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- Herausgeber: tredition
- Kategorie: Fachliteratur
- Sprache: Englisch
The 1-Minute Doctor: mastering communication in medicine for smoother, more effective interactions. Bridging the gap between where you are and where you want to be in medical communication. The 1-Minute-Doctor by Dr. Mark Weinert is more than just a guide—it’s an eye-opener. With refreshing clarity and a touch of humor, the experienced senior anesthesiologist and communication trainer reveals why good communication goes beyond just words. Communication in medicine is more than just words, it’s about connection, clarity, and confidence. The 1-Minute-Doctor delivers a practical, no-nonsense guide to mastering communication in the fast-paced world of healthcare. With real-world examples and instantly applicable techniques, this book helps medical professionals navigate critical conversations with patients, colleagues, and even the media. What you’ll gain from this book: - Communicate with Clarity & Impact – learn how to convey complex medical information clearly, concise, and compassionate. - Master Emotional Intelligence and understand the key differences between empathy, compassion, and sympathy —and why it matters in patient care. - Handle Difficult Conversations with confidence – Get practical tips for managing conflicts, breaking bad news, and de-escalating tense situations. - Closed-Loop Communication– Avoid misunderstandings and improve patient safety with structured, feedback-driven dialogue. - Sharpen Your Leadership & Team Communication – lead, motivate, and provide constructive feedback to colleagues and staff. - Crisis & Emergency Communication – stay calm, clear, and effective in high-pressure situations like medical emergencies and crisis management. - Speak with Authority in the public & legal sphere – learn how to navigate conversations with media, legal professionals, and stakeholders in the healthcare system. - Develop Quick-Witted Responses & Resilience – stay sharp and professional—even when faced with tough or unexpected challenges. Why this book? Written by Dr. Mark Weinert, an experienced anesthesiologist and medical communication trainer, The 1-Minute-Doctor is based on years of research, practical experience, and hands-on training. Unlike traditional communication guides, this book is engaging, to the point, and tailored to the realities of modern healthcare. Communication isn’t just a skill, it’s a game-changer. And yes, you can learn it. Get your copy today and transform the way you communicate in medicine!
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Seitenzahl: 363
Veröffentlichungsjahr: 2025
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Dr. Mark Weinert
The 1-Minute-Doctor
Dr. Mark Weinert
The 1-Minute-Doctor
Communication Made Simple
The Practical Guidebook for People in Healthcare
© Mark Weinert 2025 Publishing
Label: Why Not Publishing
Cover design: Die Buchmacher, Cologne
Cover illustrations and inside vignettes: MaksimYremenko/iStock Editorial:
Cologne ISBN Softcover: 978-3-347-90206-0
Printed and distributed on behalf of: tredition GmbH, An der Strusbek 10, 22926 Ahrensburg, Germany, [email protected]
The work, including its parts, is protected by copyright. The author is responsible for the contents. Any use is not permitted without the author's consent. Publication and distribution are carried out on behalf of the author, who can be contacted at: tredition GmbH, Department "Imprint Service," An der Strusbek 10, 22926 Ahrensburg, Germany.
Table of Contents
Cover
Half Title
Title Page
Copyright
Preface to the English Edition
Foreword
Why at All be Bothered? Can't Everyone Communicate?
Hard Facts about Soft Skills: Why Compassion is More than a "Nice to Have" …
Small talk
Rapport
Building trust
Does compassion save lives?
Physiological effects of compassion
Empathy (selection)
Psychological effects of compassion
Does compassion cost time?
Does compassion cost money?
Compassion is good for the one who gives it
Can you learn compassion?
Can compassion prevent burnout?
Cold empathy
Schulz von Thun: Values and development square
Feedback and Debriefing: the "Shit Sandwich," Giving and Taking Feedback Better
Why give feedback?
When to give feedback?
Difference between feedback and debriefing
The "shit sandwich"
Feedback/debriefing according to the 2D/3D method
Active listening
Active listening checklist
Praise
Praise checklist
Feedback checklist
Accept feedback
Checklist for accepting feedback
"Just Seeing It Makes Me Sick!" Dealing with Emotions
Sensation, emotions, feeling
You cannot not communicate
All communication has a content aspect and a relationship aspect
Communication is always cause and effect
Human communication uses analog and digital modalities
Communication is symmetrical or complementary
What are emotions?
