Something You Should Know - How You Can Access Better Health Care Now & Subtle Factors That Influence Your Decisions

Episode Date: September 23, 2019

If you ever lose something at an airport – where do you go to find it? The Lost & Found of course. But do you know how many Lost & Founds there are at the airport? A LOT. That is just one of many great airline travel tips that begin today’s episode. http://www.thisisinsider.com/airport-travel-hacks-2016-8/#avoid-paying-for-a-luggagecart-by-using-one-that-was-left-in-the-pickup-area-outside-the-terminal-by-someonewho-didnt-return-theirs-bonus-return-them-for-money-1 People complain about their healthcare but things are beginning to change for the better – and there are ways you can access that better care now. That is according to Dr. Marty Makary, a surgeon, professor at Johns Hopkins University and author of the book The Price We Pay: What Broke American Health Care and How to Fix It (https://amzn.to/31FfgqN). Listen as Dr.Makary describes the challenges we face and the solutions that are already here. Most people agree that Reese’s peanut butter cups and Snickers Bars taste better frozen. But there are a lot of other foods you likely never considered that also taste really good frozen. Listen and discover some great frozen delights. http://www.prevention.com/food/12-foods-that-taste-even-better-frozen Weird things influence you. If your neighbor first buys the car you are thinking of buying, you are less likely to buy it. Same thing at a restaurant. If someone else first orders what you are about to order, you are more likely to change your mind. Why? It turns out there are a lot of these subtle influences that affect your behavior. Listen to hear what they are from my guest, Dr. Jonah Berger, a professor at the Wharton School at the University of Pennsylvania and author of the book Invisible Influence: The Hidden Forces that Shape Behavior (https://amzn.to/2V9oZDa). This Week’s Sponsors -Babbel. To learn a language go to www.Babbel.com and get a whole year of access to Babbel for as low as $3.50 a month! Learn more about your ad choices. Visit megaphone.fm/adchoices

As a listener to Something You Should Know, I can only assume that you are someone who likes to learn about new and interesting things and bring more knowledge to work for you in your everyday life. I mean, that's kind of what Something You Should Know was all about. And so I want to invite you to listen to another podcast called TED Talks Daily. Now, you know about TED Talks, right? Many of the guests on Something You Should Know have done TED Talks. Well, you see, TED Talks Daily is a podcast that brings you a new TED Talk every weekday in less than 15 minutes. Join host Elise Hu.

She goes beyond the headlines so you can hear about the big ideas shaping our future. Learn about things like sustainable fashion, embracing your entrepreneurial spirit, the future of robotics, and so much more. Like I said, if you like this podcast, Something You Should Know, I'm pretty sure you're going to like TED Talks Daily. And you get TED Talks Daily wherever you get your podcasts. Today on Something You Should Know, some great airline travel tips you probably haven't heard We'll be right back. prescribed 2.4 billion prescriptions. Last year it exceeded 5 billion. Did disease really double in the last 10 years? No. We have the medicalization of ordinary life and we've treated everything as if it needs a pill. Plus, foods you've probably never eaten frozen that you really need to try

and fascinating ways your decisions are influenced that you've probably never realized. Imagine your neighbor bought the car you were thinking of getting. You'd say, well, I should still buy that car. It's the car I like. Yet the fact that they bought it makes us a little less likely to buy it. We're worried we're going to look like a copycat when we actually avoid doing what we already liked to try to be different. All this today on Something You Should Know. Since I host a podcast, it's pretty common for me to be asked to recommend a podcast.

