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Communicating across our differences is difficult, but necessary, in today’s highly polarized environment. I share real life examples, and advice from a language expert, as encouragement for talking to someone you disagree with.

Communicating with people that we disagree with has never been easy, but today I’m arguing it’s pretty necessary. So I’m going to share some ideas and inspiration and yeah, some examples, of what it’s like to communicate across significant differences.

Hi everybody. This is 10 Minutes to Better Patient Communication, ranked number 20 in the Top 100 Podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make. If you value this show, the stories and inspiration and research, I’ve got good news: I can help your organization. Visit healthcommunicationpartners.com, click on contact, or you can connect with me on LinkedIn.

So talking about communication in today’s times is tough. The more divisive I feel like the rhetoric becomes, the more important it is for us to connect, and reject those ideas of division. This is hard work in our communication. I read a quote recently from an article I’ll share, and the author said, “In our own small sphere of moments, we are a force for promoting a more compassionate and humanized world.”

And so in today’s episode, I want to share a couple examples of folks who are doing the hard work of talking across difference, in case it can give you some ideas and some inspiration for the next time you have to have a difficult conversation. Whether it’s someone at home, someone at work, or someone when you’re just out there, living your life.

First I want to share some podcast love with a newer show called “Why Should I Trust You?” This series drops weekly but I want to draw your attention to two episodes I’m going to go ahead and link in the show notes, that are conversations between MAHA grassroots folks and public health leaders. So there’s two episodes Part 1 and Part 2. I’m going to go ahead and link to both of those in the notes.

Another example I want to share is a show that wrapped several years ago, in pre -COVID times, but it was very, I think it was fun then, but it’s very relevant now, and it’s called “Conversations with People Who Hate Me.” From the website: “Don’t be fooled by the title. It’s actually a loving show that fosters unlikely connections in an age of increasing digital isolation.” And again, I think it bears repeating now in today’s very divided world.

And now I wanna share something from a researcher and linguist that I reference quite a lot on this show: Jim Gee. I had read a passage from one of his books for an episode about two years ago that turned out to be a very popular episode. A listener had asked for a reflection to start a meeting, and that’s why I shared this passage from Gee. But in light of how things are now, I think it’s good for, it could be good for us to just read these words to ourselves. And maybe get encouraged, maybe reframe things a little bit, and take hope. Here’s that passage.

Alright now I'm reading this out of an actual book, so you'll hear the paper. Here we go:

Human communication, especially across social and cultural divides, is a very difficult matter. We humans are very good at finding meaning. We find it all over the place, even in the stars, with many people still believing in the medieval art of astrology. In fact, we are so good at finding meaning that we very often run off too quickly with interpretations of what other people mean that are based on our own social and cultural worlds, not theirs. Too often we are wrong in ways that are hurtful.

When we sit back and reflect on what people have said and written a luxury we have too little in life, but the basis of discourse analysis we often discover better, deeper, and more humane interpretations. The small child whom the teacher assumed made no sense at sharing time looks a lot smarter after a little reflection . A person from a different race, class, or culture looks, on reflection, if the reflection is based on any knowledge, to have made both a better point and a better impression on second thought than on first.

We believe it is a matter of competence to re-read a good book or re-watch a great movie to get more out of it. But we rarely apply the same principle to our fellow citizens . Indeed, writing a second time as in the case of this book is just a way to be in dialog with ourselves, to think more deeply about what we mean and how others will interpret us. In a world in which people rush off to kill those who don't agree with them and countries rush off to war, it may be a matter of survival that we learn to base our views and actions on second (and more) hearings and readings of others and second sayings and writings by ourselves.

Even after we have re-heard or re-read, we may still disagree with people. And they may have had good or bad motives. But we humans, when it comes to using language to make sense, are very good indeed. Whether we are telling the truth or lying, we build intricate, complex, and highly patterned oral and written texts with which to accomplish our goals. We are creatures of language. Evolution has seen to that.

Thus, we can say that there is an imbalance in human communication: each human being creates complex meanings in language, but each of us is so good at finding meanings that we are often too quick to attribute meanings to others that are rooted more in our own cultures, identities, and fears than they are on a close inspection of what the other person has said or written.

So a second listening or a second reading is, in many cases, a matter of competence (what we need to do to be competent in our areas of work) and, in many cases, too, a matter of ethics (if we want to be fair) . The task is this: to think more deeply about the meanings we give people's words so as to make ourselves better, more humane people and the world a better, more humane place. While we still may disagree with others after reflection, we will, nonetheless, be in a position to be a much better critic, to represent what we believe in a much better way. But we may also sometimes change our own viewpoints to be more positively inclined toward others than we were initially. We will then, too, be better placed to cooperate with them in human endeavors, especially in a fast-changing, global, culturally diverse (and often dangerous) world.

Thanks to Jim Gee for that. Now I have some questions for you to consider:

• Recall a time when you've given someone's words a second hearing.' What did you notice on second thought that you missed the first time?
• Has anyone ever given your words a second hearing, that you know of? How did that impact you?
• Is there a situation in recent memory that you'd like to be able to go back to and give someone's words a second hearing? Or has there ever been a time that you, as Gee said, ran off too quickly with interpretation of what other people mean that was based in your own social and cultural worlds, instead of theirs? What did you learn from this?

If you appreciate this approach to communication and reflection, you'll love my course Foundations of Equitable Communication in Health. Learn more at healthcommunicationpartners.com. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering by Joe Liebel, music by Joe Liebel and Alexis R.

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Competition and collaboration are sometimes thought of as opposites. I’ll share one thing people can do to help collaborations go better even when there’s competitors in the room.

Collaborations have always been popular, but it’s possible today they’re getting more common and that the stakes may be getting higher. So in today’s episode, I’m gonna give you one thing you can do to increase the quality of any collaboration that you are leading or a part of.

Hi, everybody. This is 10 Minutes to Better Patient Communication, ranked number 20 of the Top 100 Podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is the place for you because communication touches everything. We’re here to learn, get inspired, and, most importantly, make the difference we got into our jobs to make.

Did you know I work with business? Better communication is an investment that makes your business more efficient because there’s less time lost to misunderstandings. And when there’s better communication between groups, things get done with less must and fuss! So to get there, contact me through LinkedIn or visit healthcommunicationpartners.com and click on contact.

And if you’re in California or your organization has a presence in California, please get in touch with me. We’re proud to offer services as an approved vendor for technical assistance by the state of California for the PATH TA marketplace. This is a unique opportunity to receive free technical assistance for CalAIM implementation to support enhanced care management efforts. So again, Find me on linked visit healthcommunicationpartners.com and click on contact because time is of the essence here folks

And like I said, we’re big fans of collaboration. When we co-design and co develop projects, we know we get improved decision-making and quality and applicability of the project. We also get richer more robust end products. We all want to make something good. Now people are collaborating, perhaps more out of necessity. I just had a client this month say to me, “Everyone’s gonna have to do more with less and be working more together.”

So as we all carry on and find ways to continue doing the work we’re doing, collaborations are a powerful tool when done right. I’m gonna share some stories from my experience for the next collaboration you’re in or in charge of.

And again, like the rest of this series, I’m basing this on research from the University of Pennsylvania. Yes, collaborations are the topic of much research because you can’t just put people in the same space, virtual or physical, and say “work together” and call it a collaboration. There are structured, disciplined ways to design and lead collaborations. This includes managing the challenges of collaboration, which you know is important.

And I want to give a shout out here to Samantha Cinnick, who came and did a mini series with me on communication in public health, and one of her episodes was on communication in a new collaboration, so I’m going to drop that in the show notes.

There are many ways collaborations can go wrong. When that happens, quality suffers, people’s willingness to participate might be affected. So here’s one thing people can do to help collaborations go better, make sure everyone still gets their job done, and finds the collaboration worthwhile.

One challenge of collaborations that I don’t think gets talked about enough, maybe because it’s seen as the opposite of collaboration, is competition. Competition and collaboration are sometimes thought of as contrary to each other, but I’m going to take a closer look at that.

Because no matter how good someone’s intentions are for joining a collaboration, we’re all still carrying our organization’s expectations and priorities and constraints along with us into the collaboration. We still have our regular job to do. We still have rivals and competitors who are trying to jump through the same hoops we are. And some of those organizations or people might be in the collaboration with us.

This is a reality maybe people are reluctant to talk about. And one of the reasons might be they’re afraid that they’d shatter the collaboration or damage whatever coalition they’re hoping to build. But I’ll argue that talking about competition, fronting the fact that it’s there, can have the opposite effect. It can strengthen your collaboration. But I get that talking about this can still feel risky. So I’m going to give you a place to start on talking about competition and collaboration, or a way to strengthen your approach if you’re already there.

Here’s one question you want to make sure you’re asking and getting good answers to: In what ways are these collaborators also competitors?

In what ways are these collaborators also competitors? I want you to take a moment with this question. Answer it. Get lots of answers to it. Answer it well. Talk to people. Get in there. Be practical.

You want to make sure you’re designing or having a collaboration that doesn’t ignore the potentially uncomfortable reality that there’s competition in the room, but acknowledge it. We all know it’s very competitive out there, even though our collaborations seek unity. We want a group working as one on a common project. So get good answers to that question.

There’s two reasons why you’ll wanna know what those answers are. One is because you wanna know what not to ask people to do or to talk about in the collaboration. Second, you want to be able to be super smart about what you are asking people to do or what you are talking about, so that the collaboration can be a win-win even among competitors.

Let me give you some examples. A colleague who was heading up a large project to increase broadband access in rural areas told me a great story about the start of this project that had all sorts of stakeholders. Many internet service providers, big household names and little mom-and-pop companies. And leadership at first said, “Let’s get them all other, put them in a room. And my colleague had been leading collaborations for long enough to know that would be a disaster.

Yes, people would come, and yes, people would be polite. But there would be crickets around the table when it came time to talk. Because folks were all competitors, and would fear letting something slip about their operations or their plans or anything proprietary. Even though everyone in the room totally supported the project, and was very excited to be a part of it, it would have been an awkward and likely unproductive meeting because people would be guarding what they said, for understandable reasons. So thinking about competition can help you be careful about what you’re expecting people to talk about in a collaboration.

From my own experience as a consultant, I have a couple of stories too. A large organization asked for my assistance on a collaboration with many and varied stakeholders. And the leadership wanted everyone to work together. It was clear to me that there was significant competition among the participants that we needed to address.

One of the participants said to me, “Leadership wants groups working together for a unified thing. That’s wonderful. We should all aspire to that. We need to be cognizant of that. There are times when it’s appropriate, but sometimes it’s more difficult than others. We’re collaborators, but we want to win. We started this. We want our stakeholders to know we’re taking the lead.

I felt it was important for the leadership and the organization to know this and adjust accordingly, So it could make sure the collaboration was relevant and worthwhile and connected to the real -world practicalities of the participants. And that’s what I helped them do.

But it can be hard to remember or kind of keep front of mind that there is competition because our collaborations are often complicated. We’re working on big problems. Often there’s a lot at stake. So we’re kind of thinking about other things. A federal government client had asked for my help with a collaboration. And again I was reminding the team, there’s a lot of competition in the room.

Now, people were there because they cared very deeply about the issues and the project. And they still have jobs, they still have goals and priorities. So I helped the client make sure the collaboration had value to the participants beyond the collaboration itself.

Again, I want to share with you that question: In what ways are these collaborators also competitors? You could also ask, “In what ways may they be in competition?” And we’re asking this not because collaborations can’t take the heat, but because they can. And in order to succeed, they have to.

If your organization would like help with collaboration, contact me. You can visit healthcommunicationpartners.com and click on contact. You can message me on LinkedIn or you can email me info @h-cpartners dot com. That’s I -N -F -O at h-cpartners dot com. This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music from Alexis Rounds. Thanks for listening to “10 Minutes to Better Patient Communication” from Health Communication Partners LLC. Find us at healthcommunicationpartners .com

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Today’s chaotic environment can leave us feeling unmoored and lost. Dr. Saria Saccocio explains 2 steps she’s using these days to manage the chaos, and reclaim some power.In today’s episode, Dr. Saria Sacocho returns to the show and offers some incredibly timely advice on getting yourself out of chaos.Hi everybody, this is “10 Minutes to Better Patient Communication,” ranked #20 of the Top 100 Podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement, experience and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and, most importantly, make the difference we got into our jobs to make.Did you know I work with business? Better communication is an investment that makes your business more efficient. When there’s less time lost to misunderstandings, when there’s better communication between groups, things get done with less muss and fuss. So to get you some of that, visit HealthCommunicationPartners and click on contact. You can find me on linked.And if you are in California or your organization has a presence in California, please get in touch right away. We’re proud to offer service as an approved vendor for technical assistance by the state of California for the PATH TA marketplace. This is a unique opportunity to receive free technical assistance to support enhanced care management (ECM) efforts as part of CalAIM implementation. Time is of the essence folks, so again find me on linked or visit HealthCommunicationPartners and click on contact.It’s great to welcome back to the show Dr. Saria Saccocio. Dr. Sacocio is Chief Medical Officer at Essence Health Care and a family physician. And a few years back, Saria was my first post -pandemic lockdown live-in-person interview. So it was great to be able to catch up with Saria again in person. And when I asked her what she wanted to talk about, I was so relieved to hear what she said. I think you might be too, so let’s go!I am live in person with Dr. Saria Saccocio. Dr. Sacocio is the Chief Medical Officer at Essence Healthcare and a board -certified family physician. Dr. Saccocio, welcome back to the show.

Anne Marie, it’s so good to see you, to connect with you, and have a conversation today.

I’m really excited about this because you are a communication champion, you’re a health equity champion, so I’m really eager to get into the four questions that I ask all my guests. Dr. Saccocio, what is an issue or a problem in communication in health care that you’re facing these days?

Well, what I’m experiencing, I don’t believe is so personalized to health care. In fact, I believe across the entire workspace, or even in our own household: Chaos ensues. And the challenge is, how do we take a chaotic world and create sanity around it? That is the challenge today and it’s not going away.

It’s a massive challenge. You’re speaking to a lot of people right now. You’re right. So how are you facing this challenge?

Sometimes with challenge myself–and I say that because I am an eternal longitudinal learner–no one has got it all figured out, Anne Marie. Nope. And sometimes I forget what I know.

Legit.

And so I’m focusing on two things to manage this chaotic space.With healthcare, as we talked about just a moment ago, the bar is raised. The challenges change. And with the change in the challenge, so comes the chaos that we can contribute to, or we can help manage. So the two things are: one, I’m in charge of my own destiny! And so what I mean by that is, what I recognize is, that I set the road map for me. We all have a manager. We all have rules to follow, but I had to turn on the light bulb and say, “Hmm, am I waiting for someone to create my space in the roadmap?” And I realized, “No, this is my roadmap to create.” Whether you’re the leader or you work for a manager, you have an opportunity to set the example and to create a world the way that you’d like to see it. So set your structure. Set your organization.

Not waiting for permission. I love that. Not waiting for someone to say, “Okay, do this.” I love that.

Well, and being a manager myself, and having a supervisor, this is refreshing when people demonstrate and they skate to the puck and already solve for their problems. Yes! And for my supervisor, remember, he benefits from the same thing. So how do I create that world where I have the roadmap in place and I show up in my space and demonstrate and model myself?

I love this. I love this. So you said two things. What is the second thing?

Yes. And the number two, find your best friend forever at work.

Ooh. Tell me about this. I love this.

Who is your BFF? Find a BFF. Press Ganey, an organization that focuses on employee satisfaction, retention, and engagement, says that one of the key factors is having a BFF at work. And so who is that person? Who do you have a safe space with? Who raises you up rather than keeping you where you are? That’s critical too.

I love this idea of “do you have a BFF?” If you do, this is a time to tap into them. If you don’t, this is a time to warm up to somebody and have that conversation that maybe you’ve been avoiding having. Or there is a potential friendship there, there is a potential collaborator there, that you haven’t reached out to yet. Maybe this is the time, so that you can help yourself manage this enormous amount of change that we’re all under right now. So Dr. Saccocio, what are you learning from this? What are you learning from charting your own path, not waiting for permission or somebody to create the piece for you? What are you learning from reaching out to your BFFs?

Well, here’s what I’ve learned. Anne -Marie, I’ve had a BFF at work in the last several organizations I worked in because I clued into, “That’s healthy for me.” And let’s flip the coin. Is it healthy for them also. Be a good BFF. And that’s what I’ve also learned. Don’t find someone who drags you down or commiserates with everything you say. You need a moment, and a safe space for that reaction, response, and then raise them up. So that they raise you up. So what do I mean by that? Let’s say you had a rotten day at work. get it out, say it, move on. But the expectation I challenge you to set for and what I’ve learned myself is not to stay there. The purpose is not to vent. We do a lot of venting. venting is good. It can be healthy. What do you want to get out of the vent, and what’s the direction forward? Lean on your BFF to help guide you, and for you to guide them to a level up. to above the line. So here’s one thing. There’s this book that I follow, The 15 Conscious Commitments of Leadership by Jim Dethmer and crew [Diana Chapman and Kaley Klemp]. And every time I read it, Anne Marie, I pick up something else. It’s staying above the line and help your BFF to stay above the line too.

I love that, the important pivot that our friends can help us make. We’ve got to be intentional about it: going from venting to turning to action. So what are next steps for you as a leader? Where do you want to go in this moment?

And what I’ve learned in this moment, is that I continue to practice, practice, practice, practice. We are in a state of chaos and change, and you have control over your own behaviors, and how you show up at work. Do not set it and forget it because as the world changes, we must evolve with it. Practice, practice, practice.

I love this. Dr. Saria Saccocio, Chief Medical Officer at Essence Healthcare. Thank you for being on the show today. Thank you for coming back. Thank you for being the kind of leader that we need right now.

And it is so fun and it’s so fun to do it together with you, Anne Marie.

Thanks so much, Saria.

Thanks again to Dr. Saria Saccocio, Chief Medical Officer at Essence Healthcare. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music from Alexis Rounds. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners, LLC. Find us at healthcommunicationpartners.com.The post Dr. Saria Saccocio shares 2 steps to find your way out of chaos appeared first on Health Communication Partners.

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It’s our 200th episode! Today you’ll hear a familiar voice tell a story about how emotional intelligence helped communication in the workplace.

Today’s episode is our 200th episode! And today you’ll be hearing about emotional intelligence in the workplace from someone I think you’ve heard before. Hi, everybody. This is 10 Minutes to Better Patient Communication, ranked number 20 in the top 100 podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement experience and satisfaction since 2017. That’s right, we’re in our eighth year. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you, because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.

And at 200 episodes, I just want to say thank you! Thank you so much for listening. Thank you for sharing. Thank you for telling your friends. Thanks for being in touch. Thank you for downloading. Because literally, it is you that we’re doing this for. It’s your questions and your engagement that really have kept us going for 200 episodes. I had no idea it was going to last like this, and it was going to continue to have this kind of energy and engagement. Because most shows plateau, and we just haven’t. We still have those days, just randomly able to get 1,000 downloads, which is nuts! Especially for a show that’s this niche! So again, thank you so much, and I want to say thank you to all of our guests, including the guest who’s on mic with me right now who is also our audio engineer and my brother Joe Liebel. Joe it’s great being on mic with you congratulations for 200 episodes

Hey Anne Marie, good to be here with you. And yeah, congratulations on episode 200. It’s been an exciting journey to go with you from the ideation of this podcast through to where we are now and to see the series evolve.

– And it really has evolved, hasn’t it? ‘Cause it started out with patient physician communication specifically, and that’s why the title is what it is. And then it became kind of patient/provider communication. And then with, I think team -based communication and healthcare, we got into more interprofessional communication. And then when it broadened to public health, public health really brought in some questions about multi -sector communication, right? Because there are always, public health is always having to bring various folks cross sector work together. And all of us are working in our workplaces. So I think that’s the kind of inter-professional has become a bigger part of the show.

Because this show is based on what people ask about. And the work that I do as a consultant, the trends that I see as a researcher, the conversations that I’m a part of, and the things that people just write and ask me about. So if you haven’t been in touch yet with questions that you have, go ahead and go to healthcommunicationpartners .com, click on contact. You can find me on LinkedIn. You can also write me an old -fashioned email. Now we’re at more of a kind of work communication focus at both individual and systems levels, whatever your work is. But obviously we’re going to tend a little bit more to the health sector. So it’s really a holistic look at work communication.

And I’ve been thinking about, should we update the name of the series to reflect this focus? I am genuinely not sure. So if you have thoughts on this, please let me know. But here we are at episode 200. And I know, Joe, you and I have been on mic a handful of times

– Throughout the years, we have.

– Yeah, so for this I thought I’m gonna do something that we haven’t done and I really want to turn the show over to you and I thought I could you know find out what you want to talk about because you’re in the health sector as well right you’re in health IT.

– Yeah so I work for a software company that provides software services and data to life sciences clients and health IT related services. So when you had reached out about opening up this topic for this special episode, this landmark episode, I was actually going through some challenging stuff at the time in my professional life. And I was managing a difficult project with an upset client. And amid all this, I felt like I was being bombarded daily, as probably a lot of us have felt, with news at a national and global level, that was really finding that to be distressing and stressful.

Amid all this, an email comes in from our company CEO and founder. Now he does this regularly on like a Sunday afternoon, Sunday evening, send out a company email, talk about topics that he feels are relevant across the company. Sometimes our vision and value, sometimes current events. And that was really what this one was about. And it cast a spotlight on what a lot of us have been feeling in our, in our life, kind of at the national news level, let’s just say, and the stressors coming from that, and how that might be impacting our industry, our clients and our personal lives. And gave some guidance on how to cope with that. So that in turn made me look back at all of these challenges I was going through, in work and in life, and it kind of pointed me to a topic that I learned about several years back, and then I thought, let’s turn to this.

– That's great, you’re absolutely, you’re answering the first question, which is what’s the issue that you’re facing? And so what I’m hearing from you is the kind of stressor on stressors, right? We’ve got our own lives that are going on. And then we’ve got the kind of the wrapping of the national kind of tension and stress that’s definitely been heightened lately. And that’s got to affect our communication at work. It’s got to affect our communication at home, right?

– Absolutely.

– And so how are you–the second question that I ask all of my guests, I get to ask you–how are you dealing with the stress on your communication?

– Yeah, so the thing that I had turned to and went back to explore a little bit further, is the topic of emotional intelligence and resilience. And how that can help us simply take pause, take a breath, assess and reflect on all the individual stressors that seem to kind of compound each other. And then build up resilience in the capacity that we have to respond with a cool head, and choosing a path that serves us best. That’s not reactive, it’s not a fight or flight reaction, but it’s more of a strategically thought of, cool -headed approach to the individual stressors. And how to kind of peel them away and deal with them potentially in different ways so that we can have focus and clarity.

– And thanks for that. You’re already teeing up like, what my next question is, what are you learning from thinking about emotional intelligence when it comes to your communication. ‘Cause I’m already hearing you say things like, that I love about this show, which is reflective practice. That you’re already– emotional intelligence works well with reflective practice, right? Because it gives us some tools to stop and pause. It gives us ways to kind of parse out what we’re seeing, what we’re hearing, what’s running through our heads, what we’re encountering in our professional realm. So what are you learning from taking emotional intelligence as a concept or as a set of tools to help you as a communicator at work.

– Yeah. So just to give you some context, I am mostly a remote worker. So meeting with my clients over Zoom or other remote tools. And one of the things that emotional intelligence at least helps me to do is to take a step back and assess and reframe the situation. This case, a project through a series of issues and failures was not tracking the schedule, clients upset. And so like, how do you deal with that? Well, first you have to deal with it. You can’t just avoid it, ’cause then things will get worse. But we may have a tendency to do that. So You have to take it head on. You take it head on, you don’t want to be combative, you know, the fight part that we might feel like we have to charge into something. But when you think about: everybody’s remote, you get into a meeting together and there you are. You have no casual interaction context, generally not co-located or anything like that. So you really have to prep yourself for these interactions.

– That’s really, that’s true. Thanks for saying that, you know, as you’re saying it, it’s occurring to me. Yeah, we don’t talk enough about how much it’s, I don’t know if it’s harder. I don’t think it’s necessarily any easier to do work communication when you’re fully remote or even mostly remote. So thanks for bringing that up man. No, go ahead.

– Yeah, and in that sense, you don’t have the same opportunities you do in person to necessarily build and foster a relationship with your coworkers even, with your other remote coworkers. So team cohesion, you’re just kind of thrown into those meetings together. And that makes it particularly challenging. And so emotional intelligence has taught me to say: okay, take a moment, take a breath, realize, peel part the things you’re stressed out about. Maybe it’s not the best that I listen to national news in the morning right before going into a meeting.

– Legit

– You know what I mean? Just have a little bit of clarity, some mindfulness. And then approach things with a cool head. Realize that your customers, in this case, these were customers on the other side of the Atlantic. So they might not have been having the best day. They might not be seeing me in the best light right now. So how to empathize with them. And then try to repair a relationship so that you’re working together as a team.

– What I really like about what I’m hearing too, is the sense of grasping the agency that we have, grasping the power that we have, which is over our own communication. Which is over how we respond in the moment, right? And not letting all of these multiple stressors just have their way with us and take us away from our intentions. But coming back, like you were saying, just pause. Taking a breath, and kind of regaining control over one of the few things in this life we do have control over. And that’s our communication. So what’s next for you, man, when you’re thinking about emotional intelligence and communication at work?

– Yeah, so I didn’t mention how I always really learned about emotional intelligence in the first place.

– Oh, right. What’s that story?

– My previous job, going back about eight years, when I was new there, I threw my hat in the ring for when they needed people to help build out their self -paced training, their recorded training assets, which were mostly technical training and data and technology and so forth. But one of the assignments that they gave to me was on recording training on emotional intelligence. It was like emotional intelligence 101. I was like, “Oh, what is this? It’s not technical.” I was really curious. So I not only recorded that, but I kind of internalized the content. And it made me think, why is this company that’s mostly like a tech data services company, why are they pointing their people towards this kind of training? It’s a soft skill, it’s an interpersonal skill, but it must be something of value. And I’ve become a strong believer that it is. So, you know, that was when I was introduced to it about eight years ago.

And so what I want to do is that my current job is really, you know, evangelize this to my colleagues. Whether we are external client -facing or not, we all have customers, we all have colleagues. And emotional intelligence can play a role in those relationships, in those communications. And even at home too, you’re going to terrible day at work, when you’re going to deal with your people at home. And it can still help to center you and give you, you know, peel back those stressors, and then make decisions that you’re comfortable with in the long term in your communications.

– I love this. Thanks so much, Joe. And what I’ll do is I won’t put you on the spot now, but maybe if you can find if there’s been articles or books on emotional intelligence videos that have been helpful for you, and you want to share them with me before we go ahead and post this out, I’ll put the links in the show notes [below] for folks who want to take a look at emotional intelligence for their communication.

– Absolutely. I have some things to share it for sure.

– Awesome. Awesome. Well, it’s been a treat having you on the mic, man. Congratulations again for 200 episodes. Holy schmoly. And thank you again to our audience for listening. This has been 10 Minutes to Better Patient Communication from Health Communication Partners with Anne Marie and Joe Liebel today.

– Yay, episode 200!

– Woohoo!

Book references:

Optimal : how to sustain personal and organizational excellence every day

by Goleman, Daniel, author.

Publisher, Date: New York, NY : Harper Business, and imprint of HarperCollinsPublishers, [2023]

Fierce resilience : combating workplace stress one conversation at a time

by Beltran, Edward, author.

Edition: [Trade paperback edition].

Publisher, Date: Oakland, CA : BK Berrett-Koehler Publishers, Inc., [2024]

Web reference: https://www.theotherkindofsmart.com/ei-quiz

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Dr. Schiavo shares powerful stories about communication’s role in community engagement and pursuing health equity.

We’re shining a light on public health and the value of the work done by public health professionals. Today you’ll hear from Dr. Renata Schiavo, Editor-in-Chief of the Journal of Communication in Healthcare.

Hi everybody, this is 10 Minutes to Better Patient Communication, ranked #20 in the top 100 podcasts in social sciences. Giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I'm Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I'm here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We're here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.

And I don’t know if you’re keeping track, but we’re at almost 200 episodes! Our next episode is gonna be #200 so don’t miss that one!

I have a special message for our listeners in California. If your’re in California and your organization works with Medi-CAL’s CalAIM I have good news for you!

Health Communication Partners LLC is now a state-approved vendor on the California PATH Technical Assistance (TA) Marketplace. What does this mean? It means your organization can work with HCP for free, that’s right, no cost to you, to support enhanced care management (ECM) efforts as part of CalAIM. We specialize in Promoting Health Equity and Supporting Cross-Sector Partnerships. So if you work for an organization involved in CalAIM implementation, get in touch with me on Linked or visit HCP and click on contact.

Today I’m returning to an interview w. Dr. Renata Schiavo, Editor-in-Chief of the Journal of Communication in Healthcare and Senior Lecturer at Columbia University. We did this interview during COVID, and she’ll be coming back to the show soon, so keep your ears peeled for her. Her advice on community engagement and pursuinng health equity is as relevant and inspirational now as it was then. Here’s Dr. Schiavo.

Thank you for inviting me.

So Dr. Schiavo is a Senior Lecturer at the Department of Sociomedical Sciences at Columbia's Mailman School of Public Health. She's the Editor-in-Chief of the peer-reviewed Journal of Communication in Healthcare: Strategies, Media and Engagement in Global Health. And is also the Founder and President, and on the Board of Directors, of the Health Equity Initiative, which is a member-driven, nonprofit membership organization. Dr. Schiavo can you tell us a little bit about the Health Equity initiative that you founded?

Thank you Anne Marie. My passion has been always with working with under-served, marginalized, vulnerable populations, both in the US and other countries. So Health Equity Initiative is founded on the principle that we need so many different people so many different sectors, so many different communities to get engaged in addressing the social determinants of health. And so we focus on championing transformative change to advance health equity. We support knowledge, we engage community leaders, and build capacity to address the barriers that prevent people from living a healthy and productive life. Health Equity Initiative advocates for improving condition(s) and achieving equity in health for all.

Thank you for that. That's, that's a remarkable reach that the organization has. And you're already hinting at some of where I'm going with my next question, because you're someone who works on health equity in and beyond the health sector at multiple levels. So: what is a problem that is really front of mind for you, that you are trying to address, that's related to health communication?

So in this moment and also throughout my career, we have been reminded about the impact of social discrimination. whether it's racism or other forms of discrimination, just like against the LGBTQI Community, or against people from low-income settings, or immigrants, or others. So with I think that both COVID-19 and the recent episodes of police brutality against the Black community have demonstrated the importance of addressing social discrimination in our communities as a key determinant of a lot of health and social inequities we see. And I feel that communication, with its focus on building bridges, creating partnerships, empowering people, has a key role in addressing social discrimination.

Thank you for that. And I'm wondering in the multiple leadership roles that you hold, how are you doing some of this work? How are you doing some of this bridge building? What does that, does that look like in your career? What does that mean to you now?

My main concern is that lots of the work we do in health communication continues to be a bit top-down. And we really need to bring in the voice of communities, and use participatory and human-centered design solution(s) to approach so many of these inequities that our communities experience. So it's important to listen to their concerns or their issues, their needs, their priorities and develop solutions with them. And so this is an approach that is by far more common in economically developing nations such as the countries where I work. I work in Rwanda, Angola and Brazil. And so community consultation, community dialogue, tends to be approaches that are more used in a lot of those countries. And also here in the US we are seeing a lot of, you know, increased interest in community dialogue and engagement. So there's a lot to learn from these experiences from developing countries, and the importance of coming together as a community, and really raising the voice of community leaders.

So it sounds like you're using some of your experiences in Rwanda, Angola, Brazil and and seeing some traction here for the community-driven approaches in the US. How does that emerge, or does that emerge in your work with the Journal of Communication in Healthcare?

So I think that there are different ways that through the Journal that we are trying to basically advocate for these themes to be integrated in health communication. One of them is through editorials, both by myself and other members of our editorial board. And the other one is through calls for papers that highlight the importance of a community-driven approaches to communication. And also other initiatives that may bring in the voices of patients and community leaders within the materials we receive and publish.

What are you learning from going about this community- driven approach? What are you learning looking back at your career right now that might be helpful in this moment?

So first of all, it is possible to do this. that's one important lessons learned.' And in fact, you mentioned before the Health Equity Initiative we worked with the Office of Minority Health Resource Center, the HHS Office of Minority Health, on a consultative process with community leaders, with local academia, with local community centers and a variety of other stakeholders to develop Task Forces for infant mortality prevention here in the United States, in cities where there are high rates of infant mortality. There are some reluctance to do that. Because sometimes people may feel that there is a lot of time invested in participatory planning processes. But actually, the time that we may save up front we waste at the end, because the solution we may design may not be meeting the needs and priorities of our communities. And also, if we design a communication intervention with communities, we also recognize the expert in their needs and priorities. And so one of the main themes in my work has been that we need to recognize the expert in everyone. And while we may be, y'know, trained in Public Health or we may be trained in health communication, the communities are really the expert in their needs and priorities. And also this reduces the chance for any kind of bias and discrimination that we may bring in an intervention that had been designed without the input from community leaders in the communities that they are intended for.

Such a powerful set of statements too: what happens when you begin with the communities that you are trying to serve? You save time because you haven't made an intervention that is irrelevant to them because they have been informing it all along. You help eliminate bias because it's their values and their languages that are informing the processes. And you you build a different kind of relationship when you treat people as experts in their own situations and in their own lives. thank you for that! thank you for all of that. what do you see as your next steps as leader, a researcher, an editor-in-chief, a citizen?

I feel that things are starting to move in the right direction. So there is a lot of interest in community engagement, in community mobilization. We have seen the recent protests being an example of community mobilization. but it's also important that people start releasing some power, and sit down on equal footing with community members. and really start recognizing this expert in everyone! This is a lesson that I learned very early in my career. As a young practitioner in Angola, I was basically working on malaria prevention in refugee camps. And I had, in one of these (meetings), encountered a young mother approaching me. And she just came to thank me for being there but she also said, Look What you are talking about, malaria prevention, in this moment is not important to me. What I'm concerned about is where my children are going to sleep tonight, whether they are going to have food, and that fact my husband just recently died.' And this was a very important moment in my career, in which I learned about the importance of attending first to the needs and priority of the communities we we serve. So I think that this is an important moment for the Health Equity and racial equity movement. A moment in which we need to put health and social justice at the forefront of everything we do. A moment in which we have to make every action and policy count toward heath equity. And making sure that the community voices are heard, and that they are incorporated in our communications, in our policy, in our intervention(s).

Wow! Thank you for that. thank you for the Angola story too. And and for the emphasis on these, on the kind of coming together the institutionalizing, the formalizing, the codifying of these practices that have been going on in different places around the world for for decades now but let's go ahead and make that mainstream. Let's go ahead and really focus on seeing the expertise that's in the communities, and engaging that in every step of the process. Thank you Dr. Schiavo for being on the show and sharing this with us.

Thank you very much.

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel, live via Skype with Dr. Renata Schiavo.

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Hear the story of a complicated workflow improvement case, and learn what you can do to help your own workflow…flow more smoothly.

Is something in your workflow not working? I’ll help you get the workflow improvement process off on the right foot in today’s episode.

Hi everybody! This is 10 Minutes to Better Patient Communication, ranked number 20 in the Top 100 Podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement, experience and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.

Yes, I had a client who identified a workflow problem that their staff was having. And this was happening right as a big new collaboration was about to be launched. Now first of all, their workflow was important to their service delivery. And they needed that workflow problem fixed pronto! And in a way that would be quick to implement because of this new collaboration. Because it had a lot to do with communication they called me. I’ll tell you what we did that I think can help your workflow improvement go smoothly.

Now this show, you may know, is about real problems faced by real professionals, and I have a holistic approach to communication. But we’ve had kind of a systems-level flow going on these past few weeks. I wonder what that indicates, right? I’ve had a couple episodes on quality improvement, now one on workflows, so maybe just in general people are thinking more in systems ways, which is good. The show started with patient-physician communication, hence the title, but a couple of years in, I started getting a lot of requests for interprofessional communication. Which definitely has kept on going, so I’ve included more in that in the show as well. This workflow improvement I was asked to help with involved patient communication, and interprofessional communication, and different organizations communicating with each other as well.

Now workflows in general are designed to help us get our work done by looking at the structures or patterns or flows underneath parts of our work that we tend to do often, or regularly repeat. And how these typically go, the steps we and others typically take. They can be handy for groups of any size. I even find them helpful as a small business owner.

And it’s hard to think of a workflow that doesn’t include communication. So many workflows in healthcare and public health include not only patient communication, but also interprofessional communication. And increasingly, like in this project, we’re seeing separate, different organizations tied into the same workflow, and therefore needing to communicate.

Public Health, we know, has a long history of this, but now with value-based care, the triple aim, social determinants of health, health systems are also integrating other organizations into their clinical workflows. If this is you, there’s a 2020 study on workflows and integrated care that I’ll drop into the show notes.

I also found this reminder from our friends at AHRQ: “Always keep in mind that workflow occurs between organizations, between people at a clinic, in one’s head, and before, during, or after a patient visit.” Now the one I’m talking about had all of the above, maybe yours does too! I’ll link to that AHRQ page because it has a tool on it on how to analyze workflow.

Because everyone with a workflow is probably aware there is also ongoing process improvement, which is also something I help with. We want to continue to assess workflows even after we’ve implemented them — because of all the benefits, right?

You’re likely familiar with these. Providers can improve efficiency, increase care coordination, improve error prevention, streamline processes, and otherwise deliver higher quality care, maybe even at a lower cost.

So I had this client, they had spotted a problem in their workflow, asked for my help, and in this case it was service delivery improvement. And there was a lot going on. It was very elaborate. Many complex interactions, sometimes two people, a dyad, sometimes the triad, many communication steps. We had multiple teams interacting, within teams and across teams, and also interacting with patients and caregivers. We had face-to-face communication, digital communication, voice communication.

But however much communication your workflow has, whatever kind of workflow it is, whatever and whoever your workflow includes, if you want to get those great benefits from your workflow, it needs to work well. And to help it work well, I suggest that you start here: talk to the people involved.

Before you do anything else, before you take another step, talk to the people who use this workflow.

I know, it can be so tempting to just take care of it yourself. Especially if you’re in a leadership position or the person on the team in charge of keeping your eye on the workflow. You call up that one colleague, between the two you come up with something. It’s faster, you got control of it. I get it. Please do this brainstorming. We need your brilliance.

I’m saying, talk to your people, and make that your starting point if it’s not already.

Why? Many reasons.

First of all, the people doing the work know a thing or two about the work. We are living through an extreme example of the lost opportunities when you don’t ask the people who know the work. These drastic cuts that we’re seeing in the federal government, dismantling of whole agencies and departments. As these have been going on, we’re hearing in every news outlet across the board, we’re hearing workers, leaders, directors in these agencies and departments saying, “We know change is needed, and we know how it can be done, and we’re willing to do it.” But these people are not being listened to, sometimes being fired. These people are best positioned to see the problems, understand where change is needed, how changes can be made, yes even drastic changes, and take responsibility for these changes. So remember, you have people like this in your organization. You’re probably one of them.

Another reason to talk to people first is to help you have more confidence in your decisions. The problem you see, validate it with your team. Once you agree on the problem, you’re halfway to a solution. And when you’ve talked to the people, you know you’re representing them, their voices, in any solution.

Another reason: I’ll tell you what my client said. They said, “Your approach was helpful because it aligned really well with our existing ways of working. You’re not coming in to teach us ‘you must use this,’ because people already have their ways of working and that creates the buy-in, that creates the forward momentum.

I appreciated that, because my client, I suppose, could have quickly put together a solution on their own and told people “use this.” But what they really needed was a solution that would be meaningful, make Sense to people work It wasn’t just they needed a solution any solution, quickly. They needed one that worked quickly that could be implemented quickly and that’s also about cultural fit. And that’s what I work hard to do.

Talking with your people will help you with cultural fit. In fact, a lack of cultural fit or a lack of kind of cultural alignment, is a reason many initiatives struggle or fail. I just read a news story this week about improvement initiatives that might be backfiring, but are certainly cringey. One of them was Starbucks requiring baristas to write notes, like little friendly notes, on people’s cups in what the reporter called forced joy (here’s the author’s Linked post in case of firewall). They added that the only people who looked like they were having fun with this initiative, was the Starbucks employees who were going to TikTok and absolutely slamming this initiative. So, if you don’t want to deal with that kind of a headache, talk to your people first.

And it doesn’t have to be a big deal. We did a short, and I mean short, survey. We talked to a cross-section of folks. I met with people one-on-one for super brief conversations. You could do that. If you have regular meetings you could all grab a few minutes in the meeting. Just make sure you’re recording or capturing people’s suggestions somehow.

And now a bonus point: if your workflow includes patient communication like ours did, make sure you’re talking to patients as well. However you can. Maybe that patient advisory group. Again, ugh! Another step? Yes.

I got to talk directly to a patient and wow was it worth it! I was so grateful for that, because she made such an important contribution. She had an idea no one else had thought of. She was one of the last people I talked to. And her idea wasn’t mentioned in the literature that I read either. When she said it, I literally smacked my head. Why didn’t I think of that?! And when I presented it to the leadership, they had the same reaction. They’re like, Oh, what a great point!

So if you do this, if you talk to patients, please circle back with them and tell them the result of the workflow improvement, and the importance of their contribution.

Listen to your people. I loved working on this project and the client was happy too. So if you want expert help improving your workflow, or other process improvement activities where communication is involved, contact me. We can connect on LinkedIn or you can visit healthcommunicationpartners.com and click on contact. This has been “10 Minutes to Better Patient Communication” from Health Communication Partners, Audio Engineering and Music by Joe Liebel, Additionally Music by Alexis Rounds.

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Learn about 7 common QI trip hazards, and how you can avoid them.

Now, I don’t typically start conversations with negatives, but sometimes when I talk with clients, especially super focused go -getters, they’ll ask me right out the gate, Tell us what we’re getting wrong so we can fix it! This episode’s for you, and it’s about quality improvement.

Hi, everybody. This is 10 Minutes to Better Patient Communication, ranked number 20 of the Top 100 Podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement experience and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you wanna strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.

Did you know I work with business? Better communication is an investment that makes your business more efficient, less time lost to misunderstandings, better communication between groups, things get done with less muss and fuss. Want some of this? Visit healthcommunicationpartners and click on contact. Or find me on LinkedIn. You can even email me, Anne Marie at h-cpartners .com.

So there are so many quality initiatives going around everywhere. There’s quality measures flying around everywhere. You’re probably involved with some of them. Continuous quality improvement is a thing. I did an episode about QI a few weeks ago. It was well received. This is kind of a follow-up. This is about some common QI trip hazards that I’ve experienced firsthand and also learned about from others.

Now, this advice is not specific to any industry, but most of the examples are from health care. So consider this a refresher for you or the QI person in your life. With links to resources in the show notes with also transcripts to this episode and all episodes and they’re available at HealthCommunicationPartners.com. Okay, here we go.

Number one mistake: Using one size fits all quality guidelines. This means we’ve got to take a close read of any guidelines we’re using to see: how equitable are they? That is, are they working better for some groups than for others, just by how they’re written? I’m going to put a link in the show notes to an article called From Quality Improvement to Equality Improvement Projects. It’s a scoping review and framework. and the authors say, guidelines themselves might lack inclusivity. They also have a nice lit review, so go ahead and check out that one in the show notes.

Okay, mistake number two. Thinking all quality measures are created equal. That’s right, the tools you use to assess that quality need to be looked at closely as well. If you want to get really good at this, I’m going to put links in the notes to a Johns Hopkins webinar on equity in quality improvement featuring Dr. Andrew Anderson. Definitely check that webinar out. It’s on YouTube.

Alright, mistake number three. Forgetting to center the person. Person-centeredness is crucial, and yet it can be tough to keep doing, right? We gotta keep tying ourselves back to the person. I’m helping a client with this right now. So we wanna make sure that what we’re doing centers people, people’s perspectives and their experiences. Ask yourself, how straight is the line from this measure to the person that it’s gonna be impacting? Could this line be straighter? Be honest.

Alright, mistake number four. Not talking to the folks on the front lines. Now in QI, it can feel like it’s only the people with the dashboards who can make the calls and be valuable to talk to, but that would be cutting us off from an incredibly valuable set of perspectives: Frontline practitioners. Those involved in the work. No a thing or two about doing the work. So put time in your plans to talk to them and write down what they say.

Mistake number five: letting data collection become a burden. Quality improvement leaders, you need to watch out that the collecting of data doesn’t become onerous in itself, ’cause We’re trying to improve things around here, right? I’m gonna go ahead and put a link in the show notes to an article called Organizational Health Literacy Quality Improvement Measures with Expert Consensus. The authors say measurement burden is a concern in the US healthcare system. Now, yeah, we need to be accountable, but that accountability can’t take us away from our work so much, or we’re setting up antagonism and risking resentment. The authors recommend that you ask people at multiple levels “how QI initiatives could help them further their progress” toward other requirements, other aims, other goals. And I really like this advice because, hey, double dipping for the win. People don’t mind being accountable for metrics that matter to them.

This brings me to mistake number six: counting what’s easy to count instead of what matters. You’ve heard this before, right? If quality improvement is gonna be part of how we work, you gotta be vigilant about how you’re doing it. So if it starts to feel like you’re measuring things that are easy to count, but not valuable to people, not valuable to staff, trust yourself, trust that noticing and pause. Take time to step back, take a look. Not just how you’re measuring quality, but what are people expected to do with the outcome of this study, right? What kinds of assumptions are being made about how these measurements are gonna translate into concrete practice recommendations. The clearer they can be, the easier it’s going to be to get people on board with them as well.

Mistake number seven: working in silos or in isolation. Now for this, I’m going to put a link into an article. It’s kind of old. It’s from 2016, but I’m including it because it’s good and also because of the title, Does Quality Improvement Improve Quality. The authors say, too much improvement work is undertaken in isolation at a local level, failing to pool resources and develop collective solutions and introducing new hazards in the process. So link to the rest of that article in the notes.

This brings to mind the parable about the blindfolded people encountering the elephant. You’ve seen that one. Though everyone’s individual level deductions in that parable made sense, what they really needed to work accurately and effectively was each other’s perspectives so that they could get the bigger picture. So make sure you give yourself time to talk to your colleagues, help take off each other’s blindfolds, and zoom out to see the bigger picture.

If you want to talk more about quality improvement, find me on LinkedIn. I’m Dr. Anne Marie Liebel. You can visit Health Communication Partners and click on Contact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel, additional music from Alexis Rounds.

Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners, LLC. Find us at healthcommunicationpartners.com.

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Interviews or evaluations are tough, but storytelling helps. Here’s how to use the SWOT matrix to help you prepare 4 stories you can use to answer common interview questions.

This is an episode that I was planning for later in the year, but I’m doing it now because of all of the government employees who have recently lost their jobs and suddenly and abruptly are finding themselves job searching. This episode I hope will be helpful for when it’s interview time. I’m going to talk about four stories you can share in a job interview.

Hi everybody, this is 10 Minutes to Better Patient Communication, ranked #20 in the Top 100 Podcasts in Social Sciences, giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and most importantly make the difference we got into our jobs to make.

Now you may know this show is about actual questions and issues raised by actual professionals, and I was coaching somebody a while ago on self evaluation, and I thought this would be good episode to run maybe in the late fall. But no. The last few weeks have shown this is the least I can do to come out and support some of the civil servants who have found themselves in this just crazy position. Please take good care of yourselves. Please prioritize your health and the mental health issues that come along with sudden job loss.

When you are ready to get back on the horse and go ahead and apply, I hope this can be helpful when it comes to interviewing. Because it’s an uncomfortable kind of scenario in the best situation. All this talking about ourselves can be incredibly cringey. We don’t like hearing our own voices, right? It gets our imposter syndrome flaring up. So I want to try to get you back on more comfortable ground. Because we can be more comfortable when we’re telling stories, especially stories about something we’re passionate about.

So I’m going to suggest four stories specifically, and the way I’m going to suggest this is through something you’ve probably heard of before, the SWOT analysis. Or SWOT analysis. Where S stands for strengths, W for weakness, O for opportunities, and T for threats. It’s used to analyze like a whole business or a unit within business, but I’m going to go ahead and take it kind of off script because I think we could use it to think about ourselves, and some of the stories we could tell about ourselves when we have to self -evaluate or when we’re going into an interview.

So I’m going to go through each of those letters and suggest some stories that you might tell, give you some things to think about, and then I’ll wrap up with some tips.

StrengthsOkay, first of all, S for strengths. Yes, this is where you’re going to tell stories about your strengths. And that can make people uncomfortable right off the bat. But remember, there’s no wrong answers to “tell me about yourself. Tell me what you do well.” If something like that makes you uncomfortable, you might be more likely to talk about your most significant achievements.

Thinking about achievements is nice because that allows you to shift to a project or a problem, and the strengths you used to do something great there. Accomplishments are natural stories too because there’s a beginning and a middle and an end. And that’s what you want to do, is be able to tell a story. Accomplishments usually also come with some of their own data. So give yourself a chance to think about what you consider some of your significant achievements in your last role.

And slow down the train of what happened. Let yourself think about: what was the beginning? How did that start? What was going on, middle of the way through? How did I wrap it up? What happened in the end? All the steps it took to get you there.

This can be tricky to do, especially if you’re really good at your job, because you just did it. But slowing this down and getting to some of the steps and the details can really help people appreciate your expertise. Not everyone knows what you know. And of course, if you have other folks working with you, give them flowers in this story, too.

So for S, I’m also going to suggest you have a little bit of a backup story because it’s about strengths. Do yourself a favor and as cringey as this might make you feel–it’s okay, no one will know, you’re just going to write it down for yourself–get yourself a couple answers to this question: What have people said they like about working with you? Because they have! So go ahead and remember it or find those emails or find those messages.

It’s good to have these in your pocket especially if you get real nervous or self -conscious, because talking about these good things people have said about you gets you outside your own head. You are telling the truth. Someone did say that thing about working with awesome you.

WeaknessesOkay, second story, W, weaknesses. Ugh! This is particularly ugh. No one likes talking about our weaknesses, so I hope you like my approach. I suggest you think about something you thought would be easy for you, but wasn’t. Maybe it’s part of a project, maybe it’s a task, maybe it’s an interaction.

I like this approach because it’s an automatic story setup. Here’s the setting, here’s how it started out, here’s me going into it, here’s what I thought I was getting into, and then bam! Unpleasant surprise. It's a great storytelling chance for you, right? You can talk about how you handled it in the moment if you want to. You could share some thoughts you’ve had about it since, or you can limit yourself to what you’ve learned. How you know this is something you want to work on because it’ll help you in the future, and leave it at that.

Now S and W on the SWOT chart are like internal tasks or internal traits. So we’re done with the internal, your internal world now, so you can relax! O and T are about the external world. So let’s get into them.

OpportunitiesO is opportunities. Here, go to town. Give yourself a whole lot of these, right? Any work situation you think would be a good stretch for you. Or a good place for you to put your energy and your attention. Or work situation you’re looking forward to. Here again, give yourself several opportunities to talk about and I’m going to suggest that repetition is your friend.

I was in a storytelling workshop recently and one of the presenters said this, “Repetition is your friend even when it feels ridiculous.” I thought that was such a good point, not just the reminder about repetition, but that it can feel ridiculous, but it feeling ridiculous should not stop you from doing it.

So especially in an interview, when you’re talking about the image of the professional that you want this person to have, this opportunities that you are looking forward to, don’t limit yourself and also keep repeating yourself. Okay.

Oh, and also, if you’re a little stuck here. Hey, I’m going to go ahead and make a plug. It’s always nice to talk about how you’re going to improve your communication. Maybe there’s a group of people that I really want to get better at communicating with–suppliers, or I really want to get better at communicating with my mentees. Or you could pick a part of your communication. I want to be better with those emails after a meeting. I always drag those out, and I really want to get better at those. So always a good thing to talk about improving your own communication.

ThreatsOkay, T, last one, threats. For this one, I’m going to suggest this is a good chance to show off. And here’s why: Threats are what you notice that’s coming down the pike, and how you’re going to deal with it if it does.

So what threat stories do is show that you are watching the field. You are paying attention to your profession, you’re paying attention to your market, you’re paying attention to your industry. So think of a potential situation that’s outside of your control, that could cause trouble for you, your team, your division, your whole industry. The point is that you’re keeping your eye on it, in case you have to manage it. So in the threat story, you’re going to acknowledge this thing. Whatever it is, you’re going to show us that you see it because you are savvy that way. And you have a plan or you’re cooking up a plan in case it comes to pass. Here’s how you’re going to deal with it.

So that’s the threat story. So SWOT, four stories you can tell in an interview.

TipsHere are my tips to wrap this up:

First of all, give yourself something you are excited to talk about. Every one of these stories should show you in a good light, and if you go ahead and listen back to this episode, you’ll see that I’m encouraging you toward that: showing yourself in a positive light. Because it also helps you give yourself something you’re excited and passionate about. You’re going to tell a better story, people are going to be more engaged, and they’re also going to remember your story better.

Secondly, brainstorm a little, don’t hold back. And remember this is preparation. You’re writing things down. So if it feels too much, if it starts to feel a little bit cringy, step away from it. Do it in chunks, put it down, do something else, and come back to it.

Third suggestion, data, have it, use it, right? You’ve heard this suggestion before, anything quantifiable, work it into your conversation.

And finally, I’m going to suggest you involve a friend, right? Yes, practice these stories to an actual human being. That flip that your stomach just did, you can reduce that flip actually happening during the interview if you practice ahead of time, and the benefit being you can also turn around to your friend or colleague and offer to listen to them work out their stories ahead of time.

I take a holistic view of communication because I know how important it is to teamwork, to problem solving, and to innovation. So if your organization wants some help on this, contact me. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel, Audio Engineering and Music by Joe Liebel, additional music from Alexis Rounds.

Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners LLC. Find us at healthcommunicationpartners .com.

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A close look at some of the ways we use our phones to communicate can teach us how to improve our communication in general.

Need a break from the news? Today, I’m going to ask you to think about your phone. If you care about communication, and I think you do, considering the ways we communicate with our phones can teach us a lot about how we communicate in general. And that’s what today’s episode is about. I want to introduce you to a scholar, and to a term, that could be helpful in the way you think about your communication.

Hi everybody, this is 10 Minutes to Better Patient Communication, ranked #20 in the top 100 podcasts in social sciences. giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I'm Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I'm here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you, because communication touches everything. We're here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.

So today’s episode is about a concept called “multimodality” and it’s kind of a mouthful. I was made aware of the work of Professor Gunter Kress when I was in graduate school. Gunter Kress was Professor of Semiotics and Education at the Institute of Education at the University of London, and he was a leading contemporary voice in language studies. Professor Kress died a number of years ago, and that’s when I decided to do an episode on some of his work in multimodality. So let’s listen to that episode now.

Generally speaking, a mode, in language and literacy terms, is a way that meaning is communicated. Examples of modes include speech, written text, images, signs, etc. I have a link to a video of Kress answering the question, What's a mode? Any work that combines more than one mode is called multimodal.' For instance, think of how videos combine images and sound. Those are two different modes. Videos are, by nature, multimodal, whereas a photograph is monomodal.

It might be easier to understand multimodality if we consider what it's not. Kress and his collaborator Theo van Leeuven point out that Western culture has historically preferred monomodality, writing:

The most highly valued genres of writing (literary novels, academic treatises, official documents and reports, etc.) came entirely without illustration, and had graphically uniform, dense pages of print. Painting nearly all used the same support (canvas) and the same medium (oils), whatever their style or subject. (Multimodal Discourse p.1)

Hmm graphically uniform, dense pages of print, that are entirely without illustration? This makes me think of some discharge instructions I saw once. Anyhow moving on. They describe how, as monomodality gave way to multimodality, it was still a monomodal scene for a while. This is because even though multimodal works were being made, it was a team effort, made by a group where each person was responsible for one mode. Everyone a specialist. For a newspaper story, for example, you have a writer, a designer, a data visualizer, etc. They're acting in ensemble to make the newspaper article. Such works were produced in this way, with different, hierarchically organized specialists in charge of the different modes, and an editing process bringing their work together. (p. 2)

Certainly, this still happens. But now with digital media, the different modes can be operated by one multi-skilled person, using one interface so that he or she can ask at every point: Shall I express this with sound or music?' Shall I say this visually or verbally?' and so on. (Those excerpts are from Kress & van Leeuven's Multimodal Discourse and links are in the show notes here.) Simply because we're alive in the 21st century, we all consume and often produce complex multimodal texts. Any work with more than one mode, more than one way of making meaning. If you've ever shot a video or added images to text, you've produced a multimodal work. That is to say, because of digital communication, we can all do multimodal work. The same is true for your patients.

Because of the rapid pace of technology, the expensive design suites that were once only owned and operated by specialists, are now available to all of us. And they're on our cell phones! Think about all the multimodal work you can consume and produce with a cellphone. Emojis are added to text messages, images are modified with color and shape, videos are shot, edited, viewed, shared, social media is scanned and updated. For more examples, ask the nearest 10-year old. Multimodal communication is true of all of us. Including your patients.

