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Nudge: Improving Decisions About Health, Wealth and Happiness [Format Kindle]

Cass R Sunstein , Richard H Thaler
3.5 étoiles sur 5  Voir tous les commentaires (4 commentaires client)

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Amazon.com



Questions for Richard Thaler and Cass Sunstein

Amazon.com: What do you mean by "nudge" and why do people sometimes need to be nudged?

Thaler and Sunstein: By a nudge we mean anything that influences our choices. A school cafeteria might try to nudge kids toward good diets by putting the healthiest foods at front. We think that it's time for institutions, including government, to become much more user-friendly by enlisting the science of choice to make life easier for people and by gentling nudging them in directions that will make their lives better.

Amazon.com: What are some of the situations where nudges can make a difference?

Thaler and Sunstein: Well, to name just a few: better investments for everyone, more savings for retirement, less obesity, more charitable giving, a cleaner planet, and an improved educational system. We could easily make people both wealthier and healthier by devising friendlier choice environments, or architectures.

Amazon.com: Can you describe a nudge that is now being used successfully?

Thaler and Sunstein: One example is the Save More Tomorrow program. Firms offer employees who are not saving very much the option of joining a program in which their saving rates are automatically increased whenever the employee gets a raise. This plan has more than tripled saving rates in some firms, and is now offered by thousands of employers.

Amazon.com: What is "choice architecture" and how does it affect the average person's daily life?

Thaler and Sunstein: Choice architecture is the context in which you make your choice. Suppose you go into a cafeteria. What do you see first, the salad bar or the burger and fries stand? Where's the chocolate cake? Where's the fruit? These features influence what you will choose to eat, so the person who decides how to display the food is the choice architect of the cafeteria. All of our choices are similarly influenced by choice architects. The architecture includes rules deciding what happens if you do nothing; what's said and what isn't said; what you see and what you don't. Doctors, employers, credit card companies, banks, and even parents are choice architects.

We show that by carefully designing the choice architecture, we can make dramatic improvements in the decisions people make, without forcing anyone to do anything. For example, we can help people save more and invest better in their retirement plans, make better choices when picking a mortgage, save on their utility bills, and improve the environment simultaneously. Good choice architecture can even improve the process of getting a divorce--or (a happier thought) getting married in the first place!

Amazon.com: You are very adamant about allowing people to have choice, even though they may make bad ones. But if we know what's best for people, why just nudge? Why not push and shove?

Thaler and Sunstein: Those who are in position to shape our decisions can overreach or make mistakes, and freedom of choice is a safeguard to that. One of our goals in writing this book is to show that it is possible to help people make better choices and retain or even expand freedom. If people have their own ideas about what to eat and drink, and how to invest their money, they should be allowed to do so.

Amazon.com: You point out that most people spend more time picking out a new TV or audio device than they do choosing their health plan or retirement investment strategy? Why do most people go into what you describe as "auto-pilot mode" even when it comes to making important long-term decisions?

Thaler and Sunstein: There are three factors at work. First, people procrastinate, especially when a decision is hard. And having too many choices can create an information overload. Research shows that in many situations people will just delay making a choice altogether if they can (say by not joining their 401(k) plan), or will just take the easy way out by selecting the default option, or the one that is being suggested by a pushy salesman.

Second, our world has gotten a lot more complicated. Thirty years ago most mortgages were of the 30-year fixed-rate variety making them easy to compare. Now mortgages come in dozens of varieties, and even finance professors can have trouble figuring out which one is best. Since the cost of figuring out which one is best is so hard, an unscrupulous mortgage broker can easily push unsophisticated borrowers into taking a bad deal.

Third, although one might think that high stakes would make people pay more attention, instead it can just make people tense. In such situations some people react by curling into a ball and thinking, well, err, I'll do something else instead, like stare at the television or think about baseball. So, much of our lives is lived on auto-pilot, just because weighing complicated decisions is not so easy, and sometimes not so fun. Nudges can help ensure that even when we're on auto-pilot, or unwilling to make a hard choice, the deck is stacked in our favor.

Amazon.com: Are we humans just poorly adapted for making sound judgments in an increasingly fast-paced and complex world? What can we do to position ourselves better?

