This sentence makes it feel more observable when you go to the polls, and it increased the effect of the letter by 50%. Making the letter more effective reduced the cost of getting an additional vote from $70 down to about $40.
Observability has been used to do things like get people to donate blood more frequently by listing the names of donors on local newsletters, or to pay their taxes on time by listing the names of delinquents on a public website.
What about this example? Toyota got hundreds of thousands of people to buy a more fuel-efficient car by making the Prius so unique that their good deed was observable from a mile away.
All right, so observability is great, but we all know, we’ve all seen people walk by an opportunity to do good. They’ll see somebody asking for money on the sidewalk and they’ll pull out their phones and look really busy, or they’ll go to the museum and they’ll waltz right on by the donation box.
Imagine it’s the holiday season and you’re going to the supermarket, and there’s a Salvation Army volunteer, and he’s ringing his bell.
A few years ago, researchers in San Diego teamed up with a local chapter from the Salvation Army to try to find ways to increase donations. What they found was kind of funny.
When the volunteer stood in front of just one door, people would avoid giving by going out the other door.
Well, because they can always claim, “Oh, I didn’t see the volunteer,” or, “I wanted to get something from over there,” or, “That’s where my car is.” In other words, there’s lots of excuses.
And that brings us to the second item on our checklist: to eliminate excuses.
In the case of the Salvation Army, eliminating excuses just means standing in front of both doors, and sure enough, when they did this, donations rose.
But that’s when things got kind of funny, even funnier. The researchers were out in the parking lot, and they were counting people as they came in and out of the store, and they noticed that when the volunteers stood in front of both doors, people stopped coming out of the store at all.
Obviously, they were surprised by this, so they decided to look into it further, and that’s when they found that there was actually a third, smaller utility door usually used to take out the recycling — and now people were going out that door in order to avoid the volunteers.
This teaches us an important lesson though. When we’re trying to eliminate excuses, we need to be very thorough, because people are really creative in making them.
All right, I want to switch to a setting where excuses can have deadly consequences.
What if I told you that the world’s deadliest infectious disease has a cure, in fact, that it’s had one for 70 years, a good one, one that works almost every time? It’s incredible, but it’s true. The disease is tuberculosis.
It infects some 10 million people a year, and it kills almost 2 million of them. Like the blackout prevention program, we’ve got the solution. The problem is people.
People need to take their medication so that they’re cured, and so that they don’t get other people sick. For a few years now, we’ve been collaborating with a mobile health startup called Keheala to support TB patients as they undergo treatment.
Now, you have to understand, TB treatment, it’s really tough. We’re talking about taking a really strong antibiotic every single day for six months or more. That antibiotic is so strong that it will make you feel sick. It will make you feel nauseous and dizzy. It will make your pee turn funny colors.
It’s also a problem because you have to go back to the clinic about every week in order to get more pills, and in sub-Saharan Africa or other places where TB is common, now you’re talking about going someplace pretty far, taking tough and slow public transport, maybe the clinic is inefficient.
So now you’re talking about taking a half day off of work every week from a job you desperately can’t afford to lose. It’s even worse when you consider the fact that there’s a terrible stigma, and you desperately don’t want people to find that you have the disease.
Some of the toughest stories we hear are actually from women who, in these places where domestic violence can be kind of common, they tell us that they have to hide it from their husbands that they’re coming to the clinic. So it’s no surprise that people don’t complete treatment.
Can our approach really help them? Can we really get them to stick it out? Yeah.
Every day, we text patients to remind them to take their medication, but if we stopped there, there’d be lots of excuses. “Well, I didn’t see the text” Or, “You know, I saw the text, but then I totally forgot, put the phone down and I just forgot about it.” Or, “I lent the phone out to my mom.”