The 1st Step | Behavior Change

You won’t believe how much deliberation went into deciding what this first Blog Post topic should be. It’s really quite pathetic to think about the mental energy and procrastination that was wasted on milling through potential topics and themes especially considering that this is he very first post on a blog that no one knows about (I haven’t exactly been telling everyone I have a new website and blog) and the readership that could probably fit comfortably in a phone booth (does anyone know what these are anymore?).

So, I got to thinking about what is the purpose of this blog (Start with the end in mind, right?). Well, like any blog the purpose is going to be to voice my opinion which is based on my experience & research. I will try to back up any crazy looking (or not widely excepted truths) with some literature from self proclaimed or actual experts and/or studies (if available). In the process maybe someone out there will see me as an expert. Perhaps I’ll be the expert of reading experts and formulating expert opinions on expert opinions :P

“An expert is a man who has made all the mistakes which can be made in a very narrow field” — Niels Bohr

In the end (and the middle and the beginning too) I want this Blog to be helpful, thought provoking and bring value to those that want to know more about the medical interests that interest me. I hate to sound so self serving but there would be no other way I could spend any real time and bring anything of real value without the topics being ones that I have the most interest in. Just to give a heads up; my primary interests are sports and mental performance, the systems of medical practice, and preventative medicine (the BEST medicine!).

So, being that I have been lately fascinated by the latest book I just read, the classic Dale Carnegie book “How to Win Friends and Influence People” — I just had to make the very first medical Blog post about this book. I hope that starting the Blog with a topic that seems so far off topic doesn’t serve as a testimonial to my worthiness as a serious Blogger in the future.

Hater circa 2018 — “Look back at his first post! It’s hardly even about medicine at all!”

Me and my Gazillion followers — circa 2018

First, I had to say that this book, “How to Win friends and influence people” has of the most poorly and inappropriately named book of all time. I mean, I have heard of this book for years. I’ve seen it and heard other people talk about it from time to time but I would pass it up over and over again because of the frankly crappy title. This book was written and published literally decades ago so perhaps this was some sort of marketing ploy for the time to name it like this. But in today’s world the title just sounds gimmicky and creepy. But the thing is, the book isn’t either of those things. Once you look past the dated examples and stories, the meat of the material has some timeless lessons in good ole human behavioral psychology and social skills.

“How can this benefit me?” I thought.

It turns out that was a very poignant thought. I will get to that later.

As physicians, especially Emergency Physicians, and as people in general we are constantly called upon to influence people for better or for worse. On a daily basis I try to convince people to quit smoking, wear a helmet, take their medications, use their walker, and use common sense (another misnomer).

One of the most memorable statements and advice given to our Emergency Medicine residency class by one of our best attendings was “There is a little used car salesman in every good Emergency Doc.”

No truer words have ever been spoken.

Whether convincing a patient that his smoking and not the “dust from (his) baseboards” is the reason why they are requiring face mask oxygen to breathe or whether it’s convincing a surgeon to come in and take care of an intoxicated substance abuser with intractable gallbladder pain at 3am in the morning, a little bit of salesmanship and influencing goes a long way!

“What does this have to do with medicine?” — Everyone

I first got interested and reading “How to Win friends and Influence People” after a recommendation from a colleague. I thought “that’s interesting”. I brushed it off and forgot about it almost immediately. Ironically the same week it was brought up on a Podcast I was listening to and then again on another podcast I listened to. My interest was peaked.

The Book & The Takeaways

So finally, I read the book. It’s insightful in, so many ways, on human behavior and the psychology of influence. This is critical to what we as health providers, educators, and ambassadors to health need to be doing. If we want to make a difference in peoples’ lives and help people live better quality healthier lives, we have to influence people to make better lifestyle choices. What we have been doing so far has only limited efficacy and especially for most of the people we want to reach (those that are currently making poor health decisions) the message we use now doesn’t work.I’m an Emergency Doc, so I’ll get to the point of what we in healthcare can take from Mr Dale Carnegie:

1. People don’t want to be criticized. Obvious, right?! Still, how often do we start a conversation with the intent on changing someone’s behavior with criticism? The result of criticism (or anything that can perceived as criticism) can be crippling to a person’s ability to influence. It is more than counterproductive, it is destructive to the connection that must be made in order to influence change in a person’s behavior.
2. People want to be understood from their own perspective. Mr Carnegie makes a great statement that I will carry with me forever: you can always say this to a person with true and complete honesty, “I would feel the same way as you do if I were in your shoes”. It’s true, if you were born when and where they were born, had the same parents, and the same experiences you would feel the same way they feel in any particular situation. Everyone has a legitimate and real perspective that you have to acknowledge and respect before you can influence their behavior.
3. People want to feel special. No duh, right? This is easy to forget especially in a situation where you are trying to influence someone to change their behavior. Think about it; you are the one feeling that you have the answers that the person you are speaking with doesn’t have. That makes you feel that you are in the position of authority and even if it’s subconsciously, you undermind the other persons feeling of importance by the way you convey your advice unless you consciously keep their self importance at the center of the conversation. After all, if the person wasn’t important, why would you take the time to try and influence their behavior? People do horrible things when they feel that others don’t appreciate their importance.
4. Telling someone what to do is much less effective than letting them discover for themeselves what they should be doing in order to achieve a goal. Presenting a person with an argument to “change their mind” is rarely effective. On the other hand if you help a person discover something “on their own” (at least what feels like on their own), they will own it.
5. Praising a person and their attributes or gifts prior to any constructive remarks or leading into the self discovery of influence (leading questions that allow a person to discover their answers) is the best way to move a person to action.
6. Foot in the door technique. The best way to get a person to be agreeable to change is to get a “small win” with an easy small change in behavior. The first “yes” is the portal to all future wins when it domes to behavior change.

How are we going to use this advice?

As you will see as we go along, so much of performance enhancement & preventive medicine is centered on behavior change and action. As a matter of fact so much of our daily relationships are based on our ability to influence others and understand others that using these techniques will enhance not only our performance & health, but also our relationships.

If you have read “How to Win Friends & Influence People” by Dale Carnegie let me know what you took from it, how it’s helped you, & and what advice you would give to others to enhance their health, performance & relationships.

Originally published at jkeithhallmd.weebly.com.