Conflict happens. Learn the 4 parts of any conflict, and some questions and phrases you can use to help you handle interpersonal conflict in communication.

When we’re in a conversation, we want things to go smoothly. We want the relationship between us and the other person to work. But conflict happens, and that’s what today’s episode is about.

Hi everybody, this is 10 Minutes to Better Patient Communication, giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.

In the last week, I had two different people in two completely different conversations bring up interpersonal communication and conflict. One of them was a colleague who does teaching about this, who was saying they were doing more teaching about this, they were getting more requests about it. And then sure enough, later that same week, or it was just earlier this week? Gosh, wow, just earlier this week, I had someone come to me and want to talk about: Can you give me some advice in a professional conflict and in this conversation? What should I do?

So, take from that what you may, but I know it means time to do an episode on it! Because it’s been a while since we’ve talked about conflict in this show.

So this is for those times when an otherwise normal or unremarkable conversation goes sideways, takes a turn, gets tense, maybe gets derailed.

Because we know when communication falls short in the health sector, patient satisfaction and outcomes get impacted. And that’s what we don’t want. And that’s why we’re here in this show. The majority of the people that I talk to really wanna preserve the relationship as well. So we’re gonna talk all about that and maybe refresh some of what you know, and hopefully give you some new tools, because I’m going to take time at the end of this episode to give you some phrases that you can use and questions that you can ask yourself.

What I’m sharing is leaning on a book that I have leaned on a lot in my professional life, from the Harvard Negotiation Project, it’s called Getting to Yes, and it’s been around for decades. I don’t know how many editions this book has gone through. It analyzes decades of cases from international negotiation and conflict resolution, and I think it’s got great advice in it.

So the authors suggest we look at interpersonal conflict as having four parts. And I found these four parts handy when you want to break something down–especially a conflict that has just happened, and you’re trying to make sense of it. You want to be better next time. So those four parts are: you, the other person, the relationship between you, and the problem.

You, the other person, the relationship, and the problem.

Now the authors say there are two sets of concerns in any conflict. One is the people: you, the other person, the relationship. And the other is the problem at hand.

And they spend a lot of time in this book helping you untangle the two of those. Because if you’re like me, you’re thinking, “Well, what about when the person’s the problem?!” And yeah, Okay, I’m gonna talk about that too. But it’s important that we at least give ourselves a chance to think about them separately.

And to help you do this, the authors give us this example. It’s two shipwrecked sailors in a lifeboat fighting over limited supplies. Each sees the other person as the problem, instead of the fact that they’re in a lifeboat with limited supplies.

To survive, the authors say they will want to “disentangle the objective problems from the people.” So that’s what they’re trying to tell us to do: identify the objective problems. Once we can do that, we can focus on shared goals. In this case, the objective problem: they’re in a lifeboat with limited supplies. The shared goal we’re going to assume is survival. So they will want to focus on the shared goal, regardless of whatever personal relationships are like between them right now.

So the authors use this story to remind us how important it is to separate the other person from whatever issue that they are raising. They say, “Deal with people in personal ways, and deal with issues in strategic ways.”

Now, you may have issues with the other person’s approach to the problem! And okay, so maybe they are thinking the same thing about us! This can feel like a personal attack, which can get our hackles up and make things even more difficult to deal with.

So I want to remind you–like the authors do–that it’s not really us. It’s not really the other person either. It’s the conflict in our approaches to the problem. That can also make the problem a little more difficult to see and to tackle. So let’s get to tackling this.

Here are some phrases and questions that you can use broken down by those four parts of a conflict. And of course, this is a reflective practice show, so we’re starting with you.

You

Give yourself a moment to think about your interests and ideas in this conversation. This is going to help you when it comes to dealing with the problem, too.

• What do you need to have happen here in order to feel successful as a practitioner?
• What are your fears, or what buttons of yours are being pushed right now?
• How is your attitude toward this conversation influencing your perception of it?
• What would be an ideal outcome from your perspective?
• What assumptions are you making about the other person’s intentions?

The Other Person

Alright, now let’s talk about the other person. Even if you know this person well already, it’s a good idea not to assume anything. Go ahead and ask the questions I’m going to share with you, listen to what they say, and keep in mind that it’s possible your idea of what a good outcome is different from theirs. So:

• What is this person thinking about this situation? That is, what are their ideas about what should be happening right now?
• What are some of their needs? What are some of their fears!
• What does this person see as the problem here?

Repeat back to them what you heard and consider asking clarifying questions to make sure you understand their perspective on the issue. Like:

• Do I have this right?
• Am I missing anything?

The Relationship

Okay, number three, the relationship. I had a professor in grad school who laid down this really basic truth. It’s one of those that it’s easy to say but it’s incredibly hard to remember to put into practice: People want to be understood on their own terms. Right.

When you think you understand the other person’s perspective, the easiest, most important move you can make is to let them know you hear them, whether or not you agree with them. Here are some ways you can do that:

• I see what you mean.
• That makes sense.
• I see how that could make sense.
• I understand how you could think that.
• If I were in your spot, I’d probably be thinking that too.

So this is letting a person know that you heard them, even if you don’t agree with them.

The Problem

And number four, the problem. The authors of Getting to Yes recommend that you tackle this together, because collaboration isn’t just good for the relationship, it’s also good for problem solving. So ask the other person what they think might work. And whatever they say, find something you can agree on, that you think you can work with, and build on it. You might have heard this as like the yes, and move. So let me give you some examples of how you can say that.

• Why don’t we work together to solve ___?
• How can we make this work?
• How can we resolve this?
• What do you need from me?

Now, what about those times when the person is asking for something that you can’t do, or you can’t meet all of their requests. Here are some phrases to get you out of that tight spot.

• If I had a magic wand, I would.
• I wish I could say yes to all of that.
• I’m sorry I can’t give you the answer that you want.
• I know this is important. Here’s what I can do.

And if you want to introduce a compromise, you can use these phrases:

• What would you say if ___?
• How would you feel about ___?
• Would you be open to ___?

These questions and phrases help you focus on the issue while respecting the people: yourself, the other person, the relationship. And these phrases can help you get the conversation back on track while keeping the relationship intact, and dealing with the objective problem out there in the world. If you’d like more help with this, go ahead on LinkedIn and message me, or visit Health Communication Partners and click on Contact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional music from Alexis Rounds.

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We start the year by grounding ourselves. Why are we here? What are we doing? Why are we doing it this way? And I give one suggestion to guide your work in communication this year.

The start of a new year is a good time to think big picture, so we’re asking big questions. Why are we here? What are we doing? Why are we doing it this way? And I’m also going to give you one suggestion to guide your work in communication, no matter what you’re planning this year.

Hi everybody, this is 10 Minutes to Better Patient Communication. Giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives.

And if you want to strengthen or extend the work you can do in your professional sphere, this is a place for you. Because communication touches everything. We’re here to learn, to get inspired, and most importantly, make the difference we got into our jobs to make.

So yeah, it’s the start of the new year, so let’s think big picture for a little bit. Let’s step back and remind ourselves why we’re here. Communication is the thing we’ve all got in common here, communication in our professional contexts. But why communication? Right, it can be hard to remember why? Because while we’re doing it all the time, we’re in the weeds every day. So that’s why I wanted to take a moment to kind of reset for us.

Let’s remember why we’re doing this. Let’s remember why we’re focusing on communication. Because we know how valuable it is. Sometimes it can be hard to remember that not everybody else does. And yes, probably part of your job is convincing somebody of the value of the work that you’re doing. So hopefully what I’m sharing today can help you make arguments when you need to make them. But I’m also hoping you can enjoy kind of articulating this to yourself as well.

So communication is the thing we’ve got in common. And we’re using it mostly–I think I can say this with some confidence–most of the people listening here are trying to improve some sort of outcomes. It might be your role involves improving patient safety or patient experience, patient engagement, patient satisfaction.

Maybe you’re on the employee side and you’re looking at employee satisfaction, employee engagement, employee retention. We’re all looking for ways to improve these factors. So why communication? because communication is integral to every one of them. So working on communication helps us be more effective at our jobs.

Another way of saying this is communication and patient education, which I talk about in the show too, are modifiable factors in satisfaction, engagement, experience.

So let’s noodle on this question about why communication a little bit more.

Another way to answer it is ’cause it’s something that we all do all the time. Therefore, communication is a tool we all already use. It’s a leverage point that we all already have at our disposal. Communication applies to everyone. Every role, every rank, every title in an organization.

When we focus on communication and the ways that language gets used the possibilities are also very very broad because of how powerful communication is as a tool. It’s how we connect with other people.

It’s how we build some of the most important things in this life: our relationships, our identities. We also use communication to build spaces, habits, ways of working and thinking. A lot of this work is done through language. We build ideas, we build momentum, we build boundaries, we build walls, we build bridges.

We can shape things with language too. We can shape a story, an argument, an issue, shape relationships. We also can and do use language to tear things down, tear down those walls, tear down ideas, unfortunately also tear down people.

So a focus on communication is going to help you no matter what you’re creating. And this is just our professional lives I’m talking about. I’m not even touching a communication in our personal lives, I’m not even touching all of the artistic uses of communication and language, song, stories, poetry. I’m just talking about everyday work communication here.

And most often I hear that people want to know how to be more effective and efficient across all social groups. Like people want to work as well with diverse communities as they do with mainstream audiences. So this is where working with equity lenses on communication helps us. And that’s part of what I do here in the show and with my clients.

