Patients as Customers – Lessons for businesses like yours

The healthcare system around the world, faced by ever increasing costs and the challenge of budgetary constraints, has in recent times being putting more focus on prevention rather than focusing purely on cure.

One of the tools being used for this is the application of behavioural insights. And the lessons from the health sector research could prove invaluable for us in business especially when it comes to wooing, winning and keeping customers.

Here are some of the key findings from ApplyingBehavioralInsightsHealthUK2016 - 'Simple ways to improve health outcomes', a report from the World Innovation Summit for Health 2016.

Research from the last 40 years shows that people’s decisions are often not deliberate and considered, but habitual, automatic and heavily influenced by the environment in which they are made.

The healthcare system in major countries around the world is using the Easy, Attractive, Social and Timely (EAST) framework as a simple way of applying behavioural insights to policy and making behaviour change more likely. This is a simple tool that we can all use to better understand and enhance the customer experience.

While this isn’t yet ‘mainstream’ in health circles, it is being taken more seriously. For example, the UK’s Behavioural Insights Team was set up in 2010 as the world’s first government institution dedicated to the application of behavioural sciences to mainstream policy. A core part of its work has been to explain behavioural science concepts to government officials. The EAST framework, explained below, has emerged as a way of addressing this challenging task.


Requiring even small amounts of effort (‘friction costs’) can make it much less likely that a behaviour will happen.

The most powerful way of making something easy is to ensure a person does not have to do anything for it to be achieved.

This is seen with the debate about opt-in versus opt-out systems for organ donors. Opting in requires effort, thinking “will I or won’t I?” creating decision fatigue and when effort like this is required people often avoid taking action.

In the U.K., for example, more than 90% of people say they support organ donation, but only 29% have registered to donate their organs.

According to the Mayo Clinic (11 April 2019) over 100,000 people in the U.S. are waiting for an organ transplant. Unfortunately, many may never get the call saying that a suitable donor organ — and a second chance at life — has been found. It's estimated that in the U.S. 20 patients die every day because of the lack of donor organs.

Yet it could be so different. In a 2014 study conducted in the U.K., researchers studied the organ-donation systems of 48 countries over 13 years and concluded that Spain, with an opt-out style of consent, had the highest rate of organ donation of the countries studied and represents a successful model to emulate.

Lesson: Just think of the lives that could be saved if government policy makers understood behavioural science and the concept of reducing effort for customers.


We have only limited capacity for focusing on and processing information and as you know, we are overloaded with information from all sorts of sources every day.

Therefore, we have developed strategies for separating pieces of information that are relevant and important to us from the rest. Some of these strategies can be very effective. One everyday example is the way we are able to notice our name being spoken, even if we are concentrating on something else and there is much background noise.

Our attention is limited and so we need new ways of attracting it to cut through the noise.  One way of doing this is to identify the messages that work best. For example, a study in the UK found that missed hospital appointments could be cut by a quarter if a reminder stated the specific cost of a missed appointment to the health system. This message reduced no-shows by 25%. The same cost message presented in general terms was less effective.

This kind of cost message can also attract the attention of health professionals. In another study where hospital clinicians were given the cost of a discretionary laboratory test, ordering levels were reduced by 32%.


People are strongly influenced by what others do – researchers call this adhering to ‘social norms’. Even telling people what others do in the same situation is effective. For, example, doctors prescribed antibiotics at a lower rate when told that most of their peers were doing this.

Another example outwith this report, from Yes – 50 secrets from the science of persuasion, concerns encouraging hotel guests to reuse their towels during their stay. Usually, this is an environmental message and as a result the majority of guests do actually recycle their towels at least some time during their stay.

In a study in which an alternative sign was used advising guests that most other guests at the hotel reused their towels (the social proof appeal) guests were 26% more likely than those who saw the basic environmental protection message to reuse their towels.

Lesson: Show or tell people that others are performing a ‘healthy’ behaviour.


People are more receptive to change at certain times and not so at other times. Typical examples are when undergoing significant events such as moving house, changing jobs, getting married or getting divorced. With health interventions they also mentioned religious or cultural holidays and the start of a new year.

As an example, a successful diabetes screening program in Qatar timed the intervention, which required fasting, to coincide with Ramadan when many people were fasting anyway. Similarly, Ramadan was found to be a particularly timely moment to ask Muslims to join a smoking cessation program in Singapore. Over 18 times as many Malay Muslims joined the program during Ramadan alone compared to any other month.

A large study from the US suggests that having major surgery doubles the likelihood of quitting smoking. Even minor operations increased stop smoking rates by 28%.

Lesson: Launch interventions at times when people are most receptive to change.

The report concludes by saying there are many opportunities to improve healthcare worldwide by applying behavioural insights and that many of these insights can be realised by applying simple tools to make practical changes.

The same holds true for understanding and positively influencing the customer experience. And it has great benefits for your happiness and the health of your business.

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Jurek Leon is a storyteller, speaker and trainer. Subscribe to Jurek's FREE monthly 'Terrific Tips' e-newsletter at Alternatively, email