Site icon ICE Blog

Professional ghosting in the post pandemic clinical learning environment.  Is this a thing?

ICE Blog Admin

View of woman wearing protective mask through frosted glass

By: Ezgi Tiryaki (@Neuro_Edu_ET) and Felix Ankel (@felixankel)

You are an associate dean for graduate medical education and are looking towards creating a post-pandemic clinical learning environment which is generative, healthy, and aligned to your health systems strategic goals. You plan a retreat to outline a five-year strategic plan and start your pre-work by having 1:1 interviews with key stakeholders.  In your discussions you notice an emerging theme in different departments that you try to make sense of after having the following three conversations.

  1. A well-respected award-winning residency director discusses a change in departmental culture and communication when a new chair is appointed.  She is disinvited from key departmental strategy meetings by the chair’s administrative assistant and her calls and emails to the chair are unreturned.
  2. A senior clinical faculty describes concern from several faculty applicants that have not heard on the status of their application for several months.
  3. Residents describe a feeling of isolation after advocating for better working conditions and describe it as “ghosting” from their peers and educators.

You start thinking about “professional ghosting” and the clinical learning environment.  Is this a thing? What is the etiology? How does it manifest itself?  How should it be addressed?

Definition

Ghosting, in its original context, refers to abruptly ending a personal relationship by ceasing all communication, without any explanation. Since Covid, there has been an increasing amount of lay press discussion around “professional ghosting. In the professional realm, ghosting can be seen as the cutting off all contact with a person without providing clarity or closure, usually after a series of interactions or promises.  Examples include not answering e-mails, cancelling meetings without explanation, not delivering on agreed-upon tasks, and stopping to communicate with team members considered to be “high maintenance” or “problematic”.

Etiology

There are varied opinions on why people ghost. Nuela Walsh lists five reasons why people may ghost.

  1. Convenience
  2. Conflict Avoidance
  3. Apathy
  4. Low accountability
  5. Data overload

People that ghost may be too busy, too overwhelmed, or not have the skill set to communicate awkward or unpleasant information. They may lack security in their position and may need to enforce positional power on a subconscious basis.

The effect of ghosting

Ghosting has been described as having the hallmarks of a sudden and unexpected death with feelings of confusion, unfairness, and grief. People want to “matter” and may feel triggered by ghosting in the workplace. Common triggers may center around the SCARF model.  Ghosting can cause emotional distress by negatively impacting self-esteem (status), creating unresolved questions (certainty), holding up projects (autonomy), damaging relationships (relatedness) and undermining trust (fairness).  People often feel challenged in making sense of the behavior and may have difficulty letting go of “unfinished business”, obsessively replaying conversations in their mind. There is also significant reputational damage to the person who is doing the ghosting: They are seen as unreliable, disengaged, vindictive or self-important which can limit opportunities for future collaboration and success.

Does ghosting occur in your clinical learning environment?

Consider evaluating your work environment.  Are individuals disinvited from meetings without explanation? Are meetings “tellings”? Is there a work standard to respond to inquiries? Are individuals with divergent views “celebrated”, “managed”, or “ignored”?

Tips to mitigate “professional ghosting”

Explore why people in your department may be doing this. Different etiologies have different solutions. Conflict avoidance can be addressed with skill development in crucial conversations. Data overload may be helped by creating automated structures and processes such as “calendaring” specific times to follow up with others. Apathy and low accountability can be addressed with explicit workplace standards.

Tips if you have “ghosted” someone

Make sure you analyze what led to it so you can avoid it going forward. Reach out and apologize. Acknowledge the negative impact. Share what you will do differently so it does not happen again. Make sure you do communicate consistently and reliably to rebuild the trust.

Tips when you are “ghosted”

There might be a legitimate reason for a delayed response, so if in doubt, give it more time or send a follow-up message. Reflect on possible reasons for the lack of response and use this opportunity to analyze your own reaction to the situation. What emotions are coming up and what unhelpful story is emerging in your head? Deliberate processing by reframing the situation can help get a sense of control back and contain the negative impact. Is there a lesson to be learned and is there anything you want to do differently going forward? Ultimately, it might be time to disengage and move on.

Professional “ghosting” may be a phenomenon of the post pandemic world.  Recognizing its harmful impact on all involved and addressing it in a proactive, transparent way helps maximize health and well-being in the clinical learning environment.  M.H. Miller provides the following description of a ghoster’s impact in their Halloween 2023 New York Times Magazine article.

“But as scary as a ghost can be, a ghoster is even more vexing: What do you do when someone suddenly no longer acknowledges you exist? What can you do, besides take all the sadness and anger that will never be recognized by its source and find a way to live with it all by yourself? No ghost hunter or exorcist will help you. Ghosting, as we understand it today, is the worst kind of haunting because the burden of the disappearance is left entirely on the shoulders of the haunted. It makes you long for an old-fashioned demonic possession. At least in horror films, the ghost, however unwelcome, still bothers to make an appearance”

About the authors:

Ezgi Tiryaki, MD, Dr. med., FAAN, ACC, is a Professor of Neurology and specializes in the care of ALS. She is board-certified in five specialties (Internal Medicine, Neurology, Neuromuscular Medicine, EMG and Hospice and Palliative Care Medicine) and practices in a person and caregiver-centered, interdisciplinary clinic setting. She serves as the Associate Chief of Staff for Education at the Minneapolis VA Healthcare System providing institutional leadership for professional development of over 4000 employees and 1500 health professions trainees. Dr. Tiryaki’s current focus at the VA is to enhance educational resources and improve the trainee and staff experience. Her efforts led to close monitoring of the clinical environment and innovative Upstander Training to effectively address mistreatment.

Felix Ankel , MD is one of the ICE blog editors. His profile can be found here: icenet.blog/about/about-the-editors/

References:

The views and opinions expressed in this post are those of the author(s) and do not necessarily reflect the official policy or position of The University of Ottawa. For more details on our site disclaimers, please see our ‘About’ page

Exit mobile version