Over the last six weeks, four different health care professionals have asked me about interprofessional communication.
Two were public health administrators, one was a medical educator, and one was a physician-administrator. All four were in different organizations.
I don’t know why the sudden uptick. But I am taking notice, and taking this chance to share some of what I have talked about in these conversations, in a way that may be helpful to you.
I sometimes have to remind myself that I am doing interprofessional communication all the time here. These articles, and podcasts, and workshops, and talks. I’m talking and writing from my experience mainly in the education sector, to an audience who’s mainly in the health sector.
And it’s tricky. I like to think I’ve gotten better at it over time, when I look back at some of my earlier writings (including manuscripts given a hard pass by reviewers, ouch).
That’s not to say when I was still working in the education sector, it was all rainbows and sunshine. Most of what I learned about interprofessional communication came from decades of trying to collaborate with colleagues.
So I will share here some of what I’ve learned, and what health professionals have shared with me, about some challenges we may face during interprofessional communication. And, of course, I’ll end with a few things you can do to begin to move past these constraints.
Moves toward interprofessional teams
Multi-sector collaborations are not new in healthcare, but they’re certainly popular. With the move to team-based care, and increased focus on population health, professionals who have not traditionally worked together are finding themselves around the same metaphoric table.
This 2017 Discussion Paper from the National Academy of Medicine underscores how much communication is involved here:
[E]fforts to improve health and eliminate disparities require professionals to understand audiences, share across knowledge arenas, provide culturally appropriate and accessible health information resources, and innovate strategies to engage vulnerable populations.
It’s not news that difficult and deep-seated challenges benefit from collaborative efforts. The pooling of knowledge and resources eliminates time wasted to duplicated efforts (and helps under-resourced groups). A public health administrator told me,
[We want to] look at healthcare as…a group effort. It’s impossible for a physician to have a counseling session [with a patient] about transportation and finances, and their mental health, and their needs to manage their medications correctly, all within 20 minutes and send them on their way.
This seems to underline what I hear from many physicians frustrated at being told to do ‘one more thing.’
We know it takes a village. We know none of us is as smart as all of us.
Still, the challenges are real.
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We all have our communication hangups. None of us wants to look foolish. When it’s something we care about, or it’s a difficult issue – or both – we can put additional pressure on ourselves.
Wouldn’t it be nice if we could magically leave our awkwardness, doubt, or frustration at the door when we have to communicate in a professional capacity?
We all believe we have good reasons behind what we do and say. We develop ideas that work for us. They are based on our experiences, our knowledge, and our communities.
And these processes are largely unconscious on our part. Our language reflects what we think is normal, natural, or the way things should be. That’s not necessarily a problem…but it can show up like one.
What’s more, when we speak with another human being, we are strengthening (or weakening) our relationship with them. We are revealing our perspective. We are making a case for our priorities. And more.
That can be intimidating for anyone.
Ok, it’s obvious that communication is an interaction between people.
It’s easier to forget that different people are more comfortable speaking in some places, to some people, than others.
We also can feel more or less confident in our knowledge, depending on where we are, and who’s listening.
Folks on your team may be coming from different places, or standing in different spaces–economically, politically, or culturally. Your team members participate in different communities: professional communities, neighborhoods, families, and multiple other social groups.
And these groups tend to impact the ways we talk, think, act, and more. So we’re all coming together with what we believe to be good reasons for doing, saying, and believing like we do.
You won’t be surprised at the two institutional constraints most often shared with me: time and technology. That’s largely because when, where, and how you interact shapes what you do together.
One public health department was trying make their EMR system work with the system used by local PCPs, in order to facilitate referrals. (Another was attempting to qualify to have an EMR to begin with.)
Where and when group meetings are held matters. Some times and locations will make participation easier for some group members than for others.
This is about logistics and structure, but also organizational culture. I have done some work in the business sector, and I’ll say it took me a while to wrap my head around the maxim “Culture eats strategy for breakfast,” but I’m inclined to agree.
Whether it’s down to institutional norms, or the status quo, we feel a more valued part of some contexts than others.
And there’s plenty of variation within contexts. What is acceptable or normal communication in one institutional context is not necessarily so in another. Success or comfort (or lack thereof) in one does not automatically translate into another.
We all know about academic silos. Those silos are the places each of us learned to talk, think, read and write in ways that are necessarily specific to our area of expertise.
But we get silo’ed within our institutions. Once, I gave a talk that drew folks from different departments in the same organization. After my talk, I was eavesdropping on their conversation. It turns out they didn’t really know each other, and hadn’t realized how much they could be working together given their shared interests.
I realize there are many, many other structural and social issues I’m not even touching (enough for at least one other article) but let’s turn to the good news. Because there IS good news.
What you can do
There are ways to constitute these interprofessional groups, and there are ways they can work and sustain themselves. (Check out my earlier piece on hotspotting for some examples and encouragement.)
Easy first step
Who’s one person you can reach out to and say, “We probably have common people (or problems), so maybe we can help each other?” Just one person. You can do this.
If you’re already in a group
For your next meeting, make sure you have an agenda. A quick one. An objective and some action steps will ensure you make the most of the time.
I know this sounds obvious, but it’s easy to forget. I’ve said this to multiple people. One appreciative physician told me, “It’s different to just hang out and say we’re talking–it’s different if we have an agenda. There has to be a little bit of formality.”
Questions to go further
- Personal level: Notice some commonly used phrases or terminology. What are the underlying assumptions about patients (or colleagues) within these words and phrases?
For example, calling patients “frequent fliers” or “noncompliant;” describing a colleague’s contribution as “soft skills.”
- Interpersonal level: Who is best served by the current arrangements in your group? Who designs and reinforces these arrangements?
For example, is there a small shift that would make collaboration easier for more participants? Maybe occasionally switching to conference calls, making an online meeting space, or rotating who’s in charge.
- Institutional level: What knowledge is typically dominant, and which is typically marginalized in your group? Who gets to decide this, and how is this decision-making power ensured?
For example, who typically is not invited or involved? What might change if this person or group was considered part of the team?
Interprofessional groups are intended to be collaborative, and collaboration hinges on open communication. These tips might help you see some small ways communication in your group could be brought more in line with its goals. Want more help? Drop me a line.