Behavioral Science in Medical Affairs
I read medical affairs should be using behavioral science—are they?
In short—not nearly as much as they could be. Why? There isn’t a single explanation, but one is a lack of awareness or understanding or general organizational resistance to big, new ideas. Another possibility is preexisting perceptions or gut reactions. We sometimes hear “that’s too flashy” or “that looks promotional” in response to a streak of color on a KM curve or a reduction of text on a PowerPoint slide to less than 500 words. In reality, good design is rooted in behavioral science, not marketing wizardry or mental trickery. At the 2020 MAPS meeting, I was amazed by the number of medical affairs professionals who seemed resigned to having unsightly, overcrowded, and convoluted presentations, thinking that any improvement would be a burdensome investment. And perhaps a more provocative explanation is that those of us who spent years elucidating molecular or cellular behavior in the “hard” sciences do not have an understanding or appreciation for the scientific rigor of the “soft” sciences like psychology, sociology, and anthropology that study behavior at a macro scale.
But here’s the good news! Advances in technology (artificial intelligence, among many others) are making behavioral science increasingly quantitative, analytical, tangible, and actionable. Additionally, there seems to be a growing social acceptance of things like mindfulness meditation and cognitive behavioral therapy. The combination of these things is creating momentum, and I’ve been encouraged by the open-mindedness of more and more medical affairs professionals to questioning status quo. It does not need to be expensive or time-consuming, and you do not need to start a revolution.
One more thing: scientists, clinicians, educators, executives, payers, and patients are all still human. There is tremendous value—beyond pharma—in just a little more understanding of what makes us think, feel, and do the things that we do.
Has digital helped advance the use of behavioral science and why?
Technology is rapidly advancing our understanding and use of behavioral science. Traditionally, physicians became experts on a surgery type or delivered a difficult diagnosis to a patient based on what’s worked previously—a trial and error approach applied to a real-life patient. Educational simulations have changed the game. With simulations, physicians can practice surgical procedures, make circumstance-based adjustments to their emotional intelligence, or read a new type of diagnostic tool.
In other words, physicians can test different approaches in a safe environment. We all form habits and cognitive biases to simplify our complex lives. Technology backed by behavioral science will allow physicians to overcome those habits and biases for the betterment of patient care. Think of Malcolm Gladwell’s 10,000-hour rule. You no longer need 10,000 actual patient hours to master a skill. With simulations, physicians can now master life-saving skills before they even approach a patient.
What sort of digital tools are being used to change behavior among patients and physicians?
There are several digital tools available which offer immediate feedback to change physician and patient behaviors. From simple educational, knowledge-sharing platforms, to gamification of simple tasks for continuous quizzing, to more experiential tools like virtual and mixed reality.
Sharing knowledge is foundational for behavior change and providing a simple tool that people can use on their own time is key.
To supplement increasing knowledge during an activity, sending a series of questions to spur contemplation is a powerful tool for creating behavior change. However, breaking habits or biases is challenging and requires a mix of several tools.
For example, mixed or augmented reality devices can simulate those complex real-world experiences where healthcare providers have formed those biases and habits and provide ways to break them. Through well-designed story lines, experiential reality can provide alternative choices for healthcare providers to try various approaches to understand the results. This can then be supplemented by a questionnaire or a knowledge-sharing platform. Ultimately, changing behaviors requires a mix of tool types to create lasting change.