The Present Bias: How We Tend to Overfocus on What’s Right in Front of Us, at the Expense of Preparing for the Future — A case for healthcare operations

Human beings have a natural tendency to focus on immediate threats and problems, rather than those that may arise in the future. This phenomenon is known as present bias, and it can have significant consequences for our ability to plan and prepare for the long term. In this article, we’ll explore the ways in which the present bias affects our decision-making, its effects in healthcare operations, and how we can work to overcome it in order to more effectively navigate the challenges of the future.

Have you ever found yourself procrastinating on a task that you know is important, but just can’t seem to bring yourself to do it? Or perhaps you’ve put off making a tough decision because it seems easier to just stick with the status quo for a little while longer. If so, you’re not alone. These behaviors are examples of "present bias," a psychological phenomenon that refers to our natural tendency to overvalue the present and undervalue the future.

Present bias can lead us to make decisions that are not in our long-term best interests because we are more focused on immediate rewards or consequences. For example, we may choose to eat that extra slice of pizza because it will make us feel good in the moment, even though we know it’s not the best choice for our long-term health. Or we may put off saving for retirement because the immediate costs seem too high, even though we know it’s important for our future financial security.

In the context of healthcare operations, present bias can have a number of negative effects.

One way that present bias can manifest in healthcare operations is through short-term thinking. For example, a healthcare provider might prioritize the needs of current patients over the long-term health outcomes of their patients. This can lead to the neglect of preventative care and a focus on treating illnesses after they have already developed.

Another way that present bias can be harmful in healthcare is by leading healthcare providers to overuse certain treatments or medications that provide quick and immediate relief, rather than those that might be more effective in the long term. Similarly, patients may demand short term treatments that have quick impact but have negative side effects rather than more time consuming but more effective long-term treatments

Present bias can also play a role in healthcare decision-making when it comes to the allocation of resources. For example, healthcare organizations might prioritize the purchase of new equipment or the hiring of staff based on short-term needs, rather than considering the long-term financial impact of these decisions.

Some specific examples include:

1. Short-term thinking in patient care: Imagine you’re a doctor, and you have a patient with a sore throat. The patient is in a lot of pain, and they want something that will make it go away right away. You could prescribe an antibiotic, which would work quickly to clear up the infection. But, antibiotics come with side effects and overuse leads to antibiotic resistance. If you took a long-term perspective, you might instead recommend that the patient wait a few days to see if the infection clears up on its own, or to try a less invasive treatment first.
2. Overuse of tests or treatments: Another example of present bias in healthcare operations is when healthcare providers order unnecessary tests or treatments. For instance, a CT scan might show what is wrong with the patient quickly, but its use exposes the patient to radiation and increase cancer risks in the long term, other less invasive options such as an ultrasound or MRI might be a better choice. The same thing can happen with treatments; for example, a patient with back pain might want to take a painkiller right away, but physical therapy might be a better option in the long run.
3. Resource allocation: Present bias can also play a role in how healthcare organizations allocate resources. For example, imagine a hospital has to decide whether to invest in a new MRI machine or in a program to help patients manage chronic conditions like diabetes. The new MRI machine would be helpful in the short term because it would allow the hospital to perform more scans and make more money. But, investing in the diabetes program would be more cost-effective in the long run because it would help patients avoid more expensive treatments down the road.
4. Prioritizing immediate patient satisfaction: Imagine a patient is being discharged from the hospital and is upset because their pain is not completely gone. The healthcare provider wants to keep the patient happy and satisfied, so they might prescribe a strong painkiller for the patient to take home. This might provide immediate relief for the patient, but it could lead to addiction, dependence and potential overdose issues in the future.
5. Overuse of imaging tests: Imagine a patient comes in to see a doctor with a headache. The doctor wants to make sure that there’s nothing seriously wrong with the patient, so they order a CT scan or MRI. This might provide an immediate answer and peace of mind for the doctor and the patient, but the excessive use of these imaging tests can lead to false positives, overdiagnosis and increased healthcare costs.
6. Neglecting preventative care: Imagine a patient who comes in for a checkup and the doctor finds that they have high blood pressure. The patient’s pressure is not critical and they don’t feel any symptoms, so the doctor might just check it again in a few months, instead of recommending lifestyle changes, such as a healthy diet, weight loss, and exercise that would help in preventing more serious hypertension related conditions in the future.
7. Focusing on profitable treatments: Imagine a patient has a minor injury and there are two possible treatments: a surgery that costs a lot of money, and a physical therapy that will take longer but has fewer risks. The hospital or surgeon might be tempted to recommend the surgery because it’s more profitable, but this could lead to the patient experiencing unnecessary risks and complications.
8. Stockpiling resources for short term use: Imagine a hospital or health system that is running low on personal protective equipment (PPE) due to an unexpected event, instead of investing in building an inventory that would ensure long-term supply, it might use up the PPE in an inefficient way leading to stock out in case of future needs.

How can Present Bias be controlled or avoided in Healthcare Operations?

1. Adopting a long-term perspective: One of the most important things you can do to control present bias is to adopt a long-term perspective. When making decisions, try to think about how they might affect patients in the future, not just in the present. This can help you to avoid short-sighted decisions that might seem good in the moment, but could have negative consequences down the road.
2. Use data and evidence to inform decisions: Another way to control present bias is to use data and evidence to inform decisions. For example, when deciding on a treatment plan for a patient, consider the available research on the effectiveness of different treatments and the potential side effects. This can help you to make more informed decisions that take into account the long-term effects of different options.
3. Involving stakeholders in the decision-making process: It’s also important to involve all stakeholders in the decision-making process. This includes patients, their families, healthcare providers, and healthcare organizations. By hearing different perspectives, you can better understand the potential long-term effects of different decisions and make more well-informed choices.
4. Setting up a system of checks and balances: Establishing a system of checks and balances is an important step in avoiding present bias. This can include things like having multiple people review decisions and establishing clear guidelines for how decisions should be made. This can help ensure that present bias is identified and addressed early on.

Understanding and recognizing our present bias can help us make better decisions and more effectively plan for the future. It can also be helpful to develop strategies for overcoming present bias, such as setting specific goals and deadlines, seeking the advice of others, or using tools like decision-making frameworks or mental models. By recognizing and addressing our present bias, we can work towards making decisions that are more aligned with our long-term goals and values.