What is the purpose of emotions?
Four uncomfortable truths about feelings
Your feelings are yours only.
Your feelings have meaning.
Your feelings are your sole responsibility.
Your feelings are a unique product of how you interpret what is going on around you.
Emotional intelligence
What emotions exist?
The four basic emotions
Joy
Fear
Dealing with anxiety
Breathing exercise to cope with anxiety better
Sadness
The difference between grief and depression
Anger
The four types of anger
How to deal with anger and rage
Triggers
Strategies
How do I stay calm when it's appropriate?
Guilt, shame and regret
"Somebody Get the Defibrillator!" Communication in Emergencies
Interaction styles
Directive
Transference effect
Democratic (cooperative)
Benevolent (caring)
Laissez-faire
What is the best interaction style?
CRM principles Sterile cockpit rule
Closed-loop communication
Sufficiency: As much as necessary, as little as possible
ISBAR
FOR-DEC: Dynamic decision-making
10-for-10 principle
"You're Lucky, We Very Rarely Forget Anything in a Patient!" Error Culture and Communication
Everything that can go wrong will go wrong
When do you need to talk to the patient? (Disclaimer: I am not a lawyer, and this is not legal advice!)
From a legal perspective, when must the patient be spoken to?
What do patients and family members want?
How specifically should the conversation proceed?
Error culture
The cheese slice theory according to Reason
Blame and shame
CIRS
"I Can't Give any Information about That." Doctor Refuses to Testify! Communication with Media
News
Report
Interview
Preparation
Questions before the interview:
General tips
On the phone
For radio
For newspapers
For television
"To Tell the Truth, Your Honor …" Communication with Lawyers
Points of contact of physicians with the law and with lawyers
Teaching legal knowledge at school and at university
Meeting of medical doctors and lawyers
What to do in case of emergency and afterwards?
Basics
Quick first contact with a lawyer after the event
What could possibly be so important that a lawyer needs to help in the early hours?
A case study from practice
Legal support during the prosecution investigation
Behavior in a trail Criminal proceedings
Civil suit
"No, I'M Not Eating My Soup!" Assertiveness
"No!" is a complete sentence
What BATNA is and why it is often not the best alternative in medicine
Emotional blackmail
Different negotiation strategies: cooperative and competitive
De-escalation
Sorry
De-escalation checklist:
"Do You Think This is Funny?" Why Humor is Important at Work
Why humor is important
Medical benefits of humor
Laughter can reduce pain
Laughter reduces anxiety
Humor is a creativity valve
Advantages of Humor
Benefits of humor for leaders
Humor helps you take yourself more seriously as a leader
Humor can help learning
What is humor?
What are the types of humor?
What is humor allowed to do?
The five levels of laughter
Laughter can build relationships and create (bonds)
Humor helps heal (at least some)
How does humor work?
The surprise
The exaggeration
The incongruence
Social context
What makes a good joke?
Status and what it has to do with humor and working in the medical field.
Contact and fun as primary motivation
How to become more sparkling
Gelotophobia
Indications for humor
Contraindications to humor
Summary
The "Difficult" Employee, Patient, Colleague, Relative.
Who is a "difficult person?"
Taibi Kahler: Process communication
Stress level
Projection, transference and countertransference
Projection
Transference
Countertransference
How do I deal with my difficult person?
How do I react when I am verbally attacked?
Quick-wittedness
Superelevation
Like with like
Strategies for pathological personality structures
How do I prepare the ground for an open conversation?
Seeing and hearing the other
"Standard situations" and strategies for dealing with them as successfully as possible.
Yes, but…
“And” instead of “but”
Resistance and negativity
Instead
Constructive W-questions
Anyone who claims something must prove it
How far must my willingness to compromise go?
What Now?
