American Association for Physician Leadership

Operations and Policy

Teaching Your Staff to Reframe Negatives into Positives

Laura Hills, DA

August 12, 2024


Summary:

Reframing makes the most of positive language (and congruent body language) to reinforce positive yet accurate messages. It can help your good employees shift your patients, the other members of your staff, and even themselves away from anger, frustration, and blame, and move gently and steadily toward openness, satisfaction, and gratitude.





“What’s wrong?” “Are you dissatisfied?” “What’s the problem?” “Are you confused?” “I’m sorry, I don’t understand you.” “You’re not being reasonable.” “There’s no need for you to be rude to me.” “We can’t do that for you.” “No. The answer is no.”

Do you cringe when you hear your staff use negative phrases such as these in your healthcare organization? If you don’t, you may want to rethink that. According to Andrew Newburg and Mark Waldman,(1) negative words are the most dangerous words in the world. That’s because they worsen the way people feel and function emotionally and physically.

Newburg and Waldman explain, “If I were to put you into an fMRI scanner ... and flash the word ‘NO’ for less than one second, you’d see a sudden release of dozens of stress-producing hormones and neurotransmitters. These chemicals immediately interrupt the normal functioning of your brain, impairing logic, reason, language processing, and communication.” In fact, just seeing a list of negative words for a few seconds will make a highly anxious or depressed person feel worse.

The more a depressed person ruminates on negative words, the more damage will be done to key structures that regulate memory, feelings, and emotions, Newburg and Waldman warn. Negative words can ultimately disrupt sleep, appetite, and even a person’s ability to experience long-term happiness and satisfaction. On top of that, negative words lead to negative thinking, which is self-perpetuating. “The more you engage in negative dialogue — at home or at work — the more difficult it becomes to stop,” Newburg and Waldman say.

Clearly, then, negative language brings with it a host of physical and emotional problems. It will undermine good customer service in your healthcare organization, too. But it can also make your organization an unhappy, stressful, and miserable place to work. So how can you get your employees to stop speaking negatively, even when your patients speak negatively to them? How can you encourage the use of more positive language without forcing your staff to sound like they’re reading from an overly upbeat and insincere customer service script?

The answer is: First, get your good employees to want to reframe their communication, then teach them how to do it. According to Carter McNamara,(2) “Reframing is seeing the current situation from a different perspective, which can be tremendously helpful in problem solving, decision making, and learning.” The key is for your employees to believe that that’s true and to regard reframing as a truthful and empowering new way to look at things.

When the healthcare organization’s employees learn to reframe negative ways of communicating into sincere positive ways, they do not change the basic situation or problem; they change the way that they and others look at it. Brenda Hooper(3) explains, “The purpose of reframing is ... to shift the person’s feeling about the issue/problem.”

Reframing makes the most of positive language (and congruent body language) to reinforce positive yet accurate messages. It can help your good employees shift your patients, the other members of your staff, and even themselves away from anger, frustration, and blame, and move gently and steadily toward openness, satisfaction, and gratitude. Fortunately, as you’ll see in this article, reframing can be taught, practiced, and learned.

FIVE WAYS THAT REFRAMING CAN IMPROVE YOUR HEALTHCARE ORGANIZATION

Although negative language has all of the disadvantages just described, reframing to more positive language offers equally powerful benefits. According to Conversational Receptionists,(4) “Not only do positive words encourage and motivate others more effectively than negative words, but they also help forge meaningful connections between the speaker and receiver.” Reframing language from negative to positive leads to:

  1. Less patient conflict. The wrong words can put a tense patient on the defensive and make a bad situation worse. “When you start every interaction with positive language, you’ll experience less conflict overall,” according to Conversational Receptionists.

  2. Better relationships with your patients. With fewer instances of conflict, better relationships and connections can be formed. Reframing paves the way for building the connections with your patients that are necessary for creating and fostering their loyalty.

  3. Faster resolution times. Miscommunication, patients’ perceptions of negative language, and allowing an angry patient to take control may result in longer resolution times. However, as Conversational Receptionists suggests, “Using positive communication from the start ... can keep the conversation focused on the issue at hand and resolve it faster.”

  4. Improved reputation. Less conflict will create better relationships and faster resolution times. Therefore, patients will be more satisfied in general with your healthcare organization. Satisfied patients are more likely to remain loyal to your organization and to recommend you to their friends, colleagues, and family. That ultimately leads to improved patient retention and a better reputation for your healthcare organization.

  5. Stronger culture for your healthcare organization. The changes that occur as a result of reframing negative language can create a stronger organizational culture that is unified toward a common goal. When your employees can see for themselves the positive changes that occur with positive language, they will be more invested in what you do. That, in turn, creates a stronger loyalty to your culture with more faith in your organization and its inner workings, Conversational Receptionists suggests.

