THE EFFECTIVENESS OF COMMUNICATION AMONG

HEALTHCARE PERSONEL

INTRODUCTION

The Communication is a two-way process wherein the message

in the form of ideas, thoughts, feelings, opinions is transmitted
between two or more persons with the intent of creating a shared
understanding.Simply, an act of conveying intended information
and understanding from one person to another is called as
communication. The term communication is derived from the
Latin word “Communis” which means to share. Effective
communication is when the message conveyed by the sender is
understood by the receiver in exactly the same way as it was
intended. The elements of the communication process are the
sender, encoding the message, transmitting the message through
a medium, receiving the message, decoding the message,and
feedback.
Types of Communication

There are different kinds of information. The two major types

are verbal communication and non-verbal communication.

Verbal Communication
Verbal communication is the sharing of information through
speech. It includes the information that people hear on radios,
televisions, telephones, speeches and interviews.
Effective verbal communication incorporates the use of
interpersonal skills. Factors that contribute to the effectiveness
of verbal communication are the clarity of voice and perception
and listening skills of the recipient. Verbal communication, if it
is conducted in a two-way loop, is usually based on immediate
responses. Verbal communication is also influenced by eye
contact, gestures and facial expressions. The hearing and
understanding skills of recipient help him understand the context
of information and develops his responses accordingly.
Linguistics and the way of presenting information build the
impact of communication on the recipient. (2)
Non-verbal Communication
Written or spoken words are not the only means for sharing a
message. When there is no use of words, and the recipient
understands what the sender is asking, then it is known as
non-verbal communication. Non-verbal communication is
conducted through eye contact, postures, gestures, facial
expressions, chronemics and haptics.

Body posture (how we stand or sit): we’ll communicate much

better when we bring our face to the same level as the other
person and do not tower above them if he or she is in bed or a
chair. We should be relaxed, not fidgety and impatient. And it’s
important that we adopt an ‘open’ stance, showing the person
that we want to be there and are not desperate to rush away and
do something else – standing well back from the person with
your arms crossed and flicking your eyes constantly towards the
door isn’t exactly an encouragement to good communication!

Eye contact: keep good eye contact with the person, but don’t
stare – and remember that for people from some cultures,
making eye contact can seem a bit rude. This emphasises the
importance of knowing about the individuals we’re caring for
and learning how to approach them in the right way.

Facial expression: so much of what we are thinking is given

away by the expressions on our face. We may not even realise
we are rolling our eyes, grimacing or stifling a yawn, none of
which will encourage patients/clients to keep talking to us. We
need to be aware of our facial expressions and control them at
all times.
Touch: touch is a very powerful means of communication.
Lightly touching a person’s hand can convey your concern and
affection for them. But as with eye contact, the touch has to be
appropriate, and there are important cultural issues around touch
that need to be understood. It’s also important that
patient/clients give permission for you to touch them, something
we looked at in more detail in consent

Communication Process
The communication is a dynamic process that begins with the
conceptualizing of ideas by the sender who then transmits the
message through a channel to the receiver, who in turn gives the
feedback in the form of some message or signal within the given
time frame. Thus, there are Seven major elements of
communication process:
1. Sender: The sender or the communicator is the person who
initiates the conversation and has conceptualized the idea that he
intends to convey it to others.
2. Encoding: The sender begins with the encoding process
wherein he uses certain words or non-verbal methods such as
symbols, signs, body gestures, etc. to translate the information
into a message. The sender’s knowledge, skills, perception,
background, competencies, etc. has a great impact on the
success of the message.
3. Message: Once the encoding is finished, the sender gets the
message that he intends to convey. The message can be written,
oral, symbolic or non-verbal such as body gestures, silence,
sighs, sounds, etc. or any other signal that triggers the response
of a receiver.
4. Communication Channel: The Sender chooses the medium
through which he wants to convey his message to the recipient.
It must be selected carefully in order to make the message
effective and correctly interpreted by the recipient. The choice
of medium depends on the interpersonal relationships between
 the sender and the receiver and also on the urgency of the
message being sent. Oral, virtual, written, sound, gesture, etc.
are some of the commonly used communication mediums.
5. Receiver: The receiver is the person for whom the message is
intended or targeted. He tries to comprehend it in the best
possible manner such that the communication objective is
attained. The degree to which the receiver decodes the message
depends on his knowledge of the subject matter, experience,
trust and relationship with the sender.
6. Decoding: Here, the receiver interprets the sender’s message
and tries to understand it in the best possible manner. An
effective communication occurs only if the receiver understands
the message in exactly the same way as it was intended by the
sender.
7. Feedback: The Feedback is the final step of the process that
ensures the receiver has received the message and interpreted it
correctly as it was intended by the sender. It increases the
effectiveness of the communication as it permits the sender to
know the efficacy of his message. The response of the receiver
can be verbal or non-verbal.

