The Illusion of Choice in Healthcare

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Blog by Joe Babaian

The illusion of choice is the greatest magic trick ever performed.

― Ziad K. Abdelnour

Free will and the meaning of choice have been a philosophical discussion since the beginning of spoken language. I’d like to focus on something a bit less esoteric – choice or the illusion of choice in healthcare. Far from me telling you that you really do or do not have a choice, let’s open the discussion to an evidence-based answer. All of you, #hcldr participants and readers, are great examples of what is real, right now and in your experiences. Nothing is more valuable than that.

In healthcare, the comparisons to consumer models are popular. We’ve discussed the similarities and differences, we’ve looked at how forced choices are not really choices at all. My #hcldr partner Colin Hung made a comment that sticks with me,

A forced consumer is not really a consumer.

This statement underlines the essence of this week’s topic and asks us, “Is choice an illusion in healthcare – and does the answer differ for certain populations?” Further, do we need full choice in a healthy healthcare system (suspend your disbelief here for a moment)? Are we content to settle for a less-than-ideal path but one that nevertheless provides an acceptable level of care?

Through the lens of the industrial age and its clear influence on our entire healthcare system, has the value of standardization gone too far – taking the human element out of healthcare? Perhaps we agree, one size doesn’t fit all even as our many clinicians and staff members operate in a system designed for standardization. The lessons on speed and efficiency are part and parcel of standard medical education. We’ve familiar with the famous quote by Henry Ford,

Any customer can have a car painted any color that he wants so long as it is black.

A great graphic from the consumer world drives home what the illusion of choice looks like for us. Just take a look and you’ll think twice the next time you buy one of these products. Not good or bad, just sobering.

Is it time to divorce healthcare from the 20th-century lessons and dogma on standardization?

Today, let’s share our experiences on choice in healthcare. With vastly improved #AI tools and exploding #DigitalHealth within reach, we need to assure these technologies enhance the ability of healthcare to be personal vs just another way of speeding things up.

Please join the #hcldr community of friends and peers as we work to make a difference, one idea and one action at a time. Join us on Tuesday, December 3, 2019 at 8:30pm Eastern (for your local time click here) as we discuss the following topics:

  • T1: How do you feel choice might be an illusion in healthcare? Why or why not? Examples?

  • T2: How can medicine be truly personal or will efficiency/standardization be primary?

  • T3: In what ways can technology be used to increase choice/access for underserved populations? What obstacles are found here? Examples?

  • T4: Beyond technology alone, what other things will increase choice and personalization in healthcare?

 

Resources for Further Study

Annas, Georges. “The Illusion of Choice in Patient Power.” Nature, vol. 390, no. 6656, Nov. 1997, pp. 133–34. http://www.nature.com, doi:10.1038/36487.

Bojalad, Alec. Black Mirror: Bandersnatch and the Illusion of Choice | Den of Geek. https://www.denofgeek.com/us/tv/black-mirror/278365/black-mirror-bandersnatch-and-the-illusion-of-choice. Accessed 3 Dec. 2019.

Desjardins, Jeff. “This Infographic Shows How Consumers Only Have ‘the Illusion of Choice.’” Business Insider, 23 July 2016, http://www.businessinsider.com/this-infographic-shows-how-consumers-only-have-the-illusion-of-choice-2016-7.

Dolanjski, Peter, and Steven Englehardt. “The Illusion of Choice and the Need for Default Privacy Protection.” The Mozilla Blog, https://blog.mozilla.org/blog/2019/10/22/the-illusion-of-choice-and-the-need-for-default-privacy-protection. Accessed 3 Dec. 2019.

Forrest, Sharita. How Might “Medicare for All” Reshape Health Care in the U.S.? https://news.illinois.edu/view/6367/801191. Accessed 3 Dec. 2019.

Frost, Dennis. “The Illusion of Choice and Decision Making in Dementia Care.” Criterion Conferences, 3 Dec. 2019, https://www.criterionconferences.com/blog/social-services/illusion-choice-decision-making-dementia-care/.

Lammers, Stephen E., and Allen Verhey, editors. On Moral Medicine: Theological Perspectives in Medical Ethics. 2 Sub edition, Wm. B. Eerdmans Publishing Co., 1998. https://books.google.com/

MacKinnon, Matthew. “Illusion of Choice: The Myth of Free Will.” Psychology Today, 28 Aug. 2016, https://www.psychologytoday.com/blog/neuraptitude/201608/illusion-choice-the-myth-free-will.

Macknik, Stephen L., Susana Martinez-Conde. “When Free Choice Is an Illusion.” Scientific American, 1 Jan. 2017, https://www.scientificamerican.com/article/when-free-choice-is-an-illusion/.

Seervai, Shanoor. How the U.S. Fails Women When It Comes to Health | Commonwealth Fund. doi:https://doi.org/10.26099/3n5h-m863. Accessed 3 Dec. 2019.

Vigo, Julian. The Technology Of Choice. https://www.forbes.com/sites/julianvigo/2019/02/12/the-technology-of-choice/#39525c7f3d57. Accessed 3 Dec. 2019.

Weber, Brenden. “Black Mirror Bandersnatch: The Illusion of Choice.” Medium, 21 Jan. 2019, https://medium.com/the-philosophers-stone/black-mirror-bandersnatch-the-illusion-of-choice-2c6c52ab2d7d.

Willis, Karen, and Kirsten Harley. “Private Health Insurance and the Illusion of Choice.” The Conversation, 6 Feb. 2013, http://theconversation.com/private-health-insurance-and-the-illusion-of-choice-10985.

 

Photo Credit: Photo by JOSHUA COLEMAN on Unsplash

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