Thaler and Sunstein: The human brain is amazing, but it evolved for specific purposes, such as avoiding predators and finding food. Those purposes do not include choosing good credit card plans, reducing harmful pollution, avoiding fatty foods, and planning for a decade or so from now. Fortunately, a few nudges can help a lot. A few small hints: Sign up for automatic payment plans so you don’t pay late fees. Stop using your credit cards until you can pay them off on time every month. Make sure you're enrolled in a 401(k) plan. A final hint: Read Nudge.




Review
"How often do you read a book that is both important and amusing, both practical and deep? This gem of a book presents the best idea that has come out of behavioral economics. It is a must-read for anyone who wants to see both our minds and our society working better. It will improve your decisions and it will make the world a better place."-Daniel Kahneman, Princeton University, Nobel Laureate in Economics (Daniel Kahneman )

"In this utterly brilliant book, Thaler and Sunstein teach us how to steer people toward better health, sounder investments, and cleaner environments without depriving them of their inalienable right to make a mess of things if they want to. The inventor of behavioral economics and one of the nation''s best legal minds have produced the manifesto for a revolution in practice and policy. Nudge won''t nudge you-it will knock you off your feet."-Daniel Gilbert, professor of psychology, Harvard University, Author of Stumbling on Happiness (Daniel Gilbert )

"This is an engaging, informative, and thoroughly delightful book. Thaler and Sunstein provide important lessons for structuring social policies so that people still have complete choice over their own actions, but are gently nudged to do what is in their own best interests. Well done."-Don Norman, Northwestern University, Author of The Design of Everyday Things and The Design of Future Things (Don Norman )

"This book is terrific. It will change the way you think, not only about the world around you and some of its bigger problems, but also about yourself."-Michael Lewis, author of The Blind Side: Evolution of a Game and Liar''s Poker (Michael Lewis )

"Two University of Chicago professors sketch a new approach to public policy that takes into account the odd realities of human behavior, like the deep and unthinking tendency to conform. Even in areas-like energy consumption-where conformity is irrelevant. Thaler has documented the ways people act illogically."-Barbara Kiviat, Time (Barbara Kiviat Time )

"Richard Thaler and Cass Sunstein''s Nudge is a wonderful book: more fun than any important book has a right to be-and yet it is truly both."-Roger Lowenstein, author of When Genius Failed (Roger Lowenstein )

"A manifesto for using the recent behavioral research to help people, as well as government agencies, companies and charities, make better decisions."-David Leonhardt, The New York Times Magazine (David Leonhardt The New York Times Magazine )

"I love this book. It is one of the few books I''ve read recently that fundamentally changes the way I think about the world. Just as surprising, it is fun to read, drawing on examples as far afield as urinals, 401(k) plans, organ donations, and marriage. Academics aren''t supposed to be able to write this well."-Steven Levitt, Alvin Baum Professor of Economics, University of Chicago Graduate School of Business and co-author of Freakonomics: A Rogue Economist Explores the Hidden Side of Everything (Steven Levitt )

Extrait

Common "Nudges"

  1. The design of menus gets you to eat (and spend) more. For example, lining up all prices on either side of the menu leads many consumers to simply pick the cheapest item. On the other hand, discretely listing prices at the end of food descriptions lets people read about the appetizing options first…; and then see prices.
  2. "Flies" in urinals improve, well, aim. When Amsterdam's Schiphol Airport was faced with the not uncommon issue of dirty urinals, they chose a unique solution: by painting "flies" in the (center of) commodes, men obligingly aimed at the insects, reducing spillage by 80 percent.
  3. Credit card minimum payments affect repayment schedules. Among those who only partially pay off credit card balances each month, the repayment level is correlated with the card's minimum payment — in other words, the lower the minimum payment, the longer it takes a consumer to pay off the card balance.
  4. Automatic savings programs increase savings rate. All over the country, companies are adopting the Save More Tomorrow program: firms offer employees who are not saving very much the option of joining a program in which their saving rates are automatically increased whenever they get a raise. This plan has more than tripled saving rates in some firms, and is now offered by thousands of employers.
  5. "Defaults" can improve rates of organ donation. In the United States, about one–third of citizens have signed organ donor cards. Compare this to Austria, where 99 percent of people are potential organ donors. One obvious difference? Americans must explicitly consent to become organ donors (by signing forms, for example) while Austrians must opt out if they do not want to be organ donors.

