilities to have this important conversation with us here today. We're going to again, this is going to be a little bit of a different episode in our conversation.
00:04:16:12 - 00:04:39:21
Nick Dorich
Well we will address why this is an important conversation to have on the Quality Corner show, because it's not something that's specifically about medicines or people. But this actually does tie in to how we as people work, teach, educate and ultimately help improve the lives of the patients that we're working with, because that really is the goal. But as we know in pharmacy, it's not as simple as taking a medicine.
00:04:39:21 - 00:04:51:17
Nick Dorich
There's it's so much of the health care aspect is how we as people work together. So we're going to jump into that. But real quick, we're going to pause for a moment and hear a quick message from the team.
00:04:51:19 - 00:05:16:06
Breakdown
Now it's time for the breakdown. As Quality Corner Show host Nick Dorich asks three main topic questions. Our guests will have a chance to respond and there will be some discussion to summarize the key points. This process will repeat for the second and third questions, which will wrap up the primary content for this recording. After that, I expect to end on a closing summary, usually containing the bonus question.
00:05:16:08 - 00:05:23:14
Breakdown
Now that we have described the process, let's jump into the questions.
00:05:23:16 - 00:05:41:05
Nick Dorich
All right, very. We're back and ready to jump in for today's conversation and what we're going to talk about. I didn't address this briefly, but we're going to talk about conflict, interpersonal conflict and how you resolve that. So this is something where I know people are already, you know, in their headphones or in the car as they're driving listeners up.
00:05:41:05 - 00:06:03:06
Nick Dorich
So they're thinking, wait, conflict, what does this have to do with health care? We're going to talk about that. But first, let's talk about conflict. Generally, it is something where it can be abrasive, and it can be stressful. But the theory, why is conflict really, why is it necessary to grow, to evolve, to change into really kind of improve our process and the things that we do?
00:06:03:08 - 00:06:46:00
Vibhuti Arya
Yeah. So it's probably the thing that raises a lot of eyebrows when I say that I love conflict, including my partners. I'm sure he was very excited about that. I think that generally speaking, when we hear conflict, there is a sort of physical, maybe visceral reaction to wanting to, you know, tense up shoulders, condense, kind of your body kind of feels a lot more tense and you for some people can kind of get triggered and to go into like shutdown mode, I think that systemically across many institutions, cultures and systems that we operate in, there is a sense of avoidance of conflict all the way stemming from like interpersonal one on one communication to families
00:06:46:00 - 00:07:20:20
Vibhuti Arya
to systems and organizations and for me, I think conflict. I see it as an opportunity. I see an opportunity for connection, not just with a person, as in our relationship. We'll get closer or not, but really how a connection to how a person perceives value, what they prioritize, what's important to them. And so for me, it's kind of an insight for look at looking at how people can turn into how we can turn conflict into creating connections both again with people but also in what is important for them.
00:07:20:22 - 00:07:46:02
Nick Dorich
Yeah, exactly. So conflict, it doesn't always right. When we hear conflict, we always think of these catastrophic, you know, blow ups or physical altercations. And that is certainly one extreme of what conflict is. But conflict can be a disagreement between coworkers. It can be a stress between a manager and an employee. Conflict can be. And I think this is where it relates into why we're having part of why we're having this conversation.
00:07:46:03 - 00:08:06:09
Nick Dorich
A conflict can be the patient at the pharmacy counter getting upset with the pharmacist or the pharmacy technician because they don't understand why they have a co-pay or why this. Right. That is a form of conflict. So this comes in many different ways, shapes and forms. But ultimately conflict is it's a bad thing. We like to many people like to avoid it.
00:08:06:09 - 00:08:27:16
Nick Dorich
And that's typically the response most people have. But Vibhuti, as you said here, it also creates us an opportunity to really kind of change something, form a new connection and often in life, the things that are most difficult and that push us the most. These are the things that lead us to be stronger people, to lead us to be better people, and to be able to address this in new ways.
00:08:27:16 - 00:08:50:24
Nick Dorich
So I want to transition us to really this idea, perhaps maybe a mantra, maybe it's a slogan. It's something that you're that you love to say. And that is really meaningful to you. It's turning conflict to connection. So what does this mean? Can you expand upon this thought? I've got some additional items here that I may ask you as follow up questions, but I'll let you respond before I before I jump into it further.
00:08:51:01 - 00:09:10:02
Vibhuti Arya
Yeah. And I think maybe people might be familiar. I've heard it more in the context of relationships with one of my favorite sort of therapists, if you will, is there. PEREL And part of it is really for me, it's not just a relationship, it's actually inner conflict. So where this stemmed from for me actually was a spiritual basis.