About the Author
Acknowledgments
Bibliography
The 1-Minute-Doctor
Cover
Title Page
Copyright
Preface
Preface to the English Edition
Foreword
Acknowledgments
Bibliography
Bibliography
The 1-Minute-Doctor
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Preface to the English Edition
Though often overlooked, and routinely understated, the importance of effective communication in the breakneck-paced world of medicine cannot be overstated. Whether between a physician and patient, amongst interdisciplinary medical teams, or within the broader orbit of the healthcare umbrella, high-quality communication remains the bedrock upon which successful treatment and compassionate care are built. It is with great pleasure that I introduce The 1-Minute-Doctor, a comprehensive exploration of communication in the medical field by my friend and communication mentor, Dr. Mark Weinert.
As a physician, I perform high-risk, complex interventional procedures often in patients with advanced malignancies or with immediately life-threatening illnesses. As such, I face challenging conversations on a near daily basis with patients and their families who entrust their care to me at their most vulnerable stage. I provide unfavorable diagnoses when necessary and disclose adverse events that occur under my care, and the expectation is that I am able to communicate with grace, humility, honesty and integrity. Similar qualities are imperative during interactions with colleagues within the care team. While achievable, effective communication requires effort and intention.
This book provides an insightful blend of sociologic theory and practical scenarios from real world medicine, addressing the full spectrum of communication in the healthcare domain. From the intimate, one-on-one conversations with patients to the complex dialogues that occur within multidisciplinary teams, to the intricate interactions with mass media and legal representatives, this book encompasses the variety necessary to understand the nuances of such delicate interactions.
The 1-Minute-Doctor is written in a conversational tone, making even the most challenging concepts mentally digestible and engaging for all readers, particularly those entrenched in the demanding realities of medicine.
Real-life experiences permeate this work, providing physicians with invaluable, actionable insights that can be applied directly to their daily routines. The case studies and examples discussed within these pages will resonate with practitioners at every stage of their careers, offering both guidance and inspiration. Dr. Weinert’s deep understanding of the medical profession, combined with his unwavering commitment to improving patient care through better communication, shines throughout this book.
This work should function as an invaluable resource for all healthcare professionals who strive to enhance the quality of their interactions with patients, colleagues and interrelated personnel alike. I applaud Dr. Weinert for his exceptional work and masterful ability to simplify the complicated dance of communication within the medical field. His ability to weave together scientific rigor with the human element of medicine makes this book not only informative but also profoundly human.
May this book serve as a guide to fostering deeper, more meaningful conversations in medicine, and ultimately, to improving the lives of those we care for.
Ryan Law, DO
associate professor of medicine
Mayo Clinic Rochester,
Minnesota, USA
Foreword Words are an instrument
Words and their mere meaning can do wonderful things and be terrible at the same time, because they aren’t a solo instrument but one of many embedded in an orchestra called communication.
This orchestra can achieve great things or even cause great damage because wrong tones can quickly make a song sound crooked or unintentionally different, and a botched concert can even cause one to question the entire concert hall. Where would wrong tones of communication have a more serious impact professionally than in high-risk areas such as aviation, a nuclear power plant or medicine?
As a physician, I’ve been working in high-risk medical areas for almost 20 years, cared for people in the resus room, in the intensive care unit and operating theatre, saved lives and lost people to death, accompanied the dying and cared for relatives, experienced thousands of stories and certainly made just as many decisions that then had to be explained in discussions under the most varied circumstances and in the most varied situations. Today, I also face many communication challenges as a chief physician and the associated leadership role, and regardless how different the examples described here may be, they have one fact in common: success and failure are always significantly dependent on the type of communication. This book conveys in a refreshingly colloquial way what matters in medical communication: that there is more to it than simply the spoken word.
Why is it important to distinguish between empathy, compassion and pity? To what extent do emotions play a role and can communication really be learned? What is closed-loop communication, how can I best give feedback, and how can I succeed in being quick-witted despite being in danger of being torn apart for a moment in a discussion?
With the help of practical examples, doctors will quickly find themselves in situations that are familiar to them from everyday life. All essential topics are covered and all essential questions about communication in medicine are answered. Among other things, the book deals with communication in emergency management and the communicative aspects of the doctor-patient relationship, including tips and tricks for managing employees, conversations with relatives, addresses communication with the media and lawyers, and so much more that many would have wished for in medical school.