HELP YOUR STAFF SEE THE VALUE IN REFRAMING

Despite these advantages, it will do little good for you to give your staff a list or chart of reframing words and phrases and require them to start using them. If you do that, you may be able to get them to say the right words; however, you cannot get them to mean them. Unfortunately, insincere positive language is easy to detect. A phony, overly positive style of communicating can sound like the speaker is out of touch with reality. It can easily come off as uncaring and condescending and backfire by fanning the flames of anger and hostility.

Therefore, the first step in introducing reframing to your staff will be for you to share how negative and positive communication affects others. Help your staff recognize that communicating negatively almost always works against what they are trying to accomplish. Explain that using positive words and phrases can enhance patient engagement, increase satisfaction, and reduce patient ambivalence. Also help them to see how reframing their negative language can be beneficial and how it can make your healthcare organization a happier place for everyone. In other words, bring your staff along with you on this journey.

TEACH YOUR STAFF TO REFRAME

As a next step, introduce reframing as both a concept and a tool your employees can use with your patients. Share with your staff a quote that supports reframing, such as this one from Justyna Polacyzak(5): “The most important rule of verbal communication is to forget ‘no, ‘can’t’ and ‘don’t,’ as these are the worst words that can be said [to a patient].” Discuss with your staff whether they agree and why.

Make sure that your employees understand that reframing does not require them to lie or to do something that feels false. Rather, reframing encourages them to look for and discover true, accurate, and positive new ways to look at things. Then offer them some examples. For instance, ask them to suggest truthful, positive ways to reframe typical negative communication such as:

“No. We have no openings next Tuesday.”

“No. We can’t do that.”

“I don’t know the answer.”

“Well, I’m not the one who told you that/established this policy/made that mistake.”

“You don’t have things right.”

Explore with your staff how they feel about the negative and the more positive reframe of each phrase. Be open to what they say. Remember that they must feel comfortable with the concept of reframing before they can use it effectively in your healthcare organization.

An excellent way to reinforce the value of reframing with your employees is to use role playing to demonstrate the power of both negative and positive language. A good place to begin is to ask an employee to participate in a role play with you in which you play the part of an employee and the employee plays the part of an angry patient. Suggest one or more scenarios or ask your employees for suggestions. Encourage the employee playing the part of the patient to be forceful but realistic.

In the first role play, respond negatively to the “patient.” Focus your language on what you can’t do, what the patient can’t do, problems, what the patient is doing wrong, how unreasonable the patient is being, and how bad the situation is. Then, do a quick debrief. Ask the staff to give you examples of your negative responses. Ask the employee who played the part of the patient to describe their feelings about the negative communication.

Then, do a second role play, asking the same employee to behave the same way. This time, respond with more positive and constructive language. Again, debrief your employees. Ask the staff to give you examples of your positive responses. Ask the employee who played the part of the patient to describe their feelings about the more positive communication. Describe the truth in your positive reframes. Draw from your staff the lessons they learned through this role play. Offer to do a second or third set of role plays as need, interest, and time permit.

Going forward, share examples of positive language for reframes and give your employees opportunities to practice using them through additional role plays. You may need several sessions with your staff to allow the lessons to sink in and to provide ample practice time. While your employees are learning to reframe, ask them to pay closer attention to their day-to-day interactions, especially with patients or colleagues who are confused, displeased, or angry.

With practice, your staff will begin to identify opportunities for reframing in their daily activities. They will become increasingly more comfortable reframing their communication and will eventually master the technique.

TEACH YOUR STAFF TO FOCUS ON WHAT THEY CAN DO

As your employees become more comfortable with and adept at reframing, they will be able to express themselves more frequently with positive language. However, there will be times when they just can’t give your patients what they would like. In such instances, they may be tempted to focus on words like unfortunately, but, and I’m sorry. However, as Gao(6) suggests, such words still express a negative thought. They focus your patient’s attention on what can’t happen.

Of course, a sincere, well-deserved apology is always a good idea. In addition, Gao suggests that you teach your staff not to leave the communication on a sour note if there is a legitimate way to end things more positively. Teach your employees to focus their communication whenever possible on what they can do, Gao says, not to leave things stuck on what they can’t.

For example, if a caller can’t be fit into the schedule that day, the employee should provide the soonest appointment and offer to put the patient on a short notice call list in case of a cancellation. Or, if the patient objects to paying for services the day of the appointment, the employee can require that day’s payment but offer to work out a payment plan for future appointments, if your policy allows for that.

