Unveiling the Hidden: Beyond Patient Objections
In my previous discussion, I explored how objections are often requests for more information rather than outright rejections. Now, let’s delve deeper into why healthcare professionals might misinterpret these objections and how you can broaden your perspective to uncover the real issues at hand.
Read the previous article: From Defensive to Explorer: A New Approach to Patient Objections
The Spotlight Effect in Patient Care
Daniel Kahneman’s insight, as quoted by the Heath brothers below, sheds light on a cognitive bias that significantly impacts patient-clinician or peer interactions. This ‘spotlight effect’ can lead us to fixate on the immediate objection the other person presents, potentially missing crucial underlying factors.
“Kahneman says we are quick to jump to conclusions because we give too much weight to the information that’s right in front of us, while failing to consider the information that’s just off stage.” Chip Heath and Dan Heath ‘Decisive’
Connecting Objections to Hidden Concerns
When a person objects to your suggestion, your initial reaction might be to address the stated concern directly. However, this approach may fall short if you don’t consider the information ‘just off stage’. For instance:
- A patient objecting to physiotherapy exercises might actually be anxious about pain, rather than unwilling to put in the effort.
- Resistance to a treatment plan might stem from undisclosed financial concerns or fears about the impact it may have based on a friend’s or family member’s experience.
- Reluctance to follow advice could be rooted in cultural beliefs or social dynamics not immediately apparent.
Practical Strategies for Widening the Lens
To move beyond the spotlight and uncover these hidden concerns, consider the following approaches:
- The ‘What Else’ Technique: After addressing the initial objection, always ask, “What else concerns you about…..?” This simple question can reveal layers of concerns.
- Scenario Exploration: Present hypothetical scenarios to patients. For example, “If time/money/pain weren’t an issue, how would you feel about this treatment?” This can help uncover hidden barriers.
- Reverse Perspective: As best you can, try to see the situation from the perspective of the person offering the objection. This can sometimes uncover concerns they’re hesitant to express directly but you realise may be an issue.
- Silence as a Tool: After someone expresses an objection, practice comfortable silence. Often, the other person will fill this space with additional information if given the chance.
The Role of Emotional Intelligence
Expanding on my previous discussion about managing emotional state, it’s crucial to develop emotional intelligence to pick up on subtle cues that the other person may be giving. This includes:
- Paying attention to non-verbal communication
- Noting discrepancies between what they say and their body language
- Being attuned to changes in tone or hesitations in speech
Overcoming Our Own Biases
To truly see beyond the spotlight, you must also confront your own biases:
- Confirmation Bias: Be wary of seeking information and confirmation that only confirms your initial suggestion. An initial agreement might make you feel good until they cancel or come back with excuses as to why they haven’t followed through on the agreement.
- Availability Bias: Don’t let recent or memorable cases unduly influence your current patient engagement.
- Anchoring Bias: Avoid fixating on the first agreement especially if it doesn’t match non-verbal signs.
A New Approach to Patient Narratives
Instead of seeing patient histories as a series of facts, consider them as narratives with potential plot twists. This storytelling approach can help you remain open to unexpected information and connections.
Practical Exercise: The ‘Off-Stage’ Checklist
Develop a mental (or physical) checklist of ‘off-stage’ factors to consider in each interaction:
- Social support system
- Financial situation
- Cultural beliefs and practices
- Past experiences with healthcare
- Daily routines and lifestyle
- Emotional state and mental health
Real-World Application
Let’s revisit a previous example of a patient objecting to starting a new exercise regime. Using your expanded perspective, you might approach the situation like this:
- Address the stated objection
- Explore related concerns: “What else worries you about this exercise regime?”
- Investigate past experiences: “Have you or someone you know had experiences with similar exercises?”
- Consider practical aspects: “How do you think these exercises might fit into your daily routine?”
- Explore emotional factors: “How do you feel about needing to do these exercises?”
Summary
By combining your understanding of objections as requests for information with Kahneman’s insights on the spotlight effect, you can dramatically improve your approach to patient care.
This expanded perspective allows you to address not just the stated objections, but also the hidden concerns that often drive non-adherence.
Remember, the key to effective patient care or leadership often lies in the information just beyond your immediate focus – you must train yourself to look for it, ask the right questions, and create an environment where the other person feel comfortable sharing their full story.
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