Note: The Noise shows the barriers in communications. There

are chances when the message sent by the sender is not received
by the recipient.

The other important feature is the feedback cycle. When two

people interact, communication is rarely one‐way only. When a
person receives a message, she responds to it by giving a reply.
The feedback cycle is the same as the sender‐receiver feedback
noted in Figure . Otherwise, the sender can't know whether the
other parties properly interpreted the message or how they
reacted to it. Feedback is especially significant in management
because a supervisor has to know how subordinates respond to
directives and plans. The manager also needs to know how work
is progressing and how employees feel about the general work
situation.
The critical factor in measuring the effectiveness of
communication is common understanding. Understanding exists
when all parties involved have a mutual agreement as to not
only the information, but also the meaning of the information.
Effective communication, therefore, occurs when the intended
message of the sender and the interpreted message of the
receiver are one and the same. Although this should be the goal
in any communication, it is not always achieved.

The most efficient communication occurs at a minimum cost in

terms of resources expended. Time, in particular, is an important
resource in the communication process. For example, it would
be virtually impossible for an instructor to take the time to
communicate individually with each student in a class about
every specific topic covered. Even if it were possible, it would
be costly. This is why managers often leave voice mail
messages and interact by e‐mail rather than visit their
subordinates personally.

However, efficient time‐saving communications are not always

effective. A low‐cost approach such as an e‐mail note to a
distribution list may save time, but it does not always result in
everyone getting the same meaning from the message. Without
opportunities to ask questions and clarify the message,
erroneous interpretations are possible. In addition to a poor
choice of communication method, other barriers to effective
communication include noise and other physical distractions,
language problems, and failure to recognize nonverbal signals.

Sometimes communication is effective, but not efficient. A

work team leader visiting each team member individually to
explain a new change in procedures may guarantee that
everyone truly understands the change, but this method may be
very costly on the leader's time. A team meeting would be more
efficient. In these and other ways, potential tradeoffs between
effectiveness and efficiency occur.
Impotence of Communication
Effective communication between a health practitioner and their
patient can improve overall satisfaction and contribute towards
better longterm health outcomes. How well a patient
understands the information provided can also have an impact
on healthcare decisions they might make in future. If a patient
does not understand the information they receive, there may be
an increased risk of instructions being followed incorrectly, or
an adverse event occurring..

Having good communication with patients/clients helps them in

three main ways.

Good communication helps patients/clients feel at ease

It’s common for people who need health care services to feel
anxious about their health, about what tests and treatment they
might have to undergo and about what the future holds for them.
This can sometimes lead them to speak out of character, perhaps
being a bit rude or aggressive. Having good communication
with health care workers will reduce their anxiety and build their
confidence.

Good communication helps patients/clients to feel in control

It’s easy for people to feel that they give up all control of their
lives once they enter the health system. If they’re in hospital, for
instance, even simple everyday things they normally control,
like when they get out of bed, when they wash and when they
eat, might be dictated by someone else. Losing control can make
people feel helpless and hopeless, which isn’t good for boosting
their chances of recovery from illness. But good communication
can avoid these feelings – it can help people to see that they still
have a say and are still in charge of their own lives.
Good communication makes patients/clients feel valued

The most precious thing we can give to another person is our

time. When we show we’re prepared to lay aside all the other
things we need to do to spend time with someone, to listen to
them, get to know them and understand how they are feeling,
we’re showing that we really value that person. Being able to
communicate well helps us achieve this with patients/clients.
Introduction to communication Barrier

Most people would agree that communication between two

individuals should be simple. When you communicate, you are
successful in getting your point across to the person you're
talking to.