The author Dr. Mark Weinert benefits from the fact that he himself is a specialist in anesthesiology in a leadership role as a senior physician. His obvious intuition and keen interest in communication in the sensitive environment of medicine are palpable throughout every chapter of his book. Mark wanted to know what good communication was all about from the very beginning. The deficits in medical training on this topic were already fully clear to him early onwards but accepting them was not an option. He therefore embarked on extensive research, committed to a comprehensive and long-term education in various aspects of communication. To this day, he actively applies his knowledge as a presenter in teaching settings and as a trainer in medical simulation centers. The accumulated knowledge gives this book a strong scientific foundation, which beyond the content of everyday experiences, once again consciously brings irrefutable, almost unmasking truths to light: you can’t not communicate, and you can learn to communicate.
In order to achieve the intended effect, our instruments must be mastered individually and – like in all other orchestras – in their interplay, regardless of which role one takes on at the respective moments. This book will benefit anyone who is looking for a successful summary, regardless of the current level of training, who enjoys real-life examples and the possibility of gaining deeper insights into the fundamentals of communication.
I am grateful for this book, in which Mark easily succeeds in placing the art of communication in medicine where it belongs in terms of its everyday importance: at the center of our actions.
Sebastian Casu, MD
Medical Director
Chief Physician Clinical Emergency and Acute Medicine
Asklepios Clinic Wandsbek
Why at all be bothered? Can't everyone communicate?
Introduction: In which I will tell you what I will tell you before I tell you. It should make you curious. I will give you information, opinions and ideas to think about, and to put into practice, seasoned with a pinch of humor.
"The biggest problem with communication is the illusion that it has taken place."
George Bernard Shaw
"Everything good in life - a cool business, a great love, a powerful social moment - begins with conversation. Talking to each other, one-on-one, is the most powerful way for people to tune in to each other. Conversation helps us understand and connect with others in a way that no other species is capable of."
Daniel Pink
"A sick person's life can be shortened not only by a doctor's actions, but also by his words and behavior."
Founding document of the American Medical Association from 1847
Assume you can do magic. You can change and create reality with your magic spells. You can cause physical changes in the world with words. A tempting thought? Well, you can. Don't worry, this isn’t an esoteric book. When we say something, our thoughts become electrical signals that cause physical muscle movements in the speech apparatus. This in turn generates sound waves, which are converted into electrical signals in the auditory apparatus of the other person and transmitted via the auditory nerve to the acoustic region of the brain. The other person heard what you said. When enough significance is attached to the circular excitation in short-term memory and the information passes into long-term memory with the help of the hippocampus, new connections are made between neurons, and you have changed matter with words. However, that’s not all: depending on the meaning and how the other person attaches to our words, even more can change. He takes the medication, or he doesn't. He stops smoking, or he doesn’t. He yells at us, or stops. He doesn't get it up anymore. What do you mean? You’ve read that correctly. Words have an incredible power. They can have a decisive influence on our lives and the lives of others. The placebo effect is commonly known, accounting for up to 80 percent of an effect, depending on the disease and the grade of intervention. The nocebo effect [1] is less known but equally important, as the evil twin of the placebo. Silvestri's study included men aged about 50 years old who had been newly diagnosed with hypertension. The study had three intervention groups, and all participants received a beta blocker and were asked to report any side effects that occurred at their next appointment. The difference was what they were told when they were prescribed the new medication.
In the first study group, the patients were given the drug by the physician, and he said the following: "You’ll be given a medication to treat your high blood pressure."
3.1 percent of study participants reported erectile dysfunction at the follow-up visit.
In the second group, participants were told: "You're being given medication for your high blood pressure. This is a beta blocker." 15.6 percent of study participants reported erectile dysfunction at the follow-up visit.
In the third group, the message was: "You've being given medication for your high blood pressure. This is a beta blocker. It can cause erectile dysfunction as a side effect." 31.2 percent of study participants reported erectile dysfunction at the follow-up visit.[2]
All three groups hadn’t received a beta blocker, but simply a placebo. Those who had reported erectile dysfunction as a side effect received Sildenafil (Viagra®) as therapy. There were two groups here: one group received a placebo, the other Viagra. Both therapy groups were equally successful in treating the side effect. You can do magic with words, and make a major difference with them, or not. This book deals with special situations in which we communicate with other people. Situations that you won’t find in every book about communication. I sincerely hope that you will get the most out of these words.