00:09:10:02 - 00:09:46:08
Vibhuti Arya
It's understanding conflict within oneself, which if anybody has any inclination towards any sort of religious understanding or spiritually with meditation and stuff, since my other life really looking at, it's funny to say other life because it's actually super connected. But anyway, but really looking at conflict within the self, right? So a lot of teachings, a lot of elders, a lot of oral traditions, the psychology around human connection and how we look towards counsel advice really, if you think about it, stems a lot from conflict that you have with it.
00:09:46:08 - 00:10:15:23
Vibhuti Arya
That's what I'm more interested in. So the way I kind of describe it visually is think about kind of having like, you know, we all have energy, right? And so think about like this, a lot of energy. All right, Like right here, remember Street Fighter, like, you know, so like having that energy right here where we're dealing with things within ourselves, why something may trigger me, why something may bring up something inside of me that makes me be defensive or makes me want to fight or, you know, all the static load fight and flight kind of thing with stress and coping.
00:10:16:00 - 00:10:38:04
Vibhuti Arya
But whatever that energy is right now, everything. So visualizing it right here in front of me, everything that you might be delivering to me verbally, non-verbally, that's coming through is kind of going through this lens. Right. And so you may not intend things a certain way, but the impact that it's having on me is through the lens of like this stuff that I'm dealing with.
00:10:38:06 - 00:11:03:03
Vibhuti Arya
And if I am not aware and can consciously understanding of what this stuff is, that all my stuff is filtering through and if I don't like learn to kind of part it a little bit so that what you're coming at me with, I can receive the way it was intended, or at least understand a little bit of how it was intended, then it's going to likely result in some sort of conflict, right?
00:11:03:03 - 00:11:36:00
Vibhuti Arya
Because I'm looking at it my way. And what happens is that in my observation and experience, when I've done a lot of trauma work and a lot of facilitation work, is that people then tend to be entrenched in their own polarized views. So you're here. I'm here. And because my perception is that you have no intention or you are not interested in understanding what I'm thinking about, or you're just dealing with a lot of stuff and I'm dealing with a lot of stuff, and none of us have any sort of awareness to, you know, figure out and process that stuff.
00:11:36:00 - 00:12:11:14
Vibhuti Arya
Then we become entrenched in where we are, even more so. And sometimes the conflict, what it is, is kind of like each person's perceived defense and role in like further, you know, sort of grounding into that. And so conflict for me that the insight and the awareness that it gives really is about yourself, right? So that's what I'm talking about is the internal awareness, the internal conflict we may have that actually influences the external relationships that we engage with, the external interpersonal relationships, but also how we show up in a system, how we show up in a team.
00:12:11:16 - 00:12:25:24
Vibhuti Arya
The values we both consciously and unconsciously or intentionally and unintentionally impart into, you know, the sort of aura of the team and infuse it in a way that becomes part of a culture.
00:12:26:01 - 00:12:50:08
Nick Dorich
So when we talk conflict and the beauty you mentioned this where folks can often, often their response is try to avoid or bury it, just ignore it. Other folks may dig in and become rigid to it. And when I think about conflict or how we deal with it, it's all about really creating that flexibility, right? Because there are what, 7 billion people on this planet and growing.
00:12:50:10 - 00:13:12:02
Nick Dorich
There's going to be a lot of people we have conflict, conflict with. And simply, if we avoid conflict, we're not developing any of our tools to be able to deal with that. And the different interactions that we may have along the way, or if simply we become stuck to just our one own way to deal with conflict, become very rigid and over the course of time that doesn't actually sort conflict.
00:13:12:04 - 00:13:38:17
Nick Dorich
That leads to more conflict with the more people that we meet along the way. That is, unless we stay into our own little echo chamber with thoughts and people that stay with the same way. So really this whole idea about conflict to connection, it's about emotional intelligence, right? Being able to read and understand people where they're coming from In a lot of ways, as I think about this idea, it's really from a pharmacy standpoint, we think about motivational interviewing.
00:13:38:19 - 00:14:03:15
Nick Dorich
This is in its own way, motivational interviewing, but for dealing with people on a personal level. Right. And how we work through that part of it, how that's going to matter and why that really makes a difference. Now, the beauty the follow up question that I want to ask you about, this is a conflict, a connection. There can be an assumption here that this means that we have to resolve the conflict and that both sides need to be happy.
00:14:03:17 - 00:14:16:23
Nick Dorich
But I don't think that's the intention. Right. Like, we can we can walk away and we don't need to be on that necessarily. We don't need to have the same solution, but maybe we're at least on the same page of an understanding. So can you help us extrapolate that idea?
00:14:17:00 - 00:14:41:10
Vibhuti Arya
Yeah, So I'll do that in two parts. One part I would say is I'll challenge this to take it even one layer deep, which is it's actually before we look at trying to have conflict or think of conflict with others external to us, take it one step internal. So when I do a lot of conflict like workshops and stuff and this inevitably comes up particularly, you know, you're looking at implicit bias and health equity.