And I tell people, if you like Something You Should Know, you're going to like The Jordan Harbinger Show. Every episode is a conversation with a fascinating guest. Of course, a lot of podcasts are conversations with guests, but Jordan does it better than most. Recently, he had a fascinating conversation with a British woman who was recruited and radicalized by ISIS and went to prison for three years. She now works to raise awareness on this issue. It's a great conversation. And he spoke with Dr. Sarah Hill about how taking birth control

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or wherever you get your podcasts. Something you should know. Fascinating intel. The world's top experts. And practical advice you can use in your life. Today, Something You Should Know with Mike Carruthers. Hi, welcome to Something You Should Know. We will soon be heading into the holiday travel season,

so we're going to start today with a few things worth knowing if you travel from airline people in the know. First of all, if you lose something at the airport, remember to check all the lost and founds. The TSA, the airport police, and each airline all have their own lost and found. It's a really good idea to take batteries out of electric toothbrushes and other appliances before you pack them. Vibrating suitcases have grounded many a flight due to security reasons. Anything that's been sitting in lost and found for more than 90 days

is usually up for grabs. So if you need something desperately, like, say, a phone charger, just be honest and ask. Chances are one has been unclaimed for 90 days and, more than likely, they'll just give it to you. If your flight is cancelled or overbooked, you should call the airline's 800 number from the airport instead of getting into that terrifyingly long line. The customer service representative on the phone can do anything the gate agent can. Maybe even better, call while waiting in line and then just work with

whoever becomes available first. And you can avoid paying for a luggage cart if you use one that was left in the pickup area outside the terminal by someone who didn't return theirs. And that is something you should know. As the saying goes, nothing's more important than your health and your health care. And yet it might also seem that nothing is more dull and boring than a discussion, than listening to a discussion on health care. In fact, you might right now be thinking, let me rush to turn this off. Well, don't, because this is actually going to be really interesting. Everybody knows that health care is a bit of a mess in this country. However, good news abounds, according to my guest,

who has examined the health care system, is part of the health care system, and is trying to help fix the health care system. Marty Macri is an MD. In fact, he's a surgeon, and he's professor of health policy at Johns Hopkins University, and he's author of a book called The Price We Pay, What Broke American Health Care and How to Fix It. Hi, Marty. Welcome to Something You Should Know. Great to be with you, Mike. So health care is too expensive.

You have to wait too long to see a doctor. There are just a million things wrong, it seems, with health care in the United States. How did we get here? Well, there's a big blame game going on right now with health care costs. But the real story that no one is talking about, that we need to talk about, is pricing failures. You know, the combination of pricing failures and inappropriate care, or stuff you just don't need done, drives up the cost of health care to make it so unaffordable. That's why we're seeing high deductibles and so many people getting crushed right now with medical bills.

So explain what you mean by a pricing failure. Well, you know, if you went on an airline travel site to look for a flight and there were no prices, that's a pricing failure. If airlines simply billed you after the flight, we would say that the incompetence of that marketplace, the lack of showing prices for fairly predictable services enables price gouging on the back end. And I'm a doctor. Look, we're not going to give you a price if you're having a heart attack or we're doing trauma surgery. But 60% of medical care is shoppable and predictable.

And the exciting thing right now, Mike, is there's a new movement of apps and patient navigation tools and medical centers that are saying, hey, you deserve to see the price ahead of time, and we're going to show it to you. It only makes all the sense in the world. You don't go shopping at a department store and just throw things in your cart and say, what do I owe you? You look at the prices as you go.

You figure out, do you want that sweater or that sweater? I mean, somehow medicine gets a pass. I can't show up and mow your lawn and send you a bill for $4,000 without some kind of agreement or understanding. I went to a hospital once where I asked them, as part of our advocacy work, I said, how much is a CAT scan here? Because I had heard stories of price gouging. And the receptionist at the counter said, it's about $5,000 to $10,000. But if you go to this website, mdsave.com, the hospital has the CAT scan listed for $500. That is how showing prices is now creating a competent marketplace. Look at LASIK eye surgery, IVF therapy, cosmetic surgery, all those sectors of healthcare already have pricing, and you've seen a global reduction

in prices over time. Well, one of the reasons that obviously pricing matters less is because people don't pay for it out of their pocket in many cases, or at least not much of it. And one of the things that I've never gotten a good answer to this, but I remember as a young child going to the doctor, my mother taking me to the doctor, and we had a doctor visit, and she wrote a check and said thanks, and that was the transaction. And there was only insurance in the event that I got hit by a bus or fell off a building or got some horrible disease.

