Think Deeply, Write Clearly: Why Communication Matters with Brian Morgan | Episode 58

In Episode 58 of The Healthcare Leadership Experience, Lisa Miller and Brian Morgan, CEO and Founder of Think Deeply, Write Clearly explore the impact of the written word and what it means for healthcare. 

Episode Introduction

In this episode, Lisa Miller, Managing Director at SpendMend, interviewed Brian Morgan to learn more about the principles and mission of Think Deeply, Write Clearly. Topics include the impact of language and communication on business credibility, why comprehension of the written word belongs only to the reader, how better communication could improve healthcare, and why innovation isn’t always exclusively about technology. 

Show Topics

• Why we’re good at writing, but terrible at thinking for writing
• Solving the challenges in the drafting stage
• Comprehension belongs to the reader alone
• Communication at discharge is a big challenge for hospitals 
• Treating patients as more than a transaction
• Our default position is to protect ourselves
• The impact of hospital bills 

Main Topics

06:24 Why we’re good at writing, but terrible at thinking for writing. 

Brian explained how the language and communication we use can create a business credibility or cultural problem. 

‘’…..we can run through life where we have provable statements that are not useful statements. And we aren’t very good at saying, “Well, wait. What is this problem in its entirety? What are all of the factors that go into that problem? What are all the factors that go into that decision? And then, how do we curate all of that information down to show not what we believe, but why we believe that to be true and a trustworthy decision for you?” And that would be the same in real estate as it would be in a hospital as it is for somebody working on their marketing or anything else. How do we create trustworthy conclusions, where people see the transparent assessment as opposed to hide the transparent assessment because there’s a certain amount of data that is not realistically supporting facts….there are cultural ramifications for this. And so I would say as a rule, we have not treated language and writing and communication with nearly the business credibility problem that it creates or the economic problem that it creates, and certainly, the cultural problem that it creates…We’re very good at writing, but we’re terrible at thinking for writing. So I decided to take that on.’’

09:30 Solving the challenges in the drafting stage

Brian noted that templates must help people think well, rather than short-cut the critical thinking process. 

‘’…there are a ton of factors that go into that drafting stage that we hardly ever talk about, and many of them are just business process communication things. For instance, what would normally happen is somebody says, “Well, we have a template for that.” And so we say, “Well, okay. That’s fine. Let’s grab the template.” And the template is going to say something like “insert site description here.” Well, there’s a lot of ways you can write a site description. And the client wants it a certain way, and somebody who’s been in the business for six months who’s drafting this document because they’re inexpensive and we think that that’s the way to use money and usability well, is to have that person draft the document. And that person drafts it the way they want it. And now the manager and the editor are going to spend a ton of expensive time fixing that and reframing that site description. And so, all of a sudden we’re at, “Well, now we have to talk about factors and we have to talk about checking in and we have to talk about are these templates actually helping people think critically about the problem, or are these templates just rote things that we say, ‘Well, if you follow this, everything’s going to be fine.'” And if you asked any company across this country, they would all say, “Our templates are not helping people think well. We’re trying to shortcut critical thinking with our templates and it shows up in the end product, that we have a short-cutted critical thinking process here.”

14:11 Comprehension belongs to the reader alone 

Brian explained why it is only the reader’s comprehension that matters.

‘’We are writing as if we have to provide the decision-making information. And that is true, except we’re missing one big part of it, which I’m now going to mention. The writer never, ever, ever gets to comprehend for the reader. Comprehension is completely the reader’s. So we can do this with your podcast guest right now, right? So if I say, “Lisa, picture a coffee cup.” You and I are probably going to end up with a very similar image, but I’m not holding a coffee cup and you’re not holding a coffee cup. So what I’m doing is triggering an image that we happen to agree upon for you, but your comprehension is yours. I didn’t tell you what it looked like. I didn’t tell you what it was made of or if it had a handle or didn’t. Your comprehension is completely yours. And so when it’s a coffee cup, it doesn’t matter. Nobody cares. But now, I’m going to say, “Lisa, the most important thing for this particular hospital is that they spend $3.5 million on this initiative.” And now somebody says, “Hey, wait a minute. What’s that coffee cup made of?” Right? And comprehension is theirs, it’s not mine. Now I have an obligation to say not, “This is the right thing for you to do,” ….But I can say, “Let me describe for you how I see the coffee cup. Let me describe for you of what I looked at, all the factors that I looked at, and let me transparently assess all of those factors….We have to understand that they own their own comprehension and we have to respect that. And then, we have to say, “I’ve thought about this problem enough. I’d like to share my thinking on you and this is why I’m suggesting this conclusion.” And they say, “Yes, I think that’s a coffee cup, too.” 

(22:01): Communication at discharge is the most challenging aspect for a hospital

Lisa commented that the point of discharge in hospitals has the potential to be transformational with better communication. 

‘’I think you would just do an amazing job if someone said, “Okay, Brian. Here are our communication points to our patients. We want you to review them.” Often when I have been in the hospital or a family member has been in, sometimes I read things and I’m like, “Oh. This could be just stated better, kinder, or with more detail,” right? Because there’s room for confusion. There’s an interesting aspect to a hospital, where a point of discharge is really the most challenging part. And how they communicate at the point of discharge, even that of itself could be just transformational because that’s where people get confused. They’re not hearing things. But it’s a printout, it’s … a template….

So there are all these areas to how we communicate with patients and there are areas of how we communicate with physicians. We wonder why we can’t get alignment, administrators with physicians, because we’re not communicating well. Sometimes we’ll work with physicians or hospitals to communicate, and we don’t have those same problems because we are thinking deeply… I’m always thinking about putting myself in their position or just providing information in a way to help them make their own decision, not trying to manipulate it.’’

