Words can shape our perceptions and influence emotions. They can connect us with others or separate us. While words have definitions, their impact is influenced by the context in which they are used and the context of the listener. I had several recent experiences that remind me of the importance of words and context—and how easily our words can be misunderstood or evoke different feelings depending on the listener and their context.
During one of our planning calls for the 2024 Annual Meeting, we discussed strategies for involving our past presidents and other prominent leaders from SGIM and ACLGIM. Every time someone said, “senior leaders” or “senior members,” they would look at me and quickly correct themselves to say, “later career.” I was never offended, especially in the context of SGIM and our leaders who have done so much for us and had significant impact on clinical care, education, and research. It also doesn’t bother me to be referred to as senior, but I have friends who bristle when someone alludes to their age. I also mistakenly used the term abrasive to describe a communication style when I should have used other descriptors. I did not realize that in the context of the individual’s background that abrasive had negative personality connotations, which was not the message I wanted to communicate. I am thankful they felt comfortable pointing this out and helping me understand their context.
This month, SGIM announces the Council’s decision to hold the 2025 Annual Meeting in Hollywood, Florida, as planned several years ago. (See the CEO Q&A column in this issue of the Forum for a description of their work.1) My recent experiences, as well as national and international events, caused me to reflect on the communication skills we will need when discussing this decision. The SGIM Meeting Site Selection Workgroup did extensive work to understand the perspectives of our members in Florida and perspectives of members who feel strongly that SGIM should not meet in Florida, a state with laws that run counter to SGIM’s vision and values,2 or have fears for their safety.
How we talk with each other about our views and values regarding this decision will be important. We are a diverse professional society; yet, we have much in common. I hope we can find common ground and support each other no matter what our views are about the 2025 Annual Meeting. We need to use the communication skills we teach our trainees to be sure we understand the views and context of those with whom we may not agree.
A general model for communication skills, which I learned, is likely familiar to many of you: the Three Function Model of the Medical Interview.3 Although developed to guide interactions with patients, it is useful in other areas. The skills I find most helpful and use frequently are grouped into two functions: 1) information gathering to build understanding and 2) rapport development to build relationships.
Information-gathering skills promote understanding of another person and their perspective. The skill is in using them at the right times in a conversation. They include the following:
- Using focused open-ended questions. This question format invites individuals to share their viewpoints and experiences about something specific (e.g., “Tell me about your concerns,” or “past experiences,” or “goals in doing…”).
- Facilitation. This technique encourages individuals to expand on what they said and maybe offer new insights (e.g., “Tell me more about…” or “Help me understand…”).
- Surveying. These questions probe to determine if there are other potentially related issues underlying a viewpoint (e.g., “What else are you concerned about?”).
- Summarizing. Providing a summary of what you heard, lets others know that you heard them and gives them the opportunity to correct any misunderstandings (e.g., “Let me make sure I understand what you just told me… [give a brief summary of what you heard]”).
Rapport-development skills strengthen relationships because they let people know that you heard them and want to be engaged. These skills include the following:
- Reflection. The intent of reflection is to recognize the feelings underlying a viewpoint or experience in a non-judgmental manner (e.g., “I can see you really care about…” or “this issue really worries you…”).
- Support. These statements acknowledge diverse experiences or viewpoints and end with the common ground you may share or the value the relationship (e.g., “I want you to know that although we don’t agree on this, I am here as your colleague, friend, etc.”).
- Partnership. Fostering a sense of partnership helps build bridges and understanding (e.g., “Let’s work together on… [the areas where you agree with each other]”).
- Respect. Statements that show respect for another person, even though you do not agree on a viewpoint, foster cooperation, and promote positive interactions. Finding something you respect about someone deepens your understanding of them and helps you maintain a positive relationship. Ruth Bader Ginsburg and Antonin Scalia maintained a friendship built on finding common ground and respect, even though they often ended up on different sides of Supreme Court decisions4 (e.g., “I’m impressed by how well you’ve…” or “You really care about…”).
I recently had the opportunity to use these skills when in Celina, Texas, to help my brother who was hospitalized. My brother and I joke about our differing views. I’m his bleeding-heart, liberal, doctor sister, and he is my fiercely independent, conservative brother who raises cattle in Texas. We often agree to disagree and respect each other’s hard work and commitments to improve the lives of others, each in our own way.
How we talk with each other about the 2025 Annual Meeting will matter. Effective communication facilitates meaningful dialogue, encourages empathy, and lays the groundwork for finding commonalities that can unite and move us forward despite different viewpoints. Although there may be times when we must agree to disagree, we will continue to work together and support each other. Dr. Jada Bussey-Jones, our President-Elect, and her Annual Meeting Committee will work with SGIM members over the coming year to understand what you would like to see and do during the 2025 meeting in Florida. Please contribute your ideas and be a part of the planning!