Don’t freak out, but your doctor is irrational*

If you’ve been following the work of Common Cause for a while, you’ll be well aware that human beings are not completely rational. Instead, most of the time, we form beliefs and make decisions based on a range of subconscious cues and short-cuts. This includes our values.

But what about evidence-based professionals – people like scientists, judges and doctors? These people pride themselves on following the evidence in the way they work. Surely these professionals don’t let values and emotions get the way of “the truth”?

I’m afraid they do. They just don’t realise it.

Take doctors, for example. People who literally make life and death decisions on a daily basis. As comforting as it might be to believe your doctor is only ever making decisions about your health based on the best available evidence, the reality is these people are human beings too.

Like all humans, most of their cognition happens below the level of conscious awareness, which means it’s inaccessible to conscious reasoning. As much as doctors might try to be rational most of the time, they can’t help but be influenced by subconscious influences – including their values.

How do I know this? Because we tested it.

In a recent research project for Quit Victoria, we were tasked with finding out how to motivate more GPs and pharmacists to provide best practice cessation care to their patients who smoke.

To explore this topic, we ran focus groups with around 100 GPs and pharmacists across Australia and an online message testing survey with over 1,000 medical professionals (split evenly between GPs and pharmacists).

Our research showed that while almost all GPs believed smoking was a clinical priority, a large portion do not follow best practice cessation care clinical guidelines most of the time. In fact, only a small minority of GPs followed the guidelines consistently.

So we asked the obvious question: what are the key differences between those who follow the guidelines most of the time and those who do not?

Sure enough, one of the key difference was their personal values.

Those most likely to follow best practice cessation care guidelines were also most likely to prioritise self-transcending values including helpfulness, responsibility, equality and social justice. Meanwhile, those least likely to engage in best practice cessation care were the most likely to prioritise an oppositional set of self-enhancement values that includes ambition, success, authority and wealth.

These correlations mirror those of other values studies around the world that consistently find self-transcending values to be associated with more cooperative and helpful attitudes and behaviours while self-enhancement values are associated with more individualistic, antagonistic, and competitive attitudes and behaviours.

In the case of smoking cessation care, this may explain why health professionals least likely to follow current guidelines were more likely to blame patients and their lack of motivation for their failure to quit rather than external factors such as lack of support from healthcare professionals.

Further, our research showed that when it comes to building support for best practice cessation care among health professionals, the messages that worked best were those based on self-transcending values. In some cases, these messages helped more than double the percentage of health professionals intending to engage in best practice care.

The question isn’t, therefore, whether experts like medical professionals are as influenced by values as the rest of us, but how best do we use values in our messaging to influence them in helpful ways.

For more on our research, check out the Framing Cessation Care message guide.

*Okay, that might be over-selling it. Another way to put it, is that doctors are just as influenced by their personal values as the rest of us. But that wouldn’t be a punchy headline :-)