DPC News

(EDITOR) Halo and Horn Effect: the Differences & Similarities Between Concierge Medicine and DPC and Today’s Cognitive Bias By Some Young Doctors

7th GRADE RULES of DEBATE FOR GRUMPY YOUNG DOCTORS – There are so many grumpy 😡 opinions in healthcare, often exhibited in comment threads by young Physicians as well towards older Physicians. Let this be a simple but caring reminder of the basics of debate courtesy of my visit to the 7th grade last night. 😀 #familymedicine #wecandobetter #internalmedicine #patientburnout #docscandobetter #fundamentals Photo Credit: The DPC Journal; 2019

By Michael Tetreault, Editor in Chief

So we write and talk to all different types and specialties of Doctors and healthcare practitioners each day who are seeking educational resources, advice or even looking for a career change and they ask us the difference between today’s “Membership Medicine” or two primary subscription-based healthcare delivery models … Concierge Medicine and its younger cousin, Direct Primary Care (DPC).

DPCs Inherent Advocacy vs. Activism Struggle Among Its Doctors. Opinions Abound, Patients [and Physicians, as of late] Now Find It ‘Off-Putting.’

We take the educational approach that each have unique patient demographics, some similarities and quite a few differences. We believe there’s not one that’s better than another. That would be like saying every patient is the same. They’re not.

‘The Clock Will Help You Decide: DPC or Concierge Medicine.’

We don’t have the liberty to paint with such a broad brush. Therefore, we don’t paint a halo on one and horns on the other. That’s not fair to anyone, let alone the Doctors working in each field or the patients they serve. Each business model, while having similarities, also have drastic differences. It’s up to the Doctor and your own intelligence to pick which subscription-based business model will work for you and your community of Patients.

To that end, I think it’s important to understand the psychological principle of the Halo and Horn Effect as you decide which business model is right for you. But please, don’t be so quick to criticize something you don’t understand until you’ve done a deep dive into learning more about it.

According to Joshua Kennon or Kennon and Green Co.,[2] he says:

It is a cognitive bias that causes you to allow one trait, either good (halo) or bad (horns), to overshadow other traits, behaviors, actions, or beliefs. In psychology, horns effects and halo effects happen all the time. Attractive people are, on average, though to be more intelligent even though this isn’t true. Overweight people are thought to be lazy, which is not necessarily the case.[2]

(C) 2019 Concierge Medicine Today & The DPC Journal | Infographic

The power of the horns effect and halo effect comes from the fact that it is closely related with several other mental models and, working together, you get a magnified influence. On one hand, you have mere association at work. On the other hand, you have the mental model of implicit personality theory, which states that individuals believe traits are inter-connected so that the presence of one traits means the presences of others, which isn’t true (e.g., a girl who dressed provocatively might not sleep around and someone who speaks slowly might not be unintelligent).[2]

The Challenge: DPC Must Empathize. They Must Uplift. And, They Should Never [EVER, under ANY circumstances] Villainize Different or Modified Models.

For added perspective, MBASkool is a one-stop management knowledge portal and a B-School community for all MBA students, professionals and MBA institutes, with the motto “Study Learn Share” and wrote the following:

HR (Human Resources) Definition: Halo & Horn Effect

Halo & Horn Effects, both of these effects come under the category of the first impression error. To elaborate these terms signify the error one makes by forming an opinion about a person/ situation, just by keeping the first impression in mind.[1]

Halo Effect

When we meet someone, and the first impression of him is very positive, then we tend to ignore the negative characteristics in the person and concentrate only on the positive characteristics. We start seeing the person in the halo of the positive first impression. This is called Halo effect. For example, if the interview starts with a very positive statement from the interviewee, then the interviewer tends to form a positive impression about the interviewee due to halo effect.[1]

Horn Effect

If our first impression about a person is negative, we tend to ignore his positive characteristics and concentrate only on the negative ones. We tend to see the person in the light of the negative first impression and hence there is higher probability that we will not like the person. This is called horn effect. For example, if an interview starts with a negative statement from the interviewee, there is higher chance that he would be rejected due to horn effect.[1]

So, In Summary, What Can or Should You Do?

We can appreciate what Joshua Kennon write in 2011 when he said this about protecting yourself against the Horns and Halo Effect.

How to Protect Against the Horns Effect and Halo Effect

The best defense against the horns effect and halo effect is to always adhere to one rule: Every idea must stand on its own merit regardless of who proposes it.

That is easier said that done.  Consider the case of the average Republican, who is supposedly pro-tax cut.  A few months ago, President Obama proposed a 50% payroll tax cut that would have been one of the greatest middle class tax cuts in the history of the United States.  They opposed his jobs bill, which included the tax cut, in large part because it would have been a political “win” for him.  In the far-right mind, the “horns” of Obama’s personality overshadowed their own self-interest.

Go through life evaluating every proposal and every situation on its own merits, its own rationality, and its own opportunity costs and outcomes.  This is exactly why John Stuart Mill would read books, articles, and other evidence that he knew to be wrong in order to, ” [see] that no scattered particles of important truth are buried and lost in the ruins of exploded error”.  He had built a system that compensated for the horns effect and halo effect, allowing him better cognition.

It is important that you realize the horns effect and halo effect are not without merit.  While you should strive to remove them from your cognition, they should still influence your behavior.  I wouldn’t want to be around people who lie, steal, or cheat even if they are good at their job or otherwise pleasant.  There is nothing wrong with being cautious when an otherwise bad person says something that might seem to make sense; the proverbial “devil in a Sunday hat”.

NEW! Latest Edition – Over 700+ Pages of Education, Tips, Tools, Strategies and Insight Into Concierge Medicine and Building A Subscription-Based Healthcare Delivery Model … LEARN MORE …

A good idea is a good idea even if it is proposed by the town drunk.  A bad idea is a bad idea, even if it is proposed by the town hero.  Never forget that and act accordingly.  This is one of the reasons that mature thinkers don’t take offense when someone attacks their positions or ideas – they are not extensions of the person, but rather must stand on their own.  There is nothing I enjoy more than assaulting my own beliefs from all sides to see if it can withstand the force.  That approach is why I get more and more rational with each passing year, and my real-world results reflect that.  There is nothing original in this approach.  Anyone is free to adopt it.


1. https://www.mbaskool.com/business-concepts/human-resources-hr-terms/3895-halo-horn-effect.html

2. https://www.joshuakennon.com/mental-model-horns-effect-and-halo-effect/

Categories: DPC News

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