Why is this good news? Because it invites us to reconsider what assumption we are making about the interpretational resources and practices of our audiences. So I'll invite you to consider: what you are assuming about what your patient reads and writes, or produces and consumes? How is this shaping the way you are interacting with them? Your patients are likely making and interpreting multimodal work (maybe on their cell phone). Rather than worrying about a patient's educational level or low score on some assessment, focus on the ways they are producers and consumers of multimodal works.

Multimodality is also good news for you in your practice. This is because it helps you focus on the parts of health literacy you can actually do something about. The in-person conversations you have with patients. Any digital patient communication. Any materials shared with patients. In short, multimodality invites you to think about any way words and images are used before, during, and after the patient encounter. What can you do with this cool new information when it comes to communicating with your patients and the ways they communicate with you? Here's three ideas to get you started:

1. As I've said before, one of the most powerful ways you can help patients learn is through mixing your modes.

This can be simple and unfussy. For example, take a written text you use frequently. Read it aloud the voice recorder on your phone works just fine turn it into an audio file. Post the audio file on your website. You only have to do this once, to help many patients. They can read the text, listen to the audio file, or both.

1. How long has it been since you looked at the written materials you give to patients?

Make sure written materials are accompanied by images, and broken up into small paragraphs. Everyone finds this more manageable and memorable.

1. Apps are nearly always multimodal.

They are also interactive. Both of these traits are beneficial for learning. Apps can also be less intimidating than pages of solid prose.

I'll challenge you to consider any communication as multimodal. Kress and van Leeuven warn us that pretending that language is the central means of representing and communicating is simply no longer tenable, that it never really was, and certainly is not now. (p. 111) So pull on those other modes! Think: images, layout, color, motion, sound.

You and I are both trying to reach people, and I invite you to join me in using multiple modes. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music from Joe Liebel, additional music from Alexis Rounds. I’m Dr. Anne Marie Liebel, Thank you for listening.

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Learn 20 different ways communication can help in QI. In 10 minutes!

Whether you’re in healthcare, public health, industry, or academia, quality improvement is part of your professional picture in one form or another. If you want to reach your quality improvement goals, I’ve got good news. Communication can be your secret advantage. More good news? In the next 10 minutes, I’m going to give you 20 different ways communication can help in QI. So you’ve no excuse for not making communication a bigger part of your quality improvement activities.

Hi everybody. This is 10 Minutes to Better Patient Communication, ranked number 20 in the Top 100 Podcasts in Social Sciences. Giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne -Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you. Because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.

I want to start by sending out love to the QI experts out there ’cause you’ve got a tough job. I’ve been directly involved in quality initiatives, and as a consultant, all of my clients are also involved in quality initiatives. And way back in education and higher ed in my past, you might know that those sectors have been subjected to near-constant reform. And dealing with those reforms, thinking critically about those reforms was a significant part of my education at Penn. So I’m drawing on that too, and what I’ve learned from clients and from QI experts. Whoever you are, what kind of organization you work in, I’m hoping this is going to be helpful.

Now the examples are going to be from the health sector, but I’m trying to choose an approach that will apply across contexts because lots of different folks are listening to the show right now, so I’m hoping you’ll see possibilities for your situation reflected here.

When you hear the term “quality,” I wonder what it makes you think, because it can encompass so much. And yes, some of those initial thoughts you had might not have been particularly warm or fuzzy ones. That’s also me. So if that’s you, I still hope what I’m sharing today can be helpful. I’m thinking about QI as encompassing all sorts of activities that promote evidence-based practice and person centered principles to improve quality, improve outcomes, and ideally lower costs.

Everyone’s collecting data to see where they need to improve, and then looking for ways to improve. That’s why communication is so valuable and so helpful. Because whether you’re collecting data to see where improvement is needed, or you’re looking for ways to improve once you know where you’ve got to work on, or both, communication is your friend.

Communication can help with quality improvement in two distinct ways. One, as something to measure. And two, as an action item on nearly anything that you do measure. So I’m going to give you 10 examples for each. Get your thinking, maybe spark some ideas and provide encouragement. As a consultant, a lot of what I get asked to do is capacity building for clients, to help them reach their goals. And I was talking with a former healthcare administrator about this. And he said the quote that’s the title of this episode, if communication isn’t part of your quality improvement, it should be. So I thought there’s a great placeto start this miniseries.

All right, first, when communication is the thing you’re measuring. Here’s 10 different ways you could measure communication. Just to get your thinking, I’ll follow up with some tips as well. Now, most of these have to do with patient/provider communication, but you could think about this as like employee -manager communication as well. Okay, here we go, communication quality metrics:

1. Rate of patients reporting that their provider actively listened to their concerns.
2. Rate of patients who feel their provider explained their condition and treatment options clearly.
3. Rate of patients stating they were able to ask questions and received satisfactory answers.
4. Percent of patients reporting that their provider was sensitive to their cultural background and needs.
5. Percent of patients who received not just written information about their care plan but received this in multiple ways. That’s called multimodality. If you want to geek out on it, we have a podcast episode, I’ll link to it in the notes.
6. Number of patients with limited English proficiency, for whom the consent discussion involved an interpreter This one’s from a great study of QI measures and health literacy that I’ll link to in the notes. And if you’re thinking about the new quality requirements around health related social needs screenings, you could modify this for that as well.
7. Observed instances of providers using open-ended questions to encourage patient input.
8. Rate of providers demonstrating empathy and respect towards patients through their communication.
9. Proportion of interactions where providers actively summarize key points with the patient.
10. Reported instances of community members’ involvement in identifying needs, and/or designing and implementing interventions, and/or evaluating effectiveness

Okay, a couple of tips for those quality measures. Context matters, right? So any of those metrics you want to tailor to your setting and to your patient population. Also, keep in mind things like the Culturally and Linguistically Appropriate Services standards, and organizational health literacy from Healthy People 2030, I’m going to go ahead and link to them in the notes as well.

So these are some ways to think about measuring communication, get some meaningful data. And then of course, we need to act.

So that’s the second way communication can really be helpful to you in quality improvement. Regardless of whether you’re measuring communication or something else! Communication can help you improve on any process metric.

How do you do this? Well, here’s 10 resources exclusively from us here at HCP.

1. Number one, a podcast episode I wanna draw your attention to called Why Focus on Communication? This episode helps us articulate to ourselves and others why communication is a smart thing to focus on when we really want to make things happen.
2. Two,the podcast 5 reasons why communication should be part of any health equity strategy. This is about communication as a lever for health equity, integrating it into organizational cultures, missions, and strategic plans.
3. Number three, the episode 11 updated health literacy tips. Yep, just like it says. 11 updated tips to help you support individual and organizational health literacy. Big quality improvement issue there, health literacy is.
4. Number four, we have a course, Foundations of Equitable Patient Education. This course reveals barriers that people often miss to improving access and quality of care and services. And then how you can address those barriers. Right on healthcommunicationpartners.com. Click on courses.
5. Number five, Dr. Bradley Block has a podcast and he stopped by our show to talk about efficiency in patient communication. Check out that episode.
6. Number six, we have an episode called A New Way to Say the Same Thing. In that episode, I tell you 10 different ways you can express a complex idea so you can have different approaches for different patients.
7. Number seven, “Any conversation about care is also a conversation about culture.” That’s a quote from a physician. That’s the title of a podcast episode we did about learning how to reflect on your cross cultural communication.
8. And if you’d like an example of a physician doing just that, Number eight is an episode from Dr. Raj Sundar on considering cultural context during patient communication. And there’s two parts to that one. Definitely check it out.
9. Number nine is an episode called Collaborating? Here is four hints to help things go smoothly, because we know if we want to get work done on big problems, it means collaborating. So I share tips that I’ve given to clients.
10. And finally, number 10, contact me. Visit healthcommunicationpartners.com and click on contact. Or if you’re on LinkedIn, connect with me and we can message there.

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music from Joe Liebel, additional music from Alexis Rounds.

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Conflict happens. Learn the 4 parts of any conflict, and some questions and phrases you can use to help you handle interpersonal conflict in communication.

When we’re in a conversation, we want things to go smoothly. We want the relationship between us and the other person to work. But conflict happens, and that’s what today’s episode is about.

Hi everybody, this is 10 Minutes to Better Patient Communication, giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives. If you want to strengthen the work you can do in your professional sphere, this is a place for you because communication touches everything. We’re here to learn, get inspired, and most importantly, make the difference we got into our jobs to make.

In the last week, I had two different people in two completely different conversations bring up interpersonal communication and conflict. One of them was a colleague who does teaching about this, who was saying they were doing more teaching about this, they were getting more requests about it. And then sure enough, later that same week, or it was just earlier this week? Gosh, wow, just earlier this week, I had someone come to me and want to talk about: Can you give me some advice in a professional conflict and in this conversation? What should I do?

So, take from that what you may, but I know it means time to do an episode on it! Because it’s been a while since we’ve talked about conflict in this show.

So this is for those times when an otherwise normal or unremarkable conversation goes sideways, takes a turn, gets tense, maybe gets derailed.

Because we know when communication falls short in the health sector, patient satisfaction and outcomes get impacted. And that’s what we don’t want. And that’s why we’re here in this show. The majority of the people that I talk to really wanna preserve the relationship as well. So we’re gonna talk all about that and maybe refresh some of what you know, and hopefully give you some new tools, because I’m going to take time at the end of this episode to give you some phrases that you can use and questions that you can ask yourself.

What I’m sharing is leaning on a book that I have leaned on a lot in my professional life, from the Harvard Negotiation Project, it’s called Getting to Yes, and it’s been around for decades. I don’t know how many editions this book has gone through. It analyzes decades of cases from international negotiation and conflict resolution, and I think it’s got great advice in it.

So the authors suggest we look at interpersonal conflict as having four parts. And I found these four parts handy when you want to break something down–especially a conflict that has just happened, and you’re trying to make sense of it. You want to be better next time. So those four parts are: you, the other person, the relationship between you, and the problem.

You, the other person, the relationship, and the problem.

Now the authors say there are two sets of concerns in any conflict. One is the people: you, the other person, the relationship. And the other is the problem at hand.

And they spend a lot of time in this book helping you untangle the two of those. Because if you’re like me, you’re thinking, “Well, what about when the person’s the problem?!” And yeah, Okay, I’m gonna talk about that too. But it’s important that we at least give ourselves a chance to think about them separately.

And to help you do this, the authors give us this example. It’s two shipwrecked sailors in a lifeboat fighting over limited supplies. Each sees the other person as the problem, instead of the fact that they’re in a lifeboat with limited supplies.

To survive, the authors say they will want to “disentangle the objective problems from the people.” So that’s what they’re trying to tell us to do: identify the objective problems. Once we can do that, we can focus on shared goals. In this case, the objective problem: they’re in a lifeboat with limited supplies. The shared goal we’re going to assume is survival. So they will want to focus on the shared goal, regardless of whatever personal relationships are like between them right now.

So the authors use this story to remind us how important it is to separate the other person from whatever issue that they are raising. They say, “Deal with people in personal ways, and deal with issues in strategic ways.”

Now, you may have issues with the other person’s approach to the problem! And okay, so maybe they are thinking the same thing about us! This can feel like a personal attack, which can get our hackles up and make things even more difficult to deal with.

So I want to remind you–like the authors do–that it’s not really us. It’s not really the other person either. It’s the conflict in our approaches to the problem. That can also make the problem a little more difficult to see and to tackle. So let’s get to tackling this.

Here are some phrases and questions that you can use broken down by those four parts of a conflict. And of course, this is a reflective practice show, so we’re starting with you.

YouGive yourself a moment to think about your interests and ideas in this conversation. This is going to help you when it comes to dealing with the problem, too.

• What do you need to have happen here in order to feel successful as a practitioner?
• What are your fears, or what buttons of yours are being pushed right now?
• How is your attitude toward this conversation influencing your perception of it?
• What would be an ideal outcome from your perspective?
• What assumptions are you making about the other person’s intentions?

The Other PersonAlright, now let’s talk about the other person. Even if you know this person well already, it’s a good idea not to assume anything. Go ahead and ask the questions I’m going to share with you, listen to what they say, and keep in mind that it’s possible your idea of what a good outcome is different from theirs. So:

• What is this person thinking about this situation? That is, what are their ideas about what should be happening right now?
• What are some of their needs? What are some of their fears!
• What does this person see as the problem here?

Repeat back to them what you heard and consider asking clarifying questions to make sure you understand their perspective on the issue. Like:

• Do I have this right?
• Am I missing anything?

The RelationshipOkay, number three, the relationship. I had a professor in grad school who laid down this really basic truth. It’s one of those that it’s easy to say but it’s incredibly hard to remember to put into practice: People want to be understood on their own terms. Right.

When you think you understand the other person’s perspective, the easiest, most important move you can make is to let them know you hear them, whether or not you agree with them. Here are some ways you can do that:

• I see what you mean.
• That makes sense.
• I see how that could make sense.
• I understand how you could think that.
• If I were in your spot, I’d probably be thinking that too.

So this is letting a person know that you heard them, even if you don’t agree with them.

The ProblemAnd number four, the problem. The authors of Getting to Yes recommend that you tackle this together, because collaboration isn’t just good for the relationship, it’s also good for problem solving. So ask the other person what they think might work. And whatever they say, find something you can agree on, that you think you can work with, and build on it. You might have heard this as like the yes, and move. So let me give you some examples of how you can say that.

• Why don’t we work together to solve ___?
• How can we make this work?
• How can we resolve this?
• What do you need from me?

Now, what about those times when the person is asking for something that you can’t do, or you can’t meet all of their requests. Here are some phrases to get you out of that tight spot.

• If I had a magic wand, I would.
• I wish I could say yes to all of that.
• I’m sorry I can’t give you the answer that you want.
• I know this is important. Here’s what I can do.

And if you want to introduce a compromise, you can use these phrases:

• What would you say if ___?
• How would you feel about ___?
• Would you be open to ___?

These questions and phrases help you focus on the issue while respecting the people: yourself, the other person, the relationship. And these phrases can help you get the conversation back on track while keeping the relationship intact, and dealing with the objective problem out there in the world. If you’d like more help with this, go ahead on LinkedIn and message me, or visit Health Communication Partners and click on Contact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional music from Alexis Rounds.

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We start the year by grounding ourselves. Why are we here? What are we doing? Why are we doing it this way? And I give one suggestion to guide your work in communication this year.

The start of a new year is a good time to think big picture, so we’re asking big questions. Why are we here? What are we doing? Why are we doing it this way? And I’m also going to give you one suggestion to guide your work in communication, no matter what you’re planning this year.

Hi everybody, this is 10 Minutes to Better Patient Communication. Giving you inspiration and strategies to improve engagement, experience, and satisfaction since 2017. I’m Dr. Anne Marie Liebel, a researcher, consultant, and educator with expertise in communication and education. I’m here to dig into some of what we might take for granted about communication in our professional lives.

And if you want to strengthen or extend the work you can do in your professional sphere, this is a place for you. Because communication touches everything. We’re here to learn, to get inspired, and most importantly, make the difference we got into our jobs to make.

So yeah, it’s the start of the new year, so let’s think big picture for a little bit. Let’s step back and remind ourselves why we’re here. Communication is the thing we’ve all got in common here, communication in our professional contexts. But why communication? Right, it can be hard to remember why? Because while we’re doing it all the time, we’re in the weeds every day. So that’s why I wanted to take a moment to kind of reset for us.

Let’s remember why we’re doing this. Let’s remember why we’re focusing on communication. Because we know how valuable it is. Sometimes it can be hard to remember that not everybody else does. And yes, probably part of your job is convincing somebody of the value of the work that you’re doing. So hopefully what I’m sharing today can help you make arguments when you need to make them. But I’m also hoping you can enjoy kind of articulating this to yourself as well.

So communication is the thing we’ve got in common. And we’re using it mostly–I think I can say this with some confidence–most of the people listening here are trying to improve some sort of outcomes. It might be your role involves improving patient safety or patient experience, patient engagement, patient satisfaction.

Maybe you’re on the employee side and you’re looking at employee satisfaction, employee engagement, employee retention. We’re all looking for ways to improve these factors. So why communication? because communication is integral to every one of them. So working on communication helps us be more effective at our jobs.

Another way of saying this is communication and patient education, which I talk about in the show too, are modifiable factors in satisfaction, engagement, experience.

So let’s noodle on this question about why communication a little bit more.

Another way to answer it is ’cause it’s something that we all do all the time. Therefore, communication is a tool we all already use. It’s a leverage point that we all already have at our disposal. Communication applies to everyone. Every role, every rank, every title in an organization.

When we focus on communication and the ways that language gets used the possibilities are also very very broad because of how powerful communication is as a tool. It’s how we connect with other people.

It’s how we build some of the most important things in this life: our relationships, our identities. We also use communication to build spaces, habits, ways of working and thinking. A lot of this work is done through language. We build ideas, we build momentum, we build boundaries, we build walls, we build bridges.

We can shape things with language too. We can shape a story, an argument, an issue, shape relationships. We also can and do use language to tear things down, tear down those walls, tear down ideas, unfortunately also tear down people.

So a focus on communication is going to help you no matter what you’re creating. And this is just our professional lives I’m talking about. I’m not even touching a communication in our personal lives, I’m not even touching all of the artistic uses of communication and language, song, stories, poetry. I’m just talking about everyday work communication here.

And most often I hear that people want to know how to be more effective and efficient across all social groups. Like people want to work as well with diverse communities as they do with mainstream audiences. So this is where working with equity lenses on communication helps us. And that’s part of what I do here in the show and with my clients.

Putting on equity lenses helps us see when we’re doing better with some groups of people than with others. And certainly over the past couple years the equity conversation has evolved. But in general I find that people now know what they need to be doing and are looking for new ways to do it or more ways to do this work.

Again, why communication when we’re talking about equity? Because communication is a modifiable factor, everyone does it, it’s powerful, the leverage points, and if we’re careful and thoughtful, the ways we communicate can help promote equity.

This does mean additional effort. We know how important it is to reach everyone, connect with everyone, teach everyone, but we know that this is difficult to do. So when we are asking questions about what are we doing here and why communication, I’m also asking you to constantly challenge your assumptions about your work.

This challenging of assumptions is one of the secret ingredients to 10 Minutes to Better Patient Communication, the particular way I encourage reflective practice. We have reflexivity as a tool to examine our language, scrutinize it, interrogate it, and people tell me year in and year out this is one of their favorite parts of the show. Which, my friends, is saying something about you because these kinds of questions, What are we doing here? Why communication? These kinds of questions can make people itchy!

Because sometimes it can feel like the answer should be obvious. And people can get uncomfortable when we start poking around a little bit too much. We see that there’s more going on below the surface. And you’re aware of that, and my clients tell me that they’re aware of that too.

And I want to let us all off the hook, because it’s hard for us to notice our own language, largely because language is meant to be used more or less on autopilot. And so as a result, the sophisticated things and the complicated things that we’re doing with language can pass us by unnoticed.

Another reason it’s hard to notice our own language is because over years of being in a profession or in an organization we’ve been kind of acclimated into various specific ways of communicating by our organizations, by our contexts, and again this tends to happen largely without our noticing.

So for each of us we have a kind of normal way of communicating, a way of thinking about communicating. So this year, no matter what you’re doing with communication, I’m going to ask you to keep noticing your normal. Keep scrutinizing your communication to help you switch off autopilot and be more intentional with your communicating. This is about willingness to stir up the habits we can get into, the ways that we work, that we’re kind of used to, that we all carry around with us.

Examining language use at an individual level and an organizational level is a process. It takes effort. It takes courage to question assumptions, it takes courage to reflect, it takes courage to scrutinize and interrogate and question ourselves. It can feel threatening to admit we don’t have all the answers. It can feel threatening to acknowledge our limitations.

And I want to validate how hard this work is. In our jobs, we’re already dealing with incredibly complex, often intersectional issues, often deep -seated issues. And we still need to act with discipline and rigor and high standards. Can’t be messy. We need this work to last.

Now you could be turning away. You could be choosing not to see, not to struggle. Nope, not my lane, but you’re not! You are choosing to spend your time thinking about your own communication voluntarily. That is a sign of courage and bravery and imagination. That’s part of why this show exists, because it’s part of the community of people doing this work.

If you value this show and the stories and inspiration from the series, the research, I’ve got good news. I can help your organization! Message me on linked, visit healthcommunicationpartners.com and click on contact, sign up for the newsletter while you’re there. If you get my newsletter just respond to it–it comes right to me! Thanks for listening. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel, additional music from Alexis Rounds.

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Year end countdown time! Here’s our Top 5 Most Popular Episodes from 2024, as determined by you!

Here we are! It’s the end of the year, and what I get to do now is count down for you the top five episodes as judged by you, this year 2024, from health communication partners. Hi everybody, I’m Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication from Health Communication Partners. Yes, this year we got ranked number 20 the top 100 podcasts in the Social Sciences by Goodpods. So grateful to you for that. And I’m thankful that you’re with us. I’m thankful that you’re continuing to download. If you haven’t been in touch, please do be in touch. You can find me on LinkedIn. Message me there. You can go to healthcommunicationpartners.com and click on contact. It comes right to me. If you get our newsletter, you can go ahead and reply to that, and that comes to me too.

And I want to give you props for being here. Because just that very fact means that you have an instinct or a sense that the communicating and the educating that you’re doing with patients could be better, and that that betterness is in your hands. That there’s something that we can do about our own language use. About our own educating. And I think it’s fascinating the types of creative thought that can go into our conversations. And this list of top five is a bit a sampling of that too.

And not to get obsessive about it, but I think we’re all in the camp where we know if we do a little bit more work on our on our language use, we can get closer to what we want to be. Closer to what we wish for ourselves to be as practitioners. And this is part of the kind of creative enterprise I invite you into in this show. And I’m so glad that you’re here!

So we’ve got five episodes to countdown, and these are done–I'll tell you how I do this. To keep it fair, what I do is I look at all of the podcast episodes that we’ve dropped throughout the year. And I look at the 30 days from when they were dropped. How many downloads did they get? And these five episodes are the ones that scored the highest. So let’s get to it. We’re gonna go count it down, right!

So number five is an episode called How Reflective Practice Can Help You Improve Your Communication. And I love you because you love reflective practice, and you keep coming back for it, which is why I’m so excited to keep sharing it. This episode is really reflective practice in action.

It was a fun episode to record because I got to tell six different people’s stories, their examples of reflective practice on patient communication. ‘Cause I know sometimes when we hear reflective practice, it can mean a whole lot of different things to people, depending on kind of what you’ve heard before. It can also feel kind of vague, it can feel kind of squishy. Or it could feel kind of like a luxury, like you do it if you have spare time every once in a while. But if you’ve listened to a few episodes of this show, you know we take a very different stance here. We look at reflective practice as a strategy, as an intentionality, a technique, a process, an attitude, a stance. And so do my guests. So I encourage you, if you haven’t heard number five, go ahead and check that out. How Reflective Practice can help you Improve your Communication. Obviously, I’m gonna put a link in the show notes. That’s what this episode is about!

Now, number four. Before I get to number four, this next episode is one of two interview episodes to make the top five. And it’s so inspiring to me to hear from you, and to hear from people who are doing the work, about how they are rolling up their sleeves and doing the work. How they think about doing the work. How they think about how they’re treating people. And my guests are incredibly generous with this storytelling, this conversation that they have with me about conversation that they have with their patients. I find it very inspiring, their kind of opening a door into their process for us. Without getting didactic, without kind of getting up on the big box and making pronouncements about the way it needs to be.

And the number four episode of the most popular this year, is definitely an example of that. It’s from Dr. Jonas Attilus on the Benefits of Taking a Learner’s Role During Patient Interactions. And Dr. Attilus is so careful and so thoughtful and does not take anything for granted. So please check out this episode. I’m kind of shocked at how much he can get us thinking about in the short time that he has in the interview. And you’ll also see why he also made the most popular list three years ago, the last time he was on the show! So he knows what he’s doing. And I’m super glad that he came to the show, and again, kind of gave us a door into his process.

Alright, number three, this episode’s about free stuff, right? It’s a free episode about free things. Which is good, because who doesn’t love free stuff? Number free most popular episode this year was Previewing a Free Maternal Health Course from the Office of Minority Health. This is hilarious because this is a repeat of an episode that I had done before. But maternal health had come up in the news again. So I was like, oh you know what I got to tell people about this course. It still exists out there. It’s from the Office of Minority Health. It’s a free course on providing culturally and linguistically appropriate services in maternal health. So what I did is I took the course, and in this episode I preview it. And then I give you tips on how to get the most out of it. And the course is still up as of you know as of this recording the course is still up there. So go ahead and take it while it’s still out there and still free and if you want a little bit of a preview obviously check out the episode.

The number two most popular episode on health communication partners this year is Reflecting on the Connections between Health Disparities and Communication. Now again if you listened to this show more than once you know this topic as well we spend a lot of time on. I was really surprised that this one made the top five. I mean I’m incredibly surprised it made it to number two. Because I make some kind of subtle points in this one. And I’m beginning to wonder if maybe it was the subtle points that made it more popular? Because maybe we’re a little bit tired of being hit over the head with things that are kind of ham -fisted sometimes.

I think we all know that one size fits all advice only gets us so far. And we all live a lot of our time in situations that are unique. Where there is often some degree of uncertainty. And so in this episode, I share some thoughts on this. And I’d love to hear what you think about it. Again, message me on LinkedIn, visit h-cpartners.com and click on contact, and let me know what you think about this.

And drum roll please. The number one most popular episode of 2024, Health Communication Partners, 10 Minutes Better Patient Communication, is from friend of the show, Dr. Ashley Love, when she visited us to talk about Communication about Mental Health in Asian American, Native Hawaiian, Pacific Islander communities. Now, Dr. Love has visited the show before right prior to COVID, or right as COVID was really coming out, I think, Yeah, that’s what it was. Right as COVID was coming out. So it’s been a while since she’s been to the show.

But she came back this past May, which was mental health awareness month and Asian -American and Pacific Islander Heritage Month. So I love the fact that Dr. Love gave us this two-fer by combining both of those topics, and talking about both of them. And she and I go way over time because she has so many stories to share. And I’m just in awe of her stories and the breadth of her knowledge. And we also have great time on mic together.

So I’m delighted and so thankful to Dr. Ashley Love for coming to the show, and for making what would become the number one most popular episode on our platform this year 2024, Dr. Ashley Love. So please check out that show.

And I want to end this episode, but also this year with a message of hope. It’s not easy for me to keep hope up, I don’t think any easier than it is for anyone else, even when doing this show. Sometimes, like for this episode, and for many other episodes really, and especially you know in the past like during COVID, I really have to work myself around to get into a hopeful space. And set aside whatever fear or anger or disgust I’m feeling at the time, and get to a hopeful place. And it’s got to be a genuine hopeful place, or else really, why bother? And you’d probably be able to tell anyhow.

And the fact that people all over the world are tuning in to this–this very niche show–along with you and me, that I think is a reason for hope. Because come on folks, this is a very niche program. We are real word-nerding it out here, in very specific ways. So, I think this is encouraging, mostly encouraging, a little bit terrifying to me, but mostly encouraging that you’re here. To know you’re here. Because you’re change agents. You’re here, you’re pushing the envelope. You’re in this. And when I hear from you about what you’re moving toward, you get that this is long-term work.

I’m proud to offer you things to consider, things to try, things to keep in mind while you’re doing the work. And hopefully strengthening what it is that you’re doing. Because we’re all concerned about the future. We’re all still here, doing the work together. Happy holidays. Happy New Year to you. Thank you for being here. I’m Dr. Anne Marie Liebel and this has been 10 Minutes to Better Patient Communication from Health Communication Partners.

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Improve your shared decision-making (SDM), no matter how you do it.

Just like it says on the label, today’s episode is a quick exercise to help you improve your shared decision-making, no matter how you do shared decision-making.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication from Health Communication Partners, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, you can visit healthcommunicationpartners.com or connect with me on Linked.

And I have to tell you, you are the most talented, cutting edgiest, best-looking audience in the podcast universe! You’re already great at what you do. What you want is more tools to address problems that you see, so you can move forward in a way that’s relevant to you and your situation. That’s what I support in this show. That’s what I support with my clients. And yes, you can work with me.

I had a physician give me a huge compliment and call me a “shared decision-making guru,” which meant a whole lot to me as an educator too. Ever since medicine started shifting away from its paternalistic model toward more patient-centered care, shared decision-making has been talked about.

So here’s the point where I go to a couple definitions. One of them is from the Clinical Journal of Oncology Nursing that says shared decision-making is quote, “A healthcare delivery model that mandates patient-centered care for clinical practice.” The journal Patient Education and Counseling offers a slightly different view, and says that shared decision-making is related to “an ethical imperative to respect the agency of individuals, offer information, collaborate, and support deliberation when difficult decisions arise.”

I had one physician tell me a story of when she was told to “go do a shared decision-making” with a patient. As you might suspect, things are not often quite that straightforward.

An article in the journal Social Science and Medicine says that shared decision-making kind of suffers from a problem of not reflecting well how decisions are typically made by real people in the real world. The authors say, “This model rarely incorporates what is known about decision-making, or makes room for the various ways that decisions are made in the real world.”

For example, they say that shared decision-making policies and guidelines “do not adequately support clinicians in considering the needs and experiences of individual patients, nor in attending to aspects of the patient-clinician relationship or the healthcare environment that may impact decision-making.” They go on to say, “Healthcare systems are not designed to support clinician-patient collaborations.” They point out, “Patients are influenced by their changing circumstances and experiences, but shared decision-making does not typically acknowledge these contextual and dynamic processes.” They further go on that “clinicians’ attitudes, experiences, and behaviors also influence the decision-making process, but clinicians are inadequately prepared to deal with the impact of these factors when engaging their patients in shared decision-making.”

So, maybe you do shared decision-making because of the ethical imperative. Or because you were told to. Or because of the benefits you want to get. Whatever your reason, you know, it’s important and you do it and that makes me a fan of yours. You want to help patients understand something important. So you’re educating them, communicating with them. Maybe you’re handing them something to read.

In those moments, your patient is going to try to make some sense of what you’re saying or what you’re handing them. This sense -making is where I want to park it for a moment because it is a complex process we’re all involved in all the time, as living, breathing human beings.

Now the article I just referenced emphasized that what shared decision-making is missing is understanding how real people make decisions in the real world, and the importance of contextual factors on us. So I want to take you through an exercise to kind of help remedy that. To help you maybe get a different perspective, or deepen your appreciation of some of what’s involved when we make sense of something someone is telling us, or something we’re reading or writing.

This is to help you be aware of and deal with the impact of context in your shared decision-making, so you can get the benefits.

What are some of those benefits, you ask? Better patient-provider communication, strengthening the patient-provider relationship, patients’ greater satisfaction with their care and engagement in that care, a greater sense that patients have of control over their health decisions, an improved understanding of their condition, and overall better outcomes.

So let’s get to this exercise, a bit of a thought experiment. Play along with me, won’t you?

I want you to think of the last time you made up or used a grocery list for your food shopping. We’re going to unpack this very mundane text. And you’ll see how it’s not just the words on the page that matter, but contextual factors that influence how we make sense of those words.

So think about that. Maybe you’re writing a list. While you’re writing down things on that list, you’re doing it in a specific situation that has an impact on what you write. For example, how much of a rush you are in. What budget you’ve got. Maybe you’re trying to keep a handle on your feelings about food shopping, or a budget, or both. You’re thinking about who’s at home. Who’s eating what? How quickly? What’s in the fridge? What’s in the closet? What’s on sale? What’s easiest? What’s new? What do you have time to make? Maybe there’s someone else whose responsibility it is to take care of meals. Maybe on different days this week. What do they make?

Thoughts like these and more come into play when you’re deliberating over what to write on that shopping list.

Or maybe you didn’t write the list, it’s just your job to do the shopping. When you’re reading that list, stood at the store maybe, you’re not just reading the list, you’re also interpreting the meaning of what’s on the list. And you might go through some similar processes. Thinking about time, all the other things you have to do today after this shop. Thinking about money. Also thinking about the person who wrote the list. What do they tend to always put on the list? What do they tend to always forget from the list? How much you do or don’t agree with what’s on the list. The conversations you might have later around what you did and didn’t get from the list. And what all of this has to do with the week stretching ahead of you, who’s in charge of the budget and grocery shopping and cooking to begin with.

Well, let’s just think for a moment about what contextual factors came into play: Time, money, other people, emotions, past experiences, values, power dynamics, priorities. They came into play, influencing your thoughts and decisions and ultimately your actions about what you put on the list, or bought from the list, how you read the list.

We’re making connections to a lot more than just words in the here and now and your patients are no different. Every day, people encounter and interpret information related to their health and health care. The vast majority of the time they’re not with you, but during shared decision making, they are. They’re interpreting and making sense of what you’re sharing with them by making countless connections like those that we just talked about, other factors: people who may or may not be in the room, past experiences, emotions, values, power dynamics, priorities.

These make a difference to the kind of sense we make of what we hear and read.

This short exercise was to help your awareness and appreciation for the role of contextual factors in our thoughts and actions. I hope it also strengthens your respect for the mental calculus you and your patients are going through in shared decision-making. This “real-world” example can also help you avoid what those authors called “shared decision-making’s problem” with the way decisions are made in the real world.

If you’d like more help with this our course Equitable Patient Education helps you avoid obstacles in six common educational scenarios, so you can reduce barriers to access. For more information on this visit healthcommunicationpartners.com or connect with me on Linked. I’m Dr. Anne Marie Liebel. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional music from Alexis Rounds.

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Here’s three questions to help you look analytically at some communication patterns in your organization’s meetings. When meetings can value and accommodate diverse voices, that’s a big step toward creating an inclusive environment.

At work, many of us have the responsibility to collaborate and innovate, and we’d like to be more inclusive in these processes. In today’s episode, we’re going to look at communication in one very common workplace structure–meetings–and see how we can make them more inclusive.

Hi everybody, I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, recently ranked #20 of the top 100 podcasts in the Social Sciences by Goodpods. If you want to take your communications to the next level, we’ve got the way. BRIDGES is our continuous improvement process. We evaluate your communication on seven important dimensions, to help you reach more people. For more information, visit healthcommunicationpartners.com or you can message me on LinkedIn.

So yeah, at HCP, I often help clients with patient communication, but I also help clients have better work conversations. We’re talking about interprofessional communication here, and organizational communication. And whether an organization wants to maximize the potential of their workforce, create a safe work environment, strengthen their brand, or bring diverse people together to innovate, communication is integral in these processes. We’ve done plenty of episodes on communication and collaboration, but it’s important in inviting contributions from the people who drive organizations forward.

The ways we come together and communicate can help us reduce barriers, unlock potential, and be smart together in new ways. But it takes effort, right? And that’s what this episode is about.

More organizations are looking for structural- or systems-level approaches these days. And meetings, it was the subject of our most popular episode last year–a reflection to open a meeting. I’ll put that link in there. And also just a couple weeks ago, I was talking to a client who really appreciated a new meeting structure that I’d helped them set up.

I want to get you thinking about communication patterns over time in your organization. Because they have a significant impact on people’s professional growth, on their participation in your organization, on their advancement, and on their relationships–colleagues, mentors, sponsors, partners.

These communication patterns over time can also either spur innovation or stifle innovation. So they are definitely worth looking at.

So let’s step a little bit closer.

Meetings. There’s a lot that could be said and a lot that has been said about them. They’re so common, they’re often kind of a pain. We want to get them over with, but they’re potent organizational and social events. In fact, the godmother of meetings research, Professor Helen Schwartzman, said almost 40 years ago that the meeting is a microcosm for the organization itself, its powers, its structures, its functions.

So talk at meetings is then a powerful element of corporate culture.

Now I want to point out this is systems-level we’re talking about. We’re not talking about one person’s communication style, or one person’s way of holding meetings. We’re looking at patterns over time, and maybe even across groups, in an organization. Usually these kinds of patterns are subtle enough that they can be tough to notice, but hey, that’s why I’m here. So let’s dig in!

Think about meeting agendas. We’ve all seen them. Even the language of a meaning agenda communicates a lot. It says what’s appropriate to talk about, how it should preferably be talked about, and usually who gets to do the talking. I love the description of an agenda from an article in the Lancet where the author says, “An agenda is a statement of power, influence, inclusion,
and exclusion.” That’s a lot: power, influence, inclusion, exclusion. So we want to look at the communication habits around your organization’s meetings to make sure that they’re not unintentionally making it easier for some people to participate than others.

We don’t want this, because it threatens one of the deep benefits to having a diverse workforce, which is employees being able to contribute, right? Leverage their different perspectives, experiences, knowledge bases. Because hiring employees with diverse backgrounds is an essential step, but representation is not enough. People need to contribute, participate, and much participation is done through communication.

So a shift of communication habits can produce meaningful effects.

If meeting organizers can give a fair shot to people who aren’t the loudest voices or the usual suspects, if meetings can value and accommodate diverse communication styles and preferences, that’s a big step toward creating an inclusive meeting. Now having equal participation and engagement is a worthy goal in itself, but organizations want inclusive meetings because we want all those benefits. People have unique perspectives that can help provide a fuller picture, point out dead zones, reduce mistakes, bring new ideas, fuel for innovation, fuel for smart decision-making.

So how do you get this? I’m going to give you three questions to help you look analytically at communication in meetings in your organization. Three questions. Here we go!

1. How do people get the floor?How do they get to talk? Does someone explicitly invite them to speak, by calling their name? Are they named on the agenda? Do people just speak up, raise their hand, use the chat? How do people get the floor?

2. How much talking time do people get, who are not the meeting organizers?This can be a real eye-opener and it’s super easy to do now with virtual meetings. You literally can just time it and see how much time people get. I used to do that with my students, and they couldn’t believe it, oh my gosh. So how much talking time do people get who aren’t the organizer?

3. Who asks questions?This can be another real eye-opener. Literally, the next time you’re in a meeting, when someone asks a question, just jot down who it was. How often are those people not the organizers?

All right, those three questions. How do people get the floor? How much talking time do people get who aren’t the organizer? And who asks questions? For each of those answers, I want you to consider: how might this be keeping some people from participating as much as others do?

Because people want to stay at an organization where their opinion is not only encouraged, but valued. Making things more inclusive and participatory doesn’t have to mean a free-for-all! Even a small shift in the communication habits around your organization’s meetings can invite more people in, and have more inclusive participation.

You want to know how communication during meetings could improve at your organization? Ask your colleagues. This will help show that you take them seriously, and you consider them to be a valuable and productive member of a team.

If you want more help, ask me. BRIDGES is our continuous improvement process. We evaluate your communication on seven research-based dimensions to help you make changes that have immediate impact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional music from Alexis Rounds. I’m Dr. Anne Marie Liebel.

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Whether you’re a patient or a health care worker, learn how to encourage partnership through communication, thanks to Pharmacist Dr. Paul Ranelli. This is one of the many interviews you can find in our archives! Check them out at h-cpartners.com/podcasts.

Partnering with patients. It’s a phrase we’ve all heard before, and it might sound like some feel-good cliche, but it is real. It has real benefits. And it takes real work to do it well. In this episode, Dr. Paul Ranelli shows how he uses specific ways of communicating with patients to encourage this partnership.

Hi everybody, I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication from Health Communication Partners. Since 2017, HCP has been helping organizations like yours reach their engagement, experience, and satisfaction goals with our next-level, inclusive solutions. If you’re in industry, healthcare, or government and want to improve the efficiency and effectiveness of your quality improvement activities, I can help. Visit healthcommunicationpartners.com and click on contact, or you can find me on LinkedIn.

You might know we just celebrated the 7th anniversary of this series, and again I want to thank you. This community continues to grow. Most shows don’t make it this long. Those who do, many of them plateau, and we haven’t. We keep growing, and that’s because of you, and I do not take this for granted. Thank you for finding us. Thank you for listening. Thank you for sharing.

And with seven years of the show to go through, I was thinking some newer listeners might not have heard some of our amazing guest interviews, especially those in the early part of the series. So I’m going to be better about bringing these up so you can hear them if you’re newer to the show, or revisit them if you heard them years ago, to see how they sound to you now.

But I was just thinking about whose interview, which of these great interviews should I share first, when I got an email from Dr. Paul Ranelli. Dr. Ranelli is now Professor Emeritus of Social Pharmacy at University of Minnesota, and he’s been on our show more than once. I’m going to share one of his interviews for three reasons.

One of them was that email. This gives me a chance to share some podcast love with another series, because Paul was telling me he’s recently been on another podcast series. It’s called The Clinic and the Person, and it is a medical humanities series. I’m gonna give the link to the show that Paul was on. It’s just outstanding, and really I’m excited to know about this series, too, and I’m excited to share it with you.

The second reason is the kind of listener feedback I got about Dr. Ranelli. One of our listeners said, “He has compassion in his voice. You can hear it. And he’s so interesting. He’s the real deal,” and I couldn’t agree more.

And my third reason is it’s always good to be reminded of how patients are experts on their own lives. So here’s Dr. Paul Ranelli.

Paul: Thank you and thank you for having me. Glad to be back!

Anne Marie: I'm so glad you're here. You were my first interview and I'm going to go ahead and put the link to that show in for anybody who hasn't heard it. Please do go listen to it. And Dr. Ranelli in that first interview, you spoke about information giving and information-gathering. I wonder if you could give our listeners kind of a quick reminder of what you meant by that?

P: Sure. Glad to. Those are my simpleton or fancy words for what a pharmacist does a lot. With their medications that they're giving to a patient, is giving information about that drug or about that medicine to the person who's going to be using it. So that's the information giving. That seems pretty standard. The information-gathering is something I try to emphasize, and that's getting information from the patient, is gathering information to help you be a better Giver of information. So what information does that patient have about their medication-taking experiences with this drug, with another drug, with this disease state, with this illness? So I try to divide those in my teaching, with the Gathering it, what you got from get from your patient, and then giving what you give about the drug.

AM: Thanks for that, because I think that was the feedback that I got from your interview was so strong and so positive. And the thing that people remarked on the most was this idea that of the information-gathering from the patient. Like people, once you said it, made sense, but people hadn't thought about themselves as valuable sources of information for the pharmacist. I wonder if you can tell us a little bit more about that idea of the patient as a holder of valuable information.

Sure, well they're very valuable to that relationship. I consider them an expert. We may be experts in our clinical and drug knowledge with all the schooling that we get. But that patient is an expert in their life. And an expert in how they take their medicines, or what experiences that they've had. And they have a great deal to offer to us. So I try to use that as a way to, if you think that there may be an information power differential, “well this is the almighty pharmacist with all this drug information and I'm this lowly patient that doesn't know anything.” Well, that's balderdash! They aren't an empty vessel. They have data to give to us or information that they can share. You may think, they may think it's mundane, but it's not. It's their experiences that they are bringing to the medication taking experience. It's the idea of concordance. You want that patient to be a partner. And you are giving them the confidence to be a great partner. That I want to hear from you.

And you're you're anticipating my next question. And that's, I ask all of my guests, what's the problem or the issue in patient communication that you're addressing or that you're facing? And I just heard you name three or four different kind of problems and issues that get raised in patient communication. The idea of being on the same team together. The idea of a patient having enough confidence in their knowledge to take good care of themselves and to see themselves as a partner. The building of the relationship. The trust issue. I mean, the concordance, you brought that up. There so many issues or problems in patient communication that you are addressing in thinking about the patient as a holder of equal information. The power differential! There you go! There's another one! So, how have you been encouraging this approach with your students?

We do a lot of role-playing in class. And I use techniques of sometimes deconstructing. I sometimes use a technique of deconstructing a patient record, where the students only get the drugs that someone's taking, not any background information. So then they have to make a history from the different kinds of pharmaceuticals that the person is taking. And it could go in many different directions, there's not one right answer. That's the point, there is not one right answer. But it's interesting to see how many different histories you can develop backwards, deconstructing just from the drug list.

Wow that's really powerful. I've never heard of something like that before, but it makes sense just I mean from my outsider perspective. Recently you've been working with some more arts-based pedagogy as well. You had a pretty exciting project this past semester. Do you want to tell us about it?

Sure, I'd love to. We had, the last few years of my work as an academic and my teaching in pharmacy school I've been working on how to bring the Arts Theater, Visual Arts, let's say into the classroom, but also as a way of teaching. As a pedagogy. A way of explaining this medication use process with the public, with other health professionals, with students. To have a way to make this richer, these stories that people have about their medication taking experience. To make them richer. So this Spring, I've been working with a course with two theater professors at the University of Minnesota where I work. They're at the Theater Department and I'm in College of Pharmacy. So the three of us got our heads together and had a course called Pharmakon: Performing Science. And so the students who signed up for the class, had to the function of the class was to produce a play at the end about medication taking experiences. And they had to bring their own experiences to the class. And then we had them read some old Greek tragedies. I presented some Pharmacy history to them, discussing how drugs developed, and how important the gods were, way long ago about medicine, then science came in. So they produced, with their own medication experiences, and all the history and sociology of medication taking, they produced a play that was for a class exercise that was put on at the end of the class for a couple hours.

So remarkable so many layers here that that we could talk about: the drama pedagogy. The fact that you're again centering the patient. Asking people to share their own experiences. You and the other professors layering in your knowledge as ways of thinking about those experiences. Getting students to interrogate those experiences. And then sharing that with an audience!

Paul: Right

Anne Marie: Who gets to think about, oh! Wow, what does this have to do with the way I think about medication? And pharmacy?

P: Yep.

AM: And Pharmacists? And that you know you brought in religion and science. There's so much richness here. And I think there's, if there is anything that I can link to for our listeners to have a chance to see some of this. It is okay if I do that?

P: Yes, yes.

AM: Super!

P: That's' great

AM: Because I got to watch it, I got to see it live

P: That's right, yes

AM: So let me let me finish with it with the question that I that I finish all of my interviews: what advice can you give to people, whether pharmacists or patients, considering what we've talked about today, in terms of seeing the patient as an expert.

P: So the patient I'd like to you to be kind of assertive, and say, Yes I want to speak to the pharmacist about my medicine. And also have a question or two in the back of your mind if the pharmacist stumbles a little bit. Is there something I should be asking that I'm not asking? You know that's always a great question to have. Is there something I'm missing? You as the patient helping that conversation along, if the pharmacist is a little bit shy. So from the pharmacist perspective, I would like them to come out from behind the glass and be more assertive, and not even wait for someone to say yes I'd like to talk to you” but say “well what can I help you with about this drug? I would like to hear from you about your experience with it, or what you talked with the physician about with it. So that's kind of the way I approach this from the student's perspective, and that's how I would like pharmacist and patients to plan that visit.

Thank you. Thank you for this, Doctor Paul Ranelli. Thank you for coming back to the show, thank you for sharing this with us today.

Oh you're welcome, my pleasure.

Thank you again to Dr. Paul Ranelli for returning to the show. Be sure to check out the student-produced video on Pharmakon, I’ve got link in the show notes. Support this series and your own learning with our digital educational products. Available right now on HealthCommunicationPartners.com. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. I'm Dr. Anne Marie Liebel, thanks for listening.

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It’s our show’s 7th anniversary! Hear a story about a literacy trailblazer, and learn 3 steps you can take to improve patient relationships.

It’s our series anniversary! Yes, 10 Minutes to Better Patient Communication has been on the air for seven years! Oh my gosh! In today’s episode we’re gonna go back to where it started–with health literacy. And I’m gonna share a story that I think can help you improve your relationship with your patients.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, from Health Communication Partners, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com or message me on LinkedIn.

Thank you for being here. Thanks for celebrating with us. It’s been an enormous privilege to have this show on the air for so long. Thanks for making this possible, because it’s you sharing and downloading that keeps us going. We were one of the first podcast series focused on patient communication, and I’m thrilled to say we’ve become one of people’s go-to sources, heard all around the world. Which as an educator means an enormous amount to me, because this is not easy stuff that you are choosing voluntarily to focus on.

With COVID and the increased focus on health equity and whiplash on DEI, we’ve been through a lot together. We’re way out of one-size-fits-all, easy, quick fix territory. This is deep work here, messy work, and that’s why you’re here. We’re seven years in, hundreds of thousands of downloads, which means many people like you also see that communication is important, and also know reflecting is key.

Reflection is a power move. If you haven’t reached out to say hi, please do! Again, message me on LinkedIn, email me, go to healthcommunicationpartners.com and click on contact. Because I’m proud of what we accomplished in these seven years and I’m excited for what’s to come.

It’s Health Literacy Month. Not coincidentally, this is the month I launched the show, because health literacy is a big part of what drew me into the health sector. So in today’s episode, I want to talk to you about the work of one of my favorite professors, Dr. Brian Street. Brian opened up so many horizons for me, changed so much of what I took for granted, how I understand literacy, how I relate to my students. He didn’t just do this for me. He did it for thousands of people around the world.

Your relationships to your patients are important to you on many levels. You know better patient relationships mean better outcomes for everyone. And patient care is what got you into this in the first place. So in today’s episode, I want to tell you a little bit about what Brian did in the literacy field that made that huge change.

For this story, we’re gonna go all the way back to the 1980s when Brian was doing his research that would transform the literacy field. The literacy field up until that point was dominated by researchers searching for a universal thing called “literacy” that was the same everywhere and for everyone, and if you have it you could use it anywhere, and get the same results, no matter who you were.

Brian Street had a different starting place. He decided to spend time with people from different social and cultural groups around the world, paying attention to the different ways actual people use language in their everyday lives, and what their reading and writing and listening and speaking meant to them. And what Street really found challenged decades of research and opened up new directions for all of us.

One of his findings was that, hmm, there’s not that one universal thing or skill that you could point to and say “that’s literacy.” On top of that, he found evidence that the whole idea that there ever had been one universal thing tended to be put forward by people in positions of power, like university-based researchers or policymakers–who tended to be from one particular social group and were often in a position to impose their values on other groups. When these researchers or policymakers made the definitions of what counts as literacy, for instance, maybe in a global health project, they held the ruler by which other people were measured, and sorted, and labeled. And this had consequences.

Where the attention was not, was where Brian Street was putting it. He wanted to understand what people were already doing with language, their words, the meaning they were already making, what this meant for them, how they already used their literacy to navigate life in sophisticated ways. Run households, run businesses. And Street found a lot of literacy of many different kinds, happening where other researchers found none. It turns out that when someone’s literacy didn’t fit a researcher’s or some test’s narrow definition, that literacy wasn’t counted at all.

That left literacy programs open to abuses of power. Turned out literacy could be used, and sometimes was–is–used as a cover for more political efforts.

If you didn’t have what those in power considered to be enough of, or the right kind of, literacy, you could be labeled illiterate, lacking, with connotations of being backward, poor, unfortunate, even uncivilized, somehow not prepared for the modern world. This, in turn, could be justification for all sorts of actions taken by the powerful, those holding the ruler.

Now, Street and his colleagues were not the first to point out this dark reality. They did connect it to some other powerful insights. Street and his colleagues found that there wasn’t a single universal thing called literacy that other researchers had been promoting. Language and literacy were not specific traits that people had, either, or even a single set of skills they used, as much as sets of social activities. Practices or processes that people engage in, every day, in different contexts, all throughout our lives. And these practices or processes vary by context, instead of being that one identifiable, true, universal thing held by some.

I can’t overstate what a transformation, what a game change this was, and still is, in literacy studies. Now there’s thousands of studies that approach literacy as a social process, including in health literacy. So if you’re looking for these studies, look for the phrase “social practice” or “social process” in addition to “literacy” and it’ll get you there.

However, this one-universal-skill way of thinking about literacy, and health literacy to an extent, is still the dominant way. The idea that you’ve either got it, or you don’t and you’re lacking. It’s still everywhere. You could probably start to imagine how thinking about patients that way and thinking about literacy and health literacy that way could cramp your relationship.

Let me give you an example. I said it’s our seventh anniversary. Way back in the beginning of the series in 2017, I did an episode about a nurse manager who, right before she went in to see a patient, glanced at their chart and saw that the patient had taken a screening that indicated that she was illiterate. And that one word threw her off completely.

I want to stop on that for a second. The result of that screening stunned this nurse manager. There’s the power of that label to throw her off her game. The power of that label to make the patient who is standing in front of her suddenly seem so different.

Too different.

The relationship suffered to the point that the nurse did not know how to approach her. The gap between them suddenly became her focus. Instead of everything else she knew about this patient, everything that made her a great nurse, everything that connected the two of them in that moment.

This is what we’ve inherited. It’s not that nurse’s fault, and that’s why I’m telling you this story. It’s very hard to shake off this dominant narrative. I had to get a doctorate to begin to do it! But I’m going to give you three things you can do to help shift the narrative–in your head, and with your patients.

1. This first one could be handy at any point when you feel like things aren’t going the way you want to, and you kind of want to reset, and catch your breath for a moment. You could acknowledge out loud that the way we speak in medical settings is particular. It is its own language. And it often doesn’t have much in common with the way anybody talks outside of these medical spaces. Remind yourself and your patient that you are doing your best to stay aware of that.
2. A second thing you can do is tune your spidey sense. Watch out for anything that feels too top-down, too exclusively one-sided. Or the conversation is too much one way. And no the irony is not lost on me that I’m saying this to you in a monologue podcast episode, do better than me, right? If it feels too much like there’s only one party here with something important to say, remember: this is a legacy of that way of thinking that’s generations deep. You know you have got important information to share, you know your patient does too, but this top-down view has been in place for a long time, and it’s hard to shake.
3. Thirdly, make sure you’re sharing the floor. One way you can do that when you’re teaching a patient something they need to know, or remember, or decide on, start with talking about what they are already doing to be healthy, including what they’re reading, writing, viewing, and discussing.

If you want more support on this, talk to me about our course, that Equitable Patient Education online course. It shows you mistakes that can be made in six common educational scenarios, so you can identify these obstacles, and disrupt this kind of thinking so you can reduce barriers.

And give yourself some grace. Challenging a dominant narrative, you might run into some interference from other people, even in yourself, because you might be going against the grain. And not being in the patient role, but in the, well, powerful person role, by nature of our jobs, we are challenging a system that we’re a part of. But we can do it. We can do it.

People are doing it. My clients are doing it. You want help? Give me a call. I’m Dr. Anne Marie Liebel, and this has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering, music by Joe Liebel, additional music by Alexis Rounds, and it’s our anniversary!

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In Part 2 of my interview with Jessica Halem, MBA, Jessica shares useful phrases and encouragement for the next time you’re speaking with LGBTQ+ patients.

Jessica Halem has spent the past 25 years working in LGBTQ health. First as the executive director of the Lesbian Community Cancer Project in Chicago, to serving on the Board of GLMA which is the largest association of LGBTQ healthcare professionals, to now 10 years in academic medicine at Harvard Medical School and the University of Pennsylvania, teaching the next generation of healthcare providers how to care for LGBTQ patients. She currently serves on the Board of the Tegan and Sara Foundation where she built the LGBTQ+ Healthcare Directory.

This is Part 2 (Part 1 here) of my interview with Jessica Halem. Jessica fills your cup to overflowing with useful phrases and encouragement for the next time you’re speaking with LGBTQ+ patients. Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com.

In Part 1, Jessica and I talked about medicine’s historical role in creating and perpetuating LGBTQ health disparities, and the important work that’s been underway to address these harms. In Part 2, Jessica shares so many precious jewels of wisdom with us, it’s staggering. One of my favorite parts is how she lets us off the worry-and-guilt hook, and focuses us on what’s really at issue here: patient care. We pick up our conversation as Jessica teaches about opening a conversation with an LGBTQ patient by acknowledging past harms, and offering a new start.

Jessica: And so that’s a piece of what I always want to remind people of is saying, “Hey, I bet you’ve had a bunch of bad experiences before we met today. It might have just been on the way into the facility. It might have been over the years in the health care system, but I want you to know that I see you. I hear you. I’m glad you’re here. How can we start fresh? How can I start over with you? How can I start to heal maybe some of those bad experiences you’ve had? Or how can we just start anew, right? Can we start from the beginning? Tell me what do I need to know?” And those healthcare workers, again, they know the kinds of help that people need. It’s how to get there. So, you know, what do I want people to know is I just want them to know that saying things in a different way, recognize that historic injustice, whether it’s personal or communal or the big picture, hundreds of years of history is a great place to start.

Anne Marie: And that also takes the onus off them if we’re going to talk about a large history.

J: That's right

AM: Like you don’t, you might not know so much about this individual in front of you, but you know something about the history and you can at least motion to the group and motion to, you know, the widespread difficulties that you are aware of

That's right

before you try and dial down. We were talking before the show about how the willingness, you’ve seen the willingness to do the right thing. And you told me this great story about trying to–it’s not as easy as fixing a form or just adding another question.

That’s right. I wish it was. I wish it was!

And you said you’d have this meeting at Harvard Med School with a whole bunch of Senior Vice Presidents and they, you know, “what can we do?” and you’re like “we’ll look at the forms.” “Well, come to our next committee meeting on forms. There are 6 ,000 different intake forms.”

