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Boundedly rational patients? Part 1: Health and patient mistakes in a behavioral framework


  • Ada C. Stefanescu Schmidt

    (Division of Cardiology, Massachusetts General Hospital and Harvard Medical School)

  • Ami B. Bhatt

    (Outpatient Cardiology, Massachusetts General Hospital, Professor at Harvard Medical School)

  • Cass R. Sunstein

    () (Robert Walmsley University, Professor at Harvard University)


During medical visits, the stakes are high for many patients, who are put in a position to make, or to begin to make, important health-related decisions. But in such visits, patients often make cognitive errors. Traditionally, those errors are thought to result from poor communication with physicians; complicated subject matter; and patient anxiety. To date, measures to improve patient understanding and recall have had only modest effects. This paper reviews the current literature on behavioral insights in the patient experience and argues that an understanding of those cognitive errors can be improved by reference to a behavioral science framework, which distinguishes between a "System 1" mindset, in which patients are reliant on intuition and vulnerable to biases and imperfectly reliable heuristics, and a "System 2" mindset, which is reflective, slow, deliberative, and detailed-oriented.

Suggested Citation

  • Ada C. Stefanescu Schmidt & Ami B. Bhatt & Cass R. Sunstein, 2017. "Boundedly rational patients? Part 1: Health and patient mistakes in a behavioral framework," Journal of Behavioral Economics for Policy, Society for the Advancement of Behavioral Economics (SABE), vol. 1(2), pages 11-15, September.
  • Handle: RePEc:beh:jbepv1:v:1:y:2017:i:2:p:11-15

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    References listed on IDEAS

    1. Berg, Nathan & Biele, Guido & Gigerenzer, Gerd, 2010. "Does consistency predict accuracy of beliefs?: Economists surveyed about PSA," MPRA Paper 26590, University Library of Munich, Germany.
    2. Kahneman, Daniel & Tversky, Amos, 1979. "Prospect Theory: An Analysis of Decision under Risk," Econometrica, Econometric Society, vol. 47(2), pages 263-291, March.
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    More about this item


    System 1 and System 2; cognitive errors; patient-reported outcomes measures; heuristics;

    JEL classification:

    • D03 - Microeconomics - - General - - - Behavioral Microeconomics: Underlying Principles
    • D83 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Search; Learning; Information and Knowledge; Communication; Belief; Unawareness
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior


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