Human Connection in Modern Medicine with Laura Cooley, PhD

In this episode of This Clinical Life, we welcome Dr. Laura Cooley, Editor-in-Chief of the Journal of Patient Experience, an academic, open-access, peer-reviewed publication dedicated to transforming health and care experiences. 

Dr. Cooley joins us to discuss what patient experience really means beyond metrics and satisfaction scores, how communication drives outcomes, and how clinicians and leaders can bring research into everyday clinical practice. She also shares practical ways to elevate human connection at scale, ensuring that every patient interaction reflects both empathy and evidence-based care. 

Practicing Excellence is a human development company. We help coach and develop the healthcare workforce to make a meaningful impact by building proven skills in patient connection, team collaboration, and leadership effectiveness.

Learn more about our approach to empowering health systems, care teams, and individuals at PracticingExcellence.com.

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Transcript

 0:01
 Welcome to this clinical life.

 0:03
 My name is Steven Beeson, founder of Practicing Excellence.

 0:05
 This podcast, we uncover the impact of raising human capabilities for physicians, nurses, care teams and leaders to improve healthcare.

 0:16
 And today I'm delighted to have a colleague as a guest on Doctor Laura Cooley.

 0:23
 Doctor Laura Cooley, how are you?

 0:26
 Great.

 0:27
 Thank you.

 0:27
 Great.

 0:28
 Yeah.

 0:29
 So.

 0:29
 So anyway, I'm going to do your bio, which is always super awkward to listen.

 0:32
 It's like you're at your own memorial service.

 0:35
 I'm ready.

 0:36
 So anyway, in this episode of This Clinical Life, we're joined by Doctor Laura Cooley, editor in chief of the Journal of Patient Experience and Academic Open Access, peer reviewed publication dedicated to transforming health and care experiences.

 0:48
 Also author of the book Communication RX Transforming healthcare through communication and relationships.

 0:55
 Fantastic book.

 0:57
 The the, the the Journal of Patient Experience really serves as a practical source of perfect for professionals and clinicians who deliver care and design systems with an emphasis on strategies, practices, and innovations that improve experiences for patients, families in the healthcare workforce.

 1:15
 Doctor Cooley joins us to discuss what patient experience really means beyond the metrics that we're all so obsessed about and patient satisfaction scores, which we talked endlessly about, and how communication drives outcomes and how clinicians and leaders can bring research into everyday clinical practice.

 1:33
 So welcome to this part of life.

 1:36
 So I want to begin with how you got here in this position as a national thought leader, author, editor in chief and champion advocate for the experience of patients across the nation.

 1:50
 Because I understand that you were selling cutlery out of college.

 1:58
 Well, that's true.

 2:00
 That's a great place to start.

 2:02
 I learned everything I needed to know while I was carrying around a bag of sharp knives and going into homes of strangers.

 2:09
 I And what I mean, that requires a little bit of trust, right?

 2:14
 It, it, I, I learned very quickly how to establish trust, to earn trust, how to speak and interact in a way that felt authentic enough that strangers would not only schedule the invitation for me to come to their home, but open the door and let me sit down.

 2:32
 And little things matter.

 2:34
 Like I was trained that if someone offered me a drink of water, like always say yes, because it builds some kind of relationship.

 2:44
 They want to feel like they're hosting you.

 2:46
 You're in their home.

 2:48
 And, and I think most importantly, I, I learned how like an interactive conversation can lead to a sale.

 2:58
 I was selling cutlery and that was my college job.

 3:02
 And by building relationship, I and, and providing them with evidence and, and asking them good questions and being open-ended, we would end like with a shared agreement in most cases.

 3:15
 And they would be happy because they got an outcome.

 3:18
 They wanted a great tool and a great product.

 3:21
 And so how does that relate to serving patients, which is where my career really shifted.

 3:27
 And that is when I think about communication and healthcare, much of my career has been about the patient physician relationship.

 3:37
 And we do kind of the same thing.

 3:39
 Like we walk into their, their space, so to speak.

 3:43
 They're in our space.

 3:44
 So it's a little less comfortable for them in many instances.

