Professional Development

A Journey to Understand Change Resistance

Being a healthcare informaticist usually means that you are in a role that is constantly changing. Every week there seem to be new products, new data, artificial intelligence, machine learning, and more.  Keeping up with the changes can be daunting, even to the most capable people. Change is hard. 

There are times when it feels like nothing is constant, when you may find yourself, or one of your employees or colleagues not being able to change. This may lead to decreased job satisfaction, decreased output, and frustration. While there are many ways to approach this, I have found one that has worked for me, and I wanted to share it.

I recently read the article “The Real Reason People Won’t Change” by Robert Kegan and Lisa Laskow Lahey in the Harvard Business Review and decided to put it to the test. I engaged a few friends, and we walked through the article and tried out the recommendations. 

The article discusses that some people who don’t seem to be changing may not be doing it purposefully.  Instead, they may have a competing commitment – a subconscious, hidden goal that conflicts with their stated commitments. An interesting thought…. I wouldn’t have any of these, would I? 

We decided to walk through the steps the authors outlined in the article to see if it worked. The first step includes uncovering the competing commitment by answering five questions, the answers building on the response to the previous question. The first question is “What would you like to see changed at work so that you could be more effective or so that work would be more satisfying?”. Following that, we discussed “What commitment does your complaint imply?”. This helped us to determine what we really cared about. “What are you doing, or not doing, to keep your commitment from being more fully realized?” was the third question. Now started the time for introspection… where am I not doing a good job? This is never a fun question to ask of yourself or to ask of others, but we persevered and dug into it.

The fourth question was “Imagine doing the opposite of the undermining behavior. Do you feel any discomfort, worry, or vague fear?”. At this point, the answer for all of us was “Yes!”, but we realized that the one-word answer wasn’t enough, so more introspection and discussion occurred. WHY did we feel that way? And finally, “By engaging in this undermining behavior, what worrisome outcome are you committed to preventing?”. THIS answer is the competing commitment. This is what was causing us to not change.   

Next, we had to identify the “Big Assumption”. What were we all subconsciously assuming that was coloring our view and affecting how we did our work? We each had to create a sentence that inverted the competing commitment to illuminate what we were subconsciously assuming. 

Getting to this point was exhausting for a group of introverts, so we paused to reflect and decided to go into one more step, and then reconvene in a week. The next step is to notice and record current behavior. Luckily, the article told us NOT to make any changes at this point, just to be more aware of what’s happening with regards to your assumption and document it.

After a week, we got back together and discussed what we had found.  It was illuminating. Recognizing our assumptions really allowed us to be able to see our behavior in a different light. Three more steps to go!  Our next task was to look for contrary evidence. What were we seeing that cast doubt on our assumption? For this step, having others provide evidence was very helpful, and allowed each of us to identify more evidence than we probably would have alone. 

Since the next step was to explore our history and try to determine where our assumption came from, we decided that was best done individually.  We determined that we would take 2 more weeks to complete that and one more step before getting back together.  That was to test the assumption.  Working with each other, we had to come up with a modest test of the assumption, nothing too big or too small.

Getting back together, we reviewed each other’s findings and evaluated the results (the final step!).   We found that this process helped us to better identify the cause of some of our resistance to change.  Personally, I found that after going through this process, it was much easier to continue to work to improve my change resistance. 

By doing this process together, we found that we learned more.  We were able to push each other to really dig into the competing commitment and having to be accountable to the group helped us get through the process.  If you are interested in doing this, I highly recommend reading the full article.  It has a lot of examples that helped us work through the process and understand each step.  If possible, I would also recommend doing this with people that you feel comfortable with.  Opening up with some of the answers in a large group may be too much for some. 

Is this the perfect answer for everyone?  No.  But it was a new perspective on an issue that I think impacts many, and helped to open our eyes to the fact that some people may not realize WHY they are resistant to change, and that may be why they aren’t changing.


  • Kegan R., Laskow Lahey, L. (2001). The Real Reason People Won’t Change. Harvard Business Review.

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