Most healthcare solutions struggle to impact patient outcomes as expected because of seemingly irrational patient behavior .
Do patients simply not understand or appreciate the risks or impact on their health? These irrationalities can constitute barriers to effective behavior change, appropriate management of a chronic condition or maintaining a healthier lifestyle over time.
But what if we could ‘predict’ patient behavior, or more importantly what appears to be ‘irrational’ patient behavior. This is where behavioral science (the study of human behavior) comes into play, as it gives us a new lens through which to evaluate patients’ seemingly irrational behavior (and inaction), and address systematic shortcomings we all face.
Patient Behavior is Human Behavior
It is seductively appealing to reason that if a patient is not doing a particular behavior (that would help them manage a condition effectively), it is because they simply do not comprehend or appreciate the risks associated with not performing the behavior. Unfortunately, this thinking doesn’t pass a scrutiny test in the real world. The problem of behavior change isn’t quite as simple as a lack of information.
Often, people are well aware of the consequences of their behavior (or lack thereof) and though they really might want to behave better, they are unable to act on their good intentions. This is commonly referred to as the ‘intention-action gap’ .
This gap leads to negative outcomes such as obesity, with about 35% of people who intend to be more physically active failing to translate these intentions into action . Information alone does not help to narrow this gap, as the intention to do the right thing is already there. Other factors are preventing the individual from acting (and doing so consistently over time).
Every patient is human, and we must treat and care for them accordingly. As such, they face challenges and have limitations the same as everyone else. We all have a limited amount of attention, limited capacity to process information, and can struggle to make the best choices in life.
One of the core ideas in behavioral science is ‘bounded rationality’. At any given moment, we generally have limited time, information, and cognitive capacity. Life pulls us in many different directions and the only way that we can manage to make decisions and not be overwhelmed is by deploying shortcuts and ‘rules of thumb’ (heuristics) .
Heuristics are mental shortcuts that allow us to solve complex problems using simplistic rules. They often lead to relatively good and efficient decisions in a given moment, but they can also lead to systematically biased decisions .
An understanding of ‘Bounded Rationality’ and the ‘Intention-action gap’ shows us some of the reasons behind ‘predictable irrational’ decisions. This matters greatly when we start to think about how best we can improve decision-making in healthcare.
Behavioral science seeks to recognize the challenges we all face, and looks to address the behavioral barriers patients face when seeking to change their behavior or follow treatment guidelines.