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Ada C. Stefanescu Schmidt, Ami B. Bhatt & Cass R. Sunstein, Boundedly Rational Patients? Part 2: Health and Patient Mistakes in a Behavioral Framework, 1 J. Behav. Econ. for Pol’y 11 (2017).

Abstract: We present the results of a randomized-assignment experiment that shows that patients perform very poorly on the Cognitive Reflection Test and thus are overwhelmingly in a System 1 state prior to a physician visit. Assigning patients the task of completing patient-reported outcomes measures immediately prior to the visit had a small numerical, but not statistically significant, shift towards a reflective frame of mind. We describe hypotheses to explain poor performance by patients, which may be due to anxiety, a bandwidth tax, or a scarcity effect, and outline further direction for study. Understanding the behavioral sources of errors on the part of patients in their interactions with physicians and in their decision-making is necessary to implement measures improve shared decision-making, patient experience, and (perhaps above all) clinical outcomes.