00:14:41:16 - 00:15:06:10
Vibhuti Arya
As you can imagine, a lot of things kind of get stirred up. And one of the things that I kind of offer to people is that there's an invitation there when that happens rather than what we've been conditioned, I think, socially a lot to do, particularly I think in health care, it's like turn the thing to patients or turn the thing to your colleagues, like move that inside of you and say, what did this bring up in me?
00:15:06:12 - 00:15:29:22
Vibhuti Arya
Why do I have the reaction that I have? What is it doing to me? And I think part of what that gives you is an exercise or an invitation to think about ways in which you have to actually figure out why you're feeling a certain way. So what that means is, is there some sort of thing this reminds you of?
00:15:29:22 - 00:15:46:08
Vibhuti Arya
Is there an incident that happened that has put you in a constant mode of, you know, feeling this way? And so this is another example of that. There's so many layers to this, but the layer deep that I would invite us all to do is like, okay, hold up, timeout. What is this doing to me? And where did that come from?
00:15:46:14 - 00:16:06:21
Vibhuti Arya
Where did I learn the language that I'm associating with this conflict? Where did I learn that reaction? What is happening to that reaction and how I'm doing this? One of the things that or I guess the importance of why that's important is also understanding your own boundaries, right? So when you have that conflict again, it tells you more about yourself, I think.
00:16:06:21 - 00:16:31:08
Vibhuti Arya
And when you have more awareness of yourself, the work that you constantly keep doing is deepening that journey within yourself and understanding how you can show up to be the most compassionate person, not to resolve everything and to walk out holding hands. It's to offer compassion. I can understand that. I have learned through this conflict. Basically, it teaches me it's something that's important to you.
00:16:31:10 - 00:16:53:22
Vibhuti Arya
And it also might teach me what the limitations of our relationship are going to be. And that's really important. I think that there is a desire or maybe a seduction to want to always have something, you know, nicely packaged and bow tied and kind of saying great, I know a conflict is because now we're going to go to a happy hour together or now we're like hanging out and that's not the resolution.
00:16:53:22 - 00:17:12:13
Vibhuti Arya
So you don't have to be resolving the conflict the way you think a resolution looks like. What that actually means is that you have to be fine with the ambiguity, and you have to be fine about learning about things that you may have discovered or learned about. Now, this person that is pertinent to their journey, they may not be at a point.
00:17:12:13 - 00:17:35:01
Vibhuti Arya
So I talk a lot about certain things, right, Like health equity, like people sometimes are not where others may be. And so it can get very tenuous some time. And, you know, taking let's say somebody it's kind of like think about pharmacy school like a it's not that a P4 student is better than a P1 student. It's just that they have more experience and time and understanding, right?
00:17:35:07 - 00:17:54:23
Vibhuti Arya
So you can't say that like you can't compare them in say a P4 student is better at explaining ACE inhibitors and arbs and mechanism of action than like a P1 might be right get all nerdy about this, but a P1 student may just be learning. They're like what's angiotensin right? And so that's not a fair comparison. It's just where people are at.
00:17:55:03 - 00:18:12:18
Vibhuti Arya
So it's important for the P4 student to understand that. Okay, your P1, I see where you're coming from and I know how to frame this a certain way. And for the P1 to also understand the P4 is not, you know, they're at a different kind of experience, but we can kind of still meet some way.
00:18:12:18 - 00:18:35:20
Vibhuti Arya
We can learn about where each other is and meet there. So you have to learn or I guess anybody has to learn that we have boundaries and that's a really difficult thing. That could be a whole other podcast episode in understanding how to create and have boundaries. But I think the, the again, that opportunity that the conflict gives you is to learn about what your boundaries might be right?
00:18:35:22 - 00:18:55:14
Vibhuti Arya
And how do you cultivate a collective so that you're constantly not battling this one on one as your own. You have to have people around you. And what I mean with that collective is not people who tell you you're amazing and you're right all the time. It's people who tell you you're amazing, but also point out that, okay, you might need to let this one go.
00:18:55:20 - 00:19:15:24
Vibhuti Arya
This might be, you know, where you're at, but the other person's not or, you know, I wonder what this triggered in you. It sounded like the same conversation we had last time about a similar situation. And now there's a pattern. So how do we uncover that? So that's a very maybe emotionally mature and evolved conversation, but that's what the collective helps you provide.
00:19:15:24 - 00:19:39:24
Vibhuti Arya
It's helping in assisting kind of the journey with each other in progressing into a way that's not resolving anything. And I put that in air quotes. It's actually just deepening your understanding of that conflict, what that opportunity has given you, what that invitation has brought you. And really, again, like I said, it teaches you something important about what could be a value, a priority for the other person perhaps.
