I’m going to start a new discipline called behavioral
physics. Unlike traditional physics, which assumes that objects just fly apart
from each other, behavioral physicists recognize that a phenomenon they call “gravity,”
prevents this from happening. Or maybe I
will create behavioral evolutionary biology based upon the concept of natural
selection, rather than the assumption that everything just stays the same,
which traditional evolutionary biologists rely on. The way a physicist or
biologist would feel reading those sentences is the way that I feel most of the
times I read about behavioral economics.
The latest irritation is an article from the New
York Times about getting doctors to stop over-prescribing antibiotics.
Getting doctors to stop over-prescribing antibiotics is a good thing.
Personally, I worry more about the negative consequences of overuse of
antibiotics than I do about the negative consequences of the overuse of painkillers.
On the other hand, their suggestion that they are able to solve this problem
because behavioral economics has remedied the flaws of traditional economics is
nonsense.
They describe how various attempts to get doctors to stop
prescribing unnecessary antibiotics have failed because they “are all based on
the assumption that physicians are rational agents who will do the right thing
if provided proper information and incentives. But,” they ask, “what if doctors
are a little irrational, like the rest of us? They may over-prescribe
antibiotics out of an unrealistic fear that the patient could eventually
develop complications and need them, or because it is easier than arguing with
a patient who insists on getting them.” The situation they just described is
practically a definition of a rational choice. Prescribing the antibiotic has a
benefit for the doctor (the patient is happy) and no cost to the doctor.
Nevertheless, they go on to explain that “Over the last few
years, our research team has developed several new approaches to reducing
unnecessary antibiotic prescribing, drawing on insights from behavioral
economics and social psychology. These disciplines acknowledge that people do
not always behave rationally and are strongly motivated by social incentives to
seek approval from others and compare favorably to their peers.” I have no idea
what they mean by rational. There is nothing
irrational about being motivated by social incentives or wanting to compare
favorably with peers. One of the characteristics of traditional economics is that economists don’t care what your preferences are, or where they came from.The only thing that is really required for rational
behavior is that you respond in predictable ways to changes in the costs and
benefits of a choice, which brings us to the interventions they introduced.
In one of their interventions “whenever doctors prescribed
an antibiotic that was not clearly called for by the diagnosis, the electronic
health record system asked them to provide a short “antibiotic justification note.””
Wait a minute, did they just say that they increased the cost to the doctor of
prescribing an unnecessary antibiotic, and doctors chose to write less unnecessary
prescriptions. Let me see if I’ve got this straight. As the cost of doing
something increases, other things equal, people will do it less. Thank God for
behavioral economics. If only someone had thought of this before, they could
have given it a name like “the law of demand” and taught it in every principles
of economics course.
Next week, I think I’ll invent behavioral history, which,
unlike traditional history, relies on critical analysis of primary sources. You
can play along too. It’s easy. Take any discipline, x. Identify one of the
primary features of that discipline, y. Assert, contrary to all evidence, that
x does not do y. Claim that the new discipline “behavioral x” does y. Repackage
some standard results from x as startling new results of “behavioral x.”