The idea of ‘nudging’ in behavioral economics gets a lot of play in healthcare. But most of the attention is on the public health/patient side — i.e., how to persuade patients to do what public health administrators believe is best for them. These ideas often focus on negatives and can be controversial — prompting cries of ‘nannying’ and ‘coercion.’ But some fascinating recent research by Balaji Prabhakar of Stanford shows that positive, incentive-based nudging can help reduce traffic and even help people have a little fun at the same time — and it got me to thinking, should we take a look at this type of positive nudge as a way to improve medical practice workflow?
If you have a minute, take a look at this brief article on the Stanford Business School site — it explains how Prabhakar was inspired to try to help address the insane traffic problem he observed when visiting Bangalore on business. A commute of 9 miles to his client’s office in one of the busier areas of the city took employees an average of 71 minutes! Prabhakar thought a scheme of incentives might help persuade employees to commute at off-peak times.
His goal was to apply a key insight from his work as a computer scientist: that reducing peak load by just 10% would dramatically improve other metrics like wait times. Could this insight also help your practice?
Prabhakar used an interesting incentive to encourage off-peak commuting: lottery entries. Each early arrival earned an entry into a weekly lottery — so more early arrivals meant more chances to win. This was a positive approach (unlike some nudges that are perceived as punishments), and it helped make the program fun and created weekly excitement.
So what if your practice wanted to reduce congestion — say, due to late-arriving patients? What about rewarding patients who arrive on time with a thank you and a scratch ticket or other small gift? And are there times of day that are harder to book at your practice? Perhaps a little reward for patients that can come in at those less popular times — a gift card for a latte, a lip balm, travel-sized lotions, pens branded with your practice’s name (there are lots of equivalent promotional products that can be branded and cost $1 or less when you buy in bulk).
Another possible application of this theory: your patient portal. During the Q&A for my recent webinar with Kareo on patient portals, we got a great contribution from a practice manager who had used Starbucks gift cards as an incentive to encourage patients to engage with her practice’s portal.
The possibilities abound! If you have any ideas for positive nudging to improve the flow of your medical practice, we’d love to hear them — click here to email me or just reply in the comments.
And if you’re interested in more workflow-related content, check out my ebook on how to spot bottlenecks in your practice’s patient flow: Patient Flow Mistakes Smart Managers Make — And How to Avoid Them (Management Rx).