00:19:40:05 - 00:19:45:09
Vibhuti Arya
And it also very importantly teaches you what the limitations of your relationship may be.
00:19:45:11 - 00:20:02:10
Nick Dorich
I like to think of that, Vibhuti. It's the sort of idea where, at least in my life, the people that I’m most honest with or that I feel I could be the most honest and forward with are the people that I'm closest with. And if there's something that's there that's going on, I'm going to tell it to them or let them know about it, warts, and all.
00:20:02:12 - 00:20:21:03
Nick Dorich
Right, That may be more difficult for you with someone that you don't have that understanding with. And then the other aspect of this, as we talk about conflict or just as I think about it, we don't necessarily all have to be experts in dealing with conflict in different ways. Right. And it is okay sometimes to walk away, right?
00:20:21:03 - 00:20:41:18
Nick Dorich
There are some times where you can see that, hey, this the way to resolve there is a way to resolve this conflict. Or maybe there's a way that I can work with this person. But there are there can be instances where it goes against your values or your morals and being able and right and respecting your boundaries to say that, hey, this is not a conflict that right this this whole idea, we're not necessary, that you have to resolve every conflict.
00:20:41:20 - 00:21:05:09
Nick Dorich
And then there are going to be people that are somewhat more rigid in how they resolve conflicts. And I think we all, when we think about our friends or family, when there are conflicts that come up, there are some times where you say, hey, I need the bulldog to go into this fight for me, right? We all have that one friend when you're at a party or something else like that, or maybe you're out at dinner and you're having a hard time getting the waiter's attention so you can get the check right.
00:21:05:13 - 00:21:20:12
Nick Dorich
You may need to have the bulldog who goes right up to the waiter stand and finds the host so that you can, you know, that's another way that you resolve that you may need to resolve conflict, knowing that this is maybe a tool that can do it, but it's not a tool that I feel comfortable with.
00:21:20:14 - 00:21:57:10
Vibhuti Arya
And I would say to that, I don't know if that's resolving the conflict. I think it's navigating it because you haven't really dealt with the problem, which is that I feel discomfort in calling somebody's attention, for example. And I think what that does is there is different ways, right? There's and this is what I mean about the collective also, is that I have had super deep conversations with people I just met, because where they're at is that level of authenticity, where they're real with themselves and then can be real with me in a conversation that we don't because maybe we're used to doing the work of going layers deep.
00:21:57:12 - 00:22:19:24
Vibhuti Arya
There's a certain amount of comfort, there's a certain amount of know, just comfort, like being okay with that. And then there are people who I've known for years who probably could not have that level of conversation because that's just not where they are. Right? And so there's I always say that there's just like a dance you play with life and it's not right or wrong.
00:22:19:24 - 00:22:37:15
Vibhuti Arya
It's not good or bad. It's not that kind of binary dichotomous feeling. It just is what it is. And I think you have to be good about if I have the awareness and the insight of where I'm at, I am able to then right? There's another process then of making sure where I'm at. I'm communicating it with the person.
00:22:37:17 - 00:23:03:01
Vibhuti Arya
And a lot of times the reason even people when they know where they're at, may not be able to communicate because now they're constantly worried about how the other person's perceiving it. Right? And so that's another layer. So there's lots of layer.. We’re a beautiful mess, Humans, right? It's complex. But the the place where that comes in is that, for example, there might be situations where I know that let's go back to the oversimplified example of like calling the waiter over, right?
00:23:03:03 - 00:23:29:08
Vibhuti Arya
I know that there are some people who have, for example, social anxiety. I've had I've worked with people and I've had people in my life were just like, I'm just not it just like they literally it's too much stimulation. And so, yes, there are points where like you have the basketball assist, right? Like you just need the assists where somebody comes in and says, You know what, I got this for you, hang out, do your thing, I'll take care of the situation.
00:23:29:10 - 00:23:50:22
Vibhuti Arya
Now, I do go back to that person and say, okay, my golden question, should you find yourself here again? What could you do differently? These situations will come up again and so why I love conflict is that it gives you insights so that you can apply that quality improvement to the next situation right there, insights that you gain that you can be like, you know, should I find myself here again?
00:23:51:02 - 00:24:09:18
Vibhuti Arya
I could have done this differently. And so I'm constantly like in that cue a cycle with just things that happen in life. And it's a lovely way for me to engage with somebody because it doesn't blame people. It doesn't say, you know, Nick, why didn't you say? But it, it, it it's more like, okay. Nick, you and I had a conflict.
00:24:09:20 - 00:24:31:16
Vibhuti Arya
Should we find ourselves here again? Which we probably will. What could we do to kind of take us to the next level of this so we're not at the same level in the same surface of conversation. And I think that's the other piece is that it's not like I tell my children this, right? I don't ever tell them like, don't fight it, because it sends this message that like conflict is bad.