 3:49
 And you know, as as welcome as as we can create the relationship and as warm, we can sell them something which hopefully is like better health and following a treatment plan and sharing an agreement.

 4:01
 And all of those communication skills that we now, you know, from decades have been teaching clinicians to practice with their patients to get to better outcomes.

 4:12
 Like they matter everywhere, even when you're selling knives.

 4:16
 Well, it's so fascinating.

 4:19
 I mean that this idea of forging a relationship with subtle micro behaviors that build trust, a bond and, and influence and how that translates from cutlery and your, you know, example and how incredibly important that is in the exam room.

 4:37
 My question is what are the things that matter most if you, if you're, if there's clinicians that are listening to this to say, you know what, I got a 24 patient every single day.

 4:51
 I've got an AI scribe, but it's still a lot of documentation and stuff I got to do.

 4:55
 I got to do all my HCC code, I all that stuff.

 5:00
 That is the work of medicine.

 5:03
 Why is this stuff that you're speaking about, which is the relationship between clinician and patient based upon all your research and all the the work that you've done, what are the, what are the most important pieces of evidence that we can communicate to physicians that this is a worthy endeavor?

 5:23
 Well, one of the first things I like to start with is grounding in evidence.

 5:27
 And there are hundreds, thousands of evidence based articles out there, not just at the Journal of Patient Experience, which is my current professional affiliation, but in many publications.

 5:40
 And there are fundamental skills that have been shown time and again to impact the outcomes we seek.

 5:48
 I would think that the most simple answer to your question, though, is if we look at research about what matters to patients and why, and I think we often sort of forget what sounds really simple.

 6:01
 And one of my favorite studies to cite is this, this research, research that was conducted in seven different countries across 66 hospitals with more than 1800 adult patients who had just been admitted to the hospital.

 6:16
 They're in their first 24 hours of admission.

 6:18
 And this study asked them simple questions.

 6:21
 What matters most to you right now?

 6:25
 Why does this matter most and how do you feel you're treating doctor or provider knows what what matters to you?

 6:34
 Like, do you feel that they know?

 6:36
 And interestingly, you know, what patients said sort of as we analyze that data is that what matters to them is getting better and being a good health.

 6:47
 And it matters because they want to return to their family and their friends and their everyday life and they want to get their independence back.

 6:55
 And and then the second thing was about going home.

 6:58
 You know, this was a study they said in the hospital.

 7:02
 They, they, that matters to them because they want to have physical and emotional comfort and they probably have somebody else care for responsibilities.

 7:11
 And then thirdly, the category was just having a diagnosis, of course, and it matters because it reduces uncertainty, fear and anxiety.

 7:20
 It's not just about getting some kind of a prescription and then we of course can get more appropriate treatment.

 7:27
 But my favorite part, Steven, I'll end with this with my little research download, is that we need to know what matters to them.

 7:35
 And in this study, more than half of them felt that that their provider did not know what mattered to them as a person in that moment.

 7:45
 And it, it's, it's not I'll intended.

 7:48
 Our providers are busy and they may not explicitly ask or think that they should ask.

 7:54
 And it's a missed opportunity.

 7:56
 And so if anything, like open-ended questions that help ask like what matters to you rather than assume I, I think is the the key thing I wish we could all think about, you know, we should replace the chief complaint with identifying what matters most to the patients or what they're most afraid of.

 8:16
 And, and again, you've done, you've spent a lot of time in the exam room by shadowing clinicians and I've shadowed almost 900 now over the course of the last 20 years.

 8:25
 And I got to tell you that that even with the positive bias of a coach being in the room, they still hardly ever ask what about all that you're going through right now worries you the most or what matters most to you, What do you want to achieve?

 8:39
 And, you know, how is it that we can guide a partnership towards a treatment plan and a diagnostic evaluation without knowing actually what the end game is for the patient?

 8:51
 So yeah, yeah, it's, it sounds simple, like ask open-ended questions, find out what matters, right?

 9:00
 But but what, what I've been kind of coming back to this, which has been around in my irking me for years.

 9:07
 But you know, we still are calling communication a soft skill.

 9:13
 OK, it's a soft skill and it's maybe the hardest skill.

