When It’s Harder to Talk With Colleagues Than Patients

“Psychological safety and courage are simply two sides of the same immensely valuable coin.  Both are – and will continue to be – needed in a complex and uncertain world.”  Amy Edmondson, PhD

Recently, a physician colleague said something that stopped me short: “Why is it that I find it so easy to talk about difficult things with patients, but so hard to talk about them with colleagues?” Many of us recognize the truth in that question. In the exam room, we routinely navigate grief, fear, anger, and uncertainty, often with people who see the world very differently than we do.  Yet in our workrooms and meetings, especially amid today’s divisive social, political, and cultural issues, we often retreat into silence. The stakes feel different. With colleagues, what’s on the line isn’t just the conversation; it’s belonging, trust, and the relationships we have to return to again and again.

I too have noticed my hesitancy to talk with colleagues about the many things going on in the world that are directly or indirectly negatively impacting patient care.  And I am far from alone.  Colleagues across the country have shared stories of environments where speaking up feels risky, where difficult conversations are avoided, and where the cost shows up as psychological distress, fractured teams, lack of trust, and compromised care. What strikes me is that silence doesn’t mean neutrality; it usually means fear. And fear rarely brings out our best thinking or our best selves.

Amy Edmondson defines psychological safety as a shared belief that a context is safe for interpersonal risk-taking; that questions, concerns, ideas, or even mistakes will be welcomed rather than punished.  In healthcare, psychological safety has been linked to improved learning, error reporting, team performance, and patient outcomes. When it is absent, people don’t stop having concerns, they simply stop voicing them. Importantly, the goal isn’t to create perfectly “safe” spaces (which no one can guarantee), but safer spaces that allow us to move from simply working alongside each other to truly working with each other.

What seems to help is approaching conversations with colleagues in the way we approach them with patients; with intention, curiosity, and regulation. Naming purpose, grounding the discussion in shared goals, and staying with observable experience rather than assumptions all matter. Curiosity is essential: asking how someone’s experiences shape their views rather than trying to change them. So is slowing ourselves when emotions rise and remembering that understanding does not require agreement. These moves don’t remove discomfort, but they create enough space for honesty and respect to coexist.

This week, I invite you to reflect on two questions: How am I contributing to psychological safety for those around me? And where am I holding back because I don’t feel safe myself? Consider engaging your PeerRx partner in this reflection, exploring together what makes conversations with colleagues feel risky and what small steps might help move us from silent safety to brave engagement. After all, it is in those safer-to-braver spaces that our best thinking emerges, our teams grow stronger, and our work reflects not just technical excellence, but collective caring and compassion.  That seems worth the risk ....