Everyone can speak, except for people who have speech impairments. Most of us can walk, although there are people who run marathons and others who run 100 meters in less than 10 seconds. Essentially, it's the same movement, just faster or farther. It’s similar with speaking: we all can talk, it's just hard to get people to listen to you. It’s even more difficult to make them grasp what you’re saying, and harder still to get the other person to do what you want him or her to do. Just like with running, it’s possible to improve considerably with just a little more knowledge and appropriate training. So why is it important to communicate better? Because everything’s at stake. We can’t "not" communicate, as Paul Watzlawick rightly wrote, but we can do things right or wrong. Good communication is the oil that keeps the gears running in interpersonal relationships. In the same way, bad communication is like sand in the gearbox.
However, before we start, let me tell you a story. Who am I to tell you about communication? I’m a physician from the last millennium, by background as an anesthesiologist, intensivist and emergency physician. Anesthesiologists aren’t necessarily known for talking to patients very much. They usually inject the white stuff and then the others don't talk. Some anesthesiologists think that's particularly good and that's why they chose that specialist field. However, the fact is that anesthesia is more than that and can come with sometimes very rare complications. In the event of an emergency, the correct response must be made very quickly. To train this from early onwards, anesthesiologists began to practice emergencies and incidents in a simulator, like pilots in a flight simulator. The anesthesiologist enters the operating training room, and there lies a manikin, that – depending on the manufacturer – has a lot to offer, such as various medical procedures that can be performed on it or different complications that might occur during an operation. The anesthesiologist who is the main participant of the scenario is called the hotseat because he is in the focus. He gets a briefing on what to do, for example: "This is Mrs. Heiner, she's here on vacation and has come down with acute appendicitis." The anesthesiologist then performs the anesthesia, and he knows something terrible is about to happen, and that's exactly what will happen. There is a complication, and he must react to it, under great time pressure. In addition, the whole thing is filmed from several camera perspectives and discussed in detail in the debriefing after the scenario.
Then you look at exactly how you did this or that in an emergency, or what you forgot. The debriefing is the heart of the simulation training and usually lasts at least twice as long as the scenario itself. Here, we discuss how the medical problem was treated: Was it identified correctly? Was it treated according to the guidelines? This is the first part of the debriefing. The second and at least as important part is to discuss the so-called non-technical skills, often called soft skills. What about situational awareness? How about decision-making? How about team leadership and communication? Although the hotseat is in charge, he isn’t alone in the scenario. He’s acting in a team with people who may have very different ways of communicating. This is the point where it gets exciting. The medical knowledge and skills needed to resolve a situation are most likely guaranteed in case of an emergency at the hospital. The all-important question is: Will the horsepower hit the road? In 70 percent of emergencies, the precipitating factor in patient harm is the lack of or inadequate communication.[3] While we have known this for a long time, this aspect is still given almost no attention in training and continuing education. 99.9 percent of our training is of a purely technical nature. Soft-skill training and communication training hardly exist, yet these precisely make the decisive difference, not only between life and death, although sometimes successful or unsuccessful communication can make the difference. Less dramatically, but with major impact: successful communication can make or break a relationship. This is true for relationships at home and the many relationships we have with others at work. How do I work with my colleagues, my patients and my family members? Is it working smoothly or is there sand in the gearbox?
Not knowing all of this, I completed my first simulation training as an anesthesiologist in 1999. When I looked at myself in the video in the debriefing, I realized that my technical knowledge was commensurate with my level of training, and I was almost satisfied with it. However, as far as communication and team leadership were concerned, I saw clearly room for improvement. A lot of room. My journey to becoming an outstanding team leader and a communication expert hadn’t really begun at that point. Indeed, I probably hadn't even arrived at the airport yet.
That was the time when I realized that something had to be done, as so much can be achieved with little knowledge, training and commitment. Since then, I have been intensively involved in the topic: I’ve read up on it, attended courses and taken training courses to become a communication trainer, simulation trainer and de-escalation trainer. I have also worked scientifically on the subject, planned simulation centers and – among other things – worked in the working group that developed the longitudinal communication curricula for the learning objectives catalog for medicine on a cross-faculty basis.[4] For more than fifteen years, I’ve trained and accompanied executives in medicine and other high-risk industries worldwide in communication and soft skills.
