Parents and politicians share the same struggle: How do we make people behave?
The new Ontario government talks about accountability almost as much as it does about debt.
No money means no carrots, which leaves only sticks. Is leadership only carrots and sticks?
Leadership is influence. Influence comes from relationship. Successful leaders influence others toward positive ends. As a parent/leader, how do you make your son clean his room?
You could:
Give a pep talk.
Lay down the law.
Nag.
Bribe.
Give up. He’s a boy.
Change Doctors’ Behaviour
Governments repackage these tactics to change doctors’ behaviour. Politicians often:
Give a pep talk from a famous leader on the privilege of caring.
Tighten accountabilities (Lay down the law).
Increase oversight and add behavioural prompts (Nag).
Incentivize behaviour and offer bonuses (Bribe).
Give up. Impose global cuts and offer sub-inflationary fee increases.
System leaders repackage the same rules for everything: after-hours care requirements, surgical outcomes, in-patient lengths of stay, etc. But better rules do not guarantee better patient care. Better rules make doctors focus on rules, not patients.
Rules change behaviour the way speed limits change driving habits. People perform to the limit of what goes unpunished. This Faustian deal works for speed limits. It does not work for patients. Continue reading “How to Change Doctors’ Behaviour”