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Nudging in the Life Sciences

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Darshan

Hey everyone, welcome to another episode of DarshanTalks. I'm your host Darshan Kulkarni. It's my mission to help patients trust the products they depend on. As you know, I'm an attorney. I'm a pharmacist, and I advise companies with FDA regulated regulated products. So if you think about drugs, wonder about medical devices, consider cannabis, obsess or pharmacy or wonder how someone will take all of these and actually keep coming back in a way that's compliant and meets their healthcare needs. This is the podcast for you. Remember, as a lawyer how to do it, I do have to say not legal advice, not clinical advice. Hell, it's not even nudging advice. We're just sort of playing this out. It's educational, and I hope you enjoy it. In fact, that's why I do these podcasts. I do them because they're a lot of fun. And I find myself learning something new each time. So it'd be nice to know when someone's listening. And if you like what you hear, please leave a comment, please subscribe. And if you know someone who might benefit from this talk, please share. If you want to find me, you can please you can reach out to me on twitter at DarshanTalks, or just go to our website at DarshanTalks calm. Our podcast today is actually going to be really interesting we've actually spoken about, about this topic before it's the quote unquote, nudging behavior. So if you are in, in healthcare, you've seen numerous startups pop up, I've actually worked for startups that worked in the modern world, and they are founded by some of the stalwarts in the field. So so if you are in the life sciences, you're wondering how patients can actually take their medications. If you're wondering how to convince physicians that, that do at least listen to you and maybe find out more. If you're trying to convince a pharmacist to stock your product, you probably should care about today's discussion. Our guest today is actually really quite interesting. She is a behavioral scientist at the behest of the BVA nudge unit, where she co leads the healthcare division globally. So you know, just casual co leading a global healthcare division. Her passion lies in the worlds of psychology, public health and behavioral economics to craft impactful behavior changes across the healthcare ecosystem. Prior to joining BVA g unit, Suzanne developed a industry leading social science group at a global marketing network McCann health, she completed a Master's in Public Health at Columbia University's Mailman School. So our guest today Suzanne kirkendall Susan, Suzanne, how are you?

Suzanne

I'm doing well. Darshan, how are you?

Darshan

I am well it's good to have you. But before we start Before we continue, for those of those people don't wait till the very end. How can they reach you?

Suzanne

You can always find me on LinkedIn. Suzanne kirkendall, or you're welcome to send me an email at Suzanne kirkendall at BVA nudge unit calm. I love hearing from people I love talking with people about the real science obviously. So feel free to reach out.

Darshan

So So Suzanne, let's talk about just behavioral science in the news. What What have you sort of been been seeing that's been popping up for you? That's that's made you go you know what? That's my field, I understand a little bit more than the average bear. So what's been showing up for you?

Suzanne

Oh, I can answer this a few different ways. I mean, for me, when I say that's my field, I see this stuff everywhere I look right? Because human behavior is everywhere. It's all it's always see in the news. But I mean, specifically, I know there was nudge stock just happened a couple of weeks ago, which is a really major event in the industry. But I know you know, before you and I were talking started we were talking about a really interesting kind of ethical issue that came up in the news recently.

Darshan

So I'm gonna get to the ethical issue but but you have to be curious at nonstock because I'm imagining a bunch of hippies hanging around with guitars and free love and and listening to the Greatest Guitar performance of all time. I'm guessing that's not what not stock is like.

Suzanne

So Ned Stark is a big annual event where they get a bunch of, you know, really fantastic, famous, well established behavioral scientists together to present on the latest and greatest, obviously this year and last year, it's virtual, so they really pack it in. Unfortunately, I wasn't able to attend myself but I know a bunch of my colleagues went and of course had a great time. But events like that are so fun, because even just the marketing you can tell it's being done by behavioral scientists, like the subject lines of the emails just grab you in a way that's just they really know how to tap into their the motivations of their audience. So it's a lot of fun. I'll definitely be catching up on on the recorded talks in a couple of weeks. But as far as hippies and guitars go, I mean, maybe maybe after hours. But I'm certainly definitely kind of a big event during the year for us behavioral science nerds.