This project is the result of 23 years of working with patients and colleagues from all health care professions, fifteen years of work as an international leadership and communication trainer, reading more than 100 books about communication, leadership, personality and psychology, over 1,000 abstracts screened and close to 200 studies cited. Is that the last word of wisdom? Certainly not! It's just a start. Certainly, a profound one for someone who hasn’t yet dealt with the subject in such great detail. I would like to impart knowledge without being boring, lecturing or detached. That’s my plan.
I’m particularly proud to have designed and conducted the training for the TeamBaby project.[5] Here, among other things, it was shown for the first time that with pure communication training the rate of adverse preventable events (commonly referred to as complications) could be reduced by 4.5 percent (from 13.35 to 8.83 percent).[6] That corresponds to one-third fewer complications through a one-time communication training! How could this be possible? Quite simply: since communication is the main cause of errors, emergencies and damage in medicine, rather than a lack or absence of (specialist) knowledge, better communication is the answer, and thus better cooperation.
➽ In approximately 70 percent of all emergencies (whether in aviation, medicine, naval industry, or the nuclear industry), poorly run communications are triggering factors or at least decisive contributors.[3].
➽ In approximately 70 percent of legal actions against physicians or hospitals, poor communication is the initiating or the key contributing factor.[7][8]
Why is the book called "The 1-Minute Doctor?" Trying to treat patients in one minute is nonsense. That isn’t what this book is about. What is it about then? The Formula 1 racing driver Emerson Fittipaldi once defined the art of racing as follows: "To be the fastest as slowly as possible." This characterizes us very well as physicians, therapists and caregivers in today's economic pressures. We should treat as quickly as possible, but the human being (therapist, patient, colleague, and oneself) shouldn’t be neglected.
Physicians have always been expected to be good communicators. I’d like to reproduce a story for "successful" communication from a colleague at a university hospital from 2019, which I was able to witness live. Imagine: a 65-year-old patient – whom I know well, which is why I was there in the hospital with him – falls at home and hurts his neck. An X-ray showed no abnormalities, and the family doctor prescribes physiotherapy. Two weeks pass and it hasn’t really gotten better. After a sudden movement in bed, the patient can no longer lift his head due to the pain and goes to the university hospital, where a computer tomogram of the cervical spine is performed. As the patient waits in his box in the emergency room, a man in a white coat enters the room. He doesn’t shake his hand nor introduce himself or his function. He sits down in front of the computer and looks at the CT, then he says – without looking at the patient – as he stares at the screen:
"You've had a CT scan. We must operate on your cervical spine; we'll do it on Monday!"
It’s Friday. He gets up and leaves without saying goodbye. He’s the neurosurgical senior physician on duty, who himself plans to perform the surgery on Monday. How likely is it that the patient will choose to stay in this hospital? What do you think? How likely is it that the patient will trust this doctor? What do you believe? How likely is it that the patient will contact an attorney if anything doesn't go the way they think it will? What do you think? How much time will it take to deal with this case? Certainly, considerably more time than the one minute that the colleague could have invested in the relationship. He had to then, as he had a long talk with his boss, who performed the operation in his place.
Why? Because everything always comes down to interpersonal contact. Communication is the key resource. If this isn’t successful, important information is lost or not given in the first place. It may even lead to a dispute. The unnecessary friction consumes energy that would be needed elsewhere, or even brings the machine to a complete standstill. Communication can be disrupted in many ways. It’s therefore even more surprising that for a long-time communication had virtually had no place in medical training. It’s only since 2016 that the longitudinal communication curriculum has been in place, which teaches communication to students uniformly across all universities over a period of two years, always interwoven with exercises in clinical practice and supported by best-practice examples. [9][10]
On the other hand, this means that prior to 2016 communication in medical studies strongly varied and usually only took place for one or two weeks (out of a standard study period of six and a half years!). That's exactly how it goes in further education. Think for a moment about how much theory you received in professional training during your continuing education. How many training courses did you attend? How many of them dealt with communication and soft skills?
