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Education-based health

Book Review- Switch: How to Change Things When Change is Hard

Switch 2When your passion, your profession and your education all align… you’re doing something right.  I forget, sometimes, how fortunate I am to be so passionate about my industry and to have found a job where I’m able to use my talents and my passions, as well as the material that I’ve learned and continue to learn in my grad program.

This week, I was reminded while reading an assigned chapter from the above book, Switch, by Chip and Dan Health.  This was the first chapter in the book and it served it’s purpose of drawing me in for more.

I don’t believe this book is related at all to healthcare, but if you’re familiar at all with what’s going on in the world of health care delivery in the United States, you know that change is needed. (A brief synopsis of our healthcare issues would be to say that we spend more money on healthcare in our country than any other nation, yet we have some of the worst health outcomes of industrialized nations. Some would go as far as to say rather than calling it healthcare it should be known as disease care, as we often spend more time and effort putting a band-aid over the issue, rather than fixing the source of the problem. I’ll expand on this topic in future posts.)

Suffice it to say, all of the money in this country, all of the advanced medicines and treatment plans, all of the new technology has not helped to solve this problem.  It doesn’t take a scientist to know that we need to try something different.  Change.  That’s the big word right now.  It’s the one-word that elected our most recent president.  It’s interesting how one word can bring so many different emotions to the table.  Some people openly fear “change”.  Some people embrace it.  All people seem to recognize that change is an inevitable part of progress.

In this chapter, the authors give an incredible illustration of the difficulties of change for people.  They use this diagram:

Switch Rider and Elephant

  • The rider is the brains behind the operation… this is the area of you that controls understanding and facts. 
  • The elephant illustrates the emotions of the operation.  This is where passion, and excitement and fear live.

Chip and Dan use a fantastic example in their book about someone who sounds so perfectly like my husband that I have to compare them.  Let’s take Michael for example.  At night, his mind (the rider) knows that he has a lot of work to do the next day.  He recognizes the delayed gratification that comes from forward thinking and preparation.  He will set his alarm an extra 20 minutes early so that he has time to get everything done before leaving for his destination.

Unfortunately, the next morning when the alarm goes off, the elephant in Michael takes over.  His emotions sense the darkness in the house, the warmth of the sheets around him, the peace that he feels in that bed, and he turns off the alarm clock. Occasionally, the “rider” in Michael tries to outsmart the “elephant” in him, and he’ll place his alarm clock on the far side of the room in an attempt to FORCE the elephant against it’s will the next morning.  This may work on occasion, but eventually the rider will exhaust from his attempts and the elephant will win.

This is the war that resides in all of us.

Maybe for you, the war is not fought over sleep, but health or diets.  Check out this interesting study that is discussed further in the chapter:

A group of researchers invited several students in to conduct a study.  The participants were asked not to eat for a few hours before the study was conducted.  When they arrived, they found a bowl of chocolates, some chocolate chip cookies (freshly baked, with their pleasant aroma filling the room) and a bowl of radishes.  The participants were divided, and some were asked to eat cookies and some were asked to eat radishes.. both groups were asked not to eat from the other’s supply.  As you can imagine, the researchers expected those who were asked only to eat radishes to perhaps cheat and eat a cookie or two.  At the “end” of the study, the participants were thanked and things were wrapped up.  They pretended to be finished, but asked if they’d be willing to stay and participate in the next study that was being conducted, in which they were testing who could solve a problem faster high school students or college students. (This was, of course, a staged test for these very participants.)

The problem that was given, was rigged to be unsolvable, and what they found is that those participants who ate the goodies during the first challenge, worked longer at the problem and gave up less quickly than those who had resisted the temptation of chocolate chip cookies and had only eaten radishes. They deduced that perhaps we all have a minimum level of “willpower” and once it’s gone, we’re unable to control our emotional sides. This was such an interesting realization.  I started to analyze how this might be shown in my life.

Unlike Michael, my rider often overpowers the elephant when my alarm goes off… I rarely have any problems getting up for the day, but after I start my day am I missing some of my willpower?  Do I have less by noon, when Michael may be first using some of his?  Perhaps this is the main problem with dieting in our country.  We put all of our facts and mental energy towards the diet, but nothing appeals to the elephant that controls most of our decisions.  We can’t always trick this monster into obedience, and after a while our “rider” has lost his bank of willpower and he relents, thus the diet fails.

The authors go on to list ways that we may be able to appeal to both the rider and the elephant. Riders need facts, elephants need emotions.  So consider the case they present about Dr. Berwick, CEO of the Institute for Healthcare Improvement who saved +100,000 lives through one powerful message.  The chapter discusses how he made a plea in front of a crowd of health professionals that we needed to save the lives of those currently dying from medical defects that were preventable. Of course, he would run into the difficulty of hospitals not wanting to admit fault or incidents in their facilities, these administrators and doctors were experiencing fear an emotion from their “elephant” side.  Dr. Berwick knew he couldn’t reach everyone with the facts and numbers behind the goal, so he brought in the mother of a young girl who died a needless death due to medical error, she spoke and talked about what it meant for her to be a part of this goal.  This was the emotional spark that most of them needed to be bought into the task.  18 months later, on the due date they announced that they saved an estimated 122,300 lives with changes made to processes.

What kind of CHANGE could I find to make a difference in others’ lives?  What about you?

I highly encourage this book, and I’ll update you as I read more throughout the semester.  Click on the picture at the top to order it on amazon.

Tell me what struggles you’ve had creating change in your life?  Write more in the comment section below!



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