Darshan

So it sounds like we should all be behavioral science nerds, because it's just human behavior. So um, but let's talk through some of those basic things you actually referenced in what you just said. So you talked about how the emails themselves are being crafted and the subject lines are grabbing you better? Could you talk a little bit more about that? Like, it's, it's something I struggle with all the time, because I send out notices saying, you don't come listen to the podcast. Or here's a really interesting bit of news that you might care about. Well, I feel like there's no good way to actually introduce that, but But obviously, they did it well. So talk to me about how they did it.

Suzanne

Yeah. So when it comes to things that seem little, like a subject line of an email, but are actually really important, because that's kind of the make or break moment of whether that person is going to engage with your entire email and everything that it's leading them to. There are a few different fun things that you can do. So I mean, obviously, as personalized as you can make it, if you can use someone's name, that sort of thing, that's always nice. If you've ever read How to Win Friends and Influence People, one of the big principles in that book is, you know, someone's name is the sweetest sound in the world. So as much as you can drop it, you're you're going to be garnering some some extra attention. But beyond that, it's really about kind of conveying as quickly as possible, the end value of what you're providing to someone, so not necessarily what you're actually giving them. But what it means for them if they get that educational information, for example, right? So not necessarily just three fun facts about, you know, regulatory stuff and life sciences, but you know, be the most interesting person at your next work get together with these facts, right? What's the actual emotional payoff? Not just, you know, literally what you're giving someone, although that should be if you can be clear about it, but the kind of the, the ultimate goal is more valuable.

Darshan

That's, that's really interesting. But here's the thing. What you're describing to me, is what I see spam do badly. Yeah. Cuz I feel like there's that uncanny valley. Have you ever heard that term? uncanny valley? Yes. Um, for those people who haven't heard it, could you tell us what it is? So that we can explain that in this context?

Suzanne

Yeah. So uncanny valley is usually used in more of like the AI space when you're getting towards developing like AI personalities and or robots that look human enough or act human enough that you start to kind of put them mentally in that category, but they're not quite over the line of being totally convincing. So it really throws you off. So like, a Roomba does not fall into that category, even though we see them as like having little personalities, we name them and, you know, talk to them, that it's not human enough like that, it freaks us out. But if you if you get like 90% of the way there, that's not the actual number, but just like to illustrate the concept, it just feels off because it's close, but not quite. So when it comes to these email subject lines that you're referring to, in this context, it's more about like, technically, they're using some of these principles that I'm dropping, but like, it doesn't quite work. And so it's off putting more than it is engaging. And that's where experience comes in. That's where having a really good knowledge of these principles and how to actually apply them and not just apply them by rote, becomes important. And that's also where it test and learn philosophy becomes really important. Wherever you can kind of test AV test or however else you want to test your your materials, your subject lines, all of that you're going to, you're going to have the best luck with optimizing that sort of thing. So one

Darshan

of the things I've seen done in these subject lines, especially in the spam, spammy versions of these is a lot of emojis and a lot of colors ever appropriate. And I just missed that memo somewhere or what happened.

Suzanne

I mean, I haven't seen a lot of the colors, that's a bit much but in terms of emojis, you know, if you're really strategic and thoughtful about like, one that that can work, right. But again, you also need to know your audience. Like if this is a support email, your audience probably is going to be amenable to like a heart emoji or a fire emoji, more than necessarily that stereotype email to a bunch of lawyers right? at work about work. But again, it depends. It's all very context specific. That's why this stuff gets hard. There are general principles, but then you know, you really got to know your audience know the goal of the communication and kind of know the context around it.

Darshan

So what I'm hearing you say in many ways, And this is something that keeps coming back over and over and over again, is nudging is about cutting through the noise. And it's about everyone doing the same thing and you sticking out. And but sticking out in a way that's good, but not sticking out in a way that's bad. And that's, that's where you have that dip of the uncanny valley, when you're talking about subject matter, subject headlines and emails, the good news is that you in Moji, could get you past that no one else was doing it. But you may fall into that uncanny valley because no one else is expecting him, there's a good reason not to do it that way, right. But with the right experience, you might be able to pull it off. And that's when you reach out to Suzanne, and go help me here,

Suzanne

right experience and test and learn. Because you know, every again, every con, I'm a scientist at heart, so I'm going to tell you, you got to experiment, you got to tweak and optimize you can do as best you can, with what you know, upfront, but every situation, you're going to get the best best result if you do a little experimentation. But yeah,

Darshan

so what stops us from doing that say I am and I don't work for them. So I want to be very clear about this. But Sam, right, a pharmacy, and I want to get my patients to take their medications, or, quite bluntly, I don't even care if you take your medications. I care if you come pick up your medications, because then I get paid. I have no idea, right? I believe this I'm gonna guess Hopefully not. But But let's assume that that's the direction they wanted to go. How? How do you set up an email to remind patients to take their medication on a routine enough basis that they'll open the email and go, Oh, yeah, I should take that medication, but not enough to bore them to not open that email anymore?