It's important to remember that there are differences between

talking and communicating. When we talk, we tend to erect
barriers that hinder our ability to communicate. Some of the
communication barriers during conversation include:

 The use of jargon. Over-complicated, unfamiliar and/or

technical terms.
 Lack of attention, interest, distractions, or irrelevance to the
receiver.
 Differences in perception and viewpoint.
 Physical disabilities such as hearing problems or speech
difficulties.
 Language differences and the difficulty in understanding
unfamiliar accents.
 People often hear what they expect to hear rather than what is
actually said and jump to incorrect conclusions.
In this Guide, we will cover the seven types of barriers to
effective communication.

Physical Barriers
Physical barriers are easy to spot - doors that are closed, walls
that are erected, and distance between people all work against
the goal of effective communication. While most agree that
people need their own personal areas in the workplace, setting
up an office to remove physical barriers is the first step towards
opening communication.

Many professionals who work in industries that thrive on

collaborative communication, such as architecture, purposefully
design their workspaces around an "open office" plan. This
layout eschews cubicles in favor of desks grouped around a
central meeting space. While each individual has their own
dedicated work space, there are no visible barriers to prevent
collaboration with their co-workers. This encourages greater
openness and frequently creates closer working bonds.

Examples Of Physical Barriers

Examples of physical barriers that prevent individuals from
effective communication include:

 Environment - Some barriers are due to the existing

environment. For example, if you are standing in adverse
weather conditions, your conversation would be hampered
because you would not be able to pay full attention to what
the other person is saying.
 Distance - Distance also plays an important part in
determining the course of a conversation. For example, if the
staff in an organization are made to sit in different buildings
or different floors, they might have to substitute face to face
communication with phone calls or emails.
 Ignorance of Medium - Communication also includes using
signs and symbols to convey a feeling or a thought. However,
if there is a lack of ignorance about the medium in which
sender is sending the message, the conversation can be
hampered.
Overcoming Physical Barriers
To overcome physical barriers within the workplace, here are
some helpful hints:

 If you send a lot of email or digital messages, make sure you

are surgical in your word choice. Choosing the correct words
 and stamping out ambiguity is the only step to making
communication more effective. Face-to-face communication
is far superior for most people, especially once the connection
has already been made.
 Open-concept offices are designed to improve workflow and
communication. This concept have grown rapidly over the
last decade. A report outlining 6 design meta trends for 2014
by Gensler, states, "As organizations recognize the benefits of
face-to-face interaction, 'getting everyone under one roof' will
grow.
 Video conferencing adoption is increasing as enterprises turn
to higher-quality, lower-cost video technology to improve
workforce collaboration and reduce reliance on travel.

Cultural Barriers
Cultural barriers are a result of living in an ever shrinking
world. Different cultures, whether they be a societal culture of a
race or simply the work culture of a company, can hinder
developed communication if two different cultures clash. In
these cases, it is important to find a common ground to work
from. In work situations, identifying a problem and coming up
with a highly efficient way to solve it can quickly topple any
cultural or institutional barriers. Quite simply, people like
results.

Examples Of Cultural Barriers

Examples of cultural barriers that prevent individuals from
effective communication include:

 Generational - Each age group has a different general

approach to work, which often leads to conflicts with older
workers describing younger workers as "slackers," and
younger workers criticizing older workers as being "out of
touch."
 Status and Resistance - Workers who are accustomed to
workplaces where seniority and status are emphasized may
find it difficult to adapt to more fluid environments, where job
 titles are de-emphasized and production methods do not
always follow a predetermined set of guidelines.
Overcoming Cultural Barriers
To overcome cultural barriers within the workplace, here are
some helpful hints:

 Determine whether a specific behaviour or attribute is a

requirement of the job. There are some cultural differences
with your employees that you just have to accept and not try
to change if you want your employees to perform well.
However, there also are some cultural issues that are relevant
to your business and to which employees of a different culture
will have to adapt to if they are going to succeed in
the work culture.

 Identify whether or not you can reasonably accommodate

the cultural difference. Some cultural differences - such as
an employee's willingness to confront her boss - can be
accommodated by slightly altering the expectation or
changing the circumstances of the situation. For example,
some cultures are not responsive to stern feedback, but they
are receptive to less direct insinuations regarding their
performance. If you ask your employees they will tell you
how best to communicate with them without violating their
cultural norms.

