MGMA Insights: Compliance, Consent, and the Psychology of Defiance

In this MGMA Insights podcast episode, Daniel Williams sits down with Dr. Sunita Sah, a tenured professor at Cornell University and author of Defy. Together, they explore the subtle but powerful psychology behind compliance and informed consent. Drawing from her experiences as a physician and organizational psychologist, Dr. Sah discusses why patients — and even medical professionals — often follow advice they disagree with, and how we can build greater confidence, clarity, and autonomy in healthcare decision-making.

[00:04:00] The Scan She Didn’t Want

• Dr. Sah tells a personal ER story that sparked her research into why we comply, even when we know we shouldn't.

[00:09:00] The Five Elements of True Consent

• A breakdown of capacity, knowledge, understanding, freedom to say no, and personal authorization — and how this differs from compliance.

[00:14:00] Why It’s Hard to Speak Up

• “Insinuation anxiety” is the discomfort we feel when we risk questioning those in power — even when the stakes are high.

[00:20:00] Leadership Lessons from Healthcare Classrooms

• Dr. Sah shares how physicians in her Cornell classes are rethinking how they lead and communicate through values-driven decision-making.

[00:24:00] False Defiance vs. Real Defiance

• Not all resistance is rooted in values. Dr. Sah explains how to recognize the difference between performative opposition and meaningful dissent.

Resources:

• Dr. Sunita Sah’s Website
• Defy by Dr. Sunita Sah - Buy on Amazon or Listen on Audible
• Join the MGMA Book Club — Defy is featured in an upcoming session
• More MGMA Insights Episodes

Additional Resources:

• MGMA Playbooks
• MGMA Events
• MGMA Consulting
• MGMA DataDive
• MGMA Stat
• MGMA Podcasts

Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts.

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