The Building Blocks of Discipline and Willpower: Compliance

By Marshall Goldsmith

We tell ourselves that we need discipline and willpower to succeed. But I have found that there are four actions that replace discipline and willpower. They are 

  • compliance 
  • accountability
  • follow-up 
  • measurement 

Here, let’s look at compliance. 

Compliance

Compliance reflects your adherence to an external policy or rule. You hear it most commonly applied in the context of medical treatment. Your doctor prescribes medication, and your only task is to take the medication on schedule. You’re not being ordered to do anything extraordinary. Just follow the instructions and you’ll get better. That means you’re complying with the doctor’s suggestions. Sounds simple, but an estimated 50% of all U.S. patients either forget, abandon, or never take their prescribed medication. 

That’s how tough compliance is. Even when our health, possibly our life, hangs in the balance, we don’t comply with a sure-fire remedy. 

When I was 24, I mangled the middle finger of my right hand catching a hard pass in a basketball game. The top third of the finger dangled loosely from the rest of my hand like a broken tree limb. I researched the injury in the library, learning that I probably had what was known as a “baseball finger.” The treatment was simple but tedious. I needed to wear a splint for eight weeks, even in the shower, after which I had to wash and dry my finger on a flat surface to make sure I didn’t re-stretch the tendon and undo the healing process. When I described my research findings to the UCLA clinic doctor, he said, “That’s right. Baseball finger. Just follow the splinting procedure and see me in twelve weeks. You should be fine then.” 

My compliance was total. I washed, dried, and re-splinted my finger with the devotion of a mother changing a newborn’s diaper. On my return eight weeks later, the doctor examined my finger and declared it healed. Then he added, “I am impressed that you actually followed through. Very few patients do this for twelve weeks.” 

This was one of the more disappointing statements I’d heard from a doctor. He had diagnosed my problem and offered the correct therapy, but he’d made no effort to warn me that adhering to the steps would be difficult, or that he expected me to fail utterly. Compliance was up to me, and he had not been optimistic. It was as if he had sent me on a journey by car on a route that had no stop signs, no speed limits, and no warning signs announcing “Steep Hill Ahead” or “Dangerous Curve.” 

Marshall Goldsmith Meme

It reminded me that Hippocrates famously exhorted physicians to “First do no harm.” But he also urged them “to make the patient cooperate.” Not only did my doctor expect me to fail at compliance, but he was failing to comply with Hippocrates’s edict. Sadly, the attitude of this doctor remains the rule rather than the exception. Patient noncompliance costs American medicine $100 billion a year. Raise your hand if your doctor has ever checked with the pharmacy to see if you actually picked up your prescription, or called you a week or two after your visit to make sure you were taking your medication. 

My doctor back then was right, of course. Compliance is easy to understand (“If I comply, I get better”), but hard to do (“I have to do it every day. Ugh!”). People are woefully bad at compliance, whether we’re flouting our doctors’ recommendations, our teachers’ summer reading lists or nightly homework assignments, our parents’ requests to make our beds, or our editors’ deadlines. I only wish he’d felt a little responsibility to warn this patient of that. 

Here’s a simple truth: You can’t count on the people issuing the orders to hold your hand to ensure compliance. You’re on your own. Nor can you count on every situation to compel compliance. I completed the splint therapy only because I was in pain, and I didn’t want a crippled hand for the rest of my life. Absent the pain and disfigured hand, I doubt I would have been so compliant. 

The baseball finger incident taught me this: We’re more likely to comply with a recommended course of action when failure to do so results in extreme pain or punishment, either physical, financial, or emotional. Your health doesn’t improve. Your injury doesn’t heal. You lose your job. Your relationship founders. You suffer long-lasting regret for an opportunity squandered. 

When you’re faced with one of those extreme situations that threaten you with existential pain or punishment—and you recognize the seriousness of the moment—compliance should not be a challenge. 

You have no other choice.

Marshall Goldsmith Meme
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