Locus of Control
It is important to differentiate between an internal and external locus of control when working with men and women in the Late Majority. Members of this group tend to view the healthcare world from the perspective of an external locus of control. They believe that most of the important things happening in their organization (and in their life) are outside their control. These men and women are inclined to feel helpless and hopeless when considering their own role in the large and complex healthcare system in which they work. They typically don’t have the anger that we will witness when considering the mindset and emotions of the last diffusion group (the Laggards). They are more likely to experience low-grade depression.
Those in the Late Majority are particularly inclined to feel betrayed if something changes in their organization that impacts their work or challenges their mindset (attitudes) about their organization. The unconsciously based covenant appears on the surface to be nothing more than a desire for security and organizational stability. Yet, the covenant is much more than this. And it is often emotionally charged. An effective engagement by an organizational consultant or coach who focuses on personal issues often can lead to the surfacing of this covenant. The consultant or coach can assist their client to more realistically address their expectations regarding what they should be doing in the organization and what the organization, in turn, should provide them as a dedicated and hard-working member of the organization.
We often find healthcare burghers entering the scene when there is a stable source of support and funding for a new procedure or program. This is often a chicken-and-egg phenomenon. There is greater support and funding because more people and organizations are involved, and more organizational leaders (Late Majority) are involved because there is greater support and funding. Given the financial instability found in many of our contemporary healthcare systems, we may find a retreat in the funding of new procedures and programs—and a retreat in the number of leaders willing to take a risk. The “burgher” (member of the Late Majority) may return to safer financial ground (the chartered town).
I can identify a set of promotional principles that hold the potential of drawing in members of the Late Majority: surveys, focus groups, and advisory committees. In each of these instances, it is not so important that one make use of the data gathered from these initiatives; rather, these research tools are engaged as promotional tools. Participants in the survey, focus group, or advisory committee get the sense that they are not alone—other people are involved. Furthermore, since they are being asked for their opinion, this activity must be legitimate and mainstream: “If it was not legitimate then they wouldn’t be among those being asked.” Psychologists, such as Kurt Lewin, have counseled us for many years that cognitive dissonance is created if people participate in something that they don’t value. Once they agree to participate, these men and women must support (at least minimally) the activity in order to restore cognitive equilibrium (Marrow, 1969).
An effective promotion of a new procedure or program should target several populations, with different communication strategies being used for each of them. One of these populations can be the Late Majority and cognitive dissonance-based marketing can be an effective leverage point for this constituency. At a more fundamental level, innovative practices will become acceptable if they are associated with other traditions, values, and activities that are already widely accepted and respected by the Late Majority.
