Saturday, November 10, 2007

decision heuristics and power of the media

I heard a great comment on NPR this morning by host Scott Simon. He was discussing former Illinois Governor George Ryan, who has many good and bad events in his history. He was nominated for a Nobel Prize for his suspension of the death penalty in his state because of uncertainties and unfairness in how it was applied. He also was the manager of a corrupt government that accepted bribes, one of which led to a horrible accident where several children were killed.

What makes this story relevant to human factors is that Scott Simon remarked that if you tell the story beginning from the traffic accident, Ryan comes across as a terrible person. Listeners may cynically discount the death penalty suspension as an attempt by Ryan to make friends in the prison system, knowing that he may end up there soon. On the other hand, if you tell the story beginning from the Nobel Prize nomination, listeners may sadly wonder how a principled man could be tempted by the power and influence of politics.

It is amazing how much power the media has in the way it presents stories. A little bit of knowledge about anchoring bias, confirmation bias, representativeness bias, and others can make a newspaper or TV news editor incredibly influential. You could craft a series of stories, without doing anything deceptive, unethical, or improper, that significantly skew public opinion one way or the other.

And it can be done so subtly that no one would really know the difference. It would not be like Chavez, Putin or Musharraf intimidating the opposition media.

Friday, November 09, 2007

direct to consumer ads for medicine

There was a paper in this year's Human Factors Conference that got me thinking. The results of the research described are not new, but they cited some past work that always gets me so frustrated by regulatory cluelessness. DTC ads for prescription drugs are required to include both the benefits and the risks. But the regs don't show any knowledge of HF by the regulators. We all have seen or heard the ads where the benefits are promoted in 90% of the ad with smiling faces, well designed graphics, etc. And then the risks are in small print on the bottom or in 1 second of babbling audio. What a waste of an important regulation.

In order to make good health care decisions - and reduce the tremendous cost of health care, we need to be able to make intelligent decisions about our care. Or at the very least, please don't make it worse by encouraging patients to march into their doctors offices demanding the latest name brand drug that is 100 times the cost of the generic but only 1% more effective (or not even that).

This study found that only 5% of people reported that their doctors turned down the request. Doctors would rather give the patient what he/she wants, avoid the conflict, and make the drug rep happy (after getting some sweet perks).

And who cares - its the insurance company that pays the tab. Except that when our policy premiums go up at double the rate of inflation, we wonder why. Duh !!