Overwearing contact lenses. Noncompliance with medication. Poor blood sugar control. As a physician, would you like to be more effective at getting patients to change behaviors that negatively impact their vision and health?
In episode 18 of “Can I Ask You One Question?”, I ask Dr. William Miller (author of Motivational Interviewing in Health Care: Helping Patients Change Behavior) to share some ways we can be more instrumental in motivating patients to change behavior.
Below are the key points from the interview. Scroll down to see the entire interview.
Dr. Miller has been studying the topic of Change for 50 years and is best known for developing a communication method known as Motivational Interviewing.
“Giving information and advice is part of our job, but it really matters how you do it.”
Ambivalence is at the core of resisting change. Most of us are comfortable with how we’re doing things now.
What happens when you argue for change? For example, “This is important and you need to do this!”
A very predictable response is the patient argues against it. What they’re doing is giving you the other side of their own ambivalence.
Most of us have a bias toward believing ourselves. When someone is arguing for change, and we’re arguing against change, we’re likely to convince ourselves change is not good.
A common response in these scenarios is either not to do it, or to do the opposite.
“How you give the advice really matters.”
It’s important to honor the person’s autonomy. One way to accomplish this is to ask permission first. For example, “Would you be interested in hearing about…” or “Is it ok if I tell you a concern I have with your health?”
Another method is to give people permission to disregard what you’re going to say. For example, “I don’t know if this will matter to you or not.”
Ironically, the effect is that they’re more likely to listen and do it.
Another option is to give a menu of options. “There are a variety of ways we could approach this. Can I tell you what some of the options are?”
“If you push for change, they will push back and the net result of that is they’re unlikely to do it.”
Find out from them what they think about it, why it’s important to them, what they like about it or how they would like to go about it. Have them voice their motivations for change and they’re more likely to do it.
Watch the interview below:
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