Under promise and over deliver!

During the years I spent within the Sales industry, certain mantras were repeated over and over again. Some could be regarded as cliches but contained a great deal of wisdom for all that. One example was the observation that we have two eyes, two ears and one mouth. The trick was to try and employ them in the same proportions. Another was more of a truism. I was constantly being encouraged to under promise and over deliver. Broadly speaking, this means that you refrain from over-committing yourself to any agreements with customers lest you be unable to honour them. The supposition followed that the customer was never let down and constantly satisfied that promises were duly kept - albeit promises often with the substance of tissue paper. To a point this approach sustained many a business relationship.

It was with a great deal of interest that I read recently the conclusions of the inquiry in to the events at Stafford hospital which resulted in so much harm and suffering. Health Education England which does not yet exist has promised that future medical students will be recruited based on their compassion. Henceforth, universities will be required to recruit medical students based on their values and behaviours. So far so good. For those of you who have followed this blog, you will be familiar with my views on this. It was my wish to undertake research into this area last year but I was sadly if predictably rebuffed by my medical school. It was deemed more important for me to pursue research in a more scientific area. To tick the box, I treated their approach with the contempt it deserved and studied the psycho-social aspects of being the recipient of a renal transplant. I thus studied an area about which I already knew rather a lot while at the same time being involved in an overtly non-scientific area. But enough about my relationship with the medical school to which I am currently affiliated. I make a broader point here. It is my view that the feelings of patients are as important (if not more important) than the science underpinning the clinical decisions being made about them. It is one thing to qualify as a doctor with an encyclopaedic knowledge of the textbooks which you have studied for the past few years. It is quite another to connect with the person in front of you with basic humanity and understanding.

I made the assertion this time last year that empathy is the result of many factors. Our upbringing is hugely important as are the life experiences to which we are exposed. You can teach a wide variety of subjects but empathy is not one of them. I have seen doctors in hospitals whose empathy I would deem insufficient to attend to an animal. It is all very well claiming that medical students will now be assessed based on their values and behaviours but I wait with baited breath to see how they propose to achieve this. I just can't see how you can gauge or measure such qualities. My fear is that a separate multiple choice paper will evolve along similar lines to the current situational judgement test being used to determine foundation year allocations. The only problem here is that a new mini industry will spring up whereby companies will offer advice in to how to achieve higher marks. From an altruistic standpoint, I think I understand the words of Health Education England. What I don't understand is quite how they propose to achieve this. Put simply, they can't.

If they refer back to the work of Carl Rogers in 1951 they will begin to form a more clear appreciation of what empathy is. For the record, Rogers' seminal work remains the key work in this field and has been referenced over the years to within an inch of its life. Rogers asserted that for a person to grow, they need an environment which provides them with genuineness, acceptance and empathy. Genuineness arises from openness and self-disclosure. Acceptance stems from being treated with unconditional positive regard. Empathy results from being listened to and understood. Only when this trio were established could self actualisation take place. Furthermore, we behave as we do because of the way we perceive our situation.Rogers believed people to be inherently good and creative. They only become destructive when a poor self-concept or external constraints over-ride the valuing process.

Carl Rogers (1902-1987) was a humanistic psychologist agreed with most of what Maslow believed, but added that for a person to "grow", they need an environment that provides them with genuineness (openness and self-disclosure), acceptance (being seen with unconditional positive regard), and empathy (being listened to and understood).
Without these, relationships and healthy personalities will not develop as they should, much like a tree will not grow without sunlight and water.
Rogers believed that every person can achieve their goals, wishes and desires in life. When, or rather if they did so, self actualization took place
- See more at: http://www.simplypsychology.org/carl-rogers.html#sthash.4QpYZ7ru.dpuf

Carl Rogers (1902-1987) was a humanistic psychologist agreed with most of what Maslow believed, but added that for a person to "grow", they need an environment that provides them with genuineness (openness and self-disclosure), acceptance (being seen with unconditional positive regard), and empathy (being listened to and understood).
Without these, relationships and healthy personalities will not develop as they should, much like a tree will not grow without sunlight and water.
Rogers believed that every person can achieve their goals, wishes and desires in life. When, or rather if they did so, self actualization took place
- See more at: http://www.simplypsychology.org/carl-rogers.html#sthash.4QpYZ7ru.dpuf

The problem with Health Education England is that they have over promised on a subject area in which they appear painfully lacking in knowledge. The only possible outcome of such a knee-jerk response is under delivery. As it stands, medical students are coached liberally leading up to their interviews to gain entry. The real challenge is this: How do you get the true measure of the human being sitting in front of you? Not the bright student who studies hard and achieves straight A grades. Not the well presented and well dressed person with the well rehearsed answers. Not the person who sounds more like one of those Miss World contestants who claims all sorts of nonsense. What you really want to know is how they would instinctively react if an 85 year old gentleman lying in a bed couldn't reach his drink or his food. I wish Health Education England well and hope they have a trick up their sleeve which has thus far eluded me.