Every health care worker knows this story, that the forms, that the data collection is such a challenge. There’s so much, we’re almost swimming in data, but maybe not the right data, maybe not the right questions, maybe not the right check boxes. And that’s just the beginning. We do want to make sure that LGBTQ identities and behaviors and experiences are reflected in the forms. We do want to take a bit of that onus off of that health care worker. We do want to make sure that people and their real experiences are reflected on the form. So you do need to ask people their sexual orientation on the form. You do need to ask people about the genders of their partners. You do need to find out about their current gender identity and their sex assigned at birth. We can do a lot of this in the forms. But boy, those IT departments, they’ll have you believe that this is the biggest challenge you’ll ever face and I know it can’t be true! But, you know, it doesn’t, it doesn’t replace the good old -fashioned face-to-face conversation that a health care worker and a patient have to have. Tell me about your partner. Tell me about what kind of sex you’re having. Tell me about your gender. Tell me about your gender journey. But it can really start the conversation. And those forms can be an important place to capture the data correctly, but also make sure that we’re having the deep, deep conversations, face to face.

And thanks for teeing up my last question, which is, is there anything that you want to tell people who are having these face-to-face conversations, who do have the values are in the right place and the goals are in the right place and they want to do the right thing? Do you have anything that you want to share with them?

I am so thankful that they are going to try. I think my number one piece of advice is always that you were not taught how to do this well and you’re going to need to find your own path in asking the questions the way that you are comfortable and feel powerful asking. I don’t want any health care provider to feel, what’s that expression, on the back foot, on their heel? I don’t want them to feel like I’ve got to say it in the perfect way. I need the perfect script. “Jessica, just write it down and tell me exactly what to say, how to say it.” I need you to find your way to get to the place that allows that patient to open up to you in a way that is honest and meaningful, and gets them the kind of care that they truly need. So you want to ask a patient, I am here. I am listening. Tell me about your gender. Tell me about your gender identity. Tell me how you identify today. How is that going for you? Do you have any questions for me? Tell me about your sexual orientation, your sexual partners, how is that going for you? How can I help you? How can I help keep you safe, happy and healthy?” right?

Because that's what it comes down to.

Right.

You want to make sure they're getting the right care. And one of the things I'm loving is that you're not getting tied up in terminology or pronouns.

No, oh my gosh! I mean, I wish that, you know–I can’t make a living just telling people that if you ask someone their pronouns, you’d know everything about them. Unfortunately, that’s not true. I think for a lot of, especially young people, it’s an exciting conversation to have. But for most LGBTQ people, pronouns are not the beginning nor the end of the conversation. They’re just one piece of the person. You don’t know someone’s gender identity by asking them their pronouns. You don’t know someone’s sexual orientation by asking them their pronouns. Unfortunately, pronouns are how we speak of each other in the third person. We all have one. We all need one. We sometimes do need to speak of each other in the third person. But I will tell you a really valuable lesson this one's a bonus freebie which is: you could just use somebody's name. And if you don't know their pronouns, you do not need to make a big to-do about asking pronouns, you don't need to figure it all out, you don't need to feel terrible you got it wrong, you don't need to fall apart because you didn't ask! If I'm a patient I don't need to wait for that. I can talk to people like a person and use their name, speak of them in the first person. When I’m in the hallway talking about them, I can talk about them with their name, right? We don’t have to trip over ourselves with the pronouns, everybody. Let’s jump to the real heart of the matter, which is, “I’d much rather you know what my blood pressure is than get my pronouns right! I’d much rather you screen my cholesterol and just help me understand why my cholesterol numbers and my blood pressure numbers really, really matter, right?” And perhaps I am somebody that when everyone gets my pronouns wrong, my blood pressure goes through the roof. Sure, that’s a great conversation. But it's about the blood pressure numbers, the stress, the anxiety of being seen and understood in the world. And that's my hope for everyone listening to this, is to get to the heart of the matter and getting people the kind of care, the real health care needs that they have.

Jessica Halem, thank you for being on the show. Thank you for the wisdom that you're sharing. Thank you for the work you're already doing in the world and continue to do. I'm just delighted that you've spent this time with us today and you've shared these insights with our listeners.

I'm grateful that everyone listening to this is going to try and be part of this challenge we have in ensuring that all LGBTQ+ people can live long, happy, healthy lives.

So many thanks to Jessica Halem for coming by the show and sharing insights, encouragement and improv energy with us. Don’t miss Part 1 and links to what we talked about in the show transcripts for this and every episode at H-CPartners.com.

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I get to talk–and laugh, a lot–with Jessica Halem, MBA. We discuss communication with LGBTQ+ patients, improv, and her fancy article in the New England Journal of Medicine. Her insights are as powerful as her joy.

You are in for a treat. Jessica Halem is a health communication expert who specializes in communicating with LGBTQ+ patients. I had so much fun interviewing her we went over time, and I had to split her interview into 2 episodes! And believe me, you won’t want to miss a word.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. HCP’s online course, Equitable Patient Education, promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com.

When Jessica Halem and I sat down at the mic, the time just flew. In this first half of our chat, she drops so much knowledge you might actually want to take out a notepad. Her insights are as powerful as her joy. She talks about her recent article in the New England Journal of Medicine about how medicine itself has helped create and perpetuate LGBTQ health inequalities. And her message is one of encouragement, appreciation, and possibility. And she teaches us about improv! I’m so excited to share this with you. Here’s Jessica!

Anne Marie: I’m live via Zoom with Jessica Halem. Jessica has spent the past 25 years working in LGBTQ health. First as the executive director of the Lesbian Community Cancer Project in Chicago, to serving on the Board of GLMA which is the largest association of LGBTQ healthcare professionals, to now 10 years in academic medicine at Harvard Medical School and the University of Pennsylvania, teaching the next generation of healthcare providers how to care for LGBTQ patients. She currently serves on the Board of the Tegan and Sara Foundation where she built the LGBTQ+ Healthcare Directory. Jessica, welcome to the show.

Jessica: Oh, my goodness. She sounds fabulous. I can’t wait for her to join us. I love that. I love whoever she is. She sounds terrific.

AM: Jessica, thank you so much for agreeing to be on the show. And this is a real treat for me. We have the Penn connection, but then I also found out in our pre-roll talk that you have a history in improv. So I’m a little bit nervous because, oh, the last thing I can do is improv, the last thing I can do is be funny. So really, I’m just going to learn from you during this podcast.

J: Well, you know, the secret, the secret of improv is that they’re not funny, they’re just present. That’s the secret. I just taught you two years of improv into one nugget, which is: don’t worry about being funny, just stay present, and you’re already perfect.

I love this. I love this. Do you hear that, everybody? Do you hear that? Remember that.

Yeah.

All right, I’m jumping right into the questions that I ask all of our guests.

Great, great.

So what is an issue or problem you are facing related to patient communication or patient education?

Well, the problem I have been trying to address to improve patient communication, patient education, are those moments, those difficult moments, between a provider and a patient. I am trying to tackle the alarming LGBTQ health disparities. I am trying to tackle that through cultural competency training, which it turns out itself needs an overhaul as well. I’ve been doing that for over 25 years, right? I’m sure that’s half of your conversations. If we were doing it perfectly, we wouldn’t be having this terrific podcast, but we’ve got some challenges, right?

Yep

We’ve got training’s not working. The education that’s already out there is not working. Thank goodness that you’re supplementing all of that. But I am trying to, you know, tackle the disparities that we see in my community, the LGBTQ+ community.

And you’ve anticipated where I’m going next with this. You know, how are you facing this, really? Because it is a communication problem. It’s an education problem. Yeah. How are you facing these LGBTQ health disparities in communication?

Well, what I love about your question is that it is a communication problem. It’s not a values problem. It’s not a goal problem. It’s not that people don’t want to do the right thing. I mean, I have been working with health care facilities big and small and providers all over the place for decades now. It’s not that people don’t want to do the right thing. It’s just they don’t know what to say and how to say it. We are not biologically different people. We need the same tests you already know about, the same screenings, the same care. There’s nothing fundamentally different. It’s just eliciting the information that people need, and translating it in a way where your care and concern can really come through, right?

So much! And I love that you’re starting with the fact that people really do want to do the right thing.

They do. They do. Yep. They do. And it’s so important to remind people in the work that you’re doing. I know you hear this every day. The values are there. The people who go into health care are terrific people. They want to do the right thing, but they just don’t have that education or training.

Right. Right. And it’s still kind of edgy, even among those of us who are in communication. Now, you recently were the lead author on an important article in the New England Journal of Medicine.

Fancy. Fancy! My parents are so proud. My parents are so proud. To be a non MD, a non Ph.D. and to, you know, have a first author article, it’s a testament to, as you just said, that this, we are still at the edge of this work. We are still at the edge of this work.

I’d like to tell people a little bit about this article. So this was the New England Journal of Medicine's kind of attempt to locate themselves as also responsible for these health disparities that we’re all witnessing over the course of their long history. As a high-profile Journal, as a well-respected journal, knowing that they have been part of the problem. And can you tell us a little bit about what your article was about?

That’s right. It’s very historic and important that the New England Journal of Medicine is trying to reflect on their own history of what they’re calling this Historic Injustice series. Historic injustices perpetuated on the basis of race, ethnicity. They have wonderful–it’s a whole series of articles that are free. You don’t have to have a subscription to be able to read these. They’re free, not behind the paywall. It’s the New England Journal of Medicine trying to really recognize Medicine’s role in creating the health disparities that we see today. And taking responsibility for healing that damage, that historic injustice. And just like we are learning about racism in medicine, we know that the pathologizing and the stigmatizing of gender differences, of sexuality, sexual minority people, gender minority people, we know that those experiences have been pathologized in the pages of the New England Journal of Medicine. So when we say we’ve got a communication problem, this isn’t just a verbal, I walk into the exam room, and you say the wrong thing, and it’s like a womp-womp. This is the written words that you studied as a Doctor. And we know this is true in other healthcare professions, too, actually taught you this categorization and this classification of differences, and what’s normal and abnormal, and healthy and unhealthy, and risk and not risk. So we know that it’s in the written word and the and the verbal communication as well.

Yes absolutely! Thank you for that. And that’s also why I’m just so excited to have you on the show today. And this next question is such a big question, so you can really take it any way you would like to. What are you learning from your work with health care professionals, your work with community health workers, your work with writing articles like this in the New England Journal of Medicine? What do you want to tell us, some of what you’re learning?

Yeah. Well, you know, I started off by saying just how good people are and what great work is happening. And I, when someone like me comes in to do a training or an education, I think the first thing that I observe from all of these amazing healthcare professionals on the front lines, in the back offices, at the front desk, in the exam rooms, is that they are doing really, really good work. And they’re really frustrated by how it feels like a drop in the bucket, right? They feel like they’re a part of this sort of tsunami waves of bad experiences that patients have had.

Thank you again to Jessica Halem. Tune in next time for Part 2 when Jessica rapid-fires the most useful, wonderful phrases you could use, or that could be inspiration to get you thinking and open things up for the next time you’re speaking with an LGBTQ patient. You will want to take notes and you won’t want to miss it. And there’s links to what we talked about today in the transcripts at h-cpartners.com.

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Fall fashion is the best fashion. But there’s another seasonal trend none of us wants to participate in. COVID was in the news again, as the fall transmission season started earlier than anticipated. Here’s some tips and encouragement for you when talking with people about getting vaxxed or boosted, again.

The fall COVID season arrived early! Here’s some tips and encouragement for you when talking to your patients about keeping themselves safe, including being vaxxed or boosted.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com.

Yes, COVID was in the news again recently. Apparently, the fall transmission season started earlier than anticipated. That’s according to Harvard T.H. Chan School of Public Health website. “Case numbers are currently high, but hospitalizations and deaths have not reached the levels of previous surges.” Many experts are now saying about COVID that it has moved from a pandemic to an endemic phase, which generally means “a constant presence rather than a disruptive outbreak,” accorrding to William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health. And i’ll link to that article in the episode notes.

Another expert, Aron Hall, the deputy director for science at the CDC’s Coronavirus and Other Respiratory Viruses Division, told NPR in an interview, “At this point, COVID-19 can be described as endemic throughout the world.” NPR added that “The classification doesn’t change any official recommendations or guidelines for how people should respond to the virus. But the categorization does acknowledge that the SARS-CoV2 virus that causes COVID will continue to circulate and cause illness indefinitely.”

COVID is still killing hundreds of people every week in the US. NPR cites a new report from CDC that COVID is projected to kill close to 50,000 people here in the US every year. This year, and next year, and the year after, according to the new report from CDC. Just here in the US! 50,000 people is not a small number. It paints a bleak and ghastly future image, but I hold with a lot of people who say it doesn’t have to be this way! There are things we can do, and you know it because you are doing them, and you’re helping other people do them, too.

I’m going to give some encouragement for when you need to talk to people about keeping themselves safe. Because this new data underscoring the importance of people getting vaccinated and boosted taking what steps they can to reduce their risk, as NPR puts it, “for the foreseeable future.” So as you’re talking with patients about these steps, let me share some encouragement from an episode about reflecting on your vaccine communication we ran when the COVID vaccines became widely available.

All right so let's go. Number 1. What kind of person are you trying to be or sound like? If you're writing, what kind of a voice are you giving your organization? How's your language reflecting this? Communication is about more than imparting information. Said it before, gonna say it again. One of the things that's also going on is you're hoping to show yourself as a certain kind of person or organization. You can't help but speak from your own position. And when it comes to vaccinations, your position is probably: do it!

You're also speaking from the blend of the personal and professional cultures that you're part of. You're speaking from your organization's history. Speaking from the history of health care and public health. And when it comes to vaccines, these collective histories are complicated.

Nonetheless, we can all fall into the trap of thinking that our ways of seeing things are normal or common sense. So, when speaking or writing about vaccines, remember where you stand, how you're seeing, how you got there. If you'd like a bit of practice, listen closely to the next person you hear speaking. What kind of person do they reveal themselves to be through their language?

All right, number 2. Might've heard this one coming: what kind of person do you think your patient is? Or if you're writing, what kind of people do you think you're writing to? What do you tend to think of people in that social group? How does your language reflect this? Now conversations about vaccines can present challenges because of the tendency to focus on social groups who are either expressing interest in not being vaccinated, or they're expressing skepticism, or they're expressing their intention to remain unvaccinated.

Now when you've got the majority of health professionals who are on #teamvaccinate, there is a kind of built-in battle! Think about how many well-meaning posts that you've seen, or presentations, or talks about vaccines, and how many of them are framed kind of antagonistically.

Conflict isn't great for any relationship, and it can bog down communication. An Us-Versus-Them attitude can also have the effect of short-circuiting any attempts you would have made to try to find out people's reasons for thinking what they think. So take a close look at your language. Keep an eye on how your word choice or framing even conversational dynamics might unintentionally be reflecting biases or stereotypes. Including those about social groups such as anti-vaxxers, or people who are reluctant to be vaccinated.

Here's a trick that can help you become sensitized to framing and word choice in language. The next time you hear someone speaking in the media, or you read a statement from an organization, or even see an ad: ask yourself who they think you are. How can you tell through the ways they use language and images?

All right number 3. What do you tend to assume normal people do in terms of keeping healthy? What do you consider normal knowledge, beliefs, assumptions about vaccines and vaccination? I ask this because when we're not hearing from a person or a group what we think is normal or basic or fundamental, that perceived gap between what we expected to hear and what we're hearing can become our focus. That is, sometimes we can focus on a person or group's perceived weaknesses, based on what we think is or should be normal.

This risks getting close to a deficit perspective. You've heard me talk about deficit perspectives before. They can hurt the relationship. They can also hurt your chances of being helpful. Communication about vaccines can surface differences in people's knowledge, beliefs, and assumptions real quick! And once you get to thinking that you're not on the same sheet of music as the person you're talking to, or writing to, all sorts of kind of mental and emotional barriers can emerge.

This is because it can be easy to regard the ways that other people understand vaccines, or act upon health information, as problematic especially when it's not what you think is or should be normal. Your assumptions about what's normal inform the style and the content of your communication. Often unconsciously! So be ready to look closely at what your assumptions are, cuz they're turning up in your words.

Okay finally number 4. If your audience's attitude toward vaccines and vaccinations differs from yours, how–or under what circumstances–might their attitude make sense? This one is perhaps the most difficult to do, and I'll argue it's the most important, if you really want to educate and not just lecture, or lose your chance. Let's dig in!

Health professionals like yourself have some of the best informed stances on vaccines and vaccinations on the planet. They're built on decades of research and some of the latest science! They're supported by your study. They're enriched by your years of experience and your participation in professional communities.

The rest of us non-specialists are also walking around with ideas about vaccines or vaccinations. These ideas may or may not have scientific merit, but just like yours, they are based on our experiences, our knowledge, and our communities. Differences in ideas can feel like barriers to communication.

But as the holder of the expert information, it's part of your job to make the connection between where your audience is at, and where you're at. In order to do this, you need to know where you're at hence question number one but you also need to take seriously what that person or group thinks about the topic at hand: vaccines.

Even for just a moment, try to find a part of their understanding that makes sense to you. The faster you can see the sense behind what your audience is thinking, the faster you can get on with communication that's going to connect to them. So keep in mind that whatever your audience says is related to assumptions or beliefs that they hold. And that these assumptions or beliefs make sense to them.

Now, I focused in this short episode on interpersonal conversations, a bit of mass communication, but there are systemic factors at play too, and serious work to be done here. If you'd like help put this in your organization, contact me. Visit HealthCommunicationPartners.com, click on contact. Find me on Twitter. Find me on LinkedIn. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel.

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Tips on what not to say when you’re thinking about trust.

Trust in health care and public health captured a lot of attention during the pandemic, and it’s still going strong. When it comes to communication and patient education, there are things we can do related to trust, and I’m going to share a few of them with you in this episode.

Hi everybody, I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, ranked #20 of Top 100 Podcasts in Social Sciences by Goodpods. Our online course, Equitable Patient Education, promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say, There's a lot of eye-opening information I hadn't considered before. For more information, visit healthcommunicationpartners.com.

Now, you know there’s a trust problem in health care. Deloitte reports that 55 % of the people they spoke to had a negative experience where they lost trust in a health care provider and 36% skipped or avoided care because they didn’t like the way that the health care provider or staff treated them.

So lots of people are working very hard on these issues and you might be one of those people. I hope to add to this conversation from the perspective of communication and patient education because there are things we can do.

The focus on trust that came up during COVID asked the explicit question was often, why don’t they trust us? And the answers came back loud and clear! historical discrimination, current discrimination. and a lot of people paid attention and heard these well-justified reasons.

The focus was on the public for quite a while, though, specifically people who did not trust doctors or vaccines or the health care system or public health messaging. And the focus kind of stayed on their feelings of mistrust. Interventions were focused on patients. And it didn’t take long for practitioners to kind of flag this and go, wait, hang on, this is not okay to just say, like, if we could fix their feelings, the problem would go away.

Looking outward is important. Looking at patients is essential, but it’s only part of the picture. And these same practitioners were insisting, we can’t locate the problem just in other people. Externally, outside the health professions. We have to ask the question that someone asked in a meeting I was at, that is the title of this episode: “what are we doing to be trustworthy?”

This locates the problem inside. It flips the question. It’s a hard question to ask. focusing on our role, locating the problem and solution partly in us and in systems we’re a part of. One of the benefits of not locating the problem entirely out there is when we look for obstacles and opportunities internally, we can do something about it!

And lots of people are. In 2022, there was a review of research on trust research that was in health affairs. And the authors said “the issue of trust has gained increasing attention in the past couple of years. We speculate that this is largely motivated by the COVID -19 pandemic, renewed emphasis on racial justice, and the increased proliferation of mis- and disinformation.”

And that study found a “growth in projects that aimed to address trust through specific interventions, striving for impact, instead of only documenting the problem.”

Another review of research published earlier this summer said, “The COVID -19 pandemic reignited a commitment from the health policy and health services research communities to rebuilding trust in health care and created a renewed appetite for measures of trust for system monitoring and evaluation.”

So that focus is inward. That indication is we’re looking inward. And I want to add something to this conversation. As you know, the show focuses on language use in communication and when we’re educating. It gives you ways to think about common things that you do, common arrangements, conversations, interactions with an equity lens. because there is so much we can do with our words. We actually have control over them. We famously don’t have control over other people, but we do have control over our words.

So I want to start with a kind of what not to say when you’re thinking about trust. Something to watch out for in our language that could get in our way, send a message we don’t want to send or don’t mean to send. Because we want our words to meet our standards.We want our words to reflect our values. And one of the biggest requests I continuously have gotten as a consultant over the years is a version of this: “I don’t want to unintentionally offend people. Help me out with this.” You’re listening to this show. So you already got a leg up on this. There is something that you can do.

I’m going to give a real quick mini lesson about the nature of language. Language is a social phenomenon. The words and the phrases that we grab for are influenced by the words and phrases used by people around us. Words, phrases, and also bigger pieces of language like ways of talking about a topic, or ways of talking about people. or ways of not talking about topics like taboos, stigmas, the elephant in the room. We pick these up from other people. And sometimes we don’t even notice it.

What we hear and say and learn and pick up in our communities informs our thinking as we read, write, talk, and listen. This goes for our professional communities as well. The process of earning a professional degree or a certification is a significant socialization process. That’s where we learn to talk, think, read, and write in ways that are specific to a discipline.

So let’s connect this to trust.

None of us set out to say things to erode trust. However, you are probably already aware that patients and clients can be framed or positioned in negative ways by research, by policies, by theories, or by everyday taken for granted arrangements at an organization or an institution. So these ways of talking and thinking can make it into our language, and sometimes we don’t notice it.

So what is this thing you want to watch out for in your language?

I want to talk about deficit perspectives. what they are and why they matter.

You may have heard me talk about deficit perspectives before. They can relate to maintaining a focus on what a patient doesn’t understand or doesn’t do. An emphasis on an individual’s negative attitudes. What a patient’s situation lacks, what it seems their community can’t provide. It can also refer to a focus that’s limited to negative results, negative effects, negative examples, negative depictions, negative instances. The deficit. We’re looking at people and we’re attaching a deficit to them primarily.

Now, we might all say, I don’t think that way about people. We want to make sure our language meets our own standards. We want to make sure that deficit perspectives are not creeping into our language, that we’re not by chance picking up deficit words or phrases or ways of thinking because they’re in the air around us.

Because they are in the air around us. In spoken and written form, in research, theory, practice, and policy. I’ll link to a previous episode I did about this. And if you’ve been working on shared decision-making, or if you’ve been keeping your eye on paternalism and communication, you might also have run into some of this deficit perspective research. One study about how dentists perceive poverty and people who are on social assistance found that dentists emphasized individuals’ negative attitudes toward work and their lack of capabilities. And the research results suggest that this perspective, this deficit perspective, impeded the care relationship between dentists and their poor patients.

We want to have good relationships. We want to meet people where they are. So we’ve got to watch out for inherited language that gets in the way of those goals.

So how can you spot a deficit perspective in talk or writing? I’ll give you two ways. And you have to listen or look closely.

First of all, reconsider anything that implies that other people and their actions are really the problem. That they’re really what’s at issue here. And the focus is making them do something. The responsibility is on them. If only they would do this thing or if only they would be this way, the problem would be solved.

For an example, you can go back to the beginning of this episode and the early days of trust research and some of it still has a deficit perspective kind of scratching around the edges when it implies that really the problem is in the public, and the intervention should be on the public, instead of also looking internally. So that’s one thing you want to look out for.

Another thing is any talk or words that indicate or imply that other people have erroneous thinking or misguided thinking that must be remedied by experts. So the thinking is wrong. And if we could just replace their thinking with correct thinking, the problem would go away. We know that’s not the case, too.

So what are you looking for instead? Instead, you want to pay attention to and seek out language that takes people seriously. That takes their thinking seriously. That attempts to see where they are coming from, and how their responses make sense. Like we would want people to do for us.

If you want more support on this, our online course Equitable Patient Education shows you deficit perspectives in six common educational scenarios. You learn how to identify them, how to disrupt this kind of thinking, and then reduce barriers to access in your patient education.

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel, additional music by Alexis Rounds. I’m Dr. Anne Marie Liebel. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners, LLC. Find us at healthcommunicationpartners .com.

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Organizations are considering how they can sustain equity work over the long term.

I’m excited about today’s episode because it’s the 7th Anniversary of Health Communication Partners. And I get to talk to you about a trend I’ve seen and been a part of with organizations pursuing equity and health equity goals. I wonder if you’ve seen it too. It’s around concerns about this being sustainable. As in, How do we keep this going? How do we make it last?

Hi, everybody. I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, recently ranked number 20 in the top 100 podcasts and the social sciences by Goodpods.

So, yeah! It’s been seven years for Health Communication Partners, my Woman-Owned Small Business. It’s been a huge pleasure and a privilege after a 20 plus year career in academia and education to start my own business and help you reach your goals. What we’re doing together is unique. It’s not a typical approach or what you’re typically going to hear. So thank you for trusting me and HCP.

Thank you too to my awesome clients. Maybe you’ve taken my courses or we’ve partnered on consulting or research services, sometimes all three. So thank you for letting me work alongside you and get to know you, get to know your work.

And thanks for listening to the show. You know, you’re going to hear things that you won’t hear other places. That’s why you’re here. It’s not the same as what you’ll typically get.

And I love to hear from you. If you’ve never been in touch, now’s the time. It’s our anniversary. Let me know you’re here. Find me on linked or go to h -cpartners .com or if you get my newsletter, hit reply, comes right to me. Hearing from you and your stories is a big part of my work. It’s part of what helps this all stay grounded in the realities of day -to -day work.

So let me hear about what you’re doing. And speaking of what you’re doing. I want you to think about the equity work you’re in the middle of now.

Take a moment and consider this: How would you like things to look in five years? What would you want to see happening or maybe not happening? While you’re thinking on that, I’ll go back in time a little. Over the past few years, I’ve podcasted about trends that I’ve seen in equity work from my vantage point as a consultant who works with organizations who are doing equity -oriented work or are pursuing goals and including equity concerns in them.

And the years since 2020 have been unique and incredibly busy on the equity front. I remember in 2020 being on a Zoom call with Dr. Camara Jones. Dr. Camara Jones is a family physician and longtime leader in equity in health care and public health. And in this call, Dr. Jones was addressing the explosion of interest in issues of equity and health equity, which had just started to happen, largely in response to the pandemic and the murders of George Floyd, Ahmaud Arbery, and Breonna Taylor. And she put it like this, Some of you are a little late to the party, but welcome.

And I loved that metaphor and it stayed with me. So no matter how long you’ve been at the party, inequalities and their root causes have become almost common knowledge. One of my clients said health equity became “buzzy.” All of you, I’m sure, can speak to the why and the who and the what of inequalities and their root causes and what you have been doing to address them. Many organizations get that equity is not a short -term project, not something you fix and are done with, but is embedded in how you do business as usual.

Organizations have elements in place, and there are things they know to do, and they’ve been doing them, bringing people to the table who traditionally have not had a seat. There’s a lot of collaboration. You’ve got data. You’ve got stories to tell. Yes, some organizations are dealing with blowback of different kinds, but lessons are being learned.

The conversation is evolving. And this is meaningful to witness and be a part of. Because no matter how long organizations have been addressing equity, I’m seeing a new wave of questions and insights and possibilities. This overall vision is of a sophisticated, active organization who’s embedding equity in core processes and asking the question, how do we keep this going? How do we make this last?

I see this is a different question than a primary one that people were asking a couple years ago, which was, what do we do now?

The question, how do we keep this going? How do we make this last? I see this as a shift that involves keeping our eye on the long game. And focusing on our long term takes a different skill set and a different mindset that deserves support.

Over the years, I’ve been incredibly fortunate to work with the best, be deep in the thick of it with organizations in health care and government and academia and industry. And though some of this can feel like uncharted territory, there is quite a lot that is known about walking this path of equity. Like Dr. Camara Jones said, there’s been a party going on. We’re really glad you’re here. So there is much that’s known about the twists and terms of doing this kind of work, what you’re likely to face, what it takes to do this work long term.

And there is a framework I use to guide me and my clients and bring this research and knowledge to them. And this framework is called BRIDGES.

It’s been a while since I’ve talked about BRIDGES. If you get our newsletter, you know it’s called BRIDGES. Well, this is why. BRIDGES is continuous improvement. Like Agile, but for equity. And I want to talk about it now because it helps with this shift I’m seeing to include long-term thinking and equity strategy.

Because long -term work and short -term work are different. If we want to promote equity in sustainable ways in our organizations, we need to be good at both of them. Thinking and working long-term and short-term together, that is tricky. We’re all human. We tend to focus on what’s in front of us, right? Putting out fires, the immediate needs. And it’s important to have short -term victories and short -term work and deal with the immediate pressing needs.

But long -game thinking is different. It involves stepping away from that press for quick answers, that press for certainty. It can involve being more comfortable with waiting, being more comfortable with being uncomfortable. And this takes different skill sets than time -bounded projects.

If an organization wants to keep reaping the benefits, it’s got to keep doing the work. But it is doable, right? It’s not a mystery. There is a research base and proven approaches that really work.

Now, I said BRIDGES is continuous improvement. You know continuous improvement by now. You’ve got a problem or a question. We gather data. We act based on the data. And then we evaluate to see what happened. How do we do? We use our findings to inform our next steps. We act and we reflect. We act and we reflect. This approach to reflection and action that I have that I use with my clients and that you hear in the show is from the research at the University of Pennsylvania.

And it’s especially well suited to when there’s a lot of unknowns, when problems aren’t clear, but they’re messy and indeterminate and ill-defined.

And also in situations where you’ve got to act smarter than just trial and error. Many of my clients are in contexts where throwing spaghetti at the wall to see what sticks is just not an option. They have to be much more informed and intentional and strategic and tactical.

And it also helps with innovation. I’m hearing more edgy, exciting, potentially transformative questions being asked. I think now, perhaps with the experience to reflect on and some successes and the larger priority that equity still holds for a lot of us, folks see there’s new vistas opening up too. Imagine where this could go. Look what we could do with this. Now, how do we help ourselves get there?

These are next level questions, and they demand next level work. If this sounds like you, BRIDGES can help. Because we’ve always known this was a long game. We have our short game and our long game. Everything on the show and the site at Health Communication Partners.com is grounded in the BRIDGES framework.

Yes, we need quick wins. Yes, we need short-term gains. Yes. But these need to be connected to a long-term strategy that’s cohesive, that’s grounded in your organization’s unique culture as well as in your data. And that’s what BRIDGES supports.

I first articulated BRIDGES back pre -COVID times in 2019 when I was doing a series of talks at Columbia University with the Region 2 Public Health Training Center. And it’s evolved since then, in part because the conversation is evolving. And part of this evolution is organizations seeing for themselves how much there is the gain and how much can be done.

And that it becomes a mindset, a way of working. That’s what BRIDGES is. You’ve got the mindset and the skill set from this research base at University of Pennsylvania. And it’s been my great privilege to carry it across sectors and work with organizations, from mom and pop startups to Fortune 100.

My clients are always looking for new ways to embed equitable, inclusive practices in their core processes,
whether it’s patient outcomes, community engagement, employee retention.

Across my clients, leaders are also all seeking to support their teams who are doing difficult work. They want to keep the momentum going, strike the right tone, the right cadence, maybe even draw more people in.

And these are highly experienced teams we’re talking about, people with deep involvement in issues that are coming together. There’s a lot of power there, and BRIDGES helps channel that power.

Everyone wants to derive the well -documented benefits of equity work–better outcomes, satisfaction, engagement, experience. And if we don’t want equity to be a checkbox, we have to think and work long -term, as well as short -term. The good news is there are well-established, research-based ways of working. And as I said, it’s been incredibly meaningful and exciting to take these concepts and this research and this knowledge base and see how it helps my clients. See it really working.

Clients find new ways of being smart together, new ways to extend and enrich their work, new ways of tapping in to the expertise and experience of their teams, new ways to collaborate, new tools to reach their goals.

These are important goals and worthy goals that you’re working on. We can do this. My clients are doing it. You can do it, too. To learn more about BRIDGES, visit healthcommunicationpartners .com or find me on linked. I’m Dr. Anne Marie Liebel, and this has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Lebel, additional music from Alexis Rounds. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners LLC. Find us at health communication partners .com.

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It’s our long-overdue episode devoted to listening. I read from Professor Katherine Schultz’s book on listening, and we do a quick exercise to help you think about improving your listening.

Maybe you are working on trying to reduce avoidable health inequalities. Or maybe you want to try to promote a more welcoming work environment. Or you’re just here to improve your communication or your patient education as a whole. In this episode, I’ll share something that can help with these problems and more. Yes, today it’s all about listening!

Hi, everybody. I’m Dr. Anne -Marie Lebel, and this is 10 Minutes to Better Patient Communication, recently ranked number 20 of the top 100 podcasts and the social sciences by Goodpods. If you want to take your communication to the next level, we’ve got the way. BRIDGES is our continuous improvement process. We evaluate your communication on seven important dimensions to help you reach more people. For more information, visit healthcommunicationpartners.com or message me on linked.

And yeah, you are listening to me. you’re listening to this show right now.and i want to listen to you. so if it’s been a little while, get in touch! messawe me on linked. ask me a question, send me a message. you can also email me at annemarie at h-cpartners dot com. If you like what you hear please leave a review on your listening platform of choice! if you’re on ituens go to the show page, scroll to the bottom. If you’re using this show in a course, I’d love to know how it’s going and what students are doing, how they are taking it up.

Now I am embarrassed to say it’s taken me this long to do an episode just on listening. We’re ready to celebrate our seventh anniversary soon. I’ve got 180 some odd episodes. And yeah, I talk about listening a little bit, but I’ve not dedicated a whole episode to it. And this is especially bad because I learned from the best about listening. I had on my dissertation committee, Professor Katherine Schultz, and she literally wrote a book on listening. So I’m going to read from some of Dr. Schultz’s book today, share some passages to inspire you and give you some new ways maybe to think about your listening.

And being curious about your communication is definitely a needed ingredient, but you’re listening to this show, so you’ve already got that.

At its most basic, we’re talking about how people address one another and talk to one another in the same space, the kind of expectations we have for how people are going to interact with one another. And what I really appreciate about Dr. Schultz’s work is it’s not just practical, it’s consequential. It has an impact. When you work on your listening, you actually can change things for the better. It can change the quality of the work that we do in our own sphere. And I want you to be able to get more out of each interaction that you have. and also help promote health equity and reduce avoidable disparities. Those things are important, right?

This is also going to be helpful for communication in the workplace. Because it’s it’s a way of looking at listening with a new lens. Some tools from a perspective you don’t always get to hear. So now Professor Schultz, like I am, is coming from the education world, and specifically the language and literacy space. And people who study language and literacy the way I do, it’s more than just how individuals are talking that we’re concerned with, although obviously that’s part of it. We’re also obviously looking at listening, and then the larger language patterns around us that we’re participating in. Because these shape how we listen, and how we talk, and how we respond. So we’ll look at how individuals interact with other individuals, but also interact with larger groups, and larger contexts.

So I can’t capture, and I wouldn’t try to capture, the deep work that Kathy Schultz’s book does. It’s called Listening: A framework for teaching across differences. but i’m going to read you a little bit from it, and give you some of its flavor. So you can get to know yourself a little better as a listener. Maybe learn something about some of your default listening modes. Here’s some passages from the opening pages:

“Locating listening at the center of teaching works against the notion that teachers talk and students listen, suggesting instead that teachers listen to teach and students talk to learn… Essential to this theory of listening is the proposition that listening necessitates action. That is, the act of listening is based on interaction rather than simply reception… Listening closely to students implies becoming deeply engaged in understanding what a person has to say through words, gesture, and action. Listening is fundamentally about being in relationship to another, and through this relationship, supporting change or transformation. By listening to others, the listener is called on to respond. The notion of listening to teach focuses on what to listen for, as well as how to listen. It emphasizes both the active listening and the actions that result from paying close attention to another.”

Now, this is from the start to Kathy’s framework, and the first part of it is “listening to individuals.” So I want to use that as a kind of jumping off point to do a little exercise. Not hypothetical.

I want you to actually think about your work schedule over the next coming days. When is your next meeting or appointment? When’s your next kind of scheduled interaction with another person? Who is it with?

Take a minute and find it, think about it, because I want to ask a couple of questions about this. What do you expect to hear from this person in this scenario?

I want you to catch that you do have expectations, and then see if you can identify any of them. This is because Dr. Schultz reminds us to be aware of how much pressure there is to make the individual fit into the whole. fit into some predetermined larger script that we are all walking around with in our heads, right? so i want you to catch that you have expectations for this upcomin meeting or interaction. and then i want you to think about:

What do you think shaped those expectations? where did those expectations come from? maybe they’re historical. Maybe they’re from your profession. Maybe there’s another place that shaped the norms around what you should be listening for. Because these kind of norms can unintentionally imply that the rest of what that person has said isn’t as important as what you are usually listening for.

Given these expectations, your focus on whatever you’re listening for, what falls outside it might be hard for you to notice or hear. And you may wind up unintentionally tuning out and effectively excluding information that could be helpful or significant. Now, what shapes these larger expectations we have for what we’re going to hear from a certain person in a certain scenario, are part of larger social patterns. like notions of who is believable or who is trustworthy or who is healthy, who is competent. And all of these, of course, are culturally driven. These norms we can be unaware of that nonetheless shape the way we regard oters and how we interpret their words.

So what Schultz invites us to do is to catch this pressure, acknowledge that we have these kinds of expectations that we’re going to fit an individual into a larger group, and instead: flip it. Flip that script. Instead of trying to make the individual fit into the larger group, be ready to change our individual response based on the particularities of what we hear from an individual.

So what I’m suggesting, and what I think Schultz is suggesting, is this: Pay a little extra attention to how you pay attention.

The key issue to address is how our experience and larger forces shape our listening. We can get into routines or default settings and miss a lot! Opportunities for improvement can be right in front of you. For instance, information about how to reach people, what matters to them, what is important to them–they’re giving it to you in various ways through their communication with you. So listen closely and be ready to change or shape your response based on this precious information.

This approach also helps promote equity by individualizing individual people. Besides the fact that listening itself is a profound show of respect.

Communication is one of the most modifiable actions we do during the day, and it’s also one of the most impactful when we change it. It’s also kind of cheap, right? It’s free! if you just think about it, you can change your talking, right?

But communication is still hard. It’s human interaction. Some of the most complex phenomena there is in this world. and you care deeply and are working hard at it. I want to support your curiosity about your communication, support your innovation, and support making yourself more effective and efficient and locally-relevant ways. If you want more help in this process, give me a call. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. audio hearing and music by Joe Liebel. Additional music by Alexis Rounds. Thanks for listening to 10 minutes to better patient communication. From Health Communication Partners LLC, find us at healthcommunicationpartners .com.

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Medical Librarian Amanpreet Kaur talks about having imposter syndrome, what it feels like to be “in a rabbit hole of learning,” and how she’s leaning into her impostor syndrome as a health professional.

How many letters do I need behind my name? That rhetorical question was put out to me from Medical Librarian Amanpreet Kaur. In today’s episode, Aman talks about an issue that I’m sure many of us struggle with: imposter syndrome. Aman talks about what imposter syndrome has to do with her communication, and how she navigates being both an expert and learner together.
Hi everybody, I’m Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication, recently ranked #20 of the top 100 podcasts in the social sciences by GoodPods. If you want to take your communication to the next level, we’ve got the way. BRIDGES is our continuous improvement process. We evaluate your communication on seven important dimensions to help you reach more people. For more information, visit healthcommunicationpartners.com or you can message me on LinkedIn.

Medical librarians are in such an important position in the whole patient communication and patient education ecosystem. And they are champions of health literacy. What I especially appreciate about Amman’s choice of topic is that it’s reflective. She reminds us how much we are each a part of our work, our communication work, our education work. We bring it all with us: our position, identities, histories, worldviews, assumptions, fears. And this show and all of my work with Health Communication Partners tries to make space and support such reflective practice. So I was very happy to have Aman sit down with me and talk with me. So let’s turn to that interview.

I’m live via Zoom with Amanpreet Kaur. Amanpreet is a Health Literacy librarian and a Master of Public Health student at University of Pennsylvania. Aman works at the Leon Levy Dental Medicine Library, which serves the information needs of the School of Dental Medicine. In collaboration with the School of Dental Medicine’s Community Oral Health Division, Aman coordinates the Health Literacy Study Club, which is a virtual dental student -led discussion series for anyone interested in health literacy and patient education focused on oral health and dental medicine. Aman, welcome to the show.

Thank you.

Now you and I have known each other for a few years through the health literacy community. So I’m glad to have you on the show for how much we do talk about health literacy here. So let me ask you the question that I ask all of our guests to start us off: What is the problem or issue that you’re facing in patient education or communication?

That is a great question. My, um, I guess issue is imposter syndrome. I don’t know how many letters I need behind my name, what kind of credentials, what makes me an expert in this field. And it’s one of those things where I feel like I don’t know enough.

Well, thank you for that. That’s a really brave response. A lot of times when we talk about health literacy and problems in patient education or patient communication, we’re looking out. We’re looking at society, or we’re looking at something that patients or communities might be struggling with. But we don’t often enough, I don’t think, look at ourselves as having so much to do with the interaction that is health literacy, that supports health literacy. So do you think your own feelings about imposter syndrome are a problem or an issue for your patient communication?

So luckily I don’t interact directly with patients, but I am surrounded by like highly credentialed health care workers. People who are seasoned professionals, who have way more experienced than I do. And it’s one of those things where I think being active in the health literacy space, it’s luckily it’s introduced me to a wide variety of people. And I’m becoming more and more comfortable with you know, like what my perspective is, what I bring to the table. But it is very intimidating to be in these spaces. I just got my health literacy specialist certificate from the Institute for Healthcare Advancement. Couple of years ago, I renewed my Consumer Health Information Specialization Level 2 through the Medical Library Association. So there’s a lot of letters, lots of CEs, continuing education programs. And things that I’ve been learning, through the public health classes that I’ve been taking in grad school, like I’ve been learning a lot as well. And I feel like sometimes I’m just in a rabbit hole of learning. And it can be overwhelming in that way. How in-depth do my skills need to be, or my knowledge base needs to be, for the health literacy world.

Because you’re helping people who are interacting with patients. So you’re talking to providers, right?

Yes.

So when you’re doing that, how are you facing this problem of wrestling with your feelings of impostor syndrome?

So I’ve noticed at least like in my experiences, people who work in healthcare are very patient and understanding themselves. So it’s, I was recently reminded in one of the health study club and discussions, you know, when I mentioned like, “Oh, I’m not a oral health expert, but I am a patient, blah, blah, blah,” you know, in my commentary. And a faculty member spoke up and they’re like, “Oh, that’s actually a really cool perspective to have.”

Right?

And so I do get those kinds of reminders as well. Sometimes providers want a patient perspective or someone who’s closer to the typical patient experience as well. Those kinds of experiences are helpful, perspectives are helpful. It’s nice to be able to pull from those personal experiences as well.

So what are you learning from facing your imposter syndrome, or dealing with your imposter syndrome while you are supporting providers to help promote health literacy in the communities that they work with?

Yeah, I’m learning to embrace my imposter syndrome. I’m reframing it as a way that it keeps me grounded. And I’ve also learned that other people face imposter syndrome as well. And in a wide variety of of contexts too. So it’s, I’m not alone in these experiences.

No, you’re not.

But sometimes it feels like that, you know, when you first start to like question your credentials or your experiences. And, that more of us should be having this conversation and reflecting on why it happens.

Agreed. Agreed. 100%. I’ve been thinking about the ways that health literacy is an interdisciplinary field and it’s kind of a young field. And there are still, even in this young field, kind of images of what a professional looks like, and what a professional does, and how a professional sounds. And what happens when you don’t feel like you live up to that image. Are there other images? And so thank you for making this space for this too, for this conversation. and for kind of going a vulnerable place with me and letting our listeners kind overhear this conversation. So do you have any words for people who might also be feeling like they have impostor syndrome that they’re wrestling with?

That is another great question. I think it’s staying positive and staying grounded. I think it’s quite an asset to remember our own patient experiences, or to bring in our personal experiences. I was a former child interpreter for the grownups in my life. And I question some of my experiences of like, whether or not I was successful in helping my parents navigate the health care system when I was younger. I think there are times where I still struggle with it. I got lost in a hallway in a building that I had walked in for work related purposes. But as a patient, I got lost in it! And it’s one of those things where luckily I wasn’t wearing my work ID or it would have been quite embarrassing!

And imagine how patients feel, right?

Exactly. But it was a humbling experience that I can bring in, like, when I was a patient, I must have been more nervous walking into this building.

What a story, too. I’m sorry. Thank you for telling that story. And I want to go back for a second and let that little girl Aman off the hook. She wasn’t responsible to help her parents navigate,
but that was a role she was put into. I am sure she did a fabulous job, but it wasn’t her job to do. So yeah, let that go. But thank you for also kind of fast forwarding in time for us and reminding us about what it’s like for patients to be in a space that even you are in every day, and when you’re suddenly in the role of a patient and not as an employee, it feels different. And that change was enough to throw you off, “Oh gosh, I’m lost in the building that I work in.” Thank you for that. Another brave point of vulnerability. Aman, I really appreciate your bringing this up and coming onto the show with something that was so intensely personal and meaningful.

Thank you for having me.

Thanks again to Amanpreet Kaur for her candor and her insights. If you would like support on reflective practice in your communication and patient education, join the many other practitioners who have worked with me and Health Communication Partners over the years. Visit healthcommunicationpartners.com and click on Contact, or message me on LinkedIn. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel, Additional Music by Alexis Rounds. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners, LLC. Find us at healthcommunicationpartners.com.

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Want to be more patient-centered in your patient education? Hear about one common challenge to patient-centeredness, and how to handle it.

I recently had a client ask me for help with being more patient-centered in general. And one of the challenges they were facing is one I’ve seen a lot, and I’ve definitely faced it myself a lot over the years. I’ll tell you what it was and how to manage it.

Hi everybody, I’m Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication, recently ranked #20 of the top 100 podcasts in the social sciences by Goodpods.
If you want to take your communication to the next level, we’ve got the way. Bridges is our continuous improvement process. We evaluate your communication on seven important dimensions to help you reach more people. Visit healthcommunicationpartners.com or you can message me on LinkedIn.

So I recently had a client ask me for help with being more patient-centered when they interacted with patients. The thing is, these folks were already very on top of things in terms of their awareness, empathy, bias, trauma-informed. The problem was they felt they sometimes struggled to bring those values through to the ordinary, everyday interactions with patients as much as they wanted to. And, yes, I do often get to work with people like this, who are already very knowledgeable and very sophisticated about the complex realities of doing equity-centered work.
I’ve also had a few of these people as guests on the show, so I’ll put some links in the show notes if you’re looking for some patient education inspiration.

Because ultimately, we want to reduce avoidable health disparities. So we’re all trying to integrate health equity into core processes. And patient education, super smart place to focus. It’s effective across patient scenarios, across diseases. It’s applicable to many departments’ work. You’re talking about patient safety, patient experience, quality improvement. Now, to get down to reducing those avoidable health disparities, I think we’ve all heard that we need to work at systems levels and individual levels. So what I’m going to talk about today, this challenge that this client and other people have faced, including myself, is I think interesting because it’s a system-level issue that becomes a problem for us individually. And it can be tough to track and tough to notice.

And I want to talk for a moment about this, about learning how to do this kind of stepping back and noticing things you hadn’t noticed before. Because I had been teaching for about 10 years before I started a doctoral program at the University of Pennsylvania. And we started learning about structural obstacles. And I think when people hear structural level or institutional level, our minds can go right to policy. And definitely, policies are one way that structural level effects can get felt at the individual level.

Well, there’s a whole lot more ways that structural level concerns make it into our day-to-day. And when I was finding out about this, it just about knocked me over because there were things that had been right there the whole time, and I had just never seen them, even though they were all around me.

So this client that I was working with, it wasn’t that people didn’t already have the skills and have their hearts in the work–and they were committed to equity! It’s that we’re working in systems and models that have been around a long time and exert a lot of influence. We’re talking about our organizations, institutions, our professions, our disciplines. They have their own ways of doing things, their own cultures, traditions, logics, expectations.

And on top of this, just being alive and part of society today means we’re all part of and involved in larger conversations about what it means to be healthy or what healthy people look like, or do,
or who does health properly. Conversations that reflect ways of thinking that are some generations deep. And these larger conversations are very powerful. They count as systems-level influences too. They can also be tough to spot because they’re so normalized.

And that’s part of why putting on equity lenses is so important. I’ve talked about this before, equity lenses, “putting on equity lenses” is a popular kind of phrase because the idea is when you put on lenses and you look at something that you’ve looked at before, suddenly you’re seeing anew. You see things you didn’t notice before. So I want to tell you about this systems-level issue, how it becomes a challenge or can become a challenge at an individual level, and what to do about it.

So a structural level reality that can become an obstacle at times for a lot of us is when there is a sense of urgency or a real time crunch, time pressure, or we’re over-scheduled. And I mean, honestly, this happens for most of us most of the time.

But this particular structural-level reality shows up in a quirky way when it comes to educating.

I’ve noticed over the years that in these situations, professionals tend to focus on what they have to say. That in itself is not a problem. You should focus on what you have to say. It can become a problem when that’s as far as we go. You’ve got information, you get right down to delivering it, and that’s the headspace you’re in. Maybe you fall into like delivery mode, informing, telling, focus on what we have to say, “the spiel,” as one physician called it, getting through the spiel.

This becomes a problem if we become more spiel-centered than patient-centered.

One negative effect of this kind of delivery mode is that it can have us over-focus on our role and under-focus on the other person’s role. It’s true, in the patient education scenario there’s huge amounts of pressure on you. You’ve got a plan, you’ve got to get through it. Focusing on what you have to do makes sense. What you have to say, the questions you need to ask, the data you need to gather, the answers you need to confirm, the form fields you need to fill out, your side of the process in the educator role. Focusing on this is completely understandable.

The task then becomes reminding ourselves to make room for the other adult in the room. That adult who has their own experiences, knowledge, worldviews, priorities, worries, things to say. Things to say about themselves, things to say about the topic at hand.

So the next time you are about to enter a room, enter a conversation with a patient, make some conversational room for that person. This can be as simple as:

• taking a statement you were going to state and make it a question instead.
• Give them chances to correct your understanding of them and what’s going on with them. You can ask, “what did I miss here?”
• I’m going to be so bold as to suggest you get them talking as much as you are talking.

It will help you both if you make time to let them contribute as much to the conversation as you do. This takes intentionality. I’m gonna drop links into a wonderful interview with Jonas Attilus and how he takes a learner’s role in patient education.

If you wanna get better at this, I have a course, Equitable Patient Education. Because it’s not a mystery. These kinds of structural-level obstacles are known. And managing them is what I help people do. This course has an on-demand portion, videos that you watch when it’s convenient for you, but then you, me and your colleagues, we get together, we meet live, we talk about it, we get down to work. I call it courses + action. Because that’s what it is! If you want more information visit HealthCommunicationPartners.com or again you can message me on LinkedIn.

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering by Joe Liebel. Music by Joe Liebel and Alexis Rounds. Thanks for listening to 10 minutes to better patient communication from Health Communication Partners LLC. Find us at HealthCommunicationPartners.com.

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A nurse educator shared a question that was on her students’ minds as they approached patients: “How do I talk to you?” Learn three ways to improve your patient communication.

How do I talk to you? A question like that is probably on a lot of our minds when we’re going into an important conversation. I was talking with a nurse educator, and she knew that question was on the minds of a lot of her students. I’ll share what we talked about, and end with three things you can keep in mind during your next patient encounter.

Hi everybody, I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, recently ranked number 20 of the Top 100 Podcasts in the Social Sciences by Goodpods. If you want to take your communications to the next level, we’ve got the way. BRIDGES is our continuous improvement process. We evaluate your communication on seven important dimensions to help you reach more people. For more information visit healthcommunicationpartners.com or message me on linked.

This nurse educator had asked me my thoughts about the stress that she was noticing from her students, in kind of two dimensions. One was how difficult it was to learn the specialized language of medicine. And the other was talking to patients who didn’t use that specialized language. She put it like this. She said, Because this is a different language. It's very difficult for a student to come in and talk urination.' They're used to saying pee.' And yet their patients aren't going to say, I urinated today.' They're going to say I peed today.' [So students wonder] how do I talk to you, how do I talk to you?

I’ll tell you what I shared with that nursing educator, and we’re going to turn to a previous episode. I’ll end with three things to remember in your next patient encounter so you can make some progress on that question, how do I talk to you?

Now, we all use language every day in complex ways. We are often unaware of the sophisticated uses of language in our everyday lives, as they are habitual or unconscious. So let's stop for a moment and think about some things we tend to take for granted when we speak.

The groups we're a part of have an enormous impact on the words we use. They shape what counts for us as normal or common language. The way our words have been used by people in the past and by whom influences how we use them in the present. Think of language as something in our human tool kit. It's one of our most powerful tools, and we're always using it to make things happen. We make our words do work.

The nurse educator and I continued to talk about the shift in the work, and the thinking, and the context, involved in the shift in language from pee' to urine.' She added that there's another, potentially earlier, step here, isn't there? She pointed out that parents may teach children the term pee-pee' in the context of potty training.'

So let's think about pee-pee for a moment. In a language sense, pee-pee does specific work. It gives a label to a body function that, for the child, has been unnamed until now. But now, this body function needs a name! Because it's an important topic in the household!

So the child transitions from diapers to toilet use, through learning to be aware of and monitoring this body function. And that monitoring, that awareness, is supported by talk. Namely, everyone's very pointed use of the term pee-pee.

The word does its job. The child is potty trained! Eventually, though, the word pee-pee outlives its usefulness, as the child learns, maybe when they're in school, that big kids don't say pee-pee. When it ceases to be useful for the child, it's dropped in favor of the grownup version, pee.

Like pee-pee, pee works just fine. Unless you go into medicine. It's not that there's anything wrong with the word pee. And it's not that non-medical professionals couldn't understand the word urinate. It's more that we will use a term that does the work we need it to do, until we have a good reason for changing it.

The Discourse of Medicine was published about 30 years ago, and it underlined the significance of the ways people use language in health-related interactions. The author Eliot Mishler says:

The point of departure for this research is to treat medical interviews as a form of discourse, that is, as meaningful talk between patients and physicians. Further, this discourse is viewed seriously; it is not mere' talk, but the work that doctor and patient do together as an essential and critical component of clinical practice.

We all have been socialized into various ways of thinking about and talking about health, well-being, and health care. It can be easy to take for granted that the people around us share our linguistic and cultural practices. In health care, the people you work with use the same kinds of language you use, for the same reasons you use it (more or less). So when it comes to your patients and their families, it can seem natural to compare their ways of talking, thinking about, and doing health with yours. Or maybe with your idea of the average' or mainstream' patient.

Don't let that difference become an obstacle in your relationship. Their words work for them in the context of their lives, just as surely as yours do for you.

Sure, pee-pee, pee, and urine are different terms for the same thing, at least on a surface level. But they do different work. They are used for different reasons, for which they are entirely adequate. One is not better than the other.

I want to return to what the nurse educator said when talking about her students' concerns: how do I talk to you? how do I talk to you?

Here are three things to remember, and some phrases you might consider, in your next patient encounter:

1. Your patient's language

Approach your patient as someone who uses language in sophisticated ways in their everyday life. Speak to them with this assumption in mind. An important approach in patient communication is connecting the health information you hold, to what the community you are trying to reach already values. And that includes the language they already use.

1. Your language

In whatever wording feels natural to you, mention that you're aware medicine has some of the most unusual language out there, and that it took you years to learn it. Now, you're surrounded all day by people whose jobs require this specialized language use. This can be a drawback in conversations with people whose jobs don't depend on speaking this same language. But you're doing your best to be aware of when you're using insider terms.

1. The work you're doing together

Looking at patients' knowledge and language use as a gap' between you, can imply that your position is the one to be reached. In this view, progress counts as how far patients can make it in your direction. Mention that, as you talk together, you the practitioner are drawing on all your medical experience and education. And they the patient are drawing on a lifetime of experience with their body. You both have your areas of expertise. Assure them these are complementary and not competing knowledge bases. Because both of them are necessary for this to work.

The benefits to paying attention to your language are that you can make adjustments. So that you can speak in a way patients will understand. Build those bridges, you've heard me say that before. The benefits of paying attention to your patients' language includes learning what matters to them, and therefore, where you can start to build the bridge between you.

I'm Dr. Anne Marie Liebel. This has been 10 Minutes To Better Patient Communication. Audio Engineering and Music by Joe Liebel. Additional Music from Alexis Rounds.

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Learn how reflective practice can help you improve your communication. Hear six examples of reflective practice on patient communication, along with something you can do today, to improve your communication.

You’re already good at patient communication. I know that because you’re listening to this show! So today’s episode is about how reflective practice can help you–Yes, you– improve your communication. I’m going to give you six examples of reflective practice on patient communication, and I’ll end with something you can do right now, today, to get even better at communication than you are right now.

