Switch - Chip Heath [7]
What looks like resistance is often a lack of clarity. Before this study, we might have looked at these West Virginians and concluded they were the kind of people who don’t care about their health. But if they were indeed “that kind” of people, why was it so easy to shift their behavior?
If you want people to change, you don’t ask them to “act healthier.” You say, “Next time you’re in the dairy aisle of the grocery store, reach for a jug of 1% milk instead of whole milk.”
9.
Now you’ve had a glimpse of the basic three-part framework we will unpack in this book, one that can guide you in any situation where you need to change behavior:
Direct the Rider. What looks like resistance is often a lack of clarity. So provide crystal-clear direction. (Think 1% milk.)
Motivate the Elephant. What looks like laziness is often exhaustion. The Rider can’t get his way by force for very long. So it’s critical that you engage people’s emotional side—get their Elephants on the path and cooperative. (Think of the cookies and radishes study and the boardroom conference table full of gloves.)
Shape the Path. What looks like a people problem is often a situation problem. We call the situation (including the surrounding environment) the “Path.” When you shape the Path, you make change more likely, no matter what’s happening with the Rider and Elephant. (Think of the effect of shrinking movie popcorn buckets.)
We created this framework to be useful for people who don’t have scads of authority or resources. Some people can get their way by fiat. CEOs, for instance, can sell off divisions, hire people, fire people, change incentive systems, merge teams, and so on. Politicians can pass laws or impose punishments to change behavior. The rest of us don’t have these tools (though, admittedly, they would make life easier: “Son, if you don’t take out the trash tonight, you’re fired”). In this book, we don’t talk a lot about these structural methods.
As helpful as we hope this framework will be to you, we’re well aware, and you should be, too, that this framework is no panacea. For one thing, it’s incomplete. We’ve deliberately left out lots of great thinking on change in the interests of creating a framework that’s simple enough to be practical. For another, there’s a good reason why change can be difficult: The world doesn’t always want what you want. You want to change how others are acting, but they get a vote. You can cajole, influence, inspire, and motivate—but sometimes an employee would rather lose his job than move out of his comfortable routines. Sometimes the alcoholic will want another drink no matter what the consequences.
So we don’t promise that we’re going to make change easy, but at least we can make it easier. Our goal is to teach you a framework, based on decades of scientific research, that is simple enough to remember and flexible enough to use in many different situations—family, work, community, and otherwise.
To change behavior, you’ve got to direct the Rider, motivate the Elephant, and shape the Path. If you can do all three at once, dramatic change can happen even if you don’t have lots of power or resources behind you. For proof of that, we don’t need to look beyond Donald Berwick, a man who changed the face of health care.
10.
In 2004, Donald Berwick, a doctor and the CEO of the Institute for Healthcare Improvement (IHI), had some ideas about how to save lives—massive numbers of lives. Researchers at the IHI had analyzed patient care with the kinds of analytical tools used to assess the quality of cars coming off a production line. They discovered that the “defect” rate in health care was as high as 1 in 10—meaning, for example, that 10 percent of patients did not receive their antibiotics in the specified time. This was a shockingly high defect rate—many other industries had managed to achieve performance at levels of 1 error in 1,000 cases (and often far better). Berwick knew