On Praise

August 11, 2019
by Mark David Siegel

Hi everyone,

The teaching service at Penn is named after Don Martin, my Program Director. Dr. Martin came to HUP from MGH to direct the diabetes program. He was a teddy bear: stately and tall, with salt and pepper hair. He lived in a grand home on the Main Line and he loved Handel. He was utterly devoted to his residents and we adored him in return. His support was constant, reliable, and generous. He flooded us with rivers of praise: “strong effort,” “keep up the good work,” and “great job.” His praise came easy, though the individual compliments were less memorable than the recognition that he was our biggest cheerleader.

Praise from other faculty was rare by comparison. One of the pulmonary faculty, Mark Kelley, was among the medical center’s premier physicians: all-knowing, diagnostically brilliant, revered for his clinical prowess. One time, I diagnosed a patient with a PE. His brief acknowledgement—that “the resident made the diagnosis”—has echoed in my memory for decades.

Easy praise has its place. It’s pleasant and soothing, predictable like oxygen. In contrast, special praise has unique power. It fuels us. It persists. It proclaims that our efforts are worth it. It’s rich with meaning.

So what makes praise meaningful? Some thoughts:

  • Consider the judge. I’m sure it feels nice when I compliment your EKG interpretation, but it means more coming from a cardiologist. It’s also nice when a student compliments an intern’s presentation, but the praise carries more weight coming from a resident. Praise is most valuable when endowed by authority.
  • Be specific. “Nice job reading that x-ray” is okay. “Nice job finding that subtle infiltrate” is better. 
  • Praise effort. Acknowledging hard work encourages more of the same- like the effort expended to dig up details buried in the chart, the energy devoted to helping a patient stop drinking, or the time spent at the bedside comforting a dying patient.
  • Be judicious. When we praise everything, the praise loses meaning. If every job is “great,” then no job is. Don’t be stingy, but don’t overdo it either.
  • Be sincere. Mean what you say, but don’t just praise to be kind. If you want to be kind, bring in donuts. Did you really witness something praiseworthy, or was the resident just doing her job? Don’t let “participation trophies” crowd out the real ones.

On balance, I think we don’t praise each other often enough. Yale residents make heroic efforts every day, and those efforts should be acknowledged. But we need to praise well. Praise what you’re in a position to judge. Acknowledge effort. Be specific. Be judicious. Be sincere.

Now, go ahead, make someone’s day.

Mark

Submitted by Mark David Siegel on August 11, 2019