Negotiation – Persuasion & Influence 1Negotiating – Persuasion & Influence 1 Persuasion &...

Negotiation – Persuasion & Influence 1Negotiating – Persuasion & Influence 1

Persuasion & Influence A Core Leadership Attribute Seminar on Negotiation

Created By:Vince Markovchick, MD, FACEP, FAAEM

Past-President, American Board of Emergency MedicineDenver Health Medical Center, Denver, Colorado

Tenet Editor:Barbara Blok, MD, FACEP

Assistant Director, Denver Health Residency in Emergency MedicineUniversity of Colorado School of Medicine, Aurora, Colorado

Persuasion and Influence

A diplomat is someone who can tell you to go to hell in such a way

that you look forward to the trip.- Caskie Stinnett

Persuasion and Influence

An EM physician cannot function effectively if he cannot persuade and influence

those around him.

Outline

• Key terms

• Weapons of Influence

• Guiding Principles of Persuasion

Key Terms- Persuasion

• An act or the action of influencing the mind by arguments of reasons offered by anything that moves the mind or passions or inclines the will to a determination.

• The condition of having the mind influenced (as to a decision, acceptance or belief) from without.

DEFINITION

Negotiation – Persuasion & Influence 6

Key Terms-Influence

• An ethereal fluid thought to flow from the stars and to affect the actions of men

• The act, process or power of producing an effect without apparent exertion of tangible force or direct exercise of command and often without deliberate effort or intent.

DEFINITION

Key Terms- A functional definition

• How to get people to do the things you want them to do

• How to positively manipulate your environment

Weapons of Influence-Six Methods of Persuasion

1. Reciprocation2. Commitment and Consistency3. Social Proof4. Authority5. Liking6. Scarcity

* Influence, The Psychology of Persuasion by Robert Cialdini, HarperCollins Publishing, 1984.

Weapons of Influence- Reciprocation

An innate obligation to RECEIVE results in a perceived obligation

to REPAY in kind.

E.g., Hare Krishna association fundraising

• Reciprocal Concessions– One type of reciprocation

– Our sense of obligation to make a concession to others who have made concessions to us

• Reciprocal Concessions– E.g., A 1976 study on blood donation

made separate requests to 2 groups• Group 1: started with request for long-term

donation, then conceded to one-time donation

• Group 2: requested one-time donation up front

• Result: great donation in Group 1

• Practical implication for negotiating

– Start big

– Have a plan when negotiating

– Don’t be afraid to make the first

concession

Weapons of Influence - Commitment and Consistency

• Once a commitment is made, one is more likely to honor it later, even if terms are changed

• We feel the urge to be consistent with what we have already said or done

• Commitment precedes consistency– When possible, first get a commitment to

the cause; once committed the party will likely respond in a manner that supports the commitment (and cause)

It is easier to resist at the beginning than at the end.

– Leonardo da Vinci

• Strong commitments are: – Voluntary

– In writing

– Publicly made (visible to others)

E.g., A faculty makes a written or verbal commitment to assist with residency recruitment activities. When additional interview dates need to be scheduled, that faculty feel an obligation to help out.

• Negotiating for consistency– E.g., the late Egyptian President Anwar

Sadat would often begin negotiations with a lengthy discussion of how the citizens of the opposing country were widely known for their fairness and cooperativeness

– Opposing country felt the need to act in a manner consistent with their perceived prior behavior

• Application of Commitment and Consistency– E.g., You are the leader of your

residency’s education track. Based on the theory of commitment and consistency, how can you increase the productivity of the members for the upcoming year?

• Working to change another’s commitment– The more publically a commitment is

made, the harder it is to back away from it– Reframe the discussion to focus on the

issue, not the commitment• Turn the divisive issue into one that is shared• Allow the other to retreat from a stated

position

E.g., A legislator has taken a stance against your proposed tort reform bill due to specialty lobbyists. By reframing the issue and focusing on the improved access and availability of patient care that the bill will provide, the legislator might be willing to restate their position contrary to their prior commitment.

Weapons of Influence - Social Proof

• Making a decision based on the action of those around you

• Humans often rely on cues from those around them to determine how they should behave and feel

When we all think alike, no one thinks very much.

- Walter Lippmann

E.g., Asch Conformity Experiments– Seven individuals had to verbally answer

which line (A, B, C) was most like the target line (on left) with the research subject answering last.

– Research subjects conformed to the other’s incorrect answer 32% of the time.

• Reliance on social proof – Unclear or ambiguous situations– Pressured decisions– When others are experts

• Pitfalls– Social proof, like an autopilot, should

never be trusted completely

– “If everyone else jumped off a bridge, would you do it to?”