That's only when the insurance kicked in. That medicine was pay to play. If you went to the doctor, you paid for his time and his expertise. And then something changed where now everybody thinks everything is paid for by insurance. And I don't know where that happened, why that happened, or exactly when that happened. But that seems that that's not insurance anymore. It's a crazy game. I mean, ironically, the first insurance company, Blue Shield, was started by a hospital

because people in the community needed to kind of pool their money together. And what we have today is this crazy game where insurance companies get a secret discount and hospitals create an artificially inflated bill. And people need to know that that bill was never intended for individuals, never intended for people who are paying out of network or have high deductibles or are uninsured. And that's why the little known secret in health care is those bills are highly negotiable most of the time. Well, and that's the other thing is that, like, it is no secret that when you go to a doctor, there are two prices very often, if you're paying for yourself or the insurance is paying for it,

because we'll gouge your insurance, but we'll give you a break. And unfortunately, people think, oh, I didn't pay my insurance paid or I didn't pay Medicare paid. Well, guess where that money comes from? It comes from your premiums. We have a study that just came out of Johns Hopkins that 48% of all federal spending goes to health care in all of its hidden forms. We are getting crushed right now by the goes to health care in all of its hidden forms. We are getting

crushed right now by the cost of health care, and these money games and the predatory billing that's now out there threaten the great public trust in the medical profession. And so what are we going to do about this? Or is it just going to limp along and someday just explode or something? I'm actually very optimistic, having done a lot of research now on this topic. I was excited to see the growth of transparent pricing at certain medical centers, centers that are saying, we can get more business because there's a demand for honest prices, and we want to give that to you. There's urgent care clinics in Los Angeles that have price menus for stitches and basic services.

There's the Surgery Center of Oklahoma. If you go to their website, they list operations not just with prices but a real fair price, the same price for insurance as it is for out-of-pocket people. And MD Save and other platforms are doing this. GoodRx is doing it for medications. We are seeing a revolution right now, and people can benefit tremendously by knowing what's out there. So one of the things that concerns me as much as price does is just the service in general. It's hard to get in to see the doctor. You end up at the urgent care with 25 people ahead of you because the doctor can't see you

for four months. It seems to me it didn't seem to be that way, and that medical care by urgent care is not great care. It's a disgrace, really. Primary care in the United States, and I'm speaking as a physician here, is completely broken. And what we're seeing now are doctors saying, let's redesign primary care from scratch. Let's say no to billing. We docs hate coding and billing. Let's get rid of that. Some of these clinics are paid in a lump sum. And by the way, people over 65 can sign on to these clinics for free many times. Medicare will agree to pay the fee, so there's no cost to them. They're called Iora, ChenMed, GenCare, Landmark, Oak Street. It's a new surgence of relationship-based medicine where doctors spend time with you and they get into the root causes of disease. They talk about things

overdone. They talk about food as medicine. They talk about treating back pain with ibuprofen and physical therapy instead of surgery and opioids. This is the new mission to restore medicine back to its roots, and it's pretty exciting. Well, I haven't heard much about this. I mean, granted, I don't run in your circles, but this is news to me, and it's certainly welcome news. I hope it filters down to where I am, because I haven't seen it yet. Well, look, the system is completely broken right now. Look at burnout rates among doctors and satisfaction rates among patients. I mean, they're in the toilet, right? The system is broken. So this new movement in the spirit of medicine developing ways out of our messes, we are seeing a whole new science, not only telling us we can

deliver care without the middlemen, but there's a new science now. We don't have to take everyone's cholesterol test every year, okay? There's a blood test called LP little a. Every American should have it done, lipoprotein little a. you usually only need it done once, and it's a very accurate predictor of early heart disease. We're learning a lot about this dogma from the past. Do you know appendicitis does not need surgery 75% of the time? Three big studies came out in the last two years showing that antibiotics are extremely effective with great long-term results and really no added risks if we treat people with non-ruptured appendicitis with antibiotics first. But medical care has always evolved.

