Positive feedback is all the rage these days. Parents (and grandparents) are hyper-focused on encouraging Junior. “Great job” may be the most common words out of this grandfather’s mouth when on duty with the little ones. A crayon scrawl that only goes off the paper and onto the kitchen table a few inches merits a “well done!” Generous kudos are a big part of the work environment as well. All bosses know to “lead with the positive” and dispense encouragement left and right. Teachers and coaches (more or less) are on board too.
This is a good thing, of course. Browbeating, relentless criticism, “punching down,” and shaming are not high-yield strategies.
But. Ask yourself. What feedback has really changed you? I’ve received a fair amount of positive strokes over the years. It may have inflated my ego, but I’m hard-pressed to say it really improved my performance. On the other hand, I have very clear memories of several instances of less-than-positive feedback that made a big impact on my behavior.
Almost thirty years ago, I found myself in a new position of authority. I promptly used it to set up a couple of 7 a.m. monthly meetings that brought together about twenty-five people. We doctors like 7 o’clock meetings because the rest of the day can often spin out of control. I gave no thought at the time to the fact that those other twenty-five attendees, most of whom were compelled to come, might not like 7 a.m. meetings. I cringe now at the thought of several moms (it’s always the moms, but that’s another post) having to scramble for child care. But 7 a.m. it was. After a couple months, I asked one of my colleagues how he thought the meeting was going. I, of course, thought it was terrific, creating all kinds of positive change in the hospital.
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“Fine,” he said, “except for one thing. You usually show up about five minutes late. And you’ve asked all these people to come. It is disrespectful.”
Damn. That landed. It was not only disrespectful, it was a waste of resources. Combined hourly salary of the people in that room was thousands of dollars. I was rarely late for a meeting after that. Thank goodness that doctor was not afraid to give me that feedback. Leaders have no excuses for such behavior (barring a blizzard or a code blue). So, shout-out to Dr. Tom P.
Not too long after that, I initiated an effort to poll the internists and hospitalists in our large multi-specialty group regarding their opinions of the specialists that they referred to. I had some pretty strong opinions about various groups. Some good, some bad. My personal report started out fine. Most of my referring doctors appreciated my support and said kind things. Overall, I graded well. However, about 5-10 percent of responders hated me.
“Condescending,” “unhelpful,” “mean,” they said. Ouch. But the comment that helped me was this (I remember it almost twenty years later):
“Bill is a great pulmonologist, when he is interested.”
The responses were anonymous, but I’m pretty sure I know who that was. She was the smartest, best doctor in our hospital. And she was right. I tended to groan (inwardly, I thought) when I was consulted on a case that I had little or no chance of having an impact on, or if I thought I was being asked for moral support more than clinical input. That was immature of me. That survey reminded me that my patients were not my only “customers.” My referring doctors (mostly very hard-working hospitalists) were my customers, too. I had a role in improving the culture they worked in, and thus in helping them create a great hospital. Groaning was never OK. And 90 percent is not good enough.
So it was that a tool I created in order to “educate” other physicians (you know, the ones with the problems) had its greatest impact on me. I hope I changed. I certainly made a conscious effort to replace eye-rolling with a “glad to help.” But we’ll never know, because the survey upset so many specialists that it was never repeated.
In medicine, in relationships, plumbing, roofs, you name it: The flaws you are not aware of are the dangerous ones. My point: Seek (or at least be open to) feedback in your marriage, your work, everywhere, and don’t assume its absence means you’re crushing it. And if asked, your response should offer some path to improvement.
Bill Kinnard is a novelist who prepared for book writing by getting a degree in creative writing at Dartmouth, then went to medical school. He enjoyed and endured a long career in pulmonary and critical care medicine, seasoned with extensive quality work, hospital leadership, teaching, and program development.
He recently published I Will Lie Down Lean, the first volume of The White Plague Trilogy, a series that explores several facets of how humankind has struggled with one of its oldest enemies: tuberculosis. He shares more on his website and on Substack.
