Klinisk Biokemi i Norden · 1 2018
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Communication
Words are used to set goals and direction. Leader-
ship is a consequence of successful communication/
dialogue between leaders and staff, but to obtain a
successful communication is not easy. A very famous
Austrian philosopher Wittgenstein L has said that
“language creates reality and transparency” (8). It
sounds easy and it is precisely demonstrated in the
example above within the Army Combat School, but
what is unique in this example is that the communica-
tion takes place between individuals within the same
social context or life frame. They have all entered the
same frame of expectations = the Army. A similar
example of a very clear cut context could be in a mas-
ter chef kitchen. However, the communication might
not be as equally successful if the social context was
not as well defined. Even though the language crea-
tes a reality and a transparency, it is not necessarily
translated into the same action and understanding in
another group of people if the social context has not
been cleared. The translation of the words will depend
on the social context into which it is brought, not only
what the words describe, but how the words are used
to create an understanding between individuals with
different experiences and life frames (8). As an indi-
vidual, you will make your own interpretation and
conclusion on the basis of your genetics, knowledge,
experiences, history, values/ethics, religion, dreams
and wishes (autopoiesis) (9). You will listen to the
words, but make your own translation based on who
you are. Communication is therefore not solely based
on the objective, and a clarification of the context into
which you are going to communicate into is a very
important part of the preparation.
I think we know this instinctively dealing with
issues related to our profession and patient related
issues. We define the receiver as a representative of
a group that is patient, doctor, nurse etc. If we have
to deliver a message directly to the patient, we will
reflect on this context without even thinking about
it and communicate into this context. This context
will be completely different than the context we would
have chosen communicating with a colleague. We
also practice it when we teach. First thing to do is to
clarify the context. Who are we going to teach (nurses,
technicians, other doctors or administrators)? But are
we also clarifying the individuals receiving the com-
munication? A lot of misunderstandings and com-
plaints in our organization is about communication
problems, and perhaps it could be of some guidance
to reflect more on the context of the communication
before entering a dialogue. Could the same reflections
be beneficial dealing with communication as part
of our leadership? If you want to create leadership
through your communication, you will also need
to clarify the context by knowing something about
the people that you would like to lead. According to
a Danish researcher in leadership, Hein HH, four
types of people are present in a profession as ours:
prima donnas, high-performance person, pragma-
tists and wage-earners (10). Prima donnas want to
do a difference and are controlled by strong values
and ideals. Prima donnas have a strong willingness
to bring sacrifices. On the contrary, the main calling
for the wage-earners would be the wages and their
willingness to bring sacrifices would be minimal.
If your communication is directed into a context
of ambition and sacrifice would be needed in order
to achieve greatness, you will probably fail in your
motivating communication with the wage-earners,
but you might have a chance of success with the prima
donnas and high-performance people. According to
Hein HH, you need to motivate these different types
of people through a prospect of getting their different
Leading change
LEADING
CHANGE
NECESSITY
VISION/
STRATEGY
COALITION
CULTURE
CONSOLIDATE
CELEBRATE
GAINS
OBSTRUCTION
COMMUNICATE
1
3
2
8
7
6
5
4
Figure based on Kotter JP: Why Transformation Efforts
Fail, Harvard Business Review 1995
Figure 2