We're always learning new things, new treatments, new ways to do things. What's different today, and why did we go in, back to my question that I say I never get an answer to, is why did we get here in the first place? What went wrong? Well, we adopted this crazy fee-for-service system that rewards quantity instead of quality. It rewards surgeons like me for just doing a ton of surgery. We have a system that pays good doctors the same that it pays bad doctors. And this crazy system is now being re-evaluated because it's resulted in two major

problems. One is an overtreatment epidemic, and the other is a sense of being disconnected from the patients. You know, 10 years ago, we doctors prescribed 2.4 billion prescriptions. Last year, it exceeded 5 billion. Did disease really double in the last 10 years? No. We have the medicalization of ordinary life. We've completely ignored food as medicine and good holistic care. And we've treated everything as if it needs a pill. And this consumerist culture that's the byproduct of our fee-for-service system has had a lot of casualties. I'm speaking with Marty Macri. He is a surgeon, a professor of health policy at John Hopkins University, and author of the book, The Price We Pay, What Broke American Healthcare and How to Fix It.

Hi, this is Rob Benedict. And I am Richard Spate. We were both on a little show you might know called Supernatural. It had a pretty good run, 15 seasons, 327 episodes. And though we have seen, of course, every episode many times, we figured, hey, now that we're wrapped, let's watch it all again. And we can't do that alone. So we're inviting the cast and crew that made the show along for the ride. We've got writers, producers, composers, directors, and we'll of course have some actors on as well, including some certain guys that played some certain pretty iconic brothers.

It was kind of a little bit of a left field choice in the best way possible. The note from Kripke was, he's great, we love him, but we're looking for like a really intelligent Duchovny type. With 15 seasons to explore, it's going to be the road trip of several lifetimes. So please join us and subscribe to Supernatural then and now. People who listen to Something You Should Know are curious about the world, then and now. It's the podcast where great minds meet. Listen in for some great talks on science, tech, politics, creativity, wellness, and a lot more. A couple of recent examples, Mustafa Suleiman, the CEO of Microsoft AI, discussing the future of technology. That's pretty cool. And writer, podcaster, and filmmaker John Ronson discussing the rise of conspiracies and culture wars.

Intelligence Squared is the kind of podcast that gets you thinking a little more openly about the important conversations going on today. Being curious, you're probably just the type of person Intelligence Squared is meant for. Check out Intelligence Squared wherever you get your podcasts. So Marty, a lot of these things that you're talking about sound great, but where do we go find them? I mean, I'm not hearing a lot about these things in my health care plan, so do we just wait for this stuff to catch up, or is there a place to go find it? I think we should not be waiting. We need to be proactive. Everybody in America can do a lot of things to help drive this change and move the markets. You know, when people demanded nutrition labels on food, the industry said they couldn't do it.

They said it was too hard and, you know, prices of food would all go up if they had to do it. Well, none of that was true. People need to demand prices. People deserve prices when they go in to deliver a baby. The price right now ranges from $4,000 to $70,000 for an uncomplicated delivery. They need to ask to see outcomes. You know, if your C-section rate is 80% in uncomplicated deliveries, those are the doctors you want to avoid. Get a second opinion. We did a national study asking doctors what percent of medical care is unnecessary. They said 21%. If that's what doctors are saying, get a second opinion. Go to these resources that

allow you to find another physician or read up on your conditions. We found that Google is 94% accurate for medical information. People who are well-researched on their conditions tend to get better care. Doctors will tell you, though, because they've told me, that one of the things that drives this is consumers demand it. They want the pill. They want the medication. And if you don't give it to them as their doctor, they'll go to another doctor. It's terrible. The consumerist culture that we've created is creating a whole new host of problems. Look, the number one public health threat today is antibiotic resistance. We've already got kids coming in with ear infections

