Effective leadership in medical group management increasingly depends on the ability to communicate clearly, read behavioral cues accurately, and navigate emotionally charged situations with confidence. 

In this episode of the MGMA Insights Podcast, Sr. Editor and host Daniel Williams sat down with Pamela Barnum, MPA, JD  — former undercover police officer, federal prosecuting attorney, and keynote speaker at the upcoming 2026 MGMA Financial Conference in Phoenix, Arizona — to explore how her 3D Communication Framework helps leaders build trust, decode signals, and deliver messages that reduce tension and strengthen relationships.

Barnum’s unique background working undercover gave her an advanced understanding of how people communicate beyond words. “I think the only thing we can agree on is the majority of our communication comes from things other than the words spoken,” she said. 

From The Wire to Rush: The Influences Behind Her Communication Lens

After introducing her background in law enforcement, the conversation naturally turned to pop‑culture portrayals of undercover work and behavioral reading. Barnum pointed to The Wire as “really gritty and fairly authentic;” though, also wryly acknowledging, “TV is TV.” She shared that NYPD Blue was a formative favorite — “I thought it was an awesome, awesome show” — even though her real undercover life looked nothing like it. 

When asked about book or film inspirations, Barnum highlighted Rush —  the version “with Jennifer Jason Leigh and heroin and drug dealers.” She noted its realism, in part because the author of the book inspiration, Kim Wozencraft, “was a real undercover drug cop” whose experiences inspired the story. 

She also discussed the series Lie to Me and the work of Dr. Paul Ekman, pointing out that Ekman’s website breaks down “what’s based on fact and what’s kind of Hollywood.” 

Moving from pop‑culture portrayals to real‑world practice, the discussion shifted to the workplace. Barnum emphasized that “there are these nuances that we pick up on,” and knowing how to recognize them can transform everyday communication.

Understanding What Nonverbal Communication Really Tells Us

Medical leaders encounter nonstop communication: patient updates, staff concerns, financial discussions, and critical decision-making. Yet, Barnum noted, many misunderstand how much meaning comes from what isn’t said.

She explained that the “7% rule" — which claims most communication is nonverbal — is an outdated myth. “It was research back from almost 50 years ago… Clearly, there is no way to say X percent across the board for every human being, because that would be nonsense.”

Still, the underlying concept is true: Tone, cadence, pauses, posture, and presence communicate far more than words alone. As Barnum noted, “Even though we are speaking, I’m also referencing the cadence of our voice, the melody, the tone, the inflection, how many pauses we take.”

This becomes especially important in situations such as:

• Delivering corrective feedback to staff
• Communicating revenue updates under stress
• Responding to upset patients
• Leading through organizational change.

Misreading cues — or sending the wrong ones — can derail conversations before they even begin. Barnum emphasized that “people are making determinations about whether they trust you or distrust… within one-tenth of one second.”

The 3D Communication Framework: Display, Decode, Deliver

Barnum’s signature model, 3D Communication, gives leaders a practical way to strengthen interactions in real time. The framework includes:

1. Display: What You Signal

“How you show up often matters more than what you actually say,” Barnum said. 

Leaders must be aware of their presence, tone, and body language, especially in high‑stakes conversations. Something as subtle as standing partially turned toward the door, checking a watch, or rushing a greeting can send unintended messages of disinterest — especially in fast-paced clinical and administrative settings.

2. Decode: What You Observe

Decoding means reading shifts in energy, behavior, pace, or engagement. Barnum explained: “It’s noticing a shift in behavior or their energy or maybe the pace that they’re speaking. Do they seem engaged or disengaged?”

Leaders can use decoding skills to:

• Recognize early signs of burnout in staff
• Identify when a physician is overwhelmed even if they say they’re “fine”
• Understand patient frustration before it escalates.

3. Deliver: What You Do With the Information

This is where leaders turn awareness into influence. “When we can marry our situational and our personal or self-awareness, that’s really when we can take it to a 10 out of 10,” Barnum said.