Hi, Everybody, I’m Dr. Anne Marie Liebel for Health Communication Partners, and this is 10 Minutes to Better Patient Communication, recently ranked number 20 of the top 100 podcasts in the Social Sciences by Goodpods.

Yes, this episode is about reflective practice and what it can do for you. And I think people, sometimes when they hear reflective practice, they think it’s soft, they think it’s something that you just kind of do if you have spare time every once in a while.

And what I’m going to present to you is a very different picture, about reflective practice as a strategy, reflective practice as a technique, a process, an attitude, a stance. And I’m going to share six examples with you of people reflecting just like that on the problems that they are experiencing. Because whether it’s an interview or a monologue, this show takes up problems that are really problems, that real people like you in the health sector face. Not the problems I imagine you have, or the problems that I think, or someone thinks, you ought to have, but the problems and issues you tell me you have. That includes our guests, too.

Now this episode is running in June and so far this year, we’ve had six interview episodes–which is a lot for us. This show is mainly monologues. So it was super exciting for me that things turned out this way, where I got to have six interview episodes already this year.

I was blown away by our guests. And they are our six examples of reflective practice. I’m going to give you a quick flyover, to encourage you to listen to them or maybe give them a re -listen. And peel back a little bit of the layers about what’s going on in these interviews, so you can maybe get a little bit more out of them when you listen.

So we had some folks who are new to the show. We had Dr. Bradley Block, Dr. Erin Bassinger and Dr. Maggie Quinlan, and Dr. T.Q. Davis.

Bradley Block talked about efficiency in patient communication and really, who doesn’t think about that?! But he’s got interesting things to say. He takes it some places–he’s reflective about being efficient. Definitely check that out. Erin Bassinger and Maggie Quinlan research provider communication and anti -fat bias in the reproductive health context. This is a life and death issue for the people involved, so if you haven’t listened, definitely give that a listen. T.Q. Davis talks about the issue, it’s not really a problem, but it’s an issue, of when patients are making medical decisions, how their faith or religious backgrounds may come into their decision-making processes, and how important it is as public health professionals or medical professionals to be aware of this.

We also had some returning friends to the show, Dr. Ann Ancona, Dr. Ashley Love, and Dr. Jonas Attilus.

Ann Ancona is a nursing professor, and she talked about encouraging her students toward reflecting, toward being critical thinkers. So if that’s you, definitely listen to what Ann has to say. Ashley Love came to the show in May, which is both AAPI Heritage Month and Mental Health Awareness Month. She combined both of those topics, and talked about throughout her career how she has communicated with AAPI communities, as a member of those communities, about mental health. And Jonas Attilus was also talking about mental health as a psychiatry resident, and how he takes a learner’s stance when he interacts with his patients, and how this helps him give compassionate care. So I’ll go ahead and put links to each of those episodes in the show notes.

Each of those practitioners chose the problem or issue that they wanted to reflect on. And these are real problems in the field. That is what reflective practice really has going for it. The way that I practice it is that we look straight at reality. We are talking about the real problems that you have. So every one of them is addressing problems and issues in patient communication. Every one of them is reflecting, right? They’re brave enough to reflect out loud, with me right? Another person! Then they let us all kind of eavesdrop on that reflecting. And it’s so great and helpful to hear how other people think, right? You get to hear them describe how they work, what’s going through their heads.

And they’re doing such great work and such difficult work–like you do, work that defies simple solutions. Which again, this is where reflective practice as a strategy is so key. They’re all dealing with different problems, different issues, they’re knocking themselves out. They’re keeping going. They’re very good at their jobs, like you are, and they want to keep getting better, but in ways that matter to them. And that’s why they’re drawn to this show, I hope that’s why you’re drawn to this show, because that’s what reflective practice helps us to–really press into issues in a way that matters to us.

It’s refreshing, I think, to hear people being thoughtful, and wrestling with important contextual elements. There are nuances to their stories. They’re a kind of antidote to a lot of the, I don’t know, neat and tidy narratives flying around. My students used to call them sunshine-and-rainbow stories, “Everything’s great.”

What these people are not doing is important too, as part of the way that I practice reflective practice, and part of what I invite in other people. They’re not saying, “you should do this like me.” They’re inviting us to learn from their reflection. They’re not jumping to conclusions. They’re not reaching for quick fixes. They’re not sweeping things under the rug.

They’re looking hard at reality. This is what reflective practice supports. It’s generous of them to let us into their day-to-day in this way.

And it’s brave to be vulnerable, because I’m not giving them a neat narrative saying, “Tell us how you solved it so we can all be like you!” I’m not asking them to pretend to have certainty about something, a neat, tidy answer, if they don’t have it.

We all want to be better at our jobs. One of the things I have learned over the years is this. We all want to be better at our jobs. For a lot of us, working across sectors, working across industries, I’ve noticed that for a lot of us, this means in one way or another we want to reach more people. What “reach” means is going to depend on your industry. We also want to be better with the ones we’re already with.

Also, most of us want to support the missions of our organizations. a lot of those organizations want to have positive engagement, positive experience, positive satisfaction– whether you’re talking about employees, clients, patients, other stakeholders, suppliers, again, depends on your industry. But over years of working with people like these, I have learned this is something that we are all reaching for.

I said I would end with something you could do right now to improve your own communication. What is it? Well, if you’ve listened to any of my interviews, you’ve heard it. But have you tried it yourself?

It’s my four questions. I always ask our guests the same four questions in any of the interviews. It might be worded a little bit differently, but these questions are because this series is based on addressing problems, real problems, that real people face. So I asked the guest: what is a problem or an issue in patient communication or patient education that you are facing? How have you been facing it? What are you learning from facing it this way? And what are your next steps? Or, do you have any advice for folks facing a similar issue? That’s it.

What is the problem or issue that you’re facing? How are you facing it? What are you learning from facing it in this way? And what’s next for you?

I’m inviting you now to ask these questions of yourself, and answer them, honestly, to yourself. Don’t change the questions! these are powerful tools in reflective practice they’re designed to get below the surface. And they’re part of why the interviews are what they are, because people do take up these questions. and they answer them honestly for themselves, sometimes for the first time, on air with me. and we get to hear them.

And this gives you a taste of what it’s like to work with me. And with BRIDGES. BRIDGES is the name of my continuous improvement process that uses reflective practice.

Everyone knows about continuous improvement processes like Agile and Lean. BRIDGES, you know about, if you’ve been listening to this show for a while. I talked about BRIDGES on air, I think last, right before COVID. So I figured it was time that I brought it back up again. But if you get our newsletter, you know our newsletter is called BRIDGES. If you don’t get our newsletter, message me on linked or visit healthcommunicationpartners.com and sign up for it.

BRIDGES is an iterative approach that helps you break down and analyze your existing patient communication or patient education. There’s seven dimensions I evaluate you on. We look for strengths, obstacles, and opportunities so you can make sustainable change over time.

And we use this continuous process to help organizations in patient communication, in patient education, because they’re cross -cutting, right? These touch everybody. These touch all business processes. So, also helpful for you personally, and for your organization if they’re concerned with engagement, experience, and satisfaction.

For you, it can change the way you communicate, the way you educate, the way you think about these things, so you can get even better at what you do, in ways that matter to you. For more information, visit healthcommunicationpartners .com or message me on LinkedIn.

This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music from Alexis Rounds.

The post How reflective practice can help you improve your communication appeared first on Health Communication Partners.

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Dr. Ashley Love returns to the show to talk about her experiences with mental health and communication in AANHPI communities. She shares powerful stories about the importance of culture and context in communication, the heterogeneity in the broad AANHPI classification, how AI can help make communication easier, and when she realized clients’ complaints about a stomach ache meant something more.

May is Mental Health Awareness month and Asian American and Pacific Islander (AAPI) Heritage Month. Today’s episode combines the two. We talk about mental health awareness in the AAPI community with researcher, educator, and friend of this show, Dr. Ashley Love.

Hi everybody, I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication, recently ranked number 20 of the Top 100 podcasts in the social sciences by Goodpods. If you want to take your communications to the next level we’ve got the way. BRIDGES is our continuous improvement process. We evaluate your communication on 7 important dimensions to help you reach more people. For more information visit Health Communication Partners or message me on Linked.

Yes, I’m so delighted to have Dr. Ashley Love back to the show. She was on the show during COVID and she has some remarkable stories to tell us. So this episode might go a little bit more than 10 minutes. Okay, here’s Dr. Love.

Dr. Liebel: I’m live via Zoom with Dr. Ashley Love. Dr. Love is Director of graduate studies at the Dreeben School of Education, University of the Incarnate Word, and she is an active duty military spouse. If you recognize her name, it’s because she was on this show before! four years ago. So Dr. Love, welcome back to the show.

Dr. Love: Thank you so much, Dr. Liebel. I cannot believe it’s been four years since I’ve been on this show. Where did the time go?

Dr. Liebel: Honestly! It was during COVID. You were talking about your work as the former state epidemiologist of Delaware. and difficult communication during COVID was something that we all needed to learn about. So welcome back. Thanks for… coming back on the show. Thank you for agreeing to kind of let us know what you’ve been working on. So I get to ask you these questions again. What is a patient communication or patient education issue that you are facing?

Dr. Love: No, thank you so much for having me back. And one of the issues that I feel passionate about is talking about mental health, especially among Asian American,
native Hawaiian and Pacific Islander. I know it’s a mouthful, so I’m going to use the acronym A-A-N -H -P -I. Why is it so important to talk about this? It’s because we need to focus on culture. We also have to pay attention to the way we communicate. and also think about the context in which we are communicating.
mmhmm. I mean, I’m already going to agree with you on all three of those. So this is a significant issue, communication, mental health among AA nh HPI populations.

So how are you facing this significant issue?

Yeah, no, it’s a great question as a practitioner, researcher, educator, and also as an individual of Asian American descent, i’m Korean American, raised in New Jersey, and I definitely can relate to some of the things that we’re going to be talking about today. So I started my work back in, oh my goodness, over two decades ago in New York City in Flushing with Korean American aging population. And we were looking at nutritional studies as well as the Asian Americans, looking at some of the curriculums. And when Dr. Liebel, when you were communicating with me, I was in San Francisco, Northern California area, during COVID, where we were facing some of the mental health, and also some of the things that the AA NHPI population was facing due to the COVID and where it originated from. And what really propelled me was the Atlanta shooting in March of 2021, of the six Asian American descent women who were killed due to their identity. So that’s a lot, right?

It is a lot. I mean, you’ve been you’ve been dealing with mental health communication among AANHPI populations for more than 20 years. So I know the next question is a very loaded one to ask: what have you been learning? There’s got to be a lot, but maybe a couple things that you want to share with us that you have learned, that you think would be valuable for the audience today.

That’s a great question. The role of culture and context really matters, especially for AANHPI population. I could probably share two stories as a researcher practitioner as well as a personal story.

Love it, love it.

The first one is when I was in Flushing, Queens, as a practitioner as well as a researcher, I was doing a nutritional study with 65 and over Asian American, particularly Korean American elders. Because I speak a third grade level Korean. So I was able to communicate with them and also have rapport. And one of the things that I discovered was that a lot of the folks were having stomach pain. So they would say “my stomach hurts.” And I realized as a Korean American, that the stomach, that phrase “my stomach hurts” was not really referring to actual stomach being hurt. It was about the loneliness, depression, or some of the mental anguish that they were experiencing as an elder, or aging population in United States. And not, the whole stigma of mental health–having mental health disease or status. And also bringing shame. And also putting a burden on the family. They weren’t able to communicate that. So in order to communicate what they’re feeling, they were referring to “my stomach hurts.” And I realized that gave me an opening to kind of talk about, “Tell me a little bit more. Like, what is your living situation like?” And some of them lost their spouses, some of them were experiencing language barriers, so they weren’t able to get the support that they needed. And it was just a very isolating experience for some of them, just because they’re in a new culture, even if they lived in United States for a long time. It’s hard to assimilate and also acculturate into another culture when you lived in another place.

I love this story about, you know, “my stomach hurts,” talking about the stomach instead of talking directly about mental health issues. And your recognition that the stomach was kind of, a way to talk about mental health issues without talking about them. So that people could save face. So that people were talking about something that was a little bit more acceptable, you know, a stomach ache. I think that’s really, I mean, about the importance of your listening and the importance, for all of us, remembering that we need to take culture into consideration when we’re thinking about communication. Thanks for that story, Dr. Love. What’s the next one?

Oh, the next one is my own personal story. I am active duty military spouse, over 20 years, and I had the wonderful opportunity to be stationed in South Korea. I was so excited just because I’m Korean American and I wanted to live in Korea. And when we got stationed in Korea, we were there for about three years. I realized even someone who is coming from health professional, public health, I spoke the language somewhat– third grade level– I was not seen as one of the Koreans in the culture. And that’s one of the reasons why I was talking about role of culture and context really matters–because I grew up in United States. So I may look Korean, but the culture that I come from was very different than South Korea. So that was the experience that I experienced as well. That gave me that aha moment where, wow, like I thought I was the same.

Wow

But yeah, the context really matters.

Wow. Well, thank you for that. Thank you for that personal story as well. So do you have any advice for people who are working with AANHPI patients or populations?

Yeah, and we are making really great progress. but we do need to develop and curate more specialized curricula. There are some out there, but for each group, just because this group is very heterogeneous. there’s over 50 different languages, 100 different ethnic groups that are in the group.

Thank you for pointing that out too, right? AAHNPI is not one homogenous group.

Exactly. And it could be challenging for some of the mental health providers. However, what we are seeing after the COVID pandemic is the technology, the tools that are being developed, is going to help us. So the progress is faster. And easier. So for example, video chatting, like having a zoom call is no big deal anymore.

Right?

Yeah, an instant connection like telehealth in the medical health care setting. We’re not just solely dependent on translators on the ground, but we can invite them into a zoom setting. And also the fact that we can use tools like artificial intelligence.

That’s a really good point about AI and language, especially these highly contextualized languages. Have you gotten a chance to use this yet?

Yes! actually, one of my personal stories that’s inspiring a lot of the research and also the work I’m doing at the university, is working with my mom. Of course, English, although she lived in the United States for a long time, sometimes the medical terms for patients is really hard, even if you’re a native speaker. So she feels very, very comfortable in Korean. And for years, I’ve been trying to translate the Medicare terminology into Korean. And as soon as AI came out, I decided, “Hey, let’s see if it could translate the Medicare A, part B, all those different parts into something that my mom can understand conversationally.” And in minutes, as opposed to years

This is true, too

It instantly produced something that was manageable for my mom to understand completely, actually. With the different parts and some of the nuances in different parts. So that was just amazing when we saw that.

I just love this. Here you are, trying for years to translate this, as a public health professional, as an educated person who’s trying to translate, who knows both languages, and still! AI comes in and goes “boink, here you go.” And your mom’s like, “Oh, yay!”

Exactly. The reason is because I realize I don’t know the jargon. I don’t, some of the context that you have to present, some of this medical terminology in a way that makes sense. We have used Google Translate. They’re wonderful, but it’s not the natural language generator and et cetera that the AI is able to do. So, we’ve been, it’s been a great experience, especially some of the legal languages, or medical terminologies that I’m unable to translate. We were able to do that.

Well, and not to put too fine a point on it, but I think this is a really encouraging story for practitioners of any social or cultural background who are gonna be dealing with patients who are AANHPI. You don’t have to be an insider. You don’t have to speak the language. You know, this is something you can educate yourself, and you have some tools at your disposal that you can use, so that you can be more culturally relevant. so that you can be more appropriate with this patient or with this population. Dr. Ashley Love, thank you for coming back on the show.

Thank you so much for having me. Wow, the time always flies when I talk to you!

Thanks again to Dr. Ashley Love for coming back to our show. This has been 10 minutes, eh, maybe a little bit more than 10 minutes to better patient communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music from Alexis Rounds.

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Psychiatry Resident Dr. Jonas Attilus returns to the show to tell us why and how he takes the role of a learner during his interactions with patients, and how this helps him to give compassionate care.

May is Mental Health Awareness month, and today we get to hear from Psychiatry Resident and friend of the show Dr. Jonas Attilus. Dr. Attilus comes back and tells us how he takes a learner’s stance toward his patients, and how this helps him give compassionate care.

Hi everyone, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel. If you want to take your communications to the next level, we’ve got the way. Our continuous improvement process for communication evaluates your communication on 7 important dimensions to help you reach more people. For more information, visit HealthCommunicationPartners.com.

Dr. Liebel: I’m live via Zoom with Dr. Jonas Attilus. Dr. Attilus is a Psychiatry resident at University of Minnesota, Twin Cities. And he was a guest on our show years ago, and his interview episode was the most popular of the year. So Dr. Attilus, welcome back to the show.

Dr. Attilus: Thank you so much, Dr. Liebel. Thank you so much. I am very excited to be back to be honest, and and see what we can share this time, and you know I’m very excited to be here.

Dr. L: Thanks! Our listeners are excited too. I literally had a listener say, “Can you please just let him talk more. We need to learn more from him!” So this is me making good on that. Yes, he’s back! So Dr. Attilus, a lot has happened in the three years, almost three years, it’s been since you’ve been on the show. But the questions have not changed. So can you tell us what is an issue you’re facing in patient communication?

Dr. A: Yeah, I think for us as health care provider, it is very important to provide compassionate care. It is something that a lot of people talk about, people write about. But you know, when the surveys come out, and then patients talk, and they don’t often kind of like reflect what we think we are doing. If we are doing a good job or not. Some of us succeed. But you know, because it’s, medicine is the art and also science.

My next question is, how are you approaching this issue of providing compassionate care in Psychiatry?

Yeah, in Psychiatry and any other medical specialty, it is extremely important to approach our patient as the expert of their own sickness. So we know diseases. We study them. That’s why we go to medical school. So we are the expert on the medical knowledge. But the experience of being sick, the patient is the expert in that. So we need to put ourself in the learner’s role when it’s come to know about what’s happening with the patient. Ask their opinion. Know how they’re doing and how they interpret that. What the impact is in the family and the impact in the community and all that. So there’s a lot to learn from our patient when it’s come to meeting them. So I think that’s where we should start if we want to provide compassionate care.

Thank you so much for that. It’s reminding me of something that another guest of the show, Dr. Paul Ranelli, said–almost the same thing. He was also at University of Minnesota, Duluth campus. There must be something out there in the water! That approaching the patient as an expert, as the expert, is really the stance that he goes into as well. And you just mentioned a few ways that you enact that. Here’s how I approach the patient as an expert: You ask their opinion, you ask for impact on the family or community. And you’re going in there as a learner.

Yeah, yes, yes, yes. Yeah, as a learner, because you cannot learn what you assume that you already know. I think that’s a that’s a quote from, I think, from a philosophy of Stoicism or something like that. Anyway, but the point is, I need to learn. Even though I have seen this particular disease so many times, but probably I’ve not met this particular patient. And the way they experience the illness and the way it impacts them is very different. So I usually start there, like what is your experience. I will ask them anything that you would like from me, from this conversation? And also feeling grateful that patient can trust us with their own stories, with what they understand. Because none of us are entitled to the patient knowledge and their experience. So I feel very grateful. I feel very grateful that they can share those pieces of information with me. And it’s made a lot of difference, you know. So I’m very grateful, and I learn every day from my patients.

I appreciate your, the stance that you’re taking of, “I’m not entitled to your story, I’m grateful for your story.” That’s got to inform the way that you approach patients. So–and when you were here last and we did your interview, you talked about respect and humility

Yes

In your conversations with patients. So I know, just from getting to know you over the years, that that’s something that’s very important to you. So what are you learning from approaching the patient as an expert? From approaching the patient as yourself being the learner? What are you learning from approaching it that way?

Oh, I learned a lot. You know, I can definitely talk about my experience as a Psychiatry resident and also my experience as a medicine intern at some point. So I think for me, when I ask the patient, they share their story with me. And based on the story and the physical signs that I have, and the lab that I have, I’m able to make a good clinical judgment. To have a plan for this particular patient. And also there’s something very particular about psychiatry: those patients help you reflect sometimes in your own life. omebody will share something with you and will will help you reflect about your family, or about the place you live. I can share something: I remember I had a patient who once attempted suicide. And at that moment, they share with me that they couldn’t afford their rent. And it makes me reflect: What does that mean for somebody to not being able to afford their rent? And I, I, like as a provider, I’m able to do that. So at that moment, I tell myself what I’m going to do with that privilege right now. So that’s one, one way I can learn something from a patient. And other times, somebody will trust me about, you know, people taking advantage of it. them. And that helped me reflect about my own parents, how they cared for me, how they support me, how they protect me. And that’s helped me reflect about people who are older than me, the elderlys Haitians that I grew up with who are there for me. So it goes both ways, kind of like. The patient never leaves the room without one, teaching me something about Psychiatry, and two, teaching me something about life. So that’s definitely it.

Wow. I mean, what stories and what insights that you are able to access. And I mean, gosh, thank you for sharing that with us. My last question is, do you have advice for people who are trying to also provide compassionate care?

I would say that first of all, I would start from a stand of giving ourselves as healthcare professionals, grace, because the world currently is understaffed. So, so much is being asked from us with very little tools or very little time, a lot of cuts is being done in jobs. So I would start there, like giving ourselves grace that we are doing our best and we’re trying to do our best with what we have in hand. And second, I will say that the patient also is doing their best. Even the patient who arrives very angry at you, very mad. Those are people who have been hurt by the system or who have been harmed. And they bring their best. Their best is kind of like, “I need to protect myself. I need to react. I need to be angry.” And sometimes the patient don’t know there is a much better way. They have not processed the trauma. They have not processed what has happened to them. So they are not sure, or at least they don’t know is there is a better way. And once we know better, we do better. So, I would extend grace to myself. I would extend grace to the patient. And, you know, and also probably I would advocate, too. I would advocate for my patient and I would advocate for better tools. Because compassion is not only you want to do the best. It’s also about being in the right environment. Being surrounded by amazing people, good people. And then trying to do our best. So that’s where I would start.

Dr. Jonas Attilus, Psychiatry resident at University of Minnesota Twin Cities, thank you for coming back to the show.

Yeah, thank you for having me and I’m happy to be back again.

[laughs] I’m delighted to have you here. Wow, I’m gonna be processing this for weeks, what you just shared. Thank you so much.

Yeah, yeah, thank you. Thank you. It was it was so nice to be here and yeah, so nice, yeah.

Thanks again to Dr. Attilus. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music from Joe Liebel, Additional Music by Alexis Rounds.

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National Minority Health Month is an opportunity to reflect on the connections between health disparities and communication. It’s essential to lean on research and outside expertise when communicating. But I share what might be an unpopular opinion about the role of expert recommendations in our communication efforts.

It’s National Minority Health Month, so we’re going to talk about health disparities and communication, and the relationship between the two, and I’m going to tell you something you can do today the next time you are communicating.

Hi everybody, I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication from Health Communication Partners. Our online course, Equitable Patient Education, promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say, “There’s a lot of eye-opening information I hadn’t considered before.” For more information, visit healthcommunicationpartners.com.

And if you didn’t hear the news, we got ranked, yay! We made it to number 20 on the Top 100 Social Science Podcast Series on Goodpods, woohoo! And I think really it’s because of last month. I have to say I got so many nice messages about the episodes we ran in March. We had three sets of interviews from women differently positioned in the health sector (Dr. Taquina Davis on understanding the impact of religious beliefs on patients' decision-making; Dr. Ann Ancona on encouraging critical thinking in health professions students; Dr. Erin Basinger & Dr. Margaret Quinlan on Anti-fat bias in reproductive health). I’ll go ahead and drop those links in the notes. But if you like what you hear, leave a review on your listening platform of choice, message me on linked, or send me an email AnneMarie at h-cpartners .com.

Like I said, it’s National Minority Health Month, and you already know that this is a show about communication. Patient provider communication, yep, that’s where we started. Also, we branched out to more interprofessional communication and other workplace communication, whether it’s written, spoken, or digital. You’re already aware of many, many documented health disparities, right? We almost can’t mention minority health without also talking about disparities in access and quality and outcomes. So I’m not going to rehearse those. But I am going to review some of the relationships you probably already know between minority health and communication and disparities.

We know there’s more than 20 years of research tying poor communication to disparities. I want to first start with written communication and a shout out to my public health friends who are doing great jobs engaging communities early in the communication process. And you’re testing the form and the content of your communication campaigns. Also health literacy people! Absolutely this field leads the way here reminding us all how the accessibility of information has a great deal to do with how it’s written, right? What words and images are being used, and that considering the intended audience is essential.

As many as nine in ten Americans struggle with complex health information. And I’m one of the many people who hold this is largely because of the way that health information is written! The content in digital tools like apps, patient portals, devices, and websites is often written in a way that is inaccessible to most Americans. Add to that, 24 million Americans are not considered proficient in English and that’s the language used in most digital health environments, which is how most people get their health information now.

Let’s review some stuff in patient-provider communication. An American Journal of Public Health study summarizes some of the ways that patient -provider communication can unintentionally advantage or disadvantage some groups of patients. For example, “by providers approaching patients with a dominant or condescending tone, that decreases the likelihood that patients will feel heard and valued.” Also, “by failing to provide interpreters when needed.” Also “by doing more or less thorough diagnostic work,” or “by recommending different treatment options for patients based on assumptions about those patients’ treatment adherence capabilities.” I’ll drop the link in the show notes to that study as well.

And to a report from NPR, which says nearly 1 in 5 LGBTQ adults has avoided seeking medical care for fear of discrimination, which we know is often conveyed through communication. Just on this very show, just last month, communication researchers Erin Bassinger and Maggie Quinlan reported on the negative messages that fat people receive during conversations with their providers about reproductive health. Definitely a link in the show notes.

So, I want us to remember this: words and silences in clinical interactions can erode equity.

I’ll say that again: words and silences in clinical interactions can erode equity, even and perhaps especially when we don’t notice them. And communication can be tough to notice because we’re doing it all the time.

This tough to notice aspect about communication was mentioned just recently at the White House Minority Health Forum. It was a live broadcast on YouTube, and I’ll drop the link to that video in the notes. And there was a statement made by Eliseo Perez-Stable, who you may know is the director of the National Institute of Minority Health and Health Disparities at the National Institute of Health. He talked about communication as something we can take for granted. Yeah, that’s legit. We can take communication for granted. We’re doing it all the time. And he pointed out that, “There is a science behind it. It is a skill you get better at when we prioritize it and value it.”

And you do value it. You care deeply. You are working hard at making good things happen, seeing improvement. You’re already thinking deeply and reflecting on your communication and studying your own communication. It’s the stories that you’ve shared with me over the years–how hard you’re working to connect with patients. And what an honor it is to hear these stories, to be privileged with these moments inside your day-to-day practice. You tell me your gripes and complaints and also what you’re up against, what worries you at night.

And it’s clear to me you are knocking yourselves out to treat patients equitably. You’re engaging them, you’re involving communities, you’re not just dropping stuff on them, but you’re collaborating. And you’re also listening to each other. You’re sharing knowledge. I also hear you telling me you’re looking at data. You’re reading research. You’re keeping current. You’re listening to podcasts. Hey, shout out to Dr. Raj Sundar and his podcast, Healthcare for Humans. If you haven’t checked that out, please do. It’s just outstanding.

You’re in many ways turning to expert knowledge, to inform your communication, and this is, of course, super important. But as much as there’s this kind of discourse of the right word for the right patient at the right time, from what I’m getting from you, there’s an understanding that there’s not going to be one right answer most of the time. That we get that we’ve got to turn to experts. It’s essential, it’s important and we all need to do it.

Someone on Twitter put it this way–I’m sorry I just can’t call it X, so here we go–someone on Twitter put it this way, and I thought I would take this up and talk about it because it helps me make a point that’s a subtle one that we don’t always get. They were making a point about “being consciously aware of whether our judgments, opinions, preconceived assumptions, and beliefs are forming the basis of our communication, or whether it’s tried, tested, and proven recommendations that have worked successfully with past or current patients.”

And when I read that, I was like, Okay, I get it. This person’s reminding us not to just kind of go off the cuff and write or say what we think or feel or guess. They’re recommending we turn instead to proven recommendations.

I definitely think we should turn to proven recommendations, but I’m not sure it’s an either/or. I don’t think it’s either our judgments, opinions, assumptions, and beliefs or proven recommendations, but that both are working at the same time.

We are all necessarily using judgments, we’re working with assumptions, we’re working with beliefs, and it’s important to be aware of both of them–both our kind of like inside knowledge, and also outside knowledge. Yes, it’s important, it’s crucial for us to lean on expert knowledge. Consider that how we take that knowledge up and use it in the specific scenarios in our local contexts is a matter of our professional judgment. We’re necessarily exercising this judgment.

Hey, and don’t also forget what we bring to the table. We bring knowledge and experience to our communication practices. Subject matter knowledge, knowledge of local people, practices, contexts, policies, materials. This knowledge is is also crucial along with outside expert knowledge.

So these two knowledge bases, inside knowledge and outside knowledge, can and should both inform our communication design. This is what I teach people to do, so if you’re interested, you can take one of my courses or you can contact me. Visit healthcommunicationpartners and click on Contact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music from Joe Liebel, Additional Music from Alexis Rounds.

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I preview a free maternal health course from the Office of Minority Health, and give you tips on how to get the most out of this great resource.

April is National Minority Health Month, so we’re diving into a resource from the Office of Minority Health about maternal health care. I preview this free resource for you including a nifty design feature. Hi everybody. I'm Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication from Health Communication Partners. Our course Equitable Patient Education promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say , There's a lot of eye -opening information I hadn't considered before, For more information, visit healthcommunicationpartners .com.

Now last month was so cool! Celebrating Women’s History Month, we did 3 interviews with women in health. If you missed any of those, I’m gonna drop the links in the notes (Dr. Erin Basinger & Dr. Margaret Quinlan on Anti-fat bias in reproductive health; Dr. Ann Ancona on encouraging critical thinking in health professions students; Dr. Taquina Davis on understanding the impact of religious beliefs on patients' decision-making). We’re keeping that train going into National Minority Health Month with a resource on maternal health.

There’s been a lot going on in maternal health lately–I’m watching you, CMS. So if you need to brush up, or you’re looking for heaps of resources and some good stories, this freely available course is for you. We’re gonna flip back in the archives for my review.

The course is called Culturally and Linguistically Appropriate Services (CLAS) in Maternal Health Care.

It's free, anyone can take it. You have to sign up with an email address. And the course is designed for “maternal health care providers and students seeking knowledge and skills related to cultural competency, cultural humility, person-centered care, and combating implicit bias across the continuum of maternal health care.

Now I'm thinking strategically, and you might be, as well. Many people are having to build coalitions, or build arguments, about some elements of women's health and health equity. So I'm going to talk about this course as a strategic resource. OK, here we go!

Reproductive injustice. Weathering. Medical apartheid. Institutional racism. Slavery's existing impact on the US medical systems, and on how doctors treat patients. This is what you're going to get in this course. So if you want to read up, or refresh on any of these topics, this is your resource.

One of the things that didn't occur to me until well after I was done the course, is that they pull off a pretty neat trick in the design. So I'm going to tell you about it.

The course is strictly text based. When you click on it, when you progress through it, you get a screen's worth of reading, which is fine. There is a feature on the screen that I like, a dropdown box called tell me more. And if you click on it, you get a small portion of additional reading that isn't otherwise visible on the page, unless you click on it. And if you click on them, there are some of the most interesting, and perhaps controversial, ideas and concepts in the course. So don't skip them.

There is another feature at the end of each module. There's a screen full, it’s more than a screen full, of what they call next steps, or what to do next. It's full of suggestions, and most of them are links to high-quality resources. Right there. There's heaps of research, as you would expect from U.S. Department of Health & Human Services!

And that's when I realized the trick they pull off in the design. When you're clicking through the course, you're just reading it, what you're getting is kind of the tip of the iceberg, what you're seeing there on this one screen of reading. And that can be all you see, if that's what you want. That's fine. But there's so much more to explore to these topics and these issues. I think that's one reason the drop-down boxes are handy. They allow you to take it in stride. When you're ready to read more, you click on it, and there, you've got it.

And then those next step' features at the end of each module, whoa. All sorts of paths you want to go down, you can go down. So I think what they've done is they've made this enormous topic accessible, because they start at the tip of the iceberg. And then when you're ready to dig deeper, there's layers and layers of information there that you can go into. Really high quality stuff. I'm gonna talk about those layers in a bit.

But first I want to make a plug for how efficient this is as a resource. Yes, I think it's efficient. I think it's a good use of your time. And I'll tell you why it's efficient: the resources are all in one place, they're from a very trusted source, HHS, and the resources are grouped thematically. So if you have an argument you need to make, or you're getting ready to give some sort of a talk, if you need to talk to any audience about maternal health, go here. In a way, it's a kind of one stop shop for data, and for stories.

Now, back to those layers. This course uses data to expose layers of infuriating reality. Let me quote you from some of the text: “Over the past 30 years, the maternal mortality rate in the U.S. has doubled. Black women were three to four times more likely to die during pregnancy, childbirth, or the postpartum period, regardless of income or education level. American Indian/Alaska Native women were two to three times more likely to die.

And then they explain, in a very hard-hitting sentence: Social determinants of health do not fully explain disparities. So we're getting down another level deeper. They point out that, the health care professional has a role to play, saying: “Make sure you deliver the highest quality of care to all women. In part, this means going back to the basics of care: connection and compassion.” They say The bottom line is: you can improve your quality of care by understanding, respecting, and responding to a patient's experiences, values, beliefs, and preferences.

They also front that this is a challenging process. They say, It requires courage and self-reflection. It is normal to experience feelings of discomfort, anger, guilt, or sadness when exploring topics in this Course. They give a whole module on self-awareness.

While we're on the topic of self awareness, if you have to make a case about maternal health to some audience. Let's say you know you're dealing with some folks who can get a little spiky at the mention of terms like “bias,” or “stereotype.” Check this out, from this course, check these definitions out:

Biases are mental shortcuts that help us simplify our complex world. I think that was really nicely put. I think that's a great definition. It might be handy!

How about this one about stereotypes: Stereotypes are common, but when left unchecked, they may cause you to treat a patient based on assumptions instead of as an individual. Again I think that's quite nicely put. If you're looking for more handy phrases like these, check out our prior episode on the NYC Health system's language use guide.

OK here is another strategic move they make that is handy. Because the numbers we're dealing with are so big, and the concepts so overarching and sometimes overwhelming, it's easy to feel disconnected from some of them.

This course makes it real, so we can connect what we're reading, we can connect these big issues to the actual experiences of actual people, with names. And they do this by having quotes from actual patients. Some of these people are well known, and some are ordinary folks like you and me. Some have positive experiences to share, but many do not, and they paint a picture that is infuriating, like I said before, chilling, not surprising. But it helps us see our own connections to health inequalities.

I want to make sure we're all embedding equity and intersectionality in our communication as we move forward. And that we can be strategic in the ways we're having these conversations across groups of people with varying degrees of willingness, or reluctance, to engage in these important topics. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. I'm Dr. Anne Marie Liebel.

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We’re celebrating Women’s History Month with 3 interviews with women from across the health sector. Today I sit down with Dr. Taquina Davis as she shares research and a personal story about understanding the impact of religious beliefs on patients’ decision-making.

March is Women’s History Month, and to celebrate, we’re bringing you 3 interviews with women from across the health sector who all care about health equity and patient communication. In today’s episode I get to sit down with Dr. Taquina Davis as she shares research and a personal story about spirituality and faith, and its influence on people’s decisions.

Hi everybody, I’m Dr. Anne Marie Liebel and this is “10 Minutes to Better Patient Communication” from Health Communication Partners. If you like this show, you’ll love our courses. Our course Equitable Patient Education promotes high-quality clinical practice in patient education by helping prevent avoidable errors. Learners say, there's a lot of eye -opening information I hadn't considered before, and, This course helped me look at myself as an educator and helped me to step back and analyze how I can be a better nurse. For more information, visit healthcommunicationpartners.com.

Dr. Taquina Davis has researched the role of spirituality and faith as part of what shapes patients’ decision-making, and how they approach their health. Dr. Davis tells me how she connects research and practice as a health educator, and she shares a powerful story about what she is learning about the blending of the personal and the professional.

Anne Marie: I’m live via Zoom with Dr. Taquina Davis. Dr. Davis is a managing partner for Health-E Strategies and adjunct professor at Purdue University Global in the Health Sciences Department. Dr. Davis, welcome to the show.

Dr. Davis: Thank you so much. Thanks for having me, Dr. Anne Marie.

Anne Marie: I’m so glad to be here and I’m gonna ask your permission–Dr. Davis and I have known each other for years. Dr. Davis, can I call you TQ?

Dr. Davis: Anne Marie, yes, you can.

AM: Thank you so much. (laughing) So, TQ, what is a problem or issue that you are facing related to patient communication?

TQ: Well, one thing that has been on the top of my priority is how spirituality and faith is considered a part of modeling and sculpting decision-making. And so, when we look at religion and spirituality, it has a significant influence on people’s understandings of the world, their emotions, their psychology, and how they approach their health. So as public health professionals and health care providers, understanding the impact of religious beliefs on patients’ decision-making is crucial for providing appropriate care. So one thing to think about, Anne Marie, is there was a poll done in 2021 through Gallup. And it stated that at least three out of four Americans identified with a specific religious faith. So that’s a large amount of folks that consider religion as part of their lives.

Mhhmhh. And so that this is, this sounds like something where there’s, is there research on this? Do we know, this sounds like something that been studied before.

Yes, that’s a really good question. So like in the past decades, like several, even several organizations like the American College of Physicians, the American Medical Association, and the American Nurses Association, they have recognized the role of spirituality in clinical care. So the incorporation of spirituality into medical education has been prompted by many publications. And the growing and of relationship with health has resulted in thousands of articles actually being published in scientific journals. So again, it just harkens on acknowledging patients religious beliefs and fostering cultural sensitivity is essential for providing holistic and effective health care. Understanding the intersection of religion and health allows public health professionals and clinicians to support their patients’ well-being better. Spiritual and religion has a huge impact on decision-making.

So thanks for that, TQ. And this is not a research base that I knew a whole lot about. So how have you been facing this issue of trying to understand more about the intersection of religion and health? How have you been facing this?

Good question. Another good question. So I’ve actually had the opportunity of doing some research myself. So my research aligns with other research identifying that patients often turn to their religious and spiritual beliefs when making medical decisions. Religion and spirituality can impact someone’s diet, medicine, treatment, and self-care choices. Other research supports that many groups dealing with major life stressors, such as natural disasters, illnesses, loss of loved ones, divorce, several medical illnesses, show that religion and spirituality are generally helpful to people in coping. Especially with people with fewest resources facing the most uncontrollable problems.

Hmm.

So it’s important that people can draw on religion and spirituality resources to tie better adjustment in times of crisis. So there’s lots of research that actually supports this type of work. So as a health educator, I’ve had the opportunity to speak to various community members and provide education on various health topics, like diabetes, hypertension, stress management, and tobacco education. And I would always share my story and my perspective. As I would open up regarding my religion and how it helped me cope with life stressors, I would notice like eyes were lighting up, and slight smiles starting to form on people’s faces. Or even heads start to nod. So like, these nonverbal cues would tell me that what I was saying was resonating with a few of the people in the room. And then all of a sudden I would hear, “well, yes, me too.” So this allowed the floodgates to open up. And once that happened, it was a party, right? And so we would be able to share stories, and open up to them, they open up to me. And in the mood in the room, it changed. So it’s been very impactful from a research perspective and also as a health educator.

I mean, that’s right. I’m sitting here nodding and trying not to make noises to interrupt you too, but I’m absolutely, I’m feeling it. Like I can see you’re not just coming from the research base, but you’re also, and you’re also living it. Like this is your practice. You’re talking about your own experiences and you’re using that shared connection with the patients to kind of make, allow other things to happen. So what are you learning from doing it like this, TQ?

Well, my personal experiences have changed how I’ve related to patients in the past, and how I navigate health education and promotion today. So as public health professionals, and me specifically as a health educator, y’know we have hearts and we have a passion to always wanna help others and point them in the right direction. Within my new professional journey, I’m learning more about biases, I’m learning more about stigma, and I’m learning more about the application of empathy. So with the current project I’m working with, it’s a faith-based organization and also leaders, to address addiction and recovery within their congregation and within their community. So we all know we think about addiction as having a stigma, and there’s a large body of research there that indicates the stigma is like pervasive, is rooted in the belief that addiction is a personal choice. But this project has allowed me to do self-reflection Anne Marie. So like my previous work experiences were guided by Professional TQ, and with this recovery project, Personal TQ is now taking over. And so what I mean by that, I was recovering from a loss of identity. Changing careers. I had medical issues. I had family dynamics shifting, financial uncertainty and unpredictable situations. So I wasn’t in control. So I realized that I was internalizing and handling the outside situation very unhealthy. And I knew I needed help. I knew professionally that a mental health professional could help me. I knew mental health was an issue. And I learned from my professional life how behavioral health impacts your overall health and quality of life. So I had to tell myself, “go get help.”

TQ, thank you for that. Thank you for sharing that and trusting me and us with your story, that you’re truly practicing what you preach, truly living your mission in what you are doing. So what are next steps for you? Or do you have any words for people who are facing similar issues?

So next steps from a health education, public health, and even a clinical perspective: How can we tap into this whole idea of spirituality and religion, and understanding how spirituality has a cultural impact, and it’s an identity, right? It has come increasingly recognized as a factor to why patients make certain decisions.

Mmhmm.

So we all understand from a clinical standpoint, from a professional standpoint, we understand cultural competency and healthcare involves the recognition of differences, and cultural knowledge and identity, including language, religion, and can be addressed at multiple levels. So public health and healthcare professionals, we go through much schooling, we do a lot of continuing education. I would encourage professionals to keep an open mind to understand the why. And for some, religion could be the why. And as professionals, we must do everything we can do to provide the best quality of care, so our patients can have an excellent quality of life. And it doesn’t mean you need to go out and read the Quran or the Bible or the Torah. It’s about respect and empathy so our patients feel okay in opening up to us.

Dr. TQ Davis, thank you so much for being on the show today.

Thank you for having me, Dr. Anne Marie, I appreciate it.

Thank you again to Dr. Davis for her scholarship and her candor, both of which take enormous strength and grace. Links to Dr. Davis’ info is in the transcripts at healthcommunicationpartners.com. This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music by Alexis Rounds. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners LLC.

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We’re celebrating Women’s History Month with interviews from women across the health sector. In today’s episode, Dr. Ann Ancona from Kent State University College of Nursing tells you how she encourages her nursing students to think critically about patient care and communication.

March is Women’s History Month. To celebrate, we’re bringing you 3 interviews with women from across the health sector who all care about health equity and patient communication. Today’s episode is about critical thinking in patient education. Dr. Ann Ancona from Kent State University College of Nursing tells you how she encourages her nursing students to think critically.
Hi everybody, I’m Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication from Health Communication Partners. If you like this show, you’ll love our courses. Equitable Patient Education promotes high quality clinical practice in patient education by helping prevent avoidable errors. Learners say there's a lot of eye -opening information I hadn't considered before, and, this course helped me look at myself as an educator and helped me to step back and analyze how I can be a better nurse. For more information, visit healthcommunicationpartners.com.

Now I get to be back on mic with friend of the show Dr. Ann Ancona who is a pediatric nurse practitioner and educator. This time Dr Ancona talks about supporting her students to be better patient educators and communicators by encouraging critical thinking. Let’s hear what Dr. Ancona has to say.

Anne Marie; I’m live via Zoom with Dr. Ann Ancona. Dr. Ancona is Professor and Coordinator of the Pediatric Nurse Practitioner Concentration at Kent State University College of Nursing. And this is Dr. Ancona’s third time on this show. So Ann, welcome back to the show.

Dr. Ann Ancona: Thank you. It’s nice to be back.

Anne Marie: It’s great to see you again. and you and I got to see each other in real life recently!

Ann: We did. That was very nice.

AM: It never happens! I was traveling and we happened to be in the same place at the same time. I’m super glad to be back on mic with you.

Ann: Thank you. It’s really nice to be back too. I hadn’t realized it was so long since I was on the show.

AM: It has been. So the first time you were on the show was five years ago in 2019. And then you came back during COVID in 2020. So I’m really glad for people to have a chance to kind of catch up with you and hear what’s going on. When you were here in 2019, you picked up the really interesting issue of patient communication when that patient is a health professional themselves, or when the patient’s parent is a health professional themselves. And then when we came back during COVID, you were working with your students and you were having them reflect about their COVID experiences during your class using reflective practice. So those have been two really very interesting topics and issues that you chose to talk about. So I can’t wait to hear what is a topic in patient communication or patient education that you’re facing right now?

Well, what I’m facing right now, and have faced for a while now, is critical thinking. I like my students to reflect and really critically think about what they’re doing as students and as future healthcare professionals.

Mmmhmm, really important and also part of the reason I like having you back on the show. So how are you facing this issue of encouraging critical thinking in your students?

Well, I’ve realized over the years that the ability to think critically varies quite a lot between students. So I try to encourage the skill in all students and I think it’s important that they are invited to think critically rather than accept something at face value and go with that. So one of the things that I do is to include a critical thinking portion in all of my assignments. So this might include something like reading an article. They thoroughly review it, they compare that article to the care of a patient. And then I tell them to ask themselves, what would they have done differently after they read that article? Would they have cared for that patient in a different way? Would they have educated the parents in a different way? And then to take a little step further, how does that apply to their practice in their student role? And then as a future advanced practice nurse?

Mmm-hmm. I love that you’re starting with the inviting because you can’t force people to reflect, right?

Right

You can just you can only invite them to think critically. So what are you learning from inviting your students to think critically about patient communication and patient care?

Well, I’m learning that they often learn better from each other. I make a lot of comments on their assignments to kind of get that critical thinking going.

Yeah.

And the assignments to me are better for the students to read those because it makes them think, rather than just using it as an evaluation tool and giving them a grade. So I encourage them to read all of my comments, respond back to me with what they think about the comments or what they think about the patient. But then I’ve also learned– back to the point about them learning from themselves–is that one of my classes has a discussion board. And they talk about their patients they’ve been seeing in practicum, and share the information about the patient but also how they took care of that patient and what they thought about while they took care of that patient.

Ah.

So it used to be an assignment that they turned into me. but then I thought, well, this is great that they turned into me but it could be so much better if I let them kind of turn it in, so to speak, to each other and learn from that. which has been really great.

That’s what I was thinking. It’s got to be great because all of these people aren’t necessarily in the same specialty, right?

Correct. Yes, that’s correct. They are in different pediatric subspecialties. So the class I have now is rather small, but still makes for great conversation, and they can all talk about different patients depending where they are, Neurology or orthopedics or endocrinology, a variety of sub -specialties really which has been really great for them.

And a chance for them to learn from each other and hear what another specialty is doing and maybe someone from another specialty would have a certain perspective on their problem that they might not have thought of before.

Yes, exactly. and I love that part. It’s usually a very chatty discussion board, in a good way.

Love it! Love it!

They really do love, “oh this is so great, I learned this” or “this is what we did,” or “I came across something similar,” or “this is how my preceptor approached this but i would have done something different or extra.” It’s really and it’s actually is kinda fun to sorta hear them talk on the discussion board!

I mean, that’s what it’s about too, pushing in that kind of learning, or setting up the context where they can do that kind of learning. Now, we’re talking about this and when it’s working well, but have you learned anything about inviting students into this kind of critical reflection about, you know, what makes it a little bit difficult? Is there anything complicated, you know, how do you deal with that?

Yes, there are some complicated areas, mainly with students who don’t quite understand what it means to think critically. So their reflection might be just below the surface, but they’re not really getting into it. But I’ve noticed once I push a little bit or encourage them to think more outside just that patient, in all of the factors we need to think about, that they do better. So I want them to see that patient as a child first, and then they’re a patient. But that also encompasses their parents or siblings. Their household, if it’s smooth, if it’s chaotic. And then, older kids, I want them to think about how school affects whatever’s going on. Or their neighborhood, Is it safe or unsafe? And just more of that global approach to that patient. So once I start asking them more questions like that, then they’re better at, “Oh, yes, I didn’t think about this, but now I do, and here’s what I think about that.”

I love it, Ann. So you’re helping them, you’re scaffolding them to think critically by the way that you’re responding to them, the kinds of questions that you’re asking them, and the kinds of assignments that you’re designing so that they have a chance to learn from each other.

Yes.

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I think that’s great. So my last question is always, you know, you’ve got an option here. You can say what’s next for you in terms of your pedagogy with your students, or you can decide to give some advice to folks who want to encourage critical thinking in their students.I’ll go the advice route.

Ok sounds good!

Just from what I’ve learned is that starting with critical thinking at the beginning of, for me, for my nurse practitioner program, I start with my first class that I have students. And for me it’s a fall semester. So I start right then with critical thinking. So they might not be great at it that’s okay. But I start there and keep building on that into different semesters and then I sort of rearrange it a little bit, like the student to student learning, as they get, as they become more familiar with each other in the classroom, and as they are more confident in their role as a student PNP. So I think that’s important not too much right at the beginning

Yeah sure you’re starting from the beginning but you’re not expecting too much.

Right

I think that’s a really important way to go about it too. You’re not kind of saving the critical thinking as something that we can kind of sprinkle on later.

Right

Like, no, it’s core to what we’re doing.

Yes, and one more piece of advice too is I have my beginning students write their philosophy of what it means for them to be a Pediatric Nurse Practitioner. Then they go through the program. And then at the end, I tell them to save that. And then at the end, they have to go back and reread their first philosophy, reflect on that, and tell me what they learned about themselves as a student and themselves as a soon to be graduated advanced practice nurse. And I love that, too. That’s it’s very eye opening for them.

I bet! I bet it. is. Oh, wow, how great for them to read. And also, gosh, interesting for you to read. Well, Dr. Ancona, this is another, I mean, you’re knocking them out of the park. Thank you so much for coming back on the show and giving us a chance to learn from you about this topic of encouraging critical thinking in the nurse force. And I really appreciate your coming back on the show today.

Thank you, thank you for having me back again. It’s always fun to talk to you.

Yay! Thanks again to Dr. Ann Ancona from Kent State University College of Nursing. I’ll link to Dr. Ancona’s bio and program in the show notes. Transcripts for this and all episodes available at healthcommunicationpartners.com with links to relevant research and resources. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music by Alexis Rounds. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners LLC.

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Today’s episode is about anti-fat bias in the reproductive health context. I talk with two researchers, Dr. Erin Basinger and Dr. Margaret Quinlan, about anti-fat bias as a life-or-death problem in patient communication. They also generously share a fantastic list of resources that I link to in the transcript below.

Dr. Erin Basinger is Associate Professor of Communication Studies at UNC Charlotte. She studies how people manage stress in their interpersonal relationships. Dr. Margaret Quinlan is Professor of Communication Studies at UNC Charlotte. She's interested in the role communication plays in public understandings of health.

Today’s episode is about a specific issue in women’s reproductive health. This issue is anti-fat bias that people encounter in the reproductive health context. I talk with two researchers, Dr. Erin Basinger and Dr. Margaret Quinlan, about anti-fat bias as a life-or-death problem in patient communication.

Hi everybody. This is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel. If you like this show you’ll love our courses. Equitable Patient Education promotes high -quality clinical practice in patient education by helping prevent avoidable errors. Learners say there's a lot of eye -opening information I hadn't considered before, and, this course helped me look at myself as an educator and helped me to step back and analyze how I can be a better nurse. For more information, visit healthcommunicationpartners .com.

March is Women’s History Month and it’s also a 3 episode month for us here at HCP. To celebrate, this month we’re bringing you 3 interviews with women from different places and spaces who all care about health equity and patient communication.

First, it’s Dr. Basinger and Dr. Quinlan talking about anti-fat bias in reproductive health. What they have to share is difficult to hear. For some people, it may be triggering. If this might be you, I appreciate your listening and we can catch up in the next episode. Transcript continues below.

Many thanks to Dr. Basinger and Dr. Quinlan for these resources:

Peer-Reviewed Journal Articles

• Basinger, E., Quinlan, M. M., & Curry, A. (2024). Trust yourself and your body : Advice from fat individuals on how to navigate fat fertility, pregnancy, and birth. Fat Studies, 13(1), 6-21. https://doi.org/10.1080/21604851.2023.2248364
• Basinger, E., & Quinlan, M. M. (2023). She didn't think fat women deserved to have children : Memorable messages from healthcare providers in the context of fat pregnancy. Women's Reproductive Health. Advance online publication. https://doi.org/10.1080/23293691.2023.2174823
• Basinger, E., Quinlan, M. M., & Rawlings, M. (2023). Memorable messages about fat bodies before, during, and after pregnancy. Health Communication, 38(13), 3069-3079. https://doi.org/10.1080/10410236.2022.2131982

Recommended Podcasts

• Maintenance Phase
• Burnt Toast Viriginia Sole-Smith
• PlusMommy
• Fat and Fertile

Social Media Accounts

• Nicola Salmon
• Plus Mommy/Plus Size Birth

Recommended Readings

• What We Don't Talk About When We Talk About Fat by Aubrey Gordon
• You Just Need to Lose Weight and 19 Other Myths About Fat People by Aubrey Gordon
• Fearing the Black Body by Sabrina Strings
• Fat Talk: Parenting in the Age of Diet Culture by Virginia Sole-Smith
• Fat and Fertile: How to Get Pregnant in a Bigger Body by Nicola Salmon

Anne Marie: I’m live via Zoom with Dr. Erin Basinger and Dr. Margaret Quinlan. Erin and Maggie, welcome to the show.

Erin: Thanks for having us.

Maggie: Thank you. It’s such an honor to be here. We’ve been looking forward to it.

Anne Marie: And I’ve been looking forward to interviewing the both of you. So we’re going to go ahead and jump right in. What is an issue in patient communication that you have been facing?

Erin: So our work focuses on anti -fat bias and negative attitudes that people encounter, especially in the context of reproductive health. We started this work because I had personal experiences, I, Erin, had personal experiences navigating this context as a fat person, the reproductive health care context. And Maggie had research background in fertility, and patient communication in that context, in parenting. And so our experiences together led us to look at what’s happening in interpersonal interactions when people are trying to conceive when they’re pregnant and then postpartum. What is it that they’re hearing from their providers?

AM: So you are facing this problem through research.

Erin: We are, and our research has taught us a lot about what’s happening in these conversations. We were not exactly sure what we were going to find when we started asking people about these experiences, but we found that they were really hungry to share what was happening when they were talking to people across the pregnancy trajectory. And it was really striking that a lot of what they heard was super negative. We didn’t ask people to report on negative messages, but 77% of what people told us was negative messages. “Your body is to blame. Your body is bad. Your body is wrong.” And so our research showed us this is something that really needs attention.

AM: So you just asked for, like, tell us about the messages you received. You didn’t ask for negative messages.

Erin: Right, exactly. And it is often really shocking to people, especially thin people, that what we heard was overwhelmingly negative. But for people who are fat, like me, it’s not surprising at all because this is our lived experience all the time. So it is rage-inducing. It’s terrible. And if you read our article, you can see some really vivid examples of what these messages sounded like. But unprompted, all we said was “tell us what you’ve heard.” And what they heard was really, really horrifying.

Maggie: Yeah. I mean, for me, that somebody could get denied fertility treatment because of their body size, even though I’ve been researching fertility for about five years before, it was still really hard to hear. Somebody saying that, “you don’t deserve to be a mother because of your body size,” like just still like blew my mind. And, you know, to say that fat mothers are the cause of the “obesity epidemic” in quotes like is, I mean, you know, just saying like very eugenic thinking that they don’t deserve to be mothers is horrific to me.

AM: So what are you learning from your research into this particular problem in patient communication?

Erin: So if we kind of distill down our findings, there were three overarching ideas that we saw coming up over and over and over. So the first one was the idea that fat mothers cannot be good mothers and there’s a lot there. But the overarching idea is that if you are not healthy–because we assume that fat people can’t be healthy–you cannot be responsible for the health and well-being of a child. So that was the first thing we found. The second was a lot of blame and shame around pregnancy experiences. So people not being able to to get pregnant, that was blamed on their weight. Or if they experienced any challenges during pregnancy, or even just kind of holding the idea, “you’re gonna miscarry” over people’s heads. So just generally a lot of blame and shame. And then the third big idea we saw was just a denial of treatment, that if you have a BMI of X or above, you will not receive fertility treatment. So we saw those three big negative messages and we saw those come up in different ways over and over and over in our data.

AM: Wow, thank you.

Maggie: And there were positive messages that we found. And it’s going to sound a little ironic, but providers not talking about weight or body size at all was seen as very positive. So the silence around weight was seen as something that patients really appreciated. And instead, you know, focusing on, you know, bio-indicators of health, that was more comforting to patients than, you know, anyone mentioning weight or body size for every appointment, or every concern that an individual has.

AM: Wow, it’s remarkable to think about that. Not commenting on somebody’s weight as taken as a positive. Thank you for that. So you’ve shared with us the problem, how you are approaching it, what you are learning from this approach. And the fourth question I ask people is, what are next steps for you? But I also want to give you the option of, are there things you want to share with folks who are listening who want to get better at their communication with patients?

