Managers, Do You Wait for the Doorknob Effect?

Written by raphael.moutard | Published 2020/06/03
Tech Story Tags: management | employee-engagement | doorknob-effect | doctor-i-forgot-to-tell-you | mental-health | hr | hackernoon-top-story | medical | web-monetization

TLDR Managers, Do You Wait for the Doorknob Effect? The phenomenon occurs when patients wait until the last moment to provide crucial information about their condition. Patients are scared to reveal frightening or embarrassing symptoms so they wait. Managers should slow down, ask follow-up questions and listen to the answers. The solution is counter-intuitive: Don’t be a predator and try to hide something before anyone noticed it’s noticed. The author's sister works as a pulmonologist at the ICU in a French hospital.via the TL;DR App

If you are not sure what a Doorknob effect is, you probably want to keep reading. Either you’ve seen it before and didn’t act properly, or worse you just missed it.

“Doctor, I forgot to tell you”

In Clinical practices, this phenomenon occurs when patients wait until the last moment — usually when the physician is grasping the doorknob walking out of the examination room — to provide crucial information about their condition.
“Sorry, I forgot to tell you, but I got a weird chest pain a couple of times last week”.
This can be explained in 3 words: Patients are scared! Physicians tight schedules can create a rushed atmosphere. Patients then feel uncomfortable to reveal frightening or embarrassing symptoms. So they wait. When the doctor is at the door they can’t delay the announcement anymore.

From Physicians to Managers

As a manager, I have 8 one-on-one meetings per week. Those are dedicated moments to know if team members are feeling good or if they struggle. My main goal is to identify where I can help.
But I face the same type of problem as physicians. Some team members tend to wait the last minute to tell me difficult things like “I think I am stuck on this project”, “I lost my motivation”, or “It’s hard working with my teammates”.
Even if the context is different, the same reasons apply. They are scared! Nobody wants to look weak at work. Why would you say to your manager, that you are struggling? After all, he is the one who decides about promotions or underperforming behaviour, if you should stay or if you should leave. That's a lot of reason to be nervous.

5 tips to fix the Doorknob effect

The solution is counter-intuitive. My sister works as a pulmonologist at the ICU in a French hospital. During one of the worse sanitary crisis, where cases are growing exponentially, it’s easy to start rushing from one patient to another. You will actually lose time in the long term. Ten extra minutes during a consultation can allow you to detect a problem before it gets worse and to save days of treatments. But you need to make sure a patient will tell you what's wrong at the beginning, so you can see more of them.
🐢 Slowdown
Last quarter, I was constantly 5 to 10min late for all my meetings. People started to tell me “We can postpone and talk when you have time”, “It can wait I know you are really busy”. I realised that I created an environment where my colleagues thought I didn't have time for them anymore. So I started to slow down. I cancelled meetings to free my calendar, I put a time buffer between meetings. I also spent time organising team building and took more time for lunch. The idea was to show everyone that I had plenty of time.
🙊 Stop talking, listen.
I plead guilty; I speak too much. I always want me to tell people what to do, I need to listen more. So, I start most of my 1:1 by “Do you have anything specific you want to talk about today?” Then I stop talking, I literally shut up, I enjoy a long silence. I make sure I give enough room for the person in front of me.
If they don't have anything to say, it's suspicious to me. On the other hand, if they talk a lot, without going to the point, you know they are hiding something. Because they are uncomfortable, they fill the silence, but they don't tell you exactly what's wrong. They expect you to pick up the clues. Take time to dive deep, ask follow-up questions and listen to the answers!
🦈 Don’t be a predator
It’s really hard to admit when we are wrong. Have you ever been scared to be fired? You may want to hide something or try to fix a mistake before anyone noticed. I want people to tell me when they screw up. But they won’t if they fear me.
Seven years ago, I went to my manager because I messed up. I told him “I think I run the wrong script on the production database.” It was a massive problem, but because I told him immediately the team managed to fix it without any consequences. I remember my manager saying "Why would I fire the only person that will never do this mistake again". He was right, I never did that again.
🐙 Postpone
Unfortunately, you don’t have height arms. You can’t deal with everything at once. The doorknob effect is a vicious cycle. Every extra minute your doctor spends with you makes him late for his next patient. As delay accumulates, patients feel rushed, they may feel angry for the waiting time. So the doorknob effect becomes more likely, making it worse.
If you have back to back 1:1 and you are late, just cancel. Everyone can understand that there was an emergency. If a sensitive point is raised just before the end, if the discussion requires more time, schedule a follow-up. It will give you time to prepare. You will have a clear goal and dedicated time to talk about a sensitive topic, without the pressure of being late.
🕸 Don’t get trapped 
Some people resort to Doorknob questions for non-constructive reasons. In the medical review about Doorknob phenomenon you can read:
“Reasons for prolonging the appointment may include primary gain (e.g., the gratification from assuming the sick role), loneliness (e.g., going to the doctor may be the highlight of the patient’s day, week, or month), or anger (e.g., wanting to punish the doctor for a too-brief encounter).”
As a manager, you can also face people who want your attention. They want you to notice them, they want to feel important. Learn to see patterns of doorknob effect, when they appear to often, it’s a sign it’s not working. Stop the discussion when you are getting stuck.

Conclusion

As for medical consultation, a one on one is useless if your employee leaves without telling you what's wrong. The only way to make a proper decision is to have all the relevant information. As a manager, it's your role to make sure you have all the data before moving to another meeting.
If you are a manager slow down and listen. If you are talking to your manager next time, start by the difficult part, you will both save a lot of time.
Sources:
(Disclaimer): I am not a physician, this is not a clinical blog post. I just saw an analogy between two types of behaviour, with common solutions. However, I'd like to thanks my sister for her inspiring insights and her hard work at the hospital.

Published by HackerNoon on 2020/06/03