Delivering includes adjusting your tone, clarifying expectations, pausing to reflect, or acknowledging concerns to build trust.

Staying Calm and Confident in Emotionally Charged Situations

Healthcare settings can escalate quickly — frustrated patients, staff conflict, scheduling crises, or financial strain. Barnum emphasized the importance of remaining regulated.

“Being regulated starts in a place from that self-awareness,” she said. “When we can regulate that internally, it comes across as a steady tone, measured movement, the ability to pause before responding instead of simply reacting.”

Calm confidence creates psychological safety. As Barnum put it, “It allows us to think more clearly, speak more honestly, and it gives other people that same permission.”

She also teaches leaders how to slow down time in difficult interactions by using an intentional 2–3 second pause. “People think that waiting two to three seconds is forever,” she said, “but it gives clarity, credibility, and calm authority.”

De-escalating Conflict Through Behavioral Mirroring

One of Barnum’s most effective undercover tools is using controlled breathing and slowed speech. She explained, “When I would slow down my breathing just a little bit intentionally… you can actually de-escalate a situation simply by doing that.”

In meetings or patient encounters, this technique helps:

• Lower emotional temperature
• Encourage others to slow their pace
• Shift a confrontational tone into a collaborative one
• Restore control during heated moments

It’s especially effective in healthcare environments where emotions can run high and time is scarce.

Why Respect Is the Most Powerful Motivator

Barnum shared a lesson she learned from an unexpected teacher: “I met a drug dealer once many, many years ago… and he gave me a theory that I have never been able to disprove.” While the original phrasing wasn’t workplace-friendly, the core idea was simple: people are motivated by money, love or emotion, and — most of all — respect.

“When we feel respected, we will often forgive people for things. We will give much more grace,” she said. Barnum advised leaders to approach conflict with respect as their “number one motive":

• Feedback lands better when people feel respected
• Teams respond more positively when respect leads the conversation
• Respect increases psychological safety and trust
• Tough conversations become easier, and more effective

In the end, respect isn’t just a courtesy — it’s the foundation that makes every conversation more productive and every decision more effective.

Avoiding Assumptions When Reading People

Although Barnum is skilled at reading behavior, she cautions leaders against jumping to conclusions. “There is not one particular thing that people will always do,” she said, dismissing common myths such as the idea that “looking up to the left means that they're recalling something.” 

She noted that cues vary widely based on how people were socialized, their environment, and even factors like vision or substance use, adding, “To draw that broad stroke, we’re doing a disservice to the person, but also to ourselves because we’re missing key information.”

Instead of fixating on individual gestures, Barnum encourages leaders to "look for variances in order to be more accurate." Real insight comes from noticing changes in energy, pace, or engagement — and interpreting those cues within the context of the full interaction. 

Final Takeaway: Slow the Moment Down

Barnum closed the interview with a powerful insight about slowing the moment down, "because that’s when we can be most effective in how we show up.” She explained that even a brief pause can shift the entire tone of an interaction. “People think that waiting two to three seconds is forever,” she said, “but it gives clarity, credibility, and calm authority.” 

Whether handling a heated staff dispute, an anxious patient, or a high‑stakes financial conversation, this simple reset can lead to thinking clearly, responding intentionally, and regaining control of the moment.

Resources 

MGMA Events

• MGMA Financial Conference
  Pamela Barnum, keynote
  “Crack the Code: 3D Communication Strategies for Powerful Results”
  Tuesday, March 3 | 8:30–9:30 a.m. | Phoenix, AZ

Books, Shows & Media Referenced

• Rush (1991 film) (film adaptation of an undercover narcotics operation) 
• Rush (author, Kim Wozencraft)
• The Wire (TV series)
• NYPD Blue (TV series)
• Lie to Me (TV series based on Dr. Paul Ekman's research) 
• Narcos (based on the life of DEA agent Steve Murphy)
• Paul Ekman Group (research on facial behavior & deception detection)