 9:18
 And so, you know, when we need to to think about it not as a soft skill, but as as a hard skill.

 9:24
 Like we can look at hard evidence.

 9:26
 And I was recently looking at this systematic review of research on empathy.

 9:32
 Like we've often been saying, clinicians need to be more empathic.

 9:35
 OK, well, let's look at some hard data about that.

 9:38
 And this is a great study published just two, two or three years ago.

 9:43
 And it looked at more than 455 quantitative studies and assessed like what they found about empathy in association with better outcomes.

 9:54
 The harder data, right?

 9:56
 And you already know this, Steven, but maybe other people won't need this to take it back to their leaders or their their clinicians.

 10:03
 It improved clinical outcomes like physical and mental health in 81% of the studies.

 10:10
 It showed stronger provider performance like professionalism competence in 84% of those studies and there were better patient experience and emotional related outcomes in 82% of the studies.

 10:24
 And last, like treatment adherence, we're always like, let's, we want people to adhere to the plan.

 10:29
 We want them to be well, 100% of the studies that that specifically looked at adherence and and you know, in this empathy frame, like all of them that we're connected statistically insignificant.

 10:43
 So I'm not really even a research person, but the reason I like to cite stuff is because we need hard evidence to prove this soft skill matters, right?

 10:53
 And you think about the all of these so-called communication connect human connectivity skills and the implication on trust, behavioral change, participation and care.

 11:04
 There's almost no clinical intervention as a standalone offering that matches that kind of transformation and patient outcomes.

 11:13
 It's like the it's like the the vehicle that all medical treatment has to ride on.

 11:19
 If you don't have trust, partnership, communication and partnership, then then all of the evidence based care pathways will fall short because patients don't take an action to render improvement.

 11:32
 And I think empathy that that empathy meta analysis was, was super compelling.

 11:37
 I've got another question in regards to using this idea of clinician skill development as a mechanism to improve the simple things.

 11:49
 So they'd be expressing empathy, listening to understand without interruption, or identifying what the patient you know cares most about.

 12:01
 What do you see in your work in terms of the effectiveness and the impact of a skill development intervention rendering behavioral change and measurable outcomes?

 12:16
 Well, good news.

 12:18
 We can look at a lot of evidence based articles that show us that when we do an intentional intervention that goes beyond just building awareness.

 12:27
 Like I can cite these studies and tell clinicians what the most proven practices are, but until they practice it and you know, have micro dosing of these skills and an opportunity for some feedback in whatever way, it doesn't become real.

 12:42
 So when we look at research on, you know, when it does become real, it there are opportunities.

 12:48
 I think we're in a really interesting place right now and I'm advising on a couple of projects that relate to this, where we can now imagine the ways AI can be trained to help us practice our skills, get feedback on our skills and to, you know, leverage ambient listening and our AI scribes to help us see what what opportunities we're missing for building connection that leads to better outcome.

 13:19
 So I'm really excited about that.

 13:21
 But we're not that's not we're not quite there yet, but like, let's all do that together.

 13:26
 And then, you know, I know you've done a lot of work about, you know, kind of providing micro learning and, you know, putting it in platforms where people can access it.

 13:35
 Much of my history was in, in person, you know, interactive small group facilitated practice and feedback.

 13:42
 You know, I think the, the, the biggest challenge I've seen in that work is like operationalizing it.

 13:48
 And I, I would be curious to hear like what, what you see as the biggest challenge.

 13:52
 Oh, well, there's no question that is the, it, it's the knowing to do in gap.

 14:00
 I think every clinician would get right on a multiple choice.

 14:04
 The expression of empathy or identifying what matters most to patients is a good thing to do that can render outcomes so that knowledge in the absence of skill application doesn't render an outcome.

 14:18
 So I, I see the biggest gap from knowing to do in gap.

 14:21
 And I, I, I also see a big gap in self-awareness and insight because you ask clinicians, do you listen to patients?

 14:30
 Oh, yeah.

 14:32
 Are you empathic?

 14:33
 Definitely.

 14:34
 Do identify what the patients are most afraid of and what they want to achieve.

 14:39
 Like every single time.

 14:40
 Yeah.

