Fri 27 Apr 2007
Do not talk about what hurts (the ELM model)
Posted by raphael encaoua under medical tourism, Wellness Tourism in Asia, Medical tourism theory, Incentive programs
According to a nationwide survey of 1000 adults conducted by Opinion Research Corp, Americans spend twice as much time researching car and computer purchases than they do in selecting a doctor, and 6 in 10 say they probably wouldn’t change their ways even if price and quality information on healthcare providers was readily available. It looks that the convenience factor is predominant yet one can wonder if this convenience is not correlated with the implicit message sent by the word doctor.
I am a huge fan of some consumer behaviour theories one of these being the famous ELM model (Elaboration Likelihood model) by Richard E. Petty and John T. Cacioppo:
A simple chart done by one of my friends at HEC to explain the ELM model
According to the ELM model one can take two routes when facing a decision problem: the central one which is rationale and the peripheral one which is affective. The most important underlying concpet is the involvement of an individual when making his decision.
The model defines the elaboration likelihood (EL) of the communication situation as the probability of message- or issue-relevant thought occuring in the consumer’s head. From the consumer’s point of view, it is about engaging or not in extensive issue-relevant thinking to evaluate an issue. According to the ELM model, the involvement or elaboration likelihood (EL) conditions choice in the following way:
+ When the EL is high, the central route should be particularly effective.
+ When the EL is low, the peripheral route should be better.
Medical tourism to gain credibility and striking power should be able to take the central route hence rationalize the decision process by identifying (or creating) key factors to be evaluated by someone opting for the appropriate surgery practice. The involvement is in fact low when talking about surgery knowing that the final decision is normally handled by a professional and there is little need (besides cost) to jump from one specialist to another. The medical service is indeed a long term involvement on which there is only one element that pressures us to decide: trust. And trust is on the peripheral route… Plus the peripheral route is a bumpy one as changing doctor is a stress factor that is added to the primary and ultimate anxiogene factor: the surgery itself.
Opting for another route thanks to medical tourism communicating through the tourism angle
Medical tourism revamp the central route by introducing new factors to be rationnaly evaluated such as: medical follow up through the trip, intrinsic quality of tourism services… Decision making will not only take into account the trust we have on a system but the rationale evaluation of the various benefits brought by medical tourism. Hospital accreditations, incentive programs proposed by companies or monospecialisation (best hospital for appendicetomy for instance…) can only help to opt for the central route…
3 Responses to “ Do not talk about what hurts (the ELM model) ”
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April 30th, 2007 at 5:04 am
Nice post applying consumer behaviour to medical tourism!
But I don’t completely agree that involvment is low concerning surgery. In the french system, seeing different specialists and comparing is refund by National Health Insurance, and for a same problem, doctor’s opinion and methods may diverge…Then invovlment is high…But the route taken does not lead to the web, but to word of mouth…Is word of mouth central or peripherical route?
April 30th, 2007 at 5:52 am
After reading again my article, I perfectly understand your criticism.
I should better explain why I pinpointed the involvement low when choosing an hospital. It is indeed because of word of mouth that is purely affective and he fact that we can hardly judge rationnally on the ability of a surgeon. Most practionners have a good track record (the bad ones are quickly discarded by medical authorities)
At the end of the day we are in front of a bunch of excellent specialists and several medical facilities.
What happens?
a. we will screen hospitals and see the one that better fits us plus sort out the total cost of our stay (if we are not totally covered by Welfare)
b. we will seek for advice on the surgeons we have found.
However this is idealistic. Honestly people often seek for advice but still opt for someone that has been recommended in first place by a series of friends.
The wording high involvement is misleading. It doesn t mean that you are not concerned but that the decision process is handled by someone else than you. In fact, when you go to see a doctor for an appendicictomy, few are those who will budge between a silvioscopy and a traditional procedure with a huge scar if they are not aware of the existence of the two procedures.
Taking the central route results from a better education of the patients. Yet, how is this achievable considering the high degree of complexity of this knowledge? this is why I think it is better to focus on the first point I put on relief above, namely choosing the place, the facilities etc… Something that is easier to grade