How to Change: The Science of Getting from Where You Are to Where You Want to Be

by Katy Milkman

What in the world happened?” Steve Honeywell wondered. Steve worked as an analyst at the University of Pennsylvania’s massive health system, and one day in the fall of 2014 he couldn’t make heads or tails of a graph he’d just created. According to his data, a persistent problem that had been costing the health system and its patients roughly 15 million dollars per year had disappeared overnight. This was not normal. So he started putting out feelers. “Did anything big change last month at the hospital? Were new best practices rolled out or something?” he asked his boss. “Could someone check?” I first heard the story of Steve’s baffling discovery when I invited Mitesh Patel, a talented physician and Wharton alumnus, to guest lecture in my MBA class. Mitesh runs a group at the University of Pennsylvania’s health system that, rumor had it, was accomplishing great things with behavioral science. And after he’d finished sharing his first slide, it was clear that these rumors were true. At the start of my class, Mitesh told us about Steve Honeywell’s miraculous discovery and why it mattered. Up until 2014, Penn’s health system had been incurring fines from its largest insurer for its doctors’ prescription practices. Much to the chagrin of Penn Medicine’s leaders, the medical staff habitually prescribed brand-name medications such as Lipitor and Viagra instead of cheaper but chemically identical generic drugs. This might not sound like a big deal, but patients were spending milli...