Putting on equity lenses helps us see when we’re doing better with some groups of people than with others. And certainly over the past couple years the equity conversation has evolved. But in general I find that people now know what they need to be doing and are looking for new ways to do it or more ways to do this work.

Again, why communication when we’re talking about equity? Because communication is a modifiable factor, everyone does it, it’s powerful, the leverage points, and if we’re careful and thoughtful, the ways we communicate can help promote equity.

This does mean additional effort. We know how important it is to reach everyone, connect with everyone, teach everyone, but we know that this is difficult to do. So when we are asking questions about what are we doing here and why communication, I’m also asking you to constantly challenge your assumptions about your work.

This challenging of assumptions is one of the secret ingredients to 10 Minutes to Better Patient Communication, the particular way I encourage reflective practice. We have reflexivity as a tool to examine our language, scrutinize it, interrogate it, and people tell me year in and year out this is one of their favorite parts of the show. Which, my friends, is saying something about you because these kinds of questions, What are we doing here? Why communication? These kinds of questions can make people itchy!

Because sometimes it can feel like the answer should be obvious. And people can get uncomfortable when we start poking around a little bit too much. We see that there’s more going on below the surface. And you’re aware of that, and my clients tell me that they’re aware of that too.

And I want to let us all off the hook, because it’s hard for us to notice our own language, largely because language is meant to be used more or less on autopilot. And so as a result, the sophisticated things and the complicated things that we’re doing with language can pass us by unnoticed.

Another reason it’s hard to notice our own language is because over years of being in a profession or in an organization we’ve been kind of acclimated into various specific ways of communicating by our organizations, by our contexts, and again this tends to happen largely without our noticing.

So for each of us we have a kind of normal way of communicating, a way of thinking about communicating. So this year, no matter what you’re doing with communication, I’m going to ask you to keep noticing your normal. Keep scrutinizing your communication to help you switch off autopilot and be more intentional with your communicating. This is about willingness to stir up the habits we can get into, the ways that we work, that we’re kind of used to, that we all carry around with us.

Examining language use at an individual level and an organizational level is a process. It takes effort. It takes courage to question assumptions, it takes courage to reflect, it takes courage to scrutinize and interrogate and question ourselves. It can feel threatening to admit we don’t have all the answers. It can feel threatening to acknowledge our limitations.

And I want to validate how hard this work is. In our jobs, we’re already dealing with incredibly complex, often intersectional issues, often deep -seated issues. And we still need to act with discipline and rigor and high standards. Can’t be messy. We need this work to last.

Now you could be turning away. You could be choosing not to see, not to struggle. Nope, not my lane, but you’re not! You are choosing to spend your time thinking about your own communication voluntarily. That is a sign of courage and bravery and imagination. That’s part of why this show exists, because it’s part of the community of people doing this work.

If you value this show and the stories and inspiration from the series, the research, I’ve got good news. I can help your organization! Message me on linked, visit healthcommunicationpartners.com and click on contact, sign up for the newsletter while you’re there. If you get my newsletter just respond to it–it comes right to me! Thanks for listening. This has been 10 Minutes to Better Patient Communication from Health Communication Partners.  Audio engineering and music by Joe Liebel, additional music from Alexis Rounds.

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Year end countdown time! Here’s our Top 5 Most Popular Episodes from 2024, as determined by you!

Here we are! It’s the end of the year, and what I get to do now is count down for you the top five episodes as judged by you, this year 2024, from health communication partners. Hi everybody, I’m Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication from Health Communication Partners. Yes, this year we got ranked number 20 the top 100 podcasts in the Social Sciences by Goodpods. So grateful to you for that. And I’m thankful that you’re with us. I’m thankful that you’re continuing to download. If you haven’t been in touch, please do be in touch. You can find me on LinkedIn. Message me there. You can go to healthcommunicationpartners.com and click on contact. It comes right to me. If you get our newsletter, you can go ahead and reply to that, and that comes to me too.

And I want to give you props for being here. Because just that very fact means that you have an instinct or a sense that the communicating and the educating that you’re doing with patients could be better, and that that betterness is in your hands. That there’s something that we can do about our own language use. About our own educating. And I think it’s fascinating the types of creative thought that can go into our conversations. And this list of top five is a bit a sampling of that too.

And not to get obsessive about it, but I think we’re all in the camp where we know if we do a little bit more work on our on our language use, we can get closer to what we want to be. Closer to what we wish for ourselves to be as practitioners. And this is part of the kind of creative enterprise I invite you into in this show. And I’m so glad that you’re here!

So we’ve got five episodes to countdown, and these are done–I'll tell you how I do this. To keep it fair, what I do is I look at all of the podcast episodes that we’ve dropped throughout the year. And I look at the 30 days from when they were dropped. How many downloads did they get? And these five episodes are the ones that scored the highest. So let’s get to it. We’re gonna go count it down, right!

So number five is an episode called How Reflective Practice Can Help You Improve Your Communication. And I love you because you love reflective practice, and you keep coming back for it, which is why I’m so excited to keep sharing it. This episode is really reflective practice in action.

It was a fun episode to record because I got to tell six different people’s stories, their examples of reflective practice on patient communication. ‘Cause I know sometimes when we hear reflective practice, it can mean a whole lot of different things to people, depending on kind of what you’ve heard before. It can also feel kind of vague, it can feel kind of squishy. Or it could feel kind of like a luxury, like you do it if you have spare time every once in a while. But if you’ve listened to a few episodes of this show, you know we take a very different stance here. We look at reflective practice as a strategy, as an intentionality, a technique, a process, an attitude, a stance. And so do my guests. So I encourage you, if you haven’t heard number five, go ahead and check that out. How Reflective Practice can help you Improve your Communication. Obviously, I’m gonna put a link in the show notes. That’s what this episode is about!

Now, number four. Before I get to number four, this next episode is one of two interview episodes to make the top five. And it’s so inspiring to me to hear from you, and to hear from people who are doing the work, about how they are rolling up their sleeves and doing the work. How they think about doing the work. How they think about how they’re treating people. And my guests are incredibly generous with this storytelling, this conversation that they have with me about conversation that they have with their patients. I find it very inspiring, their kind of opening a door into their process for us. Without getting didactic, without kind of getting up on the big box and making pronouncements about the way it needs to be.

And the number four episode of the most popular this year, is definitely an example of that. It’s from Dr. Jonas Attilus on the Benefits of Taking a Learner’s Role During Patient Interactions. And Dr. Attilus is so careful and so thoughtful and does not take anything for granted. So please check out this episode. I’m kind of shocked at how much he can get us thinking about in the short time that he has in the interview. And you’ll also see why he also made the most popular list three years ago, the last time he was on the show! So he knows what he’s doing. And I’m super glad that he came to the show, and again, kind of gave us a door into his process.

Alright, number three, this episode’s about free stuff, right? It’s a free episode about free things. Which is good, because who doesn’t love free stuff? Number free most popular episode this year was Previewing a Free Maternal Health Course from the Office of Minority Health. This is hilarious because this is a repeat of an episode that I had done before. But maternal health had come up in the news again. So I was like, oh you know what I got to tell people about this course. It still exists out there. It’s from the Office of Minority Health. It’s a free course on providing culturally and linguistically appropriate services in maternal health. So what I did is I took the course, and in this episode I preview it. And then I give you tips on how to get the most out of it. And the course is still up as of you know as of this recording the course is still up there. So go ahead and take it while it’s still out there and still free and if you want a little bit of a preview obviously check out the episode.

The number two most popular episode on health communication partners this year is Reflecting on the Connections between Health Disparities and Communication. Now again if you listened to this show more than once you know this topic as well we spend a lot of time on. I was really surprised that this one made the top five. I mean I’m incredibly surprised it made it to number two. Because I make some kind of subtle points in this one. And I’m beginning to wonder if maybe it was the subtle points that made it more popular? Because maybe we’re a little bit tired of being hit over the head with things that are kind of ham -fisted sometimes.

I think we all know that one size fits all advice only gets us so far. And we all live a lot of our time in situations that are unique. Where there is often some degree of uncertainty. And so in this episode, I share some thoughts on this. And I’d love to hear what you think about it. Again, message me on LinkedIn, visit h-cpartners.com and click on contact, and let me know what you think about this.

And drum roll please. The number one most popular episode of 2024, Health Communication Partners, 10 Minutes Better Patient Communication, is from friend of the show, Dr. Ashley Love, when she visited us to talk about Communication about Mental Health in Asian American, Native Hawaiian, Pacific Islander communities. Now, Dr. Love has visited the show before right prior to COVID, or right as COVID was really coming out, I think, Yeah, that’s what it was. Right as COVID was coming out. So it’s been a while since she’s been to the show.

But she came back this past May, which was mental health awareness month and Asian -American and Pacific Islander Heritage Month. So I love the fact that Dr. Love gave us this two-fer by combining both of those topics, and talking about both of them. And she and I go way over time because she has so many stories to share. And I’m just in awe of her stories and the breadth of her knowledge. And we also have great time on mic together.

So I’m delighted and so thankful to Dr. Ashley Love for coming to the show, and for making what would become the number one most popular episode on our platform this year 2024, Dr. Ashley Love. So please check out that show.

