Decoding patient healthcare choices

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Sep 28, 2021

The pattern is familiar: go to the doctor, sit through an exam, discuss any health concerns, and then listen to the doctor’s recommendations. Conventional thought says that people make health decisions solely based on whether they will benefit their health status. However, the reality is very different. A 2017 CNN report found that an estimated 20 to 30 percent of short-term therapies, 50 to 60 percent of long-term medications, and 70 to 80 percent of lifestyle advice given by doctors goes ignored. 

The reality is this: health professionals cannot force people to take their health seriously. 

If doctors can’t simply expect patients to follow their recommendations, then what is the best way to go about ensuring patients make the best choices for their health? Jobs Theory can provide an answer.

Jobs Theory

Jobs to Be Done, or Jobs Theory, is a framework for better understanding customer behavior. While conventional marketing focuses on market demographics or product attributes, Jobs Theory goes beyond superficial categories to expose the functional, social, and emotional dimensions that explain why customers make the choices they do. People don’t simply buy products or services; they pull them into their lives to make progress. We call this progress the “job” they are trying to get done, and understanding this opens a world of innovation possibilities.

Jobs Theory applies not just to consumer behavior, but to healthcare as well. Patients will not just adopt health behavior changes because of the benefit they will provide. And providers can’t, and shouldn’t expect patients to change simply because they’re told to. Jobs Theory tells us that patients will not make a positive health change in their life unless it addresses progress they, specifically, already want to make. 

The importance of jobs

Understanding patients’ jobs provides several benefits to healthcare providers. First, it gives providers greater insight into their patients’ life circumstances. Second, it allows providers to better tailor their recommendations to what patients are trying to accomplish. To that end, each patient’s individual job should be considered when prescribing behavioral and lifestyle changes.

Health status isn’t solely dependent on medical treatment. It mostly depends on a variety of socioeconomic, environmental, and behavioral factors commonly known as the social determinants of health. By seeking to understand their patients’ jobs, providers can gain deeper knowledge into the social determinants impacting their patients’ lives. 

For many patients, it is easy to ignore health advice when the consequences are not immediate and dire, especially if that advice does not align with the progress they truly seek to make in their lives. Much of health status relies on social and behavioral factors. While to doctors, some behavior change requests, like adjusting diets, may seem like simple solutions, for many patients these are hard (and sometimes impossible) to accomplish. This could be due to any number of functional, social, or emotional factors. 

What does this look like? If we continue with the diet change example, there are a number of potential jobs that could prevent, or hinder, the willing acceptance of this type of change:

  • Functional: Healthy food is expensive. If a patient’s job is “I need to save money to help provide for my children,” then spending additional funds on a healthier diet will take a backseat.
  • Social: Food brings people together. If a patient is new to the area and has the job “I want to establish new friends in my new city”, attending events where there will likely be unhealthy food will take higher priority than adhering to a diet.
  • Emotional: Food also contains a large emotional component, particularly in regards to cultural and familial connections. If a patient’s job is “I want to feel a deeper connection to my family”, healthy eating may be a hard sell if providers don’t help patients find suitable replacements for culturally meaningful foods.   

Doctors don’t make lifestyle change recommendations without reason. They make them because they want to see their patients live healthier lives. If providers take the time to understand their patients’ Job to be Done, there is a real possibility that behavioral changes they recommend may actually be adopted. 

Jessica is a research associate at the Clayton Christensen Institute for Disruptive Innovation, where she focuses on business model innovation in healthcare, including new approaches to population health management and person-centered care delivery.