Let’s talk about motivating patients – more specifically about using FEAR as a motivator.
If you need someone to do something for you, they need a clear motivator. It’s psychology in its simplest form.
This holds true in healthcare as well. Providing a patient with good advice and a plan to manage their own health is only as good as the execution of that plan.
One might assume that improving your own health should be motivation enough, but that’s often not the barrier.
Patients can have doubts about the efficacy of the approach, or they might feel that the time and effort required doesn’t equate to the relatively mild impact that the issue has on their lifestyle.
So it becomes tempting for a health professional to improve their impact by providing a stronger motivation that just self-improvement.
Enter FEAR as a motivator to improve patient compliance.
Creating a sense of fear as a motivator
“Complete this exercise and you’ll be slightly stronger in a few weeks” isn’t nearly as powerful as “If you don’t do this exercise, you’ll end up homeless and living out of a shopping trolley with a pigeon called Henry!”
Ok, that’s a little extreme but you get the point. Scaring people into compliance is an easier task that explaining the benefits and potential impact of a management strategy.
But creating an unrealistic expectation of negative consequences is borderline unethical and morally questionable, even if it’s to achieve a better outcome for your client.
We see FEAR as a motivator in pre-operative consultations with surgeons, when patients are told that they’ll struggle to ever walk again without the magic intervention of surgery.
We hear Physiotherapists explaining that your neck and back pain is a result of mobile phone use and poor posture, and that without these preventative exercises, you’ll be in lifelong pain.
Physiotherapists have even come up with a cool sounding, fear-inspiring name for it: “TECH NECK”.
There’s a cool graphic showing that a head bending forward weighs the equivalent of 27kg!!
It makes you scared to ever look at your feet again…
Isn’t it just stating research-proven facts?
TECH NECK is a perfect example of using FEAR as a motivator, a cruel method of ensuring compliance with a prescribed plan of action.
Sure, if you do the calculation, the head may exert 60lb/27kg of force on the neck.
But the forces exerted on the body are phenomenal and any force might seem scary without context.
For anyone who’s picked up a 7 year old child, your spine tolerated over 550lb/250kg of compressive force. But do we advise parents to never pick up their children?
Even when performing daily tasks, your spinal discs tolerate over 1600kpa of pressure – compare that to the pressure in a car tyre of just 220kpa!
Chances are, you’ve already performed a dozen tasks today that exerted those pressures on your spine. And there was nothing to fear, no adverse outcome.
The responsibility of every healthcare professional
Healthcare professionals need to educate and inform their patient, giving them the information required to make their own educated decision.
Provided a biased, skewed assortment of facts to use FEAR as a motivator is a sad indictment on the professional’s confidence in their ability to motivate the patient with effective communication and education.