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Change or Die by Alan Deutschman – Fast Company – Kate Bogh

by on October 12, 2007

When Personal Healthcare Meets the Business World: Instigating change in the workplace by examining what works in the doctor’s office.

Article: Change or Die by Alan Deutschman

Encouraging people to change and actually watching people implement change are two very different things. The article, Change or Die by Alan Deutschman, discusses motivating factors in human change behaviors relating to how people change when it comes to life or death health issues to generating change in a business environment.

The dichotomies of human behavior change when it comes to personal health versus the workplace seem to be unrelated. However, the balance between the two, in this article, was well done and the connection is clear: if you cannot change a dying persons bad habits so they avoid death how can it be expected that the same tactics will work in the workplace?
In one of our previous class discussions, Annie mentioned that what would motivate her to change her behavior in terms of her health would be much more likely to succeed than would telling her to make a change at work. An individuals’ health should be given greater weight than work changes.

Actually, Deutschman found that the odds of people changing, when faced with imminent death due to heart disease, caused by lifestyle choices, are 9 to 1. Nine to one. This is dramatic. If severe heart disease, a serious personal health issue cannot motivate change, what can?
Familiar tactics do not work. Giving people facts and statistics is not enough. And fear, it has been found, is not a good motivator for change. In fact, often it makes the negative behaviors grow worse. “For a few weeks after a heart attack, patients were scared enough to do whatever their doctor said. But death was just too frightening to think about, so their denial would return, and they’d go back to their old ways.” [pg3]. Neither fear nor facts works. Deutschman suggests appealing to emotion, appropriate framing of change requests and radical change as opposed to small change.

Instigating Change
It turns out that appealing to emotions is a powerful factor in encouraging change. “Behavior change happens mostly by speaking to people’s feelings.” [pg2]. Appealing to emotion is a skill, one that is not generally taught in school or during work meetings. By appealing to emotions, Dr. Dean Ornish, the developer of a holistic program to change the behaviors of people with fatal heart diseases, succeeded with a 77% success rate of program participants. In fact, they even maintained their behavioral changes three years after the study completed. This is a significant improvement upon the 90% of people with heart disease that would not change their lifestyles to live.

There is also significant value of a charismatic leader, someone who can deliver a message and make a powerful emotional appeal. For large organizations, the CEO needs to be a good public speaker with organizational credibility.

Also, radical changes are often more successful than smaller changes. Dr. Ornish found that people stuck with drastic lifestyle changes that caused immediate results in health and wellness were best received and encouraged people to stick with changes. Organizations can find such results as well. In one study, by Bain & Co., a management consulting firm found that, when implementing “corporate transformations”, companies saw fast results. On average the 21 companies increased their stock prices by 250% a year.

Framing Issues and Requests for Change
Change requests should be framed such that they are positive, simple and have an emotional appeal. [pg4]. The brain works in concepts, fluid ideas that form how we think and form opinions. “The big challenge in trying to change how people think is that their minds rely on frames, not facts.” [pg 4]. Frames allow us to change our conceptions. Frames put a structure around facts that make them more digestible to the human brain. The point: frames are valuable, use them.

Keep Your Brain Flexible to Change!
The article finished off with how neuroscience has offered up a lot of new information on how people change their behaviors. The brain is actually quite flexible and does not loose ‘elasticity’ with time as was once thought.

Just as flutists have larger areas in their brain for fingers, tongue and lip coordination so do business people in their respective specializations. “A specialist is a hard thing to create, and is valuable for a corporation, obviously, but specialization also instills an inherent “rigidity.” The cumulative weight of experience makes it harder to change.” A good way to keep your brain flexible is to take up a new language or instrument or hobby that allows you keep your brain learning. Merzenich, a leading neuroscientist recommends organizations allow employees to move to a different department one day a week to experience work that challenges but keeps people rejuvenated.

Gints, during a class discussion, mentioned that Nordstrom had its management and administrative staff work in stores on a day where it would be especially busy and there were not enough employees to cover the load of work. This is the same idea. Bryce also suggested a similar idea during the same discussion that maybe executives should occasionally work across departments to stretch a bit and try something new. There are a lot of potential benefits to these ideas.

When our class discussed change management issues, I agreed that health care and health related issues are much more significant influence for change than work place transformations. I was looking forward to challenging the basis of the article but after a reread I totally agree with the basis. Identifying ways in which change is successful in both environments gives us a greater understanding of what works and what does not work.

Suggested Resources:
1) Bayer, Ellen. “The Unspoken Taboos of Leadership: Exploring Charisma”. Newsletter: Inspiring Leaders: inspiring Excellence. July ’07 Volume 1, Number 5. URL:
-Discusses the importance of charismatic leadership.
2) Benjamin, Robert D. “Framing Issues”. Mediation and Conflict Management Services. URL:
-Specialist in mediation and conflict resolution, Benjamin discusses the impact frames and the soft skills necessary to deal with issues surrounding the upcoming change.
3) Booz Allen Hamilton Publications. “An Overall Approach to Change Management”. Booz Allen Hamilton Inc. 2004. URL: 8 pgs.
-A very good basic article on change management worthy of a read. Discusses how to appeal to emotion, choose team and create urgency.
4) Heath, Robert L.“Issues Management: Its past, present and future”. Wiley InterScience. July 31, 2002. URL:
Note: To view, log into the UW library system first at then access the article.
-discusses leadership and framing
5) Vucurovic, Suzanne. “Using communication to ensure user buy in”. EI Magazine; 14 Nov 2005, Vol. 2 Issue 5. URL:
-Specifically check out the sections titled ‘Gaining buy-in through communication’ and ‘Lessons learned over the past ten years’.

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