Massachusetts Medical Society: Episode 6: Holding Your Own in Difficult Conversations

Episode 6: Holding Your Own in Difficult Conversations

Holding Your Own in Difficult Conversations

Course Overview

Dr. Marie Curious reports back to Dr. Les Schwab that her arousal level is unacceptably high in the course of the work day, and he comments that difficult conversations in the clinic may be a contributing factor. He introduces her to Dr. Cathy Lanteri, a practicing psychiatrist and executive coach. Cathy explains that the current environment requires physicians to develop expertise in communication, conflict resolution and team building, and gives Marie pointers for effectively managing difficult conversations. One should take a step back, think about the primary goal, pay attention to one’s feelings, and consider how best to reach the other person. It is important to recognize how the brain responds emotionally when caught in a "limbic loop," and to short circuit that loop by thinking analytically. Cathy demonstrates the I-F-I-A-R (“if I am ready for resolution”) paradigm to help Marie navigate strained interactions more effectively.  I-F-I-A-R focuses on factual, first-person communications to help us maintain our composure and “get to yes.” Marie and Les both find utility in this approach.

Learning Objectives

  • Learn and incorporate the I-F-I-A-R (“if I am ready for resolution”) paradigm as a tool to assist with resolving day-to-day conflicts that come up in the course of everyday medical practice. 
  • Begin to apply the I-F-I-A-R paradigm in difficult conversations with colleagues and others while maintaining awareness of relational coordination and respectful, problem-solving dialogue techniques. 


Cathy Lanteri, MD
I coach leaders who wish to expand their effectiveness through a deeper understanding of their leadership capabilities and goals, and their impact on the work environment. Utilizing my multifaceted background in medicine, coaching, leadership, and broadcasting, I help medical and academic leaders succeed by clarifying their vision and implement it using an enhanced understanding of human dynamics, psychology, communication, and neuroscience.

My coaching programs also use researched-based coaching methods to help disruptive high-performing leaders become admired and supportive contributors to their organization’s advancement. 

I am a certified physician-development coach through the Physician Coaching Institute and accredited by the Boss Whispering Institute. I trained at the Massachusetts General Hospital and am a board-certified psychiatrist. After residency, I served on staff at the Brigham and Women’s Hospital and as a Harvard Medical School instructor before opening a private practice. Prior to medical school I was an award-winning broadcast journalist and honed organizational skills in government and political leadership positions. 

Outside of my coaching and medical practice, I serve on multiple committees at the Massachusetts Medical Society and am on the Board of Directors for the Physicians Insurance Agency of Massachusetts. I am a founding fellow of Harvard Medical School’s Institute of Coaching and am on the advisory board of the Physician Coaching Institute, where I’ve developed educational programing for graduate coaches. I also speak on career leadership, communications, and burnout prevention. 

Course Fees

Massachusetts Medical Society (MMS) Member: Free       
Non-MMS Member: Free       
Allied Health Professionals: Free



CME Credit

1.00 AMA PRA Category 1 Credit™

Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Massachusetts Medical Society and Physician Health Services, Inc. The Massachusetts Medical Society is accredited by the ACCME to provide continuing medical education for physicians. 

AMA Credit Designation Statement

The Massachusetts Medical Society designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This activity meets the criteria for the Massachusetts Board of Registration in Medicine for risk management study.

National Commission on Certification of Physician Assistants (NCCPA).
Physician Assistants may claim a maximum of 1.00 Category 1 credit for completing this activity. NCCPA accepts AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society.

Exam/Assessment: Please respond to the reflective statement at the end of the course to receive AMA PRA Category 1 Credits.

MOC Approval Statement
Through the American Board of Medical Specialties ("ABMS") ongoing commitment to increase access to practice relevant Maintenance of Certification ("MOC") Activities through the ABMS Continuing Certification Directory, this activity has met the requirements as an MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:

Allergy and Immunology
Family Medicine
Medical Genetics and Genomics
Nuclear Medicine
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry & Neurology
Thoracic Surgery

Activity Term

Original Release Date: January 24, 2019        
Review Date: January 24, 2021           
Termination Date: January 24, 2022

System Requirements

Windows, XP, Vista, 7, 8  
Mac OSX 10.6 higher

Most modern browsers including:   
Firefox 18.0+  
Chrome 26+  
Safari 5+  
Flash player is required for some Online CME courses.
iOS devices beginning with OS version 5 or higher (includes, iPhone, iPad and iTouch devices)  
Android devices including tablets and phones.  
Windows RT and tablets on Windows 8 are also supported. 


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