Why does humor in the workplace sometimes have magical effects and at other times is disastrous? The answer is not as simple as “some jokes are better than others,” or “some people are funny while others are not.” The reality is that injecting light-hearted remarks into professional interactions always entails risk.
Our interest in humor in health care emerged unexpectedly during explorations of a large dataset of patient comments aimed at understanding what patients value most in their care. Artificial intelligence and natural language processing were used to extract positive and negative insights from comments in 988,161 survey responses received from patients about their experiences across the United States during 2020. Of these, 17% were inpatient and 83% outpatient experiences, respectively, and it is possible that some of the responses were from the same patients.
From these comments, our analytical technology extracted 1,270,000 insights and categorized both positive and negative insights into themes and subthemes. This technology makes it possible to identify issues that are important to patients but may not be captured by standard survey questions.
In fact, there are no survey questions to our knowledge in which patients are asked if they found their doctors or nurses humorous. But in our analyses of patients’ narrative comments, humor came up repeatedly when they described positive experiences with their clinicians. Patients commented on how their clinicians interacted with them, and regardless of what survey questions they were asked, they seemed to see the clinician’s ability to use humor in difficult moments as reinforcing acts of caring.
A valued condiment
Our analyses indicate that humor is not the main course when it comes to caring but is more akin to a valued condiment. The actual main course that is appreciated by patients is courtesy, respect, and related subthemes.
Patients don’t remark on the technical skill of clinicians very often, but their comments suggest deep appreciation of empathy, kindness, helpfulness, and patience. And when patients note that care with these attributes was accompanied by humor, the humor seems more than welcome.
On the other hand, when patients perceive the absence of courtesy and respect, the use of humor by caregivers adds insult to injury.
In short, humor is not a stand-alone asset or liability. It serves to amplify the positive or the negative signals that patients pick up from their doctors and nurses.
This verbatim comment is an example of how humor can convey helpfulness: “I had an excellent anesthesiologist who came and explained the procedure, made me laugh, and put me at ease.”
And here is one that shows lack of helpfulness: “My mother drove 1.5 hours to [town] only for [Dr. Q] to question why she was in the rehab hospital for so long, who were her doctors and ‘what do you want from me?’ My mother wanted to get up and leave. He even made a comment, ‘Well I see your CAT scan. Looks like you still have a brain. I see you still have a crack on the skull. Maybe that’s why you still have headaches.’ My mother returned home without any clarity to the cause of her headaches let alone relief.”
(More examples available here.)
Although our data come from health care, we think that this basic approach is likely to be generalizable to other settings. Humor offered for no purpose other than providing a distraction is often irritating. Humor in the absence of obvious courtesy and respect can be taken as callous disregard.
Adapted from When Is Humor Helpful? published in Harvard Business Review. Image: https://bit.ly/2ZDKvGR