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 WantDr. 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 ConsentA 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 ClassroomsDr. 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 DefianceNot 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 WebsiteDefy by Dr. Sunita Sah - Buy on Amazon or Listen on AudibleJoin the MGMA Book Club — Defy is featured in an upcoming sessionMore MGMA Insights EpisodesAdditional Resources:MGMA PlaybooksMGMA EventsMGMA ConsultingMGMA DataDiveMGMA StatMGMA PodcastsEmail us at [email protected] 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 [email protected]. Don't forget to subscribe to our network wherever you get your podcasts. This episode is sponsored by ModMed. Every denied claim costs time and money to rework — for care you’ve already delivered. While payers sharpen their own AI tools, ModMed RCM Services pairs seasoned billing specialists with AI designed to help flag claims at risk before they go out the door, so your team can fix issues upfront instead of appealing after the fact. Learn more here.