And I want to end this episode, but also this year with a message of hope. It’s not easy for me to keep hope up, I don’t think any easier than it is for anyone else, even when doing this show. Sometimes, like for this episode, and for many other episodes really, and especially you know in the past like during COVID, I really have to work myself around to get into a hopeful space. And set aside whatever fear or anger or disgust I’m feeling at the time, and get to a hopeful place. And it’s got to be a genuine hopeful place, or else really, why bother? And you’d probably be able to tell anyhow.

And the fact that people all over the world are tuning in to this–this very niche show–along with you and me, that I think is a reason for hope. Because come on folks, this is a very niche program. We are real word-nerding it out here, in very specific ways. So, I think this is encouraging, mostly encouraging, a little bit terrifying to me, but mostly encouraging that you’re here. To know you’re here. Because you’re change agents. You’re here, you’re pushing the envelope. You’re in this. And when I hear from you about what you’re moving toward, you get that this is long-term work.

I’m proud to offer you things to consider, things to try, things to keep in mind while you’re doing the work. And hopefully strengthening what it is that you’re doing. Because we’re all concerned about the future. We’re all still here, doing the work together. Happy holidays. Happy New Year to you. Thank you for being here. I’m Dr. Anne Marie Liebel and this has been 10 Minutes to Better Patient Communication from Health Communication Partners.

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Improve your shared decision-making (SDM), no matter how you do it.

Just like it says on the label, today’s episode is a quick exercise to help you improve your shared decision-making, no matter how you do shared decision-making.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication from Health Communication Partners, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, you can visit healthcommunicationpartners.com or connect with me on Linked.

And I have to tell you, you are the most talented, cutting edgiest, best-looking audience in the podcast universe! You’re already great at what you do. What you want is more tools to address problems that you see, so you can move forward in a way that’s relevant to you and your situation. That’s what I support in this show. That’s what I support with my clients. And yes, you can work with me.

I had a physician give me a huge compliment and call me a “shared decision-making guru,” which meant a whole lot to me as an educator too. Ever since medicine started shifting away from its paternalistic model toward more patient-centered care, shared decision-making has been talked about.

So here’s the point where I go to a couple definitions. One of them is from the Clinical Journal of Oncology Nursing that says shared decision-making is quote, “A healthcare delivery model that mandates patient-centered care for clinical practice.” The journal Patient Education and Counseling offers a slightly different view, and says that shared decision-making is related to “an ethical imperative to respect the agency of individuals, offer information, collaborate, and support deliberation when difficult decisions arise.”

I had one physician tell me a story of when she was told to “go do a shared decision-making” with a patient. As you might suspect, things are not often quite that straightforward.

An article in the journal Social Science and Medicine says that shared decision-making kind of suffers from a problem of not reflecting well how decisions are typically made by real people in the real world. The authors say, “This model rarely incorporates what is known about decision-making, or makes room for the various ways that decisions are made in the real world.”

For example, they say that shared decision-making policies and guidelines “do not adequately support clinicians in considering the needs and experiences of individual patients, nor in attending to aspects of the patient-clinician relationship or the healthcare environment that may impact decision-making.” They go on to say, “Healthcare systems are not designed to support clinician-patient collaborations.” They point out, “Patients are influenced by their changing circumstances and experiences, but shared decision-making does not typically acknowledge these contextual and dynamic processes.” They further go on that “clinicians’ attitudes, experiences, and behaviors also influence the decision-making process, but clinicians are inadequately prepared to deal with the impact of these factors when engaging their patients in shared decision-making.”

So, maybe you do shared decision-making because of the ethical imperative. Or because you were told to. Or because of the benefits you want to get. Whatever your reason, you know, it’s important and you do it and that makes me a fan of yours. You want to help patients understand something important. So you’re educating them, communicating with them. Maybe you’re handing them something to read.

In those moments, your patient is going to try to make some sense of what you’re saying or what you’re handing them. This sense -making is where I want to park it for a moment because it is a complex process we’re all involved in all the time, as living, breathing human beings.

Now the article I just referenced emphasized that what shared decision-making is missing is understanding how real people make decisions in the real world, and the importance of contextual factors on us. So I want to take you through an exercise to kind of help remedy that. To help you maybe get a different perspective, or deepen your appreciation of some of what’s involved when we make sense of something someone is telling us, or something we’re reading or writing.

This is to help you be aware of and deal with the impact of context in your shared decision-making, so you can get the benefits.

What are some of those benefits, you ask? Better patient-provider communication, strengthening the patient-provider relationship, patients’ greater satisfaction with their care and engagement in that care, a greater sense that patients have of control over their health decisions, an improved understanding of their condition, and overall better outcomes.

So let’s get to this exercise, a bit of a thought experiment. Play along with me, won’t you?

I want you to think of the last time you made up or used a grocery list for your food shopping. We’re going to unpack this very mundane text. And you’ll see how it’s not just the words on the page that matter, but contextual factors that influence how we make sense of those words.

So think about that. Maybe you’re writing a list. While you’re writing down things on that list, you’re doing it in a specific situation that has an impact on what you write. For example, how much of a rush you are in. What budget you’ve got. Maybe you’re trying to keep a handle on your feelings about food shopping, or a budget, or both. You’re thinking about who’s at home. Who’s eating what? How quickly? What’s in the fridge? What’s in the closet? What’s on sale? What’s easiest? What’s new? What do you have time to make? Maybe there’s someone else whose responsibility it is to take care of meals. Maybe on different days this week. What do they make?

Thoughts like these and more come into play when you’re deliberating over what to write on that shopping list.

Or maybe you didn’t write the list, it’s just your job to do the shopping. When you’re reading that list, stood at the store maybe, you’re not just reading the list, you’re also interpreting the meaning of what’s on the list. And you might go through some similar processes. Thinking about time, all the other things you have to do today after this shop. Thinking about money. Also thinking about the person who wrote the list. What do they tend to always put on the list? What do they tend to always forget from the list? How much you do or don’t agree with what’s on the list. The conversations you might have later around what you did and didn’t get from the list. And what all of this has to do with the week stretching ahead of you, who’s in charge of the budget and grocery shopping and cooking to begin with.

Well, let’s just think for a moment about what contextual factors came into play: Time, money, other people, emotions, past experiences, values, power dynamics, priorities. They came into play, influencing your thoughts and decisions and ultimately your actions about what you put on the list, or bought from the list, how you read the list.

We’re making connections to a lot more than just words in the here and now and your patients are no different. Every day, people encounter and interpret information related to their health and health care. The vast majority of the time they’re not with you, but during shared decision making, they are. They’re interpreting and making sense of what you’re sharing with them by making countless connections like those that we just talked about, other factors: people who may or may not be in the room, past experiences, emotions, values, power dynamics, priorities.

These make a difference to the kind of sense we make of what we hear and read.

This short exercise was to help your awareness and appreciation for the role of contextual factors in our thoughts and actions. I hope it also strengthens your respect for the mental calculus you and your patients are going through in shared decision-making. This “real-world” example can also help you avoid what those authors called “shared decision-making’s problem” with the way decisions are made in the real world.

If you’d like more help with this our course Equitable Patient Education helps you avoid obstacles in six common educational scenarios, so you can reduce barriers to access. For more information on this visit healthcommunicationpartners.com or connect with me on Linked. I’m Dr. Anne Marie Liebel. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional music from Alexis Rounds.

The post A quick exercise to help your shared decision-making appeared first on Health Communication Partners.

Here’s three questions to help you look analytically at some communication patterns in your organization’s meetings. When meetings can value and accommodate diverse voices, that’s a big step toward creating an inclusive environment. 

At work, many of us have the responsibility to collaborate and innovate, and we’d like to be more inclusive in these processes. In today’s episode, we’re going to look at communication in one very common workplace structure–meetings–and see how we can make them more inclusive.

Hi everybody, I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, recently ranked #20 of the top 100 podcasts in the Social Sciences by Goodpods. If you want to take your communications to the next level, we’ve got the way. BRIDGES is our continuous improvement process. We evaluate your communication on seven important dimensions, to help you reach more people. For more information, visit healthcommunicationpartners.com or you can message me on LinkedIn.

So yeah, at HCP, I often help clients with patient communication, but I also help clients have better work conversations. We’re talking about interprofessional communication here, and organizational communication. And whether an organization wants to maximize the potential of their workforce, create a safe work environment, strengthen their brand, or bring diverse people together to innovate, communication is integral in these processes. We’ve done plenty of episodes on communication and collaboration, but it’s important in inviting contributions from the people who drive organizations forward.

The ways we come together and communicate can help us reduce barriers, unlock potential, and be smart together in new ways. But it takes effort, right? And that’s what this episode is about.

More organizations are looking for structural- or systems-level approaches these days. And meetings, it was the subject of our most popular episode last year–a reflection to open a meeting. I’ll put that link in there. And also just a couple weeks ago, I was talking to a client who really appreciated a new meeting structure that I’d helped them set up.

I want to get you thinking about communication patterns over time in your organization. Because they have a significant impact on people’s professional growth, on their participation in your organization, on their advancement, and on their relationships–colleagues, mentors, sponsors, partners.

These communication patterns over time can also either spur innovation or stifle innovation. So they are definitely worth looking at.

So let’s step a little bit closer.

Meetings. There’s a lot that could be said and a lot that has been said about them. They’re so common, they’re often kind of a pain. We want to get them over with, but they’re potent organizational and social events. In fact, the godmother of meetings research, Professor Helen Schwartzman, said almost 40 years ago that the meeting is a microcosm for the organization itself, its powers, its structures, its functions.

