Win Skeptics Over To Innovate

Healthcare is lagging behind in digitalization. While the technology is available, the willingness to change is limited to a small group of early adopters and changemakers. Is the health sector simply “mindstuck”? If so, what can be done about it? An interview with Michael McQueen, author of the bestselling book Mindstuck: Mastering the Art of Changing Minds.

Healthcare systems around the world face enormous challenges, but the willingness to change the status quo is low because “things have been done like this for decades.” Is this a symptom of “mindstuck”?

The situation you described is common in complex, heavily regulated industries characterized by inertia—the sense that the system is so big, complicated, and regulated that no matter what you do, nothing will change.

A great example is the NHS Day of Change program from a few years ago. Participants were given the chance to have a hackathon to come up with ideas and innovations to improve things in the NHS. Although some of the changes were not as enduring as hoped, it gave people the sense that if they brought their best ideas to the table, they would be listened to and heard.

In many organizations, especially in the medical profession, change often doesn’t happen because of this inertia. Even if some individuals within the sector are willing to try, the overwhelming sense of inertia makes it feel pointless to attempt change.

The hurdle of deploying new technologies in healthcare reminds me of Hungarian doctor Ignaz Semmelweis, who failed to convince doctors to wash their hands between handling cadavers. Why are numbers, facts, and evidence so often ignored?

Numbers, evidence, and facts are only useful when people feel their egos are safe. Brain science shows that we typically make decisions first with our instinctive mind, then use our rational mind to backfill with logic. Simply put, we often make decisions based on tribalism, emotion, or intuition and then justify them with logic. If we start with logic, evidence, and facts without convincing people about the change, they are unlikely to accept it.

If the information or logic is confronting, instead of entering fight or flight mode, our instinctive minds may go into denial, defensiveness, or deferral. We defer to what others—like us—think and don’t engage with the idea ourselves.

Imagine Semmelweis asks you to help him change doctors’ minds. What is your advice?

Interestingly, my wife and I saw a show in London about Semmelweis. What struck me was how he didn’t allow others any dignity in the change process—he needed to be right. This is common when people try to “logic bully” others into changing their views. Even if the other person sees value in your suggestion, if you force them to admit they are wrong, they won’t embrace it.

Our egos are strong, especially in the medical industry, where people’s egos are tied to their clinical prowess, the letters after their names, and their published papers. Admitting they were wrong can be embarrassing and costly to their dignity and ego. You have to give people the space and time to feel like they changed their minds themselves. They need to feel like they had an epiphany: “Now I know something I didn’t know before. I can tell the story of how I had agency and changed my mind rather than having my mind changed.”

Semmelweis failed to allow for the dignity of others, which hindered the acceptance of his ideas.

The culture of work in medicine is founded on the strong collective identity of doctors and intuition formed after years of practice. Yet, digital health – for example, data-based clinical decision support systems and AI-driven supportive tools – seems to disrupt the “old culture.” How can we convince those who are unconvinced about this transformation?

In a clinical sense, what I’m observing in the medical field is the need to recognize the strengths and limitations of AI. Skilled doctors, nurses, and ward staff often have an intuitive sense of a patient’s condition long before reviewing charts or data from monitoring machines. This gut feeling is intuitive and uniquely human—it can’t be automated. While AI excels in certain areas, there are aspects of healthcare it cannot replicate.

For instance, in pathology and radiography, AI can quickly examine a large number of scans, identifying potential issues for further human investigation. Early results show AI picking up on problems faster and with greater accuracy than humans. AI is excellent at handling large-scale data but lacks the capacity for caring. We need to be aware of this distinction.

Demonstrating to doctors how AI can be a tool to ease their workload, allowing them to focus more on patient care, is crucial. You might compare AI tools to stethoscopes or thermometers—technologies initially met with resistance but now integral to medical practice. Placing AI within this familiar context can help ease the transition.

On the other hand, some healthcare professionals fear that new technologies will take over their jobs, which is irrational thinking since there is a shortage of doctors. How can we eliminate this intuitive defense mechanism?

