Communication skills predict success

Physician Executive, July-August, 2007 by George Linney

All sorts of business, technical and commercial skills are needed to be successful as executives and leaders in any health care organization. However, the longer I work with physician executives, the more I am convinced that strong communication skills are the most important on the path to success.

Necessary communication skills include:

* Writing

* Public speaking

* Conflict resolution

* Confrontation

* Giving feedback

* Dealing with disruptive physicians

* Running meetings

* Interviewing

* Negotiation

* Listening

Writing

Your writing needs to be concise and brief. Most of us do not want to read anything long. If we do, we can curl up on the sofa and read War and Peace. When we write, whether it is a brief e-mail, a business plan or an annual report, we need to think about who the audience is. Do they need lots of facts, process details, an intuitive or futuristic approach, or feelings and stories?

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Public speaking

Brevity is as important for speeches as it is for written documents. Also, significant attention must be given to delivery, since we know that audiences will remember what they thought of the speaker long after they have forgotten what he or she had to say. Unless you know you are a pro, practicing with a coach or at least a friend or family member who can give constructive feedback is advisable. It is particularly helpful to do that practicing in front of a video camera or a mirror.

Conflict resolution

This is a regular activity for physician executives in provider or payer organizations. The ability to listen impartially to all sides of a conflict and help forge "win-win" solutions is paramount. Also, knowing when to say, "I have decided," is a critical skill.

An example of when a physician leader might need to facilitate conflict resolution is when physicians in a clinical department in a group practice are arguing about whether senior members should take less, or no, after-hours call. A resolution might allow senior physicians to get out of call by "paying" younger physicians to take extra call.

Confrontation

Confrontations are awkward for most of us. We tend to dread them and put them off. Tact and a non-judgmental approach work best. Good feedback skills get the job done.

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Giving feedback

Whether it is in a informal situation or in a more structured performance evaluation, in order for feedback to be effective it must be positive as well as negative and constructive. The positive feedback really needs to be emphasized as it is human nature to hear the bad stuff more than the good. Also, constructive criticism must be descriptive and specific, not general.

An example of negative feedback that is both descriptive and specific would be to say: "You missed three deadlines in the past two weeks." Do not say: "You are irresponsible."

An example of positive feedback that is both descriptive and specific would be "You didn't want to take the job as department manager, and yet you are doing a great job of living within your budget, handling to complaints and making your staff more productive." Do not say: "You are doing a great job," which sounds good but is too general to keep getting the desired results.

Dealing with disruptive behavior

This involves many of the skills on this list: listening, confrontation, possibly negotiation, conflict resolution, and giving feedback. First of all, the person confronting the disruptive physician must be supported by clear by-laws and a written code of conduct and the unwavering backing of the chief executive officer, the board and the medical executive committee.

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The confronter must remain calm, stay strong and be clearly in control of the situation. He or she must describe the alleged undesirable behavior clearly, get acknowledgment of what report or complaint was made (this is not an admission of guilt), get acknowledgment of the consequences if the alleged behavior continues, and agreement on what the next step in the process will be.

Doing this unpleasant task can be learned. Not doing it can have serious repercussions for the whole organization. It sends a message that the behavior is acceptable, and it will spread like a contagious disease.

Running meetings

Effectively running meetings will make you an instant hit with your constituents. Such obvious things as starting the meeting on time, ending it on time, sticking to the agenda, getting opinions from everyone attending the meeting, managing the dominant talkers and complainers, and being sure that everyone understands what needs to happen before the next meeting will enhance the effectiveness of the meeting and improve the satisfaction of the participants.

Interviewing

From either side of the table, interviewing involves listening both for what is said and not said.

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An example of something "not said" would be if the interviewer avoids talking about the organization's succession plan when asked about that by the candidate. That probably means there isn't one, this person doesn't want one or something negative.