With precision medicine and value-based care on the rise, it should come as no surprise that a “one size fits all” approach to healthcare may not be effective anymore. Now, more than ever, patients crave a personalized interaction from their providers.  

Between Myers Briggs and the Sixteen Personality Factor Questionnaire, personality tests are widely used to profile different personalities.

Gretchen Rubin, author and “observer of happiness and human nature,” developed the Four Tendencies. The Tendencies describe a very narrow aspect of a person’s character: Why we act and why we don’t act on commitments.  

According to Gretchen, people fit into one of Four Tendencies: Upholders, Questioners, Obligers, and Rebels. Our Tendencies shape our behavior and are determined by how we respond to outer and inner expectations.

The Four Tendencies Framework

DeAnn Mullins, owner and PIC of Mullins Pharmacy in Lynn Haven, FL, has found great success in her practice through applying the Four Tendencies Framework to her patients, her team members and even her marketing strategies.

DeAnn can do anything from resolve a conflict between two employees to help a person with diabetes lower their A1c.

“Getting people to do what you want them to do because they want to do it is my goal. Your communications will determine if you invite cooperation or trigger resistance. You want to craft messages that will persuade your listener and develop strategies that will help them make lasting changes. Knowing their tendency can help you do just that.” she explains.

Each Tendency can be used by healthcare professionals to work with a patient’s individual needs rather than against them.

“It’s all too easy to assume that what persuades you will persuade others, which isn’t true.” DeAnn observes.  “And in a world of pay-for-performance, honing your communication skill-power can directly improve your bottom line.”

The Upholder

“An Upholder accepts rules, whether from outside or inside. An upholder meets deadlines, follows doctor’s orders, keeps a New Year’s resolution.”

If you find your patient is an Upholder, structure their care around schedules and routine, but don’t exaggerate expectations. They will most likely faithfully adhere to patient counseling.

The Questioner

“They question rules and accept them only if they make sense. They may choose to follow rules, or not, according to their judgment.”

Questioners value information and research. They’re more likely to respond to justification instead of “That’s just how it is.” They tend to enjoy monitoring their actions, which is very useful in coaching and adherence. Be sure to answer all of their questions and offer to look for answers to questions you aren’t sure about.

The Obliger

“An Obliger accepts outside rules, but doesn’t like to adopt self-imposed rules.”

Obligers respond to external accountability and feel a sense of responsibility when someone  expects them to do something. Patient care is much more effective for Obligers when they feel they owe it to a friend, family member, or even their healthcare provider to improve their health.

The Rebel  

“A Rebel flouts rules, from outside or inside. They resist control. Give a rebel a rule, and the rebel will want to do the very opposite thing.”

Rebels excel at doing what they want to do. However, when you ask them to start keeping an eye on their blood pressure or take their medicine with food, they are likely to resist. They respond well to choices and choose to ignore supervision and repetitive tasks.

The Four Tendencies in PioneerRx

For more information on the Four Tendencies, check out Gretchen Rubin’s book and read this study conducted to test the application of the Tendencies in adherence and healthcare.  

PioneerRx users can get a head start in applying the Four Tendencies to their patient interactions. Once you have identified your patient’s Tendency, go to Patient > Edit Patient > Common > Demographics > Behavior and click the dropdown menu to select their Tendency.  

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