Maggie: One huge takeaway that that we’ve taken out of this research and hope, you know, to advocate and to remind people, that the poor treatment that individuals are facing, the discrimination that they’re facing, that it’s not an individual’s fault. That there are resources and support systems available to you, and there are people such as Erin and I and other activists and other researchers, who are really working to address some of these issues and to promote more inclusive and compassionate patient care. And just a reminder that for individuals in fat bodies that you are not broken, it’s the system that is broken. And just again, to say that this is not your fault. And a lot of work needs to be done in this area.

Erin: Yeah, one thing we always emphasize when we talk about our work is that this is not an interpersonal problem. It is a structural problem. And the stakes are very high. This is life and death for people. And so we don’t ever want people to come away from these conversations thinking that it’s about hurt feelings. “People are having their feelings hurt. So we need to make changes.” It’s lives that are on the line. And so it’s really important that we as communication researchers, and people in other fields, continue to understand more about why this is going on. And with that said, we know that this experience is not the same for every person in a fat body. That maternal mortality in general is exponentially higher for people in Black and Brown bodies. And experiences for people who are gender non-binary, genderqueer, their experiences are different. People who are not in heterosexual relationships or marriages. And so we always want to make note that an intersectional approach, when we talk about health care in general and especially reproductive health care, is really really vital. Because people live and die by what happens in these encounters. And so it’s really important we continue to look at it.

AM: Thank you so much for this. Maggie and Erin, thank you for taking the time to be on the show today and to educate us. I’m going to go ahead and drop links to your articles in the show notes so that people can read them. And thank you for the learning that you’ve helped me to through your research and through our conversation today. I’m so glad you came on the show.

Erin: Thank you.

Maggie: Thank you. This was awesome.

Thanks again to Dr. Erin Basinger and Dr. Margaret Quinlan from UNC Charlotte. They have shared with us some wonderful resources whichIi’m linking to in the transcript. So be sure to visit healthcommunicationpartners.com and click on podcast for those links. You’ll get the links to these resources and resources from every episode in our series. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional music by Alexis Rounds.

The post Dr. Erin Basinger & Dr. Margaret Quinlan on Anti-fat bias in reproductive health appeared first on Health Communication Partners.

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Our live event is just around the corner! It’s just one of many ways HCP can take things off your plate.

Because you’re listening to this show, chances are you’re also working on some of the most deep-seated and persistent problems facing society today. I talk with my colleague, India Menon, about what it means to get into the weeds with you and support the work you do in the world.

Hi everybody, I’m Dr. Anne Marie Liebel, and this is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m happy to announce my first live event open to the public here at Health Communication Partners. It’s on reflective practice. and in these tough times, reflective practice can give us the tools we need, and the reason we need, to pause and consider deeply some of the motivations behind our actions. This is what reflective practice contributes to us and our work.

You’ll hear real-world examples from healthcare, academia, academia, business, and public health, and gain insights into what reflective practice can do for you and your work. Please join me and some of your colleagues! We’re going to get to interact with each other and tickets are going fast. It’s coming up at the end of this month, so visit healthcommunicationpartners.com and register today.

Now I’m going to turn to part two of my conversation with my colleague India Menon about what it means to get into the weeds and face some of these really persistent issues along with you and the clients that I am privileged to be able to work with.

India: All right. So courses, that’s a really big part of what you do is you develop and you deliver these courses to your clients. But you do consulting and coaching, right?

Anne Marie: Yeah. Yeah. So the courses were kind of because the whole world did the switch to have, you know, online life with COVID.

India: Sure

AM: My heart’s always going to be in working with people and being on the ground and being close to the fire and just, you know, getting into the day -to -day problems and attaching them to, what is our vision? What’s our strategic mission? What are the kinds of requirements that we’ve got to meet? And that’s where, I mean even with my courses, that live session has a very coach-y, consult-y feeling to it. So what has happened is that people who’ve taken my courses have then kind of come back to me and said, You know what, can you help us with some of these issues? They’re bigger issues that you’re getting us to think in different ways about. Can you do some more work with us on them? And that’s super. I appreciate that and I see it as a real vote of trust that people have taken the courses. They're like, “Yeah, what you’re saying makes sense. You’re talking about what we are experiencing. Come on in and spend some more time with us and walk along and give us some more of these tools and help us understand how we can meet the goals that we’ve got, get to the objectives that we’ve got. And it’s gonna be a little bit different in every place, but that’s what I’ve been doing for years and years and years and I love it.

India: I am sure, it sounds like you’ve probably learned a lot.

– Oof. (both laughing) –

India: ‘Cause I think sometimes when people hear the word ‘consultant’ they kind of hide under their desks.

AM: Right.

India: But you know, I mean, my understanding of what you do is, that it’s really your focus on what resources do people have at their disposal and how can we leverage those?

AM: Absolutely. Yeah. Thanks for that too. Thanks for that. Kind of like, I’m not coming in and being like,’ all right, you’re doing it all wrong. Do it like this.’

Yeah.

We start with, all right, well, what are you doing? And it’s also not, it’s also not an additive. It’s not one more thing stacked up on top of what you’re already doing. Like, and I think that’s one of the things that people like, is that I’m getting in and helping you do kind of process improvement. Like, what are you already doing? What are the actions you’re already taking?

Yeah

Let’s optimize them. Let’s get, let’s, let’s be preventative. Let’s make sure we’re getting errors out of the way, if you want to use that kind of language, and help make the systems and processes that you already have in place work as well as you can. And then we’re gonna talk about is something we need to add.

Yeah. Awesome. Yeah Yeah, that just takes like 20 minutes, right? Done! Thanks for having me ! You know, I was wondering if you could tell me a little bit about– also because I think the people will want to know– is how do you know it works? Like if I’m a client, you know, is there data that you collect and then share with folks? Like does it work? How do you know?

Yeah, and that’s a question that when you’re in an Educational scenario, like going way back, You know, we had a whole lot of different metrics that we needed to hit to show that we were doing what it said, we said we were doing. So in healthcare and public health, there are so many metrics that are collected. So there’s always going to be engagement metrics, there’s going to be people who are registering, there’s going to be people who are responding, there’s going to be numbers like that, butts in chairs, you know. How many phone calls does it take? How many visits does this take? How long does it take? So those kinds of quality metrics depends on whatever the quality framework is that the organization is using. But people want to move those kinds of metrics. Another set of outcomes that I’m often asked to help out with have to do with, let’s say, some national standards, like the Culturally and Linguistically Appropriate Services (CLAS) standards. CMS has its health equity framework. So one of those standards or one of those priority areas that I’m working with. Right now, we’ve got more regulatory is coming along with health equity requirements. Again, it hits the quality improvement world. So those are the numbers that we’re looking at, I think most often in healthcare and also in public health. But then when you look at the corporate world, everyone’s got their employee engagement concerns, employee satisfaction, retention, attrition. Like, you know, employees are hot commodities right now,

Yes

And companies want to keep them and want to be good to them

Sure

And want to help grow their people. So it’s, it’s a similar world in that sense.

Yeah. And then you also, if you, if somebody takes one of your courses, don’t you do an assessment on the front end and back end?

So yeah. And that, yeah, really great question. And that’s something that’s evolving. Because I have these kinds of, it’s a hands on process with me, and everyone is different. So trying to learn more about that particular client and that particular group, and what their goals are and what kind of progress they’re trying to make towards a specific strategic goal.

Sure

So that you have to do on a one by one basis with an organization.

Yeah. Well, and I was also thinking about like on some of your, the courses, like the patient ed course, you know, I was just crunching some numbers last week for you. And it was a pre -test post -test. And it’s really just so fun to kind of read their comments and see what people are getting out of it. And then also the numbers tell us too, a lot, right? That they are making– I mean, a lot of the folks that come to your courses are already pretty savvy, but they walk out with even more. And the numbers are bearing that out too. Which I thought was, it’s just fun to be part of.

I’m so grateful for you and your research savvy. And to be honest, you’re numbers!

So you’ve got the webinar, you’ve got courses, you do consulting and coaching. Can I ask you to tell me about one of your favorite clients and why are they one of your favorite clients? Well, you don’t have to name names.

Right. I was gonna say I don’t really have permission to talk about people. I mean, I am really, really grateful for the clients that I have that allow me to put some of their statements with their name on it on the website. So you can definitely read like the who’s who on the website. And I have a few more of those I need to put on. I gotta refresh that. But one of the things I can say is that most of my clients are repeat clients, which is also something I am

Ooh

Yeah, I’m proud of. I never even thought about that as something to be proud of. I’m just really happy because I get to keep working with them, because I understand more about what they’re doing. And I understand their context. I understand their problems. I understand their strengths. So to be able to keep seeing people–like you said, they’re already strong–get stronger, do new things,

Hmmhmm

Break into new ground that they hadn’t been in before. It’s immensely satisfying as an educator. And it’s also really exciting as a researcher. Because for some of my clients, it goes to that level where people are actually having to do research. So that’s also immensely satisfying too. But just being people, because this is long -term work. like none of this is like quick, you know, rappel and out, we’re done. Like this is long -term change that we’re trying to make. It’s deep work. And it takes time. So I’m really proud that a lot of my clients are, most of my clients are repeat clients.

Yeah

It’s a great relationship too.

I like that. It suggests that they’re probably like focused on like sustainable change, right? Like they don’t want to just check a box usually.

That’s not who's very attracted to working with us, no.

Yeah. Well, Anne Marie, this has been lovely. Thank you for giving us like the latest, uh, like, shakedown on what’s happening at Health Communication Partners. If people want to learn more, they can of course, what like keep listening to the podcast, but where else can they learn more?

Sure. So the Health Communication Partners website, and we are also on LinkedIn, I’m probably more active on LinkedIn than I am anywhere the last few months, but we are also still on X formerly Twitter. And you can always drop me a note too. I love hearing from people, Anne Marie, A -N -N -E -M -A -R -I -E at H-CPartners.com or go to Health Communication Partners and click on contact. It comes right to me. Don’t forget to sign up for the newsletter too because if you get our newsletter, you can reply to the newsletter and it comes right to me.

Awesome, Anne Marie, this has been really fun. Thanks for taking me behind the curtain and shining the light on all the hard work you’re doing behind the scenes, it’s awesome.

And that you are helping me with too and all the hard work you’re doing too.

Oh, it’s been a real fun journey. Thank you.

Oh my gosh, thanks so much, India.

All right, talk to you later.

Sounds good, bye!

Bye!

Bye.

Thanks again to India for being on mic with me. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music by Alexis Rounds. Rounds.

Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners, LLC. Find us at healthcommunicationpartners.com.

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An HCP team member joins Dr. Liebel on mic for the first time to share some of the many ways HCP can help you and your organization. We also announce our first ever live event!

There’s a first time for everything, and today’s episode is the first time for two different things. I get to tell you about our first ever live event. And I get to introduce you to someone from my team that you haven’t met before.

Hi, everybody. This is 10 Minutes to Better Patient Communication from Health Communication Partners, and I’m Dr. Anne Marie Liebel. I’m going to go ahead and jump right into these exciting first times. So right away, I want to tell you we’re gonna have our first ever live webinar. You, Me, and Reflective Practice. Yes, the topic that most people ask me about and associate with my approach in this show. If there was ever a time for reflective practice in the workplace, it is now.

Reflective practice helps you tackle known problems in new ways. So if you would like to learn more about reflective practice and how you can apply it in your workplace context, you’ll want to sign up for this webinar. It’s happening later this month in just a couple weeks, and I’m going to keep it small so that there’s time for us to interact with each other and also time for Q &A. So be sure and register right away because it’s going to fill up quick. Visit healthcommunicationpartners.com and you’ll see the information there.

Now, I get to introduce you to someone on my team at HCP that you haven’t met before. Her name is India Menon and she’s just great. Well, I am here live with my friend and colleague, India Menon. India. How are you?

India: I’m great. I’m really happy to be here with you, Anne Marie.

AM: You’ve been here with me since the start. Since before the start, really, of Health Communication Partners, when it was just a dream on a poster board.

India: Yes, been a wild ride.

AM: Oh boy, oh boy. But people haven’t gotten a chance to hear from you before or meet you before because you’re in kind of a behind the scenes role with research support and assistance, and you’ve been doing project management, you’ve been doing social media. I still remember when you were live tweeting my first talk at Columbia, right?

Yeah, yeah.

And gosh, the vaccination campaign research. That was cool. So anyhow, hey, everybody: India. India, everybody.

Hello!

So the idea for us to talk with you today came from a text that India sent me yesterday.

Yes, yeah, last night I was washing dishes and I was just thinking about our work, and kind of like what might be some, something that we need to do. I love listening to your podcasts and I had the light bulb. And I was like, hey, you don’t just do the podcast. A lot of your listeners may not know that. We’ve gotten a lot of new listeners lately. And you’re a lot more than just a podcast, Anne Marie. And so hey, let’s like reintroduce Health Communication Partners and Anne Marie to the people.

So let’s do this, let’s do this.

Let’s do it, okay. So, Anne Marie, I just kind of thought like, well, I have a couple of questions for you. So kind of let’s just bat some questions around, and that way people can get to know a little bit about you and about health communication partners. So people listening to this. It’s 10 minutes to better patient communication.

But I also consult, I have courses, and I do coaching. I have a kind of a coachy vibe even in my courses, so.

Awesome. And wait, you also have another piece in the pipeline coming up, a webinar?

Ooh, yes.

And we’ll talk more about those other pieces in just a minute ’cause I have questions, but I’m really excited about this webinar that you’re doing. How can people find out more?

Oh, absolutely. Yes, right. So go to healthcommunicationpartners .com and we’re gonna have a banner there on the homepage. And if you’ve signed up for my newsletter, you already know about this. So if you want to keep in the know, make sure that you sign up for the newsletter, because that’s where I tell you about things like this. So I’m jazzed about that. And it’s going to be out on the health communication website too.

So that’s a big project.

Yeah. Yeah.

Big one.

I’m psyched though. I’m psyched. It’s just because it’s a chance for me to interact with people. because as you know, podcasts, you’re kind of like, you know, you’re speaking out into the void and people write and people interact with you on social media. But like a webinar is me getting to interact with you right there live, which is my favorite.

Yeah, that’s awesome. And you’re so good at it too. You really are.

Thanks, it’s my jam, I love it.

Okay, so we’ve got the webinar is in the works, but then you’ve also got courses. Tell me about them.

Oh, awesome ok. so I’ve got two courses out there. Shorthand is like equitable patient communication and equitable patient education. And those are all you want to know more about them, you can go onto this site. And those are, gosh, five years in the making because it was a lot of these, I mean hundreds and hundreds of conversations that I had with people on the ground doing the work, people who are working with patients. And the research base that I come from is part of it too, but then I had like during COVID, everyone’s going virtual. I thought, how do you do this kind of very on -the -ground, high -touch, context -dependent work in an asynchronous, remote atmosphere? And I talked to my mentor about this, and she was right. She’s like, you have to meet live with people. So the work of these courses is like I take the kind of the commonalities, the very fundamental foundational notions that you want to be able to wrap your head around that I’ve seen across the various contexts that I’ve been a part of, that’s the prerecorded part. You watch that and then we meet live, and like we get down to business.

Love it. Well, what happens in one of those live meetings? Like what’s, like what’s the power of that? class is in session! What is the power of that?

Right, thanks. It’s fun for me. I mean, it’s just wild for me because every context is different and every group of learners is different. So every time, like I’m walking into a new scenario, but all of the people–so people take these courses in an organization. So all of those people know each other, many of them work together, but like not all of them work together or get to connect with each other enough. So one of the things I’m constantly hearing from participants is how much they like being able to connect with each other during the live sessions, which is great, but it’s also where social learning happens. People are already helping each other out on their day -to -day work, but this is a very powerful space to do that and really get some intense collaboration happening together. Where people are processing together what they just learned in the prerecorded sessions. And then they get to hear what everybody else thought about those prerecorded sessions, and how they’re processing what they learned. And then we get to talk about, well how’s this going to work here and now, with you, right here in your context and your patients and your priorities. So that’s what happens in the live session.

That’s amazing. So it’s kind of, you give them the material or they kind of collect the material in that first session and then in the live session, they make sense of it together.

Yep.

Awesome. That’s really awesome.

Thanks, yeah, I think so too. And again, I want to thank my mentor, Susan Lytle, for this, at the University of Pennsylvania. Because she’s like, “it’s got to happen that way.” This is not one size fits all work. and we know it isn’t.

Yeah.

So it’s finding like, what are the commonalities? What are the foundational concepts and then how are we going to apply them? So that’s why there’s the live session.

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So that’s, you’ve got equitable communication and then an equitable patient education. And do you have another course on the pipeline or is that still kind of to be announced?There’s one. You can out me like that! So there’s one that I’ve been working on that I’m jazzed to talk about. And this is because health systems and health departments are workplaces. I’ve done a lot of the podcast episodes here have been on interprofessional communication and interdepartmental communication. And I’ve had some businesses ask me if I can do communication for them. So that’s got me thinking about what is common across industries from my own experience as a consultant and as an educator. What am I noticing that is similar across workplaces? And then another one that several people have asked for and I’ve done for clients live and now I’m turning into this hybrid course format is to help people who are maybe managing a group for the first time. and how can people who are new managers or in a new leadership role manage? Y'know, how can they communicate better? Yeah. How can they lead their team, whatever their team is?

Wow,

That’s one I haven’t talked about publicly before!

Good job on ripping that Band -Aid off. That’s exciting, though, because you’re kind of finding the cross cutting, like foundational understanding about communication. And then, you know, I think that’s something that doesn’t really know professional boundaries. That’s pretty exciting!

Now India and I will continue our conversation next time, so be sure to tune in, and also don’t forget to register for our upcoming live webinar on Reflective Practice at Work. This has been 10 Minutes to Better Patient Communication from Health Communication Partners, Audio Engineering and Music by Joe Liebel, additional music by Alexis Rounds. Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners LLC. Find us at HealthCommunicationPartners.com

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In today’s episode, I talk about time with otolaryngologist and podcast host, Dr. Bradley Block. He shares some of what he’s learned about efficiency in patient communication.

Time. It’s the ultimate constraint on any interaction. In today’s episode, I talk with otolaryngologist and podcast host, Dr. Bradley Block. He shares some of what he’s learned about efficiency in patient communication.

Hi, everybody. This is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel. Our course Equitable Patient Education promotes high -quality clinical practice in patient education by helping prevent avoidable errors. Learners say there’s a lot of eye -opening information I hadn’t considered before, and, this course helped me look at myself as an educator and helped me to step back and analyze how I can be a better nurse. For more information, visit healthcommunicationpartners .com.

So today, I get to share with you my interview with Dr. Bradley Block. Dr. Block is a private practice Otolaryngologist on Long Island, New York. He’s a partner at ENT and Allergy Associates and creator of the Physicians Guide to Doctoring Podcast. I’ll put links in the show notes. And Dr. Block said he started this podcast series six years ago to improve at doctor -patient communication and he’s expanded the topics to include, as he puts it, “everything we should have been learning while we were memorizing Krebs cycle. It was very fun to sit down with him and he’s going to have a lot to share with you about what he has learned about efficiency in patient communication. Here's Dr. Block.

Dr. Bradley Block, what is an issue or a problem in patient/physician communication or patient education that you have been facing?

My main goal, I guess, has been to tackle efficiency. Not just communicating well, but communicating well efficiently. Because it’s important to me that I’m respectful of the patient who’s in front of me. I want to make sure we cover everything that they want to cover in a reasonable timeframe . But also I want to be respectful of the people in their waiting room and their time, and the people waiting at home trying to make appointments. Because if we let people fill as much space as they want, there’s not going to be time for the people in the waiting room and the people at home to make appointments. So efficiency, without sacrificing doing it well.

That’s a big issue and ever since I first started talking to folks in the health sector, one of the first things that people are going to say is, “But I only have 10 minutes. You know, I only have 15 minutes, (this is why have a 10 minute podcast series) I only have such a short amount of time. You know, and that in itself can be just alarming. Just an unbelievable amount of work that you’re supposed to do in an unbelievably short amount of time, complicated issues, enormous institutional pressures anyhow. So it makes sense. I can get why efficiency is something that’s got to be top of mind for a lot of people. So how have you been facing, I mean, probably there’s many things that you’ve been doing to face this issue of efficiency. But what would you like to talk about?

Thinking back, how have you faced the problem of trying to be more efficient in your communication?

First, I started consuming podcasts to try and learn how to be a more effective and efficient communicator. And then I ended up creating this podcast where it’s not everything we cover, but it’s a lot of what we cover. And it’s, the main impetus for me to create it to begin with. So that’s how I faced it. It sounds ridiculous, now that I’m saying it out loud. But how did you face this communication challenge that you had? Well, I created a podcast and i’ve devoted the last five years or so to it, but yeah, that’s how I did it.

And there’s something enormously courageous about that. We talked about Raj Sundar earlier and he also had a similar impetus. He’s like, “This is a thing I don’t know. It is so important to me. I am going to educate myself, and I’m going to do it in a specific way. I’m going to consult experts, but I’m going to ask them to talk with me. I’m going to ask them to tell me their stories.” And that sounds like something that you have done. But it’s enormously brave because you’re putting yourself out there. You’re not just having these conversations in the privacy of your own home. You’re going public with this.

Yes, which has never been an issue for me until my patients find it. And then I’m like, “Oh, what did you hear me say?” And it doesn’t happen that often. You know, I never know which one they happen to listen to. You know, I never know what I end up saying because, you know, sometimes what I talk about is my own fallibility. And the challenges that I’m having. So if my patients listen, “Oh, he’s having these challenges,” but nobody’s ever taken it that way. Everyone’s always been like, “Oh, wow, he’s trying to improve himself.” So, you know, they take it as it is, as it’s meant to be, which has been nice.

What do you think you’ve learned? I mean, you’ve been doing this for five years, almost six years now. I’m sure there’s quite a lot of learnings that you’ve had about communication. I’m sure you’ve learned a lot about your patients. You might, it sounds like you’ve learned some things about yourself. You wanna talk about any of those?

The surprising thing that I learned is– ’cause I think if I go back to like a specific episode, yes, I mean, you know, each one– nonverbal communication, and the one we talked about before the show is that we developed these heuristics, these spiels that we, you know, so we can kind of like shut off our brain and just talk. And rather than doing that, you know, actually using that extra bandwidth to read the room and improve each visit. You know, it could go into each one and boil it down. But I think one of the surprising things that i’ve learned from doing the show and then incorporating what i’ve learned into the exam room, is that it can actually make the visit more cognitively taxing for me, not less so. Because if I didn’t care, and I just went about the visit and I listened and I examined the patient, and I told them what it was going to be and like the old school paternalistic way, this is how it’s going to be, I’m not taking any emotional baggage away from them. But because it’s so important to me that each visit goes well and I’m trying to incorporate all of these different things that i’ve learned into each visit–It’s a lot! It’s a lot. And even though it’s made me more efficient and it’s made me better, it’s also, you know, the goalpost never stops moving. And it’s my goalpost that i’ve set for myself! It never stops moving. So i’ve moved it further away. And therefore, like I have to be better. And so now I’m trying to incorporate this stuff. So then I have to be even better. And it just, the goalpost, it’s always out of reach. But you know, that’s– most visits end up going really well and are not that challenging. But then those challenging ones really, they end up being more emotionally taxing. Notice: JavaScript is required for this content.

Thanks for that. And thanks for that honesty. And again, a lot of courage and a lot of bravery there. Because I can only imagine how much pressure there is on you to at least seem like you’ve got it all figured out, to sound like you’ve got it all figured out. I know that in my years, now in the health sector, i’ve witnessed this kind of feeling that there is a right way' to do things. I understand medicine has to be standardized in a lot of ways, but we also understand people aren’t standardized. There seems to be like an inherent tension in there that I think people maybe are getting more comfortable talking about a little bit. But I hear you saying, “Oh no, I’m absolutely in that tension.” Like, I’m absolutely willing to say I’m not perfect at this job, and the perfection itself is kind of a pressure that I could do without. Thank you very much. But I’m willing to constantly make myself a little bit uncomfortable by moving those goalposts. Because you realize that there’s something else you need to learn. And if that’s not something to celebrate, I don’t know what is. This is what reflective practice does. It draws us deeper into our work. Because there’s so much in medicine and healthcare and public health that takes people away from their work. I mean, I’m applauding you on just deciding that you’re going to go down this path of your own learning, even if you have to forge the path yourself. Every step of the way. And when you find out that, oh, it doesn’t just automatically make things easier, it does make them richer. It does have, at least for me, like there’s enormous satisfaction, as much as there is an emotional toll to be paid too. When you are deeply engaged in the work, it takes it out of you. Which is why also I think the show that you’re having is a great idea because you have surrounded yourself with a community, and a community of people who give a damn about some of the same important things. And so when I’m working with clients, that’s something that I’m advocating: do not do this work alone. So I teach people how to, if they want me to, teach them how to begin communities of practice. Because this work is hard. It’s hard doing what you do. It’s hard being reflexive. It’s hard advancing equity. But we’re not in it alone, and we shouldn’t be in it alone. And I think we all know it’s a marathon. So building that community around it is absolutely an essential part of the work. And you knew that, and you did that. What are your next steps? What’s next for you? Or if you would like, give a word of advice to folks who are feeling the efficiency pressures

There are resources out there you can find. So if you’re having issues with efficiency, one, know that you can improve. Because what I hear from some people is, “this is how I am.” But you can be better than you are. And if you don’t try to improve, you’re never going to improve, but you can. Because I hear from physicians all the time, this is how I am. It’s not going to change. There’s no point in trying. And that’s just the completely wrong way to think about it. You can improve. You just need to try. You need to be methodical about it. And you really need to, as you say, reflect. What are the things that are really weighing down my efficiency? and it might be something simple, like get your cell phone out of the room. Don’t open up your email on your screen. Like what are the distractions? Stop talking about yourself so much to the patients. Right? There are things that we do that we really should be able to reflect on. Like what is occupying so much time in my visit? and ask someone for advice. Because if you have like a medical assistant or a PA or a nurse or a partner or someone who sees you seeing patients, they might be able to tell you, as long as you’re ready to hear it. Because you need to reflect and you need to figure it out, because it’s there and you can improve upon it.

Absolutely. Reach out to your colleagues. Even just one colleague. I love that, Brad. And then they can turn around and ask the same of you. you know, can you just observe me for a little bit and what do you see here? How do you see me spending my time? It’s not an error hunt. It’s not a free -for -all. It's a Here’s what I see. Here’s what I think jumps to mind when I look across the day of all the cases that I saw you deal with. Here’s something that leaped out to me. Take it for what it’s worth. Done in a friendly spirit, done with support, done with the idea that we’re trying to grow as professionals. It’s absolutely doable, but it does take some bravery.

You’ve got to be willing to listen to what might be perceived as criticism. If you’re genuine about your pursuit of improvement, it’s necessary.

Thanks again to Dr. Bradley Block, Otolaryngologist and creator of the Physicians Guide to Doctoring Podcast. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. Additional music by Alexis Rounds.

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Happy New Year! Here are 4 reasons to be hopeful if you care about communication. Got a minute? Tell us what you think of this series (anonymously).

We’re starting 2024 with some good news. Today’s episode is about four trends I’ve been noticing in the communication circles that I run in that I think are reasons to be hopeful.

Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel. If you like what you’re hearing on this show, you’ll love our courses. Here’s what some learners have said about our course, Equitable Patient Education. There’s a lot of eye -opening information I hadn’t considered before. This course helped me look at myself as an educator and helped me to step back and analyze how I can be a better nurse. For more information, visit healthcommunicationpartners.com.

Now I love to see what people are doing and fortunately, that’s my job as a consultant and a researcher and a business owner and a podcaster. This communication space we’re all in is big and so are the issues that we work on. They’re also very layered and nuanced. So seeing the pieces of problems that organizations and individuals choose to work on, I find really eye -opening and inspiring. So I want to share with you some of what I’ve been noticing lately in the conversations and projects that I’m a part of that I think is forward -thinking and deserves to be applauded and deserves to be uplifted. Some of the encouraging actions that people are taking and the solutions that they’re seeking.

The status quo has got to goSo first of all, I’ll call it the status quo has got to go. This change train keeps rolling and I am happy about that. the momentum to disrupt the status quo in communication is still going. And what I think is really impressive is how many folks are owning up to mistakes, then making commitments to do better, and then acting on those commitments.

For some high profile examples, I’m going to turn to some of our favorite government agencies. First, CMS, John Czajkowski at CMS said, we can no longer tolerate business as usual. What we need to do is reinvent the way we work.”

From the CDC, we had something similar, specific about communication, in their Moving Forward What It Means for the Future of Health Communication webinar. This webinar, and I’ll go ahead and put links in the notes, was about lessons learned. Evidently, there’s been a lot of reflection and hard conversation going on. at the CDC about what needs to change, and communication was definitely on the table. In the webinar, they said where they wanted to go was to create communication of care and inclusion that works for all of us and not just some of us. And I think those are powerful words from the folks who brought us the Health Equity guiding principles for inclusive communication.

They also said one of their goals was to help CDC staff more effectively communicate with the general public. And you know if you’re listening to this show how difficult that task is, to take complicated scientific knowledge and terminology and communicate it to the public– while doing so equitably.

So I applaud this, I support this kind of reflection and action. because that’s what we do here at Health Communication Partners by bringing communication research and perspectives that haven’t yet been widely used across healthcare, but have long track records and are especially well suited to present goals like the ones that we just heard from federal agencies.

Equity and communicationAll right, trend number two, equity and communication. People are more broadly aware of some of the many connections between equity and communication. This space is larger than I think people might think which is exciting because that means lots of opportunities. Health Communication Partners exists because years ago, yes pre -COVID, lots of people recognized that paying attention to communication was important to equity. Years ago, people were asking me– then it was about microaggressions and about health literacy, kind of overly discriminatory terms, and all of this is still very necessary.

Rest assured there’s a lot more work to be done in this space. I had, for example, I had a client ask me, We’re losing people. Our language is way too top -down. That was a great catch. Another client asked me for help with language that they felt was othering and excluding. I think we all know that language like this contributes to inequitable treatment because so many of the kind of touch points or interactions that people have with health systems and services are done through language.

So lowering barriers to access means getting serious about how we can sometimes get in our own way in communication, doing some soul searching like the CDC was doing. So I am hopeful about this. And I think there’s challenges here. For sure.

First of all, it’s change. It’s tough to imagine alternatives to the way we’ve always done it, because the way we’ve always done it is deeply in our language. Language that keeps people out, or you know holds people back. But I’ve been studying this for years, what equitable communication can mean, what it can look and sound like in different contexts, and that’s what I help clients understand. So I know we can do this, lower the barriers to access by looking closely at the communication that we’re already doing. Yay on the trend of equity and communication together.

Collaboration and communicationAnother communication trend I’m seeing is the continued emphasis on collaboration. Now, if we’re gonna sustain this change, I think a lot of people realize we need support in doing that. So it doesn’t become kind of silo'ed. It doesn’t become the responsibility of just kind of those people over there.

How do we sustain the change? How do we sustain ourselves? ourselves? And one way I’m seeing organizations answering this question is collaboration. Again, back to CMS on this, one of the speakers at this recent event that I was at said, “When we dare to disrupt systems, we need to learn from one another and share information and do everything we can to build the best relationships we can have.”

Another example I wanted to tell you about is from a MedEd conference I was at Anti-Racist Training in MedEd. Recently I was presenting about our Equitable Communication Course. And a few comments from participants at that at the conference are also about just the real crucial nature of collaborations. because as one person put it, A lot of us work in very silo'ed spaces where you only talk about your work with maybe a few people. You don’t realize down the hall someone else can inform what you’re doing. Community and connection is something that can break down those barriers. Notice: JavaScript is required for this content.

And this was echoed by another participant saying, “Connection mitigates trauma. Bringing people together to talk about the emotions of this work can be helpful.” I was also talking with a client who’s in cancer research who really pointed out how important it is for that organization to have increased representation of underrepresented groups in decision -making positions in the healthcare setting and other institutions.

So again, I’m applauding this recognition of how important it is to have people around the table communicating, collaborating. Are there challenges here? Absolutely. One of them is that communication champions like yourselves at all levels are spread thin. and collaboration is complicated. We can’t just put people in the same space and call it a collaboration. I’m gonna put a link in the show notes to our episode with our friend, Sam Cinnick from HRSA, talking about just this very topic.

Because we help in this area, whether you’re looking at collaboration for support, addressing common problems and barriers, or you really wanna get to work developing more equitable solutions, contact me. You know how to do that.

Workplace communicationAll right, fourth trend that I’m super happy is still going strong with communication has to do with communication at work, interprofessional communication. At that MedEd conference that I mentioned, I saw a presentation by Sarita Martínez at Columbia University with her colleagues, Keshia Pershad and Todd Bates. They described their work as “concerned with the promotion, retention, reward, and recognition of the exceptional staff that our institution attracts but does not always successfully retain, celebrate, or protect.” Now that’s a space I am in as well, so I was very excited for their talk. It was about using the Surgeon General’s framework for workplace mental health and well -being. And more or less they were saying, you know, in a lot of workplaces, but specifically in theirs, “there’s a baseline of respect you can expect from your colleagues and that they can expect from you, but some people are just not experiencing that.”

And I think we’ve all heard some of these statistics. They were emphasizing how important it is to recognize that reality and hold leadership accountable for what they can do to create a safe space. And this is where communication came in. At its most basic level, this is about how people address one another and talk to each other and how we interact with each other. This is communication in the workplace. And what I’m being asked to do most as a consultant is this continuous quality improvement on communication, including interprofessional communication at the workplace.

So those are our four trends that I want to applaud. and I’m hopeful because across them I’m seeing a real rethinking and an openness to different ways of framing and enacting communication. There’s so much sophistication. There’s a lot of maturation here. And when we’ve got large organizations and agencies saying publicly, we can do better, we must do better, I want to applaud that and support it. Because this is a long road, folks, but we are on it together. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. Additional music by Alexis Rounds.

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I share the most common question I get asked as a communication expert. I tell you how I answer, and break down why it works.

No matter what your role is as a health professional, what your specialty or topic is, or who your audience is, this episode is about the single best piece of advice I can give you. Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel, and Happy Holidays! This podcast series is my gift to you.

If you like what you’re hearing, there are other ways that you can learn from me, like our hybrid courses. Equitable Patient Education supports your mission of making the most of your time with a patient. You work hard to be an effective educator. This course helps you improve your patient education processes, because I’m as committed as you are to educating well.

Support Reflective practice by making a donation to this series. your contribution goes directly to the costs of producing this independent alternative podcast series. Click the donate link in the show notes or visit healthcommunicationpartners.com/podcast.

You may have heard we recently passed a big podcasting milestone of getting over 10,000 downloads in a single day, which is amazing! Thank you so much. Because there’s so many new folks listening, I thought this would be a good time for me to share a piece of advice that I’ve given a lot over the years, in part because it fits across multiple scenarios, and it helps avoid common pitfalls, and it aligns with top research.

So back in 2019, I’d been asked to give a plenary session at a chronic disease prevention symposium. And during the symposium, when folks would find out that I was speaking and what I was speaking about, they would ask me questions about patient communication and education. And that day, I got asked several times a question that I get asked a lot anyhow.

And it’s some version of this: How can I say something that will get through?

I’ve heard this question many times, and always, I appreciate that sense of urgency that someone’s in front of me. They know that this is an issue, and they want to be better at it. so automatically I’m a fan of yours because you’re trying to be a better patient educator, and you want to communicate better because you know you have something that’s going to help bring about some positive effects in someone’s life. So I’m going to tell you how I answer that question and I’m going to break it down.

For this, we’re going to go back to the episode I recorded right after that symposium.

Whoever your audience, whatever your topic. begin with what people already do, know, believe, and have.

Sometimes known as starting where people are. The point is for you to take the starting point that people are already doing what you want them to do or know something like what you want them to know. You start where they are, and build on and enlarge their understanding with what you have to say.

Now I’ll break this down and show you how to get going. Starting where people are works in many scenarios. Maybe you’re a provider engaged in the consent process with a patient.
patient. Maybe you’re a public health professional training the trainers, or you’re a community health worker, educating individuals during group visits, maybe even via telehealth.
These three covered most of the scenarios I got during the chronic disease symposium, but it works in other scenarios as well. Maybe you’re a medical educator and you’re preparing for a room full of different learners. Maybe you’re on a hotspotting team and you’re researching patients in their communities. or you’re an administrator and you’ve got to boost patient engagement.

Starting where people are performs one function that’s part of all of these scenarios. And it is the single most important reason why you should start where people are.
It builds a connection.

Not just in a feel-good personal relationships kind of way, although that often happens too. This connection has to do with learning. It’s where you begin to connect what your patient or client or colleague or student knows to what you know.

Starting where people are is the only starting point you need because of how much it matters to your efficiency and your effectiveness. The reasons for this are simple. Notice: JavaScript is required for this content.

First, decades of learning research shows we learn best when education links the known to the unknown. That is, we learn quickly when new information is explicitly related to what we already know, what’s already in our experience.

Second, we attend to what matters to us. We will learn what we want to learn. We learn what we feel suits our purposes. So if we don’t see a connection between what you’re saying and what we value or what’s important or interesting to us, you’re setting yourself up to fight an uphill battle.

As much as you may wish that it were different, people don’t simply absorb the information given to them. Yet too often, a transfer of information–here, write this down or take this handout, listen to me–this seems to count as communication or education. and that’s true in clinical contexts as well as in classrooms.

Starting where people are benefits your communication and education no matter what your purpose or your audience. and there are multiple ways to do it. Today we’re going to explore one of them and I’ll give examples from the conversations with providers that I just had but you’ll see the core advice applies across scenarios.

Let’s start with what people already do. When you wish to encourage an action, don’t start from scratch. To give your recommendations a greater chance of happening, let someone see how it already fits with their life, with what they’re already doing. Too often, the focus is on what people are not doing. This is understandable. There is a problem you want to help address.

But as a starting place for addressing that problem, focusing on what people are not doing is not so great. Makes your job harder, potentially less effective and efficient. Find out, or bring to people’s attention, what they’re already doing that’s related to your topic. This is a powerful place to begin an education process. To put this a different way, rather than look for what people seem to be lacking or doing wrong, begin by learning about the activities which people are engaged in already.

At the chronic disease prevention symposium, I talked with some providers about starting with the assumption that people are already attempting to take good care of themselves, already doing what they can for themselves and their families and communities when it comes to leading healthy lifestyles.

This is important in any context as well as chronic disease, but I hoped to help the providers there shift their starting point from telling patients or clients what to do, to finding out what their they’re already doing that aligns with their advice.

For example, rather than starting by telling people what to eat, first find out what people are already eating. Identify what’s helpful or healthy in those actions, and reinforce them. In one of the conversations I had, an attendee who was an MPH student said, “Tell people they’re on the right track.” And I love that. I said, “Yes, exactly. Find out what they’re doing that aligns with your advice, underline it, reinforce it, bring it to their attention. Do this, more of this.”

This puts more emphasis on the patient or the client as capable, active, and involved. as a person who’s already making sense of their health and what it means to take care of themselves. And then you get talk about going one step further, take one little action more in that direction.

One of the times I got asked this question was in the context of consent. Works here too. What does your patient already have experience with or know about that has similarities to this process or point in the process? This may take some creativity and quick thinking on your feet, but your goal is to find a meaningful point in this person’s experience or observation and begin to build connections, connecting the known to the unknown.

So when it comes to the topic or goal of your education, ask people what they are doing already in that area. This also extends to what people already read, say, view, write or listen to, especially when health literacy is a concern.

You have the power to start where people are with what your audience already does, knows, values, and believes. And begin the work of talking across the difference, bridge building if you will. If you or a group in your organization would like some help starting where people are, let me know. Go to HealthCommunicationPartners.com and click on “Contact.” Find me on Twitter @AMLiebel. This has been 10 Minutes to Better Patient Communication, and I’m Dr. Anne Marie Liebel.

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10 Minutes to Better Patient Communication recently had more than 10 ,000 downloads in a single day. I can’t wait to tell you all about it!

This is amazing. This is wild. This exceeds the realm of the normal for me. I am still in awe. And when extraordinary things happen, I think it’s okay to freak out a little bit. It was hard for me to believe, even as I saw it coming. Our little-podcast-series-that-could recently had more than 10 ,000 downloads in a single day.

In this episode, I'll tell you all about it. There’s so many new people listening, so hi everybody! I’m Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication from Health Communication Partners.

I want to introduce, or reintroduce, myself and tell you what we do at HCP. Beyond the podcast, we consult, we create courses like Equitable Patient Education. They are hybrid, part online, part live, courses. And why do we do this? Because a feedback like this that we’re getting from some of our learners. One said, “This course helped me look at myself as an educator and helped me to step back and analyze how I can be a better nurse.” Another learner said, “Educators could really benefit from this. Quality improvement folks too. Anyone trying to change policy or develop infrastructure. So if that sounds good to you, go ahead and visit healthcommunicationpartners .com and you’ll see Courses there.

We’ve worked with clients like Cleveland Clinic, Columbia Mailman School of Public Health, Bristol Myers Squibb, many more. So we’d love to work with you! Go ahead and reach out. We’re doing this because we’re all trying to reduce avoidable health inequities and promote more inclusive and respectful workplaces.

And at HCP, we’ve had a banner year even before this 10,000 download day. We have 166 episodes and still going. They’re on communication and patient education topics that you care about.

So yes, just the facts: we had 10 ,300 downloads in a single day. And for a niche, a very niche, interdisciplinary, word nerd podcast series, this is just unbelievable. If we were in a record store, we would be in the indie/alternative section because of our approach to health communication and patient education.

But before I get into that, I want to tell you really quickly, there’s a whole bunch of new platforms that you can hear us on. You can listen to tune in, iheart Media, Good Pods, and Radio Public, in addition to the platforms we already had. All of these are available at healthcommunicationpartners .com. If you pop over there, you can get our newsletter, check out our free content library, and transcripts to all 166 of our podcast episodes with links to research because I love linking research to practice. If you’re over there, some of you who have been with us a while and might have noticed our snazzy new website look that we unveiled earlier this year.

This 10 ,000+ downloads in a day is a big accomplishment. And I worked really hard to make this happen. It’s one thing to start a podcast, but it’s another to build a show with consistent episodes, consistent growth. From the research, the writing, to the rehearsals, to the guest preparation, to the music composition, to the recording, to the audio engineering–big shout out to my brother Joe, who’s been my partner in crime this whole time, and our dear friend, Alexis Rounds, for some of the great sounds that she’s sharing with us.

I also could not have done this without you. Yes, if you show up every two weeks and make a podcast episode, for more than six years, you’re gonna have 166 episodes guaranteed. But what’s not guaranteed is an audience. And you’re here, and the amount of intentionality that goes into listening to a podcast–there’s between what, three and four million podcast series out there?! You chose ours. You’re here. You’ve opted into a very specific space.

You’re taking 10 minutes out of your incredibly busy day to use equity lenses to reflect. So I’m officially one of your biggest fans. It’s you who’ve made this number happen. Thank you. Thank you for listening. Thank you for downloading. Thank you for sharing. Thanks for getting in touch with me.

If you haven’t, there’s three ways you can do it. Email me, annemarie at h-cpartners .com. Go ahead and find me on Linkedin. You can message me there. You can also visit healthcommunicationpartners .com and click on Contact. A part of why this 10 ,000 means so much to me is that the spread is mainly by word of mouth, so thank you.

Now briefly, for our friends here who are new, in this show I pull from a specific knowledge base about language and learning that I adapt to the problems that you as health professionals and public health professionals tell me that you are having in health care, in public health, in digital health, and the workplace. And these are complicated, multi -layered, intersectional problems.

Back in 2017, when I started this show, the situation and the circumstances that kind of gave rise to it I think we’re all familiar with. We’re certainly all familiar with the dominant approaches to communication and to education. And we’re all familiar with the need for alternatives. So even back in the before times, that’s what this show was about, using equity lenses to look at communication, using equity lenses to look at education.

And then 2020 happens: the pandemic, the murders of George Floyd and Breonna Taylor. And some of these conversations that had been in kind of just specific pockets here and there,
especially in academic spaces, were global. They were suddenly everywhere, and our show audience definitely expanded then too. Notice: JavaScript is required for this content.

But those situations are still here, and we still need support for everyone involved. Because this is a long road, and it can often feel overwhelming because it often is overwhelming. And you’re staying open, and it takes courage to do this. It takes courage to stay on the path. It takes courage to question assumptions. It takes courage to question ourselves. It takes courage to reflect. It takes courage to be asking these kinds of difficult questions. Because you care about educating people, communicating with people. Not just most, not just the easy ones, but everybody equitably. That’s part of what makes this show community a great community.

And it’s a good thing, too, because this is hard work. We’re dealing with some incredibly complex, deep-seated issues. And we need all the help we can get! And we still have to act with rigor and discipline. And high standards.

So there’s been struggles along the way, and I’m thinking about in this podcast series trying, for me trying to walk across kind of what I know into the health sector, front the education sector, as a non -clinician, talking mainly to clinicians and hospital administrators. There were so many times I was so scared to enter a meeting, I literally had to talk myself into opening the door. Over the years, I've sat in I don’t know how many meetings, where the main focus was a medical topic that I didn’t know anything about because I’m not a medical professional. I was just listening for something I could understand, and waiting for when people would start talking about communication. Which they always did.

One of the other struggles was it just the visibility. Like podcasts are an audio medium. It took me three years to decide to put my face out on the logo for this show. I mean, you know,
the problems of being a woman out in, you know, social media land. There’s also been tough episodes. Especially during, oh gosh, during COVID, some of them were just so desperately sad for so long. And then there were episodes where I was afraid I was going to go too far. More often, I was probably not going far enough.

There have been times I've really been caught with blindfolds on, and I’m constantly having to confront my own assumptions. One of the hardest things to do has been just to keep showing up. And I wonder if you can identify with that at all? Like when times are hard, sometimes just showing up is all you’ve got the energy for.

But with no exaggeration, what got me through was you, this community. That’s a lot of why I’m grateful for this milestone. You play a very real part in this show achieving the success it has.

If you’re liking what you’re hearing, for the first time ever, I am accepting donations to this show. Your financial support can help cover the costs of podcasting. There’s a donate button at h-cpartners .com/podcast. Here we are, the last quarter of ’23. We’re heard all over the world. Please write or message. Let me know where you’re listening from, because our group is growing. Our ideas are spreading. Who knows where they’ll go next? But I can tell you, we’ll get there the same way we got here. Together, one step at a time.

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel, Additional Music by Alexis Rounds. – Thanks for listening to 10 Minutes to Better Patient Communication from Health Communication Partners, LLC. Find us at healthcommunicationpartners .com.

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Welcome to our new listeners! Here’s some steps you can take today if you’re concerned about how bias can show up in patient education–beyond individual-level biases.

If you’re working hard on patient education, I see you. This episode’s for you. In this episode, I offer some steps you can take today to level up a bit if you’re concerned about bias in patient education.
Hi everybody. This is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m Dr. Anne Marie Liebel. If you’re responsible for quality improvement, patient experience or patient education, you’ll like our course Equitable Patient Education. It’s quick, it’s convenient, it’s accessible, it’s ready to go and the pricing is great. It ticks all the boxes and I made it for you. For more information, visit healthcommunicationpartners .com or find me on LinkedIn.

Speaking of which, finding me on LinkedIn is one of the three ways that you can get in touch with me. And I want to say hi to our new listeners because we have a bunch. This is super exciting! So if you’re new or maybe you’ve been listening for a while but you haven’t reached out in a while, there’s three ways to get in touch with me. Message me on LinkedIn. Visit healthcommunicationpartners.com and click on Contact. or old fashioned email. I’m at Anne Marie A -N -N -E -M -A -R -I -E at h-cpartners .com.

And you may know I was a public school teacher and then a professor of education. I was a professor here in South Carolina at Clemson. And so I’ve long been aware that most teachers look and sound and see the world like me, but many students do not. And as a teacher, I care about all of my kids, so it was hard for me to grapple with the fact that as educators, we do a better job at educating certain children than others.

So as an educator, I have to think deeply about what assumptions I make, and what baggage I brought to the classroom when I was a teacher, what I brought to the university, even what I bring to this show. And it was after I got involved at a research project at Clemson on patient -physician communication that I realized much of what we know about teaching and learning, and how schools structure relationships between teachers and students, also can apply to health care. And that’s why I started Health Communication Partners.

So over the years since then, one of the things I’ve learned about our audience, our listeners, and my clients really: you’re here because you’re a reflective practitioner. You’re already working hard. You care about your jobs, even though you’re rushed and overtaxed. You’re hustling, you care about all of your patients, and you know how much patient education matters to outcomes.
You’re already thinking carefully about how you provide care to each individual person. You’re aware of larger issues in the field. And that’s why you’re here. So one of the things we have in common is that we’re all working to reduce avoidable disparities.

And we know the overall effect of patient education is statistically significant and it’s positive. So we want all patients to benefit from the effectiveness of patient education, right? We’re all aiming for care that’s equitable, that’s patient centered.

And equitable just to refresh, I lean on the quality definition from the Institute of Medicine that includes quality care is equitable, meaning providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

One of the delights of being in this position that I’m in is how many people’s education stories I get to hear up close and personal. Compelling, rigorous, thoughtful, patient centered. And I get to hear about your work with trauma informed pedagogies as well, anti -racist pedagogies. Just last month I presented at a conference Anti -racism in Medical Education and I want to give a shout out to that group because it was a wonderful conference.

I also want to give a shout out to my patient experience people in the house, because patient experience is another one of these areas where equity has a direct impact. according to the press gainey people when there’s larger gaps in equity is associated with lower patient experience scores.

I think it’s fair to say we all know that one way to promote quality equitable care is to reduce bias. And I’m going to go out on a limb here and say, you’ve had unconscious bias workshops. I know because I’ve taught some of them. And yes, unconscious bias at an individual level is part of the story here, but there is more to it at the institutional level.

So that’s what I want to talk about now. I want to share with you a way to think about bias and mitigating bias that I hope will be helpful no matter what your role is or what patients you work with. It’ll take a few steps here.

First of all, I’ll ask you to step back, give yourself a moment to get a little bit of perspective on patient education as a process. If we want to get anywhere on this, we’re going to need to reflect, including if we want to mitigate bias in patient education. Let’s make sure we’re supporting ourselves in thinking about the education process as a process.

Not that we’re just going through, but that can be looked at, that can be improved. And I don’t know the last time you got asked to do this. but I’m going to invite you to see your educating as something you can study. something you can get to know better. something you can learn from. Directly.

Now this is a little different than reading journal articles or looking at outside experts. And I think it’s essential to look at other people’s educational processes. It’s crucially valuable to look at research and I’m one of the experts that you’re turning to.

But you matter as more than just an implementer of practices and steps that were developed somewhere else. You matter as a thinker and doer in your own right. So outside research isn’t the only thing worth being familiar with. Our own day -to -day educational processes are worth being curious about, getting up close and personal with.

Not in a judge-y way, not in a kind of scoring or grading ourselves way, if we do or don’t use something, or how well we do or don’t match up to our program, or how close to the plan we were able to stay today. So I’m going to ask you, as step one, give yourself permission to kind of step back, get some perspective on your own educational process.

And number two is to let yourself ask, “What’s happening here? What can I learn by looking closely at my own processes?” And I’ll ask you to keep in mind that how you assess, how you plan, how you implement your plan, how you evaluate, and much more is shaped by our individual choices, yes, and by the contexts we work in.

We’re really well aware of what’s doable, what’s done, and what’s not done where we work. So this is where institutional level pressures, norms, and biases can get in. It might seem counterintuitive to think about educating as a process that could be inequitable for some patients, but decades of research show some educational policies, practices, materials can advantage some people and some social groups. This is beyond individual level bias.

What do I mean by this? Sometimes patients can be framed or positioned in negative ways by research, by theories, by policies, and sometimes just by the everyday taken for granted arrangements where we work. For example, I’ve seen across many, many, many institutions that there are plenty of pressures against, or we could say biases against, thinking about your patients as learners.

In the patient education scenario, there’s huge amounts of pressure on you. You’ve got a plan, you’ve got to get through it. You’re focusing mainly on what you have to do, what you have to say, questions you need to ask, data you need to gather, answers that you need to confirm, form fields you need to fill out, your side of the process in the educator role. And this is completely understandable.

These are institutional level pressures that can turn into biases or blindfolds when it comes to patients. So I’ll ask you to consider these kinds of institutional pressures and what they’re doing to your patient education. There’s many more than this.

The third step is to remember, or let yourself remind yourself, that your patient is a learner who is going through a learning process just as surely as you are going through a teaching process.
Remember to see that patients are learners at a certain spot in that process too, regarding what you’re teaching. These are people with busy lives and a whole lot going on right now, where they are in front of you.

And step four, I’ll invite you to get together with other people who are doing the same thing.

If you want more help here to understand how patient education can unintentionally be inequitable, how the ways we teach can accidentally favor disadvantaged certain patients, and what can be done about it, we have our course on Equitable Patient Education. Visit me at healthcommunicationpartners.com, click on courses. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio Engineering and Music by Joe Liebel. Additional Music by Alexis Rounds.

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I look at a recent report from a Lancet Commission on Women, Power, and cancer, and consider where communication comes into it. I finish with something you can do if you’re thinking about power in your communication.

Today’s episode is about communication and power. We’re looking at a recent report from a Lancet Commission on Women, Power, and cancer. And I’ll finish with something you can do if you’re thinking about power in your communication. Hi everybody, this is 10 Minutes To Better Patient Communication From Health Communication Partners. I’m Dr. Anne Marie Liebel. If you’re responsible for quality improvement, patient experience, or patient education, you’ll like our course Equitable Patient Education. Because it’s quick, it’s convenient, it’s accessible, ready to go, and the pricing is great. Ticks all the boxes, and I made it for you. For more information visit healthcommunicationpartners.com or find me on linked.

I want to say hi because we’ve got some new listeners! We’ve had more of those days where we’ll get over a thousand downloads in a day, like today and yesterday! This is super exciting, because as you might know, it was our 6th anniversary last month. And a lot of shows plateau, and we’re not! So after 6 years of doing this, having new listeners and seeing the community keep growing is amazing to me. If you want to say happy birthday, you know what I would love as a birthday gift? A review! Let us know how you’re thinking about the show on whatever platform you’re listening.

Alright, so the Lancet. Recently the Lancet published a report of a commission that was created to investigate the intersection of women power and cancer. And I learned about this on social media, and the title grabbed me: Women, power, and cancer: A lancet commission. And you know if you’ve listened to the show for a minute that it’s about communication. So I am going to get down to what communication has got to do with women and power and cancer, because it’s quite a lot.

I’m glad people are talking about power. I’m not sure that we do it enough. There’s a lot of ways that power relates to language. Just speaking is an exercise of power, right? You’ve heard phrases like, you know use your voice or make your voice heard as meaning you use your personal power. And we, when we speak, we are using our power to make things happen or try to keep them from happening.

More subtly, maybe unintentionally sometimes, we can keep people away with our words. Or send signals like no, this is not for you. We can be exclusive. We can limit people’s chances to participate. We don’t want that. We want inclusion. We want shared decision making. We want co-creation. Which is why, when we think about communication, we also have to think about power.

I’ve talked about power and communication explicitly in the show before. But it’s always a concern on the show, even when it’s not the topic. Because the research base I come from in communication sees power as Central to communication, always a part of it. But our guests talk about it, too. And I want to share two past interview episodes where the guests explicitly talk about power and communication. One from the clinicians' point of view, with Dr. Jonas Attilus. And then one about public health programs, with Dr. Renata Schiavo. So I'll put those links in the show notes.

Now I’m going to return to this Lancet report, so you can see what I mean about the connections between power and language. Because even though that’s not what the report is really about, communication is there, so I’m going to draw our attention to it. One of these times is the implication that communication is one of the ways that power Works, in this case negatively, toward patients. And it’s through stigmatization and discrimination of patients by the health system. The report finds that, fear and experience of stigmatization, and discrimination by the health system, all of which can impede their timely access to diagnosis, treatment, and quality cancer care.

We’ll unpack that for a second. We all know, from being alive, that stigmatization and discrimination happen in part through language. So this finding here from the commission shows us images of people in power the health system–using the power of their words on others. Intentionally or not, the result of this exercise of power is impeding timely access to care. So that’s a negative show of power.

Here’s another way power works through language, again negatively. This is about women in the cancer workforce, and bullying and sexual harassment. Women in the cancer workforce, as in other disciplines, report frequent and severe experiences of gender-based discrimination, including bullying and sexual harassment, both during their medical and residency training and at the workplace. These harassment practices are usually perpetrated by male superiors and colleagues, although also by male patients and patients' relatives, and have been reported to negatively affect women's mental health, perception of workplace safety, job satisfaction, and career development.”

