Book Review: Enchantment: The Art of Changing Hearts, Minds, and Actions by Guy Kawasaki

Product Information:

Name: Enchantment: The Art of Changing Hearts, Minds, and Actions

Page count: 224

Year of first printing: 2011

ISBN: 9781591843795

Although this book is not directly related to emergency medicine, but Enchantment: The Art of Changing Hearts, Minds, and Actions by management guru, Guy Kawasaki, has a lot to teach us, doctors in ER, on the one of the very important aspect of clinical medicine - art of persuasion and influence.

In it, Guy explains how to influence what people will do while maintaining the highest standards of ethics.

The book explains when and why enchantment is necessary and then the pillars of enchantment: likability, trustworthiness, and a great cause.

The next topics are really about the nuts and bolts of enchantment - the launching, overcoming resistance, making enchantment endure, and using technology. There are even special chapters dedicated to enchanting your employees and your boss.

The following infographic summarizes the main points of the book:

Overall, I find that this book is very intriguing. Lots of lessons to learn from (see below). It is written in an easy-to-understand, conversational style with ample illustrations including the various side real-life stories found at the end of each chapters.

I have personally learned a lot from this book.

On page 14-15, Guy talks about accepting others. For people to like you, they have to accept you. And for people to accept you, you have to first accept them. That simple. No rocket science behind the theory, although in actuality it can be much harder to do because:

• we tend to think of people in terms of binary, which fortunately, they are not. People are not binary, they are not either ones or zeros, smart or dumb, worthwhile or worthless. Everyone has strengths and weaknesses.
• we think we are better or superior to them. In reality, everyone is better than you at something. No one is superior to everyone in every way.
  
• we tend to think we are the most important people in the world, the universe revolve around us and our priorities deserve the kind of attention from people like the way we ourselves give. In actuality, people have their own concerns, their own stresses, heartaches, headaches, etc. As Guy said, "Don't judge people until you've walked a kilometer in their shoes. Give them a break instead."

On page 46: One of the ways to make catchy phrases/messages is to use tricolons. A tricolon is a sentence containing three parts of equal lengths such as "Eye it, try it, buy it" (see below), "Be sincere, be brief, be seated" (Franklin D. Roosevelt's advice to speakers) and "location, location, location" (real-estate wisdom).


Then, of course, there is this principle of K.I.S.S. (Guy's version: Short, Simple and Swallowable). The basic guidelines for brevity, depending on the techniques of communication, are:

• For email: six sentences (the six sentences are to answer the following questions: 1) Why are you contacting this person 2) Who are you? 3) What your cause is? 4) What you want? 5) Why the recipient should help you 6) What the next step is)
• For videos: sixty seconds
• For PowerPoint and Keynote: ten slides
• For business plans: Twenty pages

On page 66: regarding salient points. When illustrating salient points, translate the facts and figures into meaningful and comprehensible bite-size chunks of information. For example: when promoting ipods, rather than saying xx of gigabytes of storage capacity, speak in terms of the number of songs and movies that can be stored in that device. Other examples include: cars- say in terms of cost of fuel per year rather than miles per galloon; heater: heating expense in electricity bill per month rather than thermostat settings in degrees

Interestingly, on page 64, Guy quoted Iyengar and Lepper's findings that show that people are more likely to make a purchase when there are fewer choices available to them (you can download the original paper by Iyengar & Lepper here). More choices can also lead to ambiguity and dissatisfaction because people may look back and wonder if another option would have been better or more suitable for them. Bottom line, more choices available, more choices to regret. In other words, more is not necessarily always better.

On page 68: I like the idea of the importance of getting hold of a group (albeit small one) of first followers - zealous, enthusiastic followers, who will in turn, attract more followers. Read more about it from Derek Siver's article here.

The chapter on overcoming resistance to enchantment (pages 70-94) is particularly important and has a lot of similarities with what healt hcare professionals do to impart behavioral changes in patients. The initial section on the anatomy of resistance is particularly worth reading. There are five common reasons why people are reluctant to be enchanted (or to change):

• Inertia. People at rest will remain at rest; and people in motion will remain moving in the same direction unless an outside enchanter acts upon them. Existing relationships, satisfaction with the status quo, lazyness, busyness etc
• Hesitation to reduce options. People like the ability to make choices and therefore, by making a decision, this gives them the perception of reduction of options, and the prospect of this outcome may scare them!
  
