During the recent market turmoil, a financial planner shared with me how they had a client who insisted on moving all their investments to cash, despite the financial planner’s attempts to dissuade the client from doing this. The financial planner told me they had asked the client to sign a “disclaimer”. This is not unusual. I often hear financial planners say that they get a client to sign a disclaimer when the client doesn’t take their advice. But this is not good for either party. The client is likely to be worse off, and the planner’s position as a professional advisor is compromised. Benjamin Franklin wrote in Poor Richard’s Almanack (1735),
“If you would persuade, appeal to interest not to reason.”
The power of this approach struck me recently in reading the book Supercommunicators, by Charles Duhigg, in which he relates the story of a urologist, Dr Behfar Ebdaie, who specialises in treating prostate cancer at Memorial Sloan Kettering Cancer Center in New York City. The story is close to home because my father had prostate cancer, and treating it is slightly complicated. The most certain way to prevent the cancer spreading is to have surgery or radiation treatment, but the risk of this treatment is potential incontinence and impotence, often long term. Yet prostate cancer is often slow-growing, so for most people with prostate tumours, doctors advise against surgery or any other form of treatment. Low-risk patients are counselled to adopt an approach of “active surveillance”, which usually involves periodic blood tests and possibly biopsies.
Dr Ebdaie’s patients would frequently face the dilemma of whether to have surgery or to keep monitoring and only act if the cancer grows. Dr Ebdaie would use thorough data and evidence from studies to show that in most cases it was best to adopt the surveillance approach. Yet when he advised patients that they would be better off adopting the surveillance approach and didn’t need surgery, many insisted they wanted surgery. This was bewildering to Dr Ebdaie as an expert in this form of cancer. He couldn’t understand why the patients wouldn’t take his advice, and even worse, would opt for the riskier treatment. Duhigg reports that this response is not limited to Dr Ebdaie, and that an estimated 40% of prostate cancer patients opt for unnecessary surgeries.
To help him see what he may be doing wrong when engaging with his patients, Dr Ebdaie engaged the services of Professor Deepak Malhotra from Harvard Business School, an expert in negotiation. Professor Malhotra told Dr Ebdaie that he was assuming all his patients wanted was objective medical advice in which he outlined their options to make an informed choice.
Prof Malhotra suggested that Dr Ebdaie, before giving advice, should try to understand what his patients wanted. He suggested that the best way of doing this was through asking open-ended questions, such as, “What does this cancer diagnosis mean to you?” In response to this question, patients didn’t talk about medical concerns but rather about their family and how the different treatment options might impact on them. Invariably, when Dr Ebdaie approached his patients in this way, they didn’t talk about the disease, but rather about their marriages, their memories of a parent’s illness or worries about the future.
If you would persuade, appeal to interest not to reason.
Dr Ebdaie also discovered that different people needed different things, some wanted emotional reassurance, others wanted to feel in control, and some wanted to know how other patients had made their decisions. Dr Ebdaie soon realised that his previous way of engaging in these conversations was flawed, and that it didn’t help to convey lots of information which patients didn’t care about or couldn’t process because of their emotional state. He changed his approach, asking first what mattered to his patients when they heard they had cancer, and within six months the number of patients opting for surgery fell by 30%.
Dr Ebdaie could have continued doing the surgery that patients asked for and get them to sign “disclaimers” about potential incontinence and impotence. But he was concerned about the wellbeing of his patients, and why as the expert, he was not able to get them to take his advice. His professional effectiveness was compromised. As a true professional he had his clients’ best interests at heart, and when “reason” didn’t prevail – giving them information, he discovered that finding out what really mattered to them – their “interest”, was the key to enabling his advice to land.
As a financial planner, the next time a client doesn’t want to take your advice, consider whether the best route is to get them to sign a “disclaimer”, or to see if there may be questions you could ask the client that appeal to their “interest” rather than to “reason”. After all, asking clients to sign a “disclaimer” because they don’t listen to your advice seems more like throwing reason to the wind, and not acting in the client’s best interest.
