In the world of medicine, it’s very common to hear doctors and medical professionals say stuff. Stuff that they never follow through with for whatever reason. You hear them talk to staff and patients; say a ton of stuff and the follow through is nil.
In the Arab world, a person’s word is his bond. It’s one of the reasons King Herod, acquiesces to Herodias’ daughter and chops off John the Baptists’ head. Our words mean our commitment. A sort of covenant. Anything else makes us appear shallow and self centered. I was actually going through quora on why people do this in general. The responses range from hilarious to worrisome. Some people bluff continuously, someone said.
Now, I don’t mean that doctors who don’t follow through on their promises are self seeking or unbothered. They’re busy and have tons of things to do. I know between emails and Tiger texts, when I’m on inpatient floors, my brain feels like a fish salad sometimes. There’s always just one more thing to do. However, I’m very aware and need I say hyper aware of what I say when I open my mouth. This is because, all the time, patients and medical staff are depending on my word. There’s a lot riding on it. So how can you make sure that your follow through on what you say is 100%
10 Steps when Your Word is Your Bond
These are some steps I have devised and some I have noticed practiced by the best physician communicators. They include the following
Think Before You Open Your Mouth
This is easier said than done. A lot of times, we hear a question, especially those long winded questions from some people who lose their train of thought and we already have an answer. Think. Compose your answer in your brain first, before letting random words form a sentence in your mouth. If it’s a yes or no question, respond in kind. If someone is asking for your reasoning, let them know. Take your time responding. Don’t be afraid of silence. Think. Think. Think!
Ask Yourself: Can I deliver this promise?
Don’t over-extend yourself. A patient asks you to have their tests done today. You know it’s late in the afternoon. The test can be ordered today but the techs will only add them to their queue tomorrow. They’re going to stay another day. Don’t say, “let me see what I can do.” You can do nothing. Before you respond, ask yourself can I deliver on this promise I’m making.
Can I really have these meds sent? Can I honestly discharge them today with so many things pending? Can I honestly schedule them within the week for an appointment? Can you deliver? If you can’t, don’t make that promise. Don’t make promises, however good your intentions maybe if you know there’s a 50% chance it won’t get done.
Be Honest
Tell the truth. Don’t lie. Patients know it and your medical colleagues know it. They’re just nice enough to not call it out to your face. Being honest, may sound like, “I don’t know. I cannot do that for you. I’m afraid that’s not going to happen today. We cannot fix everything. You’re at an age where your recovery is slower,” etc. If you forgot to do something, apologize and say so. Don’t lie. People can call your bluff.
Be Succinct
I’ve noticed that the best people who do this are surgeons. I recently completed my rotation with surgery and they are the best communicators with their patients. I’m not sure if this is because they round at 6:30 am (LOL) or because they’re more liable to litigation and so more careful. However, the surgeons tend to be brief, to the point and without promises. They say it like it is. No jargon, no unnecessary long discussions.
Stop Being a People Pleaser
Most people make promises because they’re simply trying to please the other person. In the heat of the moment, people say they will do many things, that they cannot do. You don’t need to please anyone. You need to do your job well. Often, people have unrealistic expectations. Communicate what’s within your power and what isn’t. If there’s something beyond your power, don’t offer it just to look good. You’re accountable for what you say, even when you think no one is watching or listening.
Learn to Say No
Say no if you cannot meet a deadline, have a meeting or cater to a request. There’s no need to pander to everyone. Say no. Don’t just stay quiet and hope the matter will resolve itself or die down. Just say no.
Err on the side of caution
Again, learned this from the surgeons. Stay cautious. Most people are focused on themselves and want their matters dealt with immediately. You know your priorities. If you think a request is more of a fine line, say no. Don’t overpromise.
Write it Down
Write what you have promised down. Make note of things, if you’re simply forgetful. I always carry a fresh page with me daily. I’ve learned from my own attendings, how they use their page to organize. Every fresh request or order gets written down. I know if i don’t write it down, it will never get done. I’m also a checklist person. I have one for my daily life. LOL. So it makes sense to keep a document all the time. If you’re more tech-savvy, use the notepad on your phone. Alternatively, you can use an app like Ticktick or Google tasks.
Reduce Distractions & One touch policy
I usually can follow through on most of what I say I will do by reducing distractions and focusing on one thing at a time. Discharge summary done, move on to next. I don’t open more tabs than I can handle. I do keep the radio on but even that sometimes can be a distraction even if its just instrumental.
I have also implemented a one touch policy for messages and emails. I will open once I’m ready to deal with a matter. If I’ve opened it, I will deal with it right away. No saving for later. I’m not sure which book I read it in, but instead of touching a matter twice, one touch saves time and energy. So deal with it and move on. Yes, no. Next!
Be a Person of Integrity
What is a person of integrity? A person who understand their word is their bond. What they speak matters, because their words have weight. People who show up at a certain time at a certain place because they said they would. People do what they committed to do because they said they would. People who take action because they said they would. They have what is called sagacity.
They make intelligent choices and exercise judgment before making a decision. They don’t oversell. They don’t talk just to fill time. They don’t try to please everyone, just do their job well. They commit to what they can do and then follow through on those commitments, even when its hard. Walk your talk. If you cannot, follow through, say so. You may require more resources than you thought, or it may just be beyond your scope than you originally thought.
When Your Word Is Not Your Bond
When you’re flippant with your words, you seem unbothered. Flaky and untrustworthy. It’s hard to take people seriously when they don’t follow through on their promises. Word travels. Don’t think, that no one knows. Your reputation gradually builds as one promises after another falls through. You also come across as selfish, when you promise your patients something knowing fully well that it won’t happen. You may have a short memory, other’s don’t. If you have the time, round with the surgeons, watch how they deal with conversations and discussions. They are by far the best communicators I have seen so far.
A man’s (or woman) word is only as good as the actions he follows them up with.
J.L.Whitley.
Walk the talk and see your star rise as your word becomes your bond. Your patients and colleagues will respect you all the more for it.