Jan 6, 2023
Explore the impact of the written word and what it means for healthcare.
Episode Introduction
In this episode, Lisa Miller, Managing Director at SpendMend, interviewed Brian Morgan to learn more about the principles and mission of Think Deeply, Write Clearly. Topics include the impact of language and communication on business credibility, why comprehension of the written word belongs only to the reader, how better communication could improve healthcare, and why innovation isn’t always exclusively about technology.
Show Topics
- Why we’re good at writing, but terrible at thinking for writing
- Solving the challenges in the drafting stage
- Comprehension belongs to the reader alone
- Communication at discharge is a big challenge for hospitals
- Treating patients as more than a transaction
- Our default position is to protect ourselves
- The impact of hospital bills
06:24 Why we’re good at writing, but terrible at thinking for writing.
Brian explained how the language and communication we use can create a business credibility or cultural problem.
‘'…..we can run through life where we have provable statements that are not useful statements. And we aren't very good at saying, "Well, wait. What is this problem in its entirety? What are all of the factors that go into that problem? What are all the factors that go into that decision? And then, how do we curate all of that information down to show not what we believe, but why we believe that to be true and a trustworthy decision for you?" And that would be the same in real estate as it would be in a hospital as it is for somebody working on their marketing or anything else. How do we create trustworthy conclusions, where people see the transparent assessment as opposed to hide the transparent assessment because there's a certain amount of data that is not realistically supporting facts….there are cultural ramifications for this. And so I would say as a rule, we have not treated language and writing and communication with nearly the business credibility problem that it creates or the economic problem that it creates, and certainly, the cultural problem that it creates…We're very good at writing, but we're terrible at thinking for writing. So I decided to take that on.’’
09:30 Solving the challenges in the drafting stage
Brian noted that templates must help people think well, rather than short-cut the critical thinking process.
‘’…there are a ton of factors that go into that drafting stage that we hardly ever talk about, and many of them are just business process communication things. For instance, what would normally happen is somebody says, "Well, we have a template for that." And so we say, "Well, okay. That's fine. Let's grab the template." And the template is going to say something like "insert site description here." Well, there's a lot of ways you can write a site description. And the client wants it a certain way, and somebody who's been in the business for six months who's drafting this document because they're inexpensive and we think that that's the way to use money and usability well, is to have that person draft the document. And that person drafts it the way they want it. And now the manager and the editor are going to spend a ton of expensive time fixing that and reframing that site description. And so, all of a sudden we're at, "Well, now we have to talk about factors and we have to talk about checking in and we have to talk about are these templates actually helping people think critically about the problem, or are these templates just rote things that we say, 'Well, if you follow this, everything's going to be fine.'" And if you asked any company across this country, they would all say, "Our templates are not helping people think well. We're trying to shortcut critical thinking with our templates and it shows up in the end product, that we have a short-cutted critical thinking process here."
14:11 Comprehension belongs to the reader alone
Brian explained why it is only the reader’s comprehension that matters.
‘’We are writing as if we have to provide the decision-making information. And that is true, except we're missing one big part of it, which I'm now going to mention. The writer never, ever, ever gets to comprehend for the reader. Comprehension is completely the reader's. So we can do this with your podcast guest right now, right? So if I say, "Lisa, picture a coffee cup." You and I are probably going to end up with a very similar image, but I'm not holding a coffee cup and you're not holding a coffee cup. So what I'm doing is triggering an image that we happen to agree upon for you, but your comprehension is yours. I didn't tell you what it looked like. I didn't tell you what it was made of or if it had a handle or didn't. Your comprehension is completely yours. And so when it's a coffee cup, it doesn't matter. Nobody cares. But now, I'm going to say, "Lisa, the most important thing for this particular hospital is that they spend $3.5 million on this initiative." And now somebody says, "Hey, wait a minute. What's that coffee cup made of?" Right? And comprehension is theirs, it's not mine. Now I have an obligation to say not, "This is the right thing for you to do," ….But I can say, "Let me describe for you how I see the coffee cup. Let me describe for you of what I looked at, all the factors that I looked at, and let me transparently assess all of those factors….We have to understand that they own their own comprehension and we have to respect that. And then, we have to say, "I've thought about this problem enough. I'd like to share my thinking on you and this is why I'm suggesting this conclusion." And they say, "Yes, I think that's a coffee cup, too."
(22:01): Communication at discharge is the most challenging aspect for a hospital
Lisa commented that the point of discharge in hospitals has the potential to be transformational with better communication.
‘’I think you would just do an amazing job if someone said, "Okay, Brian. Here are our communication points to our patients. We want you to review them." Often when I have been in the hospital or a family member has been in, sometimes I read things and I'm like, "Oh. This could be just stated better, kinder, or with more detail," right? Because there's room for confusion. There's an interesting aspect to a hospital, where a point of discharge is really the most challenging part. And how they communicate at the point of discharge, even that of itself could be just transformational because that's where people get confused. They're not hearing things. But it's a printout, it's … a template….