25:50 Treating patients as more than a transaction

Brian shared an experience of ineffective communication in healthcare. 

‘’….I’ll give you a quick sort of related story for a second. I had an ophthalmology appointment last week, and it was very clear to me that these people who’ve been my ophthalmologists for a decade had no… If they wanted me to quit being a client, it was very clear from their communication that they would not mind me quitting being a client. But that was very clear. And it was just the way the forms were written. You’ve got to fill out this form for Covid. You’ve got to fill out, then if you don’t do this, you’re going to owe us a hundred dollars and we’re going to transfer your… We’re going to… All of this stuff. And I’ve been a client there forever. And of course, inside the doctor’s office everything was fine. There’s no problem. But man, were those forms really difficult to read…did I feel like, “Man, I don’t even know if I want to do business with you guys. I don’t feel like a respected client. I feel like a transaction that you’re trying to cover all your bases.” And she’s a great doctor, but….was that a terrible feeling. And so, my sense is that that’s probably happening all throughout the hospital. And so, well, why is that happening? Well, it’s very difficult for us to understand our own subconscious responses to things and to get a hold on them. And so, let’s take my ophthalmology appointment. They were really concerned during Covid that people would cancel and they would be out money and time, and they’ve got to pay their staff. And I understand that and I don’t even mind giving them a credit card. I mind how it was phrased…..But how do I frame this around somebody else’s comprehension so that they understand exactly where I’m coming from and why?’’

29:52 The default position is protecting ourselves 

Brian said our first instinct is always self-protection, which gets in the way of successful communication. 

‘’We are right to protect ourselves. There’s no person on earth who should be running through the planet saying, “You can have my life. I don’t have any value here. And so, just take advantage of me.” … The problem is, without the ability to protect ourselves with nuance and with nuanced understanding and with a well-observed, then it’s going to come out fast. And Danny Kahneman’s terrific book, Thinking Fast and Slow, is about this. We work a lot with lawyers, right? Because lawyers end up writing contracts (that) deal with these issues. And so, in essence, what we end up saying is, “I’m going to write this as a document that protects myself. And because I need that so much, I don’t even care how you read it.” And so, I just made you a transaction. I don’t want to make you a transaction. I just made you one. And we do this in every aspect of our lives….We have a default to protect ourselves. And then, the question I think becomes, how do we show the transparent need to protect ourselves and understand somebody else’s comprehension at the same point? And now we don’t have to battle with it. We can come on the same decision space. We can say, “This is how I’m seeing the coffee cup. How are you seeing the coffee cup?” ‘’I’d really like to see the bill in the next couple of minutes if that’s all right.” And the person says, “I’m really sorry for that. Of course, yes.” Let’s do that. Okay. And so, we can get on the same page, but it’s not going to be our first instinct, because our first instinct is going to be self protection.’’

36:15 The impact of hospital bills.  

Lisa highlighted hospitals bills as a potential area to improve patient communication. 

‘’If you think about it, it’s so impactful, right? Everything from marketing to internal communication to internal influence to communications with patients, to even as they leave the hospital and transition even to post-hospital, patient gets a bill, right? And we are in a time where collections and billing is going to be somewhat problematic because of inflation, because of everything that’s going on. And I’ve often thought, “There’s got to be a transformational way to have these bills go out.” Now you see hospitals getting a little gentler. But I’ve thought, “Wow. If somebody only spent time putting together this letter, a series of letters and put, like you said, they protect the hospital, but they’re looking at it from the patient perspective, I bet you they would increase their collections.”

Show Links

Connect with Lisa Miller on LinkedIn

Connect with Jim Cagliostro on LinkedIn

Connect with Brian Morgan on LinkedIn

Check out VIE Healthcare and SpendMend 

You’ll Also Hear:

Brian’s background as Managing Editor of New York City’s premier planning and environmental firm for 16 years, the $2 billion cost of writing documents and why the issue arose from thinking, not writing. ‘’The language was not representative of the quality of the thinking and that was very expensive.’’

The importance of critical thinking in producing a document. ‘’It’s very easy to produce a document inexpensively. It’s very difficult to produce a well thought through document without a critical thinking process involved in that.’’ 

Taking inspiration from Yuval Noah Harari’s book, Sapiens, and why a piece of writing is not just transferring information, or ‘’hey, there’s food on that tree.’’ 

It’s not always about the latest technology: understanding how innovation can take communication to a different level. 

Why the depth of thinking around a problem and our ability to frame around that depth results in conversational, economic, and business influence power. ‘’My sense is that we miss that culturally, but it’s probably the most important thing in terms of actually getting things done and getting them done efficiently.’’

What To Do Next:

1. Subscribe to The Economics of Healthcare and receive a special report on 15 Effective Cost Savings Strategies.
2. There are three ways to work with VIE Heathcare:

• Benchmark a vendor contract – either an existing contract or a new agreement.
• We can support your team with their cost savings initiatives to add resources and expertise. We set a bold cost savings goal and work together to achieve it. 
• VIE can perform a cost savings opportunity assessment. We dig deep into all of your spend and uncover unique areas of cost savings.

