Washington, D.C. — The Centers for Disease Control and Prevention recently questioned over 350,000 people about their body mass index, cholesterol levels, fruit and vegetable consumption, and more. They found that only 3% of people have optimum cardiovascular health. 10% have poor cardiovascular health. The rest of us are somewhere in between.

The gap between what we should do and what we do do is obviously vast.

Should is a big world in healthcare. It’s a category full of oughts – do this, don’t do that. But, very little calibration back to what people really do.

What if we told people what people like them do instead of what perfect people should do? That approach is called social proof and it’s something Robert Cialdini has been studying for years.

Social proof: When people are uncertain about a course of action, they tend to look outside of themselves and to other people around them to guide their decisions and actions. It’s a very primitive way of deciding what to do. Basically: we do what people like us would do.

The principles of social proof have the potential to really change behavior in healthcare.

The opportunity: Show people what people like them are capable of

Cialdini bootstrapped an intriguing experiment at a hotel. His goal: Get more people to reuse their towels.

He started with a simple insight: Most hotel guest do reuse their towels at least once. But, the number could be a lot higher. The tactic hotels use today is appealing to our sense of doing what’s right (the ought):


Some ask you to save the planet, others offer to plant trees, but all are focused on environmental impact, not the social context.

Cialdini simply changed half the signs to read: the majority of guests at the hotel recycled their towels at least once during the course of their stay.

Guests who learned that the majority of other guests had reused their towels were 26% more likely than those who saw the basic environmental protection message to recycle their towels. That’s a 26% increase in participation relative to the industry standard, achieved simply by changing a few words on the sign to convey what others were doing.

How could we change chronic disease management by focusing on what people like you can accomplish instead of the ultimate long-term goal of perfection?

The watchout: Don’t give people permission to behave badly

Social proof can backfire if it’s not used in the right way. For example, the Petrified Forest National Park had a problem: People were stealing small bits of bark from the ancient trees. To combat it, they erected signs:

Your heritage is being vandalized every day by theft losses of petrified wood of 14 tons a year, mostly a small piece at a time.

The signs basically said:  “everyone is taking it.” They actually increased the amount of vandalism in the park.

Cialdini and team tested an alternate sign: Please don’t remove petrified wood from the Park, in order to preserve the natural state of the Petrified Forest.

By describing why it mattered, the new sign was able to reduce theft from ~7% of park visitors to ~2%.

Fun fact: This psychology is what made you buy that NordicTrac

Colleen Szot is one of the most successful writers in the paid programming industry. She’s the “infomercial genius” behind the fast-selling NordicTrac and built a home-shopping channel program that shattered a nearly twenty-year sales record. She used social proof change three critical words in infomercial strategy: from “Operators are waiting, please call now,” to, “If operators are busy, please call again.”

When people believe that something is in demand – that people like them are racing to get it – they feel compelled to do the same.

 Buy the book:

Yes!: 50 Scientifically Proven Ways to Be Persuasive


Posted by: Leigh Householder

About the Author:

As Managing Director of Innovation for Syneos Health Communications, Leigh is responsible for shaping the company’s perspective on the next era of healthcare marketing. Through thought leadership, strategic innovation workshops and new products and capabilities, Leigh focuses on identifying marketing approaches that will fuel that new era and generate significant growth for clients. Leigh has worked with Fortune 1000 companies to craft their digital, mobile, social and CRM strategies for over 17 years. She’s worked for category-leading agencies in retail, public affairs, B2B technology, and higher education. Prior to moving to Syneos Health Communications, she had several leadership roles at one of our agencies, GSW. There, she founded an innovation practice fueled by the zeitgeist and spearheaded digital and innovation thinking across the business. Leigh has taken a special interest in complex healthcare products that can change lives in meaningful ways. She was recently a strategic lead on the 3rd largest launch in pharmaceutical history: Tecfidera. Before that she had keys roles with Eli Lilly Oncology, Abbott Nutrition, Amgen Cardiovascular, and Eli Lilly Diabetes. A critical part of Leigh’s work is trends and new ideas. Every year, she convenes a group of trend watchers from across our global network to identify the shifts most critical to healthcare marketers. Leigh is a sought-after writer and speaker. Recognized as one of the most inspiring people in the pharmaceutical industry by PharmaVoice, Leigh also was recognized as a Rising Star by the Healthcare Businesswomen's Association (HBA) for her overt passion, industry thought leadership and significant contributions in new business, strategy and mentoring.