Behavioral Psychology

  • Medical error is #3 cause of death – what does this mean?

    By Marjorie Stiegler on May 9, 2016
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    Recently, a paper written by researchers at Johns Hopkins and published by the British Medical Journal estimated that medical error was the third leading cause of the death in the United States. This received – as you might imagine – considerable coverage in the media. The researchers proposed that death certificates should include a qualifier or indicator that medical error was linked to the death, if in fact it was, so that better statistics could be obtained. I certainly can’t argue with the fact that we do not have good data about how frequently medical error occurs, or how frequently such errors contribute to serious disability or death. However, the paper also offered a case illustration which did show how un-illuminating the death certificate is, but in my view, did not actually demonstrate a preventable error.
  • Nudging toward patient safety

    By Marjorie Stiegler on March 15, 2016
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    A nudge is a form of social engineering to help people make the best decisions by also making the easiest, laziest choices – the defaults - the "right" choice. Example of success stories include helping people to save for retirement, increasing organ donation status for people who want to be organ donors, and healthier food choices by school kids in their cafeterias – even when the unhealthy choices were still readily available. The nudge represents an untapped source of innovation in patient safety efforts. How can we apply this concept to healthcare? First, let's look at some serious nudge fails:
  • Happy Friday! Play is the new work.

    By Marjorie Stiegler on February 26, 2016
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    There’s a subculture in healthcare that seems to resent all expressions of delight that the weekend is coming. This is probably because so many of us don’t have traditional weekends. We work – maybe just a “regular” day, maybe 48 hours straight. We may or may not earn any extra money for this time, and we may or may not get a day off during the week as our consolation prize for weekend or holiday duty. So when the world is abuzz with weekend joy, some healthcare professionals are “celebrating” like this:
  • The grass is always greener: a scientific illusion

    By Marjorie Stiegler on February 8, 2016
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    Why do we think the grass is always greener? This nearly irresistible human experience is rooted in the focusing illusion. The focusing illusion describes how humans make judgments. Generally, we focus on a subset of data instead of all possible data (this may be due to priming or anchoring on a particular subset of data, as happens in marketing, or could be due to the fact that most people's working memory capacity can only hold about 3-5 data points at a time). We then give that data more weight than it otherwise deserves. In particular...
  • Have You Ever “Almost Won” The Lottery?

    By Marjorie Stiegler on January 12, 2016
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    Did you buy a Powerball Lottery ticket? With a jackpot of 1.4 billion dollars for tomorrow’s Powerball Lottery drawing, record numbers of people are frenetically purchasing record numbers of tickets. For some, it is mere entertainment – an insignificant amount of income spent on an intangible pleasure, not much different from reading a novel. For others, it represents a bad investment and a completely irrational allocation of much-needed money. Evolution is not helping us. Here are a few of the hard-wired cognitive tendencies that keep the lottery alive and well:
  • The $500 Popsicle: Perceived Value and Commission Bias

    By Marjorie Stiegler on December 31, 2015
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    A toddler falls face-first onto an iron table, bleeding profusely. Mom takes the baby to the emergency room. After her child was evaluated, it was determined that no serious injury was sustained, no further intervention was needed, and the toddler was discharged home with some wound care instructions and a popsicle. When the mother subsequently received a bill from the ER, she remarked, “That was one pricey popsicle.” But deciding to "do nothing" IS doing something - something that requires a high level of medical expertise...
  • You Should Ditch Emotional Authenticity

    By Marjorie Stiegler on November 23, 2015
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    Your quest for authenticity is holding you back. Neuroscience shows that the secret to happiness is actually to abandon how you really feel, and try these techniques instead.
  • BX2015 Highlights: The 2015 International Behavioural Exchange Conference

    By Marjorie Stiegler on September 6, 2015
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    Did you know? The relentless stress caused by poverty has the same effect as reducing your IQ by about 15 points. And if you look even a little bit poor, you are also perceived as incompetent – so things are only looking worse for you tomorrow. Most people lie and cheat a little; few lie and cheat a lot. Very few people actually steal…unless it’s for a good cause. Want someone to do something for you? Follow this formula...
  • Kahneman and Thaler – Should I Go in the Water?

    By Marjorie Stiegler on August 19, 2015
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    I’ve often used the illustration of a shark attack to explain the Availability Bias (Kahneman and Tversky) – in a nutshell, the mental illusion that memorable events are more likely than their their statistical rarity predicts. Although shark attacks are vivid, make incredible headlines, are gruesome, and therefore are memorable, we are much more likely to die from the mundane - a fall, lighting strike, pig attack, and so on. Therefore, rationally speaking, imagery from the Discovery Channel's "Shark Week" should not stop us from enjoying the waves. This Saturday, I’m heading to the same NC beaches that boast no less than 8 (!!) shark attacks in the past several weeks - the highest number in over 80 years. What is happening? Are we under siege? According to some expert reports, these shark attacks are "extraordinary," represent "incredible odds" and a "perfect storm". And so I ask Drs. Kahneman and Thaler - what would you do?
  • Idiot or Jerk? Racing to the Top of Ladder of Inference

    By Marjorie Stiegler on April 21, 2015
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    My husband and I have this recurring debate whenever we’re driving and someone cuts us off or does something dangerous: is that guy an idiot, or is that guy a jerk?
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