Lack of Communication: Too Little, Too Late

 
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As discussed, a major problem in the healthcare industry is lack of quality communication. Specifically, the fact that one-on-one communication between leaders and physicians is practically non-existent on a day to day basis. One of the mitigating reasons for this lack between physicians and team leaders is the current circumstances under which it currently exists. Spoiler alert: it’s not good. 

In many healthcare organizations, one-on-one communication only exists between leaders and physicians under stressful circumstances. For example, the organization is facing a malpractice suit or a doctor is being reprimanded by a physician leader for misconduct. Or worse, a doctor is fed-up with their current position and asks for a raise as a desperate attempt to play their last valid card.

When private meetings between leaders and physicians only occur within the context of adversarial and mistrustful defensive stances -- either for reprimand or negotiation when things are already going south -- there is no workplace standard for a non-confrontational conversation between them. 

Let’s unpack this a bit further. In the current healthcare climate, physicians in most organizations typically speak to their CMO or medical director in one of three situations:

  1. A group meeting. A, sometimes optional, group gathering where messages from the top are delivered. Depending on their style, temperament, or experience, a physician may choose to attend or not. No matter how democratic the leader may believe themselves to be, these meetings are often an extremely inefficient use of everyone’s time and contribute very little to quality communication between leadership and physicians. Physicians come to dread these meetings, not just for their futility but for the fact that this is usually when they are told about the next burden they will have to carry.

  2. The physician has messed up. There is an informal or a formal meeting where issues must be addressed and, often, liability is involved. While this can be an opportunity for genuine and helpful communication, in reality that is rare. The atmosphere is charged up and everyone is looking out for their own safety instead of one another.

  3. The physician is unhappy. After many requests, a physician is finally able to schedule time alone with “the boss”. Because other opportunities to improve engagement were never implemented successfully, this meeting often devolves into desperate ultimatums from the physician. For example, “If you don’t pay me X amount of dollars, I am going to leave.” This may be the only time when even a haphazard attempt is made to genuinely find out what can be done to make things better, but it is often too little too late. 

It’s easy to see how when one-on-one conversations occur only in harmful circumstances they’re universally associated with negative outcomes. No wonder no one wants to “chat for a quick second”, “tell you what’s on my mind”, or “run something by you later this afternoon”!

Next week we’ll continue this brave journey through the problems and lack in our industry by exploring the lack of physician engagement and how that often appears to healthcare leaders.