What if everyone knew what you were thinking? I think a lot of us would be arrested if everyone knew what we were thinking. Luckily, we don't know each other's thoughts, but we can hear what people are saying, and often what people say isn’t really clear because they may not want to share what they're truly thinking.

This leads to ambiguity.

Today’s topic is the importance of clear, honest, kind communication—not only with team members and family members, but most importantly, with our patients in healthcare. Most doctors aren’t clear in communicating with their patients; they may only say what they want the patient to hear and avoid talking about things under the surface. For example, if a patient has a problem that might lead to tooth loss or requires a specialist, it may cost more than they expected. We don’t always tell them everything, so we might only share part of it. Patients sense this, leading to a lack of trust, which we discussed in our last video. This breakdown in trust increases stress, and both parties may start acting superficially.

What does this mean? It means I’m not being fully truthful, they’re not being fully truthful, and neither of us is sure what the truth is. We’re dancing around it, creating what’s known as an ambiguous relationship. Adam Grant, a professor at the University of Pennsylvania and Wharton School of Business, talked about this in his book Think Again and a recent New York Times article, noting that the most ambivalent relationships are often the most toxic.

I have a next-door neighbor who sometimes says hello and sometimes doesn’t. I don’t know why; we’ve never had a conflict. It’s not just him; my whole neighborhood has this air of ambivalent relationships. I’ve lived here for about 25 years, and in that time, everyone has turned over; I’m now one of the longest residents. The newer neighbors aren’t as friendly, and they don’t talk as much. It’s confusing—is it something I said, something a family member said? Each time I pull into my driveway, I wonder if they’ll nod to me or ignore me. I’d like to go up to them and ask, "Is there a problem? Can we talk about it?" But what if there is a problem? This puts me in an ambiguous situation.

In my practice, however, I avoid ambiguity.

I know exactly why I’m there—to help patients. If a patient is upset, I’ll ask, "Is there a problem? Did I upset you?" Sometimes they have a hard time with this conversation, and I understand why; being open requires vulnerability. Brené Brown talks about the courage it takes to be vulnerable, which is what I’m trying to demonstrate here. The more vulnerable I am, the clearer I am, and the easier it is to build a relationship with someone who’s also open and honest. We emphasize this in our practice.

Sometimes people misunderstand me, taking things personally when it’s not intended that way. There’s a concept called "The Four Agreements," and one of the agreements is not to take things personally. This is challenging because people often react to things beneath the surface, at what I call the "subterranean level" of communication. For example, if I ask you to get me a pencil, you might react as if I’m imposing on you, even if that wasn’t my intent. This happens every day.

One day, an employee told me another employee was doing something incorrectly. They went back and forth about it without clear communication, so I’ll address it tomorrow in the office. We’ll set a clear protocol to eliminate ambiguity, which will reduce stress and prevent unnecessary arguments. In your practice and personal relationships, look for areas of ambiguity because they exist. I have a friend who hasn’t called me back. Is he upset with me, or is he going through something personal? I plan to call and ask, “Are you upset with me, or is something else going on?”

Reducing ambiguity reduces stress.

I often walk at night in New York City, and sometimes I hear footsteps behind me. I don’t turn around; I keep walking but stay aware. Eventually, I might turn and see it’s just a cat, relieving any worry. We often avoid facing what’s behind us, but addressing ambiguity head-on either removes unnecessary fear or lets us take action if needed.

Today’s thought: try to decrease stress by reducing ambiguity. I recommend reading Adam Grant’s recent article in the New York Times about ambiguity. It’s an insightful read that can help you better serve and connect with others. Have a great day, everyone.