By Aline Holzwarth
I recently had a friction-filled experience when I tried to make an appointment for a routine physical exam. It’s been a while since I’ve had my annual exam, as my previous doctor moved away in 2015 and I haven’t gotten it together enough to find a new primary care physician. (I know! Shame on me.) Finally I had a few extra hours this past weekend, and instead of using them to catch up on email I decided to take care of my preventive health needs.
So I launched myself into the research stage. I downloaded an app (very popular, highly rated, I’m sure you’ve heard of it) that provided me with information that could only be completely inaccurate (locating no doctors within 20 miles or so, despite the fact that I live in an area densely packed with medical care).
I turned to google to ask how to find a doctor, which pulled up a nifty “Find a Doctor” page. But with every answer came a new question, and I quickly found myself flooded with a deluge of information to compare but no great way to compare it. I resisted making a spreadsheet and instead opened up browser tabs for the eligible doctors, starting with 39 physicians and ultimately narrowing down to only three. To narrow my search down to three, I had to figure out where the various doctor’s offices are and how close they are to my work and home, whether their hours accommodate a 9-to-5 working schedule with night and weekend availability (none do), whether they take my insurance (surprisingly difficult to confirm), whether the cost is any different to go to a family medicine center near my house (I’m still not entirely sure), what the difference is between internal and family medicine (not much, I think?), and which physician is best for my particular needs.
By the time I had narrowed my options down to three doctors, I was exhausted and ready to quit. So I watched the short videos taken of each physician and chose the one who mentioned her collaborative problem-solving approach with patients. But mostly, she seemed nice. Note: Sometime in the future we should talk about System 1 decision-making.
Ready to get this over with and return to my weekend chores, I moved on to the action stage. Now all I had to do was make an appointment with my chosen physician. New questions arrived: First, of course, How do I make an appointment? Can I do it online immediately, or do I have to call someone? If I have to call someone, can I do it right now (remember, it’s the weekend) or do I have to wait until a weekday during work hours?
After hours spent researching physicians and finding the answers to my questions, I still didn’t have an appointment. I was left with the option to send a message requesting an appointment (no, I was not able to schedule online) or call in later when the office is open (I know myself well enough to not rely on that — after all, it did take me four years to put any effort into finding a new primary care doctor.)
Now here I am, hoping that someone will see my appointment request and reach out to me. It might not be hyperbole to say that if I don’t get a scheduling call or email, I might never go to the doctor again.
All this is to say that small barriers are a BIG deal. One tiny little step can be *the step* that prevents someone from achieving their desired health behavior. Even something as small as mental effort (deciding, what kind of doctor do I want?), or something that needs to be looked up (I have to input my health insurance number? I guess I’ll have to find my card), or too many fields in a form (I have to enter my address AGAIN?) — all these steps are friction, and they each decrease the chance that you’ll find a doctor.
Small barriers are a BIG deal. One tiny little step can be *the step* that prevents someone from achieving their desired health behavior.
These are exactly the kinds of barriers we’re talking about in the Friction and Fuel Framework (which you can read a bit about here, and download below).
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About the author
Aline HolzwarthHead of Behavioral Science
Aline Holzwarth is an applied behavioral scientist, primarily focusing on digital health research and scientifically informed product design. She is Head of Behavioral Science at Pattern Health, an evidence-based connected care platform that leverages behavioral science to help patients stick to their care plans. She also co-founded the Behavior Shop, a behavioral science advisory company, and holds an appointment as Principal of the Center for Advanced Hindsight at Duke University, an applied behavioral science lab that helps people be happier, healthier and wealthier, at home and abroad.