Applying the growth mindset to health care

I love to mountain bike. The thrill of watching trees zip by and of “sending it” through rock gardens is intoxicating, and this thrill is accompanied by a feeling of accomplishment unlike any other I’ve experienced. However, two of my good friends are professional mountain bike guides, and for a long time, I did not love biking with them – I was unable to bike as fast as they could, and I felt defeated by their superhuman ability and embarrassed by my huffing and puffing.

Then I heard Carol Dweck’s TED talk.

If you are unfamiliar with her research, she examines the differences between people that have a fixed mindset and a growth mindset. Her research has shown that people that have a growth mindset conquer challenges better and are more likely to persevere at difficult tasks than those that have a fixed mindset. Fixed mindset people think that their abilities are unchanging, and therefore, if they cannot work through a challenge, they think that they will never be able to. It is the difference between “I can’t,” and “I can’t … yet.”

After hearing her TED talk, my entire life perspective changed. (Dramatic, I know, but true.) Suddenly when I was mountain biking with friends who were undoubtedly more talented than me, instead of feeling frustrated and down, I would tell myself, “I can’t keep up with them yet.” Adding that one word to the end of my thought pushed me to bike harder because I realized that the only way I would ever be able to keep up with them was by putting in the effort to bike faster.

As I was becoming a better mountain biker, I thought about the applications the growth mindset concept could have in health care. What if, when our patients say that they can’t lose weight, we could convince them to believe that they just can’t lose weight yet because they haven’t acquired the right tools or stuck to a plan long enough? What if instead of a patient saying, “I can’t stay sober,” we could help them say, “I can’t stay sober … yet?” What if a patient after extensive surgery says, “I can’t do things like I used to,” instead says, “I can’t do things like I used to … yet.”

Suddenly, by making this simple language change, the patient is in control of their own future. By adding one word, the sentence changes from one of defeat, to one of hope. The word yet adds optimism to the statement and provides motivation. Instead of feeling like their innate qualities are lacking, making the task at hand impossible, a patient can feel like with enough effort, they can achieve their goal. Just because they have not achieved it yet, doesn’t mean they never will.

Imagine if we, as physicians, used that skill too? Instead of feeling like I cannot help this patient, a practitioner could think, “I cannot help this patient … yet. I do not yet have the skill set or knowledge currently needed to guide this patient, but if I continue to learn and discover new ways of treatment and of communicating, I could still support this patient further. I may not have the answer now, but that doesn’t mean I never will.”

Thanks to Carol Dweck I am now a much more ambitious and much faster mountain biker. I can’t quite keep up with my professional mountain bike friends yet, but I know that I will get there if I keep trying, if I keep reminding myself that my skills are not fixed and that my efforts lead to change. Thanks to Carol Dweck, I also have a new mindset about patient care. My patient hasn’t achieved their blood pressure goal? That’s OK; we will get there together. They are still smoking? Fine, we have yet to find the right motivating factors and medications that will help them. We all have walls and barriers to achievement, but none of the walls are so fixed that we cannot move them. There is nothing we cannot do; there are just things that we cannot do yet.

Bailey Wolding is a medical student.

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