The Elephant and the Rider: Dan Heath

The CEO Blog will feature posts from guests while Geraint is away, including the APAC keynote speakers and Deputy CEO, Ron Pearson. Today we’re joined by Dan Heath, writer and Senior Fellow at Duke University’s CASE Centre, which supports entrepreneurs fighting for social good. Since his engaging keynote speech at APAC, CM Health staff haven’t stopped talking about ‘the Elephant and the Rider’. Here Dan answers questions about this concept and how it can be employed to achieve powerful and positive change.

What is the concept of the ‘Elephant and the Rider’ and how can it help us achieve change?

Dan Heath, writer and Senior Fellow at Duke University’s CASE Centre, which supports entrepreneurs fighting for social good
Dan Heath, writer and Senior Fellow at Duke University’s CASE Centre

It’s an analogy coined by the psychologist Jonathan Haidt – an analogy that helps us understand why we have all had the experience of simultaneously wanting to do better at something and yet finding that we undercut ourselves at every turn. Think of the new diet that we abandon on the first day or the budget that is blown in a week.

Let me explain the analogy. Psychologists know that there are two systems in our brain: the emotional system and the rational system. Haidt compared the emotional system – which is the instinctive part of our brain – to an Elephant in our heads. It’s incredibly powerful. The Elephant gets comfortable with routines; it’s pretty comfortable with the way things were working last week or last month. Sitting on its back is the Rider, representing our rational system – that’s the part of our brains that plans and analyses. The Rider likes data, charts and PowerPoint presentations.

The point of the analogy is that you can talk logically to the Rider: You need to eat healthier foods or we need to change our strategy at work. And the Rider might agree, but if the Elephant doesn’t agree, then nothing happens. The Rider can’t wrestle a multi-ton beast into submission.

The significance for organizational change is that managers are always appealing to the Rider but they forget about the Elephant. In other words, what managers tend to do is share the logic of change but neglect the motivation for change. Motivation comes from emotion, not information.

Can you share a personal example of how you have achieved change using this approach?

One strategy for ‘outsmarting’ the Elephant is to shape your environment in a way that minimizes the constant need to fight with it. For instance, if you’re on a diet, it’s a lot easier to throw all the junk food out of your pantry than to fight temptation constantly. Here’s an example from my life: I am a serial procrastinator, especially when it comes to writing, which is unfortunate because I make a living as an author! Procrastination is classic Elephant behaviour. I know what I want to do and yet in the moment there is inevitably a YouTube video calling my name. So I decided to stop fighting the Elephant and instead shape my environment. I bought an old laptop and removed the wireless card, which basically renders it a typewriter. Now when I’m writing, I have no ability to get online, which thwarts the temptation. It sounds ridiculous, but it has worked like a charm. I have this great sense of relief to not be fighting the familiar battle anymore.

How can we apply this approach to our own lives and work?

Here’s a twist: We have been talking about the flaws of the Elephant but the Rider has a crippling flaw too. The Rider – the rational side of us – is obsessed with problems and problem-solving. He is always asking, “What is broken in this situation and how do we fix it?” The flaw with this is that it blinds us to another question that is every bit as useful: “What is succeeding right now and how can we do more of it?” That’s a philosophy that we call finding the “bright spots”. This shift in thinking, from agonizing about problems to locating and cloning successes, can have enormous consequences.

Take your own example of the Enhanced Recovery After Surgery initiative used at CM Health. This package of care maximises a patients’ ability to get better through at least 20 components, such as education before surgery and getting out of bed soon after their operation. The end result is that your patients get better faster, go home sooner and cost less to treat. But you did not invent this. Instead, you spotted a bright spot already happening in Denmark and sent a team to investigate, who brought the idea home and tailored it to your local environment.

Can bright spots be found closer to home?

Yes, you need not always import bright spots from elsewhere. You can look in your own organization for bright spots. So if you have a team of 10 doctors and 2 are doing great work, 5 are in the middle and 3 are failing, most leaders’ attention is directed towards those 3 that are failing. The 2 who are doing great are ignored. But we should flip that: Spend time studying the 2 who are doing great to see what aspects of their work may be exportable to everybody else on the team. Instinctively, we study things that aren’t working. We need to do a better job devoting the same attention to things that are working.

How can we achieve change when people are not motivated?

We often try to motivate people with information when what we really need to do is motivate the Elephant through emotion. If we want people to rally round a goal we have to tell them not just where we are headed but why it is worth the trouble. Information provides direction but change begins the moment the Elephant is ready.

Your 20,000 Days Campaign speaks to the Elephant by artfully providing a goal that is both specific and motivational: to return 20,000 well and healthy days to your community. That is something you can rally around. I have also been impressed by the patient stories used in this campaign, such as the story of Keniseli Felagai who participated in the Better Breathing Programme because he wanted to be able to mow his lawn again. What better way is there to motivate the Elephant than by identifying what really matters to an individual patient?

Speaking of motivating the Elephant, do you think we give ourselves enough credit for what we have achieved in health to date?

I do not think so. There is always so much attention paid to the next reform or the next initiative. People need to be reminded of the skills they have already built and the obstacles they have already overcome. Psychologists know that people tend to succeed when they have high ‘self-efficacy,’ which is basically the feeling that ‘I’m capable of accomplishing this goal’. Going forward, one asset your organisation now has is the ability to point to something ambitious like 20,000 Days and say ‘we did it’. I imagine when it was first announced it must have seemed kind of daunting.  There were probably a lot of adjustments that had to be made and a lot of nuisance involved with trying to meet the goal. And yet you prevailed. That success provides a well of strength that you can draw on for future work.

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Author: Geraint Martin

Geraint Martin was appointed Chief Executive Officer of Counties Manukau DHB in December 2006. It is one of the largest District Health Boards in New Zealand and services a population of half a million. He has significant experience over 30 years in national policy & in managing both primary and secondary care . Previously, he was Director of Health and Social Care Strategy at the Welsh Government .He authored a radical 10 year strategy of reform, including the successful “Saving 1000 lives” Campaign.Until 2004, he was CEO at Kettering General Hospital & had held senior positions in London & Birmingham.He has worked closely with clinicians in improving clinical standards,patient safety,chronic disease management & managing acute care to reduce hospital demand.In NZ, He has promoted clinical quality and leadership as central to improving patientcare. This has led to a significant increases in productivity and access, whilst maintaining financial balance. CMH has completed in 2014 a $500 m capital redevelopment programme, the largest in New Zealand. A central part of this is the establishment of Ko Awatea,the Centre for Innovation and Research which will underpin CMH as one of the the leading health systems in Australasia.In 2008, he chaired the Ministerial Review of Emergency Care in New Zealand, and in 2013 was an member of the Expert Advisory Panel on Health Sector Performance. Geraint has an MSc in Health Policy from Birmingham University .His post-graduate work has focused on health economics and Corporate Strategy . He is adjunct Professor of Healthcare Management at AUT and Victoria University, Wellington Elected in 2006 as a Companion of the Institute of Healthcare Management, previously he was an Associate Fellow at Birmingham University.He is is Chair of the Auckland Philharmonia Orchestra, a member of the Institute of Directors, on the Board of the NZ Institute of Health Management & previously the Board of The NZ Health Quality and Safety Commission.

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