A construction worker walked up to the reception desk at a doctor's office and was asked why he was there.

"I have shingles," he replied.

The receptionist asked for his name, address and insurance information and told him to have a seat.

Ten minutes later, a nurse called his name, took him back to the examining room and asked him again why he came to the office. Again, he answered, "I have shingles." She asked him some medical questions and told him to stay there until he could be seen.

A short while passed, and a different nurse entered the room, took his blood pressure and temperature, and asked him to change into a gown. She assured him the doctor would see him shortly.

Thirty minutes later, the doctor finally appeared. He said, "I understand you have shingles. Where are they?"

The construction worker replied, "Outside in my truck. Where do you want them? And can I get dressed now?"

Talk about a breakdown in communication!

It's been said that a message sent is only as good as the receiver's perception of it.

Verbal communications tend to create confusion and misunderstanding for a very simple reason: the 500 most commonly used words in the English language have more than 14,000 definitions.

To make communication really work, we have to make sure the people we're talking to clearly understand what we are saying, and that we understand it just as clearly. Communication requires effective sending and receiving. To avoid a breakdown in communications, break down your message so that everyone can understand it.

The most basic yet crucial leadership skill is communication. From time to time, re-evaluate your performance in these fundamental areas: speaking, listening, writing, leading meetings and resolving conflict.

Good verbal skills are essential. You have to be able to explain your requests, instructions, ideas and strategies to people inside and outside your organization. Look for opportunities to hone your speaking skills at conferences, in meetings and among friends. Pay attention to the people around you. Repeat and paraphrase what they say to make sure you understand -- and to show that you take their opinions seriously.

The paper trail you leave tells people a lot about how clearly you think and express yourself. Don't send even the simplest email without rereading it critically to be sure it says exactly what you want it to say.

Sharpen your ability to keep meetings on track and elicit productive comments. You should encourage other people to share their ideas without letting discussions meander aimlessly. Remember that every meeting should begin with a solid agenda and conclude with a commitment for action. And it is helpful to circulate a written recap so that no details are overlooked and everyone has the same information.

Conflict can be subtle, but you still must defuse it if you want things to get done. You'll use a lot of the skills already discussed to encourage people to open up and clear the air about their disagreements. Maintaining good communication is most important when conflicting ideas arise. Don't shy away from the disagreements: Often, a combination of ideas can result in a great outcome.

Finally, never underestimate the value of not saying something. Silence can be a very effective form of communication, and can prevent problems. Even carefully chosen words can be turned against you.

Consider the challenge said to have once faced Thomas Edison. A big company wanted to buy one of his inventions. But Edison had no idea how much he should ask for it, so he requested a few days to think about the price.

Edison and his wife discussed the offer. He was stunned when his wife suggested he ask for $20,000, a huge price tag in those times. But he agreed to float that figure.

When he met with the company representatives, he intended to ask for $20,000. But he just couldn't get the number out, and remained silent. After an uncomfortable silence, the Western Union rep finally said, "How about $100,000?" For the second time in a few days, Edison was stunned. His silence said much more than his words.

Mackay's Moral: Talk is cheap, but misunderstandings can be costly.

A man had gone to a circus as a small boy and decided to return years later. He was sitting in a cheap seat when an elephant came along, reached up into the stands, wrapped his trunk gently about the man and carried him over to the best seat.

The man turned to his neighbor and said, "That elephant remembered the last time I was here years ago. I fed him peanuts." Just then the elephant came back, lifted his trunk, pointed it straight at the man and blew a stream of water in his face. "I forgot I gave them to him still in the bag," the man added.

This is a classic story about memory, or what I call "that thing I forget with." But memory is no laughing matter. It's serious stuff and can help you a great deal in business and in life.

If you read this column on a regular basis, you are familiar with one of my important lessons: "Pale ink is better than the most retentive memory." In other words, write things down.

I have many coaches, including a memory coach. His name is Benjamin Levy. He's been profiled in Fortune magazine and many other media outlets. He's one of the best memory experts around. He's even performed at the White House for President Obama and friends.

I've seen Benjamin meet more than 100 people at a dinner party and be able to say goodbye to each person by name. How does he do it? He says we just need to "wake up our brain," tell it to pay attention and not just let new information slide past. Here are a few of his techniques.

The first is the power of association. For me, if I meet someone named Neil, I immediately think of all the Neils I can recall -- Neil Armstrong, Neil Diamond, Neil Young, Neil Patrick Harris and so on.

In Benjamin's case, he uses the acronym "A NOVEL" to enhance the mental images he makes that help him remember names and other things. "A" stands for active pictures or an action movie. For example, if he met a woman named Fern, he would imagine throwing ferns at her or her throwing a fern. Things are more memorable with action.

