#5 Habit EngineeringSM: The New Paradigm in Market Research

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For the past year, the innovation team at ThinkGen has been developing a new paradigm in health care marketing and marketing research called Habit EngineeringSM. Essentially, Habit EngineeringSM is an innovative way to promote customer behavior change through a deeper understanding of customer habits, and a thoughtful and clever leveraging of those habits to accomplish the objectives of the brand. ThinkGen researchers have successfully conducted multiple studies that incorporate the principles of Habit EngineeringSM. The fundamental insight behind Habit EngineeringSM is that health care customers’ behaviors (both professionals and consumers) are driven considerably by habit separate from conscious, effortful decision-making. A habit is a behavior that is repeated without the need for conscious thought. People develop habits in all spheres of their lives in order to be efficient: once they have solved a specific problem or task that repeats, human brains are programmed to delegate that task to unconscious habits—essentially putting the behavior on auto-pilot. In medical practice, once a doctor has seen a certain type of patient many times, elements of her diagnostic and treatment behavior oftentimes become habitual. In comparison to Eyal’s Hook model and Duhigg’s habit loop, which we wrote about previously, ThinkGen’s Dr. Neale Martin’s research has shown that all habits are formed within a specific context. A context can be a specific mindset or milieu that initiates an automatic behavior. In the medical world, a context can be a type of medical practice setting or a certain way of naturally categorizing the patients they see. For example, health care providers may exhibit different treatment habits for patients they see in a private practice vs. a public clinic.   Within that context, the habitual behavior is triggered by certain stimuli, called ‘cues.’ For an HCP, examples of cues include a patient complaint, symptom presentation, or a lab value that triggers them to do a certain behavior. That behavior is often performed based upon a belief system, which we refer to as ‘behavioral beliefs.’ A behavioral belief is a mental model of how something works. In medicine a behavioral belief might be a perception of the natural history of a disease, or the mechanism of action of a medication, and how it works on a specific target. Behavioral beliefs are a unique facet of Habit EngineeringSM and critical to effective health care marketing. Healthcare consumers interpret treatment results by their feedback, usually based on a reduction of symptoms and side effects, but also other factors like insurance reimbursement. Feedback can be favorable or unfavorable. For example, if the pain is alleviated quickly, the patients gets a positive feedback loop. But some drugs treat asymptomatic diseases, and this is where behavior beliefs come in. There is no positive reinforcement because there is no pain to be alleviated. On the contrary, the patient is likely only to receive punishing feedback. Only if the patient believes in the treatment, or in the doctor, is adherence likely to occur. Reinforcing feedback for the doctor is often no feedback at all. If the doctor doesn’t hear back from the patient, he assumes the treatment was effective. (In a later Ha-bit, we’ll go into greater detail on Feedback.) The more times an HCP goes through these steps, the more likely a habit is to form, and the greater the doctor’s investment. Other behaviors that increase investment include doing independent research that supports the treatment, recommending this solution to other doctors, as well as patients, and potentially buying equipment to administer the treatment. The level of investment is a measure of inertia and mental justification that must be overcome to change current behavior. Most new product introductions fail because they cannot overcome the level of existing habitual investment. We would argue that unpacking these fundamental elements involved in the formation and perpetuation of a habit – whether it in understanding an existing habit, or striving to create a new habit – is critical for pharmaceutical marketers who desire to succeed. We would argue further that not understanding the pervasiveness of habits that exist in a given market (even a ‘drug-less market’), and the origins and strength of those habits, make failure almost inevitable.  

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