Difficult to helpful conversations

I’d like to talk about the value of difficult conversations. These are often thought of as important, even high-stakes, complex conversations with differing opinions. I find framing these conversations more as advice, feedback, and suggestions has helped me see them as opportunities to improve the College of Family Physicians of Canada (CFPC).

When members or collaborators take the time to share their concerns with us, it’s our best chance to understand issues and adapt. So, I welcome feedback and might reframe difficult conversations as honest or helpful conversations. I know some people are reluctant to give feedback and advice but in general, there is no bad feedback. Let me set the bar. Almost 40 years ago, I was working for a furniture store in Ontario. It was February, the temperature outside was below −20°C, and a large truck full of furniture needed unloading. I told my supervisor I had to grab some gloves due to the cold. I will not repeat what was said, dated as it was, but the implication was I was weak for wanting to cover my hands. I got the gloves and later heard that supervisor previously lost portions of 2 fingers due to frostbite. That’s my bar for bad advice.

I recognize some individuals have lost hope for the CFPC improving, and there are challenges involved in adopting certain recommendations. Depending on the recommendations or advice, it’s possible we can’t meet some expectations. The CFPC is part of a larger, interconnected web of medical organizations. Each has a role to play in supporting physicians, with the CFPC’s specific focus being championing family physician excellence through self-regulation, advocacy, and support.

In some areas, we lack the resources to implement advice, feedback provided conflicts with other feedback received, or system rules and laws get in the way. An example is a recommendation to partner with businesses to offer more benefits to members, an area where the CFPC is very restricted as a non-profit organization that does not charge taxes for membership.

In this context, is it even worth offering ideas or advice? The week before writing this I was in Edmonton, Alta, meeting colleagues and partners. What I heard influenced how I communicated with CFPC members about advocacy items we implemented and plans for future improvements to the CFPC. In the meeting of the National Circle for Indigenous Medical Education, the term difficult conversations was used. I have had several honest conversations with the CFPC’s Indigenous Health Committee, and each discussion helped me identify key concerns, reset, prioritize our commitment, and move toward a better relationship. It’s much easier to fix problems I’ve had explained. Even for things that can’t be fixed at present, a conversation can help both parties understand the situation from one another’s standpoint, or identify the issue as something to address in future.

A member who has been considerate enough to give feedback and have difficult conversations reached out to me last week. He previously identified a concern with our communication, particularly the tone. He now felt it was improving—but acknowledged we still had a way to go. It reminded me that long journeys are accomplished with many single steps, or in this case, many helpful conversations.

Notes

Spotlight

Dr Heather Adam Sdrolias has worked as a family medicine hospitalist serving elderly patients for almost 25 years at the Manitoba Rehabilitation Hospital, Health Sciences Centre Winnipeg, and Victoria Hospital, all in Winnipeg, Man. When not reading, participating in a healthy lifestyle, or looking after her aging parents and in-laws, Adam Sdrolias can be found compiling stories about patients and families she has met in a journal. Her goal is to publish the heartbreaking and hilarious encounters in a book.

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