So there are all these areas to how we communicate with patients and there are areas of how we communicate with physicians. We wonder why we can't get alignment, administrators with physicians, because we're not communicating well. Sometimes we'll work with physicians or hospitals to communicate, and we don't have those same problems because we are thinking deeply... I'm always thinking about putting myself in their position or just providing information in a way to help them make their own decision, not trying to manipulate it.’’
25:50 Treating patients as more than a transaction
Brian shared an experience of ineffective communication in healthcare.
‘’….I'll give you a quick sort of related story for a second. I had an ophthalmology appointment last week, and it was very clear to me that these people who've been my ophthalmologists for a decade had no... If they wanted me to quit being a client, it was very clear from their communication that they would not mind me quitting being a client. But that was very clear. And it was just the way the forms were written. You've got to fill out this form for Covid. You've got to fill out, then if you don't do this, you're going to owe us a hundred dollars and we're going to transfer your... We're going to... All of this stuff. And I've been a client there forever. And of course, inside the doctor's office everything was fine. There's no problem. But man, were those forms really difficult to read…did I feel like, "Man, I don't even know if I want to do business with you guys. I don't feel like a respected client. I feel like a transaction that you're trying to cover all your bases." And she's a great doctor, but….was that a terrible feeling. And so, my sense is that that's probably happening all throughout the hospital. And so, well, why is that happening? Well, it's very difficult for us to understand our own subconscious responses to things and to get a hold on them. And so, let's take my ophthalmology appointment. They were really concerned during Covid that people would cancel and they would be out money and time, and they've got to pay their staff. And I understand that and I don't even mind giving them a credit card. I mind how it was phrased…..But how do I frame this around somebody else's comprehension so that they understand exactly where I'm coming from and why?’’
29:52 The default position is protecting ourselves
Brian said our first instinct is always self-protection, which gets in the way of successful communication.
‘’We are right to protect ourselves. There's no person on earth who should be running through the planet saying, "You can have my life. I don't have any value here. And so, just take advantage of me." … The problem is, without the ability to protect ourselves with nuance and with nuanced understanding and with a well-observed, then it's going to come out fast. And Danny Kahneman's terrific book, Thinking Fast and Slow, is about this. We work a lot with lawyers, right? Because lawyers end up writing contracts (that) deal with these issues. And so, in essence, what we end up saying is, "I'm going to write this as a document that protects myself. And because I need that so much, I don't even care how you read it." And so, I just made you a transaction. I don't want to make you a transaction. I just made you one. And we do this in every aspect of our lives….We have a default to protect ourselves. And then, the question I think becomes, how do we show the transparent need to protect ourselves and understand somebody else's comprehension at the same point? And now we don't have to battle with it. We can come on the same decision space. We can say, "This is how I'm seeing the coffee cup. How are you seeing the coffee cup?" ‘’I'd really like to see the bill in the next couple of minutes if that's all right." And the person says, "I'm really sorry for that. Of course, yes." Let's do that. Okay. And so, we can get on the same page, but it's not going to be our first instinct, because our first instinct is going to be self protection.’’
36:15 The impact of hospital bills.
Lisa highlighted hospitals bills as a potential area to improve patient communication.
‘’If you think about it, it's so impactful, right? Everything from marketing to internal communication to internal influence to communications with patients, to even as they leave the hospital and transition even to post-hospital, patient gets a bill, right? And we are in a time where collections and billing is going to be somewhat problematic because of inflation, because of everything that's going on. And I've often thought, "There's got to be a transformational way to have these bills go out." Now you see hospitals getting a little gentler. But I've thought, "Wow. If somebody only spent time putting together this letter, a series of letters and put, like you said, they protect the hospital, but they're looking at it from the patient perspective, I bet you they would increase their collections."
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You’ll Also Hear:
Brian’s background as Managing Editor of New York City's premier planning and environmental firm for 16 years, the $2 billion cost of writing documents and why the issue arose from thinking, not writing. ‘’The language was not representative of the quality of the thinking and that was very expensive.’’
The importance of critical thinking in producing a document. ‘’It's very easy to produce a document inexpensively. It's very difficult to produce a well thought through document without a critical thinking process involved in that.’’
Taking inspiration from Yuval Noah Harari's book, Sapiens, and why a piece of writing is not just transferring information, or ‘’hey, there’s food on that tree.’’
It’s not always about the latest technology: understanding how innovation can take communication to a different level.
Why the depth of thinking around a problem and our ability to frame around that depth results in conversational, economic, and business influence power. ‘’My sense is that we miss that culturally, but it's probably the most important thing in terms of actually getting things done and getting them done efficiently.’’
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