How “Mattering” Matters

 From the 1/22/2021 newsletter

Perspective

 

 

How “Mattering” Matters

 

 

Karen Marcdante, MD

 

 

Dr. Marcdante writes about the important and emerging concept of “mattering” in medical education and patient care …

It had been quite a week in the Pediatric ICU, lots of patients with complex issues and a few sad stories.  One such story involved a young girl who had been injured in a car accident.  We had just confirmed that she was now brain dead.  I sat down with her mother to explain the findings.  We spent some time talking about her daughter, who she was as a person, her joys and some of her challenges.  As we walked down the hall, back to her daughter’s room, the mother reached out to hold my hand.  We entered the room and shared a few tears as we knew what was to happen soon.  

 

This day, while encompassing the hardest part of my job, stays with me.  Why?  I left that day, knowing that I had mattered, knowing that, despite this being one of the worst days of that family’s life, I had made a difference.  

 

My forty-year career as a physician is, fortunately, full of such moments, little things that remind us of the value we bring and reaffirming our perception that we have something to contribute.   Those moments play a role in my love of my job and keeping burnout at bay.  There are also moments when I felt I didn’t matter – like when I am ignored or made to feel out of place, when my voice isn’t heard or when someone tries to micromanage (what is the point, if they are just going to redo whatever I did?).  As I look to yet another transition in my career, I have looked closely at the idea of mattering.

 

 

Mattering, in fact, is a psychological concept that involves relationships.  It is the perception that others are aware of my presence and strengths, that they rely on me and that they see me as important to them, the team, or even to society.  While it is something I perceive, it really is about relationships – as we all have a need to feel that we matter to others.  It is, in many ways, transactional as mattering is about an exchange between people where “the others’” words, actions and behaviors lead me to perceive that I matter (or don’t).  It is also reciprocal, as my words, actions and behaviors help others perceive they matter.  First described by Rosenberg and McCullough in 1981, more recent studies have demonstrated that when people feel they matter they experience a greater sense of well-being and belonging, more self-esteem and self-efficacy, and even learn better.  People who feel that they matter experience less burnout and depression.  Organizations where people feel they matter are more productive with less personnel turnover.  

 

 

Three components of Mattering

 

So, as I think about how I can still be of value and contribute, I also have been realizing just how important making people feel that they matter can be.  And it doesn’t take a lot of resources, especially to address the interpersonal mattering.  Let’s look at the three major components of mattering to identify what we can do.  

 

 

Awareness is the first component.  Recent interviews with medical students reveal that one way to make them matter is to learn (and call them by) their names.  It can be that simple.  Asking a few questions to learn more about each other is another way – one you likely already do but that you may skip if you are busy or if the other person is not likely to spend much time with you.  Saying hi in the hallway or asking, kindly, about an absence are other ways to make people feel they matter. 

 

Importance, as a component of mattering, means that someone expresses concern for you.  Again, simple things may help.  One of the simplest – but not always easiest – is investing time in people.  I recently spoke with one of our colleagues who focuses on his role as advisor by talking with students for several hours over time (not just in a single session, reaching out as they prepare for and go to their interview.  The students must feel that they matter (and, hopefully,  so does the faculty member when he sees the students’ successes!).  Advocating for others is another way to make them feel that they matter.  So is providing appropriate emotional support – often just listening to them during challenging times.   Others know they are important when you provide growth-directed feedback, especially when they need to improve performance.    

 

The third component of mattering is reliance – how others look to you for your help and skills (your contributions).  You know you matter when others rely on you to “be there,” complete tasks, or seek your advice.   A simple way to make people realize that you rely on them is to seek their input on decisions that impact them.  Acknowledging that you missed someone (not just because work didn’t get done) is perceived as a form of reliance.    Granting learners autonomy, especially if it pushes them a little out of their comfort zone, is one way to let them know you are relying on them.  

 

 

Building relationships

 

As you can see, much of interpersonal mattering is about building a trusting and reciprocal relationship.  You also want to matter to your organization.  For this, organizations need to have effective ways to demonstrate awareness (recognition, whether a supervisor’s thank you or an institutional award for a sustained contribution); importance (seeking your input, positively addressing inclusion, diversity and equity, or listening and responding to employee concerns); and reliance (making expectations clear with appropriate accountability, allowing you to use your strengths).   Organizational mattering is about building systems that support and enhance the relationship between you and the organization.  It may be harder in some ways and require more resources but being explicitly aware of how people feel they matter and incorporating ideas that help them perceive mattering more regularly can improve the work environment.

 

What I have learned as I have studied mattering is that it seems to be one of the foundational concepts, one we may take for granted or not pay attention to as we deal with all the changes and stresses of both the typical and the post-COVID-19 work environment.  I have committed to being more explicit in making people feel they matter and hope that we can find some systemic solutions that allow us all to do the same.  I wonder what would happen if we thought each day about how to make those we will interact with feel they matter – whether it is your patients, your coworkers, or your family.  Research suggests that the work environment will feel safer, and that we will be more creative, happier, and more productive.  I say, let’s try!

 

 

 

Karen Marcdante, MD is a Professor in the Department of Pediatrics (Critical Care) at MCW. She is Director of the Human Centered Design Laboratory,  a member of the Faculty Pillar and serves on the steering committees of the KINETIC³Teaching Academy and Philosophy of Medical Education Transformation Laboratory, all of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.