The previous post introduced the problem of ‘Physiological Need ≠ Want’, and held out the promise of delving into the underlying reasons for the behaviour. This post dives into those attitudes and beliefs.

Across the world, in the wellness space, people prefer to buy products that have an immediate, tangible benefit – a light feeling in the tummy, a quick burst of energy, relief from a headache / cough / cold etc, rather than buy and consume a product whose benefit lies in the prevention space, or one in which the benefit is immediate but not discernible to the consumer.

Apart from consumer education programs, doctor / nutritionist engagement programs, PR and advertising, businesses in the wellness space often address the ‘need but don’t want’ problem by linking an intangible benefit to a tangible benefit that consumers value.

The most common example is that of low calorie foods of all kinds – ads typically highlight the tangible, short-term benefit of weight loss and a shapely figure vs. the long-term benefit of weight/ sugar/ cholesterol maintenance at healthy levels. Nestle’s NesVita, a probiotic curd that has the primary benefit of being good for digestion is also 98% fat free and the packaging hints at the benefit of weight loss, presumably for the same reason.

Also remember the ads for Safi blood purifier (the intangible promise) that promised beautiful pimple-free skin (a tangible benefit). Colgate Plax is another example, a mouthwash brand that communicates the tangible benefit of fresh breath that occurs due to the germ-killing action (intangible to the consumer).

In the healthcare space, while it’s tempting to say that there is the tangible benefit of getting better and that should matter to patients, the basic issue is that all the ill-effects of ailments such as diabetes, high cholesterol or BP are typically not evident immediately, thus, the benefit of taking medication regularly and of making other lifestyle modifications is unclear to many patients. Habit change is always hard, when the reward for it is nebulous and indeterminate, it only becomes more so.

Therefore, unless an entity in the Healthcare space – either doctor, nurse, nutritionist, hospital educator or a pharmaceutical firm – explains the long-term impact on the body to the patient, and helps the patient travel from a state of lack of awareness to understanding and acceptance, patients do not view the ailment as life-threatening, and the medication is considered nice-to-have instead of a must-have. To an extent, the fatalistic Indian mind-set also has a role to play in this seemingly nonchalant and almost irresponsible behaviour of patients – ‘jo hona hai, wohi hoga’, ‘jab hoga, tab dekha jaayegaa’ (i.e. ‘whatever will happen will happen’, ‘we’ll deal with it when it happens’, quite the Indian version of ‘Que Sera Sera’).

FMCG products such as Saffola heart healthy oil have relied on an initial scare campaign through ads on TV and print to break through the layer of indifference in people’s minds and generate awareness about the ill-effects of ignoring heart health. They continue to back it up with heavy spends on PR and initiatives such as the Saffolalife program.

Pharma firms have begun to rely on IDM (Integrated Disease Management) programs in addition to doctor engagement programs.  The chronic care model prescribes a set of activities that emphasize active monitoring of disease in a panel of patients, care delivery according to clinical guidelines, education of patients about their disease and self-care techniques, interventions to provide on-going encouragement and support to patients, a comprehensive monitoring and feedback system and proactive patient outreach to assist patients in managing their disease. These activities are often collectively referred to as disease management.

Impetus for disease management stemmed in part from the poor match between the existing health care delivery system designed for acute care and the health care needs of the chronically ill. First, the chronic care patient cannot be “cured” and thus requires on-going medical care and attention; strict adherence to guideline-recommended care slows progression of the disease. Second, the effective management of chronic disease cannot be accomplished solely by the skilled practice of a single clinician; at a minimum, the patient must be engaged and actively involved. Very often, chronic disease management will require coordination among multiple clinicians and educators with various areas of expertise, working in separate settings.

Though the number of such programs is limited, those that have been implemented have seen a significant increase in patient compliance with medically recommended protocols.


Zenobia D Driver