Take Ownership in Your Communication

President George W. Bush wanted us to become an “ownership society.” While the idea that all Americans should own their own home didn’t work out as well as President Bush had intended, there is one arena in which ownership is always a smart and fruitful concept: Communication.

Many years ago I chaperoned our daughter’s kindergarten class on a field trip. After a boy (who I didn’t know and thus had no relationship with to use as leverage) ignored several requests to stop walking up and down an elevated ledge, I decided to use the advice proposed by Faber and Mazlish in their superb parenting book, How to Talk So Your Kids Will Listen, and Listen So Your Kids Will Talk. Instead of demanding that he “come down from there right now!” I simply said, “Please come down – when you walk on that ledge it makes me really worried that you’ll fall.” Guess what? He came right down!

Honestly, I was shocked. But having extensively studied communication since then, I now understand why he changed his behavior. What I did was to own my feelings and use what Thomas Gordon calls an “I-message.” In his book, Leadership Effectiveness Training: Proven Skills for Leading Today’s Business into Tomorrow, Dr. Gordon explains that “I – Messages are appeals for help and…people respond better to honest appeals for help than to demands, threats, solutions, or lectures.”
Telling a child (or anyone for that matter) that if they continue a certain behavior, a particular unwanted occurrence will happen, is actually a dare. If they believe that their behavior is acceptable, they will keep doing what they’ve been doing just to prove you wrong. On the other hand, by sharing your feelings about what they’re doing, you are asking the other person to do something noble and helpful – to alleviate your worry or improve your situation. Most people enjoy the feeling of helping others, and this reward may override their desire to continue the behavior that is troubling you.

A well-constructed I-Message has three parts: identifying the behavior, stating your feeling about it, and describing the impact. They can be placed in any order, as you see fit. As Dr. Gordon cautions, it may feel awkward or stilted as we begin to use I-Messages. But isn’t this true of any new procedure we have instituted in our life?

For an employee who arrives at work late, an I-Message may sound like: It makes me concerned and upset when you arrive at work later than 8AM because patients begin calling at that time and there is no one to answer the phone. I worry that they will decide to go elsewhere if they can’t reach us, or that we’ll miss an important call.
For a patient who doesn’t follow through on the plan that you’ve agreed on: When you don’t take your medication as we discussed, I become concerned that your blood pressure will become too high again and that you will have serious complications such as a heart attack, a stroke, or kidney damage.
For a colleague who promised to call you about a mutual patient but didn’t: I felt let down when you didn’t call me back about our patient as you had promised and embarrassed because I didn’t have the information that I needed for her treatment planning.

Most people want to be helpful and regret causing another person distress. Until we own our feelings and communicate them clearly, the other person has no incentive to change those behaviors that create problems for us. Blaming, criticizing, and humiliating may cause the person to intensify his behavior or just dig her heels in. Taking ownership of our own feelings and allowing the person to understand the consequences of continuing their behavior, and of changing it, frequently results in significant and positive change in both the behavior and the relationship. That’s a great reason to become an owner in all of our communication.

Do you find these blog posts helpful? Interesting? I hope you will share them with your friends, family and colleagues. And if you have any difficult communication situations, just let me know and I’ll be happy to help. You can always reach me at helanefronekmd@gmail.com.

About Helane Fronek

Over the past 28 years I have had a fascinating and fulfilling career in medicine, initially practicing as a general internist and then as a procedural specialist, caring for patients with vein disorders. As Assistant Clinical Professor of Medicine at UC- San Diego School of Medicine, I’m thrilled to be teaching medical students crucial communication skills along with many other aspects involved in the practice of medicine.
This entry was posted in building relationship with patients, effective communication in healthcare, honesty in medical care, physician coaching, physician communication, physician fulfillment, Uncategorized and tagged , , . Bookmark the permalink.

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