Weapons of Influence - Authority

• Perceived innate obligations– Defer to experts

– Obey authority figures • Even when asked (or ordered) to perform

objectionable acts

• “Nine out of 10 doctors prefer…”

E.g., The case of the rectal earache– Order written for patient with R otitis

media to have drops placed in R ear. Nurse dutifully administered the drops rectally without questioning the order.

• When possible, be authoritative– Come prepared– Look professional– State your qualifications – don’t assume

others know • Prior training• Practical experience

• Questioning Authority– To avoid being unduly influenced by an

authority figure– Ask yourself

• Is this authority truly an expert? • How truthful can we expect this person to be

in this situation?

Weapons of Influence - Liking

• People are naturally persuaded by people they like– This emphasizes the importance of good

interpersonal relations

– More difficult to say “no” to someone you like

• Characteristics associates with ‘liking’– Physical attractiveness (e.g., the halo

effect)

– Similarity (real or desired)

– Repeated contact

– Positive circumstances

Halo Effect - Repeated Contact - Desired Similarity - Positive Circumstances

• Getting someone to like you– Find common ground

• Sports, food, hobby, TV show• We like people who are similar to us

– Offer genuine praise• ‘I really like how you handled X’ or ‘You have

an amazing work ethic’• A positive comment will reliably generate

‘liking’ in return

Weapons of Influence - Scarcity

• Innate motivator– The possibility of losing something if a

more powerful motivator than or gaining something

• Perceived scarcity generates demand• Hard-to-get things are perceived as

better and more valuable than easy-to-get things.

The way to love anything is to realize that it might be lost.

- G.K. Chesterton

E.g., When trying to influence individuals

to write a book chapter, letting them

know that there are only two left is a

powerful motivator solicit volunteer

E.g., When trying encourage individuals to participate in committees, stating ‘you can only have 2-3 individuals involved’ will influence participation more than you ‘only need 2-3 individuals.’ You create a perceived scarcity of the opportunity.

Weapons of Influence - Putting it all Together

• Guiding Principles– Be upfront and honest at all times– Lead by example– Get a commitment to the cause– Come prepared– Work on being liked– Demonstrate authority– Use political capital carefully– Avoid unilateral decisions

Guiding Principles of Persuasion- Putting it all Together

• Be upfront and honest at all times

– Gives one credibility

– Admit any mistake

– Make no excuses

– Have no hidden agenda

• Lead by example– Demonstrate excellent work ethic

• Best way to gain trust and respect of subordinates

– Adhere to same expectation as everyone else

– Show up (early)– Dress appropriately

• Get commitment to the cause– Seek input from all stakeholders on

issues that affect them• Enables one to make more informed (and

hopefully) better decisions• Gives the stakeholders insight into the

decision-making process– Get “buy in” from the stakeholders

• Come prepared– Know the subject– Use data and facts to make one’s case

• Crucial when negotiating for more resources or funds

• Difficult to dispute hard facts

• Work on being liked– Requires networking, communication

and interpersonal skills– Find common ground– Emphasize the positive

• Demonstrate authority– Without being boastful, state your

qualifications• Prior training

• Prior experience

• Use political capital carefully– Takes time to acquire– Should only be used for the most

important issues– It is a finite resource

• Avoid unilateral decisions– May be necessary to promulgate a policy

or decision– Should be used as a last resort– Should always be accompanied by an

explanation of the rationale for this decision

Suggested Readings• Influence, The Psychology of Persuasion by Robert

Cialdini. Published in 1984 by HarperCollins Publishing.

• Harnessing the Science of Persuasion by Robert Cialdini. Published in October 2001 in the Harvard Business Review.

National Residency Leadership CurriculumQuestions?

National Residency Leadership CurriculumSpecial Thanks!

Funded By:An American College of Emergency Physicians Chapter Grant

Endorsed By:American College of Emergency Physicians

Emergency Medicine Council of Residency DirectorsEmergency Medicine Resident’s Association

Society for Academic Emergency Medicine

National Residency Leadership CurriculumSpecial Thanks!

Senior Editors:Stephen Wolf, MD, FACEP

Andrew French, MDMatthew Mendenhall, MD, MPH

Tenet Editors:Britney Anderson, MD

Barbara Blok, MD, FACEPJeffrey Druck, MD, FACEP

Maria Moreira, MDLee Shockley, MD, MBA, FACEP

Administrative Editor:Barbara Burgess

National Residency Leadership CurriculumThank You!

For More Information Please Visit:www.DenverEM.org www.CoACEP.com

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