Switch: How to Change Things When Change is Hard (review)

“What looks like laziness is often exhaustion.” We have a limited amount of self-control. A small rational Rider can only tug on the reins of a big emotional Elephant for so long!  And the rational side of us may plan forever and not get around to acting–I’ve heard this called “analysis paralysis.”  The trick is to get motivated to do what we know would make a difference.  The authors show us how to take changes in small steps and aim for early victories.  They also show how we can cultivate the belief that we are capable of change…which is key to being able to make the change we seek.

“What looks like a people problem is often a situation problem.”  If we can make it easier for people to do something different, more of them will.  If we can encourage new habits, those habits will take a lot of the stress and strain out of change.  “Behavior is contagious,” so show that a lot of other people are doing the right thing and you will get even more people to join them.  (This is a concept I’ve heard people call “social marketing,” and it’s one of the big reasons that fewer people smoke tobacco today.)

The Heaths illustrate all these concepts with stories that are “made to stick” in your mind (to use the title of one of their previous books).  Here’s one that pulls all three together:

In 2004, 1 out of every 10 patients in the U.S. received defective medical care.  For instance, they “did not receive their antibiotics in the specified time.”  So, “thousands of patients were dying every year, unnecessarily.  Dr. Donald Berwick set out to change that.

• He proposed that the medical industry save 100,000 lives in 18 months, and he gave them six specific ways to do it.  (Clarity, for the Rider.)
• He brought in a mom whose little girl had been killed by a medical error.  She told the hospitals, “I know that if this campaign had been in place four or five years ago, that Josie would be fine.” (Motivation, for the Elephant.  What greater motivation is there for a healthcare professional than saving the life of a child?)
• He made it easy for hospitals to join the campaign (by signing a one-page form) and brought them together in conferences where they could see how others just like them were succeeding.  (Smoothing the Path)

As a result. by the set date, the campaign had saved 122,300 lives, “the equivalent of throwing a life preserver to every man, woman, and child in Ann Arbor, Michigan.”

Now, I am not convinced that this formula for change will always work.  I agree with the Heaths that even a marginal improvement is better than none, and their techniques will work when there is no entrenched and powerful opposition to the change you have in mind.  You can probably lose weight this way.  You can very likely get more people where you work to respond to their email. If you are trying to raise the minimum wage, or end global warming, or stop a war, you are going to need more.

As Frederick Douglass famously said, “Power concedes nothing without a struggle.”  For struggle, you need a movement.  You cannot throw a behavioral switch. Even a social movement would have something to learn by reading this book, however, and for most of us, most of the time, this framework will be a powerful set of tools.  I strongly recommend reading this book and then going to work on making change where you live.