If you are interested in learning more, the quickest way to get your questions answered is to      speak with Lisa Miller at lmiller@spendmend.com or directly at 732-319-5700

Episode Transcripts

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Brian (00:00): We can run through life where we have provable statements that are not useful statements, and we aren’t very good at saying, “Well, wait. What is this problem in its entirety? What are all of the factors that go into that problem? What are all the factors that go into that decision? And then, how do we curate all of that information down to show not what we believe, but why we believe that to be true and a trustworthy decision for you.” And that would be the same in real estate as it would be in a hospital as it is for somebody working on their marketing or anything else. Introduction (00:38): Welcome to The Healthcare Leadership Experience Podcast, hosted by Lisa Miller and Jim Cagliostro. Lisa is the founder of VIE Healthcare Consulting and now Managing Director at SpendMend. Lisa and her team has generated over $1 billion in financial improvements for VIE’s clients since 1999. Since 2007, Jim has been a registered nurse working in critical care, perioperative services, and outpatient settings at nationally-recognized medical facilities across three states. You’ll hear conversations on relevant and trending topics in healthcare and much more. Now, here’s your hosts, Lisa and Jim. Lisa Miller (01:18): This is Lisa Miller, and I’m the host of The Healthcare Leadership Experience. And today, I am very honored and excited to have Brian Morgan today on our podcast. And I think everyone’s going to just get a massive amount of insights and come away with such, I think, tremendous new thinking on the value of writing and communication. So, Brian is the CEO and founder of Think Deeply, Write Clearly. Welcome, Brian, to The Healthcare Leadership Experience. Brian (01:55): Thank you so much, Lisa. It is awesome to be here with you. I have loved our several conversations so far and I’m really honored to be introduced to your group. Thank you for this invite. Lisa Miller (02:07): Great. Well, I’m going to give everybody a little intro to our work and then we’re going to jump in and hear about you. I met Brian this year. We’ve worked together for a few months, and I am a fan of thinking and writing and always looking at ways to do that better. And so, when I came across Brian’s work, I just was super excited about it. Lisa Miller (02:31): And he’s got a lot of different aspects and approaches and methodology. He even has a course he’ll talk about at the end. But one of the things that he’s pushed me to do, which I love, is the nuances in our thinking. So, you may have a point, and that point may be extremely relevant, but there’s nuances to it, and those nuances is really critical. Lisa Miller (02:55): So, I am not going to share much more, with the exception of that his expertise and his advisory and his coaching has made my writing better. I’m looking for that to continue, but he has certainly had a big impact on my writing and I appreciate that, Brian. So can you give everybody your backstory about you and then how you started and why you started Think Deeply, Write Clearly? Brian (03:21): Sure. And I actually really appreciate the frame there that you set. So let’s take this idea of nuance when we tell this backstory, because I think that’s really maybe even the core of it. And so, I was the Managing Editor of New York City’s premier planning and environmental firm for 16 years. And so, we did Moynihan Station, we did Grand Central Station rezoning, we did the World Trade Center. Every major project in New York for a generation went through that building. Brian (03:52): And what would happen eventually is that there was so much time being spent on editing documents that the powers that be kind of went, “Hey Brian, can you stop?” I was also teaching writing in colleges and they knew that, and, “Can you stop editing documents and start teaching writing here, because this is really costly to have every time we write a document, somebody’s got to spend $2 billion and nobody is writing at the level that anybody is comfortable spending $2 billion until it goes through so many hours of management rewriting the darn thing.” And so, the language was not representative of the quality of the thinking and that was very expensive. And so, they said, “Can you manage that?” And I said, “Well sure, except this is not a writing issue. This is a thinking issue and it’s showing up in the writing.” And they sort of went, “Well, however you want to handle it, that’s fine.” Lisa Miller (04:50): Yeah. “That’s your problem. Go ahead and fix it.” Brian (04:54): And what’s fascinating to me about that, and I think this is probably across many, many businesses, this is every business I’ve ever worked for. We have wonderful corporate clients and other clients. These are people who went to Harvard. These are people who went to MIT. These are people who went to Columbia. This is not a group of people where you would say, “Man, those people don’t know how to write.” And they do know how to write, but what we don’t know how to do is transfer credible information inside somebody else’s attention span. We’re not good at doing the thinking before the writing, and what are the parameters of framing information so that when somebody gets that document, they say, “I can trust the conclusion of it.” Brian (05:36): And if you forgive me going 30 seconds more, I do teach in colleges. And if you’re asking me, the colleges don’t help, they hinder this process. They make it worse, because the college is in essence saying, and high schools do this, too, they in essence say, “Well, what’s your conclusion? What are you trying to prove?” And somebody says, “Oh, I don’t know. I’m trying to prove that jelly beans are healthy food.” And they go, “Well, can you get data for that?” Well, you can because certain this and that, if you look at it in a certain way and you look at sugar in a certain way and you look at the liver in a certain way, maybe the liver needs a certain amount of sugar or the blood needs a certain amount of sugar. And you can go ahead and prove that with data. It’s just not useful information that somebody else can make a decision on. Brian (06:24): And so, we can run through life where we have provable statements that are not useful statements. And we aren’t very good at saying, “Well, wait. What is this problem in its entirety? What are all of the factors that go into that problem? What are all the factors that go into that decision? And then, how do we curate all of that information down to show not what we believe, but why we believe that to be true and a trustworthy decision for you?” Brian (06:55): And that would be the same in real estate as it would be in a hospital as it is for somebody working on their marketing or anything else. How do we create trustworthy conclusions, where people see the transparent assessment as opposed to hide the transparent assessment because there’s a certain amount of data that is not realistically supporting facts. Brian (07:16): And so, there