Consider showing how new technologies can be helpful tools for solving everyday challenges. When working with clients, I explain that AI typically serves as either a painkiller or a multivitamin. As a painkiller, it addresses headaches and bureaucratic frustrations that slow you down. As a multivitamin, it provides capabilities you didn’t have before.

For example, in clinics, tools like Lyrebird and Heidi can listen during consultations, transcribe conversations, send summaries to patients, and draft referral letters. They can also fill out patient records, saving doctors time and energy on administrative tasks. These tools significantly reduce workload. Communicating AI’s dual role as a painkiller and a multivitamin for individuals and the profession is key.

Around 75% of stakeholders must be convinced to make this transformation successful, and the “herd instinct” will do the rest, right?

That’s right. Typically, momentum sets in when a significant number of people sense social proof—feeling that everyone else is thinking or doing something. Not everyone needs to adopt the same behavior, but once over 75% of the group does, momentum builds, and others follow.

Advocates of digitalization in healthcare often argue that change is inevitable due to an aging society, rising healthcare costs, and health professional shortages. Is this narrative of an “approaching catastrophe” a good approach?

It would be nice to say that change is inevitable, but many systems are cracking and crumbling. Unless change happens quickly, both patients and practitioners will suffer. Practitioners are burning out, getting fed up, and leaving the profession. The need for change is more pronounced than ever, but claiming it’s inevitable is a cop-out. Things could continue to deteriorate without thoughtful and deliberate innovation.

Starting with a negative approach, like a “burning platform” scenario, may trigger short-term results but tends to focus on negative emotions. This approach narrows our thinking and stifles creativity. Instead, set an ambitious goal for what could be. Paint a vivid, clear picture of improved patient outcomes and efficiency, give examples of success elsewhere, and show a pathway from here to there. An optimistic future without a clear path leads to cynicism. People are desperate for genuine hope that things can improve. Appealing to hope and a sense of virtue, like our responsibility to our communities and profession, is more likely to bring out the best in people.

From your experience, what percentage of skeptics can be convinced, and what percentage is stuck with their point of view, making it impossible to change their minds?

Many factors come into play. According to Aristotle’s principles of rhetoric—logos, ethos, and pathos—you can reach most people with a combination of pathos and logos. Ethos, or credibility, is circumstantial.

The person who has ethos or trust with one individual may differ from another. To enact change in a department or hospital, identify the person who has ethos with the people you’re trying to influence. You may not be the right messenger. If someone with more credibility advocates for change, people are more likely to listen.

While some people may be incapable of changing, let’s assume that’s a small minority. If people aren’t changing their minds, it’s often due to a lack of ethos. You may have made the perfect case for change, but you might not be the right person to deliver the message. You need someone with credibility in their eyes.

Let’s summarize. Which techniques from your book could be successfully applied to accelerate digital transformation in healthcare?

The first technique is to help people see digital change as a continuation of the past, not a break from it. People’s greatest fear that causes them to resist change is not the fear of change itself, but the fear of loss—loss of power, certainty, and dignity. We need to help people feel that the change will improve their lives, won’t erode their power base, and is an extension of something familiar. Using familiar language can be incredibly helpful in this regard.

The herd instinct is also valuable. Make it clear that others are adopting these changes. Appeal to things people already agree on, like patient outcomes. Start with common goals, then discuss how to achieve them. This avoids clashing around ideologies and focuses on shared values.

Which of the techniques is your favorite one that you use most often?

My favorite technique is building affinity and trust with others. I love the work of Paul Zak—the founding director of the Center for Neuroeconomics Studies—on how to stimulate oxytocin release in the people you’re trying to influence. This involves being self-deprecating, relatable, warm, honest, and authentic. These qualities lay the foundation for trust and influence.

One of Paul Zak’s tips, which isn’t in his book, is to go for a walk with someone if you have a high-stakes conversation. Walking side by side helps you sync with the other person, matching their cadence and pace. This synchronicity makes them more open to engaging with you and your perspective. So, instead of sitting opposite each other, get out and go for a walk. This can help melt away resistance and build rapport.

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