RN, PhD

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How to Get Your Clinicians to Say “Yes!” to Your Request

Want a sure fire way to get any clinician to engage in your next practice change, or any other request for that matter?  Read on…

In my previous article Want Wildly Engaged Clinicians? Stop Trying to Make Them Happy! I discussed the distinction between engagement and happiness and why engagement is so much more robust for organizational performance.

In a nutshell, engagement causes nurses and doctors to want to support organizational efforts, whereas happiness causes fleeting feelings of pleasure that don’t tie to improving work performance.

Now it’s time to get practical and learn a strategy you can use to increase the engagement of your team members.

My favorite strategy comes from Robert Cialdini’s book, Influence. It’s called Consistency with Self Image, and there is a lot of research supporting its effectiveness.

Based on my own experience using it, this is one of the most powerful tools you can use to engage just about any clinician, especially a resistant one.

Consistency with Self-Image

The consistency strategy relates to our innate motivation to be – and appear to others – consistent with what we’ve done in the past.          

Essentially, once we make a decision or take a stand, we will experience significant internal pressure to behave consistently in the future with that original commitment. It’s a survival behavior that builds our credibility and enhances our influence within our social circles.

As you will see, this internal pressure can even result in us complying with requests that are only minimally connected to the original commitment we agreed to.

A Preposterous Request

The most famous study on this was the Drive Carefully study where social scientists targeted two California residential neighborhoods. One was the study group and the other was the control group.

Each had volunteers go door to door asking homeowners to agree to put a large sign on their lawns that warned drivers to drive carefully. At the time of the request, the volunteers showed the homeowners a picture of what the sign would look like: a house where the view was substantially obstructed by the sign.

It was an outrageous request.

Only 17% of the control group agreed to the sign, which is not surprising. However, interestingly, agreement jumped up to 76% in the study group – pretty amazing considering the request.          

Big Wins Start with a Small Commitment

Why did so many of the study group homeowners agree to the sign blocking their home?

It’s all in the Law of Consistency with Self Image.

Two weeks before the sign request was made, the study group homeowners had already made a small commitment to driver safety. A different volunteer went around and asked them to accept and display in their window a small 3-inch square postcard that read, “Be a Safe Driver,” which most of them did because it was a small and reasonable request.

That small commitment changed how these homeowners viewed themselves.

Now they saw themselves as people who cared about driver safety. And, to be consistent with that self-image, most of them then agreed to put the large sign on their lawns two weeks later, even though the request was utterly unreasonable.   

How You Build Commitment Over Time

The takeaway for clinical leaders trying to engage your team members is this:

Start out with something small that is easy for them to say “yes” to that is related to the larger future request. This will enable you to build commitment over time through the innate human motivation your clinicians have to see themselves as being consistent with their previous actions.

I use this strategy whenever I want engagement and commitment to a new practice change.

Instead of using the common approach of telling people what we will be doing differently (and then dealing with the backlash from imposing a new practice on team members), after I’ve invited comments about the good, the bad, and the ugly of the change proposal, I ask team members for their permission to take the proposal to the next step and test it out.

I let them know this step will be the opportunity to consider their feedback and actually observe what works and what doesn’t.

Trigger Your Team Members’ Need to be Consistent

Asking for their permission to take this next step offers them the opportunity to opt-in to a small action with little risk on their part at that point – and has the benefit of kick-starting the process of commitment to the eventual practice change adoption.

Each step along the way will trigger their need to be consistent with previous decisions. Team members will want to support the change as it goes forward; they will gladly work through the challenges that may lay ahead because they are already invested in the outcome.

In my many years of asking this question among the clinicians I’ve worked with, I have yet to have someone say no.        

Strategy, Not Manipulation

This approach might initially appear to you as manipulative. That’s what I thought when I first learned about strategies of influence.

I don’t think that way anymore.

I learned that engaging clinicians isn’t just about presenting good ideas and practices. Clinicians evaluate and engage in new ideas and practices based on how they’re packaged and delivered.

This approach gets people to consider a new practice, because it aligns with how their brains have been wired for millennia – to fulfill their motivation to be seen as credible – in their own eyes and in the eyes of others.

Practice Changes: Getting Your Foot in the Door

As an essential facet of self-concept, consistency is a positive attribute that has been linked to personal well-being and felt authenticity. It’s very much intertwined with our own identity and how we want to be seen in the world.

Remember this and you will have no problem getting your clinicians to say “yes!” to your next practice change, or any other request for that matter.

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