Modern society is riddled with examples of how poor communication can lead to confusion and chaos. Poor communication has become the standard in society, and many people have never been taught what effective communication entails.
Communication is defined as the exchange of information between individuals, whether verbal or nonverbal. Effective communication is essential in order to appropriately and accurately translate information between individuals. Communication is about gaining a connection. This may seem like an obvious concept, but it’s one that’s too often neglected, particularly in my field, health care.
For health care providers to confidently assert their expertise when working with patients, success is rooted in the performative nature of communication and their ability to demonstrate humility and embrace collaboration. In many ways, technology has had a deleterious effect on the culture of communication in health care workspaces, with communication being diminished from thoughtful, in-person conversations with patients to texting via secure platforms about patient cases. Additionally, electronic medical records are inundated with acronyms exclusive to each specialty, with no crossover understanding.
In my work as a palliative medicine physician, I encounter heavy and difficult conversations on a daily basis, especially when delivering serious news in tense family meetings that deal with navigating life-changing decisions. It is not easy, but after observing many communicators, I have learned a thing or two.
For one thing, I’ve learned to avoid being the type of doctor who can beautifully and eloquently articulate the complex physiology of disease, even mastering the art of persuasion in terms of what is safest for a patient, but then neglects to include the patient in the conversation. The soliloquist is not an effective communicator. I have sat with families who have encountered this oblivious doctor, and when they leave the room, the families’ demeanor changes from “Thank you; you’re the best doctor ever” to “I cannot believe the doctor just said that; we are going for a second opinion.”
Just as a doctor can be inadvertently ineffective in their communication, families can be with doctors as well. The tension is rooted in the unwillingness to be truthful about emotions because the exchange may be superficial or appear transactional. I have seen the breakdown of communication at the granular level. When families are told there are no treatment options left, they may feel dismissed or unheard if they are not walked through the doctor’s thought process — a doctor must take the time to build a connection.
So how can health providers ensure patients and their families feel heard and that doctors make a connection? One solution is to hire people who may speak the same language as patients. Health care centers often don’t think to make hires that reflect their community, but speaking the same language as one’s patient can help with nuances of communication that can be botched in translation, and centers should hire more people who natively speak the same language as the patient population.
Another factor is establishing what effective communication looks like. Who is deciding what is defined as excellent communication? When it comes to hiring physicians, candidates are often judged based on what their communication skills signal about subjective factors such as one’s upbringing, cultural influence, concentration in STEM versus humanities, socioeconomic factors and whether one’s parents spoke English as a native language. Unfortunately, people are still heavily judged for having an ethnic accent. Hiring managers in health care should keep in mind that when it comes to serving the greater community, communication is a connection. The more we understand one another, the greater the chances at effective communication and the more positive the outcomes.
Ivy Akid is a physician at Johns Hopkins Hospital who works as a palliative medicine doctor. The views and opinions expressed in this piece reflect those of the author and not necessarily the hospital.
