The surgeon and I sat at the table.
She was right: She didn’t raise her voice. However, her piercing glare and table thumping would rattle all but the most modulated professional.
Try not to use the word “yelling” when describing an incident: It’s too vague and raises too many questions. It’s a messy word in our messy world of human interactions. You’ll be more effective if you can get to the root of what was experienced and be clear about what needs to change.
The Yelling Experience
People often use the word “yell” when they’ve felt intimidated. “He yelled at me.”
It’s key to understand that this intimidation is not just verbal; it is also nonverbal. It can be a loud volume or a subtle glance that taunts people to fight or retreat. When this occurs in healthcare, key information may be withheld to avoid confrontation, and the result to the patient can be tragic.
As physician leaders, we can use accusations of “yelling” to reveal to our colleagues key insights about how they are being perceived. We can unroof the emotions that lie beneath the “yelling” experience to effectively figure out what’s going wrong, and we can help improve it. But first, we need to stop using the messy word “yell,” and we need to get to the real experience of what occurred.
6 Ways That Physicians Yell:
1. The Mad Dog Look
“Are you eyeballing me?”
You know the look. Locked eyes. No blinking. Piercing stare. Furrowed brow. The intent is to melt the person with powerful eye rays, and it occurs with or without flashing gang signs. When physicians use the Mad Dog Look, they are intimidating, and they are “yelling.”
2. Pounding on the table
Whoa, pounder. Stop the percussion. Every time you pound on the table to accent a negative word, you are “yelling.”
When physicians stop their colleagues in mid-sentence to disagree, they are interrupting. Controlling the conversation by speaking over them is, perhaps, “yelling.”
4. Personal attacks
When physicians make disagreements personal, they say things like
- “Those nurses are all lazy!”
- “Why can’t you do it correctly?”
- “Your grandma wears combat boots and smells of elderberries!”
They are making personal attacks, and they’ll be perceived as “yelling.” It won’t help solve problems, and give my grandma a break.
5. Violate personal space
If you can feel someone’s breath on your nose, or their hand gripping your arm, let’s hope it’s consensual. Otherwise, the drill sergeant is likely “yelling.”
6. Raised voice
Yes, sometimes “yelling” is when someone emphatically speaks in a loud voice. If you feel like you’ve been “yelled at,” you probably weren’t with someone shouting, “Go team!”
Investigating a Yelling
When you research the negative events, ask about the six forms of yelling to uncover the specifics of what occurred. The more detail you can get, the more helpful you’ll be to the physician accused of “yelling.” You’ll want to be able to paint the experiences of those involved in the most accurate manner.
Putting It Together
The surgeon and I sat at the table.
“I spoke with the nurses. They were concerned about a recent interaction they had shared with you. They experienced a number of things that made them feel uncomfortable and as a result they are afraid at times to call you to update you on your patients’ status. They felt that you had loudly made personal attacks by telling them that ‘they always call you about trivial things,’ you interrupted them when they attempted to respond, and you gave them a Mad Dog Look.”
In these situations, you’ll want to listen closely to the physician’s response, because as I wrote previously, you will lose your credibility if you pounce on the basis of an incomplete report. No doubt the physician’s experience was also negative, and you’ll want to be able to discuss her point of view with the other individuals involved. By addressing valid issues of communication and care, we can make the physician’s job and the patient’s experience better.
In my experience, by avoiding a simple accusation of “yelling,” by using a bit of subtle humor (“Mad Dog Look”), and by listening closely, you can help stop the yelling. Most individuals do not want others to experience them in a negative way. Most want to do a good job, and they want to take excellent care of the patient. You can help them find that insight.
Later That Day…
It’s time to put my daughters to bed.
I tell my six-year-old daughter, “Time to go to bed, honey.”
She screams, “Dad, I know! Stop yelling at me!”
And then there are those times when you’ve asked someone to do something that she doesn’t want to do. Yelling.
Things You Can Do Now
Read Nonviolent (Empathic) Communication for Healthcare Providers. It will teach you how to facilitate the flow of information so that you can help your colleagues work cooperatively and resolve differences effectively.