The Danger of Silence

The Danger of Silence

UnitedHealthcare dropped thousands of physicians nationwide from its Medicare Advantage programs. They’ve been silent on the reasons. What do you think they are? Evil insurance company, bad physicians, high charge physicians who wouldn’t accept low rates, great physicians who wouldn’t accept low payments?

Don’t jump to conclusions (JTC).

It’s easy to do. Depending on your frame of reference, and whatever limited information you are making a jump on, you can make some mistakes. How do careful people avoid making the mistake of JTC? According to Wikipedia, there are three subtypes of JTC:

1. Mind reading, or a sense that you can read minds. “You hate me because I’m…”

2. Fortune telling, or thinking you know the answer without data. “It doesn’t matter what I ask, you will say no.”

3. Finally, labeling, or generalizing because of some characteristic common to a group. “Insurance company executives are just out to make money for their company.”

So how do we avoid it?

First, we all have to recognize our ability to JTC. It can influence our diagnostic acumen. “I’ve seen 10 cases of gastroenteritis today, so your abdominal pain and vomiting must be gastroenteritis.”And it can influence how we approach a problem and try to solve it.

Avoiding it starts with awareness, and avoiding the subtypes, by removing the availability of answers that are not fact based. That means asking for the facts and not assuming any. Depending on your personal viewpoint, let’s pick on physicians.

“Physicians are all about doing the best for their patients.” “Physicians are all about making money and gaming the system for profit.”

Both statements JTC. Both may be true of some physicians.

So how do you identify the truth?

The devilish detail is that it requires details and information that may or may not be readily available.

How do you avoid having others jump to conclusions about you? Provide details about possible assumptions people might make? Answer questions in a direct and forthright manner, backed with data when available.

How do you allow people to JTC about you? Silence will only support their JTC. If something you do might be interpreted negatively, explain why it was done. Transparency helps where it is possible. Otherwise you support JTC.

Silence is not ever an answer

The apology bill has recently been signed into law in Pennsylvania because there is good data that apologies alone can mitigate subsequent lawsuit. Absent an apology bill, physicians were fearful that expressions of sorrow over adverse events would somehow be interpreted as accepting fault and worsen a malpractice case. “Disclosure, apology and offer” are proven strategies to mitigate actual malpractice or adverse events when they do occur.

Data and facts deny the ability to JTC. Hiding data and facts allows people to JTC in the worst possible ways.

Not caring if people JTC is not an answer either, because then the conclusions drawn may be entirely wrong and cause more problems than an honest and frank disclosure of the facts. But be prepared with facts.

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