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Copyright 2017 State Volunteer Mutual Insurance Company

Effective Communication:

Physicians, Staff & Patients

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Why Is Communication So Important?

Physicians• 66 % of

medical errors

Staff • Turnover

Patients• Care &

wellbeing

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Leadership Requires Effective

Communication

What you say to others

How others hear you

How you hear others

Do the messages match

Gossip

Silent acknowledgement

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How Are You Doing?

Leaders

93%

7%

Effective Ineffective

Employees

11%

89%

Effective Ineffective

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5

Keys to Effective Communication

Connect personally

Engage in the conversation

Ask the question you want answered

Listen for the answer

Explain the why & why not

Reflective listening

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Communication Styles

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Assertive

Passive Aggressive

Respecting your rights AND the rights of others

Respecting others rights but NOT

your ownRespecting your own rights but NOT

the rights of others

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Be Assertive

Behavior

Action-oriented, firm

Realistic in expectations,

fair & consistent

Communication style

Attentive, confident, relaxed posture

Expressive tone &

gestures

Confrontation & problem solving

Confronts problems at the time they

happen

Does not let negative

feelings build

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Emotional Intelligence (EQ)

How we:

Manage behavior

Navigate social

complexities

Make personal decisions

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Achieve positive results

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Emotional Intelligence

• Perceive your emotions

• Aware of them as they happenSelf Awareness

• Flexible

• PositiveSelf Management

• Pick up on emotions of others

• Understand what is occurringSocial Awareness

• Use emotions to manage interactions successfully

Relationship Management

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Understand Who You Are Talking To

• Mode – face-to-face, phone, emails, texts

• Style – formal, abbreviationsCommunication

• Lazy & entitled vs difficult & stubborn

Negative stereotypes

• Time spent vs performanceCultural

expectations

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Traits & Characteristics

Task

Focus

Extroverted

People

Focus

Introverted

Perfectionism

Approval

Seeking

Controlling

Attention

Seeking

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Get it right

Fears criticism

Get it done

Fears failure

Get along

Fears loss of security

Get appreciated

Fears rejections

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General Population - DISC

15%

30%

35%

25%

Controlling Attention Seeking

Approval Seeking Perfectionism

12D=10-15% I=25-30% S=30-35% C=20-25%

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Physician Population - DISC

49%

15%

7%

29%

Controlling Attention Seeking Approval Seeking Perfectionism

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Generations in the Workplace

2%

29%

34%

34%

1%

Traditionalists Baby Boomers Xers Millenials Zs

Pew Research Center 05.11.2015

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Generational Characteristics

Consistency, uniformity, privacy, authority, formal, hardworking, struggle with change, LOYAL

Traditionalists 1925-1945

Optimistic, career=identity, team oriented, relationships, hardworking, overly sensitive, OPTIMISTIC, COMPETITIVE

Baby Boomers 1946-1964

Technoliterate, think globally, independent, hardworking till 5, impatient, SKEPTICAL

Generation X 1965-1980

Optimistic, civic duty, social, diversity, want value to work, struggle with hierarchy, REALISTIC

Millennials 1981-2000

Expect immediate information from management, impatient, instant gratification, want mentors as managers, DREAM JOB

Generation Z

> 2001

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Cultural Implications

Behavior, Interaction & Communication Preferences

Age

Religion

Race, Ethnicity

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How Others Hear Us

Words7%

Body Language

55%

Tone of Voice38%

Mehrabian, Albert 17

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Effective Body Language

Arms open

Body orientation, physical barriers

Lean forward

Head nodding

Slow, steady breathing

Pause before responding

Eye contact

Same level

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Positive Body Language Trumps IQ

Changes attitude

Increases testosterone

Decreases cortisol

Makes you more likeable

Conveys competence

Powerful negotiation tool

Improves emotional intelligence

19Bradberry, Travis. “How Body Language Trumps IQ”. 02.28.2016.

https://www.linkedin.com/pulse/how-body-language-beats-iq-dr-travis-bradberry

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But How Do They Hear Us On the Phone?

