Improving Communication in Healthcare

May 11, 2018

How often does your boss tell you what to do? How frequently does your spouse insist that they know the right way to handle a situation? How many times have you seen discussions escalate into conflicts because each side wants to win the argument?

Ninety percent of conversations produce negative feelings and alienation, according to Judith Glaser. In Conversational Intelligence she cites multiple studies showing that people have become addicted to being right.

When someone disagrees with us, we’re prone to intensifying our efforts to sell our position in order to persuade the person we’re right. But no one ever says, “Now that you say that, I see I was wrong.” Often they increase their resistance and shut down. Or they turn up the volume, which can escalate the conflict to a level where people end up yelling at each other.

This Tell – Sell – Yell pattern is prevalent in most conversations, says Glaser. Consequently, employees disengage from coworkers. Couples lose their warm connection. Unresolved conflicts alienate us from neighbors and even members of our own family.

Research using brain scans reveals that in healthy conversations we take in what the other person is saying and process the information through our Left Pre-Frontal Cortex. This ‘executive functioning’ part of our human brain helps us picture possibilities. It integrates what other people are telling us they need with the result we’re hoping to attain. The LPFC figures out the best response to achieve a mutually agreeable outcome.

In discussions that devolve into conflicts, the LPFC is bypassed. Instead, incoming messages activate our motor cortex. This mammal part of our brain instantly generates fight – flight – freeze reactions. These split-second decisions were helpful thousands of years ago when a bear jumped out and humans didn’t have time to think about a collaborative solution. Our ancestors needed to act quickly to deal with the threat.

As time has gone on, the human brain has evolved to deal with more complex problems that require thoughtful consideration. It’s impossible for one person to see all facets of the problem. More complicated issues are best resolved when multiple perspectives are considered. Twelve years of PROPEL performance improvement research has proven that the best solutions come from the collective wisdom of leaders and their teams. Shared decision-making also motivates employees to work hard to see that their suggestions turn out to be good ideas.

The good news is that human beings have the capability to choose which part of their brain they wish to use. The bad news is that we have to train our brain to switch gears when we want to respond reasonably rather than react quickly. We’re hardwired for flight – flight – freeze, but must build the neural pathways that enable access to the LPFC.

When we’re around other people, our mammal brain is automatically and subconsciously scanning 5 times per second to assess friend or foe. This makes it imperative that the first thing we do to increase the chances of having a productive conversation is to send friend signals. Think smiles and warm greetings whenever you’re within 10 feet of a person. People’s brains will view us as being in a friendly mood.

Having opened the door to a collaborative conversation, the next step is to ask the other individual to share their perspective on whatever problem you’re trying to resolve. Inquiry must always proceed advocacy.

Now comes the tricky part – listening. This involves much more than hearing; it requires reflecting an understanding of the other person’s point of view. To be able to do that you’ll probably have to ask several questions to learn more about what the person is saying and why they’re saying it. You don’t have to agree, but people have to feel that you get what’s important to them. Then, and only then, will they be willing to listen to you.

When you share your take on the problem and offer solutions, expect reactions and resistance. But because you were patient in developing an understanding of the other person’s perspective, you can now ask them to slow down and think about how they can become a part of the solution. Encourage people to ask questions to discover what it would look like if there was a positive outcome that would benefit everyone.

Insist the other person offer their ideas about what changes will need to be made in order to achieve a positive outcome. Be open to incorporating their ideas into a picture of a shared goal that you co-create. End by asking how it will feel when the goal has been accomplished.

Read more about how to improve communication in PROPEL to Quality Healthcare, a guide for leaders and staff to use to overcome conflicts and disengagement. To have Dr. Muha talk to your healthcare organization about how leaders and staff can improve their ability to collaborate, email


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