YOU KEEP TRYING to reach the chief resident while you’re covering the covid ward, but your texts go unanswered. You think to mention that apparent lapse to the colleague you’re signing out to, but you hesitate. Would making such a comment be considered unprofessional or threaten collegiality?
That’s the clinical scenario posed at the beginning of a provocative perspective published in the December 2021 issue of the Journal of Hospital Medicine, one that delves into the principles and practice of gossip among medical colleagues. “In English, gossip has a negative connotation as being trivial or malicious,” says lead author Donald Redelmeier, MD, MSHSR, a staff physician at Toronto’s Sunnybrook Health Sciences Centre and a professor at the University of Toronto. “But field studies show that most gossip is either neutral or positive, and that most is accurate.”
Gossip —or at least what the authors call “healthy gossip”—is also vitally important to the self-regulation and efficiency of a group. Gossip can be a key mechanism for airing grievances, sharing information and cementing team cohesion. In the scenario posed about the chief resident, for example, you do comment on the lack of response to your colleague, who then mentions that the chief resident is understandably absent because of a death in the family.
“The exchange of information via gossip is awfully important for any group to stay efficient.”
~ Donald Redelmeier, MD, MSHSR
Sunnybrook Health Sciences Centre
That example illustrates what Dr. Redelmeier and his co-authors describe as one of three potential prosocial benefits of healthy gossip: Gossip functions as team communication. In doing so, gossip helps group members monitor each other’s professional lives as well as exchange pointers on how to behave, maintain their reputation, enhance cooperation and deter antisocial behavior. Other potential benefits of gossip include emotional support for the person transmitting it as well as a sense of inclusion for the person on the receiving end.
Dr. Redelmeier points out that the scientific literature on gossip—which is defined as specific and subjective comments about a named individual who isn’t present—goes back more than 50 years. But the topic has taken on new urgency since the start of the pandemic. That’s because the natural flow of gossip is among the many social supports that clinicians in hospitals are now starved for, along with lunches with colleagues and in-person meetings.
“Covid has dramatically constrained everyone’s circle of friendships, and we’re all missing out on so much subjective commentary,” he says. “No one is transmitting or receiving nearly the same degree of gossip as normal, and we all have this vague, troublesome misgiving that we’re being excluded from social circles.” Dr. Redelmeier spoke with Today’s Hospitalist.
How can programs foster healthy gossip?
Three points. First, don’t prohibit gossip. That’s unnatural and it just drives gossip underground. In some institutions, you’re not supposed to gossip behind anyone’s back, but that’s too sweeping and artificial.
It’s much easier, for instance, to compliment someone behind his or her back, but if you disallow all subjective comments about someone who isn’t present, such compliments would be a problem. Some authoritarian institutions want any personal comments put into an incident report. But gossip is quick, easy, and immediate, and it’s much more natural.
Second, be vigilant and weed out toxic gossip. In our perspective, we list both direct and indirect adverse effects of gossip that is malicious or misinformed. When you are faced with toxic gossip, declare your immediate discomfort. Handle it individually and escalate it up through more formal reporting systems if the toxic gossip persists.
Third, make time for gossip even when you can connect only electronically. When I’m running a Zoom session, I sign on five minutes early to give individuals some time for friendly banter and to share personal information.
You describe several potential benefits of gossip. Which do you think is the most important?
If I was an economist, I’d say the essential contribution of gossip is group coordination and coaching. It’s an effective way to guide people who are working hard, and it helps get rid of moral hazard and the free-rider problem. It’s hugely important in helping group members police themselves and safeguard their reputation.
In addition, expressing gossip can be especially constructive when in a vexing situation. Misery loves company, and there’s definitely solace in expressing a grievance to someone without it necessarily escalating. And transmitting gossip can provide a sense of justice, which is important in any power dynamic. If you’re a medical intern who wants to make sure you’re not being mistreated, gossiping with your peers gives you some understanding without the worry of retaliation. A system where people can freely talk has some adjusting effect on individual behavior.
As for the flip side—the worst adverse effect of unhealthy gossip—you might think it’s the propagation of toxic misinformation. But I believe the worst effect is magnifying a social inequity by leaving someone out. It’s darn painful for any of us to feel excluded, and when you’re not receiving any subjective commentary, it’s lonely. Moreover, you can’t force someone to be your friend.
What if you’re having a hard time judging whether gossip you’re hearing—or about to transmit—is malicious or not?
We all have fallible judgment. When I’m not sure if my gossip is appropriate, I’ll talk it over with a trusted friend first and get timely non-punitive feedback.
It’s natural for people to hold back on gossip, thinking it may be misconstrued. They’re holding back even more in the covid era because it’s awkward to exchange information via e-mail or Zoom for fear the words will come back to haunt them. You don’t know how you’re coming across and the emotional reverberation is missing. And yet, the exchange of information via gossip is awfully important for any group to stay efficient.
Phyllis Maguire is Executive Editor of Today’s Hospitalist.
Published in the March/April 2022 issue of Today’s Hospitalist