People are irrational in predictable ways. That phrase caught my attention. Economics professor and author Douglas Hough recently made this claim in his book Irrationality in Health Care. Among his many examples of behavioral economics at work in health care is the concept of action bias.
With respect to patients, action bias is the expectation that the physician do something –whether that something is to write a prescription, make a diagnosis or order a test. While sometimes appropriate, these actions are often taken to satisfy the patient’s expectations rather than a true clinical need. I’m not suggesting that physicians are consciously breaking their Hippocratic Oath, nor am I suggesting that physicians are “order takers” for their patients. Instead, I would argue that physician behavior, too, is subject to action bias. They want to do something to make their patients better or to ensure that they don’t miss a critical diagnosis.
According to Rosemary Gibson, noted author, speaker and veteran of patient quality and safety, one-third of the money our country spends on health care is due to overuse and waste. This translates to about $700 billion dollars a year without improving outcomes, and in some cases, even causing harm. While there are many drivers to overuse in health care, including fear and misaligned incentives, our need to act plays a significant role in this wasted spending.
As it turns out, health care marketing and public relations professionals can suffer from action bias too. Sometimes we do irrational things for political reasons. Other times, we make irrational decisions based on the latest trend or competitor action. Sometimes we have sipped too much of the company Kool-Aid. And still other times, irrational decisions are made for the same reason cited by Professor Hough and studied by Ms. Gibson –plain old action bias.
Here are a few scenarios to help test your action bias. For each scenario, do you act or not act?
1. You’re the PR director of a large academic medical center. A petition is being circulated on social media channels in an attempt to rally support against your recent announcement to partner with another health system.
By all means, act…and act quickly. For one, it is important to have a crisis plan in place, including a social media strategy, so that you can respond quickly and effectively, if social media activity unfavorable to your institution gains traction. Second, it is important to remember that social media is a conversation, and it affords you the opportunity to get out your message, rather than have it shaped by those opposed to you. While I am not recommending a response to every post, I am advocating against silence.
2. You’re the PR Director for a mid-size community health system. One of the premier surgeons bounds into your office demanding that you do something to promote him because his cases are down. He wants you to do something now –he wants an advertisement…..he’s even drawn something on the back of a napkin for you to use.
Don’t act….to strike him or to speed dial your team and ask them to create the ad! Physicians’ bark is generally worse than their bite. While there may be times when the CEO asks that you do something to keep this surgeon from showing up in the C-suite again, and you end up placing the smallest ad possible, it is advisable to have a conversation with the surgeon and/or his practice administrator. Rather than argue the merits of an ad, ask key questions that help you to better understand the market dynamics for his specialty, any unique skills or outcomes the surgeon may offer, and the demand the physician is able to accommodate. Then, you can develop a meaningful plan to promote the provider, which may –or may not –include an ad.
3. You’re an agency executive. One of your clients has a new service and wants you to issue a press release and pitch to healthcare trades and consumer business press such as the WSJ, the Huffington Post, and the New York Times.
Keep your action bias to please your client in check –before you act, consider the following questions: Does the story actually have news value –outside of the walls of your client’s building? Do you know the reporters that you will be pitching –what have they been writing about and how can what your client has to offer support the reporter’s need for content or sources? And lastly, make sure you know the target audience –not necessarily your client’s direct target, but the readership of the media you are pitching. If you have solid answers for these three questions, then develop a customized pitch and engage with the reporters, editors and authors, in the case of a blogger. If you have no solid answers and a Kool-Aid mustache, skip the pitch and simply post the release or counsel your client in another direction.
Whether it’s patients and doctors or PR professionals and clients, irrational human behavior cannot be denied. Just as health care dollars are wasted due to action base, health care communication budgets can be wasted due to action bias. As patients and PR professionals, let’s be part of the solution in health care –let’s resist action bias so that we receive better care for ourselves and deliver better outcomes for our clients.
What examples of action bias have you seen or experienced in PR and marketing? Any advice to offer?