Today's Practice: Changing the Business of Medicine SW Edition Q1 2015 | Page 16

P RA CT I CE MA NA GE ME NT

What Was She Saying? (continued)
Despite our best intentions—to be present, attentive,
focused, open, curious, collaborative listeners—in the
reality of our busy, stressful, competitive, failure-phobic
world, so often we miss the mark. And the result is
extremely costly! Poor listening skills waste time,
efficiency, opportunities, brilliance, profits, and the
feeling of connection missed by so many. Communication failures risk quality of care and patient satisfaction.
Truth be told, it greatly erodes our own satisfaction.
When we are so busy-brained, we miss chances to shift
perspectives, learn from the wisdom of others, get
creative, see new solutions, or feel deeply connected.
Is this unique to healthcare? Of course not, but there are
some aspects of the healthcare culture that reinforce a
less receptive, risk-avoidant mental stance. Reared in a
system where the acquisition of knowledge is revered
and rewarded, “knowing” can become the goal at the
expense of cognitive flexibility, openness, and emotional
intelligence. True, the risk of “not knowing” in medicine
can be critical to patient outcome, but somehow this
competitive culture supports a state described in some
disciplines as “already-always-knowing.”
I can remember to this day being on rounds down the
hall from my general surgeon ex-husband as he was
reprimanded for not speaking with force… whether he
knew the right answer or not! Heaven forbid, we show
vulnerability or admit we might not know something!
Sure, we are taught to listen to the patient, observe body
language, and be attuned to soft clues, but even then, the
point is to be “in the know.” In our heads we are spinning
through differential diagnosis internal dialogues, trying
to fit what the patient says into our puzzle. (And reportedly, we are so busy weaving our own thoughts that we
interrupt within 7 seconds!) This is not the style of
listening needed for effective influence, engagement,
leadership, or the deeply satisfying connection to people
and purpose so many crave.

15

Cynthia Ackrill, MD
Yet it is a style we have trained so well, it becomes our
fallback under any type of stress. 360 evaluations of
physicians in leadership development programs often
reveal a need to learn to listen more openly, with less
judgment and more vulnerability. This is what builds
the trust and engagement needed to heal healthcare.
Listening with more curiosity than attachment allows
the brain to find more possibilities, make new connections, and find collaborative solutions that value and
engage others. This is the substance of leadership presence and influence.
But how do you do that? You are sleep-deprived, need
quick solutions, and your iPhone is reminding you that
you are late to clinic. Everybody wants a part of you,
and your head spins with your never-ending to-do list.
You have to actually disrupt your busy internal
dialogue to mindfully shift to more “active listening” in
the moment. Whenever possible, take a breath before a
conversation and decide HOW you want to listen. You
can create and practice a habit of disruption. This is
mindfulness in action! There is amazing power in
choosing how to be present and think, instead of
staying in reactive mode.
I have had some coaches train themselves to take a
breath as they go through each door and choose their
present focus. Others put a tiny dot on their computers, phones, steering wheels, and doorways reminding
them to breath and choose. There are lots of techniques. Just play with one and practice with curiosity
and self-compassion—it’s a learning process. Breathe.
Does this matter? YES!! As healthcare shifts and physicians want to take a more active role in leadership, the
art of listening is critical to building influence. Vulnerability is a key leadership attribute. (See Quiet Leadership or the HBR blog, “What Bosses Gain By Being
Vulnerable.”)

TODAY ’ S P R A C T I C E : C H A N G I N G T H E B U S I NES S OF M EDI C I NE

Ja nua r y 2015