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The most important thing in communication is hearing what isn’t said.

–Peter F. Drucker

At a previous job, several directors and I were asked to attend a meeting with one of our newest senior directors, whom I’ll call Mary. Mary was an extremely charming and charismatic leader with stellar business acumen and financial experience. Mary was also well educated, with more than 20 years of experience in healthcare executive management.

Before the meeting, Mary requested that each of us bring a few high-priority departmental issues to discuss. We were told that, based on these discussions, Mary would pick the top issues, which she would then prioritize in her new leadership role.

At the meeting, Mary gave a warm introduction, asked us to introduce ourselves, and then proceeded to solicit information about our departmental issues. While my colleagues and I took turns sharing our issues, I watched how Mary’s body language changed based on some of the words she heard. Some of the many topics discussed included revenue cycle, charge entry, lack of resources, staffing issues, quality improvement, relative value units, value-based purchasing, and meaningful use dollars.

It wasn’t just Mary’s facial expression that I homed in on, but the position of her upper body (as we sat around the boardroom table), whether she was writing with her pen or just dangling it from her hand, how often she cupped her chin with her hand, and the direction of her eyes. For example, when my colleagues spoke of a lack of specific resources, I noted Mary feverishly writing on her pad, occasionally nodding, and cupping her chin with her hand. When colleagues spoke passionately about staff performance management issues, Mary looked up to the right and down to the left, sitting back in her chair.

I was one of the last of the directors to speak. I discussed clinical quality-improvement issues. As I spoke, I noted Mary looking to the right, smiling a lot, and nodding quite vigorously. After a brief discussion, as she had done with my colleagues, Mary said she would be very supportive in my endeavors. At the end of the meeting, Mary genuinely thanked us for sharing the information with her, and the meeting concluded on a positive note.

I have learned over the years that many people know just what to say to be politically correct, but most people aren’t as experienced with—or even cognizant of—what their body language is saying. When you are adept in assessing body language, you can get a better sense of what someone is thinking, even if the person isn’t speaking. Mary’s body language revealed to me what she may have perceived listening to each of our topics.

Shortly after the meeting was adjourned, I quietly mentioned to one of my colleagues that I thought the issues I shared didn’t make ...

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