How many times have you thought aloud, “I want the truth,” as you analyzed diagnostics and reviewed research? How many times have you felt the taunt, “You can’t handle the truth!” shouted back at you through inconclusive tests and vague signalment? There’s a reason that first line came from an actor playing a military courtroom advocate. After all, that’s our purpose as well: to serve as an advocate for our patient, to use subjective and objective evidence to defend our assessments and plans.
Think about how we prepared for rounds as students: researching a patient’s condition, memorizing complex pathophysiology, reviewing diagnostic results, and prepping an array of possible treatment plans. We then stand in front of our colleagues and defend our choices. We move into the exam room and justify our recommendations to owners. We mentally, but hopefully never actually, defend each choice to a veterinary medical board.
And just like the courtroom scene above, we have all experienced rounds devolving into a full verbal tirade of opposing opinions. Holding back an opinion, knowledge, or question that may improve patient outcomes is counter to the goal: the best interest of our patients. While you certainly learn from your colleagues, it is also an opportunity to prove yourself and stand up for your patient.
As I was trained to do, I remember taking this approach as I stepped into my role as a leader in the boardroom as well. As I defended my opinion, knowledge, and plans, I wasn’t met by a spirited back and forth; instead, there was silence. The feedback became clear: My communication style, awarded in a clinical setting, was failing in a leadership setting. Many years later, I finally could articulate what had happened: “What got me here wasn’t going to get me there.” The skills I had in the clinic were not going to be the same skills that were going to help me in leadership. I was going to have to grow.
Even the best clinical communicators fail as leaders if we continue to take the position of defender rather than open-minded contributor. Those of us who make great connections with clients find ourselves in a very different role with different goals and outcomes. We no longer serve as the advocate defending our mission but are working on a shared mission: the success of our hospitals, safety and community of our staff, or initiation of new policies. I didn’t need to defend my expertise; it was recognized. I needed to ask questions and find ways to fit my expertise into the puzzles we were all solving together! And I didn’t need to worry about a court-martial!