00:24:31:16 - 00:24:59:03
Vibhuti Arya
It's not something you should be doing. I am like, okay, how do I prepare you for when the conflict does occur? Because it will occur. Conflict is bound to occur both within you and outside of you. And how do you deal with that? And so maybe in that other scenario where a person's like, I don't want to call the person, call the waiter over, hold the server over, You can say, you know what, I'm right here with you and I will be with you when you go through this and come out on the other side.
00:24:59:05 - 00:25:18:01
Vibhuti Arya
Right. Is it helpful if you have that relationship to hold the hand? Is it helpful to say you got this? Is it helpful to provide information? Right. It's not always going to be looking the same, but how do we result? So like, some of the things I use is when I see kind of two or multiple parties at it, you know, it's okay.
00:25:18:03 - 00:25:42:16
Vibhuti Arya
Nick, I'm hearing that that is really important to you, and that's kind of the central thing that's emerging from what I'm hearing. Did I get that right? Right. Teach back method, motivational interviewing. Right. Resolving the addressing discrepancy. I'm hearing that you want to be able to lose weight and I'm hearing it's really hard for you to restrict food intake or kind of food intake because it's tied to your emotional well-being, because that's what we call a comfort food.
00:25:42:18 - 00:26:00:20
Vibhuti Arya
Right? So let's go layers deep and figure out. So the first person first thing of that, it's like acknowledging that, Am I even hearing correctly? Right. What I'm noticing may not be what you're intending. So how do we resolve that? How do we figure that discrepancy out? Here's what I'm hearing. Did I get that right? Okay, now let's move to the next level.
00:26:00:22 - 00:26:17:08
Vibhuti Arya
What are your goals with this? What are the things you might want to be able to do and really recognizing just like motivational interviewing, right? Like, this is not about me. It's not about my agenda. And I have students, you know, when I teach my mike break down, this is not about you go right. Like this ain't about you.
00:26:17:11 - 00:26:36:05
Vibhuti Arya
This is not something that you get to impose your agenda or your values or your priorities onto the patient. It has to be shared decision making similar ways. I may be in conflict with you as I'm talking to you. Or maybe you and I are at the board table and we're talking and a conversation comes up where we can find a resolution.
00:26:36:05 - 00:26:57:23
Vibhuti Arya
All right. Well, let's go back and figure out what is it that's bothering us about the situation. And I tell you, the beautiful part of that is this kind of idea of kind of QAing the or QIing whatever the question is that, like, should we find ourselves here again? It really helps you look through a lens of how could we tackle this?
00:26:58:04 - 00:27:34:14
Vibhuti Arya
What are the things in the process that need to look and feel differently? And then you start thinking, okay, well, I got this piece, I got that piece. I'm not I'm not okay with that piece. That's just not my style or that's not what I do. You know what Nick does? Let's get Nick in the mix, right. You can start building these connections and building the relationships and building the bridges that I think a lot of times people don't take the opportunity for because conflict carries with this such this heaviness and this, like, negative association, you know, so so there's identifying and inviting people to look at conflict a different way has been like, you
00:27:34:14 - 00:27:54:10
Vibhuti Arya
know, kind of like the passive resistance, like it's like a chef's kiss when that happens. So, you know, for example, I went to Dublin Trinity College of Trinity College basically as a visiting professor. And one of the things and they were just like, who is this? Like, Why are you trying to talk about trauma and health equity and like conflict?
00:27:54:12 - 00:28:07:12
Vibhuti Arya
I thought we were going to get a lesson about like race and ethnicity. And I'm like, Well, let's actually get into like a lot of this conflicts. It's not in the circle. We were in theater space that I requested because it's just a different feel than being around a table where I don't get to see your body language.
00:28:07:14 - 00:28:27:12
Vibhuti Arya
And as we were talking, one of the persons who kind of was with me throughout the three days said, you know, all day long, said, I don't do conflict. Diversion is like my thing. I avoid it. I want everybody to be in harmony and peace. I don't really think I have much conflict. So, we're good. And day three, as we were debriefing at the end, she was just very quiet.
00:28:27:12 - 00:28:58:12
Vibhuti Arya
We're doing this trauma session. There were a lot of tears and such, and she said, You know, you really made me think about conflict very differently. And I there's been a lot of stuff that's been coming up for me that I don't even think I was aware that I had. And, you know, the reason we do like a debriefing kind of coming together at the end is so you don't feel you don't leave people feeling kind of raw if you will, because for many people, this could be the first time that they're looking at conflict this way as an invitation, as an opportunity.
00:28:58:12 - 00:29:27:23
Vibhuti Arya
Right. Something there's a dissonance between like what has been subscribed or excuse me, associated with that word and now what you're inviting them to do. It's a little bit different. So it's a beautiful thing in my mind and experience when that happens. But it is a journey to getting that to happen and I think all of us through our experiences, will learn that, you know, baby, Nick and I thought we were at a at a place of our conflict.