are cultural ramifications for this. And so I would say as a rule, we have not treated language and writing and communication with nearly the business credibility problem that it creates or the economic problem that it creates, and certainly, the cultural problem that it creates. Because a lot of this problem is being brought forth in far left media or far-right media or our inability to have reasonable conversations at Thanksgiving dinner. And it’s all the same process. It’s all the same problem. We’re very good at writing, but we’re terrible at thinking for writing. So I decided to take that on. Lisa Miller (07:55): Yeah. So that is such a fascinating story and nuance, but I still want to hear a little more of your story. You worked for a company and you were doing so much rewriting that they said, “Wait a minute. You’ve got to go and teach this. This has to become a capability. This is not working. If our people don’t have the thinking capability and the writing capability, this isn’t going to help us transform or it’s not useful. It’s great you’re doing it, but we need to extrapolate this out and you’ve got to show us all how to think and write.” Brian (08:28): That’s correct. Lisa Miller (08:29): Somebody was very smart to catch that, I have to say. Brian (08:34): Well, it was, you couldn’t not catch it, right? Lisa Miller (08:36): Right. Brian (08:37): Because it was in the billing, that in essence, it was a very good consulting firm and it had a lot of big clients. And so, when somebody who is, let’s just say an urban planner or an engineer or something, and they are presenting a document and you put 80% of the budget of the document into that, you don’t anticipate spending another 50% fixing that language, of that time, right? Lisa Miller (09:05): Yes. That’s so interesting. Brian (09:06): You hope that the 20% that’s left is… And then, you’d realize that, “Wow. Nobody could take this document in its current form and make a decision on it, and that’s what we need.” And so, the editorial team would fix it and that would be expensive. And then, they’d say, “All right. Then the issue is not hire more editors. The issue is, let’s solve this in the drafting stage.” Brian (09:30): And what gets interesting about that is that there are a ton of factors that go into that drafting stage that we hardly ever talk about, and many of them are just business process communication things. For instance, what would normally happen is somebody says, “Well, we have a template for that.” And so, we say, “Well, okay. That’s fine. Let’s grab the template.” And the template is going to say something like “insert site description here.” Well, there’s a lot of ways you can write a site description. And the client wants it a certain way, and somebody who’s been in the business for six months who’s drafting this document because they’re inexpensive and we think that that’s the way to use money and usability well, is to have that person draft the document. And that person drafts it the way they want it. And now the manager and the editor are going to spend a ton of expensive time fixing that and reframing that site description. Brian (10:31): And so, all of a sudden we’re at, “Well, now we have to talk about factors and we have to talk about checking in and we have to talk about are these templates actually helping people think critically about the problem, or are these templates just rote things that we say, ‘Well, if you follow this, everything’s going to be fine.'” And if you asked any company across this country, they would all say, “Our templates are not helping people think well. We’re trying to shortcut critical thinking with our templates, and it shows up in the end product, that we have a short-cutted critical thinking process here.” Brian (11:04): And then, we say, “Well then, what’s the process that the company is going through to ensure critical thinking?” And it’s like, “Well, we don’t have one of those.” And most people don’t. And so, that’s really what we installed at that firm. And then, we’ve installed it across really every client that we’ve worked with since then. And that’s the game. The game is not, “How do you produce a document?” It’s very easy to produce a document inexpensively. It’s very difficult to produce a well-thought through document without a critical thinking process involved in that. Lisa Miller (11:34): I really loved… You said a lot of things and I want to just unpack some of them. I do believe we do shortcut critical thinking and we do it for a number of reasons. We think we can templatize or make it like an assembly line. And certainly, there’s some things you can do in business, but writing or thinking, really, about what you’re writing and what you want to communicate for the audience and putting it together in a way that gets that reader to understand, like you said, whether there’s decisions to be made or understanding the makeup or what’s going on, that’s completely different. Lisa Miller (12:11): And it’s funny, because we have some client documents at my company, different from kind of the work that you and I are doing about writing, and now you’ve got me thinking about them as you were talking. But typically, any kind of client-facing documents that give a summary report, I would be the last pass. And my team has gotten really, really good now. We buzz along and it’s just minor things, because I want them to be able to do it, but it’s nice to have that quick pass, right? Lisa Miller (12:43): But when I’m reading, I’m often thinking, because I know the situation or what we’re doing on my consulting projects, “What do they really need to understand?” And those thoughts are going through my head. “Are we really communicating the core elements? Are we communicating what they need to be thinking about, their decisions, next steps?” So it’s not an informational document that’s just kind of rote or templatized like you talked about. I’m always thinking, “These are things that they need to think about or decide on, so we’ve got to write it in that way.” And I believe that’s what you’re saying. We’ve got to be writing a little more carefully, thoughtfully. It’s intentionally, right? And so, you’ve got me thinking about some internal documents that I want to also re-evaluate. Am I correct in that way that there’s almost a different view in how we think first and then write? Brian (13:40): You are saying it perfectly, and I would go just one step further with it, which is, here’s what I’m hearing you say. We are writing as if we have to provide the decision-making information. And that is true, except we’re missing one big part of it, which I’m now going to mention. The writer never, ever, ever gets to comprehend for the reader. Comprehension is completely the reader’s. Brian (14:11): So, we can do this with your podcast guest right now, right? So, if I say, “Lisa, picture a coffee cup.” You and I are probably going to end up with a very similar image, but I’m not holding a coffee cup and you’re not holding a coffee cup. So, what I’m doing is triggering an image that we happen to agree upon for you, but your comprehension is yours. I didn’t tell you what it looked like. I didn’t