Suzanne

Yeah, so medication adherence is the billion dollar question, right? At least. So there's, there's a lot to say here. I appreciate that. You're thinking in the way that you know, taking medication is made up of a lot of sub behaviors. First of all, one of which is refilling your medication at the pharmacy, there's a lot more that goes into it. But when you start to think about what does it mean to adhere to your medication, and what are all the little pieces that make up that overall behavior, that's when you can start to have a hope of even moving the needle a little bit. Here's the problem with these big issues like medication adherence, things like health equity, like all kinds of stuff is you want to tackle like, the whole thing at once. And that's just not how change actually happens. It just doesn't, it happens bit by bit. So thinking of it in those sub behaviors is a really good start. When it comes to kind of those other behaviors, you start to have to think, again about your audience, their headspace, and the specific barriers and levers that lie between their current state and kind of this desired state. So if we're being specific about picking up the medication, you know, well, what kind of medication is it doesn't need to be refrigerated? Is it a pill? How often do they need to go? Does it cost the money when they go or not? You know, can they go at convenient times can they get it delivered? Do they have to wait in line for 30 minutes, because they can only go after work when everyone else goes like you can go down that rabbit hole and all these little details. But these are the details that are make or break for any given person and will, you know have an aggregate effect over certain population?

Darshan

So so what I'm hearing you say is, don't think of the problem you're trying to solve? Think of the many problems that come before it before the problem you're trying to solve?

Suzanne

Yeah, there's Um, so there's a there's a technique in the public health field for health promotion specialists, which is kind of my original academic training, which is all it's called intervention mapping, and says very rigorous design approach for how to kind of establish exactly what the need is, what the barriers and levers are for kind of that desired behavior. But you and then, you know, use those techniques to design your intervention. But you start by defining the health problem. So you still need to start with the big picture. So let's say the health problem is high blood pressure, because you're not taking Well, one of the reasons might be you're not taking a blood pressure medication, but the health problems, high blood pressure, and then you start working your way backwards to what are the behaviors that make up that that health problem or lead to that health problem. And then you start working into specific individual levers and barriers that influence that behavior that influences that health problem. And then you start to get into what about the relationships around this person, like, you know, spouse, Doctor, family, whatever, those relationships, what levers and barriers there contribute to the health behavior, and then you think about what about kind of organizational processes contribute to the health behavior which contributes to the health outcome? And what about the big picture societal stuff? Like, does their insurance cover this or not? Those sorts of things that also contribute. So when you start thinking about how do I actually solve a problem like medication adherence, you have to think much bigger than what email do I send this person, right? Because that is a factor, and you probably will send this person emails at some point. But there's so much more that influences our behavior that you need to think about. And so that, that kind of layering of individual interpersonal relationships, you know, communities and organizations, and then societal stuff, that's actually another model within this intervention mapping approach. And it's called the social ecological model. And it reminds us that there, we don't exist in a vacuum, basically, our you know, everything I do, yes, it's influenced by me and the things that people directly say to me, or those sorts of things, as in the case of an email. But, you know, I'm also influenced by these other kind of spheres of influence. So when it comes to medication adherence, you have to start thinking about what are all the different ways we can we can kind of tweak that context for that person or that group, if you really want to actually be able to change behavior.

Darshan

So let me ask you this question. Because it sounds like, let's, let's say, I was, I was a pharmaceutical company, I wanted to hire you, I would, I would go How do I make this email better? you pitch me the emails, the last problem you're trying to solve? How does that work, though? Because I, I imagine I'm a very smart person, I imagine that I can figure this out. Like, it's worked for billions of dollars already, like, how much more can you teach me about how to get my patients to get to either take their medication to take my medication? So So how, what is that? What is the behavioral nudge you show to demonstrate that, that Suzanne is the right solution for for the problem, and the problem isn't what I thought it was in the first place.

