Opinion Article - (2017) Volume 4, Issue 4
Van Dijck H*
President of the Flemis Association of Chief Medical Doctors and Leuven Institute for Health Policy, KU Leuven, Belgium
Corresponding Author:
Dr H Van Dijck, MD
President of the Flemish Association of Chief Medical Doctors and Leuven institute for Health Policy
KU Leuven, Belgium
Tel: 0032498904739
E-mail: herwig.van.dijck@telenet.be
Received Date: August 08, 2017; Accepted Date: October 10, 2017; Published Date: October 14, 2017
Citation: Dijck HV (2017) Hospital doctors are professionals and communicate in their own specific way. Br J Res Vol. 4 No. 4:27. doi:10.21767/2394-3718.100027
Copyright: © 2017 Dijck HV. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Medical specialists in hospitals are professionally organized and because of that, they tend to behave themselves differently compared to the other groups. It is important to realize that this influences their communication style.
Patients and methods: Literature Survey
Results: Communication is an important, non-technical skill in the day today practice of the medical profession.
We try to clarify the way hospital doctors communicate not only within their own group but also with the board of the Hospital and with other hospital personnel and how this is linked with their professional behavior.
Conclusion: A better communication between hospital doctors and hospital coworkers will make our hospitals healthier and safer.
Introduction
Mintzberg divided the Hospital in four distinct categories of people [1]. One category is the hospital’s medical specialists. The other are: the community of patients and support people, the hospital board members and the nursing staff. Communication between these 4 categories is vital and not easy to establish. Since the medical specialists are professionally organized and because of that, they tend to behave themselves differently compared to the other groups. It is important to realize that this influences their communication style. Communication is an important, non-technical skill in the day today practice of the medical profession.
In this paper we try to clarify the way hospital doctors communicate not only within their own group but also with the board of the Hospital and with other hospital personnel and how this is linked with their professional behavior.
In a previous paper we were able to identify some major issues concerning the professional behavior of hospital doctors [2]. We‘ll link these items with their communication style.
As professionals, medical specialists are experts in their field, independent, motivated and observant [3]. Their knowledge is by nature extensive, but it is internal to them and can be referred to as ‘tacit knowledge’. They often struggle to explain things comprehensively and that makes discussions often difficult on non-medical topics such as quality management [2,4].
Discussion
Talking amongst each other hospital doctors will most of the time do so with great respect for each other’s independence although they will give their opinion candidly on how to manage medical or other issues with no other purpose than to inform the other colleagues [5,3].
Talking to management, they will often make clear what their approach is for their own medical practice [6].
Talking to the nursing staff, they will do so with great detail, expecting the staff will incorporate this in the nursing strategy [7].
They are organized as a Complex, Adaptive System (CAS). It consists of “agents” who operate independently from each other. “Agents” can be doctors, medical associates, services, etc. Rules, structures, patterns and characteristics that govern a CAS get created autonomously. The most important characteristic of a CAS is that it is an adaptive, self-organizing structure and that it is therefore often hard to locate its center point or to identify its leader. It is complex and chaotic, with a relatively simple set of sub-processes and with a high level of self-corrective and regenerative potential. This is influences greatly their communication [8].
In a meeting on organization they often give the impression to talk broadly about anything. In fact their hope is that everyone understands the complexity of their daily work. They fear that a rigid system will prevent them from making progress in their daily search to improve their technical skills. So talking about one issue without the perspective of all ongoing problems is for them an incomplete conversation and therefore a strict agenda or a dominating presidency of a meeting makes them feel uncomfortable [1].
They expect flexibility of their coworkers. They are good in their technical work and able to multi-task and they want their coworkers to understand that there is no time for lengthy discussions about what to do. Their communication is therefore very focused and direct. This way of communication is often perceived by the patients as very direct [5].
Concerning Board activities they want to make sure that the board members understand the reasons why they want changes in the way patients are treated. They will try to communicate in very direct way with the board which makes things not easy for management [2].
Among hospital doctors there is a strong inter-professional relationship. As Mintzberg stated, hospital doctors are more directed to the outside world than to the inside world of the hospital itself [1]. So communication is influenced by that outside world. It plays a very important role in the way they are talking about problems of the hospital and their own practice.
The doctor’s extensive knowledge is not entirely an explicit knowledge. In their communication they give often the impression of not knowing why they ask something. This is due to implicit knowledge in many areas of their work. Often, they are not capable to describe in detail what they are exactly doing. They just do it and they express only the feeling that there is something wrong or that it is time to improve their normal workflow. For example when management changes one of their personnel, even when he or she is good, it might be a reason for discomfort. They will express this discomfort without knowing what the exact reason is [9].
Concerning organizational matters
As already described doctors want to bring many issues at the same time in a negotiation process. This multi actor, multi issue way is very time consuming and in contrast with the two actor, one issue negotiation style of management. While they are direct in their communication with coworkers, once on the negotiation table they will come up with stories and even when the problem is solved, keep bringing them up. It is a good management practice to discuss some of these additional issues to solve the one issue that was put on the agenda in the first place. Otherwise doctors will be disappointed and refuse to give a solution to the request of management [1].
Considering the previous elements, one can easily understood that supportive leadership is what doctors ask for. In their communication to those who are their leaders they will not accept a directive style [10].
Creating a good work environment is also for hospital doctors crucial. They will always lament over having not sufficient materials or coworkers. They try to deliver the best care and ask in return the best support to deliver it. The art of giving enough but not too much means that one must understand what they really need. Comparing with good practice in another hospital for instance can be helpful. Since doctors are directed to what the outer professional world is doing it will probably help in achieving a balance [3,4].
The key word in working with hospital doctors is professional autonomy. They will stress this point over and over in their communication. One must recognize that they know best what is good for their patients. While addressing their questions, one must realize that. It does not mean that you can’t argue with them but the point is that you must recognize this essential and crucial way of behavior of the professionals [11].
Conclusion
Non-technical skills are important and communication is by far the most important one. Hospital doctors are professionals and behave differently compared to other hospital workers. This means their communication skills are different. Understanding the doctor’s professional characteristic will help to overcome some miscommunication. We described the points that identify differences and how to work with them. If hospital doctors and hospital coworkers know how to address these, it will make our hospitals healthier and safer.
