Marketers like to think of marketing as art, not science. But most, if pressed, would confess that our business has at least reached the point of being a mixture of both.
For all the scientific tools that have fallen into our hands in the past few years and the ways to take advantage of big data and align the right audience with the right message through the right channel with the right frequency, we are still largely falling short in our efforts to influence our audiences’ behaviors.
Breast cancer survivors still stop taking medications that could significantly reduce the risk of recurrence. Transplant patients stop taking their immunosuppressants. People with lung cancer keep smoking. And not in small numbers, either. In fact, what might be called “irrational noncompliance” is quite possibly as big a problem today as it was before the information revolution. And it is not coming from a lack of education or reminders.
The easy response to this is to accept that humans will behave irrationally no matter how hard we try to prevent it—that this sort of behavior is simply a part of the business of healthcare that we must accept. But reaching such a conclusion would be equivalent to capitulation—we can do better than this. And science can help us get there. A whole field of science has grown up over the past decade that offers insight into how to predict and, what’s more important, actually take advantage of irrational behaviors.
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That field of science is called behavioral economics, and it has the potential to transform the way we communicate with patients. Behavioral economics attempts to identify the irrational biases that impact human decision making—and understanding such biases is the first step towards taking advantage of them for the benefit of both customers and marketers.
So what are some of these biases, and what might they mean for marketers?
1. Short versus long
We’ll start with a simple one. Which is more valuable to a person—a brief pleasure or a long life? Nearly everyone would say a long life and yet people smoke, drink, eat junk food, forget to take their meds and do all sorts of other things that are obviously injurious to their long-term health.
Why? Because people are wired with a bias in favor of short-term rewards. If I enjoy smoking, no amount of education in the world is going to stop me from enjoying smoking, and the immediate gratification I get from smoking a cigarette is always going to outbalance the longer-term benefits to my health and wellbeing that I get from not smoking one since there’s no obvious short-term reward for doing so.
What makes this a particularly important bias for healthcare marketers to consider is the fact that it inversely applies to most of our products. Not taking one’s meds, not exercising and not eating healthy foods are often more immediately gratifying than actually doing all those things.
Behavior economists call this hyperbolic discounting—where future rewards are evaluated as
less valuable than if they were to be given now. This is how it makes sense to value sitting on
the couch watching TV in the present more than good health in the future. So we as marketers have to spend more time thinking about short-term rewards, rather than pounding patients with all the reasons why it makes sense for them to be compliant in the long run. We need to find ways of rewarding them now for doing so.
2. Loss aversion
A few years ago a team of researchers partnered with a Fortune 500 company for a little experiment to see if they could get the company’s employees in the habit of working out. For four weeks, the company paid its employees $10 per gym visit up to three times a week. After those four weeks the payments stopped, but one group of employees was offered a “commitment contract” in which they could set aside their own money that would be released to them only if they worked out over the next two months—otherwise, the money would be given to charity.
Three years after the study’s conclusion, those who had been offered the upfront commitment remained 20% more likely to work out than those who had not been offered any incentives.
This little example illustrates the power of loss aversion: people fear the emotional pain of losses much more than they are happy with gains. The same principle can easily be applied to any other behavior, including taking medication. It works very well with other, not just with financial, incentives.
Who of us do not want to be tricked into the right behaviors? We all want to exercise more, eat better, be more compliant taking our medications or maybe just spend more time with our families. But are we always successful in doing it?
3. Choice overload
Oh, how we love our choices. It’s why capitalism works, right? All those supermarket shelves full of more brands than a person could buy in a lifetime? Arguing against choice would be like arguing against apple pie and motherhood.
But the science of behavioral economics suggests that too much choice can lead to worse, not better, healthcare outcomes. Place two or three or four treatment options in front of an individual—and individuals include physicians—and they may catch what’s called decision fatigue. They will start weighing the options and being overwhelmed by all the information and fearing the cost of making a wrong choice and may end up just plain not doing anything at all.
So if we as marketers really want to see our customers following the paths we are encouraging, we need to fall out of love with offering too many choices.
4. The memory experience gap
Other psychological mechanisms—not quite behavioral economics, but still important in how decisions are made —have also proven highly effective in influencing behavior. Let’s say you are going on a vacation to New Zealand.
Then you actually go to New Zealand and stay for two weeks. Maybe you see some of those fascinating sights or exotic animals or try some of that interesting food. No doubt you’ll also do some less exciting things, like waiting in line for a rental car or being kept awake by the noisy kid in the next hotel room over.
But if someone asks you how your trip was, your brain does something interesting. Since the period of expectations exceeded the period of the actual experience by a considerable margin, your answer to the question “How was it?” feeds more on those expectations than it does on the actual experience.
What this means, of course, is that we as marketers can positively influence the experiences patients have with our brands by setting up expectations—often in the form of patient education and support. And our patients will judge their experiences with our products based more on the expectations we create for them than on their experiences with the products themselves. Some pharmaceutical companies are already taking advantage of this principle by implementing a service-as-a-product model to drive better treatment outcomes, brand loyalty and differentiation.
What we are advocating here is a conscious and proactive use of psychological and behavioral economics principles in developing any healthcare marketing campaign that seeks some kind of action from its targets. The hard science of large-scale data crunching has carried us a long way towards better understanding of our audiences. But if we really want to convince those audiences to do anything, we need to construct our communications on a broader foundation and include another kind of science—the science of how people actually make decisions.
Boris Kushkuley is executive vice president of multichannel marketing and consulting at Intouch Solutions. Talya Miron-Shatz is CEO of CureMyWay.