tell you what it was made of or if it had a handle or didn’t. Your comprehension is completely yours. Brian (14:44): And so, when it’s a coffee cup, it doesn’t matter. Nobody cares. But now, I’m going to say, “Lisa, the most important thing for this particular hospital is that they spend $3.5 million on this initiative.” And now somebody says, “Hey, wait a minute. What’s that coffee cup made of?” Right? Lisa Miller (15:01): Mm-hmm. Mm-hmm. Brian (15:01): And comprehension is theirs, it’s not mine. Now I have an obligation to say not, “This is the right thing for you to do,” because I’m never going to be able to comprehend for them. I’m never going to be able to say, “This is the right thing for you to do.” But I can say, “Let me describe for you how I see the coffee cup. Let me describe for you of what I looked at, all the factors that I looked at, and let me transparently assess all of those factors.” And you can then say, “That’s why we paid you, because we paid you to think about this more thoughtfully, more deeply, with more time than my staff could possibly do.” Lisa Miller (15:40): Absolutely. Brian (15:41): “And with expertise. Therefore, I trust your decision.” But I have to then know that I have to give them all of the key data points that they are looking for, and that it’s ultimately their decision. And what happens when we teach writing the way we do or we see writing modeled the way we do in our culture is that we think our job is to manipulate people to see things our way. And that is nonsense. We have to understand that they own their own comprehension, and we have to respect that. And then, we have to say, “I’ve thought about this problem enough. I’d like to share my thinking on you and this is why I’m suggesting this conclusion.” And they say, “Yes, I think that’s a coffee cup, too.” So, I think the minute we add comprehension to that discussion, we’re now starting to look at it in a way where people say, “Okay. We haven’t been doing that,” because almost nobody has been doing that and it’s rarely, rarely discussed or taught in our culture. Lisa Miller (16:43): That was really brilliant. I’m not only going to replay that, I’m going to transcribe it and read it several times. Well said, Brian, as usual. Lisa Miller (16:52): So, let’s talk about why. I think you did a little bit, like why it matters, right? Is there any other aspect of why this matters, right? I think you made a solid point that comprehension is individual. And giving somebody the view that, “I’m the expert. I’m putting this together. I’m giving you all the information. At the end of the day, you’re the decision maker.” That’s a philosophy I’ve always believed in. We are here to provide deep expertise and then ultimately, our clients make those decisions. But the better we can pull that information together for them and give them all the views, that’s my job. So, I think you’ve touched on why that matters there, but I would imagine, knowing you, there’s more. Brian (17:38): Yeah, let’s go deeper, and let’s go even further into the past because this is what we miss. I think right now because we have such terrible conversations about writing and communication and it is so terribly modeled throughout our culture, including in colleges, which I despise, but it’s reality, let’s go even further back. Right now, we seem to think culturally that a piece of writing’s job is to transfer information to somebody else. If I had to generously say what’s happening, you can go even further and say to transfer an opinion to somebody else, which is probably more likely, but let’s be generous and say to transfer information to somebody else. Okay. That’s not why we started talking to each other. That’s not why human beings started writing things down. And it’s not why human beings started having conversations with each other. Brian (18:28): And so, my favorite illustration of this is from Yuval Noah Harari’s book, Sapiens, which is a wonderful book. And he talks about one-on-one, Neanderthals would kick the crap out of us if we were simply at, “Hey, I’m going to get the food on that tree,” or “You’re going to get the food on that tree.” Us against the Neanderthals, they’d kick the crap out of us one-on-one. But 100-to-100, we beat them, which is why we have universities. That’s what did it for us. Brian (19:01): So, it’s not just transferring information. It’s not just, “Hey, there’s food on that tree,” right? “Oh, thanks for telling me that,” right? Because it’s the ability to collaborate and make decisions about the fact that there is food on that tree and that there is competition for that tree and that there are environmental factors around that tree and that there are… Brian (19:21): And so, we have to look at all of those factors and make decisions for it. And so, we don’t have language to transfer information. We have language to transfer information as it relates to making human and business decisions. And we miss that. And because we miss that, we have people say, “Well, it doesn’t really matter if we have good writing in this organization. It doesn’t really matter if we get the information transferred very effectively or ineffectively.” Brian (19:56): And that is complete nonsense. The only reason the human being is such a successful animal on the planet is because we understand the ability of transferring information as it relates to decisions. And so, because we miss that, we don’t practice it and then we end up with marketing that does not work. And we end up with businesses spending a ton of money. And the only people who are effective in a business are people who’ve got a lot of experience and they happen to have decent instincts for communication. Brian (20:28): And people say, “Well, you can’t teach that,” which is nonsense. You can teach that, but the colleges didn’t teach it and the businesses don’t teach it, so it’s not taught. But that doesn’t mean it can’t be taught. And the minute we say it can be taught, we say, “Well, how come every business in the country isn’t teaching it?” And I agree with you. How come every business in the country isn’t teaching it? Because it’s probably the single most important thing that a business can do, or a human can do. “What is the information you need that I can help you provide to help you make a credible decision that helps your field go forward, that helps your business go forward, that serves your community?” That’s why we have language, and we miss it. And the colleges miss it, and so that’s what we’re trying to bring back into the conversation. Lisa Miller (21:15): Yeah, it’s fantastic. So, I love how you did go deeper. And before we get to hospitals, I want to add a preview on that. You mentioned marketing, which is really at the end of the day how we communicate with patients or prospective patients, right? And so, I think hospitals can do a vastly better job. And it’s not critical, it’s just improvement. I need to do a vastly better job at writing. I think you said earlier, this is a whole field where there needs just a complete elevation. We need to communicate with patients that are prospective patients. That starts from the marketing, but it starts even when they enter