 Determine how best to accommodate the cultural

difference. Some cultures are group-centric rather than
individually focused. In such cases praising an individual for
their effort, rather than recognizing the entire group, can
create contention among the group and embarrassment for the
individual, thereby decreasing the employee's performance
instead of enhancing it. Likewise, giving someone negative
feedback in public, even if it is not severe, can have a
detrimental effect on employees of certain cultures. Being
sensitive to and aware of the unique cultural differences of
your employees will help you determine where you need to
alter your management style or practices.
 Learn about other cultures. There are numerous excellent
books and articles on cultural diversity in your local
bookstore or library. The internet is a valuable tool of
unlimited resources explaining the differences in cultures.
There is no excuse for your not understanding the cultural
issues of your employees when you have so much information
literally at your fingertips.

 Ask your employees for insight into how best to manage

them. If you show an open and honest willingness to learn
and to adjust your management practices, most of your
employees will tell you how to accommodate their cultural
needs if you ask them.
Language Barriers
Language barriers seem pretty self-inherent, but there are
often hidden language barriers that we aren't always aware of. If
you work in an industry that is heavy in jargon or technical
language, care should be taken to avoid these words when
speaking with someone from outside the industry. Without
being patronizing, imagine explaining a situation in your
industry to a child. How would you convey these concepts
without relying on jargon? A clear, direct narrative is preferable
to an incomprehensible slew of specialty terms.

Examples Of Language Barriers

Examples of language barriers that prevent individuals from
effective communication include:

 Dialects - While two people may technically speak the same

language, dialectal differences can make communication
between them difficult. Examples of dialectical language
barriers exist worldwide. Chinese, for example, has a variety
of dialects that are commonly spoken, including Cantonese
and Mandarin.
 Language Disabilities - Language disabilities are physical
impediments to language. Physical language disabilities that
cause language barriers include stuttering, dysphonia or an
articulation disorder and hearing loss.
Overcoming Language Barriers
To overcome language barriers within the workplace, there are a
few things you can do:

 Translate all relevant documents into the primary language

of your employees. There are several free websites that
translate text from one language to another. However, you
have to be careful since the translation is not always in the
exact same dialect as that of your employees. Also,
sometimes the meaning of a word used in written translation
does not always correspond to the meaning you wish to
convey in your work documents.

 Use an interpreter whenever you give instructions or

provide feedback to your employees. There may be someone
in your organization who speaks both languages fluently
enough to convey your message to your employees. Find
someone who you trust to translate your instructions and
feedback properly.

 Provide language classes for your employees on the basic

language requirements for your business. Teach them work
words, phrases, warnings, and other critical communication
elements that are necessary for them to perform to your
performance standards. Teach the basics first. Give all of your
employees a "survival" crash course in the predominant
language of your workplace. Later, if you have the desire and
the resources, you can provide additional opportunities for
your employees to learn the language skills they need in order
to "thrive" in the workplace.

 Use both telling and showing methods of training. Simplify

your training methods, particularly those that rely heavily on
telling versus showing. Demonstrate what you want and then
have the employees perform the function as you observe their
performance. Re-demonstrate as often as needed until the
employees can perform the task successfully.
 Use visual methods of communication more than audio.
Show more than tell. Explain it with pictures as much as
possible. Take a lesson from the airlines in how they convey
their safety instructions. Use pictures in your instruction
manuals rather than words. Almost every step in every
process can be described in picture format. Give your
employees signs, cue cards or other methods to help them
learn.

 Use repetition. As with any new concept, most people don't

learn something the first time they hear it. Employees need to
hear the same message over and over before they fully grasp
it. Don't expect people to learn anything after being told once.
This is true of all of your employees whether they have a
language barrier or not.

 Never raise your voice or over-enunciate your words. Talk

slower, not louder. Speak clearly, not forcefully. People of a
different language and culture can hear fine. They probably
also are intelligent enough to grasp what you are saying if you
intelligently deliver your message without talking down to
them. Don't speak "Pidgin English." Speak correct English the
correct way, just more clearly. People cannot learn the
language right if you don't speak it right.

 Use simpler words with fewer syllables. Be aware of the

complexities of your words. Use more common words that
convey your message in simpler terms. Again, don't talk
down; just use a less complex vocabulary.