 14:41
 Yeah.

 14:42
 So we have to help, like shine the spotlight so that so that people can see where their missed opportunities are.

 14:50
 And I like to call it like that as a missed opportunity because rather than like our clinicians are doing something wrong or they're, you know, not effective, like they're just missing opportunities because it's so easy to be caught up in the busyness or to jump straight into asking the next clinical question.

 15:09
 You've probably seen this, this research, it's been around forever, but in terms of how quickly we interrupt patients in the encounter, do you, do you know, do you know the latest report?

 15:21
 I at least this is the latest I saw.

 15:23
 Well, I'm, I'm trying not to interrupt you while you speak to that.

 15:28
 Thank you.

 15:29
 You're really I really.

 15:31
 I'm gonna, I'm gonna let you finish that phrase.

 15:33
 But but I feel that you're listening.

 15:35
 So it's like it's like 11 seconds or, you know.

 15:38
 Yeah, so exactly.

 15:40
 And we've looked, this has been studied in lots of ways, but that's actually not the part that bothers me the most.

 15:46
 The part that bothers me the most is that when we interrupt our patients, research shows us that only 25% approximately will finish their thought.

 15:58
 So what that means is that when we interrupt someone, they don't finish the story and then we're missing important data and we're certainly not getting the emotion on the table so that we can acknowledge that and help the person feel seen, heard and cared for.

 16:14
 So it's not just we're interrupting and maybe that's disrespectful, it it's, it's blocking us from having a more meaningful and productive encounter.

 16:24
 It can also like end up not saving time time because the patient has these doorknob questions at the end.

 16:31
 So if we can get more of what they need out upfront, then we have a better chance for the, the outcomes we all want, right.

 16:39
 And it's, it's so simple as I hear you articulate this, you know, beginning with, you know, what's the thing that matters most to you?

 16:45
 If we're super successful, then what have we achieved?

 16:48
 And there, there's a variety of ways of saying that.

 16:50
 And, and to be able to express empathy, you know, as they articulate their fear, worries, concerns or symptoms to go, gosh, I can't imagine how tough that must be.

 17:00
 Not to be able to get your trash cans up and to rely on your neighbors to bring them up because you can no longer breathe as you're bringing up the driveway.

 17:06
 Let's take a look at that.

 17:08
 You know, and to be able to have that kind of empathy and to be able to listen in a way that not only the constant, you know, the the, the constellation of symptoms that allow you to get the diagnosis, but it's also where the relationship is built to identify the person behind the diagnosis.

 17:23
 You know, and just, if we were to take those three skills and sprinkle that across American healthcare, yeah, it gets a lot better, I think.

 17:31
 Yeah.

 17:32
 And, you know, I think stories really help us lean into a concept.

 17:38
 And, you know, what you just said really matters to me personally.

 17:43
 And I, I don't always lead with this, but you know, I have a PhD in communication in healthcare and I'm now I'm this editor in chief and people assume I love research and you're best selling author.

 17:55
 And you're also we're one of the executives at the Academy of Healthcare Communication.

 17:58
 So yeah, you're fine too.

 18:00
 Like you're pretty, you're pretty, you're pretty ******.

 18:02
 I mean, just basically speaking straight.

 18:05
 Thank you.

 18:05
 I'm going to put that in my bio, but you know what I what I often share when I'm you know, I'm speaking to audiences a lot about this and I I usually early on grounded in something that matters to me personally, some kind of story and this idea of finding out what patients care about their families.

 18:25
 It really struck home for me.

 18:28
 I opened that that book communication RX with this story.

 18:31
 But I, I went to take my 63 year old dad to what would become his last oncology appointment and he can't walk into the clinic anymore.

 18:44
 We have to use a wheelchair.

 18:46
 He's his hands and feet are in great pain from neuropathy from cancer treatment, right.

 18:52
 And he's like small now like he was a healthy man a couple years ago.

 18:56
 And the doctor comes in and he's in a hurry and like I, just like any, any of our clinicians.

 19:04
 And he stands over my father.

 19:05
 I, I, we don't get introduced.

 19:08
 My mom is there, not introduced, acknowledged.