• Fear of making mistake. Related to the above point, people may think that as long as they have not made a choice, they have not made a mistake. Once they made a choice - they are either right or wrong. In reality, not making a choice - is a choice itself. (In the case of healthcare profession, this kind of ambivalence happens when patient is confronted with the option of whether to get a surgery/procedure or not)
• Lack of role models. That's why early adopters are so important, as Derek Sivers illustrated.
• Your cause suck! People are turned off by what you are offering. Then people are right and have the right to be reluctant.
  

There are another two common marketing strategies commonly employed to overcome resistance mentioned in the book: creating the perception of ubiquity and creating the perception of scarcity. I see these two methods very often. "Everybody is using it. It is trendy now. Why not you?" (creating the perception of ubiquity). "This is the last copy available. It has been selling like hot cakes. If you want, you'd better grab it now. If not, someone else will soon take it.." (creating the perception of scarcity).

On page 113 (chapter 8), Guy talks about leveraging the use of push technology. Some of the lessons I learned concerning engaging with people in communication using information technology include:

• engage fast - fast in today's digital age, means within 24 hours. All e-mail communications, for example, should be replied within 24 hours.
• engage many (or "sowing many seeds") - don't just focus on the rich, famous and traditional influential people. I like the phrase Guy used: "[the] nobodies are the somebodies in a world of wide-open communications."
• give credit to whoever helped you find the valuable information that you provide to others. This is a hat tip. Leave positive comments when you read something you like -- these are the equivalents of thank-you notes.
• give people the benefit of the doubt. Assume people are honest, smart and decent - not dishonest, stupid or conflicted. Don't lose your civility when you communicate digitally. I like the last part he said: And assume everything you do is public and permanent, so you are leaving fingerprints for anyone to see forever.
  

In fact, in another part of the book (page 101) he talked about paying it forward by doing favors for others before you need or ask favors. Of course, in that same section, he also mentioned that we do not hesitate to ask for reciprocation, if that is needed. Ask for a favor in return -- it is a good practice because you create a way for the recipient to repay his "debt".

Being a Japanese-American, Guy also shared some Japanese Zen principles to increase our effectiveness on using technology for presentation (essentially this is based on the Zen aesthetic nature of the Japanese garden). Here are some I learned (more are mentioned in the book, page 149):

1. Kanso. Simplicity or elimination of clutter. Things are expressed in a plain, simple, natural manner. Reduce unnecessary details in your presentation.
2. Fukinsei. Asymmetry or irregularity. In graphic design too asymmetrical balance is a dynamic, beautiful thing. Try looking for (or creating) beauty in balanced asymmetry.(Note: interestingly, the "rule of thirds" for photography has similarities with this principle and explain the rationality behind why asymmetry is beautiful)
3. Shibui. Understating, direct, be brief, simple rather than elaborating too much or flashy.
4. Shizen. Absence of pretense or artificiality, full creative intent unforced.
5. Yugen. Profundity or suggestion rather than revelation. Showing more by showing less.
6. Datsuzoku. Freedom from habit or formula. Escape from daily routine or the ordinary. Away the conventional. This is why it is particularly important to break away from always using the tired text-and-bullet-points method in Power Point! Bullet kills.
7. Seijaku. Tranquility or an energized calm (quite), stillness, solitude. The oppositeof seijaku is noise and disturbance. Remove all intrusive sounds, jumpy clip-arts, etc from your presentation.
   

(Incidentally I also found an article illustrating how these zen principles can be applied to financial management. Click here.)

Of course, not to forget, his famous rule in power-point presentations: 10-20-30. 10 slides in 20 minutes with font size no smaller than 30 points. Although I find this rule to be effective, this is not always practical in my setting. It all depends on the purpose of your slide presentation. If you are doing it to engage with people, to sell a concept or product, then yes! the rule should apply. But in my case, I am using the slides for my lectures - educational purposes and for information dissemination. In such a case, 10 slides are definitely not enough, 20 minutes may or may not be enough depending on the topic of my lecture.

View the full-length lecture by Guy here:



You may also download the mp3 version of that talk here.

Original link. Click here

People don't want more information. They are up to their eyeballs in information. They want faith - faith in you, your goals, your success, in the story you tell. - Annette Simmons

View the slides below.

