It's Not What I Say, It's the Way That I Say It GREELEY, CO (KUNC) -
When it comes to motivating a certain behavior or outcome - especially in the medical community - what doctors say is often times less important then the way in which they say it. KUNC commentator Marc Ringel has more.

I have to be careful lately when I watch television. The political ads, by both parties, are likely to disgust me, to disturb my sleep even. My displeasure runs deeper than the ugly stinky mud that the candidates sling at each other. It's that there is so little underneath all that negative verbiage: no reason, no policies, no vision. All style, no substance.

Then I remember how much I love a line from That's All Brother, a wonderful little song that Mae West used to sing. She declares, in her inimitable, sultry, suggestive way, It's Not What I Say, It's the Way That I Say It. And I dig it.

So, here you have it. Sometimes I hate communication that is all style and sometimes I love it. I suppose my reaction depends on the intent. When the purpose is to be fun and sexy, I love it. When the goal is to destroy a political opponent without reference to what he really stands for, I hate it.

Where does that leave me as a doctor? Mine is a consummately human profession, hugely dependent on my skills at communicating with patients. As such, how I say something is just as important as the intellectual content of what I mean to communicate. I'm always aware of the balance I need to strike between presenting information fairly so patients can make decisions in their own best interest while giving it in a way that is most likely to be truly meaningful and helpful.

Enough communication theory. Here's a great example. It comes from a report entitled, Effect on smoking quit rate of telling patients their lung age , published this year in the British Medical Journal. The study's findings are a great illustration of the power of, to borrow Ms. West's phrase, The way that I say it.

The researchers did pulmonary function tests on 561 subjects who had smoked an average of 33 pack-years, which is number of packs per day times number of years smoked. Half of the people received their results expressed as a percentage of normal lung function. The other half were told their lung age, which is how old they'd be if their years were based on their ability to move air.

Let's say you're 50 years old but, because you smoke, your doctor tells you that you breathe about 90% as well as the average non-smoker of your same age, sex and height. Or the doctor could say your lungs work about as well as a 60 year-old's. Which way of expressing this information is liable to make the bigger impression on you?

The lung age, of course. That's exactly what the researchers found. Same data. Different way of saying it. One year after they'd been told their lung age, 14% of smokers had quit, whereas only 6% of those who'd heard their pulmonary function expressed as a percentage of normal had given up cigarettes.

Surprisingly, the superiority of the lung-age style of communication as a motivator for quitting smoking held true even for patients whose pulmonary function was normal for their age. That is, though their lung age was no greater than their chronological age, just hearing the implication from a doctor that smoking could accelerate the aging of their lungs motivated an extra one in fourteen smokers to quit.

I plan to continue being as deliberate in how I express information to my patients as I am in what I actually choose to present. I wish our politicians felt that way. In the meantime, I plan to rent some Mae West movies to watch until after the election.
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