A Nudge A Day Keeps The Doctor Away

A great number of diseases result from unhealthy behaviors. Even individuals who are fully aware of the risks associated with certain behaviors and have the intention to make good choices struggle to do so. This can cause us to feel anxiety when making choices, and regret about not doing the right thing. The main reason is that many of the decisions we face on a daily basis are made automatically. Conversely, even deliberate decisions related to health behaviors are often sub-optimal. Thoughts such as “If today I’m feeling good, why continue taking the pills?” (which in behavioral slang should be called present bias), or “I remember the last time it hurt me a lot, so I won’t do the screening test again” (availability heuristic), bedevil our efforts to stay healthy. What is more, health care system sometimes creates complex environments for patients, in the sense that completing forms are very extensive; prescriptions don’t follow recommendations of medicine based on evidence, and even general practitioners (GP) can suffer from decision fatigue, decreasing the quality of service and attempting against patient’s health.

In the light of these realities, a new hope has emerged that might improve public health: applying choice architecture to medical centers. In this domain, where consumers have difficulty comprehending and doctors have difficulty communicating information for critical choices involving health, and where bad decisions can lead to enormous negative consequences, medical centers can serve a crucial role in enabling citizens to make better choices in health.

So, what exactly is choice architecture? Thaler, Sunstein and Balz, three well-known thinkers in behavioral science, define it as the “careful design of environments in which people make decisions.”[1] In that regard, the key role for medical centers should be to simplify the decision processes of their patients or general practitioners in order to select the option that will make them better off.