TONE

OF

VOICE

86%SVMIC Risk Evaluation Data 20

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Tone of Voice

Tells patients who you are

Makes you different

Builds trust

Used to influence and

persuade

Become firmer or deeper,

never louder

Sit up straight

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Communication Techniques

You sound upset

Tell me about it

What would you like me to do

Here’s what I would like to do next

Agree in principle

Thank you for sharing your feelings, experience

Blameless apology

I can

vs.

I can’t

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Verbal vs. Written Communication

Verbal Written

Groups, attachments

Not time sensitive

Written record

Succinct & tone

Time sensitive

Difficult conversation

Confidential

Tone of voice & body language

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Verbal Communication Tips

Difficult conversations

Tone of voiceBody

language

Be preparedChoose the

locationListen

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Written Communication Tips

SuccinctConsistent in

styleMake it easy to

respond

Not time sensitive

Large number of people

Attach documents

Tone

• Subject line

• Greeting & closingWritten record Never private

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Delivering Bad Information

Setting

Patient perspective

Information

Knowledge

Empathize

StrategizeBaile, Walter; Beale, Estela. “Spikes – A Six Step Protocol

for Delivering Bad News”. The Oncologist. 2000.26

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Physicians, Staff & Patients

Physicians

Staff

Patients

• Non-confrontational

• Define your expectations

• Confirm understanding

• Please you & keep their jobs

• Clear, succinct direction

• “Do I have what I think I have?”

• “Are you going to do what I think you should do?”

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Physicians

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What’s the Difference? Physicians

Decision makers

Problems brought to

them

Cannot make

mistakes

Cannot show lack of

knowledgeAutonomous Immediate

Trust advisors

Look for negatives

All about me

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Practical Suggestions

Identify mission and core values

Common goals

Decide how/when to communicate

Clarity of roles

Do not disagree in

publicMaximize time

Demonstrate your

competency

Continue your professional development

Provide feedback

Do not let problems

fester

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When the relationship goes off track…

Have the conversationWhat is

missing?

What do you need?

Where am I failing?

What I need.

Where you are failing.

Is this going to work?

Be true to yourself

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Staff

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Performance Improvement Plan

Document problems, incidents

Discuss with employee

Summarize conversation in an improvement

plan

Provide clear expectations

Include specific, measurable

objectives within a timeframe

Meet & review progress

Adjust plan as needed

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What to Say

If do not see significant improvement during the probationary period, the next step is…

You will be expected to meet these requirements within 30 days

Here’s what needs to happen

Value your work and want to give you an opportunity to improve

Beginning to recognize a pattern of behavior forming that may be detrimental

Concerned you are having difficulties

Observed your performance over a few weeks

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3535

Patients

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Patient Satisfaction

≠

Patient Experience

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Patient Experience

=

Patient Satisfaction

+ + +Effective Communication

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Low Health Literacy

1/3 of the US

population

2/3 of those

over 60

years of age

Half walk out

of the doctor’s

office not

knowing what

to do 2Ask an average

of 0-2 questions

when meeting

with physician

40-80% of

medical

information

is forgotten

immediately

50% of

retained

information is

incorrect

37% of

patients

report they

understand

80% of

physicians

thought the

patients

understood

Infographic: Facts About Patient Education 38

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Combating Low Health Literacy

Teach back method

Ask. Tell. Ask.

Questions beginning with “how” and “what”

– “Do you sometimes have difficulty understanding…”

– Acknowledge the difficulty

Plain language, enunciate

Written materials < 6th grade

Visit summary

Alternate teaching methods

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Takeaways

Avoid buzzwords

Be positive & genuine

ListenEngage in

conversation

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Questions

Stephen A. Dickens, JD, FACMPE

Assistant Vice President

Medical Practice Services

steved@svmic.com

615.846.8336

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