00:29:27:23 - 00:29:48:12
Vibhuti Arya
But, you know, maybe we need to go two steps back and kind of revisit it. And there has to be humility in that. There has to be a certain sense of honesty and authenticity to say like, my bad, like this was not you know, there were a couple of missteps here. Let's go back and kind of figure that out rather than demonizing the other person and saying, no, you're wrong.
00:29:48:12 - 00:30:03:21
Vibhuti Arya
You did this this way. And that's it. We're done. So there's an invitation there somewhere. And again, I think part of what you may struggle with or we all may struggle with is sometimes the other person doesn't take that invitation to and that has to be okay also.
00:30:03:23 - 00:30:24:00
Nick Dorich
Yeah. So with that, Vibhuti, I want to transition us to really kind of putting the exclamation point on this conversation. And we came in saying that it may be a bit uncertain or confusing why we're having this conversation on a podcast that's typically about pharmacist and medication use. But I'll note this is a podcast and we have peaks.
00:30:24:00 - 00:31:05:08
Nick Dorich
We focus on quality improvement and quality improvement inherently is going to be about improving. It's going to be about, to some extent, I would say, embracing conflict, moving right and not moving past it, but embracing the conflict, adapting as necessary in ways that can sometimes be painful and sometimes that may take us out of the comfort zone, but with the intention of, you know, these are in a practical sense, this is about making changes to our pharmacy practice, to our public health practice, so that we can improve the health care, improve the outcomes of the patients and our communities that we're serving.
00:31:05:08 - 00:31:25:23
Nick Dorich
That is the ultimate goal. And at least from my standpoint, when when you brought this up as the topic and hey, can we can we talk about this on this particular particular episode, to me it was absolutely. We need to understand our audience. We need to understand we need to embrace that conflict is necessary for growth, but it's not necessarily conflict is necessary.
00:31:25:23 - 00:31:45:11
Nick Dorich
It's about how we address it. As a follow up. So, you know, throughout the episode here today, you talked about how social determinants of health equity. You talked about even giving references on the differences between students that are up. One MP for our items that may be seen as conflict, our differing skills aren't really about what their knowledge is or what their education is.
00:31:45:11 - 00:31:55:13
Nick Dorich
But you know, any other points that we haven't hit on about why this is an important conversation and why this is important skill to develop as a health care provider.
00:31:55:15 - 00:32:19:01
Vibhuti Arya
Yeah. So I think that the exclamation point maybe to kind of envelop this whole conversation really is that if we do not embrace conflict and if we do not make the connection between like having a really solid process, a quality improvement process and embracing conflict, we might actually be contributing to an insidious culture that actually asks us not to be honest about that.
00:32:19:03 - 00:32:53:03
Vibhuti Arya
And so what we need to do is sow the seeds of change that long before we're departed and transition from this planet. Hopefully are still bearing fruit for others. Right? Like I think inherent to the process is looking for pinpoints, is looking for things that could be better. That's the whole point, essentially. And so to do that, you have to have I have to have we have to have as a team, as a collaborative and and maybe a practice of humility and accountability.
00:32:53:03 - 00:33:11:04
Vibhuti Arya
And I think that part of why people may run away from conflict, even like now, people are using the word accountability, you know, in the water. Right. It's like accountability. But accountability is not punishment. And I think that's how in my experience in observation, I've seen it used quite a bit. We need to hold people. It's not punishment.
00:33:11:06 - 00:33:42:23
Vibhuti Arya
It's a, it's a call. It's an invitation. Perhaps I like to use that word very deliberately because it seems a lot more holistic. It's not like trying to be sly and catch you. It's actually an invitation for us to be like, okay, what can we do better? So I think that the cultural mindset shift that has to happen is rather than looking at this as a pain point, which it will be, you know, we know through humans and anatomy and civilizations and ancestry, that pain is pain is kind of good for you, too.
00:33:42:23 - 00:34:08:17
Vibhuti Arya
Like there are things about pain that are not just negative, right? Other parts of your when you're in pain, for example, other hormones and other things come to your aid to actually eases through that. And I think that sometimes as a culture, as a society, we get stuck in the pain and the negative aspect. And so it sends this sort of subconscious message again contributes to this insidious culture of like, that's bad, too.
00:34:08:19 - 00:34:25:23
Vibhuti Arya
We're going to be right here as we go through it. We're going to be right here with you as you come out of it. And that has to be the commitment, right? That's a good to I process. We're going to go in. Things are going to get revealed. We may not like it. We may feel guilty, We may feel bad.
