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Opinion: Radical listening: A critical skill for health care leaders

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Listening is difficult to master no matter what your industry. But in health care, listening is an essential skill for making decisions, resolving conflict and shaping culture. Beyond listening is a skill I call radical listening. It’s the exercise of listening when stakes are high, divisions are deep and every cell in your body wants to defend, deny or debate.

Here are three practices to help health care leaders become radical listeners.

1. Increase conflict capacity. To manage the demands in health care, leaders must be able to withstand the strong emotions arising from the unknown, such as COVID-19, as well as those from high conflict. Leaders with low tolerance to stress and uncertainty resort to aggression and defensiveness. These leadership behaviors create toxic cultures that can threaten safety, teamwork and the patient experience.

In a study called “Silence Kills,” conducted by Vital Smarts and The American Association of Critical-Care Nurses, researchers found too many caregivers delayed action, withheld feedback or just went along with a wrong diagnosis rather than deal with the consequences of engaging in a difficult conversation where they would be verbally or emotionally abused.

Increasing conflict capacity is about identifying and experiencing the emotions that provoke anger and fear without resorting to coping mechanisms or aggression. The exercise is to allow the feeling to process for 90 seconds to expand tolerance for uncomfortable emotional experiences. One resource is the book “90 Seconds to a Life You Love: How to Master Your Difficult Feelings to Cultivate Lasting Confidence, Resilience, and Authenticity” by Dr. Joan Rosenberg.

2. Practice self-control. Human beings have limited resources for self-control. But once you expand conflict capacity, self-control becomes easier, and radical listening becomes a habit instead of a forced effort. Rather than avoiding, appeasing or becoming aggressive, radical listening is about controlling your urge to be right, to be understood, to win the argument or prove a point. Most people have difficulty listening or speaking up when they feel defensive or fear aggression from the other person. The key elements are self-awareness, openness and genuine curiosity. Radical listening is an effective method for calming a disgruntled patient, as well as resolving a high stakes conflict between two high-level health care providers.

Radical listening is more than simply being quiet, suppressing emotions or shutting down. When every fiber in your being wants to fight, flight or freeze you simply stay present, take a breath, notice your feelings and listen. Avoid the urge to explain, defend or acquiesce. Instead, acknowledge the other person’s reality and get curious as to how you can help. If escalation occurs, the ability to acknowledge and then set a boundary to resume the conversation the next day works most of the time. Many clients I’ve worked with struggle with acknowledging a reality they disagree with, however, acknowledging someone else’s reality doesn’t necessarily mean you agree. Acknowledging the other person’s reality makes the other person feel understood, and when done well, it often takes them off of the defensive, allowing you to effectively problem solve.

3. Don’t hide behind digital communication. Physician leaders, hospital administrators, nurse managers and other health care leaders are required to overcommunicate, but communication is more than delivering factual data. Being an excellent communicator in health care requires the ability to notice nuances, listen for inflection, read between the lines and ask clarifying questions. The biggest mistake unseasoned leaders make is to hide behind digital communications when the stakes are high. Hiding behind the safety of digital messages compromises privacy. Electronic messages can be shared across social media or blind carbon copied to someone you don’t want involved in the conversation. In short, email or text messages should never be used to discuss high-conflict issues, solve employee disputes and implement disciplinary actions or performance reviews. Electronic communication is only for neutral information, facts and updates. In-person and phone meetings are for high stakes, private or emotional issues.

Marlene Chism is a consultant, executive educator and LinkedIn global learning platform expert. Her books include “Stop Workplace Drama,” “No-Drama Leadership” and “7 Ways to Stop Drama in Your Healthcare Practice.” She can be reached at


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