In this book, you’ll find examples and theories that you are familiar with or understand. Others will be new, and some might even challenge you. Get involved. All the examples stated in the book are real ones, although I have changed some details or names to protect the clumsily acting person, even though it is mostly myself. At the end of each chapter there is a small box providing tips and techniques and inspirations for you to try out and use in the future. What you take away is entirely up to you. If you want to read the book just to gain knowledge, go ahead with pleasure. It's your time and money. However, it’ll be even more valuable when you put it into practice.
The style of the book is clearly informal and emphasizes practical and real-world relevance. It’s not a scientific treatise (those who prefer to read that should refer to www.pupmed.gov), but I have substantiated the content with scientific studies and evidence.
In the next few pages, I’ll provide you with information and opinions that will make you think and hopefully inspire you to follow them to communicate better with friends, colleagues, employees and patients. Believe me: it's worth it. Finally, we'll have fun together. Let's go!
Hard facts about soft skills: Why compassion is more than a "nice to have" …
In my opinion, this is probably the most important chapter in this book. What is empathy and why is it so important in general, and in healthcare in particular? What is the difference between warm and cold empathy and what does it mean for you personally? Here you’ll learn why empathy is not sympathy, and why it’s necessary. You’ll also learn why empathy can ease pain and what you can do to increase your own empathy.
"It is the compassion for all creatures,
what really makes people human."
Albert Schweitzer
"Being empathetic means,
seeing the world through the eyes of others rather than our world in their eyes."
Carl R. Rogers
"The misfortune of thousands moves us less than the misfortune of one."
Otto White
Before we really get into it: some small talk…
Small talk
Small talk is superficial babbling. Just blah, blah, blah. Communication – especially in healthcare – should have relevant content and be clearly structured. That's right. That's exactly why you need some small talk beforehand. What are the benefits of small talk? More than people generally think. Small talk is a way to connect in a positive way. Complaining about something together isn’t small talk. Small talk is a cautious non-binding way to get to know each other without revealing too much about yourself, to assess the situation and the other person.[11] Topics that are addressed don’t pose a threat to the future relationship. For this reason, the topics of small talk are intentionally kept superficial and light. The first person who comes around the corner with his political and perhaps controversial opinion may have already lost the chance of further cooperation with the other person before he could even voice his concern. Small talk is the beginning of a relationship, after which a decision is then made as to whether or not to deepen this relationship, namely whether it remains superficial, will end or be the beginning of a wonderful cooperation or even friendship. Small talk is not only good conversation but the preliminary banter on the doorstep before you invite someone into your house or close the door again. Small talk can be interrupted at any time when there is something more important to do or say to establish or maintain a relationship. Rapport is established in the process. What is this rapport and what is it good for?
Rapport
"Are you actually listening to me?"
"Pardon?"
Building rapport means building a deeper relationship with the other person.[12] A relationship of trust. A mutual bond with respect. The better we build rapport with someone else, the more likely we are to succeed in working together. For this, small talk is the first step, the basis before we can form a more solid relationship. This is the (trust) rapport on which a therapeutic and collegial relationship is built. Without rapport, the likelihood of the other person doing what I tell him to do is very low,[13] as is the likelihood of him listening to me at all. How do I get this rapport: can I buy it? No. You actually have to do something about it yourself. Fortunately, several smart doctors and psychotherapists have already addressed the issue to make it easier for us. There are proven techniques for building rapport with another person: we have just learned about one of them. Another technique is so-called mirroring. You can mirror verbally and non-verbally. In verbal mirroring, you repeat the key words that the other person has used, or even the whole sentence.
"I want to go home now."
"You say you want to go home now."
You can do this occasionally if you want to be sure that you’ve understood correctly. If you always do this, with every sentence the other person says, it quickly seems strange. Carl Rogers – the founder of client-centered psychotherapy – noticed this. In mirroring, according to Rodgers, one paraphrases the statement of the other person.
"I want to go home now."
"You want to leave?"
