August 2002 Bulletin

Eliminate communication snafus in your practice

"Mindfully" listen when others talk

By Sandra Lee Breisch

Are there communication barriers in your practice? Do tasks go undone simply because someone failed to listen? Do you have high staff turnover, dissatisfied patients, high error rates and inconsistent safety records?

If so, creating a listening culture in your practice might help you unravel communication snafus that can cost you time and money, points out communication researcher Rebecca Z. Shafir, who is the author of the award winning book, The Zen of Listening: Mindful Communication in the Age of Distraction.

"It’s really a priority for orthopaedic practices to build a listening culture even if there are no major communication snafus," says Shafir. "A listening culture enhances teamwork and decreases opportunities for conflict. It makes employees, customers, suppliers and donors feel like partners. A listening culture also saves money by reducing high staff turnover and error rates; it also creates loyal customers [patients] and employees and makes meetings more productive."

Barriers to listening

Yet many barriers to listening exist, points out Shafir. "Know your barriers," she stresses. "Barriers to listening are external and internal distractions, poor concentration or fear of someone changing his/her mind due to incoming listening content. People also do not like to listen to criticism or complaints and are concerned with their own self-interest and/or allow their ego to get in the way of listening. Or, someone might be pressed for time or biased/prejudiced to the content being heard and have some negative self-talk going on in his/her head."

How do you sift out barriers and create a listening culture?

Shafir shares her FOCUS plan:

F: Have more face-to-face (FTF) interaction with staff; for example, bring in bagels, donuts and have a team building session monthly with at least one administrator, executive or department head present. What you need is more FTF. Don’t let technology such as e-mails or memos always do the communicating for you.

O: Have an open mind to new ideas. Avoid use of negative or disparaging words or talk that can shut people down from communicating with you.

C: Communication needs to be a two-way street. Instead of meetings meant to purely inform staff, ask and encourage questions to get feedback on key issues. Remember that the word "communication" is a Latin derivative of "communion," meaning "to exchange."

U: Listen to understand. Become comfortable with silence. Let staff members get to the heart of what irks them. They’ll appreciate you for listening.

S: Begin to improve your self-communication skills. Work on developing four aspects of mindful listening so you can be a good example to your staff:

  1. Watch and listen for the "whole" message.
  2. Sustain concentration over time; meditation practice is very helpful here.
  3. Make staff feel valued and respected for their contribution—even if you do not agree with their idea(s).
  4. Listen to yourself. What you say and how you say it directly affects morale, creativity and compliance of your own staff’s listening skills.

Once you’ve identified your barriers, it’s easier to identify and work with the barriers of others and find preferred ways of communication. "Some staff prefer personal dialogue, others prefer e-mails or memorandums because they might lack interpersonal skills," notes Shafir. "But the point is to get your staff comfortable communicating on an interpersonal level—rather than being afraid to speak for fear you’re either not listening or they’ll be penalized for speaking up."

What’s the difference between "mindful listening" and "active listening?"

"Mindful listening is different from active listening. It is getting the whole message across, sustaining your attention over time, making the person who is speaking feel valued and respected by offering feedback and implementing change based on the dialogue. It is also listening to ourselves speak," explains Shafir. "Active listening methods can appear mechanical and disingenuous. However, mindful listening is authentic listening—you’re really locked into how the other person is thinking."

Adds Shafir, "Remember, mindful listening evolves into trust and loyalty. Practices want loyal staff and loyal staff mean loyal customers [patients]."

Communicate welcomes suggestions about future topics for the column on patient-physician communications. Send your suggestions to the Bulletin at AAOS, 6300 N. River Rd., Rosemont, Ill. 60018.


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