Again here we have a finding of people using the power of their words. Bullying and sexual harassment we know happen in part through language. So we’ve got people using the power of their words on others. Here there’s a suggestion it’s intentionally to do harm. And this exercise of power does do harm to mental health, perceptions of safety, job satisfaction, and career development.

Beyond individual level actions, the commission shows how language is allied to power at an Institutional level through culture. They say, These unacceptable and highly prevalent practices persist due to a hierarchical, male-dominated culture that accepts abusive behaviour as part of medical training and workplace socialisation, and avoids holding offenders accountable.

We’re at an Institutional level here. It’s the culture, these repeated, historical sets of practices–in this case, medical training and workplace socialization. And again, many of these practices include language use. That is, a lot of this happens through language, including ways of talking and relating to other people through language.

The Lancet report recommends 10 priority actions, and I think these actions are doable, they're straightforward, I daresay some are kind of common sense, like why are we not doing these already?! And communication crosses several of them. So of course I’m going to put the link in the show notes so you can see them for yourselves. They also propose a set of gender competencies and communication is part of them as well.

Maybe your communication is not so full of the egregious examples that the commission found. If you’re thinking about the subtler ways language can include or exclude, and you want something you can do right now, I've got you covered.

First of all, yay! Keep being curious about your language. Let yourself be a student of your own conversations with patients or clients or colleagues. Even just for a day. You can do that by picking one piece of your everyday conversations to focus on. I’d suggest one that’s easy to notice, like how you open a conversation, or how you close a conversation. Questions are also easy to spot and generally memorable. I’m going to suggest that you, even just for one day, jot them down. Record them if you can, but jot them down right after a conversation. What did you actually say? As close as you can get to what you remember. And look at them.

When you look at what you’ve jotted down, I’m going to ask you to think of these questions:

• What kind of room are you making for other people? How are you including them?
• How are you including their knowledge?
• How are you including their questions?

Now if you like what you’re hearing, I’ve got good news for you: we have a whole course on Equitable Communication. Visit HealthCommunicationPartners.com and click on Courses.

This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio engineering and music by Joe Liebel. Additional music by Alexis Rounds.

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Today I open a health literacy time capsule, and talk about what’s changed. 6 years ago I gave you 11 health literacy tips. Which are outdated? Which stand the test of time? What do I wish I’d said? Find out!

It’s health literacy month and our 6th anniversary as a podcast series. So I'm combining the two by taking a look at one of our earliest health literacy episodes, from 6 years ago. It’s a kind of health literacy time capsule! And there are many changes I would make today. So here are some updated tips on how you can support health literacy.

Hi everybody, this is 10 minutes to better patient communication from Health Communication Partners. I'm Dr. Anne Marie Liebel. Organizations across the health sector are responsible for health equity goals and standards. Our course Equitable Patient Education helps you meet your health equity goals with whatever patient population you are focused on. If you're responsible for quality improvement, patient experience, or patient education, you'll like this because it's quick, it's convenient, it's accessible, and the pricing is great. It ticks all the boxes. And it's good! For more information visit health communication partners or find me on linked.

First, of all I'm happy that health literacy is still going strong, and so are we, the people who care about it. Health literacy is still being talked about a lot, and I am here for it. I think it’s made it into more of a wider discourse in a few ways. Just this week, in two different conversations I was in, health literacy was brought up multiple times (and not by me). And if you are new to this show, we are an education and communication consultancy. We're equity-focused. I'm a former literacy professor and I have crossed over into the health sector gradually over the last decade. And these episodes are questions that health professionals have raised, that I bring some research from my specialty and also my learning from this kind of multisector collaborative work that I do.

The show is still going strong too! 6 years in, and I'm really pleased and proud of that. Recently we had another one of those days we had more than a thousand downloads in a day, which is a big deal for a show that's really niche like this. So for all of these reasons, and also to kind of see where we’ve collectively been and where things are at right now, I'm looking at this episode from 6 years ago as a moment in time.

I also want to give a shout out to the health literacy community, specifically folks at the IHA Health Literacy Solutions. And if you care about health literacy, consider becoming a member. This isn’t spon con! I’m a member, I like them, I like you, I want you to get together. They are at healthliteracysolutions.org. Okay this episode from 2017, October of 2017, is a list of 11 tips. So we're gonna look at these: what I said then, and what I would tell you now.

Now #1 and #2 are kinda similar. And I hope that we can say we don’t need these anymore. Number one was don’t panic. Because the story behind this episode was a lengthy conversation I had with a nurse manager about her response to a patient screening about health literacy, that really threw her off. So don't panic' was the first thing I said. I was kind of talking to the health professionals who are looking at the results of their patient screenings, and kind of not being sure what to do.

2 was don’t let a label stick to your patient, which is the same thing. It was if your patient struggles with health literacy. or if your patient has a screen that shows they're illiterate, again don’t panic and don’t let this stick to your patient. But hopefully, health literacy screenings are waning. Because I think we’ve collectively figured out that they weren’t doing a lot of good, and they were doing a lot of damage in terms of potentially shaming patients, and getting in the way of our relationship. So hopefully, numbers 1 and 2 from this list from 6 years ago we don’t need anymore. Instead, we’re kind of sticking with plain language as the default approach–and overall, more helpful.

All right, numbers 3, 4, and 5. Number three: start with what your patient brings to the table. I'm going to stand by this one. What I said 6 years ago was, if your patient comes to you with any information items or written material, talking about these is a good start. These are going to be items with which they’re already familiar so the patient may be less nervous about their meaning or their significance. I’ll stand by that one.

4: “figure out where literacy is absolutely necessary. Now 6 years ago, I said get clear for your sake and your patient’s sake on what parts of their visit require them to read or write. And I was talking about this is because I was really focused on how we can put kind of an undue literacy burden on people in healthcare settings. 6 years ago I said, ask yourself what reading and writing activities could be delayed? What can patients fill out or read at home with a friend? What could be done ahead of time? I think people are pretty much on the ball with this. What reading and writing activities could be eliminated altogether? Also not a bad question. I’ll stand by that.

5 I said, have information available in multiple modes. And I'll stick by this one too. Because in literacy terms, modes are ways of communicating meaning. Videos combine images and sound, therefore they are multimodal. So yeah don’t forget, give people information in more than one mode. So looking back number three, four, and five, I’m pretty much going to stay with the way they were.

Now number 6, 7, and 8 are interesting because they’re all kind of falling in the digital health realm. And I wonder if we all in, the past six years, kind of got more sophisticated about this. So let me tell you what I said then. Number six was have a list of websites you trust. Number seven, have a list of apps that you can recommend. And number eight was, collect other multimedia recommendations. And I do feel like we’ve in general gotten more sophisticated about this. I wonder if you feel that way. Because with the rise of digital health, everyone going exclusively online during the pandemic, it almost seems like these kinds of multimodal digital health resources, we can kind of take them for granted. So maybe six, seven, and eight go without saying. We’ll just say maybe more of a reminder. Don’t forget to recommend these things to your patients.

9, somewhat similar, but I think it bears repeating. Number 9. what I said 6 years ago was know your digital communication. And I said be clear with patients what you use email for and frequently remind patients how you and your practice use social media and text messaging. And consider the patient’s side. Can patients email you? Can they text your practice? What might they expect to see on your social media accounts? Now from my perspective, advice like that is part of a bigger conversation now, than it was 6 years ago. And the bigger conversation I'm hearing is more around patient data, patients' rights to their own data with the electronic medical records. So this isn't just about how you use digital media but how patients can as well.

10 is kind of the opposite of #9. Number 10’s advice, 6 years ago, was about audio recording and patients audio recording their visits with their practitioners. 6 years ago, this was a hot topic. And as far as I know it’s kind of dropped off the radar. I don’t know if you’re hearing about it anymore. So it’s kind of the opposite of number nine. Number nine wasn’t a big deal and now it is. #10 was a big deal, and I'm not sure that it is anymore. So I'm just going to step away from that topic.

11 I would keep. Number 11, 6 years ago, I said take a look at your written materials. How long has it been since you looked at the materials you give to patients? Make sure that written materials are accompanied by images and broken up into small paragraphs, because everyone finds this more manageable and memorable. And I also added how you physically handle and talk about written materials also matters to the meaning that people take from them. If you handle a document with seriousness, people will notice. If you highlight or underline important passages, it can be helpful. Talk about them, point to them when you’re there with your patient. So number 11 I'm standing by.

Now what didn’t I say that I wish I had? In health literacy, I think it’s easy to see patients as consuming the materials we give them. And consuming is kind of literacy term, but it’s that kind of the receiver, the taking in. And they’re the consumer of talk, of our texts, of our materials. But what I want you to remember is that patients are also producers. They are sophisticated thinkers. They are sophisticated users of language. They’re also making–another literacy term–complex texts of their own.

Think about social media. Think about at home conversations around the dinner table. People are using their power, and their voices, and their experiences, to create new information. To create new knowledge. To further their knowledge. To advocate for themselves. To link together with others who care about similar health topics. So remember, all of your patients are active participants in health conversations that extend beyond traditional health settings. Keep this in mind when you’re talking with them. This has been 10 Minutes to Better Patient Communication from Health Communication Partners, Audio engineering and music by Joe Liebel. Additional music by Alexis rounds.

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What are your health equity plans? Get some inspiration with 4 health equity topics that are priorities at HCP.

It’s our 6th anniversary and we are taking this opportunity to do a little looking back and a little looking forward. I don’t know what your Health Equity plans are, but if you need some inspiration, I’m going to tell you about ours. Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners.

And I want to thank you, because really without you, I couldn’t have done this show. This community of like-minded practitioners is why the show exists. You are what keeps it going: you, the rock stars who get it. Who get the connections between communication and equity and learning. Who are reflective. And I also want to give a shout out to my brother the Audio Wizard behind the great sound of this show, cuz I literally couldn’t do it without him either! And our dear friend, Alexis Rounds, and the gorgeous sounds that she has added to this show.

I like thinking about how like the topics of the show have evolved as well. Because so much has changed in the space that the show occupies. Like ideas have caught on, stuff that was kind of niche is now being more openly talked about, especially around equity. Conversations that used to be very hard to have, are now maybe less hard to have? And I am here for it! Because there was no guarantee this was going to happen. The work we're doing is tough work. It’s next level. But we can do it, we are doing it, we’re in this together.

So I thought I would give you a glimpse into what’s going on here and what our priorities are going forward for Health Equity, in case you need some inspiration. Because I’m going to report out to some of what I've been hearing and seeing in the kind of cross-sector work that I do.

Systems-level efforts are keyFirst on this list is systems level efforts for Equity as being key. I’ve been to a couple events recently from different organizations, and different people and audiences, but it take away that they’ve had in common is this: connect Equity goals to your strategic plan. Now this makes sense. We get the moral and ethical imperative of equity work. And we also know there’s a business case to be made. So we need to keep making that case. And one of the ways of doing that is to tie it to your strategic plan.

We also want to keep our eye on leadership here, because right now that’s important. If you’re in healthcare you’ve noticed that some hospitals have added Equity Officer positions. It's a minority of hospitals right now, but according to one study that number is expected to rise. Corporate has taken a hit over 2023 in terms of the DEI officers, but we’re watching that space.

Because I can say across sectors, the organizational goal I'm hearing again and again, the one thing we're all aiming for whoever you are when it comes to equity, is making Equity part of business as usual. Like sometimes I'll hear we want to incorporate Equity into the fabric of our operations. Or we want to embed Health Equity across all of our lines of business.

This is systems-level thinking. And at least from my perspective, it’s going to take systems-level work, as well as individual-level work. There are ways to do this. There are ways to connect Equity goes to your strategic plan. And based on like the space that we’re in, the communication space, one way that we’re helping organizations is thinking about communication as a strategic lever. Cuz whatever your action plan is to embed Health Equity into your line of work, communication is involved. So I'll invite you to think about that, too.

Equity and QualityAll right the second one equity and quality. Now tying Equity to Quality is not a new idea. In the health sector, institutions have been trying to address the quality gap for years. I was recently at a National Academy’s workshop and some of the presenters there were talking about how the connections between equity and quality have gotten more attention lately because of policy. NCQA accreditation standards, The Joint Commission’s new standards, which I've talked about, CMS adopting the hospital commitment to Health Equity measure. So this large-scale attention and action is new, although the core concept is not.

So there are some challenges to be expected. A recent study on equity and Healthcare quality measurement, which I'll link to, says most existing quality measurement efforts do not explicitly Target or incentivize Health Equity despite Equity being a key component of quality. So again this is evolving, and we’re going to keep monitoring this space.

In the meantime, if your quality improvement efforts include patient education, we can help. We have a course, Equitable Patient Education, and giving it to your team is a specific tangible action you can take part of as part of your action plan.

Equity and the WorkplaceOkay number three, equity and the workplace. Now I've written about this and you’ve heard me podcast about this a little bit in the past. I did an episode on the Surgeon General’s Workplace Wellness Framework.

But right now, these days, I am thinking about culture.

No one’s got Illusions about how hard it is to change organizational culture. The study on Chief Equity Officers found that changing the culture was one of the items that the least amount of people felt well prepared to do. So this has been on our radar, and you know it if you’ve heard the show before. And if you haven’t, I'll tell you one thing for sure is that communication is part of culture in many ways. So when we want to create a culture of inclusion that works for all of us, and not just for some of us, you can bet communication is involved.

A few years ago when people found out that I was helping health professionals communicate better with patients from different social and cultural backgrounds, they started asking, Can you help us with this in our workplace culture? And hospitals are workplaces too. So this is one topic at HCP we’ve been involved with in different ways over the years. And it shows no signs of slowing, because any organization that wants to be competitive wants to cultivate an equitable workplace culture, and keep their people. So if you’d like help with this, let me know. You can message me on linked or visit Health Communication Partners and hit contact.

Equity and ResearchAnd number four is research. I was talking recently with a colleague from grad school, and she said, We never really take our researcher hats off. So yeah, I've still got my researcher hat on, cuz I've been researching the connections between equity and communication for decades. And that includes equity within research. Now, many people are looking at this from many different perspectives. Folks have been asking, what can we do to change inequities in research, who does research, how it gets funded, where it gets published. And all of this is huge, because these are not surface things, right? These are changing mindsets. We're confronting deep history. We’re trying to understand systematic issues in research. I have a prior episode on who gets to do Health equity research.

It’s been a while since I've talked about my Critical Health Stance. But basically, working for Equity means we’ve got to work in ways that are Equitable. We’ve got to use tools, concepts, discourses that are also grounded in equity. The reflective piece is really key here. The collaborative piece is really key here. So, this is how I work in general, so I am excited about this.

Because I think research, and equity in research on communication, is an area where innovation is possible. And we’ve got to be careful as researchers, methodologically, whenever we’re working across disciplines, across paradigms. Because we need to conduct the highest quality research possible, in order to advance equity.

Well those are four of our priorities at Health Communication Partners. I would love to hear about yours. Go ahead and find me on LinkedIn, that’s more or less where I’m hanging out these days. And say happy birthday, let me know what you’re working on. And of course if you've got questions about what I've been sharing, let me know. This has been 10 minutes to Better Patient Communication from Health Communication Partners. It’s our sixth anniversary! Audio engineering and music by Joe Liebel. Additional music by Alexis Rounds.

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There’s a difference between identifying someone’s needs, and regarding the person as being deficient. In this episode, you’ll learn about

• how common deficit models are in health care
• some of the damage they can do
• two things you can do to turn away from a deficit perspective.

Do you know what a deficit perspective is? If you're not sure, this episode's for you. It's an important concept to equity that you're probably familiar with, but didn't know there was a name for. It's one of those terms you will be glad to have in your vocabulary.

Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel. Organizations across the health sector are responsible for health equity goals and standards. Our course Equitable Patient Education helps you meet your health equity goals with whatever patient population you are focused on. If you're responsible for quality improvement, patient education, or patient experience, you'll like this because it’s quick it’s convenient. It's accessible. the pricing is great. It ticks all the boxes. and it’s good! I made it for you and it does the thing it says it'll do. For more information visit Health Communication Partners or find me on Linked.

Recently I was in a health equity workshop. It was interdisciplinary, and I was one of a few communication people there. We were all asked the question: if you could see 10 years into the future, what would you like to know had changed in your research area? And I said, I'd like deficit perspectives on patients to be a thing of the past! Now some of the folks there were curious, they hadn't heard the term before, and they were asking me questions about it. I thought back to one of our earliest episodes, and a time when a listener reached out and thanked me for giving a name to something she dealt with all the time. Here's that episode.

So what is a deficit perspective?

I have addressed deficit perspective before, relating it to Seeing patients as empty containers' to be filled.' Passive recipients. Not people with lives, thoughts, histories, or resources.

It can also relate to Maintaining a focus on what a patient doesn't understand, or doesn't do; what a patient's situation lacks; what is seems his or her community can't provide.

It can also refer to a focus that's limited to negative results, negative effects, negative examples, depictions, or instances.

I've been keeping an eye on deficit views in education for more than a decade, and I know they can emerge in research, practice, and policy. Here's how I have seen some deficit views show up in the health sector.

First of all, in research.

Two separate research reviews one on rural health, and one on sexual minority youth of color each make similar points:

One is that the research in their field has been characterized by a deficit perspective. And two, this has harmed the field, and potentially those who work in it as well as the patients being served.

One study on rural health found that the tendency of embedding a deficit perspective in research has stereotyped rural and remote health as poor environments to work in and as inherently problematic.

A second literature review, of health and well-being of sexual minority youth of color, found that research with SMYoC has been framed by a lingering deficit perspective, rather than emphasizing normative developmental processes or cultural strengths. The authors point out several gaps in the research base as a result of this perspective, and highlight areas for future research focused on minority stress, coping, and resilience of SMYoC.

Some studies have found a deficit view in everyday practice.

One study, about how dentists perceive poverty and people on social assistance, found a dominant deficit perspective, in which Dentists explained poverty by individual factors and emphasized individuals’ negative attitudes toward work and lack of capabilities.

Significantly, The results suggest the individualistic-deficit perspective impedes the care relationship between dentists and poor patients.

The authors of another paper on health systems suggest that Health system leaders and front line clinicians are prone to interpreting health literacy as a patient deficit. They remark that it is too easy to frame the problem as one that resides in the patient that they have to develop certain skills, become more literate, be better able to navigate, use health services, and understand and follow orders. They maintain this perspective is implicitly reinforcing paternalism.

And, there's policy.

A three-year empirical study on the impact of a set of healthy school' initiatives in the UK found these policies position the body as being in deficit, unfinished, or at risk and, therefore, in need of rescue from conditions, risks', over which individuals or populations have increasingly less control.

In the face of these policy pressures, many [young people] not only take drastic action to lose weight and become ill but also become seriously depressed.

Why does a deficit perspective happen?

As providers, you have a problem' focus when you meet with a patient. This is part of what the medical educator at the start was talking about. You're there for the complaint, the illness, disease or injury.

You get to hear many things about what is wrong' with your patients.

I am not saying this leads to a deficit perspective. But it does seem to exert quite a lot of pressure toward seeing patients as collections of problems to be solved.

One way to think about a deficit perspective is as having its roots in an ethnocentric bias. This is our tendency to take for granted our own cultural practices. Our cultural position leads us to celebrate particular virtues. That's all well and good.

Until another tendency kicks in: the tendency to describe something different from us as something less than us.

You could liken this to going to a new town, or even a new restaurant: we often judge it according to what it doesn't have that we're used to having. We focus on perceived weaknesses based on what we think is (or should be) normal, basic, fundamental, what it ought to be.

This is the ethnocentric bias.

And its effects are exponentially stronger when there is a marked power difference between the people involved.

This was the big kerfuffle in anthropology in the early-to-mid 20th century. Unknown lands tended to be judged by western European standards. So the language and customs of these new' groups were not considered on their own terms, but rather were seen in reference to the ways of the dominant group. Which tended to be where the anthropologists were from.

I'm not sure how I could scientifically prove that a deficit perspective is a waste of time. But it seems reasonable to assume that it's, at best, naïve and counterproductive.

Here's how to begin to be aware of a deficit perspective.

Turning away from a deficit perspective means being able to take some blinders off, in terms of what normal looks like. This in part means what you tend to take for granted that ‘normal’ people do in terms of reading, language use, learning, keeping healthy. What you would consider ‘normal’ displays of intelligence, concern, curiosity, commitment, and so on.

What do you focus on instead? Got two things for you.

1. Resources! All patients come to you with extraordinary linguistic, cultural, and intellectual resources. Just not always the same resources as you. Or as your other patients.

The idea is to help people be healthier and live longer. So you need as many resources as you can get. Acknowledge the resources (including the richness of language and culture) all patients bring to you. These resources might be overlooked or missed altogether –because of the pressure to be looking for something else.

1. Reflection! Self-reflection plays a crucial role in this process.

Make explicit to yourself how you name and define normal.' Really tease these meanings out. Have standards, but be ready to look closely at what yours are, and at what it means to hold those standards rather than others.

We all can overgeneralize and rely on stereotypes and sometimes (often?) we do this without noticing. Some dangers may come when the differences are perceived as deficiencies on which further action is based.

This has been 10 Minutes to Better Patient Communication. I’m Dr. Anne Marie Liebel. Thanks for listening.

The post How to shift out of a deficit model on patients appeared first on Health Communication Partners.

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In Part 2 of our interview, Dr. Sundar explains that reflecting on his communication has changed his perspective on caring for people–and made him a better clinician.

(ICYMI here’s Part 1 of this interview.)

Today is Part 2 of my interview with Dr. Raj Sundar about how he enacts his commitment to improving his communication with patients from different cultural backgrounds. Hi everybody, this is “10 Minutes to Better Patient Communication” from Health Communication Partners. I’m Dr. Anne Marie Liebel. We’re all responsible for doing work on health equity to reach specific goals and standards. Health equity goals are good to have, but not easy to reach. Our course Equitable Patient Education helps you meet your health equity goals with whatever patient population you are focused on. You will learn to manage common obstacles, and improve the patient education process, with any patient population. Everyone wants to see improvements and I give you concrete steps from years of experience working with the best. For more information visit Health Communication Partners or find me on Linked.

I’ll put links to Part 1 of my interview with Dr. Raj Sundar in the show notes. We’ll pick up here with a story I played last time, and we’re going to start with it now. It’s a story Dr. Sundar tells about what he has learned about communicating with his patients from Hawaii. And I mentioned last time, we’d recorded this before the tragic wildfires in Hawaii. I wonder if or how this new context will shape how you hear Dr. Sundar’s stories now. Here he is.

Raj: I use this example a lot because it is such a good example. It resonates with people. There’s a large native Hawaiian population, relatively, where we live. One thing that came out while I was talking to this community leader was: when we’re in the clinic, when we’re in the hospital, people often want to talk about their vacation to Hawaii as a way to build rapport. They say, “I was just in blank place in Hawaii. Where are you from?” It seems innocent enough. Maybe the clinician is well intentioned, trying to find a way to connect. Cuz we all do that with people we don’t know.

Anne Marie: Yeah.

Raj: But if you don’t understand the cultural context, the historical context, you’re actually undermining that relationship. Because Community leaders said, Hey, here you are talking about vacation. But many of us, we left our state because we couldn't afford it anymore, because of tourism. And now we're in a foreign place and we can't visit our family, because it's too expensive, because of tourism. And here you are, saying you just took a vacation to Hawaii. Then you want me to respond in a happy way and connect with you. Then, share all my vulnerabilities with you. Then, you want me to listen to what you're saying, right? And I have no doubt I've probably done this in the past. And I was damaging that relationship. And I doubt in those instances, I know for a fact in those instances, they didn’t say, stop talking about your vacation, because that is not the power dynamic in that relationship at all. So this gave me space to understand that, so I don’t do, I don’t commit those I'll say, infractions.

One of the things that I appreciate about your response there is that you’re not beating yourself up for that. You’re showing us, and I’m sure you’re showing your listeners, that you’ve learned that the remedy, right that the way to approach this is, not to go ahead and memorize aww, I should've memorized more things about Hawaiians! It's not that. It's to reflect on your communication. And to keep reflecting on your communication. And keep thinking about how your words land on others. And keep thinking about the importance of context. And keep having these conversations with yourself and with others, in the space where you’re going to know: it’s going to happen again. Because we’re human and we’re interacting with other differently-positioned humans. And there’s not a way to get it right 100% of the time. And it sounds like you give yourself that grace and you definitely give your guests that grace on your show.

Exactly. And the take away with that example: yes, it’s about Hawaii and the specific comment about vacation. The takeaway's also for me: do I know enough history about this community? Why they left the place they called home? What is their history here? How does that inform our relationship right now that we’re building? Those are big questions and now I’m very curious about that when I’m building relationships. Way more than I was before.

And taking the Long View that historical view is it’s a brave move. Because that’s it’s one of the most important contexts. I mean, we could we could name any number of contexts that have a significant bearing on a conversation. Taking a historical one is also, I think, a wise move, because it’s going to give you the historical background, historical backdrop, for the experiences of many, many people. Many, many potential patients that you might see, as you get more information about what’s going on historically, that’s a shared history, right? It’s not just one person’s history. So it’s also a very a very clever way of thinking about context that’s going to have an impact on communication.

I'll —

Go ahead! All I was going to do is ask another question just so I could hear you talk some more!

Your question about what am I learning doing this, another point I wanted to make was ways my perspective is changing on caring for people. Because another example that I provide is taking care of the Ethiopian community. You may or may not know– I know because I talked to the leader now I have a relationship with that Community, or building a relationship with that community I learned about the conflict there. Especially with the Tigrayan community. So last week, when I talked to a patient I brought this question up. I said, I know there’s a lot going on in Ethiopia. Is that relevant to you? Is that something you think about? For the next 10 minutes, that’s what he talked about. About his worry, concern about his family, his own self-identity, and how he doesn’t call himself Ethiopian anymore. Say We're Tigrayan. I think it was really important for that for that patient because that was actually what was affecting his mental health, significantly, right. And I wouldn’t have known to approach or even ask that question if I didn’t have context into the community. Another important point is that a lot of people want to share, but they don’t. And someone said this explicitly, it’s like I open the conversation, so they knew I was curious enough to learn. Which means that I was curious enough to listen. Because they’ve had a lot of experience when people ignored what they shared, or they didn’t try hard enough so they’re not even going to try to share something that is so vulnerable for them, to this person who hasn’t shown any ounce of curiosity about this part of their life, righ.t they just here to talk about diabetes, cholesterol, and then get me out.

You’re saying so much there, Raj. You know I’m thinking about the comment you made about when you put something on the table, it becomes safe for the patient to talk about it, too. You issued a wonderful invitation, and the patient decided to take up that invitation. In that response, you heard information that was clinically relevant, and you know, deepened your relationship, started to have a relationship on a different level with this person. And it’s, I know sometimes the you know the open-ended question gets a bad rep in medicine, because oh well, who has time for it? And I’m wondering how much time is saved by open-ended questions. Because of all of the other steps that you didn’t have to go through, to eventually come to– how long would it have taken to find out that these were the pressures on this person’s mental health, for example? So what are next steps for you? Or or I mean I’d love to say you know Raj please tell us you’re going to like, start another podcast series, or you’re just going to keep on podcasting forever! And you can say that if you want to. But you can also give words of encouragement, if you have them, for people who find themselves wanting to, feeling that gap, and wanting to bridge it.

I would say I would lead with a question of, what does it mean for you to learn about the communities that you’re part of, through relationships? That’s the question I’m trying to answer, and podcasting was the medium that felt right for me. I’m hoping other people benefit from it, because it is so focused on stories, voice, and conversations, to convey a complex topic like culture. Which I think is personally making me a better clinician. But people can answer that question different ways. It could be just showing up to the community center, and meeting who is the leader there. If you’re seeing a lot of people from blank Community. Because we all have that in our neighborhoods, and you may be taking care of those patients who would benefit from you knowing more about what’s important to them.

Thank you for that, thank you for that. Raj thank you for being on the show too thank you for sharing your show with us. But also you the story behind why you started the show. You took your reflective practice and decided to be very vulnerable, and go public with it. And say I don’t know this and I want to understand better than I do now, and we’re all better for it. So again, Raj hosts Healthcare for humans. I’m going to put links to that in the show notes. And I want to thank you for being on the show Raj.

Thank you again Anne Marie.

Again a huge thanks to Dr. Sundar, his podcast series one more time is Healthcare for Humans and I strongly encourage you to listen and learn along with him. Links in the show notes. This has been 10 minutes from HCP. Audio engineering and music by Joe Liebel, additional music by Alexis Rounds.

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Physician and podcast host Dr. Raj Sundar talks with me about his efforts to improve his practice by considering cultural context during patient communication.

Today's episode is about communicating across cultural difference. I get to sit down with family physician Dr. Raj Sundar who has a special interest in getting better at communicating with patients whose worldviews differ from his. Dr. Sundar is going to tell you how he approaches these questions he has, navigating what can feel like a gap between him and his patients.

Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel. At Health Communication Partners, we just celebrated our 6th anniversary. So if your organization wants to help its members or employees get better at communicating across difference, check out our courses. We have Equitable Patient Education and Equitable Communication. If you visit healthcommunicationpartners.com you can click on our snazzy new page that says Courses. You'll see both of them there, Lots more information. You can also contact me on LinkedIn or email me at annemarie at h-cpartners dot com.

Now before I get to Dr. Sundar's episode, I want to say 2 things. One, he also has his own podcast series. And when we got talking, we really got talking. So we actually have enough for two episodes' worth. So you're gonna hear Part 1 today. The second thing I want to tell you is that this episode was recorded before the catastrophic wildfires in Hawaii. Dr. Sundar tells a story about some of his patients of Hawaiian decent that I think is even more layered and nuanced and powerful now, considering the current context. So let's go ahead and turn to Dr. Sundar.

I’m live via zoom with Dr Raj Sundar. Dr Sundar is a family physician and community organizer and he hosts “Healthcare for Humans.” It’s another podcaster, so excited about this. Healthcare for Humans is a podcast dedicated to educating others on how to care for culturally diverse communities so that those clinicians can be better healers. Raj, it's a delight to have you on the show. Thanks for being here today.

Thank you so much for having me.

I'm just delighted again to have another podcaster, and to have someone who cares so much about communication. I love that one of the taglines of your show is teaching you the things that you wish you really had learned in med school.

Yeah, exactly.

And you do that by inviting the most remarkable people on your show to tell their stories. So it’s a real treat for me to ask you: what’s on your mind these days when it comes to communication or patient education? What’s an issue or a problem that you are facing?

The issue for me has been the difficulty in communicating with people who hold different values, beliefs, and worldviews. Right, like we all know we're different from each other, but it became so so powerful for me to feel the gap. Especially with immigrant communities, Refugee communities, whose worldviews are so different than mine, that when they showed up to my clinic, wanting care, I couldn’t give them what they wanted.

Hmm. I hear that. One of the images that leaped out for me is the image of the gap. Like felt that gap. I believe you, because we’re all aware, you know where as he said we’re not the same. But when you feel that Gap and that Gap keeps you from being able to provide what you want to be able to provide. I think a lot of our listeners are going to resonate with that. So how are you facing this this issue of trying to communicate across difference?

I had a hard time figuring out how. Because as many clinicians feel, I’m trying to survive. 15 minute visits if you’re lucky 20 to 30. Get through my day. Go back to my family. Make sure I show up as a father. Make sure I show up as a husband. You have all these roles in your life that seems like it is in a tenuous balance when you’re a healthcare professional. And I’m sure a lot of people feel that way. But one of the things I had time for was podcasts. Because podcasts are a thing that you can do while doing another thing. It was a great second activity.

Right?

Driving, doing dishes, we all got a lot of dishes to do.

Right

It gave me a place to learn about different topics, and be entertained, like with True Crime podcasts. I was just talking to you about Serial, which maybe your listeners know about. But it was powerful because you could hear from the person most affected by an issue. Like the person who was arrested, what was their experience, did they do it? What did they see from their perspective? Two, it was deep, because you could go to the nuances and questions that were uncertain, that were contradictory. And the podcasting gave space for that. Both of those caught my attention. And when I was facing this issue, I said, hey, this seems like a perfect medium to talk about culture, which can be nuanced, contradictory, dynamic, you name it.

Wow. So you took your question about how do I become a better practitioner? And you turned it into a public teaching and learning space. You saw the affordances of the medium, and you said, This is where I’m going to do my learning. I’m going to start a podcast aeries so I can learn about this thing.

Exactly there’s power to making things public, I've found, because you have to be confident in what you’re saying. And you have to polish it in a way that actually ultimately enhances your own learning. So it’s not just my Cliff Notes, but I’m putting it all together, and hoping to teach somebody else.

And I love that your show— and obviously I’m going to put the link in the notes because I want people to listen to it– your show–as much as you want people to learn, the show is not didactic. You don’t take a didactic tone, now I’m going to teach you about the things you need to know. You teach through the storytelling. And you don’t, you know, wrap it up in the end with, here's three things you should take away from this person’s story. Because it’s, as you said, much more subtle than that. It's much more layered than that. There are contradictions in people’s stories. So one of the things I appreciate about your show is that you resist the temptation to kind of tie it up in a neat bow.

Yeah. I think the question is can you teach culture in that didactic way. I started with the hypothesis that you can’t. Because I've seen it. I’ve seen it being done. I’ve seen it done that way, where culture, cultural competence are taught in modules. Or one lecture. Often the takeaways are one, stereotypical, like it collapses a multifaceted identity to this one thing, and these two beliefs that everybody who’s Indian holds, right?

Cringe!

Cringe, right? Two, it's Othering. Which is that, I’m normal. I have the standard beliefs. This other person has strange, different beliefs. We’re going to study them, and write it down. Because then we can give them the care they need, by overcoming those beliefs if needed. Right?

There’s so much there. And this is one of the strangest things for me when I entered the health sector, was running right into the prevalence of cultural competence. And I’m sure it had very good intentions when it started. But the way it wound up getting operationalized was highly problematic. And obviously many, many people are very aware of this. And I appreciate that in your show, you trust the listeners enough that they, too, are going to resist the impulse to, come on, Raj! Just tell us what we need to know about these people and let's get on with things! So what are you learning from facing your own questions about care, by turning to a communication medium, and talking about it with other people in a public, kinda public space?

There are so many so many aspects of this that I could talk about. I’m learning about ways that I was actively harming the relationships that I was building with my patients. Intentionally or unintentionally. I use this example a lot because it is such a good example. It resonates with people. There’s a large native Hawaiian population, relatively, where we live. One thing that came out while I was talking to this community leader was: when we’re in the clinic, when we’re in the hospital, people often want to talk about their vacation to Hawaii as a way to build rapport. They say, I was just in blank place in Hawaii. Where are you from? It seems innocent enough. Maybe the clinician is well intentioned, trying to find a way to connect. Cuz we all do that with people we don’t know.

Yeah.

But if you don’t understand the cultural context, the historical context, you’re actually undermining that relationship. Because Community leaders said, hey, here you are talking about vacation. But many of us, we left our state because we couldn't afford it anymore, because of tourism. And now we're in a foreign place and we can't visit our family, because it's too expensive, because of tourism. And here you are, saying you just took a vacation to Hawaii, and then you want me to respond in a happy way and connect with you. Then, share all my vulnerabilities with you. Then, you want me to listen to what you're saying, right? And I have no doubt I've probably done this in the past. And I was damaging that relationship and I doubt in those instances, I know for a fact in those instances, they didn’t say, stop talking about your vacation, because that is not the power dynamic in that relationship at all. So this gave me space to understand that, so I don’t do, I don’t commit those I'll say, infractions.

This is Part 1 of my interview with Dr. Raj Sundar, so tune in next time I've always wanted to say that tune in next time for Part 2.

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It’s Health Communication Partners’ 6th Anniversary! The biggest event in HCP’s history has been the launching of our hybrid courses. Sit back and listen to the stories behind them. It's the middle of a sunny morning in the Fall. I'm on the phone in the kitchen. Pacing. Back and forth and back and forth in […] The post The stories behind our courses appeared first on Health Communication Partners.

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Metaphors and analogies are powerful language tools. But they’re often culturally specific. Here’s one way to think about your metaphors–and some topics to avoid. Metaphors and analogies are powerful language tools. They're important to the way we speak and think. And medical and public health professionals use them all the time. So what’s the problem? […] The post How to reduce cultural bias in medical metaphors appeared first on Health Communication Partners.

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For Disability Pride Month, I talk with disability law Professor Doron Dorfman about the phenomenon “fear of the disability con” and what it has to do with patient communication. It's Disability Pride Month. Today I talk with Professor Doron Dorfman who specializes in disability law. Dr. Dorfman tells me about the widspread fear that disabled […] The post Dr. Doran Dorfman on “Fear of the disability con” appeared first on Health Communication Partners.

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What does it mean to look at patient education through an equity lens? Learn why this is a good idea, and how you can do it. Today I'm going to talk about taking an equity lens on the patient education process: what it is, why it’s a good idea, and how you can do it. […] The post Looking at patient education through an equity lens appeared first on Health Communication Partners.

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Inteprofessional groups have their own communication dynamics. Is it possible changing things up, and trying new communication patterns, can help groups progress? In Part 4 of our 4-part series on communication in public health, Samantha Cinnick of HRSA tells a story about the power of questions, and silence. And stay tuned – our next episode […] The post Samantha Cinnick on what groups can achieve when old communication habits are broken appeared first on Health Communication Partners.

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Everyone has equity goals we’re trying to reach, often as part of our regular jobs. Here’s one way to advance on our health equity goals: by looking at communication with equity lenses. Everyone has equity goals we’re trying to reach, often as part of our regular jobs. In this episode I offer some help, maybe […] The post Looking at communication with equity lenses appeared first on Health Communication Partners.

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In Part 3 of our 4-part miniseries on communication in public health, Samantha Cinnick from the Health Resources and Services Administration tells her story of shifting a negative narrative with an important question.

Welcome to Part 3 of our 4-part series on communication in public health. This one is really about the power of questions, good questions, to be transformative. Samantha Cinnick tells the story of working with one group, on an already tough task, when Covid hits. Things could’ve headed in a really negative direction. But she used an important question to open things up, and make sure the focus was on progress.

Hi everybody, this is “10 Minutes to Better Patient Communication” from Health Communication Partners. I’m Dr. Anne Marie Liebel. Our Equitable Communication course has been found to make a statistically significant improvement in people’s communication knowledge, confidence, and skills. What this course has, that no other does, is a one hour, live, group meeting for the course participants after the course. So we can get started applying what you’ve learned-in your specific workplace. Learn more at healthcommunicationpartners.com.

Anne Marie: I’m live again via zoom with Samantha Cinnick from the Health Resources and Services Administration. Sam, welcome back to the show!

Samantha: Thanks Anne Marie, happy to be here!

AM: I am so glad that you’ve agreed to do this four-part miniseries with us about communication in public health. And so let’s see, this is our third time sitting down. The first time, we talked about communicating for systems change, and you had some stories there for us. And then last time, you told us about communication that supports collaboration, that supports creativity. So what’s another issue that you are facing that’s related to communication?

Sam: There are so many, right Anne Marie? But the one for today that I wanted to talk about is that often in public health, we are trying to find the root causes of an illness. Of something that’s going on that’s affecting people’s health. And we ask ourselves, what’s the problem? What are we doing wrong? What do we need that we don’t have? We also ask these questions around our organizations, too, and how we’re working with other people. So when you ask these questions–what’s the problem?–you can end up with a lot of lists of negative things about your organization, or about what’s going on.

Ah.

So when you start the process with that line of inquiry, that negative questioning, it can lead to feelings of discouragement for your team. People might be thinking or saying, “I don’t know where to start when I look at this big long negative list.” Or, “I don’t know how to fix it. Why am I even here? What can I contribute?” Especially if the problem seems really big and scary. Especially if they’re not in a formal leadership role where they think they aren’t able to make change. So a communication issue is that, if you want to get people to think in a new way, in a mindset where they are able to make change, what kind of questions do you need to ask? How do you reframe your questioning about the problem so you make it easier to solve, and you motivate your team to solve it? I think in public health for me, that communication problem has been around issues with recruitment and retention in health departments, and often coming at that problem with the deficit-based mindset instead of a strengths-based one.

Yeah that’s just what I was thinking, when you said deficit-based. This is kind of deficit based thinking, and it’s a big problem. It’s a problem not just in public health, right? I’ve seen the problem in clinical scenarios too. I’ve seen the problem in organizations. So how are you facing this significant issue of our kind of tendency to have this problem focus that leads to a deficit view?

Sure thing! I think a pattern in our podcast series has been that I learned a lot from other people! From mentors, from supervisors. When I was working at the deBeaumont Foundation as a Program Officer for Workforce Development, I was lucky enough to work with staff who had this inquiry framework called appreciative inquiry. They were able to bring in this leadership program that was going to help health departments with their issues around recruitment and retention. And by using that appreciative inquiry framework for asking questions in a way that helps the health departments determine what they were already doing that would allow them to hire and keep employees, we’d be able to change the conversation from “what what’s wrong about the health department?” To “what is right? What should we strengthen? What can be?” And then using that to motivate the employees who are already there, to figure out “how are we going to continue to recruit and retain employees?” It gets people excited, they build capacity as staff members, they want to solve the problem themselves, instead of going outside, or maybe freezing and not being able to solve the problem.

I’m excited about this because, you know Sam, I think we’re talking some similar language here! Because I use a form of inquiry too, with my clients. So I mean we could talk all day about the power of inquiry to do things like you’re talking about, like interrupt deficit perspectives, and show people ways that they can act. It’s so transformative–but it also teaches us a lot about the ways we’ve been doing things, and maybe some new ways that we could do things. So what are you learning from approaching this problem of the root cause exploration with an inquiry mindset? What are you learning from that?

I really like how your how you said Anne Marie that it helps people to see the future, to see what could be. What I’ve learned from using appreciative inquiry, especially with health departments, is that it’s a powerful tool for shifting the narrative, for motivation, and for positive change management. For example, when we were working with these health departments, we didn’t originally start knowing that a pandemic was going to happen!

Aha!

Right? We got a couple months into our leadership program, and Covid hit! So health departments had to deal with one of the most difficult challenges they had ever faced in their entire organization’s history. And these health departments who were engaged in appreciative inquiry, even though they were dealing with Covid testing, and the quarantining, and getting out communications to their communities, they were simultaneously still trying to figure out–using appreciative inquiry–how do we recruit and retain staff?

Wow.

Because there were so many people who were leaving public health at that time, there was an even increased need. And they were able to stay motivated, because they were asking these strengths-based questions about what they were doing. They were looking inside of themselves, even during a public health emergency, and asking themselves: what are we doing really well in this space of recruitment and retention? What can we do to make it even more excellent? And by being able to ask themselves that question, which we very infrequently ask of ourselves–

Right, “what do you do well?”

Yeah, it led to this transformational shift for them. And they were still able to work on recruitment and retention, even during the pandemic.

That sounds like those are some of the learnings that happened with the people that you work with. Did you learn anything about you?

Absolutely! I definitely did. I was definitely inspired by those health departments. But in terms of my own individual learning, I think that what I realized was that–originally, when I started in public health, I thought asking a lot of questions might show that you aren’t a subject matter expert. That you don’t know enough. And that you couldn’t possibly solve a problem. “You’re a beginner! How are you going to solve the problem?” But after working with these health departments, and seeing my mentors and supervisors using these inquiry-based frameworks, I realized that my natural propensity–and others’ natural propensity–to ask questions, is this place where you’re continually learning. And that’s an important communication skill for any leader.

Absolutely. I mean you’ve said so much there too, Sam. Thanks for, thanks for getting personal with us on that! Because the assumptions that you had about what makes a leader were called into question, when you saw these other leaders using these questions. And I think it’s a pretty common assumption that if you’re asking questions, you must be new around here. And like wow, how backwards that is! How really good questions can open things up for people. That’s how we get creative, as you said last time. That’s how we innovate, that’s how we kind of get ourselves out of being stuck in a rut, you know? And I think that’s one of the powers of inquiry, too, is to show how much power even people who are new to a field have, and can be accessed, when we ask good questions. When we put people in the position where they can be knowers, and they can be actors. So what’s the next steps for you? Where do you want to go from here?

I loved your last thought there Anne Marie about how these skills are transferable to anybody whether they’re just starting an early career, or they’re a seasoned professional, right? We’re all leaders in some way.

Yeah.

And so I think next steps for me, I want to help other public health professionals, regardless of where they are in their leadership journey, recognize the appropriate time for expertise which is always needed. And when to lean into that inquiry-like appreciative inquiry–to help solve problems in public health. I know we’ve talked about systems change in the previous episode, and when I think about systems change, that’s not just looking at the wider community or environment. It starts with us! You got to be the change that you want to see. And for myself that includes incorporating much more inquiry into my public health practice. And ultimately what you inquire, becomes reality.

You know I’m going to applaud that. You know I’m going to applaud that Sam, because it does! It’s true! And the power of inquiry to draw people around a problem that they caught, that they care about, and then allowing them to take locally-appropriate, locally-relevant action, because they are invited to do so. Now Sam, before I let you go, in case people want to learn more about appreciative inquiry do you have any resources you can share with us?

I definitely do. They are going to be in the show notes, but there’s a training from the deBeaumont Foundation which provides a little micro learning about the appreciative inquiry cycle

Super

That you can use for your organization. And there’s some links to a book and a website where you can learn more.

Sam thank you so much for coming back on the show, and doing this four-part series with us again, and talking about communication issues in public health. I want to thank Samantha Cinnick from the Health Resources and Services Administration again for being on the show!

Thanks Anne Marie.

It’s been a treat sitting down with Sam, we really are sitting down and talking, just not in the same place. And she’s so brave coming on the show. It’s tough being interviewed. Even though she knows I always ask the same 4 questions, it’s still tough putting yourself and your story out there. She’s not reading a report or some list of statistics, this is her practice she’s talking about, bravely as an early career professional as well. Showing us how much we all have to learn from each other, no matter where we are in the career trajectory. This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio engineering by Joe Liebel. Music by Joe Liebel and Alexis R.

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It’s great that ‘equity lenses’ is a concept that’s made it into wider use. Here’s one important question I'm going to suggest you keep in mind if you decide to put on equity lenses.

There's a phrase I’m seeing crop up more and more in equity and health equity conversations, and it's equity lenses or health equity lenses. And that got me to thinking, what does that mean? What do we mean use health equity lenses? So in this episode I'll talk about one way I recommend thinking about using health equity lenses–one important question I'm going to suggest you keep in mind if you decide to put on health equity lenses.

Hi everybody, I'm Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners. I'm a consultant, educator, and researcher, and yes your organization can work with me. Courses + Action is a flipped classroom model where you and your colleagues learn what you need to know, on your own time. Then we get to work putting it into practice. Start with our Foundations of Equitable Communication course. Don't just take courses, take Courses + Action. Visit h-cpartners.com

So right away I want to say I’m going to take the broader term equity. But I know a lot of people listening here are focused just on Health Equity, so I hope what I’m going to share will also be equally helpful. But of course, you know the first part of my career was in the education sector where we have been working on equity for my entire career. And I learned from people who have been doing it for decades before me. And they made very clear that their work was on the shoulders of many generations of largely minoritized people who have been working for equity in and beyond education. I’m also noticing that equity issues are emerging in the workplace more and more, and I’m here for that. So I’m going to try to support all of those conversations with what I’m sharing today. It’s also reflecting what I have learned over time.

So there’s been a long history on what equity means, and what Health Equity means. I feel like we should pause here for a second before we talk about Equity lenses. I’m not going to tell you what you should say Equity means or Health Equity. I’ve done an episode on that already. It’s important that we think hard about what it means. But I’m one of many people who suggest that even if we tried to impose kind of one true definition, it would be antithetical.

But once you have a definition, I also want you to let that definition evolve. So whatever you personally use, or whatever is being used by your organization right now, you should be able to let that definition evolve. Because your understandings of equity are also allowed to evolve over time. You’re going to learn more. You’re going to experience more. Things are going to happen in the world. And as these ideas collide, you may well change what Equity means to you. So that’s another reason why I’m going to say, don’t worry about getting one definition that’s always going to work and sticking to that like glue.

Now, there are many ways to take up Equity lenses. But I am going to go ahead and break this down in a way that I think will apply no matter who you are, and no matter how you understand Equity. No matter how you want to take up Equity lenses. And this is largely from working with the great clients I get to work with, learning from the great people I get to learn from, my own work, and the research. When people first want to act for Equity–maybe they’re putting on Health Equity lenses–there is understandably the impulse to do something. Like we need to do this. Now we want to create this, or add this. And I agree! Asking, Where are there opportunities to do more? I think that’s important. And we need to be asking those kinds of questions. There are definitely things we need to be adding on.

However I’m going to suggest that the folks who are really taking Equity to another level, the folks that I've had the great fortune to be working with and learning from, tend to also ask another question. In addition to asking what you want to create or add? They ask: what do we want to take away?

This is a tougher question, what do we want to take away. Because the answers can be humbling. The answers can be uncomfortable. What do we want to take away from what we are currently doing?

I’m saying we because this is a structural level approach. I’m talking about looking through equity lenses at taken-for-granted arrangements, practices, ways of working we’ve all inherited. Again I I learned this from great people, and I get to work with great people. And I think this is a big part of why I get to work with the folks that I do, because this is my Approach and people recognize that. And if you have been listening to this series for, I don’t know, at least one episode, you’ll understand that this is part of my Approach too.

For example, right now, we’re halfway through a four-part miniseries on communication and public health. And I've had the great pleasure of sitting down with Samantha Cinnick from Health Resources and services Administration. Samantha’s telling us her stories about her experiences as an early career public health professional, and what she is learning about communication. And in her interviews, as well as with all of my guests, there is an understanding that there are things we all could be doing better. Some of our inherited ways of working might unintentionally be working against us, against our Equity goals.

And in this show, and in my consulting and my research, I focus on two areas where this definitely happens: communication and education. We’ve got gobs of research to show how in communication and education there are loads of ways we get in our own way when we’re working for Equity. These systems, structures, Arrangements, practices that we’ve all inherited get in the way of our work for Equity. That’s why I’m really recommending this essential question for when you’re taking up Equity lenses that you include what do we want to get rid of? What do we want to stop doing and maybe replace with something more equitable?

We’re not asking these questions with the sense of beating ourselves up, but seeing the structural nature of so many of these obstacles to equity. In a sense we’re off the hook because we didn’t invent these systems, policies, practices, Arrangements. But we are on the hook for changing them once we realize that they’re in the way of equity.

The good news is we know how we know how to address these obstacles. It is not a mystery. It is not trial and error, folks. We know how to make it better. There are proven processes, and this is really good news.

As a consultant and researcher over the years I have learned about and witnessed many obstacles to equity in communication. So I've taken some of the most common and put them together in one of my courses plus action. It’s called Equitable communication. Folks in your organization take the course–that’s the course part. And then when everyone’s done we have a 1 hour live group meeting for follow through– that’s the plus action part. If you’re interested contact me Anne Marie a n n e m a r i e at h-c partners.com or you can visit health communication partners and click on contact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners audio engineering by Joe Liebel. Music by Joe Liebel and Alexis R.

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Collaboration brings its own communication challenges. Hear Samantha Cinnick tell the story of the launch of a new Innovation Lab, and what was learned about communication in that collaborative space.

In part 2 of our 4 part series on communication in public health, Samantha Cinnick from Health Resources and Services Administration tells the story about communication challenges of setting up a new collaborative space. In her case, people had complex tasks to address and were working together for the first time. Oh and they're volunteers, and this is not their regular job. The organizers wanted this group to function collaboratively and be truly participatory. So, supporting equitable participation and forward action bring its own kinds of communication challenges. What Sam learned may help you the next time you're gathering a new group of folks together to get work done.

Hi everybody, I'm Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m a consultant, educator, and researcher, and yes–your organization can work with me. Courses + Action is a flipped classroom model where you and your colleagues learn what you need to know, on your own time. Then we get to work putting it into practice. Start with our Foundations of Equitable Communication course. Don't just take courses, take Courses + Action. Visit h-cpartners.com

Anne Marie: I'm live via zoom with Samantha Cinnick. And Samantha I'm so glad to have you back on the show, and I'm thrilled that you’re doing this miniseries with me. So welcome back!

Samantha: Thanks Anne Marie, glad to be back!

AM: I’m delighted that you’re telling us some of the communication problems that you’re facing as an early career public health professional. And you’re letting us learn from your learnings.

Sam: Yeah I'm always glad to come on the show talk a little bit about problem solving in public health, how to bring diverse voices together. Communication is always involved in my work, especially because I'm helping to develop public health workforce, and I have such a focus on leadership. You need to have good communication skills to be a good leader, right?

This is absolutely true! Absolutely true. So last time I introduced you, you're working at the Health Resources and Services Administration and last time you told us you’d recently been a chapter author for interpersonal leadership in the book Leading Systems Change in Public Health: A Field Guide for Practitioners. So what else do you do?

Thanks for the question Anne Marie. In addition to all the things you just listed, I'm also very involved in the American Public Health Association. In 2021 and 2022, I was the chair of the Public Health Education and Health Promotion section also known as PHEHP and it’s the home base for APHA members who identify as health educators. And in addition to being section chair, I also co-chaired our PHEHP'S first ever innovation lab, which was piloted in 2021.

An innovation lab okay. And it was piloted, so it’s brand new, in 2021.

Yes. The topic of the first innovation lab was very relevant to our members. We started trying to figure out what this would look like at the beginning of the covid-19 pandemic. And our first topic area was inspired by the fact that health educators were worried that their skills weren’t being used in the covid-19 emergency response and recovery. They were nervous that those unique skills and knowledge that they had in human behavior theory, needs assessment, public health program planning–that that was all being overlooked. And so members were coming to us, our leadership, and saying, hey my professional skills aren’t being used as a health educator. I feel like I'm being sidelined. I feel like I'm being asked to do kind of admin type of work. And so they wanted an outlet for finding solutions, and we decided that this would be the first topic of our innovation lab.

Wow, so you have this significant topic that’s put in front of you, an innovation lab that’s brand new. So I can’t wait to hear: what’s the what’s the communication issue that you want to talk about here? Because last time, you talked to us about communicating for systems change. But what communication are you facing here that you want to talk about today?

The communication issue that bubbled up was this idea that we need to be able to communicate the new idea, which included communicating about strategic direction, what we’re volunteers in the lab going to be doing, what were their roles and responsibilities, and also what was the scope and timeline for what we were doing. Which we had never done before! It was brand new! So to add that not only were we communicating the what but we had to communicate the how. We wanted to be really collaborative. We wanted volunteers to come back to us and say, hey this is how we want this to be run. And that’s not an opportunity that a lot of us find ourselves in, unless we’re in a very top-level leadership position.

AM: I’m so glad that you brought this topic to us today, because I think this is something that people are going to relate to. We’re bringing folks together, for the first time potentially, and we’re going to work together on a complex issue, but we don’t want it to be top-down. This isn't command-and-control, this is participatory. This is collaborative. So I think a lot of people face these kinds of situations. So I'm super glad that you chose this as a topic. So how did you all face this issue?

Sam: So I leaned on a team of seasoned health educators, academics, and leaders, who helped me to structure the pilot, figure out what our problem solving method would be in the pilot, and leverage knowledge from the volunteers that we recruited. You know they gave me — leaders gave me ideas about how we could crowdsource that information. And ultimately by working in that team-based way and communicating in that team-based way, we were able to create two work groups and worked on two very different solutions to our original problem around integrating health educators in covid-19 response.

So you know I'm going to have to ask you what–like because I want to know now–what were the two working groups? What did they work on?

So the first work group was working to educate other members of our field, other public health professionals, about what health educators do. In public health there are so many specialties and sometimes students, all the way to career professionals, might not be aware of what a health educator can help them do. So we wanted to make that really apparent so that other people could imagine what our role, health educator role, would be in covid-19 response and recovery. The second work group was working on developing a policy statement for employers and other organizations about how they could utilize health educators in future emergency preparedness. And to write that policy statement, that work group realized that there wasn’t a lot of research being done on how health educators were or were not being included in emergency response. So they ended up doing a multi-method, qualitative quantitative study, to figure out the barriers and facilitators to help educators being included in covid-19 response. And they’re going to use that evidence to justify why our profession should be included in in those activities.

Well it sounds like the innovation lab pilot really unleashed a lot of potential. Like unleashed a lot of energy, right? People got things done. Those working groups sound remarkable. What did you learn from the way that you faced it, this pilot season of the innovation lab?

I really like how you said that unleashed potential. And that’s what we were trying to do. I do think that from what I've heard from volunteers who were involved, they said, yes potential was unleashed. I felt creative. I felt like I got to be innovative. However, they also mentioned to me that sometimes there were some stumbling blocks around keeping momentum. I think that happened for two reasons: one was that it was brand new. People weren’t sure exactly where to step next, where to go next, they wanted a little bit more direction. And second APHA is full of volunteer members. You know this isn’t somebody’s full-time job. And it’s hard to put your all into something even if you’re really motivated by it, to keep going. Personally, what I learned from implementing this pilot was the important balance between gathering stakeholder feedback, right, the other part of communicating–listening to your stakeholders to figure out what you need to incorporate into this new initiative. But then also, when to make and communicate a final decision. When do you crowdsource those ideas, versus when do you make the call about what you’re going to do next? But, ultimately Anne Marie, I'm really proud of what our work groups did. They made something. They made something new.

