Asking permission

As health care practitioners, we have a veritable repository of information about positive health behaviours. We are experts in our respective fields of health care, from oral health care to nutrition management to occupational therapy etc. Sheer logic would tell us that our expert information would be warmly received from our clients and sometimes, it is. Unless we can get our clients to access and use our information and knowledge, it is just data. Contrary to the popular phrase, knowledge is power, by itself knowledge is just knowledge. In spite of our wealth of information and expertise, it seems some patients are reluctant to take our advice, don’t perceive its relevance, and/or don’t heed that advice – there is some disconnect happening. What can you do to close that gap or make the connection happen? What the use of MI can do is facilitate the transmission of our knowledge and expert information by making the client responsible for wanting access to that information. Consider an example from dental health practice. Dental professionals have expert knowledge and advice and the tendency or habit might be to dispense that advice as though it were prescriptive and wanted by patients. Oral health care professionals are trained to fix teeth, gums, the mouth etc., in short, to right what’s wrong. However, in the area of human behaviour change and in the words of MI practitioners, it is important to ‘resist the righting reflex,’ the tendency to give prescriptive, unsolicited information or advice. Instead, what if you asked each patient for permission to share that information with this statement and question: I have some information about treatment __________. Would you like me to share it with you? Obtaining permission is like bringing the right substrate in contact with the correct enzyme – the biological comparison is apt – and the behaviour change platform is established for real, two-way communication to happen. People are less defensive and more motivated to make change when the change is based on their own decision – in this case, their ‘yes’ – than when an authority figure tries to impose change . We cannot make patients follow advice, but we can communicate with them far more successfully if we know what they need and what they are willing to hear and/or do about their health care.