Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Change health behavior with a gentle nudge

Howard Luks, MD
Patient
February 2, 2011
Share
Tweet
Share

Gentle nudges is a concept termed recently to describe a micro-choice movement that is beginning to carve out a sizable niche in the healthcare start-up space, and is gaining a lot of well deserved national attention.  The secret ingredient relates to the power of a gentle nudge; verbal, text or otherwise to accomplish a change in the behavior of the person who receives the nudge.  We are just starting to scratch the surface on this remarkably powerful concept. Even the elite scientific community has verified the power of a gentle nudge from a person’s dense social network.

The folks at MIT have recently proven that people with dense social networks are more likely to acquire healthy new behavioral patterns.

Thanks to the early efforts of Contagion,  Goinfeld and PremierLogic (@Jensmccabe, @textandshout and @chadosgood respectively),  I believe this previously under-ventured space is getting ready to ignite. In addition, the entrepreneurs in this space (me included) may be able to accomplish  in short order, what medicine has not been able to accomplish for at least 100+ years. Motivate sustainable, incremental healthy behavioral changes amongst our patients with the use of gentle nudge technologies.

Why the excitement?

  • Traditional interactions with your physicians have a very small chance of leading to a meaningful, healthy change in your behavior.
  • Most physicians do not have the time, desire, nor monetary incentive to follow through with you after you have left their office.
  • It is fairly well proven that the advice you receive from your physician rarely results in meaningful or sustained positive behavioral changes.
  • The 30 day re-admission rate to institutions is unacceptably high.
  • There are many patients with hypertension who stop taking their medications because “they feel fine.”
  • A very large number of patients do not refill chronic medications.
  • And, from my own personal experience, many post-surgical patients do not follow well described, well articulated, printed,  post operative protocols.

More than a few articles on the subject coldly referred to this as self management.  Not only is the term cold, it is simply wrong.  If people were capable of modifying their behavior on their own there would be no need to write this post and our obesity rate would be 4-5%.

A few months ago the Wall Street Journal wrote about the positive behavioral changes brought about by a simple telephone call or voice message.  Great concept, but telephones are so passe.  Do you answer all your phone calls now?

What is the appropriate medium from which to nudge someone?   This is clearly a case where you need to be sure of your message, and the intended audience whose behavior you wish to modify.

How do gentle nudges pair up with mobile technology? Well, mobile phones have the great benefit of being in the pocket of more than 90% of all Americans.  Text messaging, the unsexiest part of mobile, is used by most Americans, with the average person under 55 years of age texting more than calling.  Lastly, in many minority communities, the mobile phone has replaced at home Internet access, bridging the digital divide in many urban and rural areas.

That said, how do we use mobile phones to affect healthy behavior change?  The simple answer is to do whatever is being proposed for Twitter, Facebook or iPhone and make sure it runs on SMS.  Want to know when your friend stepped on a scale and lost 2 pounds?  Text it.  Or where the nearest farmers market is? Text it.  Or heart-healthy recipes to help those with hypertension eat better? Text it.

Looking to more complex behavior changes, it’s helpful to look first at the population one is targeting, then choose the right technology.  So, iPhone apps that collect mood data for depression, for example, are great for higher-income groups, but they aren’t great for the 60% of patients who don’t have smart phones.  Patient population first; technology solution second.

Lastly, in the past year, there’s been some great data on positive behavior change when patients use texting.  Teenagers take their meds more, recently discharged hospital patients are readmitted far less, and public health compliance soars with texting.  Often, a simple text is all it takes to nudge someone forward.

This is a very hot topic in a very hot space right now.  We have some very smart people working advancing the concept further, and for good reason. We are all patients.

Howard Luks is an orthopedic surgeon who blogs at The Orthopedic Posterous.

 

ADVERTISEMENT

Submit a guest post and be heard on social media’s leading physician voice.

Prev

USA Today op-ed: Violence against doctors and nurses due health care dysfunction

February 2, 2011 Kevin 7
…
Next

Should doctors give marriage advice?

February 2, 2011 Kevin 8
…

Tagged as: Patients

Post navigation

< Previous Post
USA Today op-ed: Violence against doctors and nurses due health care dysfunction
Next Post >
Should doctors give marriage advice?

ADVERTISEMENT

More by Howard Luks, MD

  • Not so fast with joint MRIs

    Howard Luks, MD
  • Technology in health care requires context

    Howard Luks, MD
  • Shared decisions are important. This example shows you why.

    Howard Luks, MD

More in Patient

  • AI’s role in streamlining colorectal cancer screening [PODCAST]

    The Podcast by KevinMD
  • There’s no one to drive your patient home

    Denise Reich
  • Dying is a selfish business

    Nancie Wiseman Attwater
  • A story of a good death

    Carol Ewig
  • We are warriors: doctors and patients

    Michele Luckenbaugh
  • Patient care is not a spectator sport

    Jim Sholler
  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why the U.S. mental health care system is failing and how to fix it [PODCAST]

      The Podcast by KevinMD | Podcast
    • The unseen cost of detachment in radiology

      Dr. Yesu Raju | Physician
    • I thought success was a destination. Then I became a doctor.

      Ryan Nadelson, MD | Physician
    • Why psychotherapy works and why psychotherapy fails

      Peggy A. Rothbaum, PhD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • How oral health silently affects your heart, brain, and body

      Charles Reinertsen, DMD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 6 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why the U.S. mental health care system is failing and how to fix it [PODCAST]

      The Podcast by KevinMD | Podcast
    • The unseen cost of detachment in radiology

      Dr. Yesu Raju | Physician
    • I thought success was a destination. Then I became a doctor.

      Ryan Nadelson, MD | Physician
    • Why psychotherapy works and why psychotherapy fails

      Peggy A. Rothbaum, PhD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • How oral health silently affects your heart, brain, and body

      Charles Reinertsen, DMD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Change health behavior with a gentle nudge
6 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...