10 Minutes to Better Patient Communication

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,

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!

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?

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?

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.

The post How to make meetings more inclusive appeared first on Health Communication Partners.

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.

The post “You want that patient to be a partner.” Dr. Paul Ranelli on patient communication appeared first on Health Communication Partners.

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.

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. 

The post Jessica Halem on communicating with LGBTQ+ patients Part 2 appeared first on Health Communication Partners.

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. 

The post Jessica Halem on communicating with LGBTQ+ patients Part 1 appeared first on Health Communication Partners.

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.

The post 4 ways to refresh your ‘get vaxxed’ message for the fall COVID season appeared first on Health Communication Partners.

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, 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.

The post “What are we doing to be trustworthy?” appeared first on Health Communication Partners.

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,

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! Message 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 itunes, 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 others 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.

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,

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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