Enchantment v2.2

View more presentations from Guy Kawasaki

If you want a quicker overview on the components of the art of enchantment, view this abridged version of Guy's talk:

About the Author of Enchantment:

Guy Kawasaki is the co-founder of Alltop.com, an “online magazine rack” of popular topics on the web, and a founding partner at Garage Technology Ventures. Previously, he was the chief evangelist of Apple. Kawasaki is the author of ten books including Enchantment, Reality Check, The Art of the Start, Rules for Revolutionaries, How to Drive Your Competition Crazy, Selling the Dream, and The Macintosh Way. Kawasaki has a BA from Stanford University and an MBA from UCLA as well as an honorary doctorate from Babson College.

***********************
Disclosure of Material Connection: I received this book free from the publisher for the sole purpose of book review blogging. I was not required to write a positive review. The opinions I have expressed are my own. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255 : “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”
***********************

How "GOOGLE"able Are You?

As the world is getting smaller, flatter and more globalized, social media is the way to go in the near future.

Those who are not convinced, watch the video clip "Did You Know 4.0?" below:





You can read the detailed transcript of the video here.

Just to trigger your imagination:

This year (2009), traditional advertising revenue is in steep decline:

• Newspapers advertising is down 18.7%
• TV advertising is down 10.1%
• Radio advertising is down 11.7%
• Magazine advertising is down 14.8%

Meanwhile, digital advertising is growing rapidly:

• Mobile advertising is up 18.1%
• Web advertising is up 9.2%
• 47% of broadcast television viewers say they would pay for ad-less programming.

Myspace, Facebook, and YouTube collectively get 250 million unique visitors per month. None of these sites existed 6 years again.

In fact, the question today we should ask ourselves is 'HOW "GOOGLEABLE" are you?'.
It is part of our personal and professional branding in the online community.

One can test out one's online "googleability" by using the online ID Calculator here.

In fact, the webpage of that online calculator even goes to claim that "Today, if you don't show up in Google, you don't exist"

Nevertheless, I believe that social media participation by healthcare professionals are very fragmented. As highlighted in this blog story by Dr. V, physicians ought to follow one another on twitter for example, to create a loud, resounding voice. I like what he said, regarding the example of the vaccination. Here is what he said:

"60,000 is a number I reference when discussing physicians and social media. There are 60,000 members of the American Academy of Pediatrics. Every pediatrician fights vaccine misinformation, especially as they relate to autism. Consider the fact that the first two pages of a Google search for vaccines and autism are polluted with anti-vaccine propaganda driven by a loud, socially-savvy minority. If every AAP member wrote a myth-dispelling post concerning immunization just once a year, Google would be ruled by reason."

Of course, participating in social media ought to be tampered with a sense of professionalism, medical ethics and a conviction of one's professional responsibility to protect the patient's privacy. One should just take a look at this story of medical students posting pictures that compromised patient's privacy.

One of the reasons why this blog was set up is because I know emergency medicine in my country is still in its infancy and the niche area I can use to improve the development of emergency medicine in my country is through the cyber community.

Furthermore, most of my medical students today have a facebook profile, some have their own blogs, that they have been blogging about their ward experiences. Shouldn't we as doctors and lecturers do so?

Doctor-patient relationship

Mr. Siah shared in Malaysiakini.com regarding the unpleasant experience he had in bringing her aunt from Sarawak to Selayang Hospital. You can get the full article of that story by clicking here. But in summary, it is when her aunt, who had a cancer, had to be operated upon with expertise in Selayang Hospital. So, she was flown from Sarawak to Selayang but later was told that the operation had to be canceled because some emergency operation cropped up. And the surgeon in charge (Mr. B) said that the operation could be postponed until up to as long as two to three weeks (I think this is where the problem started. Mr. B was not tactful.) And he said that to a patient and her relatives that came all the way from Sarawak to KL!!

Of course, Mr. B did give alternatives to the aunt - either go back to Sarawak because a new surgeon from Selayang been posted to Sarawak General Hospital and could perform the similar operation in Kuching or wait in Selayang Hosp (two to three weeks(??), Mr. B while you are enjoying your Raya holidays?).

Finally Mr. Siah called up few ministers and VVIP and finally he got the new appointments for his aunt.

It is worth reading. I learn few lessons from that article.

I wrote back to Mr. Siah. This is my edited reply to him (I don't think I have a lot of things to hide. This is just my own views, anyway).

"Dear Mr. Siah,

I refer to your article in Malaysiakini.com. I read with great enthusiasm that I decided to write back to you....

Since I have worked in as HO and MO in these places (HTAR, SGH, HUSM), I can identify very very well with what you wrote. I can imagined what had transpired during your ordeal.

