Cognitive bias and how it affects decision-making.

Destry Sulkes

Chief Experience Officer, Wunderman Health

Behavioral economics is enjoying a major upsurge in interest, especially in the health community. You may have heard of books like Thinking, Fast & Slow, Nudge, Predictably Irrational, Blink or The Power of Habit. These all address a relatively new branch of economics founded on a startling human insight. While traditional economic theory predicts that each of us knows how to always choose what is best for our self-interest, when observing the decisions people actually make, there are many instances in which people make decisions that appear irrational.

For example, when one cohort of people were told they had a 90% chance of living after a surgical procedure, nearly 75% agreed to go forward with it, yet when a similar cohort were told they had a 10% chance of dying after the same procedure, only 50% agreed to go forward. If we were completely rational, our responses wouldn’t change based on the manner in which the information is presented. Of course, advertisers have known this truth since the beginning of advertising, yet only recently has the issue been studied in depth and named “cognitive bias.”

While you probably have heard of the books above, you probably have not heard of a 2013 article in the New England Journal of Medicine entitled “From Mindless to Mindful Practice— Cognitive Bias and Clinical Decision Making.” Though there is more and more data showing that 10%–15% of all diagnoses are inaccurate and have a negative impact on millions of patients every year, the medical profession has been quite resistant to admit that doctors experience cognitive bias just like everyone else. However, the topic is getting more and more interest lately, in parallel with the general decline of trust in authority and the specific decline of trust in doctors.



Most physician-led studies take the tone of paternalism and cast doubt on the concept that doctors could be cognitively biased. There are many academic leaders who are on record stating that healthcare professionals with many years of undergraduate, graduate and post-graduate medical training, plus an unwavering dedication to patient well-being, could suffer from the same bias witnessed in the general population.

Similarly, healthcare marketers typically feel the same way, i.e., that doctors always act rationally and would only rarely experience any type of cognitive bias, and certainly not in a manner that could harm patients. Thus, traditional marketing efforts toward doctors focus on clinical trials, peer-reviewed society guidelines and patient outcomes, and largely ignore approaching doctors as if they’re people too. In contrast, consumer packaged goods marketers have long leaned in to exploring all types of cognitive biases and leveraged them successfully to convince people to buy branded products over identical generic products.

In conclusion, there are two important trends to address this year. First is for doctors to learn about their cognitive biases and explore methods to uncover them and put processes in place to help decrease the chances that these natural human tendencies can impact their patients. Second is for healthcare marketers to revamp their approach to market research and the insights they’re trying to find. Moving on from doctors’ stated approaches to diagnosis and treatment to observing doctors’ actual behaviors in different clinical scenarios will yield radically new methods for how to approach them and help them improve their decision-making and improve patient care.