Suzanne

Yeah, that's, um, that's my job. And it's a lot of fun. No, I really enjoy. I think of myself, and a lot of my role is as like a translator, because you know, I just found it off a bunch of like, many multisyllabic model names. And that is kind of the expertise and the evidence base that I draw on in my work. But me sitting here spouting that off is not helping anyone who's not Also in, you know, my field with my lingo, right? So if I'm going to be able to provide anyone with any value, I have to be able to bridge that gap between, here's all this technical jargony stuff. And here's what that means for your email subject line, right? Because it goes back to what I was suggesting, with your emails in the first place, which is, don't think about what am I giving this person like, the materials, think about the value that's important to that person that I'm going to promise them that I can deliver, right? So I don't need with I'm going to show you the social ecological model with the intervention mapping. Because that I mean, that may be literally what I'm doing. But I'm going to leave with, I'm going to change your email subject lines, and I'm going to help you redesign the cadence of your Patient Support Program. And I'm going to revamp your call guides for your patient support, call center. And all of those things are going to lead to, you know, better medication adherence, I can't make promises about percentages or anything like that, because that's not how behavior works. And I would be lying if I tried to do that. But that's kind of a really important part of being me, a real scientist and applying it to real world problems in this way, is that translation piece,

Darshan

but I'm gonna I'm gonna challenge you on that, because I have seen or I know of companies who use these types of nudging technologies, and they basically come out and say that don't pay me, I want to be paid on performance. So I can guarantee your percentage. But if I hit this percentage, you will pay me a percentage of everything above that. So I'm in many ways guaranteed performance, then.

Suzanne

Yes, so that's an interesting point. And this is definitely you know, this is not our usual operating model. But that's definitely like we've done this with projects before as well. And we're willing to do that. The key is, it really depends on what you're applying it to. So if this is like fairly straightforward thing, where it's like, Okay, I have my website, and I don't have enough people applying for my credit card, right? We're losing people, they're dropping off a lot in the credit card application process. So there's like a very specific defined behavior with a really specific defined context. We can go in we can make some tweaks and we can be like, we know just based on best principles, like you guys weren't at best principles yet, just kind of on a basic level. So if we can tell you this, like it's probably gonna work. Great, we can be fairly confident because there's such an evidence base behind it. And because this is something that's really, really defined, right? When it comes to things like really complicated behaviors, like medication adherence, then it starts to be a matter of Well, I mean, do we have the scope to influence the things that we know need to be influenced, which is a lot more than tweaking the wording on your credit card application process, right? So then it becomes kind of a give and take, but I don't think anybody is going to be guaranteeing I can get you a 10% lift in this, right? Like, nobody's gonna do that. And a lot of people want that, because we love certainty, right? But that's not how this sort of thing works. But definitely pay performances is totally fine. It's going to be a case by case thing, and it's something that we do sometimes when these situations appropriate.

Darshan

So so we talk about pay for performance, that being okay, but let's take that into, and you made a reference to it, because we had a prior conversation about this. Um, there have been scenarios and I'll drop a link about this. There have been scenarios where companies have gotten in trouble for using nudging behavior in an inappropriate way, specifically in the opioid epidemic situation. Could you talk a little bit more about what happened there? And then we can build a little bit more into the epics? And how do you do it right? And how do you do it in a way that may not get to get you into

Suzanne

trouble? Yeah, so I'm not totally across all the details of this latest news, I think dar Shani, we're gonna have a better summary than I would. But basically, one of the EHR software companies just got in very big trouble with a massive fine, because they were inappropriately pushing opioid prescriptions within their the way that they design their EHR software and its alerts. That's my summary understanding, do you want to add some color?

Darshan

Essentially, what they were doing was they were using EHR software. And for those of you who don't know what that is, is basically the software that people that physicians use, or prescribers use to order certain medications, what they were doing. And again, I haven't dealt dug in too deep into this, but essentially what they were doing was nudging you saying, Well, have you considered opioid here? Now, the question is, is that is that behavior necessarily bad? Obviously, the settlement suggests that the DOJ at least views that as bad. But is the is the actual behavior of saying, Have you considered this medication necessarily bad? Or was it the opioid part that made it more problematic? Um, so so let's, let's start with that question. Was it the drug or the behavior?

