Good communication skills essential for your practice

August 15, 2004

Have you ever been frustrated by a patient's failure to follow instructions correctly or a colleague's failure to do a task the way you expected it to be done? If so, you may want to consider the possibility that the fault was your own-that you may have failed to make your instructions unmistakably clear.

Have you ever been frustrated by a patient's failure to follow instructions correctly or a colleague's failure to do a task the way you expected it to be done? If so, you may want to consider the possibility that the fault was your own-that you may have failed to make your instructions unmistakably clear.

The ability to communicate with precision doesn't come naturally to most of us, regardless of the extent of our education. That's unfortunate, since virtually all authorities agree that the ability to express our thoughts clearly and effectively is an essential ingredient in successful communications among humans. Nowhere is this truer than in a medical practice.

You may be familiar with this old parlor game: One person begins the game by whispering a simple story to a second person. That person, in turn, whispers the story, exactly as he or she understood it, to the next person. This continues until everyone in the game has heard it. The last person to hear the story retells it aloud so that it can be compared with the original.

That exercise is only a game, of course. Still, it provides a clear example of the difficulties faced by anyone who must communicate oral information or instructions to others.

Industrial psychologists studying the effectiveness of communications among humans uncovered an astonishing weakness in this vital area of our lives. Much of the problem is the result of the way many of us choose our words. Even professionals known for their clinical approach to other facets of their work fall prey to the temptation of relying on the first words that occur to them. Too often, they assume that everyone will-or should-understand everything they say or write.

In their book, "The Reader Over Your Shoulder" (MacMillan, 1961), authors Grave and Hodge observed: "It is remarkable that nearly all scientists, at the point where they turn from mathematical or chemical language to English, seem to feel relieved of any further obligation to precise terminology."

We may be inclined to forgive such a shortcoming among laboratory scientists, but that's an indulgence that physicians living in the real world cannot afford.

A communication failure Consider this case from the business world where communication failures can have grave economic consequences: A manager came up with an idea he felt would save his company money on shipping costs. To present his suggestion to top management, he needed a list showing the volume of sales to his company's best customers.

He instructed his assistant to prepare a list of the company's 100 largest customers. "Be sure to rank them by sales volume," he instructed.

After days of research, the assistant proudly handed in a list of the 100 largest companies doing business with the firm, ranked by their own sales volume. It was not what the boss wanted.

Not only was the work of several days a total loss, but the incident generated both resentment on the part of the assistant and an unjustified lack of confidence on the part of the manager toward his assistant. Effective communication between the two became even more difficult in the future.

Pointing the finger of blame for incidents of this type probably isn't worth the effort. Still, there is little doubt that the heaviest share of responsibility for effective communication rests with the person assigning the task (the "transmitter"), not the subordinate (the "receiver").

A useful skill The good news in all this is that communication is a skill that can be taught and learned. Everyone can become better through study and focus. Good communication skills improve self-esteem, increase productivity, and reduce workplace tension by encouraging good interpersonal relations. Poor communication results in the opposite: low self-esteem and job satisfaction, high staff turnover, poor productivity, and a miserable work environment.

Some years ago, a detailed study of executive qualifications revealed that a broad vocabulary was the most often seen characteristic in successful executives and professionals.