So talk at meetings is then a powerful element of corporate culture.

Now I want to point out this is systems-level we’re talking about. We’re not talking about one person’s communication style, or one person’s way of holding meetings. We’re looking at patterns over time, and maybe even across groups, in an organization. Usually these kinds of patterns are subtle enough that they can be tough to notice, but hey, that’s why I’m here. So let’s dig in!

Think about meeting agendas. We’ve all seen them. Even the language of a meaning agenda communicates a lot. It says what’s appropriate to talk about, how it should preferably be talked about, and usually who gets to do the talking. I love the description of an agenda from an article in the Lancet where the author says, “An agenda is a statement of power, influence, inclusion,
and exclusion.” That’s a lot: power, influence, inclusion, exclusion. So we want to look at the communication habits around your organization’s meetings to make sure that they’re not unintentionally making it easier for some people to participate than others.

We don’t want this, because it threatens one of the deep benefits to having a diverse workforce, which is employees being able to contribute, right? Leverage their different perspectives, experiences, knowledge bases. Because hiring employees with diverse backgrounds is an essential step, but representation is not enough. People need to contribute, participate, and much participation is done through communication.

So a shift of communication habits can produce meaningful effects.

If meeting organizers can give a fair shot to people who aren’t the loudest voices or the usual suspects, if meetings can value and accommodate diverse communication styles and preferences, that’s a big step toward creating an inclusive meeting. Now having equal participation and engagement is a worthy goal in itself, but organizations want inclusive meetings because we want all those benefits. People have unique perspectives that can help provide a fuller picture, point out dead zones, reduce mistakes, bring new ideas, fuel for innovation, fuel for smart decision-making.

So how do you get this? I’m going to give you three questions to help you look analytically at communication in meetings in your organization. Three questions. Here we go!

#1. How do people get the floor?

How do they get to talk? Does someone explicitly invite them to speak, by calling their name? Are they named on the agenda? Do people just speak up, raise their hand, use the chat? How do people get the floor?

#2. How much talking time do people get, who are not the meeting organizers?

This can be a real eye-opener and it’s super easy to do now with virtual meetings. You literally can just time it and see how much time people get. I used to do that with my students, and they couldn’t believe it, oh my gosh. So how much talking time do people get who aren’t the organizer?

#3. Who asks questions?

This can be another real eye-opener. Literally, the next time you’re in a meeting, when someone asks a question, just jot down who it was. How often are those people not the organizers?

All right, those three questions. How do people get the floor? How much talking time do people get who aren’t the organizer? And who asks questions? For each of those answers, I want you to consider: how might this be keeping some people from participating as much as others do?

Because people want to stay at an organization where their opinion is not only encouraged, but valued. Making things more inclusive and participatory doesn’t have to mean a free-for-all! Even a small shift in the communication habits around your organization’s meetings can invite more people in, and have more inclusive participation.

You want to know how communication during meetings could improve at your organization? Ask your colleagues. This will help show that you take them seriously, and you consider them to be a valuable and productive member of a team.

If you want more help, ask me. BRIDGES is our continuous improvement process. We evaluate your communication on seven research-based dimensions to help you make changes that have immediate impact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional music from Alexis Rounds. I’m Dr. Anne Marie Liebel.

The post How to make meetings more inclusive appeared first on Health Communication Partners.

Whether you’re a patient or a health care worker, learn how to encourage partnership through communication, thanks to Pharmacist Dr. Paul Ranelli. This is one of the many interviews you can find in our archives! Check them out at h-cpartners.com/podcasts. 

Partnering with patients. It’s a phrase we’ve all heard before, and it might sound like some feel-good cliche, but it is real. It has real benefits. And it takes real work to do it well. In this episode, Dr. Paul Ranelli shows how he uses specific ways of communicating with patients to encourage this partnership.

Hi everybody, I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication from Health Communication Partners. Since 2017, HCP has been helping organizations like yours reach their engagement, experience, and satisfaction goals with our next-level, inclusive solutions. If you’re in industry, healthcare, or government and want to improve the efficiency and effectiveness of your quality improvement activities, I can help. Visit healthcommunicationpartners.com and click on contact, or you can find me on LinkedIn.

You might know we just celebrated the 7th anniversary of this series, and again I want to thank you. This community continues to grow. Most shows don’t make it this long. Those who do, many of them plateau, and we haven’t. We keep growing, and that’s because of you, and I do not take this for granted. Thank you for finding us. Thank you for listening. Thank you for sharing.

And with seven years of the show to go through, I was thinking some newer listeners might not have heard some of our amazing guest interviews, especially those in the early part of the series. So I’m going to be better about bringing these up so you can hear them if you’re newer to the show, or revisit them if you heard them years ago, to see how they sound to you now.

But I was just thinking about whose interview, which of these great interviews should I share first, when I got an email from Dr. Paul Ranelli. Dr. Ranelli is now Professor Emeritus of Social Pharmacy at University of Minnesota, and he’s been on our show more than once. I’m going to share one of his interviews for three reasons.

One of them was that email. This gives me a chance to share some podcast love with another series, because Paul was telling me he’s recently been on another podcast series. It’s called The Clinic and the Person, and it is a medical humanities series. I’m gonna give the link to the show that Paul was on. It’s just outstanding, and really I’m excited to know about this series, too, and I’m excited to share it with you.

The second reason is the kind of listener feedback I got about Dr. Ranelli. One of our listeners said, “He has compassion in his voice. You can hear it. And he’s so interesting. He’s the real deal,” and I couldn’t agree more.

And my third reason is it’s always good to be reminded of how patients are experts on their own lives. So here’s Dr. Paul Ranelli.

Paul: Thank you and thank you for having me. Glad to be back!

Anne Marie: I'm so glad you're here. You were my first interview and I'm going to go ahead and put the link to that show in for anybody who hasn't heard it. Please do go listen to it. And Dr. Ranelli in that first interview, you spoke about information giving and information-gathering. I wonder if you could give our listeners kind of a quick reminder of what you meant by that?

P: Sure. Glad to. Those are my simpleton or fancy words for what a pharmacist does a lot. With their medications that they're giving to a patient, is giving information about that drug or about that medicine to the person who's going to be using it. So that's the information giving. That seems pretty standard. The information-gathering is something I try to emphasize, and that's getting information from the patient, is gathering information to help you be a better Giver of information. So what information does that patient have about their medication-taking experiences with this drug, with another drug, with this disease state, with this illness? So I try to divide those in my teaching, with the Gathering it, what you got from get from your patient, and then giving what you give about the drug.

AM: Thanks for that, because I think that was the feedback that I got from your interview was so strong and so positive. And the thing that people remarked on the most was this idea that of the information-gathering from the patient. Like people, once you said it, made sense, but people hadn't thought about themselves as valuable sources of information for the pharmacist. I wonder if you can tell us a little bit more about that idea of the patient as a holder of valuable information.

Sure, well they're very valuable to that relationship. I consider them an expert. We may be experts in our clinical and drug knowledge with all the schooling that we get. But that patient is an expert in their life. And an expert in how they take their medicines, or what experiences that they've had. And they have a great deal to offer to us. So I try to use that as a way to, if you think that there may be an information power differential, “well this is the almighty pharmacist with all this drug information and I'm this lowly patient that doesn't know anything.” Well, that's balderdash! They aren't an empty vessel. They have data to give to us or information that they can share. You may think, they may think it's mundane, but it's not. It's their experiences that they are bringing to the medication taking experience. It's the idea of concordance. You want that patient to be a partner. And you are giving them the confidence to be a great partner. That I want to hear from you.

And you're you're anticipating my next question. And that's, I ask all of my guests, what's the problem or the issue in patient communication that you're addressing or that you're facing? And I just heard you name three or four different kind of problems and issues that get raised in patient communication. The idea of being on the same team together. The idea of a patient having enough confidence in their knowledge to take good care of themselves and to see themselves as a partner. The building of the relationship. The trust issue. I mean, the concordance, you brought that up. There so many issues or problems in patient communication that you are addressing in thinking about the patient as a holder of equal information. The power differential! There you go! There's another one! So, how have you been encouraging this approach with your students?

We do a lot of role-playing in class. And I use techniques of sometimes deconstructing. I sometimes use a technique of deconstructing a patient record, where the students only get the drugs that someone's taking, not any background information. So then they have to make a history from the different kinds of pharmaceuticals that the person is taking. And it could go in many different directions, there's not one right answer. That's the point, there is not one right answer. But it's interesting to see how many different histories you can develop backwards, deconstructing just from the drug list.

Wow that's really powerful. I've never heard of something like that before, but it makes sense just I mean from my outsider perspective. Recently you've been working with some more arts-based pedagogy as well. You had a pretty exciting project this past semester. Do you want to tell us about it?

Sure, I'd love to.  We had, the last few years of my work as an academic and my teaching in pharmacy school I've been working on how to bring the Arts Theater, Visual Arts, let's say into the classroom, but also as a way of teaching. As a pedagogy. A way of explaining this medication use process with the public, with other health professionals, with students. To have a way to make this richer, these stories that people have about their medication taking experience. To make them richer. So this Spring, I've been working with a course with two theater professors at the University of Minnesota where I work. They're at the Theater Department and I'm in College of Pharmacy. So the three of us got our heads together and had a course called Pharmakon: Performing Science. And so the students who signed up for the class, had to the function of the class was to produce a play at the end about medication taking experiences. And they had to bring their own experiences to the class. And then we had them read some old Greek tragedies. I presented some Pharmacy history to them, discussing how drugs developed, and how important the gods were, way long ago about medicine, then science came in. So they produced, with their own medication experiences, and all the history and sociology of medication taking, they produced a play that was for a class exercise that was put on at the end of the class for a couple hours.