and older patients with an infection called C. diff of the colon, a terrible infection of the colon, that are completely resistant to everything we have. That's because of the mass overuse of antibiotics. And it's not just in patients, it's in agriculture. Buy antibiotic-free food as a public service because antibiotics in agriculture creates resistance that crosses over into humans. How do you control prices when, for example, you go into an urgent care because you're very sick or into an ER because you're very sick, and you sign documents, and I imagine in and amongst those documents is something that says you'll basically pay whatever we say. Nobody should sign any financial document when they walk into the hospital with an emergent condition. The law requires hospitals to take care of you regardless if you sign a financial document or if you give

your credit card. Don't do that stuff. And by the way, people are vulnerable when they come in clutched over in pain. You don't have to sign anything financial. If they insist you sign it in order to be treated, you write in that signature line, did not read. Okay, you can write it in sloppy handwriting if you want. But the idea that you have to sign your home away without seeing prices at a time when you're vulnerable violates the public trust of the medical profession. Hospitals were built to be a safe haven, not to gouge people. But people need to look at their bills. You know, they need to know that 80% of the time there's an error on medical bills. Talk to someone in the revenue cycle department

of a hospital. If you feel like you've been unfairly billed, talk to the CFO or the CEO, or find a board member. I mean, board members are supposed to be the liaisons to the community. And don't be afraid to talk to your doctor about your bill. I can't tell you the number of people that are afraid to talk to their doctor about an egreg I can't tell you the number of people that are afraid to talk to their doctor about an egregious bill because they don't want to bother the doctor. Doctors, when they find out about price gouging, are livid, and they want to be your advocate. Engage your doctor with your medical bills. People have been asked, and the answers are always a little fuzzy, you know, when you look at your bill and you've been charged whatever it is,

$100 for a Band-Aid, why? There hasn't been a consequence to this game for patients because insurance companies have been overcharged historically, and they pass on those costs through higher premiums. Well, now the costs are so high that they're actually increasing deductibles or increasing your share as a patient as to what you need to pay. And most hospitals, look, most hospitals are good and try to serve their communities. But we've got good people working in a bad system. And this crazy game of inflating prices so hospitals can offer secret discounts depending on your insurance carrier or employer is a complete, expensive, exhausting game. And it needs to stop.

And it is stopping. And this is the revolution right now, and we're starting to see a lot of cool stuff. You know, GM spends more money on health care than it does on steel. Starbucks spends more money on health care than it does on steel. Starbucks spends more money on healthcare than it does on coffee. GM is now saying, hey, we're just going to do a contract with Henry Ford Health System. A lot of hospitals, or sorry, insurance companies are saying, we're going to send our patients to the surgery center of Oklahoma because they have honest pricing. And so there's a lot of stuff that's happening right now. One of the things I think people wonder about is that the cost of health care, the cost of health insurance,

the cost of everything about health care seems to go up astronomically year after year after year. And yet when you talk to people who work in health care, they're not getting rich. The nurses and the people in the hospital, they don't say, yeah, we're just rolling in dough. Somebody must be getting rich. So who is it? Look at the earnings on Wall Street. Look at how does UnitedHealthcare report a 25% increase in earnings in that last quarterly earnings call? I mean, this is an actuarial business, right? Well,

they said and admitted on the call that it's in part due to their pharmacy plan. Well, the pharmacy plans are gouging employers for every drug their employees take with this thing called spread pricing. And it's one of many money games. Employers can shop better and they can bypass these money games. And we're starting to see that. But you're absolutely right. A lot of stakeholders are getting rich in health care, except for one, the patient. And so we need to rise up. It's the patients and the everyday Americans are the weakest voice in Washington, D.C. And they need to speak up. Doctors, too. I'll tell you, doctors and nurses have not seen any salary increase in

