Influence by learning how people process information.

If you use language that is typical of the processing style of people you are trying to influence, you are much more likely to persuade them to do something you want them to do. Also, when you understand their processing styles and give them some of what they want, you create rapport. Rapport is the ability to make one or more people feel understood by you such that they can trustingly and comprehensively communicate with you. Just as air will fill a vacuum, the communication space will be filled with something. Possibilities other than rapport are intimidation, avoiding, ignoring, and threats.[2]

"Today there are more than a dozen varied models of behavior differences. They all have one common thread - the grouping of behavior into four categories."[3] As far back as the middle ages, Medieval physiology grouped people four categories: Sanguine, Choleric, Phlegmatic, Melancholy. I think there is some truth to four categories, no matter what name we assign them. The names I will assign are Fact, Form, Feeling, and Future (see table on page 36). As you read these definitions, remember that no explanation of behavior can explain all of who you are. There is much about that is private and that no one can know but you.

Four Categories of Information Processing(*)

FACT: Rational Self

Is logical
Likes numbers
Knows about money
Knows how things work

FORM: Safekeeping Self

Establishes procedures
Organizes
Is neat
Is timely

FUTURE: Experiment Self

Imagines
Takes risks
Likes surprises
Breaks rules

FEELING: Feeling Self

Likes to teach
Touches
Is expressive
Is emotional

(*) Adapted from Hermann, N. The Creative Brain. Lake
Lure, N.C.: Brain Books, 1990.

Fact

People who like facts want to know who, what, when, where, why, and how. They like numbers and want logical explanations. They are good at analyzing and solving problems. These are realistic people, not dreamers. They keep up with what things cost and often mention the bottom line. They may be accused of being cold-hearted, sometimes hurting other people's feelings without realizing it. These people can tell you precisely how much money you will need to have saved in order to have the same life-style in retirement that you have now.

Form

These people also like facts, but their main concern becomes how those facts are organized. They want information presented to them in an orderly fashion. They are particularly fond of lists and outlines and are the ones who love the numerous, intricate categories of thick, leather-bound Daytimers[R]. They like to do things in a step-by-step, orderly, linear fashion. If they work out the details of a procedure, they are happy to follow it for a long time. They will read the fine print in a contract. They want life, people, files, and photo albums organized, and they are great at making it happen.

Feeling

The third types take in information and make decisions in an interpersonal, emotional way. These people want to tell and hear personal stories. They make decisions based on how outcomes will affect themselves and others. They pay attention to how people are feeling and often help resolve conflicts. They value harmony and are willing to work to make it happen. Being sensitive to others, they get their feelings hurt more easily than the other three. They make excellent teachers and counselors.

Future

The future types process information in a holistic, intuitive way. They are usually looking toward the future, following intuitive hunches, seeing far down the road, imagining possibilities. They are the dreamers. They want to talk about the big picture, and they like to combine ideas to come up with something new. They tend to work in great bursts of energy with slack periods in between. They make guesses based on gut reactions, and they are right often enough that they trust that way of interacting with the world. They are often entrepreneurs, because not only do they imagine a better future, but they tolerate not knowing where the money is coming from or when it is coming better than the other types.

When presented with this information, most people can quickly pick the processing styles they like the best and the least and number the others two and three. Sometimes people will say they like two or three styles equally well, and occasionally they will say they like all four equally well, but a strong preference for one and an aversion for another are most common. We all use all four of these styles to varying degrees, so we have the power to call on them if we need to.

"Knowing how to adapt your communication to each of the different styles is the key to successful communication. However, adaptability requires not only the knowledge of how to adapt to each style but also the willingness to communicate in ways other than your normal, preferred mode . . . . It means making the choice to speak the language of the person you are with." (3) This will be hard work. It will require increasing your awareness of others and practicing making the shifts.

If you listen carefully to someone, decide which communication style he or she prefers, and shift your style to that person's, you can increase the possibility of influence and decrease the possibility of conflict. The following examples show one type of person recognizing another type and making a shift to talk to the other in words that he or she prefers. The words in bold print indicate where the shift takes place. The examples are meant to help you begin to recognize the shifts and spur you to think of your own words for how to do it.

Fact Shifts to Feeling

Fact: John, I have the reports from Drs. Smith, Kline, and Beecham with evaluations of your work since you joined us a year ago. I've summarized their comments and would like to go over it with you. OK? (Don't wait for a response.)

The key point is that your production is not what we had hoped for. When we look at the data, you're in the lower 20th percentile of all the general internists. The numbers also confirm that your work habits have led to this below average production.

Feeling: I can tell you, Fred, that this doesn't feel good to me at all! I thought this organization was about delivering high-quality care! Sure, I tend to take more time with my patients than most of the doctors, but it's important that they see me and this organization as caring about them.

Fact: All that's fine, John, but we've got to be concerned with the bottom line, or none of us will have a place to practice.