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3.5 étoiles sur 5
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1 internautes sur 1 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 Full of illuminating examples 29 juillet 2011
Format:Broché|Achat vérifié
I really loved that book. Every scholar interested in Economics and Social Psychology should read it, for they will certainly find examples that speek to them.
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3.0 étoiles sur 5 Intéressant mais un peu long 5 février 2014
Par Tol
Format:Broché|Achat vérifié
Les idées de l'auteur sur le "paternalisme libertaire" sont intéressante. Dans son premier exemple il montre que l'ordre de présentations des plats dans une cantine influe énormément sur ce que les gens vont prendre. Comment donc choisir l'ordre de présentations des plats. Il y a beaucoup d'exemple très variés. Au final j'ai trouvé que le livre aurait pu être un peu plus bref et percutant mais il présente des idées très intéressantes.
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2 internautes sur 3 ont trouvé ce commentaire utile 
1.0 étoiles sur 5 Poor copy of freakonomics 10 décembre 2011
Par A. Clive
Format:Broché
This book is a nice idea and tries to showcase the laws of unintended consequences but it is badly written and organized. It is just much too bitty; the chapters are split into too many sections so that the whole book has a fragmented feel and chapters seem to jump all over the place. In short it reads like a first draft of someone's notes.
The underlying ideas are good but the book needs a complete rewrite. There are many other books of this genre which are much better. Not recommended.
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3 internautes sur 4 ont trouvé ce commentaire utile 
Format:Broché
Great book for those looking for tips and tricks to change people's behaviour. Thanks guys!
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Amazon.com: 3.7 étoiles sur 5  343 commentaires
234 internautes sur 263 ont trouvé ce commentaire utile 
3.0 étoiles sur 5 Homo Economicus Gives Way to Homo Irrationalus 27 octobre 2009
Par Hagios - Publié sur Amazon.com
Format:Broché
The good part of this book is that it contains a lot of practical and nonpartisan policy advice, such as requiring corporations to sign people up for the 401(k) by default and then letting them opt out. This is an example of what they mean by "nudge". You don't need to coerce people; since something has to be the default option you can at least give them intelligent defaults.

The bad side of the book is its poor understanding of human nature. Libertarian economists such as Gary Becker have been aggressively promoting free markets based on a mathematical vision of rational decision making. Needless to say, this vision could only apply to ultra-logical people like Mr. Spock - the notorious Homo economicus. The breakthroughs of behavioral economics teach us that real people do not act like Mr. Spock. This book does an excellent job explaining the major findings of behavioral economics. But rather than try to understand the richness of real human behavior, most behavioral economists tilt towards the opposite extreme. They pronounce humans as irrational and filled with hidden biases. Homo economicus has been replaced by Homo irrationalus.

That's unfortunate because the real story of human nature is far more interesting. Consider the case of loss aversion (pp 33-34). In a classic experiment which has been replicated hundreds of times, students were randomly given free coffee mugs. The mug-less students were asked how much they would pay to get a mug and the students with mugs were asked how much they would want in order to sell their mugs. It turns out that students with mugs wanted an average of about twice as much as the mug-less students were willing to pay! This goes by the name of loss aversion, the endowment effect, and the status quo bias. It is labeled a bias because a self-respecting member of Homo economicus would think about how often he drinks coffee, how often he does the dishes, and how many mugs he currently has. Based on this analysis he would put a price on a new coffee mug. That price would not influence by whether or not he just got a mug for free. But in fact this behavior is rational. Richard Thaler and Cass Sunstein conclude that "loss aversion operates as a kind of cognitive nudge, pressing us not to make changes, even when changes are very much in our interests." (p.34)

The method behind our seemingly irrational madness is found in a classic problem in game theory - the game of hawks and doves. Hawk and dove are different strategies people can use when they are in a conflict over a prize. The prize could be anything. For butterflies it could be a sunlit leaf because male butterflies have more mating success when they occupy such a position. For feral horses it could be a pool of water (Herb Gintis reviews the literature in _The Bounds of Reason_). Doves are sharers. When two doves see a prize they will share it. When two hawks see a prize they will fight over it. When a hawk meets a dove the dove will yield the prize to the hawk. A world of all doves is basically a communist utopia where everyone shares everything. It is also efficient because people maximize the use of available resources (prizes). The problem is that it is not what biologists and game theorists call an evolutionary stable strategy. It can easily be invaded by hawks. The first person to switch to the hawk strategy will get the entire prize without cost wherever he goes. Over time more and more and people will play hawk. That's inefficient because the cost of fighting must be subtracted from the value of the prize.

