Ignorance is not something we tend to look for in ourselves. We take pride in our knowledge and our competence, not our ignorance. Have you ever considered the ways in which your knowledge could get in your way? How accessing your ignorance could make you more successful?
In preparation for our annual Leadership and Legacy retreat this year I read two books: one that challenged my thinking and one that enriched my perspective. Both helped me learn to access my ignorance.
Atul Gawande’s excellent book, “Being Mortal” is rich with moving stories about end of life choices and practical advice. He is a well known author and physician with years of experience in medicine. He thought he knew a lot about how to help his patients, but he also had a lot to learn about his responsibility in helping patients make decisions about health. I believe that his insights speak to all of us who have a responsibility to influence others.
Gawande was aware that there was more than one way of influencing his patients. There was the traditional paternalistic model in which his responsibility was to tell his patients what to do. In that model the doctor takes complete responsibility for knowing what is best and choosing an appropriate course of action. Gawande preferred an informative model in which his role was to simply give patients plenty of information, and leave the choice up to them. He took no responsibility for their choices.
As Gawande helped his own father navigate through the challenges of a terminal disease he came to understand that there was a third model, one of collaboration in which there was shared responsibility for decision making. He came to understand that when he just provided information he was avoiding responsibility. He didn’t want to take on all the responsibility for his patients’ choices, but he did want to guide and support them.
Gawande learned to sit with people in end stages of disease and listen deeply for their hopes and their fears. Instead of just offering them a list of medical options, he sought to understand how they wanted their last days or months to look. Only then was he able to use his medical knowledge to offer them options. He could describe risks and benefits based on who they were and what they wanted. He became a trusted advisor because, in understanding his patients, he trusted them to make their best choices.
When we come to conversations with a collaborative perspective we come with an understanding that we have a responsibility to be helpful. We have important information to share, and so does the person we hope to influence. “Fully informed” decisions require both perspectives. Both perspectives support shared responsibility; true partnership.
We can try to influence through authority, or power, or knowledge, or manipulation, or fear, or any number of ways. We can take all or no responsibility for the outcome. But, when we influence through collaboration we acknowledge that
we need the other to accomplish our goals.
This brings me to the second book which has recently informed my thinking, “Humble Inquiry” by Edgar Schein. It’s the book I wish I had written, but I would have named it “Staying in the Question” and it probably would not have sold as well. Schein’s book reminds us that when we want to influence others it is helpful to “access our ignorance.” It helps to come to the conversation with a genuine desire to learn; a belief that the other has information we need in order to be successful.
The late Dr Bob Barkley wrote, “Dental health is peculiar. The rich cannot buy it, and the poor cannot have it given to them. I can make people more comfortable, more functional, and more attractive. But I cannot make them healthy.”
If our goal is to help people become healthier, we are dependent upon them for our success. We can’t do it alone. We enjoy success when we help patients stop the progress of disease, when we are allowed to provide beautiful dentistry, when we see a positive difference we make in their lives.
Even when we believe we know the best course of action, accessing our ignorance holds out for an element of surprise. A realization that we often don’t know what we don’t know. A possibility that new knowledge could emerge that just might enhance our decisions.
We know a lot about dentistry. It’s easy to rely on that knowledge — that strength— in conversations with patients. But our patients also know a lot; a lot about themselves. If we can open ourselves to learning from them, they can help us help them. When we access our ignorance we come to conversations both confident about what we know, and humble about what we don’t know.
When patients say, “you’re the expert” I have often responded, “Yes, I do know a lot about dentistry, but you know a lot about you. I think that if we put our heads together and share what we know we can figure out what’s best for you. How does that sound?”
How will you access your ignorance today? Will you follow up on a statement or question from a patient to gain a deeper understanding of how you can help them better? Will you listen for clues as to what your patient needs to feel really confident moving forward with treatment?
How would your day be different if you started your morning meeting with a commitment to accessing your ignorance?