As Healthcare Practice Owners you are well acquainted with the basic elements of the Communications Cycle.

In essence:

• the sender expresses a message
• the recipient receives and interprets the message
• feedback to the sender reflects understanding or misunderstanding

While it all sounds elementary, I know from experience that the communications process is always far more complicated and not always verbal. And as I dig deeper into patient-staff encounters in healthcare practices, I have occasionally discovered some alarming message interpretations.

If actions were words, sometimes here’s what’s the patient might “hear”

Fortunately, the following examples are fairly rare and usually unintended, but they do happen. It’s important to stress that I’ve never heard these words spoken, but they dramatise how patients can interpret the actions and attitudes in encounters with staff members.

• Not being greeted promptly upon arrival: “I can see you standing there, but if I stare really hard at this chart, I can avoid dealing with you for at least another few minutes.”
• You are a chart, not a person: “Address you by name? I won’t try to remember who you are anyway.”
• Just waiting in line: “Be with you in a minute. I’m busy telling my co-worker about last night’s TV show.”
• Don’t ask: “Of course that’s a stupid question. Everyone knows the toilet is upstairs, down the hall and around the corner.”
• Patients are an interruption: “Even if my clock is a little fast, I think you are late for your appointment and you don’t have your health insurance card in your hand.”
• Get-it-right sign language: “What’s with all the ‘riot act’ signs at the reception desk? Heaven knows I’ve nearly given up trying to train all you people about how we do things in this clinic.”
• Clock watching: “Your appointment isn’t really until 3:00 PM, but we told you to be here early for all the forms. Who knows, someday we might not be running 30 minutes behind.”
• A paperless office would be best: “Are you kidding? Nobody has time to read the chart. I’m going to ask you a bunch of questions which you already answered on those forms.”

In staff training, it’s important to understand how the patient can assign unintended meaning to interactions. Sometimes it’s not the words that you say, but what the patient “hears” from body language, actions, attitudes or distracted focus.