We have a problem. A world with doves is efficient but unstable. A world with hawks is inefficient but stable. The evolutionary biologist John Maynard Smith found the answer - the bourgeois strategy. That means "play hawk when you own the prize and dove when someone else does." A world of bourgeoisie is efficient because it eliminates fighting as effectively as the dove strategy. It is also an evolutionary stable strategy that cannot be invaded by hawks. That's because hawks are basically parasites on doves - they need the free prizes to offset the cost of fighting. A necessary consequence of adopting the bourgeois strategy is that people will value prizes that they own more than prizes that other people own. That's the real reason for loss aversion. It is not a "bias" but an efficient and stable strategy that provides the strategic foundation for the rule of law. The cost of enforcing the law goes up with the number of people who are trying to break it. If people did not have a sense of loss aversion then there would be more useful trades - but there would also be conflict and fighting over prizes.

That is just one example and this is already a long review but these kinds of lessons underlie nearly all of the so-called "biases" that Thaler and Sunstein identify. If you want to learn about Homo economicus then pick up _The Economics of Life_ by Gary Becker. If you want to about Homo irrationalus then buy this book. But if you want to learn about Homo sapiens then you will need to look elsewhere. I recommend starting with Gut Feelings: The Intelligence of the Unconscious_ by Gerd Gigerenzer. It is the book that _Blink_ by Malcolm Gladwell should have been. Books that talk discuss the hawk-dove game and other fascinating results out of evolutionary game theory are pretty scholarly. Games in Economic Development only requires high school algebra and you can easily skip over the math. I also think that most people interested in this book would enjoy Filthy Lucre: Economics for People Who Hate Capitalism. It is an accessible but sophisticated look at modern economics, including some behavioral economics.
167 internautes sur 197 ont trouvé ce commentaire utile 
3.0 étoiles sur 5 Interesting premise, poor implementation 30 juin 2009
Par Lena - Publié sur Amazon.com
Format:Broché
I liked the beginning of the book, but it became repetitive and boring after first three chapters. It could be due to the fact that I generally agree with the major premise of the book: people should be "nudged" to make a decision that will make them better off. And yes, the nudge should be transparent and not synonym to manipulating people's minds. And yes, the government has my permission to nudge me in the right direction; if as a result I will make a decision (for example) to exercise more and eat less junk food.
(As a side note, I will be happy to have such a smart government. Or well, this could be an issue. But this is a subject for another book).
I got it, and I don't need three chapters to convince me. Am I alone in this?

I was much more interested in why and how our brain works to react to the "nudges" ("popular psychology" side that was almost non-existent), than in authors' rebukes to the opponents of "libertarian paternalism" - the political implementation of their theory. The other thing that annoyed me was the authors' attempt to be funny and coin terms, names and definitions that were supposed to make the book readable. Instead, it got annoying after the third appearance of the term "libertarian paternalism" and after the fifth time I saw the term "Econ" (used for infamously rational person from economics textbooks).

I had an opportunity to listen to Thaler's presentation on this subject and it was lively and interesting. He is a brilliant speaker with many great ideas; unfortunately, it didn't translate into the brilliant writing.

I would still recommend the book for the ideas of "nudges" in different areas (personal finance, energy conservation, marketing, politics and everyday life). However, it fells short on the inspirational side. You shouldn't be able to put this book down. But you are.
361 internautes sur 433 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 The elephant in the room. 23 mars 2008
Par D. Stuart - Publié sur Amazon.com
Format:Relié
Richard H. Thaler and Cass R. Sunstein are both professors at the University of Chicago and where the Chicago school was once famous for the Milton Friedman doctrine of free markets (look where they've got us today!) Thaler and now his Law professor friend Cass Sunstein have swung the pendulum the other way.

Here in Nudge, they argue that totally free markets can lead to disasters precisely because human individuals are not actually very good decision-makers. As Behavioural Economists (Kahneman & Tversky Judgment under Uncertainty: Heuristics and Biases- who credited Thaler as being a key inspiration - and Dan Ariely, whose Predictably Irrational: The Hidden Forces That Shape Our Decisions has become a best seller) argue, we are riddled with little psychological tics in our decision-making processes. We buy things, then suffer remorse. We get confused by choices and often make no choice at all.

But where Ariely keeps his discourse in the world of the day to day, Thaler and Sunstein develop an argument that is political - and is bound to cause heated debate. What they argue is that, in the face of our decision-making weaknesses, Governments and Businesses can help "nudge" us in the right direction. The elephant in the room can be benign.

