“For sale: baby shoes, never worn.” These six words may be the best short story ever told. Legend has it that Ernest Hemmingway produced it in response to a wager he took on with a small group of fellow authors. These days, everyone from public speakers and politicians to creative writers and journalists use it as inspiration. They take on the challenge of telling the most impactful story in as few words as possible. It brings sharp focus on the level of effort required to communicate effectively in a succinct manner. As Mark Twain once said, “I didn’t have time to write you a short letter, so I wrote you a long one.”
A doctor’s story
A recent tweet by Dr Aoife Abbey, relaying a real life experience, is an excellent addition to the best of these short stories.
- Fellow consultant from another team: “Are you Aoife?”
- Aoife: “Hi, yes, nice to meet you.”
- Fellow Consultant: “Hi, my name is Mr xxxxx.”
This 15 word script would be right at home as an opening scene in Grey’s Anatomy, Holby City or any other hospital soap. It reads like a multi-faceted mini-drama designed as a character study to stir emotions. And it does – but it’s all too real.
What’s going on here with Aoife’s peer? What are his motivations? Reasonable considerations include power dynamics and sexism. (Or perhaps you don’t see anything wrong with the dialogue?). At very best, our fellow consultant may simply have a hopeless lack of awareness. At worst, he may be guilty of a covert act of aggression.
Without knowing more, the roots of behaviour could lie anywhere between a sense of superiority and lack of self-confidence. You will, no doubt have your own thoughts. But, whatever the specific motivations are, Aoife’s fellow consultant obviously thinks of her as being different to himself.
Sadly, as mentioned, this isn’t a work of fiction. Indeed, the responses to the tweet help to illustrate that it’s a common experience. Such exchanges happen all over the workplace and there are others worth noting. For example, it’s not uncommon that, when a doctor on one of our courses is describing a theoretical situation, they habitually refer to the imaginary doctor as “he” and the nurse as “she”. They are often surprised when we bring this to their attention.
The impact
Interesting suggestions in how to respond which readers of the tweet offered to Aoife include:
- the mischievous – “Congratulations, I also passed the exams.” or “What does your mum call you?”
- the competitive – “You can call me Dr Abbey.”
- the passive aggressive – deliberately mishearing
Please note: I’m not suggesting for a moment that any of these are the correct way to respond!
Unfortunately, such interactions can easily lead to frustrations, friction and problematic team dynamics. These are the most obvious and immediate impacts. But there’s more. The hard realities of soft-skills failures have been explored in our previous blog posts. Then there’s the well documented lack of diversity in medical leadership. We are often looking for the big answers to resolving that situation when the solutions start in the culture created through everyday conversations.
The challenges of team communication are in constant flux and they go hand in hand with cultural evolution. There’s a lot going on at the moment. For example, the integration between healthcare and social care means doctors are coming into contact with new teams and new people who may have different expectations. Then we have made significant progress in changing the language we accept when discussing race and ethnic minority groups. Even pronouns such as “she”, “he” and “they” are in the spotlight in relation to gender politics. Unfortunately, not everyone is managing to keep up.
Moving forward
I’m sure we all have plenty on our plates at the moment, so you may be tempted to think this is for other people to sort out. However, to quote American civil rights activist Eldridge Cleaver, “If you’re not going to be part of the solution then you’re a part of the problem.” Everyone has a part to play in achieving cultural progress.
Leaders must be vigilant to power-plays and bias. They must take steps to define the culture they expect and communicate this. Then they must live up to it, ensuring they have the skills to call out shortfalls and to celebrate progress.
Individual doctors also have the responsibility to attain and maintain self-awareness relating to the impact they have on others. Each must take responsibility for their own communication and develop the skills to respond to poor behaviour in a constructive manner.
What steps are you taking to rise to the challenge?
Stephen McGuire – Managing Director
