“I’ll have whatever he’s having!”

Isn’t it strange how sometimes we make decisions within the blink of an eye? Sometimes we simply seem to follow the crowd and sometimes we seem to make decisions without really thinking at all.

In fact, recent academic studies in Cognitive Psychology, Social Psychology and Behavioural Economics suggest that over 90% of our daily decision–making is to some extent unconscious and automatic.

The Behavioural Economics Framework references a series of biases and heuristics that drive behaviour independently of personal preference.

Nick Southgate, a Behavioural Economics Consultant, originally from the advertising world, often works with us to help unravel some of the threads and patterns that underpin behaviours. He suggests people often do things without conscious awareness of why they are doing them.

Southgate (2011) describes it as “they just do what everyone else does (or what they think everyone else does). They do what they did last time. They do whatever is easiest. They do what is offered, not what they want. The context of the decision is far more important than its content.”1

Behavioural Economics has been in vogue for some time now. What’s been less clear is how best to apply it to market research.

How can we best uncover and leverage heuristics, the decision–making shortcuts and rules of thumb, in our design, in the insight we derive and in the recommendations we make?

At Adelphi, applying our knowledge of the heuristics and being able to design market research with them top of mind, aids our ability to dig deeper and uncover more accurate findings from respondents.

We are able to go beyond an explanation of what our respondents do and really get under their skin to uncover what and how they actually think, revealing the biases and heuristics that drive their decisions. Here are some of the key heuristics that we’ve found useful, that you might also want to consider.

Framing

This is crucial to every day market research. By asking a question in a new way or Framing a question can generate a new response. Kahneman (2014)2 also suggests
that different emotions can be evoked when the same question is asked in different ways.

It’s important to understand how to frame your question or a series of questions to make sure you are getting the most accurate answer  that reflects the respondents’ true thoughts or intentions.

The application of Framing helped transform one of our recent projects involving a sensitive topic, similar to sexual behaviours.

As with any project, we wanted to gain an accurate reflection of reality, but we expected respondents to downplay their behaviours, to conform to social norms and expectations.

We really placed ourselves in our respondents’ shoes to understand how they would feel about revealing information that was sensitive to them and tailored the research accordingly.

We reframed questions and the language was carefully selected to instil trust. Reassurances regarding anonymity and use of the data were repeated on several occasions to emphasise the confidential nature of the research. Overall we were able to gain much higher reporting and open honesty than we thought would have been possible.

Paradox of Choice

Being offered more choices can feel confusing, making us more likely to fear making a bad choice and potentially leading us to
making different selections than we would if we had fewer choices.
Research by Redelmeier and Shafir (1995)3 investigated whether decisions involving multiple options can influence doctors to choose an option that wouldn’t usually have been selected.

The research involved family physicians and split the physicians into two arms, both with an identical scenario — a 67 year old patient with chronic right hip pain, the diagnosis being osteoarthritis, with the physician having tried several nonsteroidal anti–inflammatory agents, all being stopped due to either adverse effects or lack of efficacy.

The physician decides to refer the patient to an orthopaedic consultant for consideration for a hip replacement.

In the first arm after checking the drug formulary, the physician found that there was one nonsteroidal medication (ibuprofen) that the patient has not tried. In the second arm the physician found that there were two nonsteroidal medications (ibuprofen and piroxicam) that the patient has not tried.

The respondents’ task in the first arm was to choose between two alternatives 1) surgery and start ibuprofen and 2) surgery and not to start any new medication. The respondents’ task in the second arm was to choose between three alternatives 1) surgery and start ibuprofen, 2) surgery and start piroxicam and 3) surgery and not to start any new medication.

The results indicated that considerably more physicians chose the option of ‘surgery and not to start any new medication’ when two medications were available compared to the arm where only one was available.

The uncertainty in deciding between two medications led many physicians to avoid this decision altogether.

This case study clearly demonstrates how adding a new option can increase “the probability of choosing a previously available option, by rejecting the alternative, or in particular of maintaining the status quo.”

Not an entirely rational decision, I’m sure you’ll agree. None the less one based on a solid rationale ‘when there are too many choices, it’s safest to do nothing’.

This fascinating experiment provides us with an ideal example of the kinds of shortcuts we all make every day in our decision–making. Behavioural Economics provides us with a route map to identify and reroute some of these shortcuts.

Status Quo Bias

This leads us to ‘Status Quo Bias’ (the ‘if it ain’t broke, don’t fix it’ line of thought). If a treatment is successful, and the delivery method effective, patients are happy with the way things are done. In short, no–one sees any reason to change anything. In essence people’s default behaviour is very often to prefer to continue with what they have done before.
A successful campaign will provide credible reasons for switching. A good research study will be able to probe and uncover some persuasive levers. For example, being able to upgrade a patient’s treatment if they’ve been using the same drug for ten years, will make doctors feel like they are making an effort. It will also make the patient feel that they are being cared about. It will provide a positive reason to switch, a benefit to trade–off against the risk of switching.

Behavioural Economics provides us with clues not only as to the biases which are shaping current behaviour but also guides us on how best we can reframe what is being offered.

A recent project faced precisely the ‘if it ain’t broke don’t fix it’ conundrum in a therapy area with very little natural churn. Previous campaigns had focused on cost–effectiveness messaging. The application of Behavioural Economics principles in the analysis spotlighted the need to offer a benefit to the patient rather than focus on the cost of prescribing. It also highlighted a need to reassure the prescriber on the patients’ level of satisfaction with the new drug.

It provided clear recommendations that a less is more approach, provided a more intuitive decision process. The more we have to think about something the less credible its message. The new streamlined campaign really brought home the benefits of the brand and created a genuine interest in trying something new, unhinging the status quo.

The impact of this study on the brand’s success is a very clear demonstration of how Behavioural Economics can benefit the market researcher. It enables us to look beyond behaviour and our respondents post–rationalised explanation of their behaviour.

This provides us with an understanding of the shortcuts they use in their decision–making process and the rules of thumb that are guiding their thinking. It then goes beyond this to provide new frameworks that we can use to enable customers to see and hear brands in a new light, allowing information that may previously have been lost in the complexity of the decision, to come to the fore and make its case.

A powerful tool in market research

Our experience is showing that Behavioural Economics is a very powerful tool indeed. Through understanding the different heuristics and designing market research with them at the forefront, it allows us to dig deeper and uncover more accurate findings from respondents. We are able to go beyond an explanation of what our respondents do and really get under their skin to uncover what and how they actually think.

We have found the Behavioural Economics Framework to have been particularly powerful when investigating sensitive topics, where we have been able to gain much higher reporting of the issue and open honesty than we ever thought would be possible.

We believe that many in healthcare market research can benefit from understanding and applying Behavioural Economics principles. It provides a clearer understanding on the complex dynamics of choice, and delivers a deeper insight and understanding on what respondents truly think and feel.

1. Southgate N (2011) Why Behavioural Economics Should Only Make Market Research Stronger
2. Kahneman D (2014) Thinking, Fast and Slow. InstaRead summaries
3. Redelmeier DA and Shafir E (1995) Medical Decision Making in Situations That Offer Multiple Alternatives.

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