Sunday, September 13, 2009

Talk is NOT Cheap

Healthcare reform won't be complete unless attention gets paid to communication skills. My father is a case in point.

He's been in and out of hospitals for a number of years, but his latest visit to the ER reveals a number of fault lines in the system.

First, he has problems with numerous organs—kidneys, colon, bladder, lungs. And each of these organs is overseen by a different specialist. But there's no point person for these doctors, no one providing oversight, no one getting this brain trust together to make decisions based on ALL the variables. So if my father goes in for a test ordered by one doctor and finds that it requires contrast, my father has to speak up about it—the contrast is enough to decimate his kidney function. And then my father has to return to the doctor who ordered the test so a new plan can be hatched. This not only wastes the time of all the players involved, but it robs my father of precious time on a clock that ticks too quickly for cancer victims.

Second, he's been with some of his doctors long enough for them to know that he's a man of understatement with a high tolerance for pain and a tendency to let time heal things before asking a doctor to intervene. So when my father calls a doctor's office repeatedly saying he's concerned about the blood in his urine, I would expect the staff to recognize that there may be a problem. I at least expect someone on the staff to return his call and talk to him.

But nothing happened. Had the staff asked the right question, they would have learned that my father was seeing more than a hint of red. And he was scared. Surely this combination deserves a return phone call?

Instead, my father's energy continued to wane until finally, he fainted. At home, thankfully, and a friend took him to the ER—where he learned over the next 24 hours that he had lost half his blood supply!

The next day, when an associate of the doctor-who-doesn't-return-phone-calls stopped in at the request of the hospital doc, he was pleasant enough but never once said, "So sorry to see you in the hospital" or "We're going to do everything we can to figure this out." He didn't need to apologize for anything—just show a little sensitivity and empathy. That would have gone a long way.

Yet this doctor ruffled more feathers than mine. He ticked off the hospital doctor by writing a full page of illegible information on my father's charts . No one could read it. It revealed a lack of respect for the hospital's medical staff and a flagrant show of indifference to my father's health.

These communication lapses happen in all businesses. Before The Lull, I created a newsletter for middle managers on the subject—giving them advice on communicating with employees and upper management, providing scripts for some situations and templates for others, and offering insights about the psychology behind dealing with people. It's not rocket science but it does require you to slow down and THINK before engaging.

Author Malcolm Gladwell mentioned something related to this in Tipping Point. I believe he wrote that many malpractice suits could have been avoided if the doctors had simply conveyed their sympathy or apologies to patients. Such a small effort that goes largely ignored—not just by doctors but by many of us.

Here are some pointers for the preventive care of personal and business relationships:
1. What you say and do doesn't matter nearly as much as how other people perceive your intent and your results. (For instance, that doctor with the bad penmanship was probably just in a hurry and never intended to ignite the ire of the hospital staff or endanger my father's health.)
2. When people make vague statements, don't assume you understand; ask questions that uncover details. (In the case of the blood, questions of hue, frequency, viscosity, etc., should have been raised to gauge how serious the problem was.)
3. Take time to validate how the other person feels—regardless of what side of a dispute you're on, what position of power you're in, what you feel about the situation.
4. Return the call no matter how unimportant you believe it to be. (Again, what's unimportant to you may be extremely urgent to your caller.)
5. Make informed decisions. This means understanding the concerns of all the parties involved before implementing a plan.

Take time to communicate with care. It always makes a difference to someone.

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