Or, if you are behind schedule and the patient complains about the wait, the employee can offer to reschedule the appointment or suggest that the patient leave your office and return in 45 minutes or an hour. Never let patients leave before they know all of their options. They may not get their first choice, Gao says, but they may end up feeling much better about things if they believe your office is doing something for them or giving them a choice.

GIVE STAFF REINFORCEMENT FOR REFRAMING AND USING POSITIVE LANGUAGE

Becoming expert in reframing negatives into positives takes time. Along the way, be sure to offer additional training and support as employees expand and hone their skills. Highlight and praise the good examples of reframing that you observe. Continue to design role plays and encourage your staff to analyze their daily interactions with patients and with one another. When you catch your good employees slipping back into negative language, consider these to be teachable moments. Ask your employees to revisit those interactions and explore more positive phrasing.

Of course, an effective way for you to stress the importance of reframing negatives into positives in your healthcare organization is to include it in employees’ performance appraisals. Employees will take notice of what you measure and what you reward. Be mindful, however, that you will not be privy to every conversation your employees have with your patients. It will be hard for you to quantify improvement. One possible strategy is to ask employees to establish reframing goals and to self-assess their progress. That, along with your own observations and positive reinforcement, can help employees become masterful reframers.

Finally, good employees who have excellent reframing skills may find that they can reframe their thinking as well as their language. They can learn to reframe their own perceived weaknesses, job stress, and other potentially negative challenges as positives. For example, if employees were to stop calling themselves impulsive and instead referred to themselves as spontaneous, they would be reframing a weakness as a potential strength.

Recruitment firm Pinnacle(7) suggests, “It wouldn’t be surprising if reframing employee weaknesses made for a stronger and more productive workforce.” In addition to making employees potentially more productive, reframing also can be an effective stress manager. According to Pinnacle, “Reframing aids employees in not only seeing themselves in the best light, but also situations.” With reframing practice, employees may come to see that problem and opportunity are two sides of the same coin.

As Elizabeth Scott(8) aptly put it, “Reframing is a way of changing the way you look at something and, thus, changing your experience of it. It can turn a stressful event into either a major trauma or a challenge to be bravely overcome. Or it can depict a really bad day as a mildly low point in an overall wonderful life. Or it can see a negative event as a learning experience.”

Clearly, reframing offers potential benefits in customer service within your healthcare organization and for your employee personally.

Excerpted from Next-Level Healthcare Employees: Improving the Performance of a Good Team by Laura Hills, DA.

REFERENCES

  1. Newburg A, Waldman M. Why This Word Is So Dangerous to Say or Hear. Psychology Today. August 1, 2012. https://www.psychologytoday.com/us/blog/words-can-change -your-brain/201208/why-this-word-is-so-dangerous-to-say-or-hear\ .

  2. McNamara C. Basic Guidelines to Reframing — To Seeing Things Differently. Management blog, February 2, 2012. Https://Management.Org/Blogs/Personal-And-Professional-Coaching/2012/02/02/Basic-Guidelines-To-Reframing-To -Seeing-Things-Differently/ .

  3. Hooper B. The Awesome Communication Tool – Reframing. Brenda Hooper blog. July 6, 2016. http://brendahooper.com/the- awesome-communication-tool-reframing/ . Accessed May 24, 2018.

  4. Conversational Receptionists. 5 Ways Positive Words Can Make Customer Service Easier. Conversational Receptionists blog. www.conversational.com/5-ways-positive-words-make-customer-service-easier/ . Accessed May 29, 2018.

  5. Polacyzak J. The Art of Positive Communication in Customer Service. Ecwid blog. August 31, 2016. www.ecwid.com/blog/the-art-of-positive-communication-in-customer-service.html .

  6. Gao K. 40+ Positive Phrases to Create Positive Scripting for Customer Service. Comm 100 blog, September 15, 2017. www.comm100.com/blog/positive-customer-service-phrases.html . Accessed May 29, 2018.

  7. Pinnacle. Why You Should Teach Employees Reframing Skills. Pinnacle blog. https://pinnacle.jobs/blog/why-you-should-teach-employees-reframing-skills/ . Accessed May 21, 2023.

  8. Scott E. 4 Steps to Shift Perspective and Change Everything. Very Well Mind blog. September 28, 2020. www.verywellmind.com/cognitive-reframing-for-stress-management-3144872 .

Laura Hills, DA

Practice leadership coach, consultant, author, seminar speaker, and President of Blue Pencil Institute, an organization that provides educational programs, learning products, and professionalism coaching to help professionals accelerate their careers, become more effective and productive, and find greater fulfillment and reward in their work; Baltimore, Maryland; email: lhills@bluepencilinstitute.com; website: www.bluepencilinstitute.com ; Twitter: @DrLauraHills.

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