Health professionals and policymakers often wonder why people fail to follow a physician’s expert advice.
It’s no small problem: Medical noncompliance is estimated to increase health care costs in the U.S. by $100 billion per year.
In some cases, the reason may be that the side effects of a particular medicine are unbearable or the dosing regimens are too complicated. But a new study suggests much of the medical noncompliance stems from sheer inertia – the irrational tendency to stay in the current state, even when that state is undesirable.
In a series of studies, Gaurav Suri, Ph.D., and colleagues from Stanford and Tel Aviv Universities tested whether this status-quo bias could result in behavior that is detrimental, and whether such a bias could be lessened with minimal interventions.
In the first study, participants were told that the research would involve receiving electric shocks.
One group was told that they were required to choose one of two options: They could press a button to stop the shock 10 seconds earlier, or press another button to keep the waiting time the same.
As the researchers expected, most people opted to get the shock over with early.
In contrast, those participants who were told that they could press a time-decrease button if they wanted to were more likely to stick with the status quo: Only about 40 percent chose to push the button in order to shorten the trial.
The researchers saw similar results when they told participants that pressing a button would reduce the chance of shock by as much as 90 percent.
Those participants who had to make a proactive choice to press the button opted to leave it untouched about half the time, even though it meant they had to withstand shocks they themselves rated as highly undesirable.
These studies clearly demonstrate that, when faced with a choice that requires them to make a proactive decision, people often opt to do nothing, even when actions that are easy to perform could noticeably improve their current state.
Interestingly, the researchers found that simply requiring participants to press the button on an early trial made them more likely to hit the button on later trials.
This suggest that while medical noncompliance may sometimes result from patient inaction, individuals may be capable of making productive choices about their health if given a nudge in the right direction.
This knowledge is critical as the nation embarks on a population heath approach as the focus of health reform — an effort to reduce health costs and improve consumer satisfaction by focusing on prevention and wellness and individual empowerment.
The study results are published in the journal Psychological Science.