Feeling: If the patients don't feel cared for, they won't come back. We used to be the main group in town, but now there are three others they can choose from.

Fact: I understand your concern for the patients, and I want you to know how valuable you are to the organization because so many patients like you. Do you think the only way we can show patients we care is by spending more time with them?

Feeling: Well that is certainly the most important way.

Fact: Would you be willing to meet with some of the other physicians to talk about ways that we can show we care besides spending more time with patients?

Feeling: Yes

Feeling Shifts to Fact

Feeling: The staff is upset about the extended office hours.

Fact: To be competitive with the other HMOs, we have to stay open at night and on Saturdays.

Feeling: Mary has no child care after 5 pm. John coaches his son's little league baseball team on Saturday momings.

Fact: Their personal problems are not my problems.

Feeling: I know we have to solve this problem in order to keep up with the other HMOs. Can we get the staff together and give them choices about when they work their additional hours? Maybe we can we hire some additional staff to help with the extended hours. If I let you know what that will cost, can we talk about some ways to keep the staff reasonably satisfied?

Fact: That's a good idea.

Form Shifts to Future

Form: Dr. Sampson yelled at a 5-year-old child who wouldn't keep still during a procedure. The parents are furious. We must document everything. Talk to all the nurses who saw it. Get a lawyer. Find out our rights. What do the bylaws say we should do? He has been yelling at people more and more in the past several months.

Future: Wait a minute. Before we do all that, let's talk to Dr. Sampson and tell him our concerns about how his behavior can affect his future as well as the future of the organization.

Form: We have to be prepared for problems, and we must be sure we follow the bylaws or we can be sued and will surely lose if we haven't followed the steps exactly.

Future: I know we need to do that, but not yet. Let's take some time first to have a conversation and hear Dr. Sampson's side and remind him of the behavior we expect here at St. Mary's. He may be under some pressure that we don't know about.

Form: So you are willing to take all the legal steps, but you don't think they have to be in place before the first conversation. If he realizes how his individual behavior affects the reputation of the whole hospital and that we cannot afford such behavior in these increasingly competitive times, that may be enough to stop the outbursts.

Future: It may be.

Future Shifts to Form

Future: The future of health care is capitation. Everyone is doing it, and we have to do it, too. I've even heard reports that if we learn to manage our services well, we can make more money than we do now.

Form: What exactly does that mean?

Future: It means the doctors have to shoulder some of the risks of health care. First, the insurance companies took the risks, then the hospitals took some, now the physicians have to share the risks.

Form: What does it mean I must do differently in my office?

Future: Here is a simple and unrealistic example, but I think it will help make the point. Let's assume ABC company will give you $1,000 to take care of 10 patients. If you do three procedures at $300 each, you have only $100 left to take care of the other 7 people. You will need to see patients less and to do fewer procedures on them to make money. However, the concept works, because it is based on the same principle as traditional insurance since most patients use very few resources.

Form: How can I see patients less?

Future: Certain types of follow-up visits may be unnecessary if you or your staff can simply call the patients and ask them some specific questions that satisfy you that they are improving as expected.

Form: I understand it, but I don't like it.

If you want to make the shift and you are not sure what would do it, think about what would not feel good to do. That is probably where the shift can occur. It may involve saying you're sorry, asking for help, or giving more facts.

Here are other tips for you if you are having trouble making the shift:

* Listen longer and harder before you speak.

* Ask more open-ended questions. (What would you like for dinner? is an open-ended question. Do you want fish for dinner? is a closed question? It calls for a yes or no rather than an expanded answer.)

* When talking to fact types, use numbers if possible. Don't say, I feel...." Instead say, "I think...." For form types, say, Could I get back to you with an outline of the things we have talked about and could you fill in the details that I have missed?" For feeling types, ask, "How does that feel to you?" For future types, ask, "What is your hunch about this?"

Listening carefully to others, becoming aware of their processing styles, and speaking to them in language they prefer is very hard work, but your reward will be that you increase your ability to influence others. When you move into a position in which you don't have the power to make people do things, the power of persuasion becomes even more important.

References

[1.] Vinson, C. Administrative Knowledge and Skills Needed by Physician Executives." Physician Executive 20(6):3-7, June 1994.

[2.] Elkind, M. "Whole Brain Management and Communications," notebook for Physician in Management Seminar Il. Tampa, Fla.: American College of Physician Executives.

[3.] Alessandra, T., and Hunsaker, P. Communicating at Work. New York, N.Y.: Simon and Schuster, 1993.

Barbara J. Linney, MA, is Director of Career Development, American College of Physician Executives, Tampa, Fla. If you have examples of successful personal shifts and would be willing for them to be used in future columns, please send them to Barbara Linney at ACPE headquarters, 4890 W. Kennedy Blvd., Suite 200, Tampa, Fla. 33609, or Fax to 813/287-8993.