My invitation to develop a communication skills program for Cleveland Clinic was entirely unglamorous. Merlino took me for coffee and, as we were catching up, asked if I would take on such a role. Without thinking, I said, "Yes." As I (Adrienne Boissy) walked out of that meeting, I had the distinct feeling that I had accepted an enormous job that I felt unqualified to do. I'm a neurologist, not an educator or communications guru. By the time I made it back to my own office, I had started wondering about my colleagues and friends. How would I ever be able to deliver something to them that would matter? By the time I made it home, I had successfully talked myself out of the job. No way could we engage seasoned clinicians in communication skills training. But as I considered how I would want to learn communication skills, I decided that this was the kind of chance I needed to grab and run with. When was the last time someone helped me understand how to have the tough conversations? What if we could actually build something that would help all of us feel more comfortable having the difficult talks? The challenge was enticing. To his credit, Merlino gave me a blank slate to work on and told me to figure it out. So off I went.
Caregivers in healthcare are compassionate, dedicated, and hardworking. Physicians are also data-driven, outcome-focused, and default thinkers. When we tell patients we teach communication skills to physicians, they say, "Thank goodness!" When we tell educators, they say, "Good luck!" And when we tell physicians, they typically say, "What for?" When I was swapping ideas one day with Ananth Raman from Harvard Business School, he highlighted that we might learn something from the seat belt industry. How do you convince people that they need something they don't think they need?
The path was totally uncertain, so it seemed best to gather a team of like-minded believers in the concept of relationship-centered communication who could help define it. The core group included Dr. David Vogt (senior hepatobiliary surgeon), Dr. Amy Windover (psychologist and director of Cleveland Clinic Lerner College of Medicine communication skills training), Shirin Rastgoufard (project manager), Paula Timco (experience improvement), Dr. Tim Gilligan (oncologist), Dr. Vicente J. Velez (hospitalist), and me. We met monthly to survey the current institutional environment and to formulate an approach. What programs already existed and in what areas? Who led them, and what tools or models were they using? Areas we surveyed included the Office of Professional Learning and Development, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic Academy (Education Institute), ACGME competencies, national communication organizations (American Academy of Communication in Healthcare [AACH], Institute for Healthcare Communication [IHC]), and comparable organizations. This inventory took a year. Yes, an entire year.
An important benefit to this ...