During a routine system upgrade, an IT consultant working on the software that Penn physicians used to send prescriptions to pharmacies made a small change to the user interface: he added a new checkbox to the system. From then on, unless a physician checked that box, whatever drug they prescribed would be sent to the pharmacy as a generic. Since doctors, like the rest of us, tend to be a little lazy, they only rarely checked the box: just 2 percent of the time. As a result, Penn’s generic prescription rate shot up to 98 percent.