"N" is for new. You want a new image, one you haven't seen before. You need something exceptional. "O" is for obscene. "The big dirty secret of memory training is a tremendous percentage of it is having obscene and sexual thoughts in your head," Benjamin said. "The more you make images interesting and memorable, the better you'll remember them."

"V" is for violent. The more stuff you have going on the better -- a broken window, bleeding and so on. "E" is for emotional. "When you make your visual pictures, if people are having emotions ... your images are more memorable," Benjamin said.

Finally "L" is for ludicrous. Try to make your mental picture really ludicrous or funny in some way. Benjamin explains: "So, for instance, if I meet a woman named Karen, for me Karen is always carrots. Will I somehow connect a carrot to the woman named Karen? No, I will visualize a giant carrot connected to Karen, or I will picture hundreds or thousands of carrots connected to her. More ludicrous."

Benjamin adds one other ingredient -- color. Make your images as colorful as you can.

He also uses a lot of metaphors. "Memory work is about transformation, transforming one thing into another, to create the most powerful and memorable mental image possible," Benjamin said.

In memory training, you are constantly associating, linking or connecting one thought with another. This quadruples your retention. As Benjamin says, "You have to give the brain the material the way it wants it."

If you remember one thing from this column, it should be the title of Benjamin's book "Remember Every Name Every Time." I've only scratched the surface of his valuable advice. He shares a variety of practical techniques that have worked for me, such as rhythm and repetition.

We may not all be blessed with Benjamin's gifts, but he's given us a remarkable present: memory techniques that we can all use.

Mackay's Moral: Don't just make memories -- make your memory work for you!

You might have heard the saying: If you are persistent, you will get it. If you are consistent, you will keep it.

This statement describes professional golfer Jordan Spieth to a tee. Spieth was the defending champion of the Masters golf tournament. He led this year's tournament for the first three rounds and had a five-stroke lead going into the final nine holes. Then things began to fall apart. He proceeded to bogey two straight holes and then had a disastrous quadruple bogey on the 12th hole from which he never recovered, losing the tournament to Danny Willett.

Spieth was anything but consistent. Willett was less volatile with his scores. He made 15 birdies and eight bogeys during the tournament. But more important, five of his birdies came during the final round, with no bogeys. In short, Willett was more consistent, which is why he won the tournament.

Everyone wants consistency, whether it regards running a business, investing, supervising employees, dieting, exercising or parenting. Consistency develops routines and builds momentum. It forms habits that become almost second nature.

For example, think about one of your goals. It requires consistent effort to push toward that goal. If you are not consistently focused on achieving it, you will likely fall back into old habits or lose interest. Being consistent is the difference between failure and success. The late Jim Rohn, entrepreneur and author, said: "Success is neither magical nor mysterious. Success is the natural consequence of consistently applying basic fundamentals."

Leadership guru John Maxwell said: "Small disciplines repeated with consistency every day lead to great achievements gained slowly over time."

Consistency is especially important in business. Restaurants, for example, must be consistent, because customers come in expecting the same good food all the time. If they slip up even one day, they lose customers. Consistency establishes reputations.

In any business, customers expect the same standards. The last thing people want is to be surprised -- they want predictability. Let's face it -- we live in an unpredictable world. When people get what they want, they are happy and will return.

Managers and leaders must be consistent in their behavior and attitude. This sets a good example for employees and eases concerns. If bosses are inconsistent, it can waste valuable time for both employees and customers. That's why trust is built upon the foundation of consistency.

Even the most committed employees become bored doing routine work. It's hard for a leader to inspire people to do these tasks well; it's even harder to create a sense that this drudgery is important to the organization's larger goals. This is true even in exciting vocations like firefighting. Battalion Chief John Salka of the New York City Fire Department suggests some interesting solutions in his book "First In, Last Out."

One of the dull parts of a firefighter's life is inspecting buildings for fire code violations. Most firefighters join the department for the high-risk activity of fighting fires; however, inspections and paperwork seem miles from where their enthusiasm lies.

Salka accompanies his crews on their inspections to encourage them to take this low-risk activity very seriously. Throughout the inspection, Salka pulls his crew members aside and asks them how they would approach the building if it were on fire right then.

Soon, the firefighters are taking the inspection as seriously as if it were a real fire. After all, the problems they miss in an inspection may come back to "burn" them if a fire starts. The people you lead do better in real-life situations when you show them the significance of even dull tasks.

Mackay's Moral: Don't be resistant to being consistent.