The Poison Pill of “Yes”

November 23, 2020
Eric Postal, MD

An agreement or a promise does not mean much if it is not clear how you can or will reach the goal.

I’ve mentioned, here and on my Twitter page, some recently discovered interests during these months of living under COVID quasi-house-arrest: persuasion, influence, and negotiation, approached from a perspective of cognitive science and real-world practical applications.

One of the more valuable points I’ve been learning to apply is a healthy skepticism of “yes” when it comes from someone on the other side of the negotiation-table…and that includes when there’s no actual table, or, indeed, formal negotiating going on.

The problem is that an awful lot of the people who tell you “yes,” or its equivalent, don’t really mean it…at least not in the way you think/hope they do. They said it because they feared what you might do if they didn’t. Or, maybe you were just very convincing in the heat of the moment, and they subsequently realized they felt otherwise. Possibly they are just very uncomfortable saying “no.”

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However you wound up with such a “yes,” it might not turn out to be something you can count on. Whoever said it to you might subsequently drag their feet or even walk it back. That is, they said “yes,” but their actions are a “no.” Maybe they even resent you for having gotten the “yes” out of them, and they blame you for putting them in this awkward position.

A neat thing about learning such things is, courtesy of a fairly robust memory, I can look back on any number of events in years gone by and see how they applied before I knew about them. And contemplate how, if I knew then what I know now, I might have acted differently to arrive at better results.

Case in point: my last pre-teleradiology job. I’ve written about it in this column before, a pair of outpatient imaging centers. I signed up with a four-year partnership track, knowing that the region was decidedly not job-seeker friendly, and any promises of partnership should be taken with more than a few grains of salt.

Still, I knew I was bringing a lot to the table—not just my radiological skills, but a pretty darned good work ethic and a few other virtues that don’t necessarily get taught in med school. I expected that, in four years, I would more than demonstrate to the guy who ran the place that it was in his best interest to retain me by offering something genuine, even if it hadn’t initially been his plan to do so.

Interrupting the narrative just a sec: Note that I was aware his “yes, you can be partner in four years” was liable to be a falsehood -- a no-in-yes-clothing. Yet, I proceeded with the idea that I could turn that “no” into a “yes.”

Just about four years later, I gently reminded him that we were just about due. There was no chance that he’d forgotten; I had simply learned that he feigned forgetfulness when it came to things he wanted to avoid or delay. With my reminder, he wouldn’t be able to do that.

Thus began a campaign of months to get him to live up to the “yes” he’d given me. Almost any time the subject came up, it would be by my prompting, and he’d apologetically talk about his accountant or lawyer needing to do this or that. A reasonable enough response, at least initially…although it could be said that a good-faith partnership track would have details and documents ready to go pretty shortly after my four-year anniversary, if not the day of.

My inquiries were initially respectfully spaced a few weeks apart, but as time moved on – and it became clearer that some serious foot-dragging was happening – I gradually shortened the interval to turn up the heat. Not quite halfway into my fifth year, he finally coughed up his “partnership” terms, which I’ve detailed in one or more previous columns: a bad joke, if not an insult. Absolutely nothing of value, other than being able to say I was a partner. I’d own non-voting shares of stock in one of his money-losing corporate entities. I would not have the right to sell those shares, and they could be reclaimed at any time without compensation to me.

In other words, he had said “yes” to the notion of my eventually attaining partnership (he even used the term “equity”) when I interviewed, reiterated the “yes,” as the four-year track went along, again at its terminus, and, then, repeatedly over the course of the subsequent half-year. Then, finally having to follow through, his action was about as close to a “no” as he could get without actually saying the word. (Hence, I left.)

Whether he was lying from the very first “yes,” or he was initially genuine but came to realize he didn’t want to live up to his promises, his “yes” was counterfeit. Just a few years out of training, it was easy for me to be dazzled by the notion that, “yes,” I would be a partner in a successful radiology practice, and, thus, I was ready to be taken in.

Encountering the same situation today, I would be far-better armed with the awareness that, as my negotiation-guru on Twitter has aptly phrased, “Yes is nothing without How.” Have I really worked through the underlying issues with the person telling me “yes,” so I know it’s supported by a plan of action? If not, the negotiation isn’t over. Similarly, I know not to doggedly pursue a “yes,” especially in the face of resistance. Some people will tell you want they think you want to hear just to get a confrontation over with.

Most radiologists have, at some point, heard of satisfaction of search, AKA “happy eyes.” You’re looking over an imaging study and see an abnormality, especially one that relates to the reason for exam. Hurrah, mission accomplished…and, you are now psychologically at risk for missing other findings as you finish your interpretation.

Related Content: Missing More Than the Gorilla in the Reading Room

The same self-discipline that helps a good rad avoid falling victim to satisfaction of search can apply to following through after receiving a “yes.” “Happy ears” can be just as misleading as “happy eyes.”

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