into the journey into the hospital. How are we communicating? How do we think about that, right? Lisa Miller (22:01): I think you would just do an amazing job if someone said, “Okay, Brian. Here are our communication points to our patients. We want you to review them.” Often when I have been in the hospital or a family member has been in, sometimes I read things and I’m like, “Oh. This could be just stated better, kinder, or with more detail,” right? Because there’s room for confusion. There’s a interesting aspect to a hospital, where a point of discharge is really the most challenging part. And how they communicate at the point of discharge, even that of itself could be just transformational because that’s where people get confused. They’re not hearing things. But it’s a printout, it’s like you said, a template. And even at that point, and I’m just going to make one last point and I want to kick it over to you. Lisa Miller (22:50): So, there’s all these areas to how we communicate with patients and there’s areas of how we communicate with physicians. We wonder why we can’t get alignment, administrators with physicians, because we’re not communicating well. Sometimes we’ll work with physicians or hospitals to communicate, and we don’t have those same problems because we are thinking deeply about… I’m always thinking about putting myself in their position or just providing information in a way to help them make their own decision, not trying to manipulate it. Lisa Miller (23:23): So it’s physicians, it’s business cases, right? It’s department leaders, it’s to the board, but it touches so many aspects for our hospital. So I’m going to now kick it off to you with one last kind of funny thing is, we think emails, emails could be a good form of communication, but we’re so thoughtless. And I’m probably going to be controversial, but it’s okay. When I see an email that starts with, “Hey,” it just drives me crazy. It just does. My team knows do not send an email to me or any of our clients that begin with, “Hey.” I’m sorry, it’s a pet peeve. Maybe it doesn’t matter. But I just feel it’s not representative of somebody who’s going to, like you said, want to be taken seriously or we’re an expert, start that way. And maybe I’m a little too picky, but I think the conversation is around all these touchpoints in a hospital, Brian. What are your thoughts about what I just said, other than, “Hey”? Brian (24:28): I love it. Well, I’m now going to have to go back to my emails to you. I’m sure that I’ve messed that up at one or two points in the past. I’ll be very cautious of that in the future. Thank you for letting me know. Lisa Miller (24:39): I drive my team crazy. I’m just like, “Hey, really?” I’m sorry. But look, you’re brilliant at writing, so clearly, I may be wrong in that to say something like that. Brian (24:53): I don’t know that you are. I don’t think you are. I think different tones work for different people. Lisa Miller (25:00): Yeah. Brian (25:00): But good for you. Here’s what I would say to the larger issue, and you’re really hinting at something wonderful. Here’s my sort of high-level view. Doctors are deep experts in their space, and nurses are deep experts in their space, and hospital administrators are deep experts in their space. And so, much of what transfers between people who are deep experts but are not taught language in any detailed way is subconscious. And that is a communication problem. And it’s often, you used the word around the discharge rude, or at least that’s what was inferred. It’s rude or it’s difficult to read, and there’s a- Lisa Miller (25:49): It’s cold. Brian (25:50): It’s cold. Yeah, that’s a good word. And so, I’ll give you a quick sort of related story for a second. I had an ophthalmology appointment last week, and it was very clear to me that these people who’ve been my ophthalmologists for a decade had no… If they wanted me to quit being a client, it was very clear from their communication that they would not mind me quitting being a client. But that was very clear. And it was just the way the forms were written. You’ve got to fill out this form for Covid. You’ve got to fill out, then if you don’t do this, you’re going to owe us a hundred dollars and we’re going to transfer your… We’re going to… All of this stuff. And I’ve been a client there forever. And of course, inside the doctor’s office everything was fine. There’s no problem. But man, were those forms really difficult to read. Holy crap, did I feel like, “Man, I don’t even know if I want to do business with you guys. I don’t feel like a respected client. I feel like a transaction that you’re trying to cover all your bases.” Lisa Miller (26:51): I’d say transaction. You were treated like a transaction. That’s a really great word. Brian (26:56): Yeah. And of course, in the doctor’s office, I was not treated like a transaction at all. I’ve been there for a decade. Lisa Miller (27:01): Yeah. Brian (27:02): High-fived, we had fun. Lisa Miller (27:05): Nice. Brian (27:05): And she’s a great doctor, but holy crap, was that a terrible feeling. And so, my sense is that that’s probably happening all throughout the hospital. And so, well, why is that happening? Well, it’s very difficult for us to understand our own subconscious responses to things and to get a hold on them. Brian (27:25): And so, let’s take my ophthalmology appointment. They were really concerned during Covid that people would cancel and they would be out money and time, and they’ve got to pay their staff. And I understand that and I don’t even mind giving them a credit card. I mind how it was phrased. Brian (27:42): And so, there’s a difference between your instinct to protect yourself is good and the language you use to protect yourself is maybe suboptimal. And so, how do we frame this not through my own subconscious reaction to something, which is what they did and what I suspect happens in the hospital and why those discharge forms are difficult, and why many emails are difficult to read and too fast and everything else. But how do I frame this around somebody else’s comprehension so that they understand exactly where I’m coming from and why? Brian (28:15): And sometimes, this is literally my experience. It is 15 words. It’s not a whole document, it’s 15 words fairly early in the document where somebody says, “Thank you for framing it that way.” But we don’t know to do it because we’re reacting subconsciously to things and not consciously to them. So, the minute we say, “Okay, language is a conscious thing,” we’ve got to use it consciously. And we’ve got to understand comprehension, not just what we want to say, but how other people hear it. Now we’re in a position where we can do some pretty fast work and make a lot of progress. Lisa Miller (28:51): So, it’s really interesting what you said, because you were able to see it from two different perspectives, right? You saw it from your perspective and then you were able to see, well, you get it right? Because after Covid, a lot of these, they were afraid of cancellations, but even more so, they needed the money, right? These are places that had dropped in revenue, and they were kind of banking on that