“I’ve Never Heard This Before” – How Closed and Open Minds Can React with the Same Words

Normally, I write about substantive law, but today I’m going to focus more on psychology. The idea was triggered by the subject line in an email from the National Alliance of Medical Auditing Specialists (NAMAS) that read “I’ve never heard that before.” The included article focused on physicians resistant to education from coders, because no one had previously criticized their documentation.

That subject line triggered a memory for me. Way back in the 1990s, I was lucky enough to give a presentation at the Health Care Compliance Association (HCCA). It was my first time speaking at the HCCA. When the evaluations arrived, I read them eagerly.

The results were fascinating. While speaker evaluations seem to typically skew towards the good, rather than following a normal distribution, there is still usually a mix of all scores. But these evaluations were downright bimodal. Each was either a one for awful or five for excellent, with essentially nothing in between.

But what was more interesting was that whether the attendee loved or hated the speech, their comments were identical – both to one another and the subject line from the NAMAS email.  

They all said, “I’ve never heard this before.” To make sense of it, you have to add a voice incantation that isn’t possible with the written word. The people who hated the speech wrote “I’ve never heard this before” with a tone of contempt that was almost audible coming from the page. The people who enjoyed the speech wrote “I’ve never heard this before” with the glee of discovery. The same words, but with a very different perspective.

There is a very important lesson here about human psychology that has important implications for compliance. Some people find novelty and new ideas intriguing, while others find them suspect, if not abhorrent. Similarly, some people are open to challenging their preconceived notions, and some are much less so.

This really matters. How effectively can you conduct an investigation if you’re not open to new ideas, and you can’t seriously entertain the possibility that your assumptions are wrong?

If change is threatening to someone, can they effectively evaluate whether a longstanding practice is actually improper, or will they assume that its historical standing is proof of its validity? The ability to weigh new information without bias, either in favor or against, is essential, but it is not universal.

I have not yet figured out the perfect way to interview compliance candidates and separate those with an open mind from those who anchor to their first impressions, but I’ve tried to ask questions about situations in which the candidate changed their mind. You can also ask the candidate for examples of how they think conventional wisdom is wrong.

I think if you want to have the best compliance team possible, you want to find friendly skeptics. You want people with an open mind who will question everything, but do it respectfully. You do not want to be in a situation where you’re channeling Bob Mould, originally from Husker Du, but the lead of Sugar when he sang “if I can’t change your mind then no one will.”