PRACTICE PARTNER
“You started off with good intentions, but you’ve become too busy to pause, and eventually people complain,” says Dr. Martin.
That revelation can be shattering, she says. You’ve
worked hard, you care, maybe you haven’t taken time
off in ages, and now people are critical of your very
demeanour. How do some doctors feel knowing that?
“They’re heartbroken,” Dr. Martin
says.
successive days of on-call, personality types). Blind spots
include things like your facial expressions, tone of voice
and body language.
It’s not just what you say, but how you say it and how
it’s seen. For example, does your normal restful face appear angry? Does your tone (speaking quickly or loudly,
for example) intimidate others? Does your posture
(arms crossed, leaning away) make patients or colleagues less likely to share information or approach you?
Knowing your triggers and blind spots can help “bulletproof ” you, suggests Dr. Martin. That awareness can
remind you, she says, to “minimize the room for misinterpreDr. Martin works to help
tation when your underlying
Another example of where good intenintent is good.”
people recognize their trigtions can go awry is with humour.
Dr. Martin points out that
gers and blind spots. Both
Many doctors use humour to build
rapport and alleviate tension, but what can have huge effects on how Dr. Atul Gawande, a surgeon
and journalist, wrote a New
is considered funny is very subjecpeople communicate and are Yorker article about coaching
tive and dependent on variables such
for medical professionals, called
as culture and context. While some
perceived by others.
“Personal Best.” In the article,
patients might regard a doctor’s quip
he pointed out that world-class
as harmless, others might interpret
athletes and concert-calibre musicians have coaches, so
the joke as offensive or as minimizing their concerns.
why not doctors? No matter how well-trained you are,
Rather than building rapport, the doctor has inadverit’s hard to sustain high performance without taking a
tently broken trust.
step back to evaluate how you’re doing.
Silence is not necessarily approval and understanding
is not the same as agreement. Dr. Martin works to help
For the article, Dr. Gawande talked to renowned
people recognize their triggers and blind spots. Both
violinist Itzhak Perlman and the famous soprano Renée
can have huge effects on how people communicate and
Fleming. Both commented that the great challenge in
are perceived by others. Triggers might include certain
performing is listening to yourself. What musicians and
situations, topics and circumstances (e.g., lack of sleep,
singers perceive, they said, is often quite different from
4. ecognize when you are hungry,
R
sleep deprived, time pressured or
got up on the wrong side of the bed.
Slow down, filter your thoughts and
watch your tone of voice.
5. ilence is not approval and we all
S
have blindspots. Always invite comments so you have the opportunity
to prevent misunderstanding
6. ou can’t read minds. Frequently
Y
check in with patients/colleagues to
minimize assumption making.
7. e genuinely curious. You never
B
know everything there is to know
about another’s experience. Building
a relationship begins with listening to
understand.
8. erbally and non-verbally acknowlV
edge others. It’s not enough to
mentally note something.
9. ay attention to changes in tone,
P
body language, silence, repeated
statements.
10. atch for resistance, meaning
W
disagreement with how you view
the problem/solution (e.g., repeated
questions/statements, silence). The
more you assert your viewpoint, the
more the other person feels they
have to assert theirs.
DIALOGUE • Issue 2, 2014
PRACTICE PARTNER
along, maybe the doctor doesn’t give patients a chance
to ask questions. Or take the time to explain as well as
he did in the past. Maybe the doctor appears impatient,
glancing at the clock while a patient is talking.
31