Reinvigorating Communication at Your Medical Practice

The advent of team-based care and other emerging healthcare models rely on constant interaction between physicians and staff to work toward better patient outcomes.  But getting that communication to flow seamlessly and across varying personalities is easier said than done.

"All of these new models for care are good in their own way - good for the patient and good for us," said Krista Hirschmann, co-director of faculty development for the American Academy on Communication in Healthcare. "However, I'd argue that all these initiatives are missing something…and there's a lot on the table and a lot at stake. What we need to do is stop and circle back to those foundational things that can make or break success in new care models."

Hirschmann, who is also director of practice engagement at Lehigh Valley Health Network in Allentown, Pa., offered five key strategies to improve communication during her educational session at this year's Medical Group Management Association (MGMA) Annual Conference in Nashville, Tenn., on Tuesday (Oct. 13).

1.  Work together as human beings.

"Take off your badges, your titles … and you have a team of human beings who want to do it right," Hirschmann said. "Let's come into that connection together."

She urged healthcare teams to talk to each other as individuals and ask key questions of one another, including "What are you committed to?" and "What do I need to know about you in order for us to work together well?"

2. Establish agreed upon communication pathways.

Simply put, ask your colleagues if they are more responsive to e-mails, phone calls, a gentle tap on the shoulder, or another way of sharing information and receiving feedback. Once you know the right channel, she said, you can open up communication.

3. Understand role clarity.

Hirschmann said it is very important to know what needs to be accomplished at medical practices, who is going to accomplish it, and -perhaps most importantly - why it is that person. Also, ask how that decision will affect the roles and work of others on your healthcare team.

"Let's have the conversation in an open forum," she said. "Let's be so transparent for everyone to see and have input."

4. Establish a feedback loop.

This one can be tough, as feedback often only comes when things are going wrong.  But Hirschmann said instead, focus on appreciation and positive reinforcement at your practice. "Our relational systems need feedback so we know how to adjust," she said.

Hirschmann added that reinforcing appreciative feedback when things are going well makes a huge difference in the culture of a medical practice. It also can bank goodwill for when things get rocky.

She noted that often times, the medical hierarchy at practices "squashes [this] down, so physicians and leadership need to accept feedback too."

5. Foster co-leadership.

Whether someone was put into a leadership role because of their medical degree, they have the most seniority, or simply, no one else wanted to do it, leaders at a practice need to interact and communicate with each other. In other words, leader-to-leader communication is essential, Hirschmann said.

"We need to develop our leaders and make sure they have the ability to connect with other leaders and co-leaders at our practice," she said. "The leadership team needs to have discussions … and need to be unified and connected as a leadership team."

The bottom line, said Hirschmann, is that the relational foundation of a practice is a must.  If it is not in place or goes unaddressed, much like the foundation of a house, things will crack over time and cause larger issues later.

"I know it's hard to make time and justify that there is a financial incentive for getting to know each other [at your practice], but we need to lift the practice up," she said. "[That foundation is] the cement that holds the structure together when crisis comes along."