It was the same every year. I was a GP in partnership in a rural practice, and practices are not just ways of delivering healthcare. They are businesses too.
Once a year our accountant would come and have a sandwich lunch or supper with us, and go through the annual accounts. He, or occasionally she, was totally professional, totally expert, and went through the highs and lows, the ups and downs, in great detail. At the end he, or she, would ask if we had any questions. Typically my partners, who were a great deal more numerate – or interested – than I would ask something searching. And then we would thank the accountant and make our way home.
And when I got home, the same thing happened every year. My wife would ask me, “So, how was it?”. And I would shrug, like a schoolchild being asked how a day at school had gone, and say “Alright, I think." And I would realise that I had retained nothing, not one jot, not one iota (whatever an iota might be) and that the whole presentation had effectively passed right over my head. Yes, I had been there, listening attentively. But the words simply hadn’t taken root. I might as well have spent the time at the cinema for all I had learned.
I’ve seen the same saga played out countless times in healthcare, not from the provider end of the transaction, but from listening to patients, friends, and relatives describe their most recent consultation with a doctor. My own patients would return from out-patients, and I would ask them what had happened – essential, because inevitably the letter had not yet arrived. And they would often say things like “well he was very nice”, or “she seemed pleased”, or “he wants to see me again in a couple of months”, but when it comes down to the nitty-gritty of the consultation, the response is often pretty close to my response about the accountant and his or her report.
"I've seen it with friends who get back from hospital and then phone or text me asking for a translation of the jargon."
I’ve seen it with friends and relatives, who get back from hospital and then phone or text me asking for a translation of the jargon or just a simple explanation of what it all really means.
I am, of course, exaggerating for effect. There are some great communicators out there. But I’m intrigued about the whole issue of professional-client communication, and what gets in the way. What was it that stopped me saying to the accountant after the first minute or so, “Sorry, I didn’t get that. Could you explain?” What was it that stopped my patients doing that to me?
Professor David Haslam is chair of the National Institute for Health and Care Excellence.