They call their viewpoint `libertarian paternalism' and what they argue is that it would be a good thing for some gentle nudging of the citizenry in the right direction. As Thaler said recently in the New York Times: "In light of human limitations, Cass Sunstein and I argue for policies that we call libertarian paternalism. Although the phrase sounds like an oxymoron, we contend that it is often possible to design policies, in both the public and private sector, that make people better off -- as judged by themselves -- without coercion. We oppose bans; instead, we favor nudges."

How does a Government do this without imposing laws and edicts. A primary argument is that defaults can be set that counter the tendency by humans to procrastinate or make no decision. One example is the Save More Tomorrow Plan which Thaler developed back in 1996 as an employer sponsored retirement plan for employees. Instead of presenting the details and asking employees to consciously sign-up to increase their savings each time they got a pay rise, the plan presented the details and asked employees to basically check the box if they wished in future to automatically increase their savings as their pay went up. To pre-commit. Such schemes have proved very successful, yet they offer the same free choice, though with a different default.

As Thaler argues: "Since it is often impossible for private and public institutions to avoid picking some option as the default, why not pick one that is helpful?"

Another form of nudge might be the act of disclosure. Thaler & Sunstein argue, for example that credit card companies should issue annual statements that tell us how much we've spent this year on late fees and interest. Again: we have the complete freedom to use cards as we want, but the additional information may help us reframe our own spending strategies. Or how about stickers on new cars that show how much gasoline each vehicle would burn over the next 5 years under typical usage. Hold that Hummer.

These are examples of what the authors call helpful "choice architecture." Nice phrase. The architecture puts our options on more clear display.

I must say, I like the thinking here, and it gives credence to agent-based simulation modelling I've carried out whereby small changes can lead to big effects.

But this volume is about more than modelling and mere theory. One cannot help but think that the book has been timed to coincide with the meltdown of the present economy. The free market, the totally free market, the authors implicitly argue, needs quite a nudge itself. Rather than seeking highly regulated solutions, the better response might simply be a series of tweaks to the choice architecture that influences our spending, saving, health care and borrowing patterns.

The authors present a clear argument and no doubt it will cause heated and lively debate. This book has landed like a rock, right into the centre of the current and somewhat stagnant economic pond. It will definitely cause ripples. Well worth reading.
94 internautes sur 112 ont trouvé ce commentaire utile 
1.0 étoiles sur 5 A little of everything, and therefore unfortunately not much of anything 4 novembre 2010
Par Amazon Customer - Publié sur Amazon.com
Format:Format Kindle|Achat vérifié
This book covers a lot of ground, and none of it is covered with any rigour or depth.

There are occasional interesting pieces of insight - for example, if you want people to reduce their energy usage, it may be enough to tell above-average users that they are in that category - below-average users, not so much, they may then use more energy - but you can counter this by a nice smiley emoticon next to where that fact is displayed (implying they're doing a great thing by using less energy) and their usage will stay low.

The problem is, to gain these nice pieces of insight, I had to dig through much much more content that was not covered well.

Here are some of the the things you'll find in this book

- A superficial review of psychology research concerning a few factors on how people make choices (For example, too many choices lead to overwhelm and bad decisions. Another example - people can be influenced to make a bad decision if others around them are making bad decisions).
- A explanation of how people can be helped to make good choices, for example with food, by where food is placed on store shelves (e.g. at eye level vs not).
- Many many pages of excruciating detail on why choices of medical insurance plans can be a complex and painful process. Ditto for how the complexity of investing can lead to bad investment choices. None of this is original.
- A fairly basic solution proposed to complexity of choices - regulations to require providers to provide information on the implications of their choices - for example, lenders should provide documentation of the implications of a given choice of loan - what you'd end up paying over time (not just at the time of initial "special deals") and what the worst case scenario would imply in terms of costs for you. This information, the authors advise, should not be buried in the fine print. Very very obvious stuff.
- A chapter on making organ donation to be opt-out instead of opt-in. One of the better chapters, with some evidence given of it having worked in some countries. But could have been dealt with in a few paragraphs, did not need to be stretched to a chapter (admittedly a short chapter).
- Some attempts at philosophical argument for why governments should be allowed to "nudge" people to better choices, but not done to any depth or rigour.
- Several side comments that did not provide any new insights - for example, that the principle of what actions are being taken by those in authority should be transparent might have prevented the atrocities at Abu Ghraib. Again, nothing original here.
- Several trite pieces of advice about how publicising a commitment you've made (e.g. to lose weight) and setting up disincentives for failure (e.g. a certain amount of money to be donated to a cause you disapprove of) can help you achieve the goal. Again, nothing new here.
- A more reasonable chapter on privatizing marriage - the goal being to allow religious groups to endorse marriages based on their convictions, but for all partnerships to be granted equal legal status. Not really related to the concept of nudging though, and drawn out and padded with sociological thoughts on what function marriage has historically served, which does not seem to be the authors' field of expertise.
- Random pieces of advice such as permitting motorcycle riders to not wear helmets if they take extra training and show evidence of medical insurance. If I could be sure that they are also paying higher insurance premiums I might not be too annoyed at that one, but the authors don't venture into this area of discussion so again I felt their treatment of this topic was incomplete.
- A recommendation that the Social Security Administration assist those claiming benefits by making more clear at what age you should start collecting the benefits if you want to obtain the maximum amount of money by it (allowing for things like, maybe I'm ok with less money if I want it sooner). Having a payer assist a payee in taking maximum advantage is nice and altruistic, good luck with getting that happening.