And it’s so exciting, and I want to know what happens next. What are the next steps for you all?

That is a great question. And I'm really enthusiastic about where this could go next. This was our pilot. So this was the first time we did this. Our leadership group wants to take the lessons learned, and improve the process for a second innovation lab. We’re hoping to implement the best parts of what we learned in the process, such as unleashing the creative potential of our volunteers, making sure that people felt like their voice was heard, in addition to adding those new improvements.

Samantha Cinnick, thank you so much for spending this time with us today and telling us about what you’ve learned about bringing together people to collaborate for the first time, and really trying to make it a collaborative, flat, organization–and the communication challenges involved with that. We’re so grateful that you’re spending this time with us, Sam!

Thank you so much Anne Marie.

I'm so grateful to Sam. I appreciate especially how she's inviting us to consider how we navigate communication as leaders in groups that have a participatory approach to problem solving. Thanks again to Samantha Cinnick from Health Resources and Services Administration. Audio engineering and music by Joe Liebel. Music by Joe Liebel and Alexis R.

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When it comes to health equity, everybody knows where they need to be, and wants to take action. But how? Here’s 5 reasons why communication should be part of any health equity strategy.

Hello Partners, welcome! If you're a manager or an administrator who's tasked with moving the needle on health equity, or if you're someone who knows a thing or two about racial or social disparities in communication, I have some hopeful things to say that you might appreciate.

Hi everybody, I'm Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners. I’m a consultant, educator and researcher–and yes, your organization can work with me. Courses + Action is a flipped classroom model where you and your colleagues learn what you need to know, on your own time. Then we get to work putting it into practice. Start with our Foundations of Equitable Communication course. Don't just take courses, take Courses + Action. Go to h-cpartners.com And we have a newsletter! Twice monthly. If you don't get the newsletter, I'll put that link in the show notes too.

You know by now that healthcare organizations have aimed to reduce inequities in access and in quality of care for decades. I feel like when it comes to health equity, everybody knows where there're at, and knows where they need to be, and wants to take action. But how?

Well, it will not surprise you, I want to talk about communication. Communication as a way in. Specifically, communication as a lever for how organizations can integrate health equity in their cultures, their missions, their strategic plans.

So that's why I want to give you 5 reasons. 5 reasons why communication should be part of any health equity strategy.

1. First of all, communication is directly tied to unequal treatment and disparities in outcomes. Right, 20 years ago, the Institute of Medicine told us in Unequal Treatment that disadvantaged patients may be sicker partly because of the way in which they and their doctors communicate.

10 years ago, the survey Listening to Mothers III survey found that 40% of participants experienced communication issues. Nearly one quarter perceived discrimination during birth hospitalization. Black or Hispanic race or ethnicity was associated with nearly three times higher odds of discrimination.

Around that same time, The National Institute on Minority Health and Health Disparities identified patient-clinician communication as a priority topic.

A 2018 study reminds us that system factors, such as communication failures are part of preventable morbidity and mortality events.

That's reason #1 but it takes me right into reason #2:

1. The high costs of inequitable communication. A study from the Joint Commissions states: “Communication failures in United States hospitals and medical practices were responsible at least in part for 30% of all malpractice claims, resulting in 1,744 deaths and $1.7 billion in malpractice costs” over the five years of the study. I’ll put the link to that study in the notes.

And to this study, wonderfully titled The cost of not addressing the communication barriers faced by hospitalized patients that's the title of this study, that estimates the annual costs that are associated with the adverse events that can result from poor patient provider communication. Are you ready for this? $29 billion a year. A year!

It's important to put numbers on this. Yes we know this is about people's lives. But numbers talk. It's important to put numbers on communication. It's not all bad news. There is good news. So that brings me to reasons 3, 4, and 5.

1. Reason #3 why communication should be part of any health equity strategy: because there is a positive relationship between patient-provider communication and health outcomes. It's established. There's a wealth of research data that supports the benefits of effective communication. I've got one study that indicates Reducing communication barriers could lead to an estimated reduction of 671,440 preventable adverse events cases and a cost savings of $6.8 billion annually. So we're saving a lot when we pay attention to communication, because there is an established link between effective communication and better outcomes. More equitable outcomes.

2. Now maybe #1 you’d heard of before, #2, 3, none of this is new to you. But I wonder if maybe reasons 4 and 5 of why communication should be a part of your health equity strategy, they might be things you might not have had a chance to think about. Communication is modifiable, and it's everywhere. Why are these qualities of communication important to health equity strategy? Well yeah, there's lots of health equity strategies out there, guided by many available frameworks. Yet a Scoping Review of these frameworks found that healthcare organizations often struggle with implementing these frameworks and the strategies that go with them.

So the fact that communication is something we all do and participate in, and it’s structural, can be very helpful in a strategy way. Communication is crosscutting. This same scoping review concluded that one of the weaknesses of existing frameworks and models was a lack of concrete guidance for implementation. What do we do?

You could focus on communication! Because no matter what framework you're using, communication is involved at every step. Communication is, like I said, crosscutting. It's something we all do so it's individual. And it’s also structural, and organizational. Whether it's internal communication you're talking about, or maybe your jam is interpersonal communication. Or maybe you're in the digital health world, or you're thinking about telehealth. Maybe you're a researcher on communication. Maybe you're concerned with legal language, policy language. Marketing is communication. All of this is communication. So choosing to look at communication as a lever for action on equity makes sense–no matter where you are in an organization.

1. And #5, a focus on communication isn't really a big change from what you're doing. Organizational change in general is difficult. I've been through a lot of them, and I've helped folks with them. When it comes to helping out, I tell my clients, I'm a big fan of starting with what you're already doing, for a lot of reasons. Communication fits that bill.

Think about it: you're already gathering data on communication. All those forms of communication I just mentioned. Think about quality improvement: you're already paying attention to communication as part of patient safety and quality. You're paying attention to health literacy. You're paying attention to communication as part of the patient experience. Maybe communication as part of employee engagement, communication as part of corporate social responsibility. There has been an increasing number of studies using health communication research to address inequalities. But if you're in a sizeable organization, you don't just have the data, chances are you have the people, too. Communication specialists! Health literacy specialists!

So if I were someone in charge of moving the needle on health equity in my department, I would start by tapping the knowledge and expertise already existing in my organization. So, if this is you, if you're that leader, I'm going to ask you to reach out to your colleagues who are talking to communities, who are collecting stories and data, who are working on health literacy, who are doing research on patient-physician communication.

And ask them: what concrete guidance do you have for improving health equity? Ask them: How can your knowledge of communication help us promote equity? And they will tell you!

Now, if you are one of these professionals, I'm your biggest fan. I want to talk to you for a moment. I know you've been beating this drum for years. So here is what I am, in all honesty, suggesting you do: call a friend. Get with one of your Communication buddies. Meet together. Talk about your work, talk about your research. Remind each other of what you know. Remind each other how you have the power to effect change through a focus on communication. And then call up one of those leaders in your organization. Maybe one outside your usual hallway. Get on someone's calendar for half an hour. Share with them your research, share with them this episode. And when you’re ready to go further, contact me. I can help with tools and structure, starting with Foundations of Equitable Communication Course + Action.

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. Music by Joe Liebel and Alexis R.

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In Part 1 of a 4 part miniseries, Samantha Cinnick of the Health Resources and Services Administration talks about some of the communication challenges involved when people collaborate to bring about systems change. What she shares can be helpful for anyone who wants to communicate better with their colleagues.

Today I kick off a 4 part miniseries on communication inside public health. Samantha Cinnick of the Health Resources and Services Administration talks about inter-professional communication, and what she shares can be helpful for anyone who wants to communicate better with their colleagues. In this first installment, Samantha tells us about how she's handled some of the communication challenges involved when people collaborate to bring about systems change.

Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel. Our course Foundations of Equitable Communication in Health has been found to make a statistically significant improvement in people's communication knowledge, confidence, and skills. And This course includes a one hour, live, group meeting for participants after the course. So we can get started applying what you've learned in your specific workplace. Learn more at healthcommunicationpartners.com.

I've been looking forward to sharing with you this miniseries about communication inside public health. Once a month for the next 4 months I get to sit down with Samantha and talk interpersonal communication. so even if you're not in public health, this miniseries can help you communicate better with your colleagues. Samantha Cinnick was a guest on this show years ago talking about interpersonal communication, she's back today, and we've got a lot to catch up on! Samantha shares her experiences and what she's been learning about communication as an early career public health professional.

Anne Marie: I’m Live via zoom with Samantha Cinnick. Samantha works at the health resources and services Administration. Samantha welcome to the show!

Samantha: Hi Anne Marie! glad to be back!

AM: Yeah welcome back! Sam, you were here before covid. I can’t believe it’s been that long, that your last interview with us is in November 2019.

Sam: What is that almost 3 years?

AM: Honestly, honestly! So catch us up! like what have you been up to? what are you doing now?

Sam: Sure thing! I am currently working at the health resources and services Administration as a public health analyst. I work with the health center program, and I work to disseminate data about that program to policymakers and to the public. Within the time of our last podcast, I was lucky enough to be a chapter author on a book about systems change in public health. So the name of the book is Leading Systems Change in Public Health: A Field Guide for Practitioners. And I got to help write a chapter on interpersonal leadership.

AM: That’s awesome because that leads right into my next question which is: what is an issue or problem that you are facing that’s related to communication?

So, in my work as a public health professional, we’re trying all the time to make systems changes to influence health. And the bottom line is that in order to change a system you need to make change on multiple levels. It’s not just about individual health change in order to get people to be healthier.

Well thanks for that because systems change is I think in the air quite a lot now, and I am I’m here for it. What do you think systems change has to do with communication, specifically?

Sure, so like I said, improving Health requires real-world systems change at multiple levels. And you’re going to have to communicate your change vision, your desired future State, at all of those levels. So that means you need to be able to communicate your vision with individuals, with teams, organizations, partnerships between organizations.

In public health you’re always working with someone else!

Yes absolutely! And that’s the only way that things get done. And if you’re going to start to work with other people, one of the best ways to do that is to develop your own interpersonal leadership. And interpersonal leadership, that’s the ability to develop authentic, meaningful relationships. Not only friendships with colleagues, but really understanding their diverse perspectives about the work that you’re doing together. in a way that when it’s shared with you, you understand it and you can combine it to take action towards your shared visions of the future.

And I think there’s something interesting here about this, the interpersonal aspect. and also thinking of yourself and of your colleagues always as potential leaders. And the leaderful aspects that we all have, whether or not we have the official position of leader. So how are you how are you coming at this? How are you facing the I don't want to say problem but the challenges of communication in these enormously complicated collaborations that we need to do in order to change at a systems level? How are you facing that?

I have been very lucky. I have some mentors that I've been able to work with who have taught me Frameworks in order to build my interpersonal leadership. And one of those frameworks that’s creative interchange. And that is something that we talk about in the book I mentioned at the beginning. It’s a philosophy, and a four-fold process, in order to help people strengthen their interpersonal skills. And so with creative interchange, the idea is that you make sure everybody’s contributions are genuinely heard. And that even if they’re contradictory, you’re able to connect those contributions together, to find a solution that builds upon everybody’s ideas.

That is a high bar, right? So can you give us a quick flyover? what is what is this work?

I can, I can. So there are four elements of creative interchange and that includes: authentic interacting, appreciative understanding, creative interchange, and expanding capacity. The first one, authentic interacting, that’s your ability to bring your genuine self to an interaction with someone and allowing that person to do the same with you. That requires a lot of Courage, a lot of Bravery to be vulnerable in that space. So that’s the first one.

That’s a good place to start too.

Yeah I think so. The second one, appreciative understanding, that’s affirming somebody’s contributions. Validating what they have said to you. And not only welcoming the new ideas, but really saying to them, ‘wow, I really like that. let’s find a way to put that into what we’re trying to do together.’

Mmmhmm.

Then there’s creative interchange, which I think is the most difficult. I’m practicing a lot, practicing all of these but practicing this one especially. It’s it’s letting go of polarizing viewpoints and embracing these paradoxes and complexities in order to find the connections between different points of view.

I can see yes there’s there’s layers of challenge there.

And then lastly is expanding capacity, which I think is the most intuitive. After you’ve done your authentic interacting, your appreciative understanding, your creative interchange, that’ll bring up a lot of stuff. A lot of things to consider. And you’ll look at all of those things and think to yourself, “what am I committed to here to make change on, based on what i’ve heard so far?” And then move forward trying to improve it.

Thank you for that flyover! That was incredibly tidy, but also very deep. Like, you’ve given me a lot to think about. So can you give us a sample of something that you’ve done with this framework?

So I think an exercise that folks could use today comes from the creative interchanging piece. The piece where you’re bringing together disparate points of view to find a common way forward. And this exercise is called three pluses and a wish. And the idea is that when someone brings an idea to you, maybe you don’t like all of it. Maybe there’s something about it you wish was different. You start by naming the three things that you really like about the idea, and the one thing that you maybe want to change. You don’t frame it as ‘I don’t like that let’s get rid of it.’ you frame it as, ‘I wish that it looked like this. I wish that this idea had this in it.’ so by saying it that way, you’re opening up people to think more positively about how they can improve their idea.

I love this. Thank you. That’s so effective. 3 plusses. I see you’re validating, you’re letting people also know that you heard them. You’re reflecting back to them some of what they said. And all of that is powerful communication. And then the wish, because that’s from your perspective, the way you would like things to go. And you’re situating that in your perspective. That’s fantastic, really powerful. Thanks for sharing that Sam. So what are you learning from facing the challenges of collaborative communication with this framework?

As an early career professional, I think when I was first starting at in public health I would try to solve problems very quickly, right away. I would want to try to prove myself, make an impact, move on to the next thing. But by tapping into an interpersonal framework like this, where you’re really taking the time to think about different perspectives, it allows you to shift your thinking and be more curious about what are the potential ways to solve a problem that aren’t within just yourself. So it opens up space to see New Perspectives that the members of my team or my department have and can bring to big problems, and allows us to solve them I think more effectively.

You’ve said a lot there, Sam. Especially the idea that you, you're resisting the pressure to like boom, boom, boom, like solve these problems. And I mean which is very real at all stages of someone’s professional path. You know we’re all under pressure to pretend that there’s a way to quickly solve some of these enormous problems. So what are the next steps for you? Where are you going from here?

It’s a great question. I think next steps for me include continuing to practice my interpersonal leadership skills! I am still learning, like we all are. And I was lucky enough to work with Chris Chrisley, Christina Walter, and Pat Marshall on learning more about creative interchange and how I can put it into practice. So that’s something that I would like to continue to do. But I like to mentor others in this framework. I think that there are a lot of places where my own learning can benefit others in public health. I think lastly I want to say for others that are experiencing communication issues or problems in their work, especially on collaborative projects, that I highly recommend the book, Leading Systems Change in Public Health: A Field Guide for Practitioners. It includes not only that chapter interpersonal leadership, but other successful practices for implementing system change on multiple levels.

Thanks for that, Samantha Cinnick from HRSA. Like I’ve learned because of what you’ve shared and our listeners got to learn from you as well so thank you so much for spending time with us today Sam

Thank you for the opportunity Anne Marie!

I'm so grateful to Sam for reflecting on her experiences and allowing us all to learn from her, challenging the notion that somehow early career professionals don't have things to teach us. She took us far in her 10 minutes! This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering by Joe Liebel, music by Joe Liebel and Alexis R.

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This episode is about moving from talk about health equity to action on health equity. Hear about common challenges in doing health equity work. And we announce a new miniseries dedicated to communication in public health.

EPISODE TRANSCRIPT

Today's episode is about moving from talk about health equity to action on health equity. You'll learn about some common challenges in doing health equity work and how they can be managed. And you'll hear about our new miniseries dedicated to communication in public health.

Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel. Our course Foundations of Equitable Communication in Health has been found to make a statistically significant improvement in people's communication knowledge, confidence, and skills. This course, it includes a one hour, live, group meeting for the course participants after the course. So we can get started applying what you've learned in your specific workplace. Learn more at healthcommunicationpartners.com.

Transcripts for this and each of our episodes is at h-cpartners.com with links to relevant research. Because we are always linking research to practice. Have you signed up for our newsletter? I send out the monthly BRIDGES newsletter when I share what’s happened that month at HCP, including these episodes. And, midmonth I send out In Focus. It's our top resources on a theme. If you have signed up but you’re not getting it, check your junk folder. I use 2-step authentication, so you’ll need to confirm, and sometimes the newsletters end up there. It happens to me!

This month’s In Focus just went out and the theme was communication and collaboration. And if that’s on your mind, you’re in for a treat! We’re doing something new!

Coming up in our very next episode later this month, we're kicking off a miniseries dedicated to public health and communication. I'm delighted to welcome back to the show from Health Resources and Services Administration Samantha Cinnick. Sam visited us back before covid, and well a lot has happened since then. So she's agreed to sit down with me for 4 separate conversations about 4 different issues in communication in public health. Issues you may be familiar with, even if you're not in public health. She's sitting down and reflecting with me, sharing stories and what she's learned. I'm grateful to Sam and I really appreciate her perspective as an early career public health professional. This miniseries on communication issues in public health will run once a month for the next 4 months starting with our very next episode. So stay tuned. Sam is great and she's a really easy person to talk to.

One of the biggest delights of being a consultant is all the different people I get to work with. I get to know them as people and hear their stories, often fears and hang-ups related to communication. People are always worrying that they’re not doing enough, or that they’re doing it right, or that they're offending people accidentally. And everyone is talking about equity. Often I'm on the front lines with people who are patient facing. Sometimes I'm with people who are wanting to communicate better with their colleagues. Sometimes with the leaders who want to be better leaders or are leading communication improvement in their organization.

I'm incredibly grateful to my clients. I've learned so much. One of the things I've learned is that You are already good communicators. You are knocking yourselves out to do a good job at communicating. Another thing I learned is that you know what needs to be done to advance health equity.

The questions I'm hearing are around how we take action from where we're at. Whoever I'm talking to, in any community or organization, people know where they're at, and where they want to be regarding health equity. They know how things should look, and often how problems could be addressed.

So the commonality I'm hearing and seeing, this was said best by one physician leader. She put it to me this way, and this is the quote I used as the title of this episode: Everyone cares about health equity but we don’t always know what to do next about it.

As far as I'm concerned, there is nothing more pressing than this. So that's what I'm going to be talking about over the coming weeks. Alongside our miniseries on communication in public health, I'll be sharing my own stories. Stories of what I've been doing as a consultant and educator to help orgs of all kinds to take action on equity from where they're at.

You won't be surprised to hear that communication is a big part of this. You already know communication is a patient safety issue, a quality improvement issue, an interprofessional issue, and it's an equity issue. So I bring my specific approach to communication, one that is not commonly used in healthcare and public health. This show and all I do takes equity lenses on communication and education. In the coming weeks I'll dive more into what that means, but the short answer is: it means more tools and structures to improve communication at individual and systems levels– and improve it in equitable directions and improve it in concrete ways.

But there are challenges to doing this work that we can’t ignore.

One of the challenges of doing equity work I've heard and seen, is health equity strategy can feel too remote. Too far from having direct impact on people. Well, that’s one of the strengths of working with communication as part of health equity strategy. You can address it, yes at the organizational level and at the individual level. And as you know, changes in communication can have immediate impact.

Another challenge is everyone is grappling with scarce resources. And everyone already has demanding jobs. We're not stopping what we do to pursue equity; it has to be built in. So the way I work isn't additive, it's not adding one more thing. Instead we're strengthening and extending your existing approaches to communication. It's not that you're not working hard enough: you are. It just more tools in the toolbox. Often, a different perspective can open up possibilities we didn't see before.

Equity is a process. I had a client tell me just last week there are so many equity initiatives, people are feeling burnt out already. Yay on all the equity initiatives but we can't have burnout. We're in this for the long haul. You take good care of other people, but you need support too. Organizational integration is key, getting into existing workflows. So that we're systematically and sustainably building health equity into core functions. There isn't a core function that communication doesn't touch.

Collaboration is part of this too, because we all know if you want to get work done on big problems, it means talking to people outside our usual hallways. Yes, collaboration can have its own communication challenges. Often as a consultant I'm educating on topics that address the most pressing needs of the participants. Samantha Cinnick who I mentioned is doing a 4 part miniseries with us, well Samantha and I met years ago pre-covid at Columbia University’s Mailman School of Public Health when I was there doing a series of talks on multisector collaboration. Which holy cow, multisector collaboration, a lot of layers of communication there. So I'm going to go head and put links in the notes for that.

Over coming weeks, I'll tell you more about what I've been up to, what I've seen and heard and done around turning to action. About embedding equity in core processes, and what you can do. If you're wondering what you can do right now? You’re in luck. I'm gonna drop in a link in, to not just one, but 20 ways you can help move toward health equity.

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering by Joe Liebel, music by Joe Liebel and Alexis R.

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Starting a meeting with a reflection is a powerfully humanizing move. In this episode, I share a short passage about communication that would be appropriate to open any meeting, for any audience. It invites us to see connections between words and thoughts, and consider their impact on our relationships and world.

The idea for this episode came from a recent request from our audience for a reflection to open a meeting in healthcare or public health. You know I'm a reflective practitioner, I love this idea. So I'm going to share one today about communication.

Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel. If your organization wants to take concrete action on health equity, take my course Foundations of Equitable Communication in Health. It's been found to make a statistically significant improvement in people's communication knowledge, confidence, and skills. What's more, when your organization purchases access to this course, it includes a one hour, live, group meeting for the course participants, with me, after the course. So we can get started applying what you've learned–in your specific workplace. Because I'm serious about making progress on equity and so are you. Learn more at healthcommunicationpartners.com.

I personally have experienced the power of a good reflection in the beginning of a meeting. There's something incredibly humane about it, about someone deciding, Before we get down to business we're going to reflect, right? Because we're all busy, we're all distracted, and we're all trying to be present. So I loved the idea of finding a text that could do work like this, and reading it to you and asking some questions after. I had a lot of fun looking, so you can bet I'm gonna do another one of these.

This one is on communication. Now I'm going to read to you something from a name you've heard me reference a number of times on this show: James Paul Gee. And this is from his Preface to the Second Edition of his Introduction to Discourse Analysis Theory and Method. Jim Gee is a linguist. I like him. Not just because he worked closely with Brian Street, who I studied with, but because of how much he likes us. He’s a fan of human beings and of what we do with language.

This passage I'm about to read would be appropriate at any meeting, for any audience. Because Gee invites all of us human beings to think about our ordinary, everyday conversations, what our words mean to other people, and what their words mean to us. After this, you’ll have some food for thought when it comes to connections between words and thoughts – connections that happen so quickly we tend not to notice them, even though they have enormous impact on our relationships, and Gee argues, on our world.

I'll read you the passage, and then I have a few prompts after for you to choose from. You can think on them, and if time permits at the meeting, you could share with colleagues. Alright now I'm reading this out of an actual book, so you'll hear the paper. Here we go:

Human communication, especially across social and cultural divides, is a very difficult matter. We humans are very good at finding meaning. We find it all over the place, even in the stars, with many people still believing in the medieval art of astrology. In fact, we are so good at finding meaning that we very often run off too quickly with interpretations of what other people mean that are based on our own social and cultural worlds, not theirs. Too often we are wrong in ways that are hurtful.

When we sit back and reflect on what people have said and written a luxury we have too little in life, but the basis of discourse analysis we often discover better, deeper, and more humane interpretations. The small child whom the teacher assumed made no sense at sharing time looks a lot smarter after a little reflection . A person from a different race, class, or culture looks, on reflection, if the reflection is based on any knowledge, to have made both a better point and a better impression on second thought than on first.

We believe it is a matter of competence to re-read a good book or re-watch a great movie to get more out of it. But we rarely apply the same principle to our fellow citizens . Indeed, writing a second time as in the case of this book is just a way to be in dialog with ourselves, to think more deeply about what we mean and how others will interpret us. In a world in which people rush off to kill those who don't agree with them and countries rush off to war, it may be a matter of survival that we learn to base our views and actions on second (and more) hearings and readings of others and second sayings and writings by ourselves.

Even after we have re-heard or re-read, we may still disagree with people. And they may have had good or bad motives. But we humans, when it comes to using language to make sense, are very good indeed. Whether we are telling the truth or lying, we build intricate, complex, and highly patterned oral and written texts with which to accomplish our goals. We are creatures of language. Evolution has seen to that.

Thus, we can say that there is an imbalance in human communication: each human being creates complex meanings in language, but each of us is so good at finding meanings that we are often too quick to attribute meanings to others that are rooted more in our own cultures, identities, and fears than they are on a close inspection of what the other person has said or written.

So a second listening or a second reading is, in many cases, a matter of competence (what we need to do to be competent in our areas of work) and, in many cases, too, a matter of ethics (if we want to be fair) . The task is this: to think more deeply about the meanings we give people's words so as to make ourselves better, more humane people and the world a better, more humane place. While we still may disagree with others after reflection, we will, nonetheless, be in a position to be a much better critic, to represent what we believe in a much better way. But we may also sometimes change our own viewpoints to be more positively inclined toward others than we were initially. We will then, too, be better placed to cooperate with them in human endeavors, especially in a fast-changing, global, culturally diverse (and often dangerous) world.

Thanks to Jim Gee for that. Now I have some questions for you to consider:

• Recall a time when you've given someone's words a second hearing.' What did you notice on second thought that you missed the first time?
• Has anyone ever given your words a second hearing, that you know of? How did that impact you?
• Is there a situation in recent memory that you'd like to be able to go back to and give someone's words a second hearing? Or has there ever been a time that you, as Gee said, ran off too quickly with interpretation of what other people mean that was based in your own social and cultural worlds, instead of theirs? What did you learn from this?

If you appreciate this approach to communication, you'll love my course Foundations of Equitable Communication in Health. Learn more at healthcommunicationpartners.com. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering by Joe Liebel, music by Joe Liebel and Alexis R.

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Everyone I meet in health care and public health wants to do well at their job, and move the needle on health equity. The problem is that when it comes to professional development, too often stand-alone, one-time courses are all people get. Here’s why they don’t work at making change.

As an educator, one of the problems I'm addressing now is an education problem. Everyone I meet wants to do well at their job. That's not the problem. The problem is that when it comes to professional development, too often these kinds of stand-alone courses are what people get, and these are not great for effecting change.

Hi everybody, I'm Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners. I want to say “Hi,” because we've got lots of new listeners. We've had more of those days where we'll get more than a thousand downloads in a day! This is super exciting! Because after 5 years, more than 5 years of doing this, to have new listeners and to see the community keep growing, that's amazing to me! Lots of shows plateau, and we’re not! You're hanging in there with us, so thank you! And if you're new, I want to welcome you.

And if you didn't know, I founded HCP in 2017 after a few years of working in the education sector and health sector simultaneously. And my purpose was basically to help bring the best of what I knew could be helpful in the health sector from the education sector, over. So I made the Health Communication Partners website to be a resource hub. And I thought one of the other ways to get the word out would be to start a podcast series with my brother Joe, grateful for his help still, all these years. And my purpose I guess overall being to let people in healthcare and public health know there is a whole body of knowledge that can help with some of the tough problems you’re facing.

Over the years, people have shared with me their stories, their typical day-to-day's, and their pains, and the pressures they’re under. And that's what makes this show tick. These episodes are about the issues faced, the concerns raised, the problems experienced by people in the health sector from your perspective. A lot of times we’re told in our professional lives, in our professional development, we’re told what to focus on or what to care about.

I take a different approach: I ask you what you feel is important, what’s on your mind, what you are seeing, what keeps you up at night. And I'm not making polite conversation, although I guess it is that, too. This is absolutely intentional; this is reflective practice. And it's based in my belief that as professionals, we can enhance our own learning when we reflect on our typical day-to-day’s, the issues that we face, when we follow our curiosity about the problems we experience.

This flies in the face of most of the dominant conceptions of professional learning that we’ve all inherited. This series, I guess you could say, supports people who are questioning dominant narratives, common denominators, or dominant stories. Specifically, I give tools that are grounded in equity and justice. From the research, to the terminology that I use, to the paradigms, and traditions, and ways of working. Even the show itself as a space, a small tiny little ten-minute space, where we can imagine alternatives.

I take you seriously, as seriously as you take your patients and clients. I respect your knowledge as you respect theirs. I take our teaching and learning process–because that's what I consider this show to be–I take our teaching and learning process in this show as seriously as you take the teaching and learning processes with your patient interactions.

So as I said, one of the problems I'm facing now as an educator is an education problem, with the education of health professionals. It's true for everybody, it's true for health professionals, too. And that's that, as we all want to grow and learn, it's that often we're faced with just stand-alone, one-shot courses.

It’s a dirty secret of professional development that one-shot workshops don’t work. You know it from experience, and the data backs you up. One-shot courses alone do not lead to substantive change. That's what a lot of the conversation was about when unconscious bias or implicit bias became a big deal, one-shot workshops all over the place, and by themselves they're just checking a box and we know it. It's not our fault. We’re all clever people here, we're all lifelong learners, and I bet you can wring some learning out of anything. Even a one-time, one-shot, standalone course .that are still the bulk of what counts as professional development.

And any good that does happen is often down to happenstance. Maybe you happened to personally choose, individually, to carry something out of that course and you put it to use and stayed at it. Maybe, maybe not. But like I've said before, the connection between what is done and said in those kinds of one-shot workshops and what is done and said in real work' is often left for participants to figure out for themselves. Or to hope for some kind of magical transfer of these add on' activities to everyday work, once the course ends. The responsibility is on you to find a way to make it work. If you don't, well that's on you.

It's simply that that one-shot structure doesn't make change because it’s not designed to. Stand-alone courses or workshops can raise awareness, yes. Can be thought-provoking, yes. Maybe some collaboration will happen if you’re lucky. There's myriad other things that can happen in and through a standalone session. But change? No. Not by the best, most compelling educator on the planet, to the most motivated audience ever. Unless there’s some kind of follow-through. Some structure, some strategy, to keep it going.

And this is a little bit depressing, because over the years being a consultant in healthcare and public health, I keep being told that that's all we're gonna get. And I know everyone is overscheduled, and always being given one more thing to do. So when I set out to design professional development on the topics I get asked about the most, I had to work within that, and I had to come up with a solution.

Last year, you know I debuted Foundations of Equitable Interpersonal Communication in Health. And I typically talk about it at the beginning of the show, right? Right now I'm working on version 2.0, revisions and additions including feedback from people who've already taken it.

But there is something I need to tell you about Foundations of Equitable Interpersonal Communication in Health. And it's this: when you take the course, it includes live time with me.

That's right. It's self-paced video, it's me teaching and talking to you, and when everyone's done, we meet live. Because I am serious about follow through, and helping you use what you’ve learned and make the change you got into this to make. Because working for equity is not easy. I'm a former public school teacher and a teacher educator I know what the stakes are! You're taking care of kids and families! That's why I care enough about what you do to take time with you to talk about it.

The thing about my approach that’s quite different from other consultants, and even a lot of educators, is reflective practice. It's practitioner based at its heart. Like I'm not coming in and plonking down a course on you, and saying, Good luck! Bye!

When you take my course you get time with me after to ask questions, get specific, and get started applying what you've learned–in your specific workplace, your sphere, your unique context. It's about you. For this, I have to thank my mentor at University of Pennsylvania, Dr. Susan Lytle, and her specific way of enacting reflective practice with equity at its core, informing everything.

Our organizations are charged with moving the needle on equity. So organizations also have the option to have me work with you further, bringing structure and strategy–again from the University of Pennsylvania–ways of working for equity at individual and systems levels, that have been proven over decades all around the world. I bring specific structure and strategy and we work together I show you how you can use them over time in yoru org on locally-meaningful, locally-relevant ways to affect change.

That's an option for organizations, to get you my course plus strategy consulting wrapped around it. I love working with organizations like this. It's efficient because everybody gets to take the course in their own time, and you've got my strategy consulting to go along with it. As I was getting together my notes for this episode, I got an email from someone at one of the organizations who's doing this, I'm working with now, the course plus consulting, and I'm not making this up, there was a sentence in the email that said and I quote, I absolutely love the work you’re doing. That means the world to me to be able to help as a consultant alongside being an educator.

Regardless, when your organization purchases access to Foundations of Equitable Interpersonal Communication in Health for you and your colleagues, it includes a one hour, live, group meeting for the course participants, with me, after everyone finishes the course. Because I'm serious about making progress on equity and so are you. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering by Joe Liebel, music by Joe Liebel and Alexis R.

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Large sets of quantitative data are irreplacable resources in medicine and public health. But there are many important questions large data sets weren’t designed to answer, questions where on-the-ground research is needed. In this episode, I sample some crucial contributions ethnography has made to what we know about the influence of context on thinking, communication, and health.

Medical and public health professionals rely on large sets of quantitative data for nearly everything. But there are many important questions large data sets were never designed to answer. Ethnographic and anthropological approaches can provide needed on-the-ground perspectives to what we know about people, and communication, and health. In this episode, I sample some of what ethnography teaches us about why context matters to our thinking, our talk, and our health.

Hi everybody, this is 10 Minutes to Better Patient Communication from Health Communication Partners. I'm Dr. Anne Marie Liebel. If your organization cares about equitable communication with all patients, there are some foundational concepts it's important to understand. That's why I wrote the course Foundations of Equitable Interpersonal Communication in Health. It gets at the fundamentals everyone needs to know, it's video-based, self-paced, and for all patient-facing employees. Learn more at healthcommunicationpartners.com.

Earlier this week I was in a group of clinicians and non-clinicians using ethnographic approaches to understand clinical issues. We were looking at a data set, it was qualitative data collected on communication between teams in a trauma unit. The data was rich, it was evocative, and the discussion yielded some vivid insights.

I was happy to be talking about ethnographic approaches because I use them! I use ethnographic tools and orientations to understand issues of language and of education. That's what you hear about in this series. One of the traits I appreciate about ethnography is that it allows me to get granular, find those important distinctions that large data sets can miss. Distinctions that are so valuable right now, too.

If you're wondering about how ethnographic approaches might differ from what you typically see or hear, in one of my earliest podcast episodes, I give a quick sampling of what ethnographic research helps illuminate about the impact of context on our thinking, our talk, and our health. Here's that episode.

I was coaching a physician on making his patient education more effective. We talked about the many constraints around patient education. He was understandably frustrated, as many physicians are, over the short amount of time he has with each patient.

His voice raised at one point, and he sounded exasperated, saying: I can't follow my patient home!

There are many ways to interpret this phrase. It has stayed with me as I continue to work with providers on communication, education, and health literacy. Today, I invite you to think a moment with me about home, as we consider the impact of context in health communication and education.

Though context' is a broad term, home is certainly an important context in all our lives. Whatever home looks like, wherever it is, whatever it means to each of us. And as usual, I'll close with some practical advice for how you can keep context in mind, during your next patient encounter.

Context matters to us when we interact as people. What is appropriate or valued in one interaction is not in another. We all change our language, even just subtly, according to various contextual factors. To understand people's health-related actions and words, it is helpful to consider the influence of context. I'm an educator, so I have a sense of what that means in education. And over the last few years, I've been learning more about how context influences different health and health care conversations. You'll hear me pull from studies that are taking linguistic and anthropological perspectives on the study of language. This involves looking beyond the immediate context the individual to family, community, and organizational settings.

Context shapes our communicationThe language we use depends a great deal on context. That's not surprising, but it's important to remember. When we talk, or even when we read, we are interacting with other people and with our environment. When we interact through spoken and written language, we do it in a specific place and time.

For instance, we can quickly change our language to communicate the same idea to different audiences. Switching between the different people in our lives, we communicate differently.

A medical educator and I were talking about this impact of context on language. She offered me a hypothetical scenario:

“Consider when you come home from work on a typical day. Maybe you're a parent, and you and your young child are talking about your day. You might say, Mommy helped someone who was very sick today.' And then your spouse asks about your day, and you say, Oh yeah, I was in the OR for hours doing an appendectomy.' Then your cell phone rings and it's your colleague recapping and reporting on the patient. You get into an entirely different kind of talk.”

Same event. But different people, so different language.

Communication shapes our contextWhat's more, language and context are in a mutual relationship. Yes, we use the language we use because of our contexts. Yet our contexts are what they are partly because of the language we use in them. For instance, the patient encounter is the patient encounter partly because of the kinds of language used in it. Those predictable questions and answers. The expected flow of conversation. Language is part of what makes the patient encounter what it is.

I'll give you an example: Imagine everything in your next patient encounter remained the same, except the language. Same people, same place and time, same stuff in the room. But let's say you and the patient took turns telling jokes the whole time. It would no longer be a typical patient encounter. It would be fun, though.

Context influences our thinkingOur thinking is tied to context, too. Decades of research show that context matters to our thinking. This includes reasoning, as well as literacy and numeracy processes. This stands in contrast to the conventional view of our mental abilities as essentially fixed.

For example, on formal assessments, people can seem to lack the kinds of cognitive abilities they are able to demonstrate in everyday life.

More than a generation ago, researchers wanted to study reasoning in context. They chose to study arithmetic reasoning of American adults who were shopping in the supermarket. They found that, while shopping, adults from varied educational backgrounds were able to make virtually error-free price comparisons. However, given the same kinds of choice problems in a test, all of those people made many errors.

Anthropologist and educator Fred Erickson points out that: Human reasoning seems to consist of skills that are reflexively constituted in the context of situation of use and purpose. This is a conception of thinking as sets of domain-specific and situation-specific operations rather than sets of general abilities. (p. 529) It can be easy to overlook how much the cognitive dimensions of our everyday activities are shaped by the people we're with, and the contexts we're in.

Context influences our healthFinally, our health is related to context. You are likely aware of the social determinants of health, that body of research into the socio-economic factors that affect health, including income, education, employment, housing, food security, gender, and race (Social Determinants of Health, 3rd ed.) This body of work takes a close look at the relationships between our health, and the contexts where we live, learn, work, and play.

Critical considerations of these contexts have increased. Conversations across the health sector are moving away from reliance on the individual biomedical model, toward upstream causes of illness and disease. This includes identifying poverty, structural racism, and discrimination as root causes of health inequalities. Though researchers take up the social determinants of health in different ways, it seems to me there is at least one shared understanding: Health is not a level playing field.

So, What can you do right now to keep an awareness of context in your next interaction with a patient?

The next time you communicate with, or educate, a patient:

In whatever language feels natural to you, acknowledge to them that you know context matters. Where you are, the time pressures, and social relationships between you, all are contexts that make a difference. These matter to how you're both talking, thinking, and feeling. So go ahead and say so.

Home where we come from, and go back to at the end of the day makes a difference to what happens between you and your patient in the encounter. And yet what happens between you in the encounter can make a difference to you both when you each go home.

So go ahead and ask your patient about their home. Something simple like, How are things at home? You may just be making polite conversation, but you may also turn up information that is clinically or culturally significant. Because home is a powerful context.

You have patients who linger in your imagination. Yes, they follow you home. So I'm not sure you're not following your patients home. Choose carefully the parts that you hope linger in their imaginations when they leave you. I'm Dr. Anne Marie Liebel. This has been “10 Minutes to Better Patient Communication.”

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Patient screenings are widely used in medicine and public health. A public health administrator in California shares what she and her colleagues are learning from taking a close look at screenings.

Screenings for patients are important tools. They're ubiquitous in medicine and public health. But they're not without their challenges, for professionals and for patients. Today I talk with Melina Ortigas in Yolo County, California about what she and her colleagues noticed about screenings and how they're working to improve them across the state.

Hi everybody, I'm Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication from Health Communication Partners. If your organization cares about equitable communication with all patients, there are some foundational concepts it's important to understand. That's why I wrote a new online course, Foundations of Equitable Interpersonal Communication in Health. It gets at the fundamentals everyone needs to know, it's world-class instructional design, and it's for all patient-facing employees. Your LMS or ours Learn more at healthcommunicationpartners.com.

You know this show is mainly a monologue, with yours truly, but every once in a while someone who's doing the work, who takes a critical, social perspective on health and on language, agrees to sit down with me and reflect on their practice as a guest of this show. Getting to spend time with my guests is a high point for me in this series.

The last interview I shared back the weekend of Thanksgiving was with Dr. Paul Ranelli, Professor Emeritus of Social Pharmacy. If you haven't gotten to hear it I'll link it for you. Dr. Ranelli talked about patient communication specifically around rare diseases, and told us about a new play about rare diseases, told from the perspectives of patients and their families. This play is called RARE: Stories of Dis-ease.

Paul was one of many collaborators in RARE. When he came on the show they had just wrapped their show run. Well, he just wrote last week and let me know the final show had been filmed and is now available! It's out on youtube, we can all see it for free, and I'm going to go ahead and put a link in the notes.

I mentioned he was one of many collaborators. It turns out the collaboration around RARE is also a story in itself. It involved patients who have rare diseases and their families; UMN students; faculty at UMN College of Pharmacy Center for Rare Diseases and Drugs; faculty at the Theater Department at the University of Minnesota Twin Cities; and professional playwright Kevin Kling best known for his work with NPR's All Things Considered; and a professional theater company.

Their coming together was so remarkable it inspired a documentary, and that documentary on the making of “RARE” is also now available for us all to see. I love behind the scenes stuff in general. I think this is great because we get to see their rigorous process. I think this would be a great resource for organizations who are interested in arts based education whether it's of the public and professionals. Links in show notes to “RARE Stories of Dis-ease and the documentary on the making of “RARE.”

Next I get to sit down with Melina Ortigas, a public health professional who tells us what happened when she and her colleagues in CA took a closer look at patient screenings.

Anne Marie: I’m live via zoom with Melina Ortigas, the Management Services Officer at First 5 Yolo Children and Families Commission, in Yolo County, California. Melina, welcome to the show!

Melina: Thank you Anne Marie, happy to be here.

I’m so glad to have you here. So can you tell us a little bit about First 5 Yolo?

Yes! First 5 Yolo Children and Families Commission administers California’s Prop 10, or tobacco tax, revenue. Together with our Community Partners, we work to identify barriers to quality health care and education, and advocate for policy change at the local, community and at the state level. we are a network of 58 County Commissions working together.

Oh so throughout the state of California then?

Throughout, yes.

Gotcha. And what do you do as the Management Services Officer?

I am responsible for overseeing projects directly working with the Healthcare System. Right now, some of our main initiatives are Help Me Grow, and Healthy Families America Home visiting, and our own behavioral health navigation and home visiting.

So Melina what is an issue or a problem that you’re facing related to communication or education?

I would say that one problem we’re seeing is just making our information more accessible to families, so they understand what our services are and how they might be of benefit to them. It’s really to build stronger relationships with all of our community members.

Very understandable issues, problems, struggles I think people are all going to be able to identify with. So how are you facing these issues right now?

One concrete example I can give you is our major priority area is to make screenings, developmental screening specifically, more accessible to families. We have a lower screening rate in the state of California than compared to other states. This is an area we need to do better in for our Medicaid beneficiaries. We are looking to understand what are the barriers and obstacles for families on MediCal to accessing those developmental screens, and other families as well, but especially those who are underserved.

So what are you doing in terms of that, of looking at those screenings, working with those screenings, working with those families?

Yes, one exciting development we had was a partnership with the LEND program at UC Davis MIND Institute. We had the opportunity to partner our Help Me Grow initiative together with LEND. We had expert practitioners and local Help Me Grow families, participants in the program, who provided feedback.

So you’re working with a lot of people on these developmental screenings. What are you finding from working with people? What are some of the things you are learning?

We’re learning that the term itself is a loaded term. It’s not as friendly as we might think.

The term “developmental screening?”

“Developmental screening,” exactly.

Oh.

We heard from practitioners saying that the tools themselves, and the information that they had access to, was full of jargon–or just not the right level for all of the families that they served. And so there was definitely a disconnect. And so we’ve learned to really message it in a much different way. You know it’s a tool that is designed to be completed by parents. And parents drive the agenda. And it’s parents' concerns for their child’s growth and development that really drives that process. And really focusing on the tool as a process that builds communication and relationship. Not a checklist, a yes/no, pass/fail type of tool. And we co-created an infographic to really make developmental screening and Help Me Grow as a service more understandable.

That’s really exciting. So you're hearing back from families, you're hearing from practitioners. And what are your next steps? What are you doing next?

Our next steps are to really look at our tools critically. And think about, you know, who are they serving or who are they not serving? What languages are available, and validated or research based? And who makes up those research studies, right? Are all of our community members in Yolo County adequately represented? If not, what can we do? What more can be done to make sure that everyone has access to quality education, information, and tools that really are meaningful, and data that’s reliable?

Melina Ortigas thank you so much for spending time with us today on the show

Thank you so much Anne Marie, it’s been a pleasure.

Melina Ortigas, Management Services Officer First 5 Yolo Children and Families Commission in Yolo County, California. I want to Thank Melina for taking time to share that story. If you're interested in the infographic and other projects Melina was talking about, you're in luck! She gave me links to share with you. I have them in the show notes at HealthCommunicationPartners.com. This has been “10 Minutes to Better Patient Communication” from Health Communication Partners. Audio engineering by Joe Liebel, music by Joe Liebel and Alexis R.

Thanks to Melina for this additional information:

Parents often have questions about their child's development during their first year of life. This checklist in English and Spanish has useful guidelines to help determine when it's time to ask for professional help. When to ask for professional help in baby's first year: Infographic Spanish, English.

Why screening in early years matters: Infographic (English only)

Thanks to LEND (Leadership Education in Neurodevelopmental and related Disabilities) trainees, Help Me Grow Yolo County (a program of First 5 Yolo), and Yolo families who helped co-create these tools. Learn more about LEND here and here.

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I take a close look at The Surgeon General’s Framework for Mental Health & Well-Being in the Workplace and see that it’s not what we’re used to…and that’s a good thing.

In October of 2022, the U.S. Surgeon General, Dr. Vivek Murthy, released Framework for Mental Health & Well-Being in the Workplace. In a post on the HealthCommunicationPartners website, I promised I'd spend more time on this Framework and tell you about it in a future episode. So today, I'll tell you how this Framework breaks with tradition, in a good way, and why that's reason to be hopeful.

If your organization cares about equitable communication with all patients, there are some foundational concepts it's important to understand. That's why I wrote Foundations of Equitable Interpersonal Communication in Health. It gets at the fundamentals everyone needs to know, and it's for all patient-facing employees. Learn more at healthcommunicationpartners.com.

The Surgeon General's Framework for Mental Health & Well-Being in the Workplace came out in October of 2022. Forbes called “CEO required reading.” The Washington Post headline reads, “Bosses should fix toxic workplaces, Surgeon General says.”

Now there are Five Essential elements that make up the heart of the Framework. Here they are: Protection from Harm; Connection and Community; Work-Life Harmony; Mattering at Work; and Opportunities for Growth.

HR people are taking notice, and the ones that have been advocating for change like this have a research-based document to point to, out of a very high profile Federal Agency.

Workplace wellness initiatives are not news to anyone listening here. Physician burnout was labelled a public health crises before the pandemic. In October of 2022, The National Academies released its own National Plan for Health Workforce Well-Being.

In an interview with Bloomberg news, the Surgeon General spoke about making progress on mental health in particular, and that it is down to not just individual words and actions, but structural forces. And that thinking is evident throughout the Framework.

Here's why this is important. The Framework bucks the trend, or breaks with the tradition, in a good way–the tradition of focusing on individual employee level behaviors.

Instead, this Framework focuses on structural-level change.

For nearly a decade, I've heard stories from medical and public health practitioners and students about their individual workplace or school's wellness activities. No one disputes the need for the attention to employee wellness in medicine and public health. but I've heard some dissatisfaction with the ways in which individual organizations have gone about it. One of the critiques centers around approaches that favor individual-level rather than systems-level actions. One med student put it memorably. He said: They're making us go to an ice cream social on the lawn, while the building behind us is on fire.

So I was hopeful when I read the Surgeon General's Framework, and noticed its explicit systems-level orientation. For example, in the opening pages of the framework we're given a controlling metaphor, organizations can function as engines for mental health and well-being.

There's terminology that points to structural issues. For example, one component of Protection from Harm states: Organizations can further normalize and support mental health by modeling, communicating, and regularly promoting services. Another states: Employers can prioritize diversity, equity, inclusion, and accessibility (DEIA) norms by putting relevant policies and programs in place. So we've got terms like services, policies, normalizing, these point to systems-level actions, good to see.

Communication–which you know I care about–communication itself is addressed several times. Having clear and consistent communication, communication's role in building trust, establishing policies to limit [digital] communication outside of work hours. And this, which leaped out to me as a pretty nice phrase and kind of a consolidating idea: The future of work includes both remote and hybrid work, in a variety of full-time and part-time arrangements, so there is even more need to be intentional about how to build teams, communicate, and collaborate.

Clearly these are not only individual level solutions we're being given. After reading this it’s kinda laughable to imagine someone suggesting that if only individuals would engage in better behaviors, just buckle down at work, your workplaces wouldn’t be toxic or hazardous to your mental health!

Yet for as much as we know about the importance of looking at systems-level injustices and structural approaches to change; as much research as there is on the need for systemic, institutional and organizational action; as much as all of this is in the public eye, it can be astounding how much individual-level actions still dominate the discourse about health and wellbeing and healthcare.

It’s easy to see why individual level approaches are popular. I mean really, we each of us, I know I could be doing better, than we all are. And how great would it be if we all did eat healthier, move our bodies more regularly, not be addicted to anything!

But overall, the focus on individual-level actions steers attention away from things like root causes, upstream factors, broader approaches to health.

Which is why i think the fact that this Framework is coming from the U.S. Surgeon General, and not from another federal agency, is significant.

Because the U.S. Surgeon General is a person, right?! He's a medical professional who is very well aware of these dominant discourses. And he chose to break with this individual model that he, the person, Dr. Vivek Murthy, knows very well. You know well because you're listening to this show. It's still the dominant approach of individualizing and medicalizing understandings of health, in ways that support or invite individual level solutions. Solutions that almost all the time are behavioral, or pharmacological, or technological or biotechnological. Meanwhile keeping out of view systems-level problems and solutions.

The Framework also stays away from ‘healithism’ and other kinds of ‘lifestyle drift’ approaches to health and mental health that are also well known to many of you in medicine and public health. This overwhelming behaviorist view that individual behaviors are the key to better health. The implication or the outright statement that public health professionals' job is to motivate or inspire people to voluntarily adopt easy lifestyle changes to promote their health. As if good information and encouragement is all individuals need to be healthier!

This, despite extensive empirical evidence that behavior change accounts for up to only 10-15% of health outcomes. I have Dr. Dennis Raphael at York University to thank for this research, so I'll put links in show notes.

Health literacy is also working to let go of its individual focus on behaviors and capacities. The most high profile example of this recently is the CDC's organizational definition of health literacy.

Part of what I find encouraging about the Surgeon General's model is that it's an alternative to the common or dominant story in the field that we've all heard. The dominant stories we’ve all inherited. This series invites questioning of these dominant narratives, and supports you the people who are already doing it, specifically with tools grounded in equity and justice.

Wherever you work, I encourage you to check out the Surgeon General's Framework. If you're in healthcare, let your leadership know about Foundations of Equitable Interpersonal Communication in Health. If you're not in healthcare, hey, stay tuned: I've got something coming for you.

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Health literacy is still going strong as a field, and continues to be at the center of many policies and practices. Here’s four sometimes-overlooked reasons to feel good about health literacy.

TRANSCRIPT

Health literacy is not going away! In this episode, I'll talk about several reasons to be happy about the patient safety and quality issue that everyone is still talking about.

Hi everybody, I'm Dr. Anne Marie Liebel and this is 10 Minutes to Better Patient Communication from Health Communication Partners. Our expertise is in teaching people and organization how to get better at communication. Our new course teaches all patient-facing employees to manage common obstacles to equity in patient communication. Why? Because every interaction with a patient is important. And everyone who interacts with patients deserves high-quality communication support. So from Cafeteria to Cardiology, we've got you covered, with Foundations of Equitable Interpersonal Communication in Health. Learn more at healthcommunicationpartners.com.

Now with health literacy, there's huge interest still, after more than 20 years. There's loads of action and momentum. That's big, and important not to take for granted.

There are so many resources and people and communities making more resources every day. We got the new CDC definition back in 2020. I've been lucky to participate in and observe health literacy activities, health professionals helping contribute to better health and wellbeing for everyone. Whether it's connecting people to services or information, or helping people get the most out of their healthcare, or continuing reflective practice as professionals, and asking hard questions of ourselves.

So I want to encourage everybody and say, Yeah! This is good! Let's keep unearthing our assumptions, including those about health literacy. Assumptions about what health literacy is.

No one's denying that health literacy involves skills. And most people I think it's safe to say are on board with health literacy being context-specific. What's also interesting is that recognition of health literacy as a social practice, and that it's tied in complex ways to culture, are also gaining ground. And if you've heard this show before, you know this is how I see health literacy. I've been banging this drum for years on this show! All of my episodes about health literacy are from this perspective.

So I was super excited when last month the WHO released a report that said, Importantly, health literacy is understood as a social practice whereby decisions about health, and the available support to change, or maintain, healthy behaviours, are determined by powerful and unique community norms and cultures, and organizational and political factors impacting communities.” I'll put a link to that report in the notes.

So yes, I want to encourage everybody to keep unearthing our assumptions about health literacy. How? Well, Here's some food for thought, four reasons, maybe some less-talked about aspects of health literacy, that I think you can feel good about that I shared a while back.

Based on my background and experience in health literacy, and literacy more generally, here are 4 things to keep in mind so you can feel more confident or perhaps see yourself as more competent when it comes to doing something about health literacy.

1. You know more about health literacy than you might think

We all use language every day. Think of language as something in our human tool kit.

There is nothing magical about health literacy in and of itself. Health communication is a special subset of everyday communication. What trips us up in everyday communication can also trip us up when it comes to health literacy. But many of the same strategies and approaches that work well for you in everyday language can be helpful in health literacy.

For instance, let's say you're sending a text message. You know that you increase the chances of your message being understood when you take your audience into account. You make some choices in terms of what you include in that message and how you phrase it, based on what you know about the receiver.

This is good news when it comes to health literacy.

Even small changes can bring your message in line with what matters to your patients and their families. They're your audience. And rather than worrying about a patient's low score on a literacy assessment, focus on the ways they are successful users of oral, written, and multimodal language.

1. Health literacy happens nearly everywhere, every day, with everyone

Let me explain. No, it's too much. Let me sum up.

As I mentioned earlier, There are many different definitions of health literacy. Most of them agree in the main. Most of them focus on an individual's skills, or capacities. And the differences in these definitions tend to be fine-grained. however, there are a few definitions over the years that have looked to expand the skills and capacities focus. They do this primarily by seeing health and literacy as sets of interrelated cultural practices or activities that we all engage with. For that I'm pulling from the 1997 article that kind of kicked this off.

This more social view of health literacy seeks to complement the skills view of health literacy, since we're all doing skills in certain social situations. This is helpful because it situates health literacy in everyday life. Sure, the clinical environment gets most of the research attention. But that's not the only place health literacy happens. Since most of people's lives are lived outside of the clinical environment, far more health literacy goes on outside the health setting than inside.

Examples of health literacy in action are all around us. For example, here's some health literacy situations I have been involved in, over the years:

• An ER pediatrician deciding how to articulate bad news to parents so they can make care decisions
• An adult child searching online for alternative therapies for his dad's prostate cancer
• A medical educator socializing her students into the academic language of medicine
• A woman jogging on a treadmill in a gym watching TV ads for pharmaceuticals
• A patient advocate negotiating a bill on behalf of a clinic patient

Health literacy happens all over the place. More frequently than it might seem. And it involves all of us.

1. Health literacy is an interaction

When we talk, listen, read, watch, or write something, we are interacting with other people and with our environment.

When we read, for instance, we are always reading something, for some reason, written by someone(s), and we are somewhere when reading it. We consider these contextual factors, sometimes unconsciously, as we read and make sense of what we're reading.

Health literacy is no different. Every day, people encounter and interpret information related to their health and healthcare.

Consider those examples I just mentioned of health literacy in action. Each of these are complex interactions between people, messages, and settings.

We don't communicate in a vacuum. Where we are, when, why, who we're with, what we have all of this makes a difference to the way we use language use. You know how It makes a difference how you talk, when you consider who you're with and where you're at. That's easy to see. So it's a short leap to imagine how it also makes a difference to how we listen, read, and understand.

You knew this already. I'm reminding you of it, so it's not far from your mind the next time you think about health literacy.

1. Health literacy is not

Health literacy is not a proxy for education. Or intelligence. Or social class. Or motivation. Or overall health. Or compliance (sorry, adherence).

You know, for instance, that being highly educated does not mean having all the information one needs to deal with a health situation. Or knowing the difference between similar-sounding medical terms. Or being savvy with insurance. Or easily navigating a health system. And yet all of this is part of health literacy.

Even people who are labelled as illiterate (by one measure or another) have multiple sophisticated ways of reading a text or image, keeping track of items, measuring and weighing, estimating and calculating. Your patient may have scored badly on an assessment, but that doesn't mean they don't do any reading or writing in their everyday lives. Remember this when you face your patient, and you'll both benefit.