schedule. So, if no one showed up, maybe they could backfill it, but their people were trying to get back and fill a gap, a loss. So, you can see it from their perspective, right? Brian (29:21): Certainly. Lisa Miller (29:22): However, wouldn’t have been nice to say, “Listen,” even a preface or why can’t we be vulnerable enough to say, “Listen, we’ve all had some challenging times through Covid. This is why we’re putting this process into place. If you cancel, this creates our losses even further.” How easy is that? But it requires what? To be thoughtful. It requires, I don’t know. What? Why aren’t we doing it, Brian? Why is it so transactional? Why does it feel rushed, cold, indifferent? Why aren’t we being thoughtful about it? Brian (29:52): And we can take this to a hundred levels, but let’s go maybe to the most interesting one. We are right to protect ourselves. There’s no person on earth who should be running through the planet saying, “You can have my life. I don’t have any value here. And so, just take advantage of me.” There’s no person on the planet who should be doing that. And so, we are right to protect ourselves. Brian (30:22): The problem is, without the ability to protect ourselves with nuance and with nuanced understanding and with a well-observed, then it’s going to come out fast. And Danny Kahneman’s terrific book, Thinking Fast and Slow, is about this. We work a lot with lawyers, right? Because lawyers end up writing contracts and things who have to deal with these issues. Brian (30:46): And so, in essence, what we end up saying is, “I’m going to write this as a document that protects myself. And because I need that so much, I don’t even care how you read it.” And so, I just made you a transaction. I don’t want to make you a transaction. I just made you one. And we do this in every aspect of our lives. The bartender behind the bar seems to be a very nice person and doing good job and et cetera, et cetera, et cetera. “Hey, you’re late with the bill. Hey, you’re late with the bill. Hey, now I’m going to be really rude.” Right? Brian (31:27): We do this in every… We have a default to protect ourselves. And then, the question I think becomes, how do we show the transparent need to protect ourselves and understand somebody else’s comprehension at the same point? And now we don’t have to battle with it. We can come on the same decision space. We can say, “This is how I’m seeing the coffee cup. How are you seeing the coffee cup?” Brian (31:49): “I’d really like to see the bill in the next couple of minutes if that’s all right.” And the person says, “I’m really sorry for that. Of course, yes.” Let’s do that. Okay. And so, we can get on the same page, but it’s not going to be our first instinct, because our first instinct is going to be self protection. So that’s where I go with that. It’s probably not a hospital detailed enough conversation, but my suspicion is it’s related. But tell me how you’re hearing that. Lisa Miller (32:11): Oh no, I think you’re spot on. My head is really just kind of spinning about all the places where the hospital can protect themselves and then also kind of put themselves in someone else’s shoes. It was just in my head I was going to all these different places. I think it’s really important, and so much in healthcare is reliant on good communication. And so, it’s such an important space and such an important training that for me, I was just like, “Wait. I never thought of it from that perspective. We do want to protect ourselves, right?” We’re trying to protect our department. For physicians, what they do and how they do it. And so, I feel like it’s so relevant, probably more so even initially when you and I talked about having you on the podcast, I actually think there’s more relevancy. Lisa Miller (33:03): So, Brian, let me ask you a couple of questions. So, I’m going to ask you how you work with organizations. So, explain that process. For someone that now has heard you, and I feel like we could talk for two hours, and I think you and I would enjoy it. I don’t know how much other people might at this point. So how you work with organizations to teach Think Deeply and Write Clearly, but how do you work? Because I’m sure some people are like, “Wow, we could use this here.” And then, how you might work with the hospital. So, I’m kind of throwing both at you, because I would imagine if I’m listening, I’m like, “Okay, I got this. What’s the process? Is he easy to work with?” Brian (33:42): Gotcha. So, let’s start with the easy thing. On my website, which is www.thinkdeeplywriteclearly.com, there’s a “contact us” button, and down at the bottom of page is “contact us.” And it’s easy to get on a phone call with me. My email is bmorgan@thinkdeeplywriteclearly.com. So, it’s easy to get in contact. Brian (34:06): There are several ways that companies work with us. Most of them, but not all of them, go through a process like this. There’s a critical thinking sort of workshop that just opens up and that’s the whole team. That’s however many people you want to stick in that Zoom room or that actual room. That’s the whole team. And that tends to make a lot of progress quickly, because it’s a lot of what we’re talking about today. People say, “I’ve never really thought about it this way before and now I’m going to start thinking about that.” Brian (34:35): Most companies then have people who say, “Listen, management really is dealing with a lot of people, and they really could be presenting their ideas better in some form.” Or management is managing people who are having to present to those people. And so, then we end up with some sort of customized series of things. And sometimes that’s meetings that I do with management on their documents or documents similar to their documents depending on NDA things. And then, many times that’s, “Can we do routine quarterly webinars with the staff, or can you work one-on-one with certain members of our staff where we really want to invest in their futures and it’s really important that they get this down. They’re going to be managers or they’re really not operating very well, and we want to keep them.” Brian (35:22): And so, there are a number of things that sort of come off of that. And for anybody who wanted to do it very inexpensively, we have, you mentioned before, we have a digital course which is quite inexpensive, that really anybody, even if their company did not want to do this, they just wanted to do it for themselves, that’s like $99 a quarter. And so, that’s very inexpensive and it gives them a lot of background to make decisions. But I think the easiest thing to do would be to get on the phone and I’d be happy to talk to anybody with no obligation to them and talk through options. Lisa Miller (35:57): Right. Thank you. I’m so glad you were so clear about that, because I believe it’s going to open the eyes of a lot of people that would want, even at minimum, to have you come in and speak to leadership, speak to, like you said, Zoom, on-site, just to talk about writing and how important it is. Lisa Miller (36:15): If you think about it, it’s so impactful, right? Everything from marketing to internal communication to internal