By Matt Skoufalos
Although communication is a fundamental skill in any working environment, choosing the right words to get your message across in a fast-paced, high-stakes environment like health care, where the majority of experiences are streamlined and protocol-driven, can become complicated to the point of easily distorting a message. In the medical imaging space alone, the varied layers of messaging that can occur in the normal course of operations – patient to clinician, patient to technologist, technologist to technician, subordinate to director, etc. – present opportunities rife with potential misunderstandings. Honing an ability to get clear on communication, and developing the skills to do so, is a key to career longevity as well as a fundamental pillar of patient care.
Gregory Goll manages the Projects & Medical Imaging Services Department for the Marietta, Georgia-based WellStar Health System, which includes one of the 10 busiest emergency rooms in the country, and hospitals that stretch about as far as the Alabama state line. Managing the responsibilities of his position doesn’t always involve face-to-face communication, but Goll described “90 percent” of his professional communication as being verbal. Doing it successfully involves establishing rapport with a variety of different professionals, and one of the most fundamental ways for interdepartmental professionals to establish common ground is to reconnect over why they’re there to begin with.
“We’re here for customer focus,” Goll said. “Once you lose that focus, maybe you should consider a different career. We joined this field for patient care; otherwise, we’d all be working somewhere else.”
“Even though I’m not touching the patient every day, we’re doing the best to meet our customers’ needs, which ultimately meet the needs of our patients,” he said. “When you don’t put your focus on keeping that equipment running, you can’t call your patients making that decision to take time off work for their procedure, and apologizing for the situation you’re in.”
Another common scenario Goll says he often encounters is how communication can be clouded by the nature of the problem versus how it’s being described from one party to another. Choosing to address an issue from the perspective of identifying the problem itself rather than whose fault it may be offers many more opportunities to resolve it than assigning blame.
“Sometimes people miss things not because it’s anything malicious, but they’re under a lot of duress, and you have to be in that person’s shoes to understand what’s going on,” Goll said. “In the imaging world, it could be that my MRI scanner took a dive, and now you’ve got 15 patients who are upset, and you need to recreate a schedule.”
Beyond the initial disappointment associated with the problem itself, avoiding presumptions that an issue is the result of incompetence, neglect, or worse, always helps to clean up an interaction. Goll recommends keeping interactions focused on returning to normal operations as seamlessly as possible, and then committing to pitching in to resolve the issue. Sometimes, disconnecting from the intensity of the moment can help clarify those needs as well.
“It’s a matter of addressing the problem and getting them help ASAP,” he said. “There’s been numerous times when I’ve come out of my office, and I’ll go up and see if there’s something I can do. Sometimes it’s something simple; other times, it’s someone wanting to know that you value them in a crisis. Their number one priority is the patient, and that’s where people lose focus if they won’t separate themselves from the repair to think about what the repair impacts.”
Another key piece of any workplace interaction, particularly one involving a call for service, lies in acknowledging that such an incident has an innate emotional charge around it, simply because a piece of technology that’s supposed to function in a certain way isn’t, or isn’t working at all. Managing the moment involves understanding the initial consternation around the precipitating incident, and then working backwards from that information to calm things down and deliver the fix that’s needed. Many times, taking the emotional response out of the incident also helps clarify the moment in a way that’s useful to diagnosing the issue – particularly if people feel like the fix is the subject of the conversation, and not their individual behavior leading up to the system failure.
“If someone calls you up and says they have a problem with whatever the modality is, people should feel that you’re actually listening to them,” Goll said. “A lot of the communication is how you treat your customers, first and foremost. They know that you have a belief that they matter, and that you have their back.”
“If the person is already having a bad day, and they’re calling you for help, they’re looking for you to throw them a lifeline,” he said. “You have an opportunity of dealing with it a few ways. If you throw them a cinderblock, it forces them to go underwater, and the credibility for your whole department starts to go downhill.”
In situations where a fix might be overly technical, or has the potential to yield an explanation that might be more confusing or complicating than is helpful to defuse the moment, Goll also prizes clarity of communication. The efficacy of deriving a solution is accelerated by finding ways to make yourself understood in as simple a fashion as possible. For Goll, who was once told by a service engineer that he “translates ‘geek,’ ” getting critical information across calmly and clearly in a moment of intensity is a worthwhile skill to burnish.
“During the heat of the storm, our goal is to calm the waters,” Goll said. “Sometimes it’s not the words you say, it’s how you say them. When writing emails, I learned that you don’t write paragraphs; you write short narratives: bullet points one, two, three, and here’s the solution.” Anybody can identify a problem, but if you know a problem is there, it’s immediately working on a solution.”
Consultant Brian Parsley, co-founder of The Constance Group, an international training organization that consults with employees across a variety of different industries, believes that one way to improve communication in any scenario is to un-learn a critical assumption with which many people were raised.
“The number-one mistake that we’ve been unfortunately taught since childhood is ‘talk to people the way you want to be talked to,’ ” Parsley said. “Unfortunately, this is really bad advice. The reality is, we talk to people the way they need to be talked to; we treat people the way they expect to be treated. When you have a misalignment of expectations, it breaks down communications.”
