Open and Honest Communication Challenges the Status Quo

Helen Haskell, Rick Boothman and David Longnecker MD discuss emotional intelligence

The first day of our Telluride Roundtable on “Open and Honest Communication Skills in Healthcare” is now complete. After a full day of deliberative inquiry and exploration, some reflections come to mind:

  1. To start the day, students from medicine, nursing, public health, pharmacy and law attending the Roundtable watched the film “The Faces of Medical Error…From Tears to Transparency: The Story of Lewis Blackman” to start the day. After the film, Helen Haskell and Rosemary Gibson led an engaging and interactive discussion on the educational messages highlighted in the movie. The conversations were empowering and got us off to a great start.
  2. The students added an amazing dimension to our discussions on open and honest communication. Their excitement and passion was contagious; their ability to appreciate right from wrong without pre-existing cultural biases was refreshing.
  3. In the afternoon, Roundtable participants worked to build consensus regarding the relationship between emotional intelligence competencies and open and honest communication skills.
  4. Creating curricula around open and honest communication skills in healthcare (from informed consent through adverse events) remains challenging. Being open and honest to patients and colleagues seems easy; however long-standing cultural barriers make the task very difficult. It also does not align with current reimbursement drivers. Being open and honest when obtaining informed consent may mean losing a procedure and the income that comes from it for the caregiver and the health system; being open and honest when harm occurs may increase one’s medical liability risk. Caregivers are uncomfortable because they have been preconditioned by these financial incentives and fear.  Additionally, educators are uncomfortable with the domain because it doesn’t fit easily into pre-existing curricular models. Open and honest communication training challenges traditional scientific research approaches, “p” value outcome studies, licensing exams or assessment models used in healthcare. These are difficult obstacles to overcome when trying to create curricula.
Anne Gunderson leads Telluride Roundtable small group discussion

In the next four days, we need to figure out how to turn our uncomfortable feelings into a disruptive thinking approach that creates a constructive model for change.  As in previous Roundtables, I am confident we will move forward and create consensus related to open and honest communication in healthcare.