What Behavioral Economics Get Wrong About Improving Healthcare

It is notoriously difficult to change physician behavior. When it’s discovered that primary care physicians are, say, prescribing too few cholesterol pills or too many antibiotics, it will not be easy to change those behaviors. Physicians are strong-willed people, with lots of things competing for their attention and with many well ingrained habits.
That’s why I should be excited about several recent studies establishing successful ways of changing physician behavior. One trial, which I wrote about earlier, showed that physicians were less likely to inappropriately prescribe antibiotics after receiving feedback on how their prescribing habits compared to their peers. Another trial, published in the New England Journal of Medicine showed that an intervention combining professional education, informatics and financial incentives reduced how often physicians inappropriately prescribed high-risk medications like pain pills that can cause GI ulcers. Here is a picture of those results, showing a reduction in high-risk prescriptions after the intervention, a reduction that lasted even after the intervention was no longer being implemented:
What Behavioral Economic Interventions Get Wrong About Improving Healthcare 1
And a third study published in JAMA showed that financial incentives informed by insights from behavioral economics increased the likelihood of getting patients’ cholesterol under control.
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