Do we bet on anecdotes when it comes to our health decisions?
Gone are the days doctors used to be hero-worshipped.
Now doctors know their ‘Google’ patients. Those who are educated, have googled their symptoms, and cannot fathom why their doctor is not listening to them as any service provider should.
With education and the internet, patients and caregivers are keen to reduce the information symmetry between them and their doctor.
Doctors should respond to patients’ need to have a say. But also there are consequences to patients making healthcare decisions that need highlighting. Outcomes that transparency or information-sharing may not fully solve.
Patients are known to fall prey to several biases, most common/telling of which is deciding on anecdotes. This is natural when faced with a big decision.
The book 𝘛𝘩𝘪𝘯𝘬 𝘛𝘸𝘪𝘤𝘦 reports findings from a study on what may happen when patients make their decisions.
Researchers presented subjects with a fictitious disease and two treatment options with different effectiveness.
❓Option 1: A control treatment that’s effective 50% of the time.
❓Option 2: One of 12 options that combined 3 kinds of anecdotes (𝘩𝘢𝘱𝘱𝘺 𝘦𝘯𝘥𝘪𝘯𝘨, 𝘴𝘢𝘥 𝘦𝘯𝘥𝘪𝘯𝘨, 𝘯𝘦𝘶𝘵𝘳𝘢𝘭) with 4 levels of effectiveness (30%, 50%, 70%, 90%).
What did they find?
A happy story about a mere 30% effective treatment swayed 78% subjects in favor of it, but a sad story about a 90% effective treatment drove out all but 39% subjects.
💡The kind of stories subjects heard made the bigger difference to their decision. Not the treatment effectiveness.
What can be done about this?
👉Doctors have to start looking at patients as customers whose preferences have to be heard. They also have to get better at what Cass Sunstein and Nobel laureate Richard Thaler call ‘libertarian paternalism’–influencing choices in a way that will make patients better off, as judged by themselves, while leaving patients free to opt out of specified arrangements if they choose to do so.
Think of this as the equivalent of keeping healthy food at eye level in the school cafeteria (and sugary drinks in a corner). You’re nudging the kids in a way you know is better for them but the kids are free to choose what they want.
👉And patients may not want to be treated like kids, but they may want to balance their need for information with some rigor in the process of making consequential-irreversible decisions.
Both doctors and patients have ground to cover. Doctors could use behavioral economics to make patients not just be healthier but feel happier about their decisions. Eden Brownell, MPH 👩🏼🏫 deftly marries behavioral science with healthcare.
And even without formal medical knowledge, patients and caregivers will benefit from some training in decision-making — something I hope readers of my posts have access to!