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Friday, July 31, 2015

Bend over and Nudge: Nudges of Chance at the Urologist’s and the Drive-up ATM

PSA results aren’t the only numbers that rule at my neighborhood urologist's.  On the far side of the waiting room, past the Flomax-branded coffee dispenser that jump-starts obligatory urine samples, I marveled at a very different game of chance. Who needs Vegas? Or even Bingo? . . . when enrolling in the new patient portal positions you to score a $100 VISA card! Don't forget to tell your urologically challenged friends that there's a new winner every month!

Sadly, I was an early adopter who had already signed up for the portal ahead of the contest. But I'm all for my urologist’s probe at nudging aging patients--none of them digital natives--to embrace the portal and more active participation in their urological karma.

Nudging, as advocated by professors Thaler and Sunstein  in their 2008 book, Nudge: Improving Decisions about Wealth, Health, and Happiness, deploys (frequently creative) behavioral "architecture" and framing to position us in the direction of presumably beneficial outcomes. When employers ask us to opt out of rather than opt into 401k savings plans, it's more likely that we'll participate. Ditto for organ donation programs via RMVs.

Nudges can also bedevil the consumer. In Northampton, Massachusetts, which I frequently visit, the parking meter sticker that exempts payment on  Sundays and Holidays is on the far side of the meter, away from the payer. When payers have less than perfect information,  they often choose  the lowest-risk outcome, i.e., feeding the meter.  To that end, I noticed time on one-in-five Northampton meters on July 4th. On  Massachusetts  holidays like Patriots Day, when the holiday's parking status is unclear to most drivers, meter feeding is far higher. My own hometown of Amherst deploys a parking sign on meter-free streets that is so intentionally confusing that drivers play it safe by seeking out streets with parking meters.

Happily, the urological nudge above is nothing more than a zero-risk frisson--just like an outlandish gambit several years back at a savings bank in Easthampton, Massachusetts that transformed its drive-up ATM into a zero-risk slot machine.

1 comment:

Wesley Moons, Ph.D. said...

What a delightful and interest read. So well written. Thanks for sharing!