 19:12
 And he looks at my dad's hands, like flips over his hands and he pulls out the chart and he starts talking about the next round of chemotherapy, you know, because we have a big problem here.

 19:21
 Brain tumors had emerged.

 19:23
 Like, you know, things weren't going well.

 19:26
 And I had asked for permission from my parents to ask questions, to ask tough questions.

 19:37
 And he was about to leave and I pulled a doorknob question on him.

 19:41
 I was like, wait, before we, you know, embark on this next chemo, like, can we ask some questions?

 19:50
 And so I start asking questions like, how realistic is that this, that this is going to help?

 19:57
 Like, how much could it harm?

 19:59
 And so in that moment, my dad's oncologist aligned with us and realized he hadn't seen what mattered.

 20:07
 He sat down, he talked in a real way with us.

 20:11
 And we made a decision in lots of tears to stop all treatment, right?

 20:18
 And my dad died in four weeks like.

 20:22
 What if we hadn't made that decision and he died on the chemo table?

 20:26
 Or, you know, like, that's not not a very scientific thing to say.

 20:29
 But I was so glad that we had a real conversation and that we got to talk about what mattered to us.

 20:36
 That's when I really got schooled on communication, Steven.

 20:40
 But I was also so sad because most people are not in that room with their daughter who has a PhD in communication, right?

 20:48
 You know, who's asking the question with them for them making sure what matters is on the table.

 20:53
 And it's, it's not that that clinician didn't care.

 20:57
 He just was missing an opportunity.

 20:58
 And luckily he got that opportunity and it turned everything around for us to have the most peaceful ending under the terrible circumstance we were in.

 21:09
 Right.

 21:10
 It, you know, it's such a beautiful, thank you for sharing that story.

 21:12
 It's, I think it makes it super real for all of us.

 21:16
 And again, where we began, which is identifying as our beacon of care.

 21:23
 What matters most to you before we go down the protocols and the clinical care pathways?

 21:28
 What are the things that really, what are the things that you want to achieve and what matters most to you?

 21:33
 And, and what we could do to really honor patients wishes and family wishes and to answer their questions.

 21:40
 And may it may be a full court, full throttle chemotherapy protocol for all we know.

 21:44
 And if that's the case, then we'll do it knowingly and we will go all in.

 21:47
 And we sometimes assume that that's what they might want, Right, right.

 21:51
 It's, it's our medical conditioning.

 21:53
 We see a problem, we we make a diagnosis, we apply evidence based care pathways until we get a correction of the problem.

 22:02
 And there are many confounding issues that what matters most to you and what do you want to achieve that could illuminate that that could radically alter the care pathways.

 22:14
 And I would even contend we would do a better service to patients.

 22:18
 We would not lose life years.

 22:20
 We would improve the quality of life and we would radically diminish waste in medicine.

 22:27
 You know, soft skills, right?

 22:31
 Yeah, soft skills, soft skills, tough stuff.

 22:34
 And I, I, I don't know if you know this about me, Steven, but, you know, I served the Academy of Communication Healthcare for many years, launched, you know, 40 to 50, train the trainer programs like clinician communication and relationships at various health systems.

 22:51
 And when I decided to step away from that mission I had been on for more than 12 years, I took an interesting pause.

 23:00
 By then, I was already editor in chief for the journal.

 23:03
 And, and, you know, thinking about patient experience communication took me to patient experience.

 23:08
 But in the last year, I've been invited into specifically two major health systems to help them rethink the way they're teaching or not teaching physician communication.

 23:24
 And I think we're at a like a critical inflection point, as we sometimes say, to do things better and differently.

 23:32
 It's also harder than ever.

 23:34
 Like the soft stuff.

 23:36
 I, I, I, these health systems, I'm, I'm advising, they're telling me like we're seeing patients who are more sick, more complex and, you know, we're, you know, adopting technologies rapidly.

 23:50
 Like things are complicated.

 23:52
 And so the soft stuff is hard stuff.

 23:55
 And like figuring this out moving forward, I think it's going to require creativity and a lot of commitment to hold on to the human connection.

 24:05
 Right, right.

