Effective Communication in Healthcare: Why It Matters
This is why effective communication in healthcare is more than a courtesy: it decides whether the right information reaches the right person in a way they can trust.
Why Effective Communication in Healthcare Makes or Breaks Care
The phone call I still think about happened during COVID. I was sitting in a small office tucked behind a conference room. The door was closed, the chair was broken, and the window looked out on a clear blue sky that seemed to belong to a different world. On the speakerphone was a family whose loved one was intubated, unresponsive, and dying under my care.
I explained what the disease had done and what I expected to happen next. They questioned the diagnosis. They questioned the treatment plan, citing what they had read online. Then they questioned my credentials. I answered with evidence, and I answered with as much patience as I had left. None of it reached them.
I knew the medicine. What I could not do on that call was build enough trust for the medicine to matter. That gap is where healthcare is won or lost, and it is far bigger than one family or one pandemic. This is why effective communication in healthcare is more than a courtesy: it decides whether the right information reaches the right person in a way they can trust.
Why effective communication in healthcare matters: the cost of getting it wrong
We tend to talk about communication in healthcare as a soft skill. The data says otherwise. The Controlled Risk Insurance Company, known as CRICO, is the malpractice insurer owned by and serving the Harvard medical community. In a report released in 2016, its research division analyzed 23,658 malpractice cases filed across the country between 2009 and 2013. The analysts found that communication failures were a contributing factor in 30 percent of those cases. Those cases included 1,744 deaths and an estimated $1.7 billion in malpractice costs. The report named heavy workloads, hierarchical workplace culture, cumbersome electronic health records, and constant interruptions as barriers to communicating well. Because the study counted only malpractice claims, the true toll is likely higher.
Those failures run in two directions. They happen between clinicians and patients, like the call I just described. They also happen between clinicians, when a nurse hesitates to call a physician, when a resident stays quiet on rounds, or when a handoff drops one critical detail. Both kinds come back to the same root. People speak up and listen well only when the relationship can hold the weight of the conversation.
Communication is a leadership practice
Most of us were trained to treat communication as the delivery of information. We learn to present the case, explain the plan, and answer questions. That model assumes the other person already trusts us. When trust is missing, more information does not fix the problem. Often it makes the other person dig in harder.
I have come to see communication as a discipline that leaders practice rather than a personality trait they either have or lack. Some of us are naturally warm and some of us are naturally direct, and neither style is enough on its own. What matters is how deliberately we build understanding and how carefully we introduce challenge. Two frameworks from Self-Awareness and Trust give that practice a structure.. They are also practical strategies for effective communication in healthcare that you can start using this week.
SHARE: Communicating when nobody has the answer
COVID taught me that certainty is a poor foundation for leadership. Some of my best days in that ICU were the days my infectious disease colleagues rounded with me. We thought out loud together, challenged each other, and sometimes changed our treatment plans from one day to the next as new data emerged. Those conversations reminded me what good medicine sounds like when the answers are still being written.
The SHARE model grew out of those days:
- Shift from certainty to shared thinking.
- Hold space for uncertainty.
- Amplify other perspectives.
- Reveal your reasoning.
- Evolve decisions openly.
When leaders reveal their reasoning, people can follow the logic instead of simply obeying the conclusion. When decisions evolve in the open, a change of course reads as learning rather than weakness. As I wrote in the book, we are not changing our minds. We are updating them.
CLEAR: Communicating across disagreement
The second framework addresses the moments when people see the same situation very differently. CLEAR offers five behaviors for staying in those conversations:
- Create psychological safety.
- Listen actively.
- Establish common ground.
- Adjust your thinking.
- Respond skillfully.
Everything starts with safety. Amy Edmondson describes psychological safety as a shared belief among team members that the team is safe for interpersonal risk taking. A room can be perfectly polite and still completely unsafe. If people feel safe only when they agree, what you have is compliance, and compliance is exactly what keeps a nurse silent when something looks wrong.
Common ground is the step leaders skip most often. On that COVID call, the family and I wanted the same thing. We both wanted their loved one treated with dignity and spared as much suffering as possible. I never said that out loud. Naming the shared goal would not have erased our disagreement, but it would have given us a place to stand together while we worked through it.
Strategies for effective communication in healthcare: What to do on Monday
Frameworks only matter if they change what we do in the next hard conversation. Three practices are a good place to start.
First, name the shared goal before you name the problem. Saying "We both want your mother to be comfortable" or "We all want this unit to be safe" turns the conversation from a contest into a collaboration.
Second, say your reasoning out loud, including what you do not know. People trust leaders who show their work far more than leaders who only announce conclusions.
Third, ask one genuine question and let the answer change something. If nothing you hear could ever alter your plan, the other person will feel it, and they will stop talking.
Effective communication determines whether patients believe us, whether teams speak up, and whether the evidence we work so hard to gather ever reaches the people it is meant to help. That is why it makes or breaks healthcare.
One question worth sitting with: Think of the last conversation at work that went badly. What goal did you and the other person actually share, and did either of you say it out loud?
Practice these skills with your team
If you want your team to turn these practices into habits, physician communication skills training gives them a place to rehearse the hard conversations before they happen. I offer it through keynotes and workshops for healthcare organizations and conferences, and one on one through executive coaching for healthcare leaders. You can also start with my free resources or read the book.
Jess Bunin, MD
Jess Bunin, MD, MHPE, is a critical care physician, retired Army Colonel, executive coach, and professional speaker. She works at the intersection of leadership, trust, and communication in healthcare and academic medicine. She is the author of Self-Awareness and Trust: Leading Healthcare Teams from the Inside Out.