Suzanne

Um, I think it's both. So by that, I mean, it you got to start looking at the motivation for any kind of intervention that you're designing like, What? Why are you doing this? Who are you doing this for? Who does this benefit? Right? At the nudge unit, we talked about, you know, we always strive to do win win win type projects, where it's, you know, a win for the client a win for whoever's kind of the end user or target of the intervention into win for society. And that's kind of our our little litmus test for is this a project we want to work on? And ideally, everybody who's nudging does the same thing. But I mean, obviously, not always the case, given the example you just shared. So when it comes to things like this case, where the opioids were being suggested during during the opioid epidemic, I'm

Darshan

not sure if it was during the opioid epidemic. It may have been, but I'm not sure if it was

Suzanne

been going on for a long time. And if we're talking about EHR software, it's probably probably still an issue that's come up. You have to look at the motivation, right? Is this really for the patient's benefit, because that's the person that it's impacting at the end of the day. And there are absolutely appropriate cases to use opioids. They're very specific instances, they're not meant to be, you know, use a lot, right? So in this case, the opioids you have to think extra hard, given the context, I'm always going to go back to the context in terms of the actual behavior of a pop up or whatever alert suggesting Have you considered such and such whatever prescription it might be. That's another case where you really have to look at the context and the reason that you're doing it, to be able to judge the ethics. If it's a case where you know, we know that a standard of care is just under prescribed for convenience reasons. You Then it might be the case where it's like, no, this is appropriate to do. So like a really classic example would be cardiac rehabilitation after a heart attack. So this is something that's standard of care. Technically, that's supposed to be done in almost all cases after someone's had a heart attack, where they're referred for the physiotherapy and the rehab to kind of get themselves back up to speed afterwards. However, in real life, this happens, like a fraction of the time that it should, because usually, there's a lot of different things going on, it's too complicated to refer, there's a lot of paperwork to fill out, there's a lot of what we call sludge, which are the things that add friction to any given process, as opposed to nudges, which remove friction. So in cases like that, where it really is in the patient's best interest, there was like some kind of barrier there that we've identified that's preventing that thing in the patient's best interest to be happening. And alert, like, have you made sure that you referred such and such to cardiac rehab is actually appropriate? Right? It's, it's bringing things into line with, again, evidence based medicine. So that's where it's, it's always going to come back to it depends on the context with these, there's very little black and white, like, this is always bad, this is always Okay, when it comes to this sort of thing.

Darshan

So I'm gonna give you a more legal perspective on that. The more again, this is just what our skill sets are. So this is not I'm not disagreeing with you necessarily. No. Yeah. So so my perspective would be, the way the DOJ obligee look at this is, is it causing an extra cost to the government that they didn't have to bear before. So if you're talking about cardiac care, cardiac, we have, if you will, and that's part of what they're going to pay for anyways. And you're basically saying, I'm reducing readmission rates, I am helping patients, there's no additional cost of the government. And this is a neutral decision that that just helps patients. And again, I have no idea if it is in this case. Yeah, I'm definitely, totally okay with that. However, let's say you come up with a new fangled cardiac care process that you're going to charge extra for, that you are paying to have nudged for that is pushing your competition aside in favor of you, and you're paying to have to be marketed and sort of put out that would cause some red flags to be to be raised for you to look at. So it's not just the ethics of it, but the cost associated with it. So every time I see and I've been in a few different situations where this type of scenario has been raised, whenever I see you being you are being you as a company, being the only provider that's providing something and then causing that nudge to happen, and you're not providing options. That's when I started going, wait a second, why, the more options we can provide not just for at that particular moment in time, the more likely it is it would survive scrutiny, because the government will go look, what you're saying is, and I'm making this up. The patient was in pain, you provided the option of ibuprofen, Tramadol, and opioid and those were three options given to them, they chose the one they wanted, it was neutralized, but you still thought that you are addressing the pain situation. That's a very different situation from here's a great opioid medication you can use right, right at this moment. Why don't you prescribe it now? That's the difference. So so I think that would be the give and take you need to be aware of as you as you continue, but sorry that I cut you off there?

