Medical Malpractice & More: What Healthcare Communication Needs
Apologize more and you'll be sued less.
Physicians may have heard that advice, but still find it simplistic and hard to believe (and lawyers may loathe it altogether). Solid data backs up the claim, however: the University of Michigan Health System, for instance, requires physicians to "disclose their mistake, apologize, and when appropriate, compensate injured patients." After more than a decade of that policy, malpractice claims have dropped by 36%.
That's in a recent article by Dr. Kevin Pho in USA Today entitled "How Doctors Can Reduce Medical Errors, Lawsuits." Want more scientific evidence? A study published in Physician Executive in 2004 found that, "The most common cause of malpractice suits is failed communication with the patients and their families." These articles point to awareness--both data-driven and anecdotal--of the critical importance of improved doctor-patient communication. A keyword search of "good communication reduces medical malpractice," for instance, produced 4,770,000 results.
Yet incredibly, physicans and med-mal insurers continue to ignore easily implemented practical solutions to this problem, including speech coaching and training. Theater-based techniques especially are custom-made for the role-plays and simulations that will help doctors learn how to communicate more effectively with patients, while improving the bottom-line for medical insurers.
In addition to the doctor-patient relationship, here is a brief overview of four other areas in which healthcare communication is on life support and needs urgent care:
Presentations and Team Meetings
Physicians and other professionals in scientific disciplines inhabit a left-brained universe. Their inclination is to live in this world, and their training strongly reinforces their preference for data and metrics that will drive approaches and solutions. Informing and persuading listeners, however, is a messy business. Audiences can only perceive us and our message based on what we give them as raw materials; and often that perception is far afield from what we intend.
Even vital information can't live on its own: speakers must communicate the relevance and significance of that information. That's where skills in oral communication come in. The strongly left-brained speaker faces a chasm when speaking across physical space to reach and persuade audiences. The world of orality is a world of performance, and healthcare professionals need to learn how to negotiate its byways.
The demands of providers in giving and administering care place enormous pressures on efficient communication. All organizations face challenges in achieving productive internal communication; yet the fast-paced environment of medical care rachets up the potential for missed opportunities to achieve a tight communication environment based on openness and trust.
Recently one of my clients, a nurse adminstrator of an ER well known in the arena of Boston healthcare, gave a presentation on the areas of training identified as most pressing for the group. Her expertise and experience were immediately apparent as she moved through her PowerPoint slides. Yet evident at once was an area not on those slides: the need to frame everything she was saying in terms of the group's needs, rather than the equipment and procedures she was discussing. Focusing on people rather than clinical and administrative tasks is both self-evident and difficult in the hospital environment. Yet for any institution to grow in terms of communication skills, that focus must always be kept in mind.
Appearing on an industry panel is a golden opportunity to create a positive perception of you and your institution. It is often not exploited fully, however. Especially important are the opening remarks you will probably be invited to give. Here's why:
In the fall of last year, I attended a major healthcare symposium in Boston, sitting in on numerous keynotes and panel discussions. One panel stands out in my memory, and all because of the opening remarks. In the 2-3 minutes that each panel member spoke, I formed a clear impression of that panelist's level of expertise. But I also gained an insight into the sector of the healthcare environment each represented, and that person's communication style and (what I perceived to be) their agenda.
And how interesting it all was! The data each person offered to support their position were solid. But what entertained me most and has stayed with me were the personalities and conflicts on display. With an active moderator and audience members asking involved questions--typical of panel discussions--your speaking time as a panelist may be shorter than you anticipate. If that's the case, your opening remarks and the impression they convey about you and your institution are critical.
The Patient Experience
With Medicare imposing new standards of the patient experience through questionnaires, all aspects of what people experience in the healthcare environment will be under review. It is therefore all the more important that healthcare providers understand the perceptions that their actions and communication skills engender in the customer.
Physicians have a reputation for being notoriously bad communicators. Only some of this fault can be laid to too-tight exam room schedules and the burden of excessive paperwork. We might slightly misquote Cassius in Shakespeare's Julius Caesar to say, "The fault, dear Brutus, is not in our stars/But in ourselves, that we are careless communicators."
This seems to me an especially urgent need in oncology, where the discussion of diagnoses and end-of-life care can be as grim as the information being imparted. Like many in our society, I have personally witnessed the clumsiness, callousness, and sheer lack of skill on the part of caregivers discussing cancer in terms of diagnoses and prognoses. Associations of oncologists have cited the need for improved communication in this area. But often, little is done to back up this lip service with practical training and assessments.
usatoday.com January 18, 2012
Eastaugh SR, Physician Exec. 2004 May-Jun;30(3):36-8.