Overall it felt like the authors had a collection of unrelated instances of advice that they were trying to force to fit the concept of a "nudge".

If you are interested in this kind of content from a psychology viewpoint, read Freakonomics (Dubner and Levitt), Predictably Irrational (Ariely), Influence (Cialdini), Tipping Point (Gladwell). For the investment advice and bits of self-help associated with that, David Bach does a better job in his various books.
106 internautes sur 132 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 Important for medical decisions as well 31 mars 2008
Par Alan Schwartz - Publié sur Amazon.com
Format:Relié
"Buy on apples, sell on cheese" is an old proverb among wine merchants. Taking a bite of an apple before tasting wine makes it easier to detect flaws in the wine, and the buyer who does so will not as easily make the mistake of paying more than the wine is worth. Cheese, on the other hand, pairs well with wine and enhances its flavor, so a seller who offers cheese may command a higher price for the wine (and may even deserve it, if the wine is intended to be drunk with cheese).

The proverb captures important psychological nuances of choice. The same product - a bottle of wine or a risky medical procedure - may be perceived differently depending on its context, and it is often possible to arrange the context to influence a choice while still maintaining the decision maker's autonomy.

The practice of structuring choices is called "choice architecture" in a brilliant and important new book, Nudge, by University of Chicago Distinguished Professors Richard Thaler (Business) and Cass Sunstein (Law). Nudge lays out the groundwork for the science of choice architecture in investing, insurance, health care delivery, and other areas, and argues for a "libertarian paternalism" in which choices are structured to make it more likely that a decision maker will select what is considered the most beneficial option, without impairing the ability to decision makers to select other options. For example, making enrollment in 401(k) plans automatic for new employees, with a form for opting out, is likely to result in greater retirement savings than an opt-in system, without limiting anyone's freedom to choose.

Thaler and Sunstein apply the principles of choice architecture to a few problems in health care (How could Medicare part D be improved? How can organ donation rates be increased? Why shouldn't patients be allowed to waive their right to sue for medical negligence in return for cheaper health care?) But the concepts in the book go beyond their specific examples and could prove very useful to practicing clinicians, who, they note, are often in the position of being choice architects for their patients.

Their principles of choice architecture (paraphrased by me and focused on physicians helping patients make decisions) are:

* Make sure incentives are aligned with desired outcomes
* Help patients map outcomes of different alternatives into formats they can understand (a major focus of Medical Decision Making as well)
* Arrange default options to favor better health. Pediatricians have done a good job of making vaccination a default option.
* Provide timely and relevant feedback about choices and outcomes. A patient seeking to lose weight needs to experience feedback in the form of measurable progress soon enough that they are not discouraged.
* Expect error and develop systems to prevent, detect, and minimize it. For example, pill cases and inhalers with dosage counters are simple and valuable ways to reduce the frequent errors people make in remembering medication. Psychological research provides direction as to what kinds of errors are to be expected when people are making decisions.
* Structure complex choices to reduce the difficulty of making good decisions. In many ways, that's what medical decision making -- and Medical Decision Making -- is about.

I highly recommend Nudge. It's a great read, and has the potential to change the way you think about clinical practice and medical decisions.
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