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Addressing Complacent Inactions in Healthcare

Action tends to occur when it is urgent, easy, and clearly expected by others in our tribes. Otherwise, inaction is the norm, even in the face of failure and long-term threat. Many types of inaction are common:

  • Failure to be proactive: People focus on immediate concerns and "putting out fires". There is less focus on prevention. We tend to get the importance/urgency balance wrong by over-emphasizing the urgent issues and neglecting many important ones.

  • Procrastination to initiate: People tend to delay, "kick down the road", resist change, and generally avoid new initiatives.

  • Failure to stick with plans: People often fail to follow-through or continue with new programs they have begun. Medication adherence is a common example.

  • Progress is slow: People can delay and move at what appears to be a snail's pace on important projects that should have more urgency.


Inaction Involves Many Forms of Complacency

We use the term complacency to characterize much inaction. Inactions are not simply oversights. Complacent inaction is common because the human mind quickly defaults to habit-driven behaviors we have developed or behaviors that immediately provide relief or avoid pain points. We are complacent in what we are already doing, even if it means losing out on long term gains.

  • HCPs show complacent inaction: HCPs may be slow to adopt new products despite support in clinical guidelines and standards of care.

  • Patients show complacent inaction: Patients are slow to make lifestyle changes (including exercises and medication adherence) that they themselves recognize would bring them long term health improvements.

  • Commercial teams show complacent inaction: Commercial teams can get used to doing things a certain way and can be reluctant to go beyond their comfort zones despite market changes and weak performance.


Overcoming Complacent Inaction: Initiation and Persistence

Complacency has many causes. Behavior change is typically gradual, and often requires separate solutions to the initiation and persistence of new behaviors. Marketers and leaders need well-designed messages and programs to support behavioral momentum.


Decades of work in academia and industry have revealed some best practices in building behavioral momentum among stakeholders.


Help stakeholders create behavioral momentum

Help stakeholders initiate new behaviors and persist. Stakeholders are busy and set in their ways. Marketers and leaders can make new behaviors seem easy and urgent. They can also support persistent repeated behavior through quick wins, defaults, habit formation, and other techniques informed by decades of behavioral and consumer science.


Help stakeholders find the right moment to initiate action

Consumers have daily challenges with immediate consequences (e.g., daily work and family needs.) This often prevents them from acknowledging challenges with future consequences. Even if the challenges are acknowledged, procrastination can leave them unattended. To increase future-focus, marketers and leaders must make action easy and urgent.

"If you want to change behavior, make it easy" - Nobel Laureate Richard Thaler

People do not want to take a lot of time to figure out what to do. The problem for marketers and leaders is that it isn't always easy to make it easy.


Making it urgent can be an even more challenging problem. We can leverage "pain points" but we can also take advantage of the Fresh Start Effect - the tendency for people to engage in aspirational behavior (including self-care) after important temporal landmarks. The most famous temporal landmark is New Year's Day, but the effect has also been shown on the first day of the week, the first day of the month, and the first day after holidays and birthdays. These are moments when consumers seem to be more future-focused and want to act to create a future self that matches their aspirational self rather than their past self.


Help stakeholders persist in their good starts

Even after trial or initiation, failures in persistence are the norm. People revert to old habits. Leading habit scholar, Wendy Wood, notes that habits underlie about half of our behaviors. And she adds an important nuance- a habit is "not what the action is" but rather, "how you perform an action". Specifically, a habit is something that is performed automatically and effortlessly.


"You do not rise to the level of your goals. You fall to the level of your systems" - James Clear, author of Atomic Habits

Goals orient our interest, but habits drive our behavior. Habits are internal systems. And they drive what we do, in a way that goals simply do not. Habits come to be performed effortlessly because they get frequently repeated (initially with some effort) in the same context (same time, same place, and with the same products or people).


Marketers need ways to attach their products to existing habits to ensure persistence. Helping stakeholders is also possible, but much harder. And, beyond habits, leaders can support stakeholders' planning behaviors with prompts, reminders, and nudges. Generally, a well thought out set of approaches is needed to support behavioral persistence. The good news is that behavioral science now provides an evidence-based roadmap.

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© 2020 by Jason Riis