I became a physician “leader” frankly because staff asked me to change things or they would quit.   It started 17 years ago.  I was an informal “leader”, becoming increasingly formal over the next 5 years.  It was a rough road for many reasons, but my lack of skills, knowledge, awareness, maturity, preparedness, good mentoring, and sleep were at the top of the list.

Because I was so bad, I was given the gift of a professional coach, which was helpful with guiding my self-learning and reflecting. Thankfully, I was able to improve on some of my deficiencies; the one that I had to work on the most, both because of my ineptitude and the importance of it, was having discussions and dialogues with people.

I’m still learning and practicing dialogue. I wish it were easier, but its not. The biggest problem is that it takes time, which we don’t have a lot of. The second biggest problem is that we’re human, and have learned some unfortunate human habits. The biggest of these habits is a tendency to be defensive, to take things personally and to hold onto ideas and memories with too much dogma, blinding ideology, and just plain old-fashioned emotion. This internal milieu interferes with listening, learning, and most importantly thinking. We’ve all seen how egos and lack of humility (hubris) can derail good conversations, but that’s only part of the story. The other big problem we humans have is judging (criticus).   We judge, judge, judge.  Dialogue can be derailed by hubris and criticus. Being aware of these barriers is the first step, doing our best to abate them, without beating each other up about them, is the second.

Suppressing our hubris and criticus is important when having a dialogue, but without respect, appreciation, a desire to learn, and time, it still won’t happen. Stepping outside ourselves, our attachments and our preoccupations isn’t easy, but necessary.  Try asking yourself: do I really know everything that needs to be known? Is my view truly the only possible viewpoint that has merit? Have I thought of all the possibilities? Am I showing how much I care about the people in the room? What else might we face in the future that makes how we accomplish this conversation as important as what the conversation is about?

William Isaacs in his famous 1999 book Dialogue and the Art of Thinking Together describes 4 steps we can take when participating in dialogue: Listening, Respecting, Suspending and Voicing. Out of these 4, suspending is often the hardest (aside from leaving voicing until the end). Edgar Schein has talked about “accessing your ignorance” as a means to start the suspending process. To access one’s ignorance, one must pause, embrace humility and suspend judgment. This practice naturally leads to the advice that one ought to ask questions first, then voice their opinion second; seek to understand before being understood.  Questions are most effective when coming from a place of ignorance.

Dialogue is about reducing our collective ignorance.  It doesn’t make it completely go away, but we’re better prepared to face our challenges nonetheless, and face them together.