So remarkable so many layers here that that we could talk about: the drama pedagogy. The fact that you're again centering the patient. Asking people to share their own experiences. You and the other professors layering in your knowledge as ways of thinking about those experiences. Getting students to interrogate those experiences. And then sharing that with an audience!

Paul: Right

Anne Marie: Who gets to think about, oh! Wow, what does this have to do with the way I think about medication? And pharmacy?

P: Yep.

AM: And Pharmacists? And that you know you brought in religion and science. There's so much richness here. And I think there's, if there is anything that I can link to for our listeners to have a chance to see some of this. It is okay if I do that?

P: Yes, yes.

AM: Super!

P: That's' great

AM: Because I got to watch it, I got to see it live

P: That's right, yes

AM: So let me let me finish with it with the question that I that I finish all of my interviews: what advice can you give to people, whether pharmacists or patients, considering what we've talked about today, in terms of seeing the patient as an expert.

P: So the patient I'd like to you to be kind of assertive, and say, Yes I want to speak to the pharmacist about my medicine. And also have a question or two in the back of your mind if the pharmacist stumbles a little bit. Is there something I should be asking that I'm not asking? You know that's always a great question to have. Is there something I'm missing? You as the patient helping that conversation along, if the pharmacist is a little bit shy. So from the pharmacist perspective, I would like them to come out from behind the glass and be more assertive, and not even wait for someone to say yes I'd like to talk to you” but say “well what can I help you with about this drug? I would like to hear from you about your experience with it, or what you talked with the physician about with it. So that's kind of the way I approach this from the student's perspective, and that's how I would like pharmacist and patients to plan that visit.

Thank you. Thank you for this, Doctor Paul Ranelli. Thank you for coming back to the show, thank you for sharing this with us today.

Oh you're welcome, my pleasure.

Thank you again to Dr. Paul Ranelli for returning to the show. Be sure to check out the student-produced video on Pharmakon, I’ve got link in the show notes. Support this series and your own learning with our digital educational products. Available right now on HealthCommunicationPartners.com. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. I'm Dr. Anne Marie Liebel, thanks for listening.

The post “You want that patient to be a partner.” Dr. Paul Ranelli on patient communication appeared first on Health Communication Partners.

It’s our show’s 7th anniversary! Hear a story about a literacy trailblazer, and learn 3 steps you can take to improve patient relationships.

It’s our series anniversary! Yes, 10 Minutes to Better Patient Communication has been on the air for seven years! Oh my gosh! In today’s episode we’re gonna go back to where it started–with health literacy. And I’m gonna share a story that I think can help you improve your relationship with your patients.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, from Health Communication Partners, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com or message me on LinkedIn. 

Thank you for being here. Thanks for celebrating with us. It’s been an enormous privilege to have this show on the air for so long. Thanks for making this possible, because it’s you sharing and downloading that keeps us going. We were one of the first podcast series focused on patient communication, and I’m thrilled to say we’ve become one of people’s go-to sources, heard all around the world. Which as an educator means an enormous amount to me, because this is not easy stuff that you are choosing voluntarily to focus on.

With COVID and the increased focus on health equity and whiplash on DEI, we’ve been through a lot together. We’re way out of one-size-fits-all, easy, quick fix territory. This is deep work here, messy work, and that’s why you’re here. We’re seven years in, hundreds of thousands of downloads, which means many people like you also see that communication is important, and also know reflecting is key.

Reflection is a power move. If you haven’t reached out to say hi, please do! Again, message me on LinkedIn, email me, go to healthcommunicationpartners.com and click on contact. Because I’m proud of what we accomplished in these seven years and I’m excited for what’s to come.

It’s Health Literacy Month. Not coincidentally, this is the month I launched the show, because health literacy is a big part of what drew me into the health sector. So in today’s episode, I want to talk to you about the work of one of my favorite professors, Dr. Brian Street. Brian opened up so many horizons for me, changed so much of what I took for granted, how I understand literacy, how I relate to my students. He didn’t just do this for me. He did it for thousands of people around the world. 

Your relationships to your patients are important to you on many levels. You know better patient relationships mean better outcomes for everyone. And patient care is what got you into this in the first place. So in today’s episode, I want to tell you a little bit about what Brian did in the literacy field that made that huge change. 

For this story, we’re gonna go all the way back to the 1980s when Brian was doing his research that would transform the literacy field. The literacy field up until that point was dominated by researchers searching for a universal thing called “literacy” that was the same everywhere and for everyone, and if you have it you could use it anywhere, and get the same results, no matter who you were. 

Brian Street had a different starting place. He decided to spend time with people from different social and cultural groups around the world, paying attention to the different ways actual people use language in their everyday lives, and what their reading and writing and listening and speaking meant to them. And what Street really found challenged decades of research and opened up new directions for all of us. 

One of his findings was that, hmm, there’s not that one universal thing or skill that you could point to and say “that’s literacy.” On top of that, he found evidence that the whole idea that there ever had been one universal thing tended to be put forward by people in positions of power, like university-based researchers or policymakers–who tended to be from one particular social group and were often in a position to impose their values on other groups. When these researchers or policymakers made the definitions of what counts as literacy, for instance, maybe in a global health project, they held the ruler by which other people were measured, and sorted, and labeled. And this had consequences.

Where the attention was not, was where Brian Street was putting it. He wanted to understand what people were already doing with language, their words, the meaning they were already making, what this meant for them, how they already used their literacy to navigate life in sophisticated ways. Run households, run businesses. And Street found a lot of literacy of many different kinds, happening where other researchers found none. It turns out that when someone’s literacy didn’t fit a researcher’s or some test’s narrow definition, that literacy wasn’t counted at all.

That left literacy programs open to abuses of power. Turned out literacy could be used, and sometimes was–is–used as a cover for more political efforts.

If you didn’t have what those in power considered to be enough of, or the right kind of, literacy, you could be labeled illiterate, lacking, with connotations of being backward, poor, unfortunate, even uncivilized, somehow not prepared for the modern world. This, in turn, could be justification for all sorts of actions taken by the powerful, those holding the ruler.

Now, Street and his colleagues were not the first to point out this dark reality. They did connect it to some other powerful insights. Street and his colleagues found that there wasn’t a single universal thing called literacy that other researchers had been promoting. Language and literacy were not specific traits that people had, either, or even a single set of skills they used, as much as sets of social activities. Practices or processes that people engage in, every day, in different contexts, all throughout our lives. And these practices or processes vary by context, instead of being that one identifiable, true, universal thing held by some.

I can’t overstate what a transformation, what a game change this was, and still is, in literacy studies. Now there’s thousands of studies that approach literacy as a social process, including in health literacy. So if you’re looking for these studies, look for the phrase “social practice” or “social process” in addition to “literacy” and it’ll get you there. 

However, this one-universal-skill way of thinking about literacy, and health literacy to an extent, is still the dominant way. The idea that you’ve either got it, or you don’t and you’re lacking. It’s still everywhere. You could probably start to imagine how thinking about patients that way and thinking about literacy and health literacy that way could cramp your relationship. 

Let me give you an example. I said it’s our seventh anniversary. Way back in the beginning of the series in 2017, I did an episode about a nurse manager who, right before she went in to see a patient, glanced at their chart and saw that the patient had taken a screening that indicated that she was illiterate. And that one word threw her off completely. 

I want to stop on that for a second. The result of that screening stunned this nurse manager. There’s the power of that label to throw her off her game. The power of that label to make the patient who is standing in front of her suddenly seem so different.

Too different.

The relationship suffered to the point that the nurse did not know how to approach her. The gap between them suddenly became her focus. Instead of everything else she knew about this patient, everything that made her a great nurse, everything that connected the two of them in that moment. 

This is what we’ve inherited. It’s not that nurse’s fault, and that’s why I’m telling you this story. It’s very hard to shake off this dominant narrative. I had to get a doctorate to begin to do it! But I’m going to give you three things you can do to help shift the narrative–in your head, and with your patients.

1. This first one could be handy at any point when you feel like things aren’t going the way you want to, and you kind of want to reset, and catch your breath for a moment. You could acknowledge out loud that the way we speak in medical settings is particular. It is its own language. And it often doesn’t have much in common with the way anybody talks outside of these medical spaces. Remind yourself and your patient that you are doing your best to stay aware of that. 
2. A second thing you can do is tune your spidey sense. Watch out for anything that feels too top-down, too exclusively one-sided. Or the conversation is too much one way. And no the irony is not lost on me that I’m saying this to you in a monologue podcast episode, do better than me, right? If it feels too much like there’s only one party here with something important to say, remember: this is a legacy of that way of thinking that’s generations deep. You know you have got important information to share, you know your patient does too, but this top-down view has been in place for a long time, and it’s hard to shake. 
3. Thirdly, make sure you’re sharing the floor. One way you can do that when you’re teaching a patient something they need to know, or remember, or decide on, start with talking about what they are already doing to be healthy, including what they’re reading, writing, viewing, and discussing.

