Why Don’t You Eat Your Vegetables? Behavioral Economics and Communication in Healthcare


I do not like broccoli. And I haven’t liked it since I was a little kid and my mother made me eat it. And I’m President of the United States, and I’m not going to eat any more broccoli!

–George H. W. Bush, 41st President of the United States


Deep down, I bet George knew that broccoli was good for him. Just the same, there was no way was he going to eat it. On some level, this attitude reflects the nature of healthcare—it’s a negative good. We know things are good for us, but we’re still not going to (watch our weight, take our pills, exercise, go for routine checkups… Enter your personal healthcare gripe here). In part, we’re in denial of our own morbidity and mortality. Other people get sick and have accidents, but not me. Therefore, healthcare is a negative good: Something no one wants to buy, but that everyone knows that they should. Just like broccoli.


I’m interested in how behavioral economics and communication can solve our healthcare crisis instead of America’s go-to solution—technology. (New drug! New device! New surgery!) For those of you unfamiliar with behavioral economics, there have been 2 Nobel prizes given for research in the space (Richard Thaler in 2017 and Daniel Kahneman in 2002). In short, behavioral economics is the study of rational irrationality; that is, why we make decisions that make no sense on the surface, but upon further analysis, reflect either trend in our past decisions or, alternatively, how questions are framed. As doctors, we often refer to this as experience or the “art of medicine.” Behavioral economics offers a framework to study these relationships.


This affects provider-to-patient interactions, as well as provider-to-provider communications. In each case, when we don’t appreciate the other person’s position or logic, our value is eroded. You can be the smartest doctor in the world, but if you lack the ability to convince your patients to trust you and to follow your advice, you’re worthless.


I’ll be talking to people from the healthcare system and from other industries to determine better ways to communicate; ways that might get us to the ultimate goal—better, less expensive healthcare where we all feel validated. I’m not saying you’ll rush out and buy broccoli, but I’m a pragmatist. Convincing the masses to eat broccoli is probably a more attainable goal than healthcare reform.

Reader Interactions


    • Hi Mike- I did read the Undoing Project- you might recall I gave you a copy as a gift. There is another book on the topic I’ve been reading more specific to healthcare, Irrationality in Healthcare by Doug Hough. Overall, this topic is gaining momentum- and frankly speaks to a core value proposition for telehealth- bringing people together, particularly for more meaningful conversation, can reduce the cost of care

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