TY - JOUR T1 - What role is there for ‘nudging’ clinicians? JF - British Journal of General Practice JO - Br J Gen Pract SP - 82 LP - 85 DO - 10.3399/bjgp21X714857 VL - 71 IS - 703 AU - Luisa M Pettigrew AU - Nicholas Mays Y1 - 2021/02/01 UR - http://bjgp.org/content/71/703/82.abstract N2 - Interest in ‘nudging’ the public on health-related matters, such as healthy eating, exercising, becoming an organ donor, and most recently COVID-19, has spilled over into nudging healthcare professionals.1–6 Although experience and intuition serve clinicians well most of the time, the rules-of-thumb that drive, often quick or subconscious, decisions made under the pressures of day-to-day practice may not always result in good-quality, cost-effective care. This has generated growing interest in designing behaviour change interventions that consciously or otherwise ‘nudge’ clinicians in a certain direction.1–5 However, the ethics of nudging have been questioned, as has the science underpinning it.7 In this analysis we examine the rise of nudge-theory and discuss the opportunities and limitations of its application to behaviour change interventions aimed at clinicians.Daniel Kahneman in 2002, and Richard Thaler in 2017, won the Nobel Prize for their work in the field of behavioural economics. Their respective books Thinking, Fast and Slow8 and Nudge9 became international bestsellers by demonstrating how humans do not behave as rationally as traditional economic theory predicts, or as we would often like to think.In Thinking, Fast and Slow Kahneman presents evidence suggesting we utilise two main thought-processing systems, which he calls system 1 and system 2.8 System 1 is fast and intuitive; system 2 is slow and deliberative. Many of our day-to-day activities rely on system 1, for example, our daily commute or judging whether you think you’ll get on with someone you’ve just met. These decisions are based on heuristics, in other words rules of thumb, derived from experience, habit, emotion, and intuition. They require little effort and often happen unconsciously. By contrast, system 2 requires purposeful, slow thinking, such as doing a complex sum in your head or writing a structured argument.In … ER -