You're working hard at communication and you know health literacy is important. That's why you're here. You want something that helps because you give a darn about your patients. And you know that communication is central to your ability to do your job well.

So these reminders are to help you focus on the parts of health literacy you can actually do something about: the conversations you have with patients, and any written or digital communication. In short, any way words and images are used before, during and after the patient encounter.

Because all this is health literacy, and health literacy involves all of us. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel.

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It’s the countdown time of year! Here’s our Top 10 most downloaded episodes of “10 Minutes to Better Patient Communication” from 2022.

You’re reflective. You get how much communication is connected to equity. You get how the ways we educate are connected to equity. You’re the best audience there is! You’re the rockstars. And here are your 10 favorite episodes of this year.

Hi everybody, I’m Dr. Anne Marie Liebel and this is “10 Minutes to Better Patient Communication” from Health Communication Partners. You know by now our expertise is in teaching people and organization how to get better at communication. Our new course teaches all patient-facing employees to identify and manage those cultural mismatches that can show up in communication. Why? Because every interaction with a patient is important, and everyone who interacts with patients deserves high-quality support. So from Cafeteria to Cardiology, we’ve got you covered, with Foundations of Equitable Interpersonal Communication in Health. Learn more at health communication partners.com

Alright so I'm going through the top 10 episodes so that gives me just under a minute for each one! This gives you a way to catch up if you've missed any of these.

10 Heath communication’s messy, confusing problemsYeah–this was a hit early in the year when it came out. It was also some of the most uncomfortable I've been in recording an episode. In this one, you're gonna hear several experts’ insights on what’s wrong in health communication. The most pressing problems. Spoiler alert: they’re not new. Some, even many of them I argue are inherited ways of working in the field. So I offer some pointed questions we can all ask of ourselves and our organizations. See how far we’re willing to go, or what we’re willing to do, to address these problems and remove obstacles to equity.

9 Making sense of what we read about health equityMy inner literacy professor was super glad this one made the cut. Because I tell you one way I try to manage the complexity when I'm reading about health equity. Because not everyone defines it the same way. And some of these differences are significant. You know I’d done an earlier episode on why we need to be careful of what we mean by health equity. This episode builds on that. Making sense of the range and variation of the ways this term is used, defined, and understood. it's difficult but it's necessary if we're going to make meaningful progress together toward health equity. I walk you through how you can wrap your head around what different documents are saying about health equity, so you can choose who you’re more or less on board with and why. Because you want to work with folks who share your same or complementary ideas about health equity.

8 14 Reflective Practice Prompts on Health EquityThis is a great follow up to #9! If you’re wondering what you mean by health equity, this episode is for you. I offer 14 reflective questions designed to get at the things that we don't typically get at. Our kind of taken-for-granted beliefs or what can pass by unnoticed. And then, we turn explicitly to action because this isn’t just an academic exercise or some navel gazing, we have work to do toward health equity.

7 The nature of health communication is socialFrankly I’m amazed this made the list because it is not a click-baity title, eek. I make the argument in this one for why thinking of health communication as a transfer of information is problematic. I'm not just playing favorites. This kind of thinking is limited, and it's limiting. I argue it's holding us back. And maybe that's why it made it onto the list at #7.

6 Communication must be part of any DEI strategyI’ve written many times about interprofessional communication and equity. But I’m still kind of shocked how little I hear about communication in DEI conversations. I have helped organizations of all sizes with communication as part of their DEI strategy. So in this episode, I share with you steps your organization can take to take your DEI efforts beyond just awareness of overtly stigmatizing terms, just awareness of pronouns. Those things are important, but what do we do beyond that?

5 Introducing our new communication course for all patient-facing employeesThis was exciting to me because this was the episode where I introduced our new communication course for all patient facing employees. So that you so much for tuning into this. This was our big announcement episode and we actually had 2 big shares in it. One, that we got a brand new course platform that looks amazing, I'm so thrilled with it. It's easy to navigate on any device including your phone. And the other announcement is that we launched our first video-based course on this platform. It's for anyone who talks w patients. Because as you know, health equity is everyone’s job now.

4 Why NYCHealth's Language Use Guide is so goodI was really glad this made it into the top– not even the top 10, the top 5 most downloaded episodes of this year. Because I’d started a series near the beginning of the year where I was featuring excellent resources that really get the language-and-its-connections-to-equity thing. And one of them is from the NYC Department of Health. They have a language use guide right on their site, which I think is amazing to begin with. As a researcher and educator on equitable uses of language and literacy, I'm telling you: this guide is good if you want to level up your knowledge on some terms, including problematic ones that have crept into medicine and public health.

3 That time when Dr. Jonas Attilus visited our showThe #3 most downloaded episode of the year is That time when Dr. Jonas Attilus visited our show. So on these countdowns, it's a countdown of episodes that originally aired this year, the most downloaded episodes that originally aired this year. But for this one I'm bending my own rule a little bit. Now this episode did air this year, 2022, but it features an interview from 2021. I’m including it because Jonas Attilus is amazing and his interview from 2021 is total fire and joy. And also because I want you to read the STAT news article he was just in this year about how Black doctors are forced out of training programs at higher rates than white doctors. So you haven't heard that time when Dr. Jonas Attilus visited our show, check it out. It's our #3 most downloaded episode this year.

2 This HHS course on Maternal Health is the resource we need nowWoohoo! Another from that series where I shine a light on excellent resources! In this one, I preview the free online course from U.S. Department of Health & Human Services. The course is called Culturally and Linguistically Appropriate Services (CLAS) in Maternal Health Care. And I take a look at their instructional design. The educator in me loves it. If Women's Health is on your mind, you'll want to take this free course from HHS.

Drumroll please! The #1 most downloaded episode at Health Communication Partners from 2022 is:

1 4 reasons to take the free CMS course on LGBTQ healthYes! This series was so much fun to do and I'm really glad you enjoyed it. All 3 episodes from this series made it into the top 5 most downloaded of the year. In this one, the most popular of them all, I preview the free course Improving Health Care Quality for LGBTQ People from the CMS.gov website. and give you 4 reasons why you should take it if you want to communicate better, regardless of your patient population. And I want to give a shoutout of thanks to Dr. Lindsey who heard this episode when it originally aired, took the course, and wrote about it on linked. Oh, and Dr. Lindsey is a veterinarian.

This is what I mean, you are the rockstars! It’s an honor to be spending time with you. And whoa are things lined up for 2023! We have major things happening–so much growth, so much activity I'm really looking forward to sharing. If you have an idea for a topic for a future episode, write me. I’m on linked more than twitter these days. And you can also find me at Anne Marie at h-cpartners.com. I'm Dr. Anne Marie Liebel. This has been “10 Minutes to Better Patient Communication.” Audio engineering by Joe Liebel. Music by Joe Liebel and Alexis R.

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It’s a paradox that rare diseases are not so rare; one in ten people has a rare disease. Yet each rare disease, and each person’s experience with a rare disease, is different. This makes for complex communication with family and health professionals. Hear how Dr. Paul Ranelli uses the arts to delve into the complexities […] The post Dr. Paul Ranelli and using the arts to explore rare diseases appeared first on Health Communication Partners.

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A few health professionals recently shared stories of pushback from colleagues regarding health literacy. Learn how you can respond to the next person who believes health literacy is just about medical terms. In this episode, I take up a problem expressed recently by a few health professionals who were frustrated by some pushback they were […] The post Health literacy isn’t only about medical language appeared first on Health Communication Partners.

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Every 2 weeks for 5 years, “10 Minutes to Better Patient Communication” has been bringing you new avenues into health communication, patient education and health literacy. Find out how one physician answered the question “what is health literacy,” and hear the new sound we got for our birthday! Happy Birthday, “10 Minutes!” For 5 years, […] The post “10 Minutes” is 5! appeared first on Health Communication Partners.

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If you care about health literacy, in this episode you’ll learn why busting the myth that literacy is a skill can help you in your work–and what you can do instead. EPISODE TRANSCRIPT It's health literacy month again, so here's another look at some literacy myths. If you care about health literacy, I'll tell you […] The post Busting some literacy myths: Literacy is a skill appeared first on Health Communication Partners.

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What is the past–and future–of health equity research, theory, practice, and policy? Comments from an oncologist kick off some thinking. I recently had an interesting conversation with an oncologist about health equity and communication. It got me going back and forth in time. I want to share some of what we talked about, in hopes […] The post Addressing health equity is "the important topic of our times" appeared first on Health Communication Partners.

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I’ve been reflecting on the stories different people have shared with me about talking with patients. Whether from hospital staff, community health workers, or medical staff, these stories have important things in common. This is some of what I appreciate about you and the complexity of the work you do. So many people now are […] The post A love letter to everyone who talks with patients appeared first on Health Communication Partners.

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No, really. There are important differences between the terms “pee-pee” and “urine.” Here’s what they are, and why anyone who cares about patient communication and education should take these differences seriously. EPISODE TRANSCRIPT Aww shucks. It's happened. I got COVID. And the timing! Last episode we made our big announcement, our new course platform and […] The post Why we should take seriously the differences between “pee-pee” and “urine” appeared first on Health Communication Partners.

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We have two big announcements: our brand new, dedicated course platform, and a new communication course for anyone who interacts with patients. Learn more about them both! Today’s the day. For months I've been saying we have a big announcement to make, and today I finally get to share it with you. Really excited about […] The post Introducing our new communication course for all patient-facing employees appeared first on Health Communication Partners.

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Dr. Jonas Attilus was recently featured in a STAT News article. Dr. Attilus visited our show last year and talked about humility and power when physicians speak with patients. Hear about the article, and listen to his interview. EPISODE TRANSCRIPT At the start of 2021, we aired my interview with Dr. Jonas Attilus about humility […] The post That time when Dr. Jonas Attilus visited our show appeared first on Health Communication Partners.

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If Women’s Health is on your mind, you’ll want to take this free online course from U.S. Department of Health & Human Services called "Culturally and Linguistically Appropriate Services (CLAS) in Maternal Health Care." I preview it, and show you a cool design trick they embed to make it more accessible – and efficient. The […] The post This HHS course on Maternal Health is the resource we need now appeared first on Health Communication Partners.

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The New York City Department of Health has a language use guide on its site. I preview it, and tell you 5 reasons why you should check it out. EPISODE TRANSCRIPT The NYC Department of Health has a language use guide on its site. A language use guide! From major health department! As a researcher […] The post Why NYCHealth’s Language Use Guide is so good appeared first on Health Communication Partners.

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CMS has a free online course called "Improving Health Care Quality for LGBTQ People." Here’s 4 reasons you should take it! I'm grateful that there are so many resources out there if you care about health equity and communication. In honor of Pride month, I'm going to highlight one of them: a free online course […] The post 4 reasons to take the free CMS course on LGBTQ health appeared first on Health Communication Partners.

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Improving patient communication is a marathon, not a sprint. But who doesn’t need a quick win now and again? In this episode, you’ll learn 5 quick ways to boost your patient communication efforts. EPISODE TRANSCRIPT Improving patient communication is a marathon, not a sprint. Sustained change takes time. Still, we all need something that we […] The post 5 quick ways to improve patient communication appeared first on Health Communication Partners.

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It’s the 20th anniversary of the Institute of Medicine’s landmark report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare.” With communication top of mind for so many of us now, what did the report have to say about communication 20 years ago? It’s the 20th anniversary of the Institute of Medicine’s landmark report, “Unequal […] The post What did “Unequal Treatment” say about communication 20 years ago? appeared first on Health Communication Partners.

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It’s the 20th anniversary of the Institute of Medicine’s Unequal treatment: Confronting racial and ethnic disparities in healthcare. In honor of this landmark report, we’re spending some time with the abstract and considering how it sounds now. It’s the 20th anniversary of the Institute of Medicine’s landmark report, Unequal treatment: Confronting racial and ethnic disparities in healthcare. […] The post “Unequal Treatment” turns 20: How does the abstract sound today? appeared first on Health Communication Partners.

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Family physician and physician leader Dr. Saria Saccocio has found connections between communication and people’s sense of belonging in an organization. Belonging is one of the traits she s noticed across the most successful teams in healthcare. Dr. Saccocio shares some practical communication strategies she uses to encourage a sense of belonging in organizations. Clinician well-being […] The post Dr. Saria Saccocio on belonging and interprofessional communication appeared first on Health Communication Partners.

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There’s been a trend in some health literacy papers, presentations and conversations I’ve seen lately. I’ve noticed one way health literacy can become an obstacle to better health outcomes–and it might not be the one you’re thinking. Listen here and read the transcript below. PS – As you may have heard, my podcast hosting duties […] The post A hidden way health literacy can be an obstacle to better health outcomes appeared first on Health Communication Partners.

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If communicating across difference is important to you, we have an exciting announcement: My cat is the new host of this show! If communicating across cultural and social difference is important to you, we have an exciting announcement in this episode! Hi everybody. I m Dr. Anne Marie Liebel. This is “10 Minutes to Better Patient […] The post This podcast series will now be hosted by my cat appeared first on Health Communication Partners.

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Each day, it seems, we see more new and important publications dealing with health equity. How do you make sense of the range and variation in the way health equity is written about? A recent JAMA article brought attention to what s been called the quintuple aim in healthcare. As a result people are talking about […] The post Making sense of what we read about health equity appeared first on Health Communication Partners.

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Thinking of health communication as a transfer of information is certainly popular. In this episode, I’ll ask you to take a step back from that, and be willing to think differently about the nature of health communication. You may be used to thinking of communication as a transfer of information. Well, if you want to […] The post The nature of health communication is social appeared first on Health Communication Partners.

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When it comes to educating, one size does not fit all people. In this episode, you ll learn 10 different ways you can express a complex idea, so you can have different approaches for different patients. During patient education you are often dealing with medical or scientific concepts of great complexity. You already have ways that […] The post A new way to say the same thing appeared first on Health Communication Partners.

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This has been one of the most challenging episodes I ve ever done. Partly because we re nearing our third year in the pandemic, and that itself is exhausting. I m sorry I sounded exhausted on the last episode; I was. Partly because the news is so bad, I had to choose when to stop including items for […] The post Health communication’s messy, confusing problems appeared first on Health Communication Partners.

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What does health equity mean to you in your professional and personal lives? In this episode, you ll learn 14 ways to help you find out. Health equity is still on people s minds, and I am here for it! Maybe you can define health equity. But what does it mean to you? In this episode, you ll learn […] The post 14 reflective practice prompts about health equity appeared first on Health Communication Partners.

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In and beyond healthcare, American workers are quitting their jobs in record numbers–and this trend shows little signs of slowing. Employers who want to attract and retain talent are talking up their DEI strategy in order to be competitive. Here’s why communication must be part of any successful DEI strategy, and how you can get […] The post Communication must be part of any DEI strategy appeared first on Health Communication Partners.

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Strong and equitable interprofessional communication is crucial.

We re trying to collaborate. We re needing to communicate. We re having to coordinate within incredibly complex, overlapping systems, under unbelievable circumstances.

Here are tips to help you be more equitable while managing your interprofessional communication. And there’s an infographic!

It s Christmastime! In the spirit of peace on earth and good will to all, this episode is about communication with other professionals. Whether it s your colleagues that you talk with on the regular, or folks you interact with only once. Here s tips to help you manage key areas of concern when it comes to interprofessional communication.

Hi everybody. I m Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners, an independent health-equity focused education and communication consultancy. If your organization needs expert help with any topic in this series, visit healthcommunicationpartners.com.

Today s episode sponsored by Maven Roth Group. You listen to this show because you re good at communication and you want to get better. You ve got the words; let Maven Roth do the rest! From designing images, reports, logos, templates, and social graphics for your organization, to spreading the word thru digital, print, billboards, radio and television, Maven Roth has you covered, all the way to media buying and management. Visit mavenroth.com today.

Now there s plenty of need, and we re all stretched thin. Everyone s trying to serve their communities, whether it s directly through care or increasing access or addressing barriers to care. We re trying to collaborate. We re needing to communicate. We re having to coordinate within incredibly complex, overlapping systems, under unbelievable circumstances.

For more than 4 years, Heath Communication Partners has been making an impact in the field of culturally-relevant communication and education, partly through this podcast series heard round the world. As you know, in this series I takes up issues and questions about communication and education raised by professionals in the health sector, and address them in ways that enhance equity including equity within the teams doing the work! Yes. Doing this kind of work means collaboration, which can be tricky even under ideal circumstances–which a global pandemic is not.

In this episode from 2019, I m sharing ways you can manage three key areas of concern when it comes to interprofessional communication, on individual and systems levels. What I have learned from drawing on a large research base and also decades of experience collaborating with colleagues and clients. A 2017 Discussion Paper from the National Academy of Medicine underscores how much this has to do with communication:

“[E]fforts to improve health and eliminate disparities require professionals to understand audiences, share across knowledge arenas, provide culturally appropriate and accessible health information resources, and innovate strategies to engage vulnerable populations.”

It s not news that difficult and deep-seated challenges benefit from collaborative efforts. The pooling of knowledge and resources also helps reduce time wasted to duplicated efforts, and helps under-resourced groups. We know it takes a village. We know none of us is as smart as all of us. Still, the challenges are real. There are personal concerns, interpersonal concerns, and institutional concerns when it comes to interprofessional communication. So let s dig really briefly into each of those three.

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Personal concerns. We all have our communication hangups. None of us wants to look foolish. When it s something we care about, or it s a difficult issue or both we can put additional pressure on ourselves. Wouldn t it be nice if we could magically leave our awkwardness, or doubt, or frustration at the door when we have to communicate in a professional capacity?

Now we all believe we have good reasons behind what we do and say and feel. We develop ideas that work for us. They are based on our experiences, our knowledge, and our communities. And these processes are largely unconscious on our part. Our language tends to reflect what we think is normal, natural, or the way things should be. That s not necessarily a problem but it can show up like one.

What s more, when we speak with another human being, we are strengthening (or weakening) our relationship with them. We are revealing our perspective on whatever issue s at hand. We are making a case for our priorities. And more. That can be intimidating for anyone.

So how about some interpersonal concerns? Ok, it s obvious that communication is an interaction between people. It s easier to forget that different people are more comfortable speaking in some places, or to some people, than others. We also can feel more or less confident in our knowledge, depending on where we are, and who s listening.

Folks on your team may be coming from different places, or standing in different spaces economically, politically, or culturally. Your team members participate in different communities: professional communities, neighborhoods, families, and multiple other social groups.

And these groups tend to impact the ways we talk, think, act, and more. So we re all coming together with what we believe to be good reasons for doing, saying, and believing like we do. This is a large part of what makes groups powerful, and at times, tough to navigate and sustain.

Let s think a moment about institutional concerns. You won t be surprised at the two institutional constraints most often shared with me: time and technology. That s largely because when, where, and how you interact shapes what you do together.

For instance, where and when group meetings are held matters. Some times and locations will make participation easier for some group members than for others. This is about logistics and structure, but also organizational culture. Whether it s down to institutional norms, or the status quo, we feel a more valued part of some contexts than others.

And there s plenty of variation within contexts. For example, what is acceptable or normal communication in one institutional context is not necessarily so in another. Success or comfort in one department, or one organization, or one sector does not automatically translate into success in another.

We all know about academic silos. Those silos are the places each of us learned to talk, think, read and write in ways that are necessarily specific to our area of expertise. But we also get silo ed within our institutions, don t we? Once, I gave a talk that drew folks from different departments in the same organization. After my talk, I was eavesdropping a little on their conversations. It turns out they didn t really know each other, and hadn t realized how much they could have been working together given their shared interests.

I realize there are many, many other structural and social issues I m not even touching on, but let s turn to the good news. Because there IS good news. There are ways to constitute these interprofessional groups, and there are ways they can work and sustain themselves. Who s one person you can reach out to and say, We probably have common people (or common problems), so maybe we can help each other? Just one person. You can do this.

Another thought on a personal level: Notice some of the phrases or terminology you commonly use. What are the underlying assumptions about patients or colleagues or clients within these words and phrases? For example, calling patients frequent fliers or noncompliant; describing a colleague s contribution as mainly about soft skills.

Here s some thoughts for the Interpersonal level: For your next meeting, check ahead of time: do you have an agenda? If not, make one. A quick one. An objective and some action steps. Even something this short will ensure you make the most of the time. I know this sounds obvious, but it s easy to forget. I ve said this to multiple people. One appreciative physician told me, It s different to just hang out and say we re talking it s different if we have an agenda. There has to be a little bit of formality, she said.

Another interpersonal concern: Who is best served by the current arrangements in your group? For example, is there maybe a small shift that would make collaboration easier for more participants? Maybe occasionally switching to conference calls, or making an online meeting space, or rotating who s in charge.

Now let s turn to an Institutional level concern: What person or group, or perhaps even specialization or knowledge base, tends to dominate in your interprofessional groups? Which tend to be a little quieter, perhaps marginalized? For example, think of who typically is not heard from, even when they re present. What might change if there were more of a level playing field?

If you d like some more examples and encouragement, check out my earlier podcast episode on hotspotting at healthcommunicationpartners.com. And there s a transcript for this and every single episode I do at healthcommunicationpartners.com with hyperlinks because I love linking research to practice!

Interprofessional groups are intended to be collaborative, and collaboration hinges on open communication. These tips might help you see some small ways communication in your group could be brought more in line with its goals. If you re like more help, drop me a line.

This has been 10 Minutes to Better Communication. I m Dr. Anne Marie Liebel for Health Communication Partners.

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In this episode, you’ll learn 4 strategies to help you communicate with your employees about the omicron variant, despite widespread “pandemic fatigue.”

Here we go again! Omicron is here. If you re communicating with employees about omicron here are four strategies to support your communication.

Hi everybody. I m Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners, an independent health-equity focused education and communication consultancy. If your organization needs expert help on any topic in this series, visit healthcommunicationpartners.com.

Today s episode sponsored by Maven Roth Group. You listen to this show because you re good with communication and you want to get better. You ve got the words; let Maven Roth do the rest! From designing images, reports, logos, templates, and social graphics for your organization, to spreading the word thru digital, print, billboards, radio and television, Maven Roth has you covered, all the way to media buying and management. Visit mavenroth.com today.

The scientific community knew there would be variants to COVID-19, but not so much is known about this one yet. So people are watching and waiting. In the meantime, Omicron has had an impact on travel, global markets, and employers. New York City, for example, recently required all private employers to mandate their workers get COVID vaccinations as part of a pre-emptive strike according to the New York Times.

With the Great Resignation, it s clear that employers also want to protect their people. Employers are having to communicate with employees about health topics, quite a lot over the last 20 months. But before then, few people had reason to be aware of health communication as a specialized skill, or field of study. But it exists because when health professionals communicate about health topics with patients or the public, it s often a complex endeavor. COVID-19 has made communication about health topics more complicated, in multiple ways. And like many health professionals, employers are communicating about health topics.

Omicron comes at a time when we are collectively done with all this! That feeling has a name: pandemic fatigue.

People worldwide are suffering from pandemic fatigue, and it’s another communication challenge.

If you had to guess what “pandemic fatigue” means, you probably wouldn t be far off. The WHO Regional office for Europe calls pandemic fatigue distress as a reaction to sustained and unresolved adversity. Yeah, that sounds pretty accurate. It s associated with a decline in how vigilant we each are regarding protective behaviors and staying informed about Covid. So as an employer communicating with employees about omicron, you ll want to make sure you re doing what you can so your message gets through any pandemic fatigue.

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The WHO Europe office released a framework. It s designed to help local and national governments and decision makers to manage pandemic fatigue. And I think its advice may be helpful for anyone in a leadership position, including any employers who need to communicate with their employees.

Now, the framework proposes four key strategies, and I ll share them along with some tips on how you might use them.

#1 “Understand people.” I kind of like that as a starting place. Because when we re thinking about communication, often the topic is front of mind. That s what we re worried about, and how we re gonna get it out there fast enough. But they re starting by reminding us to understand people. How can you do this? Well, you could ask your employees what their questions and concerns are and listen to what they say. When it s appropriate cite any mandatory workplace safety rules and of course the latest Covid information from the CDC & other vetted sources.

#2 “Engage people as part of the solution.” The WHO continues: Find ways to meaningfully involve individuals and communities at every level. How could you do this? You could collect and prioritize people s questions in your communication, whatever people actually ask you about. When possible, use the actual words and phrases that your employees use. Put the questions most often asked near the top of whatever you re sharing whether or not you think they should be the most important questions.

#3 “Allow people to live their lives, but reduce risk.” How could you do this in your communication? Keep it as short as it can be! Let s start there. Also, make sure written materials you share are accompanied by images. Not just pretty pictures, but meaningful graphics that help you say what you need to say and tell your story.

#4 “Acknowledge and address hardship.” They continue, Find ways to recognize and alleviate the profound impact the pandemic has had on [people’s] lives. How do you do that in your communication? I ll suggest that you start with acknowledging pandemic fatigue might be the case for some of them. And then go ahead and repeat yourself. That s right, communicate what you have to say multiple times. Why? Pandemic fatigue can affect how your message is interpreted, first of all. How? Well, research shows our emotional and physical state has an impact on the sense we make of what we see, or read, or hear. For example, you may remember a time when you were worn out, checked out, or spaced out and trying to read something. It might not have gone too well! Now, I wouldn t send the same message twice, but lead with the key takeaways and reinforce your main message. Sending another correspondence at a later time also gives people another chance to read or view it when they could potentially be in a different emotional state. The repetition also increases the chances your message will be noticed! Which of course is another danger, or communication challenge, of pandemic fatigue. We are done with this! It s tough to pay attention to anybody s email messages.

But fortunately, employers are trusted messengers. According to a worldwide public relations study in 2019 of people s trust in institutions, people trust their employers more than any other institution. The WHO framework also identifies five principles that strengthen trust. So I ll go ahead and offer them to you now as a little bit of inspiration:

• Transparency
• Fairness
• Consistency
• Coordination
• Predictability

These are five cross-cutting principles that they found strengthen trust. So consider these when you re communicating.

Finally, the framework also gives 10 suggested actions. I m not going to read them all to you, but there were a few that leaped out to me as potentially helpful for communication. One of them is to be clear, precise and predictable. That s good advice. Another is for targeted communication to specific groups. So if you are talking to a large number of employees, it might make sense to go ahead and segment them so you can send certain messages that are going to be appropriate for certain groups. And perhaps my favorite, Appeal to people rather than blame, scare or threaten them. Recognize that everyone is contributing. I like that. Recognize that everyone is contributing. We re all trying to stay healthy the best way we know how. Keeping that in mind can help you when you re communicating. Especially if you ve gotta communicate with people who have different ideas about vaccines than you do.

This is a chance for employers to show your activity is rooted in science and in employees best interests. If you want more guidance on this and other internal communications, including how communication relates to DEI, contact me at HealthCommunicationPartners.com. I m Dr. Anne Marie Liebel. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Music and audio engineering by Joe Liebel.

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Learn two ways you can enhance your knowledge about patient education and communication, while supporting this podcast series.

You listen to this show, so you already know that communication is central to your ability to do your job well. You also know how much patient education matters to outcomes. This episode is about ways that you can get better at both patient education and communication, while supporting this podcast series.

Hi everybody. I m Dr. Anne Marie Liebel. This is “10 Minutes to Better Patient Communication” from Health Communication Partners, an independent health-equity oriented education and communication consultancy. If your organization needs expert help on any topic in this series, visit healthcommunicationpartners.com.

Today s episode sponsored by our friends at Maven Roth Group. Maven Roth is a progressively strong, women-owned creative agency with extensive experience in healthcare marketing, communications and advertising. Do you need an expert refresh on your patient education materials? Maybe your internal communications or onboarding materials? Maven Roth can help with those needs and more! Visit mavenroth.com today.

I do love working with them, we ve worked together multiple times in the past. and I also love how that particular sponsor read completely works with the topic of this particular episode. This is episode 112, oh my gosh! Thank you for being here. Thank you for listening. That means there’s 111 episodes before this, which kind of boggles my mind! I don’t know how many of those you’ve heard. Maybe you’re new here, welcome. Maybe you’ve been with us for a long time, thank you. Thanks for sharing the show, thanks for letting me know what topics that you’d like me to tackle, because this series is based on actual problems in the field. And I m not sitting around thinking, Oh, what should I talk about? So if you haven t been in touch with me yet, please do write and let me know some of what s on your mind when it comes to communication, patient education, health literacy.

One of the things I know that brings people back to the series is the reflective practice element of what I do. So what I m gonna talk about now is about reflective practice, quite a lot actually. Because I am one of the people who believes that issues of communication and education are central to the work of healthcare and public health. Integral to this work. It s not marginal, it’s not an add-on. The past 20 months have shown us in many ways, that communication and education are at the center, they re two of the engines of healthcare and public health. So I’m going to tell you about two sets of materials that can help you get better at communication and education. Which is what this whole series is about, which is really at the heart of the work that I do in the health sector. And I ve made them for you as a way of supporting this self-funded podcast series. So, help me make another 112 episodes and pick up one of these two products! Ok, here we go!

So the first one I want to talk about is how you communicate during patient education. When I’m talking about health communication or health literacy, I always wind up talking about patient education. That makes sense; there s many connections among those topics. And I’m an educator! But health professionals often get frustrated when the patient education that they’re doing doesn’t have its intended effect. One physician put it to me this way: she said, When we teach it to them, they show that they are understanding what we’re doing. But they are going home and forgetting.

That’s frustrating. You don’t want that to happen, but education is a complex endeavor. And yeah your time is short, and there’s a great deal at stake. I’m helping you with some structure, some well-designed questions, and some support. I ve created materials for you, put them together with our most popular episodes on patient education in a convenient and economical bundle. It s not about adding one more thing to your already crowded day. This is reflective practice and how reflective practice can help you improve what you are already doing. Help you reflect on your day and the ways you know it can be better. And increasing your own effectiveness in ways that make sense to you and are locally appropriate.

No matter how much time each day you spend a patient education, no matter how you currently do patient education, in this bundle you’ll find something to make that education more effective. You ll improve what you’re already doing. You’ll see what culturally and linguistically appropriate patient education can look like and sound like. You’ll get educational principles that reach all learners. And you’ll start to view your own patient education differently. I bring the best studies in the world to this. And it’s easy to access! It’s an audio book, an ebook, and exclusive supplementary materials. So I’m going to put a link in the show for how you can get the Effective Patient Education audiobook bundle.

Okay the second one is about bias. Now you know health disparities are due to many factors that are man-made and that one of these is implicit bias. And all over the world, not just in the US, all over the world there’s a lot of attention being given to unconscious bias, implicit bias, and how they show up in health care. And I encounter professionals actively confronting discrimination and bias of all kinds. I was giving a talk about addressing unconscious or implicit bias at Columbia University’s Mailman School of Public Health, and at the end, one of the questions I received from a participant was: It sometimes takes a lifetime to create those biases. They sometimes become innate. How do we unlearn those biases?

Now I want to, I want to look at that question for a second, because this participant is pointing to something that I think is one of the hardest things for people to acknowledge that they need to do. And that’s to look inside. When we re thinking about bias, really, the only person’s bias we have any control over is our own. So, that’s what I want to help you with because it’s, it’s difficult going. It’s incredibly difficult going. But it’s me, and it’s this show, and I hope at this point you trust me, that I’m going to walk along with you and help you start to reflect on your own language. Because you know, you’ve heard it from me before, when it comes to language it’s remarkably easy to slip into autopilot. And I love the quote from Derald Wing Sue who is responsible for putting microaggressions on on all of our radars. He said something like, None of us is immune from inheriting the biases of our ancestors.

So if you are interested in taking your language use seriously, I’ve created an audiobook bundle with resources on addressing unconscious bias in your everyday language, in your everyday practice, and in the organizations where you work. And it’s based on decades of research on bias in language and policy. Of course it all shares a commitment to health equity. Like Effective Patient Education, this is an audiobook, an e-book, and supplementary materials I made for you. I recently redid it to capture some of what was going on in 2020. And it’s about 2 hours of audio, and a bunch of supplementary materials. I’m really proud of the powerpoint show too, because it invites people to think about images. It takes an image-heavy kind of approach to confronting bias in our language, in our thinking. And I made it, so no matter what your specialization is, you know it’s going to help you. And obviously it also helps support this podcast series!

Thank you again for being in touch. If you haven t written me, go ahead. Let me know what topic youd like to see addressed in an upcoming episode. Catch me on the socials, I m on twitter and linked.

And thanks! It s Thanksgiving here, or it was yesterday, and I m thankful for you and thankful for your trust. I m thankful that we re all getting through this time together. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Music and audio engineering by Joe Liebel. I m Dr. Anne Marie Liebel.

The post Support your professional growth (and this series)! appeared first on Health Communication Partners.

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Everyone is dealing with exhaustion. So in this episode, I share 5 good reasons you can do one non-strenuous thing to promote health equity: pause.

I ve just been working with a great client in the health sector about diversity, justice, equity and inclusion across their organization. In this episode, I share one non-strenuous thing you can do to promote health equity. Really!

Hi everybody. I m Dr. Anne Marie Liebel. This is “10 Minutes to Better Patient Communication” from Health Communication Partners, an independent health-equity focused education and communication consultancy. If your organization needs expert help on any topic in this series, visit healthcommunicationpartners.com.

Today s episode sponsored by Maven Roth Group. You listen to this show because you re good with language and you want to get even better. You ve got the words; let Maven Roth do the rest! From designing images, reports, logos, templates, and social graphics for your organization, to spreading the word thru digital, print, billboards, radio and television, Maven Roth has you covered, all the way to media buying and management. Visit mavenroth.com today.

Organizations tend to come to me for capacity building, and it’s usually so they can grow, or have some other organizational change, while they are advancing equity, diversity, and inclusion. Looking back over this year, I think for me what was really surprising was, well, 2 things. That there are so many projects to advance equity at this time, right? These are different times and organizations are having to think differently. The ones that I work with are taking this seriously! Whether the big ones, little ones, in-between ones, they get that equity isn t a fad. It’s not some thing over there that other people are taking care of. It’s part of everything. It’s everybody’s conversation and everybody’s role.

The other thing that s surprising is that people are hanging in there! Those of us who are on that path, and many of us are–everyone is dealing with exhaustion. It can be hard sometimes, I think, just to concentrate on basic tasks. This is my inspiration for this particular episode.

In complete seriousness, I’m going to ask you to hit pause. Not on the show! I mean in your life. Step back from the moving freight train, just for a moment, and pause. Here’s five different opportunities where you might pause, and reasons why you just might want to take a moment.

All right # 1: pause before you speak. You’re super smart people. You’ve heard this one before.

Why pause before you speak? I’m going to focus on two reasons. One is to interrupt the common habit that many of us have of seeing communication as kind of an afterthought. The second: we’re not as intentional with our words as we like to think we are. To my mind, both of these are entirely understandable, and it’s how language works. I wanna let people off the hook. The answer for both of these is awareness. That’s why you want to pause.

If we want to challenge existing narratives, we’ll have to change our language. We don’t get better at changing our language without awareness. When it comes to our words, it’s remarkably easy to slip into autopilot. We ask same old questions, too. It can be difficult to step back and notice what we’re taking for granted. But I have two On Demand resources to help you do just that.

One helps you build critical awareness about your use of metaphors, and the other, about the subtle ways our everyday language can unintentionally disadvantage certain social or cultural groups. And links to those are in the show notes and on healthcommunicationpartners.com.

Okay #2: Pause instead of speaking. We tend to go into informing or telling mode super easy. Now a focus on giving good information is appropriate, but it’s easy to fall into delivery mode–especially in times of high stress.

Why pause instead of speaking? Well, when we start listening–really listening–to different people, we hear some of what we’ve been missing. In life, in our typical ways of working, maybe in ourselves. Now, you know your stuff. Listening to someone else, being vulnerable and a little humble, staying open even for just a few moments, doesn’t lessen your hold on what you know. It might even deepen some relationships.

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This bundle of audiobook, eBook, and supplementary materials will help make your life easier. And it might change the way you think about patient education, no matter your specialization or patient population. You get practical, culturally and linguistically relevant advice and research-based tools, in an unfussy, conversational format. All sales support this podcast series.

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3: Pause before you make and send that invitation list. Whether it s to a meeting, some online event, or something in person.

Why? If you want to get work done on big problems, you know it means talking to people outside your hallway. But it can be really easy to forget that in all of the hustle and the bustle. So I’ll invite you to remember who s not typically invited to meetings or included in group chats? Try to be more intentional and thoughtful about who is invited. Maybe ask someone about the thing you know well, to help get another perspective–and help others feel appreciated and included. What person or group tends to dominate where you are? Who’s typically not heard from even when they’re present? Remember, everyone bring something to the table.

4: Pause before you make a choice or a selection involving people. And this happens quite a lot. Say, for example, in citations, right? An academic example.

I just finished up a manuscript, did the citations, and realized I m citing the same people I’ve always cited! And most of them are white! What I haven’t been doing in my efforts to keep up with my field is notice who else is doing this work. Who else has been doing this work, citing similar theories and theorists, that are off the beaten path of my citations?

So I’m going to ask you to do the same thing, whenever you’re in a situation where somene’s either going to make the cut or not. Pause.

Why? Because it is so easy to go down our well-worn mental paths, especially when our bandwidth is low, like it is for just about everyone right now. We ve always done it this way. That kind of thinking tends to perpetuate traditional advantages of privileged demographics the Haves instead of the Have Nots. Now ask yourself, who have you included outside your norm? You might create some new connections, or strengthen ones that you have.

And finally: pause and do nothing besides breathe. Rest. Chill. Take a few minutes. Gather yourself. Close your eyes if you can. Turn away from the screen that you’re looking at.

Why? Lots of reasons, but i’ll give you two. When we’re in the thick of it, stepping back is a necessary step. This isn’t you not making things happen. This is you getting some fresh energy, having a chance to reset so you can take the next step. These are long paths. These are ambitious goals we all have for equity. We ll get there, a step at a time.

And secondly, equity-oriented work is collaborative. And creating safe space for others starts with compassion toward ourselves. Now if you’re not already following The Nap Ministry on the social media do yourself a favor! It was founded by performance artist Tricia Hersey who insists that naps are liberating and REST IS RESISTANCE. She reminds us that grind culture is a trap and that you don t always have to be productive. @thenapministry

Look, this episode is less than 10 minutes. You have a chance to rest right now! I won’t tell anyone. This has been 10 Minutes to Better Patient Communication. Audio engineering and music by Joe Liebel. I m Dr. Anne Marie Liebel.

The post Working toward health equity? 5 reasons to take a break appeared first on Health Communication Partners.

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It’s still October, so we’re still celebrating Health Literacy Month! In this episode, you ll learn about one potential barrier to health literacy work that comes from within the health literacy field itself, and what you can do to get around it.

It s health literacy month! If you re someone who cares about health literacy and its connections to equity–and I think you are in this episode, you ll learn about one potential barrier to health literacy work that comes from within the health field itself. And of course, I ll talk about how to get around it.

Hi everybody. I m Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners, a health-equity oriented, independent education and communication consultancy. If your organization needs expert help on any topic in this series, visit healthcommunicationpartners.com.

Today s episode sponsored by Maven Roth Group. Maven Roth is a progressively strong, women-owned creative agency with extensive experience in healthcare marketing, communications and advertising. Do you need an expert refresh on your patient education, Internal communications or onboarding materials? Maven Roth can help with those needs and more! Visit mavenroth.com today.

Many of the health professionals I know who care about health literacy are committed to taking action to improve the opportunities that real people have in their actual engagement with health services and health information wherever they live and work.

These are professionals working for change. That s because health literacy allows us to focus on the patient side, the patient world, the patient’s thoughts and processes and actions. Health literacy pros are trying to prepare individuals and groups not for some imagined or hypothetical situation, but actual health related situations in people’s real lives, across a variety of contexts.

But there s an internal obstacle here. Health literacy research has a kind of distance from real life. Largely, we re limited to big data sets or surveys. And those surveys tend to talk about planned action, or hypothetical action. So we are swimming in data, but there s not so many people with real voices. So we are left at a distance from real life, and from the different ways health literacy shows up in real life.

Now, many health professionals who pay attention to health literacy understand that people s health literacy actions and experiences are embedded in their social worlds, tied to their identities and values, as well as being connected to wider social power relations. But the bulk of the research base is still about hypothetical or imagined and not the real.

There s also this: more than one public health pro has told me that there are too many people in our field who don t ever really talk to people in the communities who are their clients. Now I m not blaming anybody here! Sometimes, your position doesn t allow you to have direct community access as much as you would like.

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This newly updated and expanded bundle of audiobook, eBook, and supplementary materials will help you address unconscious bias in your own language as a health professional. 2 hours of practical, culturally and linguistically relevant advice and research-based tools, in an unfussy, conversational format. All sales support this podcast series.

$29.99

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But I ve got good news: If you re hungry for some on the ground, close looks at health literacy in action, you re in luck. Because it s already happening, and it s been happening for decades. Health literacy research on real people s thoughts and actions around real health literacy interactions in their lives.

And for this, we re gonna turn to one of this series earliest episodes on health literacy. Here it is!

I m going to tell you about three empirical studies. Each of these studies shares the goal of advancing people s health literacy. They all pursue this goal by researching language in use in everyday environments. You know, in real life.

Links are in the show notes. I m not involved in any of these studies, I have nothing to do with them except for, I m a fan!

Papen and Walters (2008) did a nearly three year study of adults in the northwest of England and these adults were in an adult literacy learning programs. This study was about these people s experiences with language and literacy around issues of their health, and their encounters with providers and experiences in the National Health System.

In their research report, there are many reports written off this lengthy study, Papen and Walters explain that:

Another way of looking at health literacy and literacy more generally is to think of it as social practices: as activities which are always embedded in specific situations and contexts and whose actual shape and meaning can only be understood within these contexts

They looked beyond patients ability to make sense of certain words or follow instructions. We have tried to understand the broader context of their experience as patients and more generally as people being ill.

Their research report describes the many literacy, language, and numeracy demands placed upon people in health-care settings the demands of having to read, write or act upon specific health texts. They document how their participants took up and made sense of health-related information. They analyze how their participants found out about the health matters that concerned them. They find the people in our study drew on a broad range of strategies and skills, allowing them to access health information and make sense of their experiences.

A second study is Hunter and Franken (2012). They explicitly build on Papen and Walter s definition, adding that While skills are clearly important, they are inadequate for conceptualising health literacy in use.

They were involved in another lengthy study called The Health Literacy Project in the Midlands region of New Zealand. The authors say:

We proposed a broad research approach to investigating health literacy, which included not only health care information texts, but also health practitioners, who provide and disseminate health care information, and patients, who are the users of that information.

Again there are multiple papers off this long term project, and I m talking about one paper from phase one, that looked (as Papen and Walters had) at the literacy demands placed on patients through medical texts.

Hunter & Franken found that, the language and content of health information documents favour white, middle-class, educated patients who are predisposed to comply with medical advice and they they minimally acknowledged New Zealand s population diversity.

Similarly, Maricel Santos et al (2014) were interested in health literacy as skill and social practice. They studied adults in a course for English for speakers of other languages in California as part of a 4-year project called “The ESL Diabetes Prevention Project.”

Similar to the other two studies, they were interested in what people s actual experiences were around language when it came to their health, what they did in terms of language use, the challenges they faced, and how they managed. The authors give special attention to the mechanisms by which social interaction and social support facilitate health literacy outcomes in ESL contexts

Once they understood some of these, they designed and piloted a health literacy intervention which had a positive impact on their participants. [T]he classroom pilot data provided some insight into the promise of a social view in health literacy intervention studies, one that does not reject the importance of cognitive skills but situates them in a broader, multilayered, and perhaps more accurate understanding of the way adults actually go about learning to be more literate in our society and our health care system.

By expanding this characterization of health literacy beyond reading and writing skills, researchers have helped us appreciate the many ways health and literacy are practiced, understood, and navigated in peoples everyday lives. Not just as individual cognition, but as social processes as well.

We become aware of the resources of individuals and groups when we treat people as actors and not just acted upon. But we do not want to get carried away from the very real structural factors that limit access, and maintain inequality and the uncomfortable fact that some of this happens through our everyday language use.

So this is, in part, about the power of language to reinscribe inequality.

What can you do? Here are some implications for everyday practice:

• Start where your patients are, with what they are already reading, writing, and doing to be healthy.
• Reflect on your own professional language use. If high health literacy is even a thing, arguably health care providers have it! How are you doing with maintaining the imbalance between you and them?

Health literacy is complex. But tools and resources exist to address this complexity. And you don t have to be a researcher to use them.

If you are interested in taking your language use seriously, why not start with your metaphors? I ve written a workshop shows you how to break down the metaphors you use, understand their cognitive and affective aspects, and evaluate them in use. On demand, right on healthcommunicationpartners.com

I m Dr. Anne Marie Liebel, and this has been 10 Minutes to Better Patient Communication.

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It’s our 4th anniversary and we’re kicking off a new feature! Our first installment of “Busting some literacy myths” takes a look at the long-lived notion that literacy = reading. Learn one way this common misconception might be more accurate than it seems, and how this can help you in your practice.

It s Health Literacy Month, and it s the 4th anniversary of this podcast show! In celebration, I m starting an occasional series, which I’m calling “Busting some literacy myths,” where I take on some of the more common misconceptions about literacy I ve run into, and help you turn them around.

Hi everybody. I m Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners, an independent health-equity focused education and communication consultancy. If your organization needs expert help on any topic in this series, visit healthcommunicationpartners.com.

Today s episode sponsored by Maven Roth Group. You listen to this show because you’re good with language and you want to get even better. You ve got the words; let Maven Roth do the rest! From designing images, reports, logos, templates, and social graphics for your organization, to spreading the word thru digital, print, billboards, radio and television, Maven Roth has you covered, all the way to media buying and management. Visit mavenroth.com today.

You know that literacy doesn t equal reading, but I’ll tell you, this myth dies hard!

And I get it. If someone is literate we take that to mean they can read. So it s a short step to literacy equating with reading.

As it turns out, there s not a single term that s a synonym for literacy. No matter what camp you’re in in literacy world, everyone agrees that literacy is a collection of skills and practices. Early literacy research, yeah, was focused on writing and reading, and then expanded to include talk about reading and writing, and then images got pulled in there, and now digital forms of literacy are part of it, too.

So you may think, “Anne Marie, would it be fair to say literacy is reading writing listening speaking?” I think that s a big step in the right direction. Let s take it another step in that direction.

I mention this is our 4th podcasting anniversary, and one of our very first episodes was patient misconceptions and dealing with them. And that’s really the inspiration for literacy feature around myths. I m going to attempt to walk my talk and do what I recommended you do when someone approaches you with a misconception.

For instance, the first step I made here was telling you, “I hear you, I hear the myth and I see how it makes sense, I see where you re coming from.” Then I did a little bit of “here s where I m coming from.” Now I m gonna attempt to build a bridge between us, between our understandings.

I’m gonna suggest that we work with this misconception that literacy = reading. Because I think there s a way this kind of limited notion of literacy could help us get to a really rich notion, some new understanding about literacy. For this, I’m going to turn to Paolo Freire.

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This bundle of audiobook, eBook, and supplementary materials will help make your life easier. And it might change the way you think about patient education, no matter your specialization or patient population. You get practical, culturally and linguistically relevant advice and research-based tools, in an unfussy, conversational format. All sales support this podcast series.

$19.99

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You may know him as the Brazilian educator, theorist, activist, and he’s probably best know for popularizing the idea of critical pedagogy. There is a phrase Freire is known for, very well, and that’s “reading the word and the world.”

“Reading the word and the world.” I remember when I first encountered this in grad school, I didn’t get it. And I struggled because it seemed that everybody else around me ‘got it.’ So I really had to work with this and kind of turn it over in my head. It took years for me to start to appreciate it. So what I want to share with you is one of the understandings I have come to about this phrase “reading the word and the world.” Because I think it might be helpful. And now it occurs to me as kind of obvious and straightforward, but I don’t know!

We read people. We read people, right? We read scenarios, we read situations. We read a room. We read body language and facial expressions. We read people s intentions. In these cases, reading means a kind of noticing, judging, maybe formulating some thoughts about, making sense of. Situations, people, goings-on in the world. We’re always reading the world. We misread it too, right? We misread people or we misread scenarios as well, right? Misread someone, misread a thing that happened. So, reading as meaning making sense of, knowing that sometimes we read it wrong.

Now in literacy the idea of reading is broad, we can read a text. The idea of text is broad too. Texts can be written texts, they can be spoken texts. So when we hear someone talking, in a sense we’re also reading their words. We re also doing more than that, we’re doing more than reading their words. We re also reading them. Whether or not they re there, right? Right now you re listening to a podcast episode. It s audio only, so all you have is the words.

Or do you?

Whether or not you’re doing it consciously, you re also reading me, as the speaker of those words. You re making some judgements about my intent, even my character, my intelligence, my very clunky sense of humor, my likability, my trustworthiness. You re reading me and that impacts how you read or understand and interpret my words.

But wait: there s more.

We re also always reading the situation. This is a big one so I’m just gonna give one question to start to unpack it a bit. Consider this: why are you listening to this episode?

I ask this question because part of the scenario you re reading includes the reason you re there. And this also impacts how you are reading my words. I will explain! Quick example: many people listen to this series as part of a class. Ps if that s you, please write me! Because #1 I love hearing from students and #2 I love hearing how these episodes go in a class. Kind of what happens, how it all goes down. So yeah social media, annemarie@h-cpartners please get in touch with me, I love hearing from classes.

So let’s say this is your scenario. You’re listening to this as part of a class, knowing that, say, you re going to have a discussion about it afterward in which you will be expected to say or write something smart that will count, maybe even toward a grade. All of this impacts how you pay attention to and think about how you read – my words.

In contrast, imagine you re just listening to this on your own. You’re listening to this show because you like podcasts and you care about the subject. And you’re at home, and you re emptying the dishwasher while you’re listening to it. Your read of the situation also affects how you pay attention to and think about how you read – my words, which is potentially different in interesting ways than if you were a student in a class.

You re reading the words and the world. And your read of the world has a huge impact on how you read the words. Wrapping your head around that, like I did, will help you to a more powerful understanding of what literacy is. So I m gonna invite you to try. WHY? What s in it for you? A lot, I think. But I’m going to connect it to practice in 2 ways.

1. It gives you a way to think about people. Keep in mind, patients, clients, the public, you, me, we are all constantly reading the word and the world. You from your perspective, me from mine, other people from theirs.
2. You have more options for action, for what you’re going to do. Next time you re approaching a project or situation and health literacy is on your mind, remember: everyone is reading the word and the world, including you. This opens up ways you can come at a conversation or a situation or project. There are more pieces of the interaction that you know about now, and that you can choose to act upon.

Now I m writing a whole book about health literacy from this perspective and I d love to hear from you if you’ve got thoughts or ideas or questions. I’m on twitter, I’m on linked, feel free to connect with me there, or go ahead and email me. Annemarie@h-cpartners and you can always go to healthcommunicationpartners and click on contact. This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. Happy Anniversary little bro! I’m Dr. Anne Marie Liebel, thanks for listening.

The post Busting some literacy myths: literacy = reading appeared first on Health Communication Partners.

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What does it mean to do health equity research? This episode look at a recent STAT news article and asks some hard questions about health equity research.

Many of you who listen to this show are involved in health equity work in one way or another. And Health Communication Partners is a health equity focused consultancy. Recently an article in STAT news invited all of us to ask some hard questions about what it means to do health equity research. And that’s what this episode is about.

Hi everybody. I m Dr. Anne Marie Liebel. This is 10 Minutes to Better Patient Communication from Health Communication Partners, an independent health-equity focused education and communication consultancy. If your organization needs expert help on any topic in this series, visit healthcommunicationpartners.com.

Today s episode sponsored by Maven Roth group. For many people, the hardships and changes resulting from the pandemic have shifted priorities. Because of this, Maven Roth is helping organizations evolve their messaging to better meet their audiences needs. Maven Roth can refresh your marketing to reflect today s changes. Visit mavenroth.com.

So there are many things to be positive about in how many people and how much attention they’re giving to Health Equity work right now. It is certainly overdue. But along with this attention is some, I think, necessary discussion about some of the challenges, the complications, obstacles, and opportunities in working for equity. Recently STAT news published an article called “Health equity tourists:” How white scholars are colonizing research on health disparities. Links in the show notes of course. It’s getting some social media attention and they posed some hard questions about health equity research, such as, “who can and should be doing this work?” Among other examples, the authors “documented dozens of cases where white researchers are building on the work of or picking the brains of, Black and brown researchers without citing them or offering to include them on grants or as co-authors.”

As you know I’m coming from a history, right, in the education world. Language, literacy, education. And there, there is a knowledge base, decades deep on what commitments to equity can look like. And the challenges of equity-oriented work in research, theory, practice, policy. So I’m going to go back to a couple things that I ve done recently and kind of sit with you for a moment and ask some more pointed questions, so that you can be aware of some of the challenges of equity research that I know about from my experiences in the education sector.

Why am I doing this, though? Why ask hard questions? It’s because this kind of interrogation is part of the traditions that I come from. It’s part of what it means to me to take what I call a critical health stance. I believe that any equity-oriented approach to health communication, health literacy, and patient education–research, theory, practice, policy– it necessarily involves terminology, discourses, and practices that are themselves grounded in equity and justice. And we can find out if that grounding is there by starting to ask some hard questions.

Addressing Implicit Bias Audiobook Bundle 2nd Edition

This newly updated and expanded bundle of audiobook, eBook, and supplementary materials will help you address unconscious bias in your own language as a health professional. 2 hours of practical, culturally and linguistically relevant advice and research-based tools, in an unfussy, conversational format. All sales support this podcast series.

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Our most recent episode was about collaboration, specifically collaboration around Health Equity, right? This STAT news article mentions that collaboration is a necessary condition of equity-oriented work, including research. And they’re right! Collaboration I think is also the first place you can start acting on your commitment to health equity. Because whom you choose to collaborate with, and who you choose to cite, can be an equity issue. In the collaborating episode, I said people you got to find those who are already doing the work. Because yes in some ways what we’re going through with this pandemic is new, but in many ways not so much.

People and organizations have been addressing racism, discrimination, and inequities on individual and systems levels for decades. So I encouraged you in this most recent episode to ask, “Who s been in the trenches? Who’s been doing the work? Who’s been on the path since way back?” and I said: find them, listen to them, learn from them, and uplift them.

So I want to put a finer point on this. If you’re a researcher that also means citing and inviting them. I think that’s the point–one of the points–the STAT news article was trying to make. But I’m suggesting this is more than doing your usual homework.

The question I want to pose here is asking, who did work like this? Who did work adjacent to this? Even who did work in this spirit of this, before me? And really being committed to finding them and citing them, because they’re there. It means being willing to drop the notion that’s front of mind for many researchers about being the first, the first on the scene, right? So dropping that impulse is contrary to how many of us are trained and rewarded, which is itself a systematic problem. And the STAT article also addresses that.

Okay next, I want to talk about earlier podcast episode that I did on the definition of health equity as an important and consequential concern. In that episode, I cited a 2020 paper by Adam Wildjan and Keith Denny that was in the Journal of Public Health Ethics. And the authors state, “Since 1984, the idea of health equity has proliferated throughout public health discourse.” And they’re concerned about what the term means, calling it an “empty signifier.” They explain, “widespread invocation of health equity has been associated with a considerable emptying of its semantic and political content.”

Now I’m also concerned with the meaning of health equity, because a way a term is understood has real consequences in research, right? So for this, I’m going to go to some questions I ve posed in a recent health literacy keynote that I gave. Because professionals in medicine and public health who care about health literacy are very aware of the power of terms and phrases. So I thought this would be something I could share with you as well.

I’m asking you think about what equity means in practice as well as research and policy. But how do you do that? I want to give you some concrete steps, some questions you can ask.

If you’re working with a text –whether you’re reading or writing one, any kind of document–look for literally how is health equity defined. In a journal article, there’s always that definition gets dropped in the first couple paragraphs. I’m going to ask you to pay attention to that.

Also, the other ways health equity gets defined implicitly through the rest of the paper. What are the authors trying to say it means? What are you trying to say it means on the ground? What’s being taken as a stand-in for health equity? Because at some point health equity gets operationalized. So pay attention to that.

How far of a leap is it from the definition to how it’s being operationalized? What are you being asked to assume or expect, in order for that leap to work, right? What are you being expected to ignore, or kind of forget about or sideline, in order for that to work? For those basic assumptions to hold?

Another question. Any project or initiative or research that purports to address [health] equity must have at least implied if not explicitly stated within it: what are the assumed causes of health inequalities? These need to be looked at too.

I think many of us here could say we know what some of the root causes are of Health inequalities. And these are upstream and these are systematic. But, do papers, initiatives, programs that you’re involved with seek to address these upstream causes? What are the arguments being made for the project’s or paper’s proposed solutions?

This has been 10 Minutes to Better Patient Communication from Health Communication Partners. Audio engineering and music by Joe Liebel. I m Dr. Anne Marie Liebel.

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