If you want more support on this, talk to me about our course, that Equitable Patient Education online course. It shows you mistakes that can be made in six common educational scenarios, so you can identify these obstacles, and disrupt this kind of thinking so you can reduce barriers. 

And give yourself some grace. Challenging a dominant narrative, you might run into some interference from other people, even in yourself, because you might be going against the grain. And not being in the patient role, but in the, well, powerful person role, by nature of our jobs, we are challenging a system that we’re a part of. But we can do it. We can do it.

People are doing it. My clients are doing it. You want help? Give me a call. I’m Dr. Anne Marie Liebel, and this has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering, music by Joe Liebel, additional music by Alexis Rounds, and it’s our anniversary!

The post How health literacy can help your patient relationships appeared first on Health Communication Partners.

In Part 2 of my interview with Jessica Halem, MBA, Jessica shares useful phrases and encouragement for the next time you’re speaking with LGBTQ+ patients.

Jessica Halem has spent the past 25 years working in LGBTQ health. First as the executive director of the Lesbian Community Cancer Project in Chicago, to serving on the Board of GLMA which is the largest association of LGBTQ healthcare professionals, to now 10 years in academic medicine at Harvard Medical School and the University of Pennsylvania, teaching the next generation of healthcare providers how to care for LGBTQ patients. She currently serves on the Board of the Tegan and Sara Foundation where she built the LGBTQ+ Healthcare Directory.

This is Part 2 (Part 1 here) of my interview with Jessica Halem. Jessica fills your cup to overflowing with useful phrases and encouragement for the next time you’re speaking with LGBTQ+ patients. Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com. 

In Part 1, Jessica and I talked about medicine’s historical role in creating and perpetuating LGBTQ health disparities, and the important work that’s been underway to address these harms. In Part 2, Jessica shares so many precious jewels of wisdom with us, it’s staggering.  One of my favorite parts is how she lets us off the worry-and-guilt hook, and focuses us on what’s really at issue here: patient care. We pick up our conversation as Jessica teaches about opening a conversation with an LGBTQ patient by acknowledging past harms, and offering a new start.

Jessica: And so that’s a piece of what I always want to remind people of is saying, “Hey, I bet you’ve had a bunch of bad experiences before we met today. It might have just been on the way into the facility. It might have been over the years in the health care system, but I want you to know that I see you. I hear you. I’m glad you’re here. How can we start fresh? How can I start over with you? How can I start to heal maybe some of those bad experiences you’ve had? Or how can we just start anew, right? Can we start from the beginning? Tell me what do I need to know?” And those healthcare workers, again, they know the kinds of help that people need. It’s how to get there. So, you know, what do I want people to know is I just want them to know that saying things in a different way, recognize that historic injustice, whether it’s personal or communal or the big picture, hundreds of years of history is a great place to start.

Anne Marie: And that also takes the onus off them if we’re going to talk about a large history.

J: That's right

AM: Like you don’t, you might not know so much about this individual in front of you, but you know something about the history and you can at least motion to the group and motion to, you know, the widespread difficulties that you are aware of

That's right

before you try and dial down. We were talking before the show about how the willingness, you’ve seen the willingness to do the right thing. And you told me this great story about trying to–it’s not as easy as fixing a form or just adding another question.

That’s right. I wish it was. I wish it was!

And you said you’d have this meeting at Harvard Med School with a whole bunch of Senior Vice Presidents and they, you know, “what can we do?” and you’re like “we’ll look at the forms.” “Well, come to our next committee meeting on forms. There are 6 ,000 different intake forms.”

Every health care worker knows this story, that the forms, that the data collection is such a challenge. There’s so much, we’re almost swimming in data, but maybe not the right data, maybe not the right questions, maybe not the right check boxes. And that’s just the beginning. We do want to make sure that LGBTQ identities and behaviors and experiences are reflected in the forms. We do want to take a bit of that onus off of that health care worker. We do want to make sure that people and their real experiences are reflected on the form. So you do need to ask people their sexual orientation on the form. You do need to ask people about the genders of their partners. You do need to find out about their current gender identity and their sex assigned at birth. We can do a lot of this in the forms. But boy, those IT departments, they’ll have you believe that this is the biggest challenge you’ll ever face and I know it can’t be true! But, you know, it doesn’t, it doesn’t replace the good old -fashioned face-to-face conversation that a health care worker and a patient have to have. Tell me about your partner. Tell me about what kind of sex you’re having. Tell me about your gender. Tell me about your gender journey. But it can really start the conversation. And those forms can be an important place to capture the data correctly, but also make sure that we’re having the deep, deep conversations, face to face.

And thanks for teeing up my last question, which is, is there anything that you want to tell people who are having these face-to-face conversations, who do have the values are in the right place and the goals are in the right place and they want to do the right thing? Do you have anything that you want to share with them?

I am so thankful that they are going to try. I think my number one piece of advice is always that you were not taught how to do this well and you’re going to need to find your own path in asking the questions the way that you are comfortable and feel powerful asking. I don’t want any health care provider to feel, what’s that expression, on the back foot, on their heel? I don’t want them to feel like I’ve got to say it in the perfect way. I need the perfect script. “Jessica, just write it down and tell me exactly what to say, how to say it.” I need you to find your way to get to the place that allows that patient to open up to you in a way that is honest and meaningful, and gets them the kind of care that they truly need. So you want to ask a patient, I am here. I am listening. Tell me about your gender. Tell me about your gender identity. Tell me how you identify today. How is that going for you? Do you have any questions for me? Tell me about your sexual orientation, your sexual partners, how is that going for you? How can I help you? How can I help keep you safe, happy and healthy?” right?

Because that's what it comes down to.

Right.

You want to make sure they're getting the right care. And one of the things I'm loving is that you're not getting tied up in terminology or pronouns.

No, oh my gosh! I mean, I wish that, you know–I can’t make a living just telling people that if you ask someone their pronouns, you’d know everything about them. Unfortunately, that’s not true. I think for a lot of, especially young people, it’s an exciting conversation to have. But for most LGBTQ people, pronouns are not the beginning nor the end of the conversation. They’re just one piece of the person. You don’t know someone’s gender identity by asking them their pronouns. You don’t know someone’s sexual orientation by asking them their pronouns. Unfortunately, pronouns are how we speak of each other in the third person. We all have one. We all need one. We sometimes do need to speak of each other in the third person. But I will tell you a really valuable lesson this one's a bonus freebie which is: you could just use somebody's name. And if you don't know their pronouns, you do not need to make a big to-do about asking pronouns, you don't need to figure it all out, you don't need to feel terrible you got it wrong, you don't need to fall apart because you didn't ask! If I'm a patient I don't need to wait for that. I can talk to people like a person and use their name, speak of them in the first person. When I’m in the hallway talking about them, I can talk about them with their name, right? We don’t have to trip over ourselves with the pronouns, everybody. Let’s jump to the real heart of the matter, which is, “I’d much rather you know what my blood pressure is than get my pronouns right! I’d much rather you screen my cholesterol and just help me understand why my cholesterol numbers and my blood pressure numbers really, really matter, right?” And perhaps I am somebody that when everyone gets my pronouns wrong, my blood pressure goes through the roof. Sure, that’s a great conversation. But it's about the blood pressure numbers, the stress, the anxiety of being seen and understood in the world. And that's my hope for everyone listening to this, is to get to the heart of the matter and getting people the kind of care, the real health care needs that they have.

Jessica Halem, thank you for being on the show. Thank you for the wisdom that you're sharing. Thank you for the work you're already doing in the world and continue to do. I'm just delighted that you've spent this time with us today and you've shared these insights with our listeners.

I'm grateful that everyone listening to this is going to try and be part of this challenge we have in ensuring that all LGBTQ+ people can live long, happy, healthy lives.

So many thanks to Jessica Halem for coming by the show and sharing insights, encouragement and improv energy with us. Don’t miss Part 1 and links to what we talked about in the show transcripts for this and every episode at H-CPartners.com. 

The post Jessica Halem on communicating with LGBTQ+ patients Part 2 appeared first on Health Communication Partners.

I get to talk–and laugh, a lot–with Jessica Halem, MBA. We discuss communication with LGBTQ+ patients, improv, and her fancy article in the New England Journal of Medicine. Her insights are as powerful as her joy. 

You are in for a treat. Jessica Halem is a health communication expert who specializes in communicating with LGBTQ+ patients. I had so much fun interviewing her we went over time, and I had to split her interview into 2 episodes! And believe me, you won’t want to miss a word. 

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. HCP’s online course, Equitable Patient Education, promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com. 

When Jessica Halem and I sat down at the mic, the time just flew. In this first half of our chat, she drops so much knowledge you might actually want to take out a notepad. Her insights are as powerful as her joy. She talks about her recent article in the New England Journal of Medicine about how medicine itself has helped create and perpetuate LGBTQ health inequalities. And her message is one of encouragement, appreciation, and possibility. And she teaches us about improv! I’m so excited to share this with you. Here’s Jessica!

Anne Marie: I’m live via Zoom with Jessica Halem. Jessica has spent the past 25 years working in LGBTQ health. First as the executive director of the Lesbian Community Cancer Project in Chicago, to serving on the Board of GLMA which is the largest association of LGBTQ healthcare professionals, to now 10 years in academic medicine at Harvard Medical School and the University of Pennsylvania, teaching the next generation of healthcare providers how to care for LGBTQ patients. She currently serves on the Board of the Tegan and Sara Foundation where she built the LGBTQ+ Healthcare Directory. Jessica, welcome to the show.

