Nudging choice—second in a series on choice in healthcare

I believe that breakthrough thinking is born from the idea of simplification. How many times have we thought, “Why didn’t I think of that, it was so obvious.” Yet when we get to thinking about choice, we often make ideas about driving choice overly complex where simplicity is required.

The book Nudge by Richard Thaler and Cass Sunstein explores factors that influence the choices people make, how to create better choice opportunities and understanding what choice architecture is. While the primary purpose of the book is to help design choice environments, I was struck by examples that made choice simpler instead of complex. While this seems logical it’s often times counter intuitive.

Check out the following three insights found in Nudge that are particularly relevant to finding ways to make healthcare marketing more effective.

1) Choice is not always rational. Decision processes tend to be influenced by two types of cognition: automatic and reflective. Automatic is basing a response on what you know and have experienced to provide a near spontaneous response think Homer Simpson. Reflective occurs where more effort and deduction is required think Mr. Spock. Interestingly enough, choice systems can tend to have better results when geared toward Homer.

Where better to understand the concept of automatic thinking than the men’s room. Ok, I’m told that men often make messes around urinals due to poor aim, a lack of attention or a combination of both. The reflective approach might post a sign with instructions on how interact with a urinal for optimum results. The automatic was employed by the Amsterdam Schiphol Airport by painting a realistic black fly in each urinal to create a target. Net result, spillage reduced by 80%. Magic!

2) People don’t respond well to having too many choices. We live in a culture where we think we enjoy having a plethora of selection options. Yet research tells us our minds don’t process a variety of choice well.

Consider Medicare Part D. Initially the plan was launched to provide seniors with a multitude of choices to better mange their prescription care. The result was a system that overwhelmed participants with a range of options that were simply too vast to manage. and a nation full of pharmacies flooded and overwhelmed with inquires.

3) Social influences impact choice. People gain assurances from going along with the social climate to understand choice options. We tend to learn from each other and therefore place high value on what others say and do. That’s why 60 million U.S. healthcare consumers use the internet and social media to find healthcare information. As someone who spends hours each week reading medical information, I can relate firsthand to the importance and impact of social influence. There’s power in sharing.

Conclusion
When the decision making process is difficult and the stakes are high, people need help making choices. In order to provide that help, we need to understand how people behave when making decisions. We can use this understanding to influence marketing strategies that are sensitive to complex, emotional and socially based decision sets to create simple solutions.

Even if you never make the time to read Nudge, I would urge you to consider a few of the insights offered, and answer the following questions:

Can consumers easily process your point of difference?
Are you paying attention to social media?
Are you providing people the information they need, and are able to process, to make difficult decisions?
Does the experience with your health system make future choice easier?
Are you willing to think differently about how and when you interact with consumers?
Are you making it easier and simpler to choose your institution?

Homer, Spock and I would love to hear your answers.