This doesn't sound like aping to the other person, but in fact as if you really listened and understood. Who wouldn't want that? In addition to words, you can also mirror with your body. Here it is just as important not to mirror the other person completely, because that seems unpleasant. It's better if the other person changes his or her posture, gestures or facial expressions and you mirror a part of it a second or two later. My conversation partner leans forward a little, I change my posture as well. My counterpart crosses his legs, I do the same. After a while, you can see if the person you are talking to mirrors your own body language. The more synchronized two people are, the more agreement there is between them. If you want to do some real fine-tuning, you can even mirror the breathing rate of the other person. When the content of the other person's communication is mirrored, rapport is not about content but rather than emotion. Whoever builds rapport with another person creates a relationship of trust, which is the basis of all human cooperation.
Building trust
To build trust, there are four qualities that we must demonstrate so that the other person trusts us.[14]
➽ Ability: How smart and competent are you?
➽ Integrity: How congruent are your words and actions?
➽ Benevolence: How much do you care about the well-being of others?
➽ Predictability: How often do you achieve what you set out to do?
One of them – "ability" – means: Can we do what we claim to be able to do? For ability, there are various signs and status symbols, if you like, that can give us a leap of faith. MD, for example, or professor, or "I've been working for 20 years as a senior physician at XY University Hospital in exactly the area that is of interest to you now." For many, this is where the understanding of trust ends. If your title or position are right, or you have performed accordingly, then you are trustworthy. Right? No. Because for us to trust someone, it takes more than having the necessary competence in that situation. It takes integrity. Just because I can do something, this doesn't mean I'm going to do it in the way that I promise. Do I keep the promises I make? Another crucial point: benevolence. Do I mean well with the other person? Even a personal enemy of mine may have valuable qualities that he has demonstrated, or he may have shown that he does what he says he will do. However, if he is not well-disposed towards me or I don’t assume that he is, then I won’t trust him. The first three characteristics are underlined and supported by predictability. How often do my actions match my words? Always? Then I can trust the other person. Rarely? Then he can have as many doctorates in front of his name as he likes, but his ability is not sufficient for me to trust him. Think for a moment about the three most common lies in the hospital:
"We've done this a thousand times."
"This doesn't hurt."
"I'll be with you in a minute."
If you heard all three of these in one day, how likely are you to believe anything else your doctor or nurse says?
One way to build rapport and demonstrate benevolence is to show empathy and compassion for the other person. Compassion can do much more than building rapport. Let's look at how much more.
Humans produce the most helpless offspring we know, and we raise them, these helpless creatures. We do this – among other things – because we have compassion for our children. Not long ago, the jawbone of a homo erectus was found in Dmanisi, Georgia.[15] An extinct close relative of homo sapiens. He was about 40 years old and missing all but one of his teeth. It turned out that he must have lived like this for a longer time. This means that almost two million years ago, someone fed him, someone had compassion for him. Long before we knew language. At a time when from a scientific perspective we or our close relatives were certainly wrong with pretty much everything that could be known about the world. At that time, someone cared. About two million years ago, someone showed compassion just for the sake of showing compassion. Compassion is older than language and one of the reasons why we persist as a species. In addition to the jawbone from Dmanisi, there are other more recent finds – here, ‘recent’ means about 45,000 years ago – where physically disabled people lived up to 40 years. This was only possible if they were taken care of by their clan. The thought is neither new nor mine. Charles Darwin postulated in his masterpiece The Origin of Species that communities with the most compassion would thrive best and therefore have an evolutionary advantage.[16] That seems to be the case until now. Currently we are in a compassion crisis, which has been very well studied.
If you have a lot of empathy yourself, you don ‘t need this chapter or any scientific evidence for the benefits of compassion.
If you're more like me and not very empathic by nature, this chapter may be an eye-opener.
At this point, a few definitions of terms are necessary:
Sympathy means ‘I like someone. He or she is sympathetic to me.’
Empathy means that I can put myself in the other person's shoes. Empathy is passive and a one-way street. The feeling of the other person is absorbed and empathized with. Functional MRI can be used to show that sensation is being felt. The region responsible for pain sensation lights up in the brain of the empathetic person who feels the pain of the other.
Compassion means that I feel the pain of the other person and feel the urge to act. Compassion is the active part. I am motivated to alleviate his suffering. This is the crucial difference compared to empathy, where I "only" absorb. If I have compassion, I want to change something for the better in the other person's situation. Maxim Gorky has beautifully described this as follows: "Actually, one should not pity a person at all, it is better to help him.”
Self-compassion