Jessica: Oh, my goodness. She sounds fabulous. I can’t wait for her to join us. I love that. I love whoever she is. She sounds terrific.

AM: Jessica, thank you so much for agreeing to be on the show. And this is a real treat for me. We have the Penn connection, but then I also found out in our pre-roll talk that you have a history in improv. So I’m a little bit nervous because, oh, the last thing I can do is improv, the last thing I can do is be funny. So really, I’m just going to learn from you during this podcast.

J: Well, you know, the secret, the secret of improv is that they’re not funny, they’re just present. That’s the secret. I just taught you two years of improv into one nugget, which is: don’t worry about being funny, just stay present, and you’re already perfect.

I love this. I love this. Do you hear that, everybody? Do you hear that? Remember that.

Yeah.

All right, I’m jumping right into the questions that I ask all of our guests.

Great, great.

So what is an issue or problem you are facing related to patient communication or patient education?

Well, the problem I have been trying to address to improve patient communication, patient education, are those moments, those difficult moments, between a provider and a patient. I am trying to tackle the alarming LGBTQ health disparities. I am trying to tackle that through cultural competency training, which it turns out itself needs an overhaul as well. I’ve been doing that for over 25 years, right? I’m sure that’s half of your conversations. If we were doing it perfectly, we wouldn’t be having this terrific podcast, but we’ve got some challenges, right?

Yep

We’ve got training’s not working. The education that’s already out there is not working. Thank goodness that you’re supplementing all of that. But I am trying to, you know, tackle the disparities that we see in my community, the LGBTQ+ community.

And you’ve anticipated where I’m going next with this. You know, how are you facing this, really? Because it is a communication problem. It’s an education problem. Yeah. How are you facing these LGBTQ health disparities in communication?

Well, what I love about your question is that it is a communication problem. It’s not a values problem. It’s not a goal problem. It’s not that people don’t want to do the right thing. I mean, I have been working with health care facilities big and small and providers all over the place for decades now. It’s not that people don’t want to do the right thing. It’s just they don’t know what to say and how to say it. We are not biologically different people. We need the same tests you already know about, the same screenings, the same care. There’s nothing fundamentally different. It’s just eliciting the information that people need, and translating it in a way where your care and concern can really come through, right?

So much! And I love that you’re starting with the fact that people really do want to do the right thing.

They do. They do. Yep. They do. And it’s so important to remind people in the work that you’re doing. I know you hear this every day. The values are there. The people who go into health care are terrific people. They want to do the right thing, but they just don’t have that education or training.

Right. Right. And it’s still kind of edgy, even among those of us who are in communication. Now, you recently were the lead author on an important article in the New England Journal of Medicine.

Fancy. Fancy! My parents are so proud. My parents are so proud. To be a non MD, a non Ph.D. and to, you know, have a first author article, it’s a testament to, as you just said, that this, we are still at the edge of this work. We are still at the edge of this work.

I’d like to tell people a little bit about this article. So this was the New England Journal of Medicine's kind of attempt to locate themselves as also responsible for these health disparities that we’re all witnessing over the course of their long history. As a high-profile Journal, as a well-respected journal, knowing that they have been part of the problem. And can you tell us a little bit about what your article was about?

That’s right. It’s very historic and important that the New England Journal of Medicine is trying to reflect on their own history of what they’re calling this Historic Injustice series. Historic injustices perpetuated on the basis of race, ethnicity. They have wonderful–it’s a whole series of articles that are free. You don’t have to have a subscription to be able to read these. They’re free, not behind the paywall. It’s the New England Journal of Medicine trying to really recognize Medicine’s role in creating the health disparities that we see today. And taking responsibility for healing that damage, that historic injustice. And just like we are learning about racism in medicine, we know that the pathologizing and the stigmatizing of gender differences, of sexuality, sexual minority people, gender minority people, we know that those experiences have been pathologized in the pages of the New England Journal of Medicine. So when we say we’ve got a communication problem, this isn’t just a verbal, I walk into the exam room, and you say the wrong thing, and it’s like a womp-womp. This is the written words that you studied as a Doctor. And we know this is true in other healthcare professions, too, actually taught you this categorization and this classification of differences, and what’s normal and abnormal, and healthy and unhealthy, and risk and not risk.  So we know that it’s in the written word and the and the verbal communication as well.

Yes absolutely! Thank you for that. And that’s also why I’m just so excited to have you on the show today. And this next question is such a big question, so you can really take it any way you would like to. What are you learning from your work with health care professionals, your work with community health workers, your work with writing articles like this in the New England Journal of Medicine? What do you want to tell us, some of what you’re learning?

Yeah. Well, you know, I started off by saying just how good people are and what great work is happening. And I, when someone like me comes in to do a training or an education, I think the first thing that I observe from all of these amazing healthcare professionals on the front lines, in the back offices, at the front desk, in the exam rooms, is that they are doing really, really good work. And they’re really frustrated by how it feels like a drop in the bucket, right? They feel like they’re a part of this sort of tsunami waves of bad experiences that patients have had.

Thank you again to Jessica Halem. Tune in next time for Part 2 when Jessica rapid-fires the most useful, wonderful phrases you could use, or that could be inspiration to get you thinking and open things up for the next time you’re speaking with an LGBTQ patient. You will want to take notes and you won’t want to miss it. And there’s links to what we talked about today in the transcripts at h-cpartners.com. 

The post Jessica Halem on communicating with LGBTQ+ patients Part 1 appeared first on Health Communication Partners.

Fall fashion is the best fashion. But there’s another seasonal trend none of us wants to participate in. COVID was in the news again, as the fall transmission season started earlier than anticipated. Here’s some tips and encouragement for you when talking with people about getting vaxxed or boosted, again.

The fall COVID season arrived early! Here’s some tips and encouragement for you when talking to your patients about keeping themselves safe, including being vaxxed or boosted.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com. 

Yes, COVID was in the news again recently. Apparently, the fall transmission season started earlier than anticipated. That’s according to Harvard T.H. Chan School of Public Health website. “Case numbers are currently high, but hospitalizations and deaths have not reached the levels of previous surges.” Many experts are now saying about COVID that it has moved from a pandemic to an endemic phase, which generally means “a constant presence rather than a disruptive outbreak,” accorrding to William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. And i’ll link to that article in the episode notes.

Another expert, Aron Hall, the deputy director for science at the CDC’s Coronavirus and Other Respiratory Viruses Division, told NPR in an interview, “At this point, COVID-19 can be described as endemic throughout the world.” NPR added that “The classification doesn’t change any official recommendations or guidelines for how people should respond to the virus. But the categorization does acknowledge that the SARS-CoV2 virus that causes COVID will continue to circulate and cause illness indefinitely.”

COVID is still killing hundreds of people every week in the US. NPR cites a new report from CDC that COVID is projected to kill close to 50,000 people here in the US every year. This year, and next year, and the year after, according to the new report from CDC. Just here in the US! 50,000 people is not a small number. It paints a bleak and ghastly future image, but I hold with a lot of people who say it doesn’t have to be this way! There are things we can do, and you know it because you are doing them, and you’re helping other people do them, too.

I’m going to give some encouragement for when you need to talk to people about keeping themselves safe. Because this new data underscoring the importance of people getting vaccinated and boosted taking what steps they can to reduce their risk, as NPR puts it, “for the foreseeable future.” So as you’re talking with patients about these steps, let me share some encouragement from an episode about reflecting on your vaccine communication we ran when the COVID vaccines became widely available. 

All right so let's go. Number 1. What kind of person are you trying to be or sound like? If you're writing, what kind of a voice are you giving your organization? How's your language reflecting this? Communication is about more than imparting information. Said it before, gonna say it again. One of the things that's also going on is you're hoping to show yourself as a certain kind of person or organization. You can't help but speak from your own position. And when it comes to vaccinations, your position is probably: do it!

You're also speaking from the blend of the personal and professional cultures that you're part of. You're speaking from your organization's history. Speaking from the history of health care and public health. And when it comes to vaccines, these collective histories are complicated.

Nonetheless, we can all fall into the trap of thinking that our ways of seeing things are normal or common sense. So, when speaking or writing about vaccines, remember where you stand, how you're seeing, how you got there. If you'd like a bit of practice, listen closely to the next person you hear speaking. What kind of person do they reveal themselves to be through their language?

All right, number 2. Might've heard this one coming: what kind of person do you think your patient is? Or if you're writing, what kind of people do you think you're writing to? What do you tend to think of people in that social group? How does your language reflect this? Now conversations about vaccines can present challenges because of the tendency to focus on social groups who are either expressing interest in not being vaccinated, or they're expressing skepticism, or they're expressing their intention to remain unvaccinated.

Now when you've got the majority of health professionals who are on #teamvaccinate, there is a kind of built-in battle! Think about how many well-meaning posts that you've seen, or presentations, or talks about vaccines, and how many of them are framed kind of antagonistically.

Conflict isn't great for any relationship, and it can bog down communication. An Us-Versus-Them attitude can also have the effect of short-circuiting any attempts you would have made to try to find out people's reasons for thinking what they think. So take a close look at your language. Keep an eye on how your word choice or framing even conversational dynamics might unintentionally be reflecting biases or stereotypes. Including those about social groups such as anti-vaxxers, or people who are reluctant to be vaccinated.

