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What Do Divorce and Malpractice Suits Have in Common?

The human mind

What do divorces and malpractice suits have in common?

My current reading is Malcolm Gladwell’s Blink, a book about the power and perils of responding from the gut. Early in the book he examines some clever research into divorce and some other clever research into malpractice suits, which together help illustrate one surprising principle.

The divorce research is something I’ve heard about and been fascinated by before. John Gottman, a research psychologist at the University of Washington, has developed methods for analyzing a brief conversation between a married couple on any subject that has been a recent difficulty for them. Gottman’s researchers, incredibly, can predict with 95% accuracy whether or not the couple will still be together in 15 years–without knowing their history, common interests, finances, love life, how long they’ve been together, family relationships, or anything else.

The malpractice research is just as fascinating. You might imagine that the doctors who get sued most for malpractice would be the ones who make the most mistakes, yet this turns out not to be the case at all. The biggest predictor of malpractice suits is a bad relationship with the patient. That is, doctors get sued much less for screwing up than they do for being disliked!

The common element between these two kinds of relationships–between spouses on the one hand and doctors and patients on the other–is respect, or lack of it.

How to predict divorce
Gottman’s researchers are trained in SPAFF (specific affect) coding, which involves recording a person’s attitude or emotions on a second-by-second basis. Using cues like word choice, tone of voice, expression, and body language, they record how a subject seems to be responding moment by moment throughout a conversation. The biggest indicators of divorce are what Gottman calls “the Four Horsemen”: criticism, contempt, defensiveness, and stonewalling. And it’s contempt (and its close relative disgust) that is the most powerful and reliable signal of a doomed marriage.

To put it another way, as long as both partners feel as though they’re getting a reasonable amount of respect–that their spouses are not looking down on them but rather holding them in some esteem–the marriage will tend very strongly to do well. As fond as I am of the Beatles, it appears that all you need is not so much love as it is respect. (With that said, I highly recommend love as well.)

How not to get sued
Getting back to doctors, it turns out that people tend to sue doctors when they feel those doctors look down on them, have little regard for them, or treat them poorly. Acting superior, ignoring the patient, trying to rush through with the minimum amount of contact, or dismissing patients’ concerns are all dangerous behavior in this respect. Statistically, if you are a doctor and you have made a terrible error but have treated the patient kindly and respectfully, you’re much less likely to be sued than a colleague who has made only a minor error but who has alienated the patient.

I won’t go into how Gladwell shows respect applying to car salesmen and their customers, but by now you can probably guess how that works.

Using respect for personal benefit
All of this gives me one simple, clear principle to apply in my own life: the single most important thing I can do to improve my relationship with other people–whether they’re friends, coworkers, customers, family, service providers, police officers, strangers I run into on the street, or anyone else–is to try to find things about them I respect and let that respect show. Whether I want to be married to the person in question or just want to help ensure they don’t sue me (or both), the lesson seems to be the same. Relationships being as complicated as they are, simple principles for making them better are a heck of a boon.

Photo by wajakemek | rashdanothman

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