Mon. Sep 27th, 2021

Let’s talk about psychology, shall we? I have read Scott Adams’ book How to Fail at Almost Everything and Still Win Big twice. I highly recommend it. I am very interested in his thoughts about studying human behavior to hack your own life and business. He mentions all the cognitive traps we fall into. What are those?

Thinking traps are patterns of thought – usually with a negative swing – which prevent us from seeing things as they really are. Otherwise known as cognitive distortions, thinking traps are often deeply ingrained in our psyche.

The more I have studied this the more I get interested. I am therefore starting a series to show how the psychology of the human brain and subsequent cognitive traps affects Direct Primary Care. Sounds weird? Stay with me on this one.

The first cognitive trap is The Ambiguity Effect. What is that?

The ambiguity effect is a cognitive bias that describes how we tend to avoid options that we consider to be ambiguous or to be missing information. We dislike uncertainty and are therefore more inclined to select an option for which the probability of achieving a certain favorable outcome is known.

I highly recommend you go to the link above to understand this more. Don’t worry, it’s quick. Basically, people need information and will make a lot of choices for something mediocre if you don’t give them that information.

Here is an example from the link above that will hit home:

The ambiguity effect is often seen in medicine, on both the side of the patient and on the side of the doctor. 

From the doctor’s perspective, it is preferable to recommend a treatment that they are familiar with, rather than one that they don’t know much about or that is not typically used to treat this specific condition. The hesitation here is valid. The Hippocratic Oath clearly says “do no harm”, and a doctor may feel that they are going against that by recommending a treatment when they are uncertain of the effects it might have.Yet, when conventional treatment is unsuccessful, going down the more ambiguous route may be the best way to help the patient.

On the patient’s side, the ambiguity effect typically occurs when their healthcare provider does not explain the recommended treatment well enough for it to be understood by a layperson. A lack of clarity prompts unease on the part of the patient, making them hesitant to follow through with the doctor’s treatment plan. They feel as though they are missing information, which can trigger ambiguity aversion. Thus, it is necessary for healthcare providers to explain all relevant treatments clearly and without the use of medical jargon.9

Ensuring that the patient understands the treatment being recommended to them makes the treatment option less ambiguous. This will encourage the patient to agree to this treatment, which is in their best interest.

So how does this relate to your DPC practice? Simple. You can’t educate people enough about it. If they are uncertain about what your practice offers then they will choose their mediocre insurance doctor because at least they know what is there (even though is sucks). The onus is upon you to:

  • Constantly explain the DPC model
  • Have an elevator pitch ready at all times
  • Do a meet-and-greet to fully educate the patient before he/she joins (see my first book)
  • Get the word out on social media

The ambiguity effect goes both ways. You can also use this phenomenon to your advantage. If you ethically explain that the industrialized model is filled with more and more uncertainty you may get people to see how your DPC practice is the “known” pluses they need. For example, in the hamster wheel model:

  • The doctor works for the insurance company or hospital causing a conflict of interest.
  • You never know what the bill is and only months later do you find out you were gouged.
  • You never know who you will see. Is it your doctor? Is it even a doctor at all?
  • You don’t know who is answering your emails if they get answered at all.
  • What happens to your data from the EHR.

You can surely come up with more.

This is how the human brain works. Study this blog post. SHARE IT! And see how you can remove the ambiguity effect from your prospective patient’s brain so that he/she can see clearly and join your practice. And don’t forget to use it to your advantage to blow up their addiction to the insurance model.

20820cookie-checkCognitive Trap #1: The Ambiguity Effect

By Doug Farrago

Douglas Farrago MD is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Douglas Farrago, MD received his Bachelor of Science from the University of Virginia in 1987, his Masters of Education degree in the area of Exercise Science from the University of Houston in 1990, and his Medical Degree from the University of Texas at Houston in 1994. His residency training occurred way up north at the Eastern Maine Medical Center in Bangor, Maine. In his final year, he was elected Chief Resident by his peers. Dr. Farrago has practiced family medicine for twenty-three years, first in Auburn, Maine and now in Forest, Virginia. He founded Forest Direct Primary Care in 2014, which quickly filled in 18 months. Dr. Farrago still blogs every day on his website and lectures worldwide about the present crisis in our healthcare system and the effect it has on the doctor-patient relationship. Dr. Farrago’s has written three books on direct primary care: The Official Guide to Starting Your Own Direct Primary Care Practice, The Direct Primary Care Doctor’s Daily Motivational Journal and Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) are all best sellers in this genre. He is a leading expert in direct primary care model and lectures medical students, residents, and doctors on how to start their own DPC practice. He retired from clinical medicine in October, 2020.

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