00:34:25:23 - 00:34:48:19
Vibhuti Arya
We may feel like I've missed the boat on that or no, we made this. But by identifying, acknowledging, acknowledging, I want to say that again, because that seems to be also a thing that people shy away from. Acknowledge what's going on, and let's figure out a way to move through it because we will be with you and together and life is going to keep moving on on the other side.
00:34:49:00 - 00:35:15:06
Vibhuti Arya
And that has to be a crux of kind of slowing that. And I think for leadership that's so important because how you as a leader may kind of cultivate that change, may promote that change, but acknowledge the necessity of that will actually help people in your team who are prone to that kind of thinking, who may be like, I don't know, I'm shy to talk about this or I don't want to because of retaliation or whatever else, or it seems like it goes against the grain.
00:35:15:08 - 00:35:39:04
Vibhuti Arya
It can bring that out in that invitation to actually get a collective brain and trust going. And that's how you move things forward. It's not for me and you to fix everything tomorrow. It's for us to kind of sow the seeds of change that are going to outlive us, right, outpace us. And that's the piece that we want to be focusing on as a collective unit, as a way for us to improve these systems.
00:35:39:06 - 00:35:57:18
Vibhuti Arya
It's not just me and you in conflict, right? We can work on ourselves, but we have to also work on the system. We have to work on the insidious culture. We have to improve that in a way that's going to lend itself to be better. Right? And itself accountable so that we're not the only ones saying this stuff.
00:35:57:24 - 00:36:18:02
Vibhuti Arya
It has to be the vernacular of everybody has to be the vocabulary that everybody feels like. Yeah, of course. Accountability. Totally. Should we find ourselves here again? What could we do differently? Let's do this. There should be an invitation and excitement and enthusiasm about embracing UI for the self right internal conflict and for the external processes.
00:36:18:04 - 00:36:39:09
Nick Dorich
Yeah, absolutely. This is it's a it's going to be a continuous process. That's one thing, at least when we work with our clients externally, internally quality improvement, it is a continuous process. It has to be there's, there's not a form of perfection that exists for us as the humans, right? Any anything covers.
00:36:39:09 - 00:37:03:14
Vibhuti Arya
Barriers. It uncovers barriers, right. That then you can be like, we did not think about this. We weren't thinking that this seemingly non pharmacy, non med use behavior topic. Seems like that's the thing we need to tackle. Can be interesting. Uncovered something new and that's where you can look at conflict and find the connection again between yourself and you know, within yourself, but also within these processes.
00:37:03:16 - 00:37:23:12
Nick Dorich
Yeah. Yeah. So this is absolutely and like I said, we were looking to put an exclamation point in on this topic, Vibhuti. I think we had maybe two or three exclamation points on the, on the keyboard here to really hammer this message home because it is something that we're going to be working with. And the other thing that I'll just say here, progress is rare is rarely linear, right?
00:37:23:16 - 00:37:45:08
Nick Dorich
There are going to be parts where it is very much it's very much going to be hyperbolic, and there's going to be parts where that progress. It may seem like you're going downwards, but there's going to be parts where you are, the rocket ship going out, going up to space. And it's just that part where as long as we're continuing to be intentional for making these changes or embracing it, that's that is the important part that will yeah.
00:37:45:10 - 00:37:52:07
Vibhuti Arya
That's part of the culture shift, like going deep, deepening it sometimes means that you're going to uncover more stuff and yeah.
00:37:52:09 - 00:37:59:04
Nick Dorich
Sometimes, yeah, sometimes you got to dig things out of the closet before you got to dig things out of the closet so you can become the.
00:37:59:04 - 00:38:21:19
Vibhuti Arya
New you. Yeah. So like we know when people have pain and you got to like, feel around and that, that diagnostic procedure or whatever, right? Like that kind of feeling around to understand the underlying root of it might actually need that. You need to press on things and cause more pain. So it's, it's, it's the, it's the comfort with that process that I think will carry us through.
00:38:21:21 - 00:38:39:18
Nick Dorich
Fantastic. Well, the beauty before we wrap up today's episode, that that does wrap up our primary conversation about the idea of conflict, connection and why that's meaningful and why that's a necessary part of the quality improvement process for those of us in health care. But we want to ask a few questions of you to get to know you as a person a little bit.
00:38:39:20 - 00:38:53:09
Nick Dorich
I can almost promise that these won't be painful, that these are probably going to be some comfort questions for you. The first one is probably an easy one. What do you enjoy most about working in the field of pharmacy?
00:38:53:11 - 00:39:22:15
Vibhuti Arya
I love bringing pharmacy into the context of public health and vice versa. And I think having for me, an education kind of like a, you know, a la bell hooks practice of freedom, which is that being part of somebody's journey as they're looking at things and kind of, I would say, like lacing it with that social accountability, I think to me is the most exciting, exciting thing that hopefully will continue and outlive me.
