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 or literal table. In this episode, you’ll learn about three levels of concern that can emerge during interprofessional communication – and what you can do to manage them.
Hi, this is 10 Minutes to Better Patient Communication. I’m Dr. Anne Marie Liebel.
Over a recent six week span, four different health care professionals asked me about interprofessional communication. All four were in different organizations. Two were public health administrators, one was a medical educator, and one was a physician-administrator.
I don’t know why the sudden uptick. But I am taking notice, and taking this chance to share 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.
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I sometimes have to remind myself that I am doing interprofessional communication all the time here. These articles, and podcasts, and workshops, and talks. Because I’m talking and writing and podcasting 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. 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 collaborating or trying to collaborate with colleagues.
Now, 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 or literal table. A 2017 Discussion Paper from the National Academy of Medicine underscores how much this has to do with communication:
[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 also helps reduce time wasted to duplicated efforts, and helps under-resourced groups. We know it takes a village. We know none of us is as smart as all of us. Still, the challenges are real. There are personal concerns, interpersonal concerns, and institutional concerns when it comes to interprofessional communication. so let’s dig really briefly into each of those three.
Personal concerns. 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 and feel. 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 tends to reflect 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 on whatever issue’s at hand. We are making a case for our priorities. And more. That can be intimidating for anyone.
So how about some interpersonal concerns? 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, or 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. This is a large part of what makes groups powerful, and at times, tough to navigate and sustain.
Let’s think a moment about institutional concerns. 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.
For instance, 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. 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. For example, what is acceptable or normal communication in one institutional context is not necessarily so in another. Success or comfort in one department, or one organization, or one sector does not automatically translate into success in 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 also get silo’ed within our institutions, don’t we? Once, I gave a talk that drew folks from different departments in the same organization. After my talk, I was eavesdropping a little on their conversations. It turns out they didn’t really know each other, and hadn’t realized how much they could have been working together given their shared interests.
I realize there are many, many other structural and social issues I’m not even touching on, but let’s turn to the good news. Because there IS good news. There are ways to constitute these interprofessional groups, and there are ways they can work and sustain themselves. Who’s one person you can reach out to and say, “We probably have common people (or common problems), so maybe we can help each other?” Just one person. You can do this.
Another thought on the personal level: Notice some phrases or terminology you commonly use. 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 mainly about “soft skills.”
Here’s some thoughts for the Interpersonal level: For your next meeting, check ahead of time: do you have an agenda? If not, make one. A quick one. An objective and some action steps. Even something this short will help 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,” she said.
Another interpersonal concern: Who is best served by the current arrangements in your group? For example, is there maybe a small shift that would make collaboration easier for more participants? Maybe occasionally switching to conference calls, or making an online meeting space, or rotating who’s in charge.
Now let’s turn to an Institutional level concern: What person or group or perhaps even specialization or knowledge base tends to dominate in your interprofessional groups? Which tend to be a little quieter, perhaps marginalized? For example, think of who typically is not heard from, even when they’re present. What might change if there were more of a level playing field?
If you’d like some more examples and encouragement, check out my earlier podcast episode on hotspotting at healthcommunicationpartners.com. and there’s a transcript for this and every single episodes I do at healthcommunicationpartners.com with hyperlinks to all the research references. Because I love linking research to practice!
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. If you’re like more help, drop me a line.
This has been 10 Minutes to Better Communication. I’m Dr. Anne Marie Liebel for Health Communication Partners.