Lately I have heard from several friends that they have stopped watching the mainstream news.  When pressed to explain, the primary reason stemmed from an overwhelming sense of anxiety the stories would create.  Few wanted to think about the likelihood they might be caught in a shooting or in an approach toward economic depression, so they opted to deprive themselves of that source in order to preserve their peace of mind.  According to Daniel Kahneman, author of the bestselling novel “Thinking, Fast and Slow”, my friends exhibit a common social behavior called anchoring.  By ‘anchoring’ to certain ideas, it is possible to alter the perception of its probability.  Feeling overwhelmed by news of tragedy has likely exacerbated their anxiety and made a statistical improbability more threatening in their immediate perception.  

At the Center for Health Innovation and Implementation Science, we include this literature as necessary reading for those within our Graduate Certificate Program.  Not only does it provide a fascinating exploration into behavioral economics, but also its lessons can lead a medical professional to better understanding of both themselves and their patients. Turning the lens on ourselves allows us to use this book to examine motivations behind decisions and the economy of how a decision executes within a medical environment.  By examining the titular concept of the book, thinking fast and slow, we are faced with the reality that the majority of our daily decisions are motivated by emotion. 

System 1 thinking, or fast thinking, tends to our most common instinct.  Using what we have experienced before as framing references, we fall into similar decisions as we have made in the past that have netted success.  Primarily, we use System 1 thinking to understand simple sentences, localize the source of a specific sound, or solve simple equations.  These are nearly automatic deductions we make almost constantly.  Unfortunately, System 1 thinking usually does not have a quality check step and can lead to biases and mistakes.  Conversely, System 2 thinking is a slower and more deliberate behavior.  This kind of thinking takes more of our attention and cognitive resources, but it often benefits from the wealth of our experiences and knowledge.  Some examples of when System 2 thinking is in play includes digging into your memory to identify a sound or sight, determining the appropriateness of a particular behavior in a social setting, determining the validity of a complex logical reasoning, or even navigating a tight parking space.  When we slow ourselves down to exercise our System 2 thinking (slow thoughts), often we can navigate difficult problems or spot flaws in previous logic. 

Within a healthcare setting, awareness of which system is in use can be essential in determining the quality of care for each patient.  Not only should a medical professional check their assumptions with more deliberate reasoning to ensure quality diagnosis and treatment, but understanding key concepts, such as anchoring, allows an interface with their patient to be more rewarding for both sides.  By taking care to frame treatment options and difficult news in deliberate language, a patient may be spared some of their anxiety and allow them to make informed System 2 decisions to affect their ongoing health.

The concepts in “Thinking Fast and Slow” form one of the cornerstones in Agile Implementation.  Our methodology depends on taking evidence-based solutions and analyzing the impact of each new implementation and change in an expected policy transformation.  Only by firmly understanding our own behaviors and those of the people directly affected by change can we ensure efficient and lasting implementation efforts at all levels of a healthcare environment.  In addition, with practice and awareness, we can take control of our perceptions and truly choose how new information influences us.  We welcome you to stop by our website, http://www.hii.iu.edu/ , to examine our success stories and Agile methodology for yourself.  Our trained Agile agents stand ready to assist in your healthcare goals and are prepared to leverage a thorough understanding of the behavioral economics discussed and much more to ensure a successful implementation and transformation.