Community Rounds: How I Learned That Communication is the Hallmark of Great Health Care
In May, I was privileged to participate in the Community Rounds program sponsored by Fletcher Allen Health Care and the UVM College of Medicine and College of Nursing and Health Sciences.
For more than 25 years, this innovative outreach activity has invited community members like me to come to Fletcher Allen, meet with its leaders, and spend two days shadowing doctors as “community interns.”
To say my two days as an “intern” was an unbelievable learning experience is an understatement.
On both mornings, we joined the doctors on every patient consult they had. Watching these intimate interactions and conversations about care was a unique – and powerful – lesson in what makes a great caregiver. Though I didn’t say a word while I was around patients, I had plenty of time to interact with the doctors between patients to hear more about their perspective on patient communications.
In addition to spending time with the doctors, during a good part of the two days my group of fellow “interns” and I spent at Fletcher Allen, our “tour guides” were nurses, technicians and other staff members. Taking into account all of these team members – doctors, nurses, technicians, and staff – I can say with certainty that I know what it takes to be a great caregiver.
Obviously, technical skill and knowledge is important, but that’s simply not enough.
Every minute that I was at Fletcher Allen, I saw that great caregivers are driven by a fierce commitment to their patients, and that they are excellent communicators! We saw Dr. Martina Kacer, pediatric endocrinologist, patiently explaining to a young boy why he had to be more careful checking his blood sugar levels when he got home from school. We observed as a technician running a station in the Clinical Simulation Lab showed how the equipment for which he was responsible provided critical hands-on training to medical students and practicing physicians. We visited the Emergency Department, where Dr. Mariah McNamara moved from one patient to the next, calmly explaining to each one which treatments they were going to receive, or what their current situation was. Fletcher Allen’s VP of Government Relations shared with us how the hospital is planning to navigate the increasingly challenging environment of health care. In every case, communication that was direct, honest, factual, and respectful made all the difference.
That commitment to communications seems to start at the top, as both meetings our group had with Dr. John Brumsted, Fletcher Allen’s CEO, and with the deans of the medical and nursing colleges, respectively, were marked by that same level of honesty, openness, and respect for the patients, the community, and the practice of medicine.
When I say “honesty” and “openness”, I mean that I saw people who knew how to tell a difficult patient why they had to step up and do their part for their own health care, without belittling the person; or, how a caregiver who is being asked by patients to “do something right now!” explained why doing nothing at that moment was actually in the patient’s best interest. I saw leadership capable of admitting that the practice of medicine, or even some of the practices of their own organization are at times imperfect, and what work had to be done to reach a particular goal.
I don’t know how that gets trained or developed, but it seemed to me that at Fletcher Allen good communication “happens,” and we as the community served by this hospital are the better for it.
Thanks Fletcher Allen for an amazing two days “in the hospital”!
Robert Letovsky, Ph.D., of Jericho, VT, is a professor and chairperson of the Department of Business Administration & Accounting at Saint Michael’s College.
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