Does Your Organization Have a Case of UVT?

What is UVT? It’s the phenomenon better known as “Us Versus Them.” The most common symptom is the recurring use of the word “they.” You can recognize UVT in language such as, “They cut our budget,” or “They don’t understand what it’s like to work on this unit,” or “They won’t let me do this or that.”

UVT pits frontline staff against managers and managers against senior leaders and can even result in making the senior leaders look bad to the patients, family members, and medical staff. Its most dangerous effect is its ability to create a chasm between the majority of the workforce and the organization’s mission, vision, and values.

The good news is that you can recognize the early warning signs of UVT in your organization and take steps to reverse its progress.

Recognizing the Symptoms

UVT is often found in “victim think.” The “us” part of the equation always feel like the victim, being hassled or inconvenienced by “them.” Policy or budget changes are often the context or the catalyst for victim-think. It can surface in manager-to-employee discussions, employee-to-employee interactions, and employee-to-customer interactions.

For example, employees may cite policy to customers to make it seem like they aren’t the bad guy. “I’d love to let you smoke in the parking lot, Mr. Jones, but they’ve made a smoke-free campus policy.” Or from a manager to an employee, “I think it would be very valuable for you to go to that conference, but they’ve cut our education budget.” Or to the physician, “I know that you would like to schedule your patients differently, but they won’t allow me to do that for you.” These types of statements are the “victim’s” way of saying, “Don’t look at me. It’s not my fault.”

Listen to conversations within your organization. The language speaks volumes about the culture. Is there fingerpointing? Is the “they” language more prevalent than the “we/our?” Do employees view solutions as something everyone has a voice in, or do they rely on “them” to get things done? Do people feel that things happen TO them or are put upon them, rather than that they are part of an organization working with one ultimate goal in mind: to serve the patients?

While incidences of UVT increase during times of change and stress in organizations, low level UVT can create an insidious attack on a daily basis. UVT hampers productivity and takes everyone’s eyes off the end goal.

Causes and Risk Factors

It’s very easy for managers to give in to temptation to blame the senior leaders when explaining budget cuts, wage, and benefit changes or policy changes to employees. Because managers spend more of their time with frontline staff as opposed to senior leadership, they often align themselves with the frontline staff and fail to act as leadership ambassadors. This creates the two distinct camps that clearly are not on the same page with the organization’s strategic plan.

Managers are often stuck in a hard place. They form close bonds that often serve them well in teamwork in the department but make it difficult to deliver tough messages and hold team members accountable. It’s hard to say no to a friend, so they abdicate the responsibility to the nebulous “they” who make all of the unpopular decisions in organizations.

Another time UVT is likely to occur is when the organization lacks a clear vision and strategic goals or is lax in communicating its vision and goals consistently. If frontline staff have no way of identifying with the organization’s goals, then the organization will never be a part of their “us/we” thinking. Leadership will always be “they”–a separate authoritative dictatorship leaving the staff to struggle with the demoralizing effects of UVT.


While UVT is prevalent in many organizations, eradication is most probable with daily habits and simple language changes. The most effective form of treatment is communication.

Treating UVT starts with paying attention to your language and keying in on seemingly harmless statements that can undermine the organization. You might even find that you are helping to spread UVT by referencing “them” or “they” in conversations with employees. Recognize that, while these UVT statements might make you feel like you’re creating a bond with your employees or team members, in the long run, these statements do nothing to further the mission, vision, and values of the organization. For any employee or physician that uses UVT in discussions with patients, remember that it rarely helps to make the organization look good. It may ease you out of an awkward moment with a patient or visitor, but it does nothing to further patient trust and the organizational mission.

The first step in treating UVT is to refuse to feed the morale suckers. These are the employees who seem to like to stir things up and never seem happy with the direction “they” are taking the organization. The morale suckers try to recruit their co-workers to their line of thinking and reject senior leadership initiatives as not in their best interest.

Combat this thinking with “we” statements. For instance, you might hear, “I can’t believe they want us to ask patients what they want to be called. Their names are written right on the chart–what a waste of my time!”

If you’re stricken with UVT, you’d reply, “I know; it seems like they’re always asking us to do more.”

To eliminate UVT speak, you’d reply, “We put such a high priority on patient respect here. Asking them how they’d like to be addressed is an easy way to show our respect.”

But what happens when you find yourself feeling trapped between the organization and what you feel is a valid point being raised by a team member? If you don’t think the employee is merely engaged in recreational complaining, start by acknowledging their point and thank them for bringing it to your attention. Assure employees that their opinions are important.

From there, look to strengthen a shared connection between the employee and the “them” he is complaining about. It might be that the employee is dissatisfied with a new policy. Most employees will agree that they want what’s best for their patients; explain that the policy was created with the patients’ needs in mind. If the employee does have a valid concern, help him express it as an innovative suggestion to senior leadership. Coach employees to express those concerns as part of an organization-wide team that shares common goals.


Once you have reduced the damaging effects of UVT, you need to work diligently to prevent recurrences.

Managers should pay close attention to the language they are using when talking to employees, especially when the conversation is about organizational changes. Working with a learning partner, you can periodically role-play tough communication situations to make sure that you’re speaking in the “we/our” language instead of “us/them.” While one statement might seem harmless, it can worm its way into employees’ language very easily.

Ask senior leaders for talking points to help you communicate with your staff about important organizational initiatives. That way you are comfortable with why changes are happening and can feel confident when you speak with your employees.

Finally, ongoing practice of these communication skills will help make them second nature.

By diligently working to eliminate UVT from your organization, you can help align all team members toward the same goals and make your organization stronger in the long run.

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