Here's a trick that can help you become sensitized to framing and word choice in language. The next time you hear someone speaking in the media, or you read a statement from an organization, or even see an ad: ask yourself who they think you are. How can you tell through the ways they use language and images?

All right number 3. What do you tend to assume normal people do in terms of keeping healthy? What do you consider normal knowledge, beliefs, assumptions about vaccines and vaccination? I ask this because when we're not hearing from a person or a group what we think is normal or basic or fundamental, that perceived gap between what we expected to hear and what we're hearing can become our focus. That is, sometimes we can focus on a person or group's perceived weaknesses, based on what we think is or should be normal.

This risks getting close to a deficit perspective. You've heard me talk about deficit perspectives before. They can hurt the relationship. They can also hurt your chances of being helpful. Communication about vaccines can surface differences in people's knowledge, beliefs, and assumptions real quick! And once you get to thinking that you're not on the same sheet of music as the person you're talking to, or writing to, all sorts of kind of mental and emotional barriers can emerge.

This is because it can be easy to regard the ways that other people understand vaccines, or act upon health information, as problematic especially when it's not what you think is or should be normal. Your assumptions about what's normal inform the style and the content of your communication. Often unconsciously! So be ready to look closely at what your assumptions are, cuz they're turning up in your words.

Okay finally number 4. If your audience's attitude toward vaccines and vaccinations differs from yours, how–or under what circumstances–might their attitude make sense? This one is perhaps the most difficult to do, and I'll argue it's the most important, if you really want to educate and not just lecture, or lose your chance. Let's dig in!

Health professionals like yourself have some of the best informed stances on vaccines and vaccinations on the planet. They're built on decades of research and some of the latest science! They're supported by your study. They're enriched by your years of experience and your participation in professional communities.

The rest of us non-specialists are also walking around with ideas about vaccines or vaccinations. These ideas may or may not have scientific merit, but just like yours, they are based on our experiences, our knowledge, and our communities. Differences in ideas can feel like barriers to communication.

But as the holder of the expert information, it's part of your job to make the connection between where your audience is at, and where you're at. In order to do this, you need to know where you're at hence question number one but you also need to take seriously what that person or group thinks about the topic at hand: vaccines.

Even for just a moment, try to find a part of their understanding that makes sense to you. The faster you can see the sense behind what your audience is thinking, the faster you can get on with communication that's going to connect to them. So keep in mind that whatever your audience says is related to assumptions or beliefs that they hold. And that these assumptions or beliefs make sense to them.

Now, I focused in this short episode on interpersonal conversations, a bit of mass communication, but there are systemic factors at play too, and serious work to be done here. If you'd like help put this in your organization, contact me. Visit HealthCommunicationPartners.com, click on contact. Find me on Twitter. Find me on LinkedIn. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel.

The post 4 ways to refresh your ‘get vaxxed’ message for the fall COVID season appeared first on Health Communication Partners.

Tips on what not to say when you’re thinking about trust.

Trust in health care and public health captured a lot of attention during the pandemic, and it’s still going strong. When it comes to communication and patient education, there are things we can do related to trust, and I’m going to share a few of them with you in this episode.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com. 

Now, you know there’s a trust problem in health care. Deloitte reports that 55% of the people they spoke to had a negative experience where they lost trust in a health care provider and 36% skipped or avoided care because they didn’t like the way that the health care provider or staff treated them.

So lots of people are working very hard on these issues, and you might be one of those people. I hope to add to this conversation from the perspective of communication and patient education because there are things we can do.

The focus on trust that came up during COVID, the explicit question was often, why don’t they trust us? And the answers came back loud and clear: historical discrimination, current discrimination. And a lot of people paid attention and heard these well-justified reasons. 

The focus was on the public for quite a while, though, specifically people who did not trust doctors, or vaccines, or the health care system, or public health messaging. And the focus kind of stayed on their feelings of mistrust. Interventions were focused on patients. And it didn’t take long for practitioners to kind of flag this and go, wait, hang on, this is not okay to just say, like, if we could fix their feelings, the problem would go away.

Looking outward is important. Looking at patients is essential, but it’s only part of the picture. And these same practitioners were insisting we can’t locate the problem just in other people. Externally, outside the health professions. We have to ask the question that someone asked in a meeting I was at, that is the title of this episode: “what are we doing to be trustworthy?”

This locates the problem inside. It flips the question. It’s a hard question to ask, focusing on our role, locating the problem and solution partly in us and in systems we’re a part of. One of the benefits of not locating the problem entirely out there is when we look for obstacles and opportunities internally, we can do something about it! 

And lots of people are. In 2022, there was a review of research on trust research that was in Health Affairs. And the authors said “the issue of trust has gained increasing attention in the past couple of years. We speculate that this is largely motivated by the COVID -19 pandemic, renewed emphasis on racial justice, and the increased proliferation of mis- and disinformation.”

And that study found a “growth in projects that aimed to address trust through specific interventions, striving for impact, instead of only documenting the problem.”

Another review of research published earlier this summer said, “The COVID -19 pandemic reignited a commitment from the health policy and health services research communities to rebuilding trust in health care and created a renewed appetite for measures of trust for system monitoring and evaluation.”

So that focus is inward. That indication is we’re looking inward. And I want to add something to this conversation. As you know, the show focuses on language use in communication and when we’re educating. It gives you ways to think about common things that you do, common arrangements, conversations, interactions with an equity lens. because there is so much we can do with our words. We actually have control over them. We famously don’t have control over other people, but we do have control over our words. 

So I want to start with a kind of what not to say when you’re thinking about trust. Something to watch out for in our language that could get in our way, send a message we don’t want to send or don’t mean to send. Because we want our words to meet our standards.

We want our words to reflect our values. And one of the biggest requests I continuously have gotten as a consultant over the years is a version of this: “I don’t want to unintentionally offend people. Help me out with this.” You’re listening to this show. So you already got a leg up on this. There is something that you can do.

I’m going to give a real quick mini-lesson about the nature of language. Language is a social phenomenon. The words and the phrases that we grab for are influenced by the words and phrases used by people around us. Words, phrases, and also bigger pieces of language like ways of talking about a topic, or ways of talking about people. Or ways of not talking about topics, like taboos, stigmas, the elephant in the room. We pick these up from other people. And sometimes we don’t even notice it. 

What we hear and say and learn and pick up in our communities informs our thinking as we read, write, talk, and listen. This goes for our professional communities as well. The process of earning a professional degree or a certification is a significant socialization process. That’s where we learn to talk, think, read, and write in ways that are specific to a discipline. 

So let’s connect this to trust.

None of us set out to say things to erode trust. However, you are probably already aware that patients and clients can be framed or positioned in negative ways by research, by policies, by theories, or by everyday taken for granted arrangements at an organization or an institution. So these ways of talking and thinking can make it into our language, and sometimes we don’t notice it. 

So what is this thing you want to watch out for in your language? 

I want to talk about deficit perspectives. What they are, and why they matter. 

You may have heard me talk about deficit perspectives before. They can relate to maintaining a focus on what a patient doesn’t understand or doesn’t do. An emphasis on an individual’s negative attitudes. What a patient’s situation lacks, what it seems their community can’t provide. It can also refer to a focus that’s limited to negative results, negative effects, negative examples, negative depictions, negative instances. The deficit. We’re looking at people and we’re attaching a deficit to them primarily. 

Now, we might all say, I don’t think that way about people. We want to make sure our language meets our own standards. We want to make sure that deficit perspectives are not creeping into our language, that we’re not by chance picking up deficit words or phrases or ways of thinking because they’re in the air around us.

Because they are in the air around us. In spoken and written form, in research, theory, practice, and policy. I’ll link to a previous episode I did about this. And if you’ve been working on shared decision-making, or if you’ve been keeping your eye on paternalism and communication, you might also have run into some of this deficit perspective research. One study about how dentists perceive poverty and people who are on social assistance found that dentists emphasized individuals’ negative attitudes toward work and their lack of capabilities. And the research results suggest that this perspective, this deficit perspective, impeded the care relationship between dentists and their poor patients. 

We want to have good relationships. We want to meet people where they are. So we’ve got to watch out for inherited language that gets in the way of those goals. 

So how can you spot a deficit perspective in talk or writing? I’ll give you two ways. And you have to listen or look closely. 

First of all, reconsider anything that implies that other people and their actions are really the problem. That they’re really what’s at issue here. And the focus is making them do something. The responsibility is on them. If only they would do this thing or if only they would be this way, the problem would be solved. 

For an example, you can go back to the beginning of this episode and the early days of trust research and some of it still has a deficit perspective kind of scratching around the edges when it implies that really the problem is in the public, and the intervention should be on the public, instead of also looking internally. So that’s one thing you want to look out for. 

Another thing is any talk or words that indicate or imply that other people have erroneous thinking or misguided thinking that must be remedied by experts. So the thinking is wrong. And if we could just replace their thinking with correct thinking, the problem would go away. We know that’s not the case, too. 

So what are you looking for instead? Instead, you want to pay attention to and seek out language that takes people seriously. That takes their thinking seriously. That attempts to see where they are coming from, and how their responses make sense. Like we would want people to do for us. 

If you want more support on this, our online course Equitable Patient Education shows you deficit perspectives in six common educational scenarios. You learn how to identify them, how to disrupt this kind of thinking, and then reduce barriers to access in your patient education.

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel, additional music by Alexis Rounds. I’m Dr. Anne Marie Liebel. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners, LLC. Find us at healthcommunicationpartners .com.

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