 24:06
 And, and I think that you have proven through your work and, and certainly the general patient experience and many others and in some of our published data that the application of improving skills and capabilities can improve the care that we provide to patients.

 24:27
 That I always tell the story.

 24:28
 When I was at the Sharper Story Medical Group, we had a nadir of the 6th percentile patient experience and we hit the 93rd percentile a number of years later with the same clinicians.

 24:40
 So that's sort of a, you know, a meta evidence that the application of simple things that can be done and applied to close that knowing doing gap can render really incredible outcomes.

 24:56
 The another question I want to ask you is talk to us a little bit about the evidence on what the bond between clinician and patient facilitated through development and the application of skills that can forge that bond, what that does to the clinician experience.

 25:16
 Oh, I'm not loaded with like lots of research ammo here.

 25:21
 And I think there, there's a substantial body of evidence that shows us connections to better communication, better relationships, and reduced symptoms of burnout for clinicians.

 25:38
 You know, I, I feel like we are real hot on burnout several years ago and we're still sort of talking about it, but I don't know if we're talking about it quite as much.

 25:49
 And I, I actually just revisited an article that was released 20 years ago on relationship centered care.

 25:58
 And it was sort of articulating that there was a huge need to look at the moral imperative, like relationship centeredness is about like the moral value of relationship.

 26:10
 And then the second principle in that article that really kind of helped set the path for relationship centered care as a thing is that it's about personhood.

 26:21
 And then the third thing is that it's about reciprocity.

 26:26
 So what that means to me is when we think about the clinicians role in all of this, it is a reciprocal relationship.

 26:34
 And when you as a, as a doctor have a negative outcome or a dysfunctional encounter or relationship with your patient, it hurts you too, right?

 26:45
 It's, it's that reciprocity and it's that personhood.

 26:48
 And, you know, I think that that's why I'm leaning back in harder than ever to this idea of relationship centered communication, because it's, it's reciprocal and it's a moral value that we have to hold on to more than ever as AI is like shaking us.

 27:08
 All right.

 27:09
 No, I, I, I think that's so well said.

 27:12
 And, and I would even contend that our capacity to connect with each other and to our patients is an imperative for the vitality and durability of the clinical workforce.

 27:24
 And I, I have this exercise I do sometimes with groups where I ask clinicians to remember and reflect their best moments in healthcare.

 27:32
 You know that the, the moment where they go, This is why I'm here.

 27:36
 And, and they have a chance to sit and reflect and remember and then share it with their table and we have a chance to debrief.

 27:43
 And it's never clinical sequelae.

 27:46
 It's, it's not even a clinical intervention, It's a relationship, a moment even in the sense of a clinical loss where they they lost a patient, they went to the memorial service, they were at their bedside at the very end of their moments.

 28:00
 And they go, this is, you know, these are accessible moments that we can create through doing certain things to forge a bond that allows us to feel like we've got value and worth and purpose in life.

 28:14
 And anyway, so that that that's my big driving force of being involved in advanced communication is, yes, of course, there's massive clinical medications, but it is it's about the vitality of the clinical workforce to go to live out a purpose that gives us a sense of we did something.

 28:31
 Yeah.

 28:31
 And you know, everybody's talking about trust these days, you know, as it relates to artificial intelligence, as it relates to our data, as it relates to relationship.

 28:41
 But you know that trust is also a reciprocal situation.

 28:45
 And I think healthcare systems and, you know, people in the industry who want to earn trust are going to have to lean in harder to relationships and the skills that earn trust, right?

 29:01
 We can't just say like, we need to be trustworthy, like, well, how do we embody that, right?

 29:06
 And it, a lot of it is relationships build trust.

 29:10
 And that's, you know, that's what outcome I want to see, because trust enables lots of good things for lots of people and organizations and finances like so there's there's there's a huge case to be made for helping us be more human.

 29:28
 Well, I would even contend that it's not only trust with our patients through the delivery of certain skills at foster trust that we can grow and develop as we've spoken about, but also becoming a really amazing teammate and to build trust with your colleagues, psychological safety and Esprit de corps and there for each other to lift each other up.

 29:47
 All those things that say I love my team, my crew, and I think that those are developable skills as well.

