My eyes played a trick on me the other night, or perhaps it was my subconscious. Emma and I were reading by the fire – my nose was in one of my medical journals and she had a stack of animal behavior books next to her while looking intently at the screen of her laptop computer.
As I was reading along I registered the sound of the dogs snoring rhythmically nearby. My eyes glanced over my magazine’s headlines with words like guidelines, accountable care, pay-for-performance, evidence-based and quality.
I had just made the quiet observation that there are innumerable forces that create and use buzzwords like that when trying to tell front-line doctors like me how we should do our jobs without really thinking for ourselves when Emma broke the silence in our living room.
“This is really interesting”, she said. “The way clicker training works may be by stimulating the amygdala of animals, so they feel instant joy before they consciously become aware that the trainer approves of what they just did.”
I knew a fair amount about clicker training; Emma has been using it on our canine family members and I have seen it work wonders with our adolescent female German Shepherd.
“Isn’t it just a conditioned response like Pavlov’s bell?” I asked as I looked up from my journal.
“Well, some people seem to think the actual sound of the clicker may be a more direct way to stimulate the amygdala than other sounds or words people use in training.”
My eyes moved from my wife’s face, framed by her beautiful long brown hair, to her eyeglasses reflecting the light from her computer screen, to the stack of books next to her. Suddenly my mind jolted at the title of the book on top. For a split second I thought it said:
How to Clicker Train Your Doc
Emma was back to reading her webpage. The dogs snored peacefully. My mind was spinning.
Physicians are not quite subjected to clicker training, but we are certainly recipients of signals that are aimed at our preconscious minds, if not our amygdalas. All those people and institutions that try to influence physicians’ behavior are trying to get into our minds below the radar of our critical thinking, just like advertisers work on all of us. They use feel-good messages that try to do what clicker training does to our pets – create new behaviors we would otherwise not pick up on our own.
But doesn’t it go deeper than that for most doctors? It seems to me we often make ourselves do things that run counter to our nature. We do what others say we are good at, even when there’s no one around to cheer us on – even when doing it is to our own ultimate detriment. We end up using our burnout skills because we have created our own conditioned responses.
I opened my own laptop and started reading about clicker training and the amygdala. Wikipedia gave me the following quote:
“Clicker–trained animals become great problem–solvers, develop confidence, and perform their work enthusiastically.”
Just like doctors…