 Learn the basics of your employee's language. If you want

to communicate effectively and build rapport with your
employees you should consider learning a few words and
phrases in their language. Nothing sends the message that you
value the diversity of your employees more than your
willingness to learn from them. Have them teach you how to
say hello, goodbye, please, thank you, and other important
pleasantries you can use in your interactions with them.
 Have the employee demonstrate their understanding. Don't
assume the employee understands; check for understanding.
Ask the employee to demonstrate that they know how to do
what you have asked them to do.
Perceptual Barriers
Perceptual barriers are internal. If you go into a situation
thinking that the person you are talking to isn't going to
understand or be interested in what you have to say, you may
end up subconsciously sabotaging your effort to make your
point. You will employ language that is sarcastic, dismissive, or
even obtuse, thereby alienating your conversational partner.

Think of movie scenarios in which someone yells clipped

phrases at a person they believe is deaf. The person yelling ends
up looking ridiculous while failing to communicate anything of
substance.

Examples Of Perceptual Barriers

Examples of perceptual barriers that prevent individuals from
effective communication include:

 Perceptual Filters - We all have our own preferences, values,

attitudes, origins and life experiences that act as "filters" on
our experiences of people, events and information. Seeing
things through the lens of our own unique life experiences or
"conditioning" may lead to assumptions, stereotyping and
misunderstandings of others whose experiences differ from
our own.
 Triggers and Cues - What we say is affected by how we say
it (tone, volume) and by our nonverbal cues, such as body
language and facial gestures. For example, you may perceive
a situation differently if the person you are speaking with is
smiling or frowning, has body odour and is standing too close
or is not giving you direct eye contact.
Overcoming Perceptual Barriers
To overcome perceptual barriers within the workplace, there are
a few things you can do:
 
The audience may make assumptions about you or the
situation; perhaps you are new to the organization, or the
situation is a challenging one. To get your message past these
barriers, provide evidence to support your claims and enhance
your credibility.


 Effective communication relies on being aware of nonverbal
aspects of interactions with others. It is equally important to
be aware of one's own nonverbal behaviours and be sensitive
to how they may be perceived. For instance, maintaining eye
contact when communicating indicates interest. Staring out
the window or around the room is often perceived as boredom
or disrespect.
Interpersonal Barriers
Interpersonal barriers are what ultimately keep us from
reaching out to each other and opening ourselves up, not just to
be heard, but to hear others. Oddly enough, this can be the most
difficult area to change. Some people spend their entire lives
attempting to overcome a poor self-image or a series of deeply
rooted prejudices about their place in the world. They are unable
to form genuine connections with people because they have too
many false perceptions blocking the way.

Luckily, the cure for this is more communication. By engaging

with others, we learn what our actual strengths and weaknesses
are. This allows us to put forth our ideas in a clear,
straightforward manner.

Examples Of Interpersonal Barriers

Examples of interpersonal barriers that prevent individuals from
effective communication include:

 Desire to Participate - The lack of desire to participate in the

communication process is a significant barrier. There is
nothing more frustrating than trying to communicate with an
individual that clearly does not want to.
 Desire to Explore - Unwillingness to explore different ideas,
opinions, and priorities create communication barriers every
day of our lives. A clear lack of desire to explore your views,
opinions, or ideas can be extremely frustrating.
Overcoming Interpersonal Barriers
To overcome interpersonal barriers within the workplace, here
are some helpful hints:

 Use simple words to convey the message. To have an

effective process of interpersonal communication, you have to
simplify language. Everyone hates to decipher spoken words,
reserve the deciphering to the writing and when speaking,
keep it simple and easy to understand.
 Learn the art of listening. A person will always try to get his
opinions across first before listening to the other person's
point of view. To improve interpersonal communication,
listen both attentively and proactively.
 Keep composure while communicating. The process of
interpersonal communication is more effective if emotions are
kept at bay. Keeping your composure while talking or
negotiating with a business partner will keep you on the right
track towards your goal.
 Provide constructive criticism. Constructive criticism is
perhaps the best sign that you are communicating with the
other person on a more personal level. Both the sender and
receiver of communications may use feedback for effective
interpersonal communication.
Gender Barriers
Gender barriers 聽 have become less of an issue in recent years,
but there is still the possibility for a man to misconstrue the
words of a woman, or vice versa.

