A hospitalist supervisor might need to address a situation in which a physician on the team has been disruptive or needs a disciplinary talk. In these instances, Dr. Keogh says, “The leader has to somehow collect data on what the hospitalist has displayed that doesn’t fit in with teamwork. The hard part is that the data is likely to be hearsay—what was said by whom, when. That’s management.”
For example, you might receive complaints from nursing staff of abrupt or rude behavior from a hospitalist. “Physicians may not think of this as data, but it is. What someone said or did, or gestured,” Dr. Keogh points out. “You have to be able to say, ‘Here’s what we know happened on this date. Help me understand what happened, because we have to change this. This behavior is not acceptable.’”
The key to all official management communication is to carefully consider how to frame the conversation and keep it flowing for both parties: Speak with hospitalists, not to them. Here is an example: “In a performance appraisal, one suggestion we make is to have a conversation about data,” Dr. Keogh explains. “Look at some numbers on quality assurance, patient load, or whatever you’re discussing. Do your homework and allow the other person to have a look at the data before you sit down with them. That’s a sign of respect.”
Styles of Communication
Dr. Keogh’s training for physician executives—including what he teaches at the Leadership Academy—is based on the personality profile system developed by Carlson Learning Company (now Inscape Publishing).1 The DiSC model outlines behavior or characteristic leadership preferences in four dimensions:
- Dominance (D): People who score high in this category have behavioral characteristics that include being motivated by control over tasks and work environment, directing others, and achieving specific stretch goals. In general, physician managers who score high on dominance tend to be results-focused, fast-paced, and value autonomy.
- Influence (I): People who score high in this category are motivated by interacting with others, giving and receiving immediate feedback, and acknowledging emotions as well as facts.
- Steadiness (S): People who score high in this category are motivated by job security, predictability, and clearly defined expectations.
- Conscientiousness (C): People who score high in this category are motivated by needing to be right, working alone, and preferring to work on tasks rather than dealing with people.
“This model provides groundwork for seeing that other people have different ways, different preferences of communicating,” Dr. Keogh says. In his own research, he says, he has found “nearly half of all physicians are some combination of time-sensitive and perfectionist,” meaning they fit the dominance style.
The trick to effective communication is learning to modify your style when necessary. Task-focused individuals must practice taking a minute for a greeting or a pleasantry, even if it initially goes against their routine. “Someone who is extremely outgoing and open can have trouble, too,” Dr. Keogh points out. “You can’t start a conversation with a lot of chit-chat, if you’re addressing someone who is direct. … That won’t work, either.”
The solution is to practice stepping outside of your normal communication style. “You can learn how to adjust your style, how to flex to others’ styles,” Dr. Keogh says. “Depending on whom you’re communicating with, you can mirror the style of the other person.” This helps to ensure that what you’re saying is received and understood.
Practicing new ways to communicate means making a fundamental shift in your behavior. It sounds difficult, but Dr. Keogh promises it’s not.