 29:55
 I I have another question regarding improving patient experience from a leader perspective, Meaning leaders do certain things to help mobilize their people to take an action to achieve an outcome.

 30:08
 What are we getting wrong in regards to how it is that we lead that can actually perhaps decelerate or disengage teams from taking an action to improve activity to patients?

 30:22
 What do you think from your observation across our industry?

 30:26
 What do we most often get wrong as a leader?

 30:31
 I'm going to call it unintentional hypocrisy.

 30:37
 OK, tell me more.

 30:39
 What I mean is I think we have a blind spot about how what that what we say does not align with what we do.

 30:47
 And you know, for example, as healthcare leaders scramble to adopt ambient listening and AI scribes, there's this grand promise that it'll free up time so that we can have better relationships with our patients.

 31:01
 Gosh, I hope that's true.

 31:02
 And like, at the same time that we're sort of promising that to our clinicians, like, are we backing it up?

 31:08
 Are we letting them have that time back?

 31:11
 Or are we just giving them more patients?

 31:13
 So we have to like, back up what we're what we're saying and what we're asking to do by creating like the operational pathway for it to be real.

 31:23
 Like, we can't ask people to build trust and to be empathic but not give them the opportunity to do so or equip them with the skills.

 31:33
 And we also like this idea of unintentional hypocrisy.

 31:36
 We don't realize when we're leaders that people are watching and what we say and what we do matters.

 31:45
 And we can in unintentionally discredit or disqualify our own effort.

 31:50
 And so, you know, that's what I would encourage.

 31:53
 Is it being more intentional and authentic?

 31:58
 It's whatever that leadership initiative is, right?

 32:02
 Well, what do you think about the idea of and I'm not, there's no listeners, I'm sure that do this sort of thing.

 32:09
 But I'm, I'm teasing because we we all do it a lot, which is there's an immense regulatory pressure and board level objectives regarding patient experience and all the downstream chair reputation value based purchasing incentives, commercial plan incentives, whatever that there's a lot on the line.

 32:30
 Yeah.

 32:30
 So we, we tend to take those regulatory circumstances and we translate that to our teams, which is we need to improve our patient experience scores, which is lighting the soul, human soul on fire, right?

 32:47
 What, what, what do you advise to leaders to avoid walking around with the banner and the language of we need to improve our scores.

 32:54
 We need to improve our scores.

 32:55
 We need to improve our scores.

 32:56
 What's an alternative messaging to mobilize teams to take an action regarding something that syncs with why we're actually in this profession?

 33:08
 Well, if I knew that, Steven, I'd be more popular.

 33:11
 Well, I, I, no, I'm asking because I don't really know.

 33:14
 Well, if you and I don't know, how is anybody else gonna know?

 33:17
 We better find out.

 33:18
 OK, let's, let's dig in on this.

 33:21
 I, I, I guess the one thing is kind of circling back to what we started with earlier in this conversation.

 33:29
 Like, what matters to them, right?

 33:31
 What matters to our clinicians?

 33:33
 What matters to our teams, because if we have this empty request, like we need to improve our patient experience scores, like, well, why would that matter to them?

 33:45
 You know what they want?

 33:46
 They don't want patients to suffer because of how they showed up at work.

 33:50
 They, they want the best for patients.

 33:53
 They probably came into this because of that.

 33:56
 I, I think if we can like use our own practices of finding out, like focusing on what matters to them and helping them live, that it's, it's more than the metric, right?

 34:08
 And, and I think that translation is, is a, another missed opportunity.

 34:15
 We, we fail to translate why the metrics matter and to get to the granular level, like we're measuring access because of XYZ.

 34:24
 Like, for example, here's a story, you know, Misses Smith, like couldn't get access to, you know, see her doctor.

 34:33
 And by the time she did this terrible outcome habit like.

 34:36
 So I think we have to really connect things to, to help people see practical, real ways the metrics matter, right.

 34:44
 Well, I, I loved your testimony regarding harvesting what individuals, teams, and even organizations care about in terms of what they want to become and what does it mean to be us.