Suzanne

No, no, I think it's really interesting. And it's important to weigh in these different perspectives, right? Because the other thing, you know, as we progress with how do you make something ethical, as a kind of general theme is, you know, you need to involve various stakeholders, right? So it's not just mean bbnaija, who decides what's ethical, and that's it. And it's not just, you know, in this case, the pharma company or the HR company that decides, you need to also pull in other stakeholders with other perspectives, obviously, legal is appropriate sometimes in this case, definitely. But also the end users who this is going to be made for so talk to your hcps get your patients involved, like make sure that everybody who's touched by this has a chance to weigh in, and that's best practice.

Darshan

So I'm sorry to say that I'm going to ask you to repeat something that we started with already, but I just got a message from a friend who's a high level healthcare executive. And I'm not going to paraphrase I'm going to just say the words what the EFF is nudging in the life sciences.

Suzanne

I love it. It's a good question. Um, so nudging is kind of a subset of behavioral science, which is all around. Behavioral Science broadly is like psychology, anthropology, sociology, behavioral economics. We'll get into that in a second, basically, like, how do people actually make decisions? Therefore, how do we use well known techniques to guide them to make, you know, hopefully better decisions, right? So nudging is kind of a specific way of doing this, which is providing little changes to the moment that someone is making a choice. So that context around a decision moment, whether that's, you know, a website and how you've arranged your website to get people to subscribe, that's decision moment with the context, or whether that's how you design your hospital building, so people can easily find their way around. That's the decision moment and a context. Things that you do to that context to remove friction and make it easy for people to take the path you want them to take. So the trick with nudging is it's usually very tactical, it's usually very specific. We're not talking about here's our giant marketing campaign, that's not a nudge. You can have executions of that campaign might be nudges, but they're very specific tactics, and they're not removing choice, right. So going back to the ethics of this, I'm not making it illegal for someone to prescribe Tylenol, therefore, they're going to prescribe opioids, right? I'm just making it easier. I'm removing friction between, you know, choice between your person and kind of that desired choice outcome, but they're welcome to opt out and choose something else, right? So that's where you start to get into the ethics like I'm guiding you, I'm I'm lighting up this particular path, but I haven't closed the doors on all the others for you. So nudging in life sciences can be applied to a lot of different things, right? We've been talking about medication adherence, we've been talking about prescribing behaviors, is can go towards, you know, how do your sales reps communicate in effective ways? How do you facilitate HCP patient communication and better ways? Like, if you think of any kind of, you know, if you're talking to a healthcare executive, what are your business KPIs, right? At the end of the day, those are going to boil down to somebody doing something, right, whether that's your employees, because you can nudge your employees as well, or whether that's your customers, your end users, somebody in between on that path.

Darshan

That was That was awesome. I also think it was like the perfect way to end this conversation. Because we started, we usually, as you know, aim, 1520 minutes of these conversations, and we haven't even touched the topics we hope to get to. So no. This is as always amazing. Amazing. Amazing. So let's ask a couple of questions for you, Suzanne, first question, what is something you'd like to ask the audience based on what we discussed? Hmm.

Suzanne

I'd be curious to hear what nudges they've noticed in their own healthcare interactions now that we're talking about. I'm throwing out so many examples of where these can live, I challenge folks to start seeing them in their day to day lives.

Darshan

So I always try to answer the question that's asked. So my first response would be, I feel like every email marketing message is a nudge. Most the vast majority of them then are done incredibly badly, because all I want to do is stop the spam. So what I see is, here's what I can do for you. Not, here's how you will benefit from what I can do for you. So I see nudging behaviors near constantly looking at seeing a billboard is a nudging behavior. But if it doesn't speak to me, doesn't speak to my knees doesn't speak to my emotional goals. It's badly done, at least from my perspective. So nudging is is what I see as the parent of promotion. Ah, I

Suzanne

haven't heard of it. I've heard it referred to that way. But I like it. That's fun.

Darshan

There you go. We're the parent of decision making either one. Yeah, fires a lot of kids.

Suzanne

Well, it's funny, you use parent language, because so there's a really famous book called nudge, which I would recommend to your your commenter as a really nice, very readable introduction to the field. But the original book, original title of that book was going to be asymmetric paternalism, which just isn't quite as a mass market appealing. But that's right, exactly. But that's kind of the the principle behind this. It's like I'm guiding you. And it's the power dynamics a little uneven because I just shaved your environment, but like it's not like total paternalism. It's fine. Like it's fine.