influence to communications with patients, to even as they leave the hospital and transition even to post-hospital, patient gets a bill, right? And we are in a time where collections and billing is going to be somewhat problematic because of inflation, because of everything that’s going on. And I’ve often thought, “There’s got to be a transformational way to have these bills go out.” Now you see hospitals getting a little more gentler. But I’ve thought, “Wow. If somebody only spent time putting together this letter, a series of letters and put, like you said, they protect the hospital, but they’re looking at it from the patient perspective, I bet you they would increase their collections.” Brian (37:08): That’s right. Lisa Miller (37:09): I think there’s an opportunity there too, Brian. Brian (37:12): That’s right. This is one area where I’ll just briefly… Your clients might benefit from this. The reason that I have, for instance, Lisa, as a client, the reason I’ve been lucky enough to do that is because going out on LinkedIn, within six months, we had very, very significant clients come in. I’m allowed to tell you about some of them, right? So, the United States Federal Reserve is a client and other entities of that size and scope and magnitude are our clients. Brian (37:44): And so, people then started to say, “Hey, how did you do that?” And I would essentially say, “I understand human comprehension.” That’s the game here. And so, now we’re at this space where maybe we take the military aspect on this. Maybe we say, “Slow is fast here.” That, “Oh, I don’t really want to spend that much time thinking about what the collection letter should think about. Well, maybe we do. Maybe spending a couple of hours thinking about the way someone comprehends a collection letter is going to have an ROI of tremendous magnitude on the other side of that letter going out.” Maybe thinking about how a doctor’s forms are being sent out to the patients, or communication between administration and the department is being sent out, maybe there’s a massive ROI and time return on all of the things that happen by taking what feel like extra hours, which are actually saving tons of hours and making money on the other side. That’s what I’m hearing from you, but tell me how you’re hearing that. Lisa Miller (38:57): Yeah, absolutely. What an investment. What a different way to look at communication, the massive amount of ROI, to look at these important critical communication points and start changing them. I’m a student of frontline innovation. I’m a student of really listening to what people say, whether they’re as we read reviews or whether they’re online or in Amazon or even hospital reviews. And the one thing that I’ve seen over the years, particularly on reviews in hospitals, and we’ve done some work internally too, but it just seems like the communication is the stumbling block over and over and over. Either it’s a positive, like, “Oh, I was heard. They were great.” Or it was the obstacle, right? It was, “They don’t hear. They’re insensitive.” And there’s other issues, but it just seems like that’s the one. Lisa Miller (39:53): And so, this conversation today has really made me even be more excited about the opportunity for a hospital to make that investment. They’re always looking for the edge, the innovation. And I was saying to someone earlier today, “Innovation is not always the new tech or the new thing, the shiny thing. There’s innovations in processes. There’s innovations in thinking.” And so, what you’re talking about today is an innovation for them to take communication to a different level, use it for an ROI to benefit everybody, not to benefit one more or the other, but make it beneficial for everyone. And that’s super cool. That’s what I’m hearing today. Brian (40:33): I love that. And if you don’t mind a final thought on it, one thing that I think is awake here, and it’s worth mentioning, what happens when we understand our own thinking very well? What happens individually? And if I had to answer that question, I would say a tremendous amount of career and economic and personal confidence comes from that. Lisa Miller (40:57): Mm-hmm. Brian (40:58): And here’s how I would frame that. If you walk into a room and say, “I’ve done a lot of thinking about this. Do you mind if I share my thoughts?” And your thoughts really are deeper and more insightful and more transparent than everybody else in that room, they might not like what you’re suggesting, but they can’t beat it. And that is an enormous amount of framing power for the decisions that companies make and I assume hospitals make, meaning, “We’re going to have to cut 5% of whatever. And how do we frame that so that people say, ‘Yes, I understand why that decision is being made.'” Brian (41:43): And have you done enough thinking about this, or are you just being rude and mean and not thoughtful? And the minute we get to, “Here’s the nuance of that, and this is what I’m looking at, and this is what we’re optimizing around and I don’t see another way around it,” then all of a sudden, we’ve got an enormous power in the space. Because people say, “I don’t see a way around that either. And so, I understand what we’re doing here.” Brian (42:09): And so, the depth of thinking that we do about a problem and then the ability to frame around that depth is going to give us an enormous amount of conversational power and economic power and business influence power. And my sense is that we miss that culturally, but it’s probably the most important thing in terms of actually getting things done and getting them done efficiently. Lisa Miller (42:33): Yeah. That is just brilliantly said. I have nothing to add. And I just want to thank you for being on The Healthcare Leadership Experience Podcast today, Brian. I was super excited about having you, and I’ve loved our work together. I highly recommend you reaching out to Brian. His work is transformational, as you heard today and why communication matters, and I think why it really matters to hospitals. And Brian, I think you could be part of a big change movement for healthcare. I see it coming in your future, so thank you for being on our show today. Brian (43:07): Thank you, Lisa. This was so much fun. Thank you so much. Lisa Miller (43:10): And I welcome everyone to give us feedback on today’s show and other topics we can speak about, and we look forward to having you on future shows. I’m Lisa Miller, the Managing Director at SpendMend. I welcome you to check us out online, spendmend.com, and the great work we’re doing around helping hospitals improve their financial health and taking out unnecessary costs. So, thank you for joining us again today. Speaker (25:25): Thanks for listening to The Healthcare Leadership Experience Podcast. We hope you’ve enjoyed this episode. If you’re interested in learning new strategies, best practices and ideas to utilize in your career and healthcare organization, check out our website at thehealthcareleadershipexperience.com. And oh yeah, don’t forget to rate and review us and be sure to join Lisa and Jim next time on The Healthcare Leadership Experience podcast. Thanks again for listening.