 34:56
 And in my, in my limited experience, when I asked clinicians, tell me about the clinician you want to become that that that's, that's part of the narrative of the coaching process.

 35:04
 Just like tell me what matters to you in terms of a patient is knowing, knowing the end game, the future state for a clinician.

 35:12
 Every single clinician I've ever coached wants to be a kind, compassionate, a clinician who's highly trusted, who could advance the Wellness of patients.

 35:22
 So it is harvesting what they want is going to be exactly what we want to become as an organization.

 35:30
 But the idea of sourcing it from them changes receptiveness, willing willingness and ambassadorship of of that.

 35:39
 So I think that's, that's a really super powerful leader approach.

 35:44
 That's different than we need to improve our scores.

 35:46
 We need to improve our scores, but rather what kind of organization do we want to be?

 35:49
 What kind of team, what kind of care team member do you want to be?

 35:53
 Yeah, as our future state.

 35:55
 I think that that makes a lot of sense.

 35:57
 And you know, I, I feel we have an opportunity to not just focus on skills cuz I, you know, a lot of my work has thought about the skills we need to improve patient experience, but the relationships that clinicians can have with each other or the staff, like staff in general.

 36:17
 If we could give them more chances to connect with each other and to say what matters to them and how they collectively care about this stuff, I think that could really help build some, some strength and momentum towards the metrics, right?

 36:35
 Because we rarely get those moments anymore to like, talk with a colleague and talk about real stuff that matters to us and to our patients.

 36:43
 And I think we can facilitate some of those opportunities.

 36:46
 And either you asked me about kind of clinician well-being earlier or, you know, I brought up burnout.

 36:53
 A burnout study that lots of people cite is this one published by Tate Shannenfeld, who did this dinner group thing where clinicians could either get like a free hour back in their offices or something, or they could go to a dinner group that was like a small group of colleagues and they did this on a regular basis.

 37:12
 And that cohort were the ones that showed burnout improvement in a statistically significant way, not the people who just got more time alone in their office.

 37:22
 So I think those are those levels of connection can also help and, and leaders can think about ways to create those micro moments, right?

 37:31
 No, no, I, I think that, you know, we're, we're wrapping up where we began, which is our ability to facilitate connectivity to people, a colleague, a friend, a person in the elevator IA check out clerk at the grocery store or the patient behind the exam room door.

 37:53
 I think those micro connections, those micro moments is the human experience and take Jennifer identified it, but empirically, I, I think the advancement of skills that allow not a metric to move, but the advancement of skills to allow human connectivity in a real authentic and proven way can be a really powerful change accelerator for the very metrics that we're now all accountable for.

 38:21
 So well, Laura, it it's been a fantastic conversation.

 38:26
 I forgot that we're doing the podcast.

 38:28
 Oh, good.

 38:29
 Thank you.

 38:30
 Yeah, I'm, I'm, I'm hoping that, you know, something we said will be of good value to the people to, to, to the world.

 38:39
 So I'm going to, I'm going to finish with the last question on if there's one main take away that you want the world to know about communication.

 38:54
 What is that one thing that you wanted the world to know and understand?

 39:00
 In our current age of artificial intelligence, we are compelled more than ever to enable authentic interaction.

 39:10
 And I am talking about this a lot because there can be a parallel definition of AI and I hope that authentic interaction can be something we grab onto and won't let go of.

 39:24
 We can both improve efficiency and empathy when we do that.

 39:30
 Well, authentic interaction is also AI, apparently.

 39:35
 There we go.

 39:39
 Perfect.

 39:39
 There's just meant to be authentic interaction in addition to artificial intelligence.

 39:43
 All right.

 39:43
 Well, Laura, thank you so much for joining this clinical life.

 39:46
 Grateful for your work, your participation here and just your advocacy for all of these critical competencies and skills and capabilities within healthcare, for the vitality of the workforce, the the ability to manage chronic disease, the ability to have patients go home after an encounter with the healthcare system and say, I feel, I feel cared about, I feel heard and I feel confident.

 40:11
 So all those things.

 40:12
 So keep up the great work and we will see you out in the healthcare world out there.

 40:17
 Thanks for having me.

 40:18
 All right, we are out.