Even in a workplace where women and men share equal stature,

knowledge and experience, differing communication styles may
prevent them from working together effectively. Gender barriers
can be inherent or may be related to gender stereotypes and the
ways in which men and women are taught to behave as children.
Although not all men or all women communicate the same way
as the rest of their gender, several traits that tend to be more
common in one gender or the other have been identified.
Understanding these tendencies is key in creating a work
environment that fosters open communication among all
employees.

Examples Of Gender Barriers

According to Heather R. Huhman of Forbes, becoming aware of
the following generalizations may help you more effectively
communicate at work:

 Women talk about other people. Men talk about tangible

things like business, sports, food and drinks.
 Women ask questions to gain an understanding. Men talk to
give information rather than asking questions.
 Women are more likely to talk to other women when a
problem or conflict arises. Men are often known for dealing
with problems or issues internally
 Women focus on feelings, senses and meaning. They rely on
their intuition to find answers. Men focus on facts, reason and
logic. They find answers by analyzing and figuring things out.
 A disagreement between women affects many aspects of their
relationship and may take a long time to resolve. Men can
argue or disagree and then move on quickly from the conflict.
Please keep in mind that these are generalizations, and do not
necessarily apply to every individual.

Overcoming Gender Barriers

To overcome gender barriers within the workplace, here are
some helpful hints:

 Educate Team About Gender Bias. Bias is embedded in

stereotypes and organizational practices that can be hard to
detect, but when people are made aware of it, they see
possibilities for change.
 Create Safe "Identity Workspaces". Companies should
encourage women to build communities in which similarly
positioned women can discuss their feedback, compare notes,
and emotionally support one another's learning. Identifying
common experiences increases women's willingness to talk
openly, take risks, and be vulnerable without fearing that
others will misunderstand or judge them.

Emotional Barriers
Emotional barriers can be tough to overcome, but are
important to put aside to engage in conversations. We are often
taught to fear the words coming out of our own mouths, as in the
phrase "anything you say can and will be used against you."
Overcoming this fear is difficult, but necessary. The trick is to
have full confidence in what you are saying and your
qualifications in saying it. People often pick up on insecurity.
By believing in yourself and what you have to say, you will be
able to communicate clearly without becoming overly involved
in your emotions.

Examples Of Emotional Barriers

Examples of emotional barriers that prevent individuals from
effective communication include:

 Anger - Anger can affect the way your brain processes

information given to you. For example, angry people have
difficulty processing logical statements, limiting their ability
to accept explanations and solutions offered by others
 Pride - The need to be right all the time will not only annoy
others, it can shut down effective communication. For
example, you might focus only on your perspective, or you
might come up with ways to shoot down other people before
you even listen to their points.
 Anxiousness - Anxiety has a negative impact on the part of
your brain that manages creativity and communication skills.
For example, your constant worries can hinder your ability to
concentrate on the information you are giving or receiving.
Overcoming Emotional Barriers
To overcome emotional barriers within the workplace, here are
some helpful hints:

 Removing Yourself. Angry people have difficulty processing

logical statements, limiting their ability to accept explanations
and solutions offered by others. With this in mind, remove
yourself from communication until you feel you can collect
your thoughts, think clearly and hold back potentially hurtful
and undue comments.
 Accepting Imperfections. The drive to win every argument
or get the last word often spawns from overcompensation, or
trying to cover emotional insecurities with a sense of
superiority. Other people might find you easier to
communicate with when you accept your imperfections from
time to time.
 Relaxation Exercises. While a mental health professional
should address anxiety disorders such as post-traumatic stress
disorder or phobias -- typical anxiety, like the anxiety you feel
before giving a speech -- can be managed with relaxation
exercises.

Patient with sensory problems

SOLUTION
Speak slowly, listen carefully. Don’t shout to
someone who has a hearing impairment – just
pronounce your words clearly and make sure the
person can see your lips. Use communication aids –
hearing aid, Braille, written communication.

Patient living in dementia

 SOLUTION
Remove all distractions if possible, such as a TV
playing in the corner, and try to find a quiet
location where the person can focus more easily.
Ask family/loved ones how they communicate with
person – they are often expert in this

Conclusion
Communication is not a one-way street. To have others open up to you, you must be
open yourself. By overcoming the seven barriers to communication, you can ensure
that the statement you are making is not just heard, but also understood, by the
person you are speaking with. In this way, you can be confident that your point has
been expressed.