00:39:22:17 - 00:39:34:00
Nick Dorich
Okay. Next question here. What fictional character would you want to work with you for? You're pharmacy and public health experience.
00:39:34:02 - 00:39:46:18
Vibhuti Arya
I don't know. A fictional character. I don't know, maybe a Sherlock Holmes type. A kind of like the conventional ways. I'll have to think on that more. But maybe. Maybe Sherlock Holmes.
00:39:46:20 - 00:39:56:03
Nick Dorich
Okay. All right. Next question. If you have one recommendation to provide about living a happy and healthy life, what would it be?
00:39:56:05 - 00:39:59:09
Vibhuti Arya
embrace conflict, baby.
00:39:59:11 - 00:40:05:11
Nick Dorich
I should have I should have preface with that one. That's not part of the conversation today, but that that is acceptable.
00:40:05:13 - 00:40:45:16
Vibhuti Arya
I think doing the work and being ooh, I mean, I don't know. I'm very spiritual with this, you know? So it's like finding something to connect to that's larger than yourself, I think provides, provides a way for us to tap into maybe the unknown where we as a society seem to want the answers to all the time. But being okay with not having all the answers and just showing up and doing your best, showing up and doing your best always, and knowing I would say there's like the three W's that I like to reference a worry-er, a warrior and a withdrawer.
00:40:45:18 - 00:41:10:08
Vibhuti Arya
And there are times when we have all three manifest. Yeah, there are times when we may be more in one phase and the other. But finding your community through that, I think is a is a basic tenet of how I live doing the work on your own, but finding your community, its really, really important. Also Sherlock Holmes, because he always looks for the stuff that's not very obvious and I love to do that.
00:41:10:10 - 00:41:21:05
Nick Dorich
It's a good point. All right. The last question what game show or reality TV show would you want to appear on?
00:41:21:07 - 00:41:29:06
Vibhuti Arya
my God, I am. I don't think I'm really into reality TV. Does SNL count?
00:41:29:08 - 00:41:32:23
Nick Dorich
Yeah, that counts that that would count. At least it does in my book.
00:41:33:00 - 00:41:36:18
Vibhuti Arya
SNL. I want to I want to talk to Jon Stewart.
00:41:36:20 - 00:41:38:11
Nick Dorich
Okay.
00:41:38:13 - 00:41:43:08
Vibhuti Arya
Like ladies sketch show. That would be really cool to work with. Okay. Yeah. I don't know.
00:41:43:10 - 00:41:47:18
Nick Dorich
Improv comedy. Yeah. I was going to say improv comedy.
00:41:47:20 - 00:42:03:12
Vibhuti Arya
Yeah. That also like dealing with actual issues, right? And don't shy away from it's like entertainment. Plus, again, I think actually, like that's kind of a technique that I use because I used to do improv and theater. It's, it's more utilizing that to get people to have connections.
00:42:03:12 - 00:42:04:09
Nick Dorich
And yeah.
00:42:04:13 - 00:42:11:05
Vibhuti Arya
I guess peer into themselves in ways that they didn't think they were about to do. They wouldn't do that process happen.
00:42:11:07 - 00:42:31:07
Nick Dorich
Excellent. Well, I thank you for the conversation today and and our our chat here on turning conflict to connection. Before we go. If folks want to hear more from you or if they have questions for you about this topic or maybe public health or maybe they went back and listened to your other episodes on SDOH and health equity.
00:42:31:11 - 00:42:33:22
Nick Dorich
But what's the best way for folks to reach it?
00:42:33:24 - 00:42:48:22
Vibhuti Arya
I would say you can email me. I'm on LinkedIn, you can email me at my you can connect at the beauty area dot com might be an easy way, but yeah, I would love to hear from you and hear all about complex too.
00:42:48:24 - 00:43:06:22
Nick Dorich
Excellent Well variety thank you for your time here on the show. Thanks for the lessons and conflict and connection and then for our listening audience that does wrap up the show. So we thank you for listening to another episode of the Quality Corner Show. We hope you join us next time. But until then, we have one final message from the team.
00:43:06:24 - 00:43:24:24
Vibhuti Arya
Thank you so much for having me. And I will just say to an acknowledgment, none of us do this stuff alone. And so I'm not here as an expert or, you know, any sort of thing on this topic. But really, my acknowledgment and connection for all the people who've come before me and the Giants who shoulders I stand on.
00:43:24:24 - 00:43:31:05
Vibhuti Arya
So that's a responsibility I hold dearly to my heart and I hope that everybody can tap into as well.
00:43:31:07 - 00:43:32:11
Nick Dorich
Thanks for reading.
00:43:32:13 - 00:43:34:06
Vibhuti Arya
Thank you.
00:43:34:08 - 00:43:55:22
Outro
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00:43:55:24 - 00:44:18:03
Outro
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