“It’s easy to put a label on someone: he’s aggressive, she’s unfriendly,” he said. “Most of the evidence is derived based on your bias; your experience. We think we know. And we believe it to be gospel, and it’s not. We only believe what’s true in our reality. I think the real secret to amazing communication lies in your ability to connect with the other person, and the only way to make that connection is to hear it the way they need to hear it.”
Parsley defines the five pillars to any relationship as: trust, respect, credibility, likeability and rapport. Based on social science studies that show people make arbitrary considerations about whether they like someone in less than a blink of an eye, he emphasizes some key shorthand strategies for building an immediate rapport.
“The best way to connect with someone is to be like them, and try to listen with a different perspective,” Parsley said. “A lot of times, depending upon our personality or behavioral style, people are misunderstood. If I happen to be someone who is very relationship-driven, very outgoing, likeable, and I’m talking to someone who is more clinical, more process-driven, more collected in their thoughts, I might see that as they don’t have an interest in me or they don’t like me, when in reality, they’re processing what I’m saying. Then I tend to overuse that one skill I have, connecting and talking, and that skill becomes a weakness.”
The bulk of communication, Parsley said, is non-verbal: things like body language, posture, tone of voice, speech cadence, and eye contact comprise much more of an interaction than the content of the words chosen, he said. Unfortunately, in a professional environment in which the bulk of communication is written, texted or disseminated without the contextual clues of those in-person interactions, it’s far easier to be misunderstood than it is to be comprehended clearly.
“To me, the biggest issue on the hospital side is it’s very easy to become transactional in our conversations, both internally and externally,” Parsley said. “We have to move away from that; we have to get back to having meaningful conversations with people. COVID has taught us that human interaction is the key to successful relationships.”
“The biggest mistake medical professionals make is confusing the word ‘patient’ with ‘customer,’ ” Parsley said. “Even in the imaging world, there are lots of people who do what you do at the same level or even better. The only thing that separates you is your ability to serve your customer.”
Parsley also believes that a handful of institutional behaviors can help communicate the value that any institution or business places on the people whose relationships it courts. Organizations cultivate those impulses through inclusive practices like VIP programs and incentives that communicate feelings of appreciation, value and importance.
“Everybody wants to feel important,” Parsley said; “people want to feel like they belong, or are valued; that they’re part of something bigger. Everyone craves appreciation. If all you do is focus those conversations on those things, you’re going to win every single time.
“The goal is to serve the best interest of your patient, your peer, your subordinate,” he said. “If you combine that with willingness, you’re never going to have an issue. You don’t have to be sophisticated, but it requires top-of-mind awareness.”
In some circumstances, particularly leadership roles, the intensity of communication required – or expected – in a high-paced healthcare environment can fundamentally limit its effectiveness. Nicole Dhanraj, CEO of South Texas Associates of Radiology, business operations consultant, HND Consultancy, recalled prior experiences communicating as an imaging director as presenting an impossible bar to clear.
“I have been on two Zoom meetings at the same time, one on my computer and one on my phone, with someone from my office talking to me, and someone else trying to get my attention,” Dhanraj said. “I could miss something, but, unfortunately, the expectation is that you are juggling all of it.”
Dhanraj spoke about managing the expectations of a leadership role with the realities of those responsibilities in practice. She’d be told that leaders can set their own schedules, but if her calendar showed her as unavailable, she would often find herself double- or even triple-booked for different meetings in which her participation was presumably expected. The result would be that she could be virtually attending a meeting, but practically, there would be very little chance of her participating, or absorbing the information being communicated therein.
“You can see in a lot of meetings that everybody’s distracted, or that their eyes are in their emails,” Dhanraj said. “Apparently, my presence was more important than my digesting the information. I think the expectation overall is that our attention is to be divided, and there is no leniency. It’s amplified in certain industries because we’re so short-handed, and doing more with less continuously.”
Dhanraj said that in such environments, she reaches people more effectively when she manages their expectations ahead of the interaction – and sometimes during it, as well as afterwards.
“It is challenging, but a lot of times, once you start understanding how other people are seeing it, then you preface the conversation,” she said: “ ‘I’ve only got 10 minutes,’ or, ‘Do you mind if I face the computer when we talk?’ ”
Another important aspect of communication in any health care environment involves understanding cultural differences, both interpersonally and inter-departmentally, Dhanraj said. Knowing where someone is from, or how they’re used to interacting, can lead to more productive experiences because aspects of both can contribute to building trust, which will make any interaction more successful.
“In some cultures, or with some people, you just can’t come across very direct,” Dhanraj said. “Some organizations are very task-oriented. In addition to culture, as we talk about integrating that into how you communicate, we have generational differences.”
Most importantly, she spoke the clarity that can be found when individuals take ownership of their half of a conversation, clarify their own needs and experiences, and work to build a bridge across their differences, rather than widening a gulf that might exist.
“I think when we start approaching conversations about how we feel, and how we would like to be communicated with, it’s just easier and more effective,” Dhanraj said. “If you understand how someone wants to be talked to, and you lay the expectation, then it’s going to help build that relationship.”