Be honest with you, Mr. Siah, canceling or postponing operations is a norm rather than an exception in many (probably I should say ALL - I don't expect any exception) government hospital - doesn't matter whether it is a MOH hospital or a university hospital.

Most of the time, as far as I know, when postponement or cancellation of procedures have to take place, there must be a reason or reasons.

I have not seen (in my limited years of experience), a surgeon or doctor cancel an operation or procedure just for the sake of cancellation. It is an unpleasant job to go tell our patients that the procedures have to be canceled. It is just not ethical to do that (huh, still got doctor talk about ethical things ah?? actually I don't know whether I am qualified to talk like this or not)

Like in your case, this kind of scenario is very common, Mr. Siah. When an emergency case (especially trauma) came in unexpectedly and require a emergency surgical procedure, pushed in from emergency department (hah, this is where I work), that's it. Elective cases postponed. No choice. Elective cases means elective. Usually can wait. If can't wait (for example, the elective cases deteriorated with complications), then we will usually slot them into the emergency list. Being an emergency physician, I would certainly want my patient to get to the OT as soon as possible should an emergency procedure is required.

When I first read the article, my first reaction was "what again, another complaint made public, not just to the Malaysian public, but the whole world.,, can't the public understand, things are not as simple as it seems la.... making a complaint just because you are not happy with certain things.."

As I read further, I am getting more restless, I asked myself, who is this guy making such a big fuss of things like this.. It is.... common la, you know, in government hospitals; we are not in private where you can get first class treatment but leave your pocket empty la (trust me, every piece of gauze, every syringes are calculated in YOUR bill); we have to cater for everybody from the criminals (just this evening only we had to treat a caught thief trying to break in to a house), the poor, the rich, the Datos', even the royal families.

And one of things I hate, really hate (sorry, to be honest), is when a relative member or the patient himself pulling cable, calling up VIPs, VVIPs, royal families, pengarah hospital, pengarah this, pengarah that, in order to get special treatments like cutting queue to be seen and treated first, special investigations and tests, etc etc. What about those who doesn't have a cable to pull? Like the old poor makcik or a young mother who had been patiently sitting in the reception area for hours just for her child to be seen by a doctor for few minutes, I mean these are the people that I really have special empathy for.

However, as I read further, my focus began to change. Rather than just focusing on the doctor's perspective, I need to see from the patient's or relatives' perspective.

Here's what I learned from your article:

1. As a member of the medical profession, I am being constantly observed and watched. Members of the public will form impression on me and ALSO the hospital I work (see how Selayang Hospital name came out)based on how I behaved. And some of members of the public maybe a very very keen observer and I should be reminded of that (like the way you describe the sms time of the DG at 6.28 am and the sarcastic observation of the junior doctor in front of the computer. Did you actually approach her about it rather than just making an impression like that?

2. It is irritating and very very unfair for patient to be pushed around either physically (from ward to ward - it happened before, and news have came out before in papers) or in terms of appointments, etc (like in your case)

3. I agree, it is not right for Mr. B to say what he had said. He should never never have said 'maybe two to three weeks'. The public look up to the doctor to give them answers and hopes in times of sickness and when the doctor himself can't be sure, the patient would lose confidence. I don't know the tone of Mr. B when he said that. He may have said that (intentionally or unintentionally) out of his anger, out of his ego, out of tiredness, etc. But I learn that, at any time and at any cost, this does not permit me to be rude to the patient. I learn that, I must at all be good in communication with my patients, despite how frustrated, how tired, etc.

4. A promise made must be a promise kept. An alternative must be given to the patient, if the promise can't be fulfilled. but having said that, Mr. B did give alternatives to your aunt - like referring to the surgeon posted to SGH. However, again, he should not have said "two to three weeks later."

At the end of the day, I realize we doctors should be courteous, and remove our pride and ego. Thanks again, Mr. Siah. You could have gone through the conventional way of going step by step from talking to the sister, to the MO, to the surgeon himself, to the head of dept, to hosp director, etc etc rather than blowing it up. But again, sometimes it takes a hard knock to wake us up la. It is us doctors and our attitudes that should change.


Regards,
Chew"

Update (15/10/2007):
P/S: Mr. Siah did respond to my letter and had asked this is letter to be republished.
Click here to view the edited form of the letter in Borneo Post Online.

Update (17/10/2007):
The edited form of the entire letter was also published in Malaysiakini (Rentakini section).
URL: http://www.malaysiakini.com/rentakini/73632