Daniel Kahneman’s book, Thinking, Fast and Slow, has been sitting on my shelf for a year. I have started reading it three times and just can’t get into it.
John Lumpkin to the rescue! His engaging 15-minute talk places Kahneman’s essential points in the context of his experience as a clinician and as an observer of our current health care landscape:
Lumpkin’s call for “personalized health” to help people make decisions based on what is important to them, in the current context of their lives, resonates with what E-patient Dave wrote in a comment earlier this year connecting behavioral economics to health care culture change. Essentially: we need to stay based in reality, fight naiveté, and respect different ways of thinking.
On Friday I’m going to be talking about sharing data and decisions for health with Sally Okun, Francisco Grajales, and Amy Abernethy (if you don’t know them, click and be envious). I’ll share the latest findings about the reality of health data collection in the U.S. and I’ll be listening for more examples of how we can harness the power of thinking, fast and slow, about health care.
Ideas welcome on any of the above, particularly if you have tips for which sections of Kahneman’s book I really should read.
Dear Suzannah,
Your post reminded me that in June, following that same comment of e-Patient Dave, I had bought Kahneman’s book together with that of Eric Topol and Siddartha Muckerzee and while I have almost finished (except the last 50-60 pages) S. Muckerzee, I only had a look during the return flight on the other two…
Thanks for reminding me about interesting books during the holidays
Yes! The Emperor of All Maladies was another landmark book, well worth the investment of time to read it. It was the first one I read on my ipad, so I didn’t have a sense of its heft until I was about 2 weeks in and at only 30% of it read.
Lest anyone think I’m a lazy reader, I am going to post a list of my favorite books of the year, in case you are looking for holiday gifts for health geeks. Three to start:
Brain on Fire, by Susannah Cahalan (a first-person medical mystery)
On Purpose, by Vic Strecher (a graphic novel that will make you a better, more grounded person)
Far From The Tree, by Andrew Solomon (a tour de force, each chapter could stand on its own)
You WOULD post this on short notice when I’m out of town all week, away from my copy of the book!
Actually I “read” it in audio. Maybe I can find the many notes I added in Audible.com. I was severely hampered though by the fact that most of my “reading” was while driving, which is not conducive to note taking. I want a reader app where I can just swat the phone and dictate a note that gets speech-to-texted.
Honestly I thought there were so many mind-pops in this book that it could have been a series of at least 3, perhaps 5, books – even richer and deeper than Emperor of All Maladies, which is so profound it stopped my thinking for a year. There’s SO much more to behavior change data than I ever would have imagined … for instance did you know he and his partner Amos managed to *quantify* the additional value of that last unit of certainty …. the distortion of the value curve from “0%” to “1%” to “5%” …. “99%” “100%”?
You may also recall my post on just one tiny aspect – the stunning and unstoppable power of illusions. (The post has an animated PPT I made that illustrates the point.)
That passage in the book gave me probably the biggest “OMG” epiphany in a decade – even if you now it’s an illusion, you can’t stop seeing it. (In the book he talked about how even when psychology grad students were taught about a gambling illusion, they persisted in choosing wrong.)
That DESTROYS the superstition we so often see, that the way to pop an illusion is to educate people. That ties into my book’s chapter “Information alone doesn’t change behavior.” To you and me that’s obvious, but I see so many people trying to solve behavior with facts … and complaining about stupid non-compliant patients when it doesn’t work.
And those are just two isolated points.
Enough – gotta run –
Okay, this one wins the internet today – the BEST example of an illusion that you still see even when you know it’s an illusion.
http://distractify.com/fun/amazing-t-rex-optical-illusion/
Fantastic!
An amateur video of a similar illusion:
http://www.youtube.com/watch?v=7hLPhdjj0Uo
My eye is tricked every time I visit this sculpture!
Further to my previous comment – I’m at a Robert Wood Johnson conference on giving health consumers better info on quality and price, to help them choose. The following tweet was deemed worth, well, tweeting:
“J. Greene research found #patients made better decisions when given fewer quality measures & less description #hctransparency”
That’s no news at all to students of behavioral economics, and it was hammered home by Kahnemann with study after study.
I’m starting to think that if most of healthcare’s problems boil down to bad decisions, then the people trying to fix them better study up on how people actually make decisions.
(A hoot of a sidebar to the book, btw, is that the guy wants a Nobel, and there ain’t no Nobel in behavioral psychology, so he rebranded it behavior economics.)
Dave, you, writing with your left pinky on your phone while walking down the street holding an umbrella and pulling a wheelie bag, share more insight than most of us do when in a quiet room, typing on a keyboard. Thank you!
Well, I guess I’ll just say “I’m glad you feel that way.” 🙂
(And I wish I could go back and edit my typos in my comments… even though it wasn’t one-pinkie typing!)
holidays with family is great time to read, the case examples happen right before your eyes! i remember our conversation about the book over a year ago.
i use the “plausible vs probable” almost daily, wrote about it here: http://opensource.com/health/12/4/part-iii-moneyball-medicine-narratives-probabilities-and-making-better-medical-decisions
also, just the idea of the mental contexts we inhabit is so powerful, and these context ultimately are the basis for how decisions get made.
http://www.hl7standards.com/blog/2013/03/22/rise-of-contextual-medicine/
An update: I’m reading the book, thanks to all the encouragement here and on Twitter. Thank you!!
Just keep smiling! The world will become happier.
Good timing. I’m entering the same “laboratory” here in Brazil, be sure to send tweet reminders on how to use these priceless behavioral lessons…
Update: the paper that Sally Okun and Cisco Grajales presented at the IOM has now been published:
Social Networking Sites and the Continuously Learning Health System: A Survey
At the event, Okun & Grajales handled questions about the methods and question wording very well. I admit that I’m always a little hesitant about survey results in the 94% range but the authors point out that the most intriguing findings are below that headline number — such as PLM’s members being more tuned to helping drug makers rather than public health surveillance officials.
Here’s a nice write-up by Ken Terry of InformationWeek:
What Patients Will Share To Improve Care
Thanks! Very helpful for an eBook I’m working on…