Flattery
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* James P. Waddell

Who doesn’t like flattery? To be wanted and appreciated is a universal human trait and one that is frequently exploited when seeking to influence thought or behaviour.

The deliberate use of flattery to induce certain behaviour is known to all surgeons — we use it to try to influence the behaviour of our coworkers, our patients use it to try to influence our perception of them, and I am sure that we all use flattery on a day-to-day basis in our non-professional lives.

Pam Leece and colleagues1 describe in this issue of the *Canadian Journal of Surgery* (page 90) how they attempted to quantify how flattery might influence the behaviour of surgeons when asked to respond to a questionnaire by sending surgeons either a standard cover letter or one that emphasized the recipient’s expertise and the importance of the recipient’s response. It is a struggle to get surgeons to participate in these questionnaires if only because we seem to be inundated with them and rarely, if ever, see the results of the questionnaire or, more important, find out if an analysis of the results will influence or change our standard of practice.

It is of interest to me as one of the surgeons approached by Leece and colleagues that I can’t recall which version of the letter I received. I do know, however, that I followed the suggestion of the writer of the questionnaire to direct further inquiries to the address on the letterhead. I wrote on 3 separate occasions and never received a response! One way of improving physician participation in these questionnaires, I am sure, would be to have an interactive dialogue between the person seeking information and the person supplying it.

I agree with the premise of the authors that questionnaires of this type are important in defining current practice patterns and in helping us to frame the questions that should be answered by randomized trials comparing 2 or more treatment arms. The authors suggest that one method by which participation can be increased is to appeal to the vanity in all of us, and their results seem to support this assumption. Perhaps we can all look forward to receiving letters praising our perspicacity, surgical skill and overall importance on a regular basis!

## Footnotes

*   **Competing interests:** None declared.

## Reference

1.  Leece P, Bhandari M, Sprague S, et al. Does flattery work? A comparison of 2 different cover letters for an international survey of orthopedic surgeons. Can J Surg 2006;49(2):90–5.