Darshan

It's the difference. It's, here's my question is it and I think it's a superpower. It's the difference between the doctor telling you take your medication is going to make you better, or the neighborhood crack dealer saying, here's one more hit, and you've got to basically go, I need to use it for good. It's got it's got to be because it's a win win win win scenario for everyone involved. And if you do it badly, you're looking at 140 $5 million fines.

Suzanne

That's right. They did it effectively. But they did it did bad. I guess. That's great.

Darshan

Well, I guess that comes down to the question of what is effective is, is it effective if everyone doesn't win in the first place? So so there's a good question. Um, so so. So that was my first question. My second question, what was what did you learn in the last week?

Suzanne

Oh, in the last week. What did I learn, I learned honestly, totally unrelated, but it's coming to mind. I went out to dinner for the first time like to sit at a restaurant outside still. But I relearned and re remembered how beautiful New York City is because I got to go sit on the water and look at the sunset and feel a little bit normal for a second.

Darshan

Right? God it's been it's been good to just see life coming back to normal. And then I remember how much I hate life as normal, because there's just too many people out there.

Suzanne

Right? I relearned that Oh, it's actually not that nice takes away.

Darshan

Exactly. What What is something that made you happy, not counting what you just told me in the last month,

Suzanne

last month. Um, honestly, the work I've gotten to do with some of my clients in the last month has been, like, totally, genuinely, like, awesome, like really excited about kind of what we're doing, you know, getting to work on projects that are genuine Win Win wins with, you know, clients who really care and really are engaged, and we're all kind of pushing each other to do some really cool new thinking. So it's been it's been a long month. But it's been awesome. That's made me very pleased.

Darshan

There you go. Um, and how can people reach you again,

Suzanne

so please find me on LinkedIn, Suzanne kirkendall, or send me an email directly at Suzanne kirkendall at BVA Ned unit calm, as I said at the beginning, and as always happens, because our show has to make me stop talking about this. I love talking about behavioral science. So please, you know, reach out even if it's just a question or a fun fact, you want to share I love love hearing from you.

Darshan

Awesome, I do want to do a quick summary of what we talked about. We landed up starting off with just what was happening that is memorable, which really taught took us to a virtual conference that you did not attend. But we had a lot of opinions about. So we talked about subject lines that came from that we got we got into personalization, we talked about talking about the end value and not so much about what you're giving. And we obviously pull that back into the end. For example, don't talk about three tips I can tell you about Regulatory Affairs, because no one cares, talk about how to be the most interesting person in the room. And that's it appeals to everyone's emotional needs, and then test test test. We then tried to tie that into the multibillion dollar question of medication adherence. And we were and I asked a very simple question of how do you solve it? And why is this so difficult? And why haven't we done it already? What you explained to me was, no, no, no, that's actually the end. That's almost the last question. you're answering of the many, many questions you have to get to before that. And you talked about things like intervention, mapping, and removing obstacles. And then there was another sociological term you use, which I can't remember what was that one?

Suzanne

social ecological model, social

Darshan

ecological model. There you go. And then we sort of pivoted into ethics, and we talked about this penalty and this fine around nudging using hrs. And how do you do it right, can you do it right, versus how do you do it wrong? And how to avoid doing it wrong? And what are some considerations as you start doing that? I, We then talked a little bit about the opioid epidemic that came out of that as well. And then we ended with the very simple question of Sorry about that.

Suzanne

You left us on a cliffhanger. What's the matter? No,

Darshan

it was it was a behavioral nudge, you waited. So that's a very simple question we tried to answer was what the EFF is nudging in the life sciences. So That's how we ended and Did I miss anything, Susan?

Suzanne

No, that was great. Awesome.

Darshan

If you have any more questions, you can reach me at DarshanTalks on Twitter or just go to our website at DarshanTalks COMM And we'd really love it. If you'd like leave a comment, please subscribe. If you know someone who might enjoy this podcast, please share it. So again, thank you everyone for coming on. We hope you enjoyed this. I know I did.

Suzanne

This is the DarshanTalks podcast, regulatory guy, irregular podcast with host Darshan Kulkarni, you can find the show on twitter at DarshanTalks or the show's website at DarshanTalks.com

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