the last 20 to 30 years. Salaries are stagnant. The appendix removal surgery that I did 15 years ago uses the same chromic suture material and the same knife that I used 15 years ago. The nurses and the staff are paid the same amount of money how is it that health care went up seven hundred percent over that time period it's the money games it's the pricing failures what spread pricing so uh... an employer book find out for a pharmacy plan for their employees just like they sign up for health insurance

and the part of the pharmacy benefit manager or the PBM, the middleman that manages these pharmacy costs, will bill the employer, say, $200 for a medication the employee takes and only pay the pharmacy, say, $20 for that medication. And they're making a massive margin. That's spread pricing. It's complete gouging, and it's wrong, and it's fueled by kickbacks called rebates in the industry. You've heard it in the policy world. Trust me, these are not like a rebate on cornflakes. These are kickbacks. And I think with all the divisiveness that cable news puts in front of us, suggesting we're a divided country on health care. There's so much agreement. Can we agree to get rid of kickbacks and secret pricing in health care? Because if we can, there's broad

consensus for a revolution right now. I imagine there's a lot of people in the health care business who don't like you very much. Well, a lot of people are getting rich, and honestly, they're often good people. They're just doing their job. This is a terrible system that we've inherited. And so, you know, I can just show up to work and collect my paycheck every two weeks as a surgeon. I love my job. But somebody needs to speak up.

These money games are violating the public trust, and it's violating our heritage. People are at home sick and scared to go to the doctor because of gouging. People are calling Ubers to go to the emergency room because they're afraid the local ambulance company is going to gouge them. And, you know, we have an incredible history of taking care of people. As it's been said, who else has an eye on human equality than physicians and nurses as the witnesses of birth and death? Dr. Banting sold that insulin patent for $1 so as many people could get it as possible. And Salk refused to sell the polio vaccine, quote unquote, so as many kids could get it as possible. That is our great medical heritage. And that is being threatened today with these many money games.

Well, I'm glad you're optimistic and parts of it sound optimistic. Parts of it don't sound very optimistic, but we'll see what happens. And people clearly now have some options that can help fix the problem. Marty Macri has been my guest. He is a surgeon and professor of health policy at John Hopkins University and author of the book, The Price We Pay, What Broke American Healthcare and How to Fix It. You'll find a link to that book in the show notes. Thank you, Marty.

Thanks, Mike. It's been great being with you. Do you love Disney? Then you are going to love our hit podcast, Disney Countdown. I'm Megan, the Magical Millennial. And I'm the Dapper Danielle. On every episode of our fun and family-friendly show, we count down our top 10 lists of all things Disney.

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In Don't Blame Me, we tackle our Wrong? Each week, we deliver four fun-filled shows. In Don't Blame Me, we tackle our listeners' dilemmas with hilariously honest advice. Then we have But Am I Wrong?, which is for the listeners that didn't take our advice. Plus, we share our hot takes on current events. Then tune in to see you next Tuesday for our listener poll results from But Am I Wrong? And finally, wrap up your week with Fisting Friday, where we catch up and talk all things pop culture. Listen to Don't Blame Me, But Am I Wrong on Apple Podcasts, Spotify,

or wherever you get your podcasts. New episodes every Monday, Tuesday, Thursday, and Friday. Some people are just more influential than others. And some people are more influential in some situations than others. So what are those factors that make someone influential? Particularly those hard-to-detect but powerful factors that make somebody very influential. And more importantly, how can you become more influential? Here to discuss that is Jonah Berger.

Jonah is a professor at the Wharton School at the University of Pennsylvania and author of several books, including Invisible Influence, The Hidden Forces That Shape Behavior. Hi, Jonah. So is being influential and being persuasive, do you think it's a talent? Is it a gift or what? Not so much. You know, we definitely have people in our own lives that seem to be more influential, but we can be more influential ourselves if we understand what makes people influential in the first place. Some researchers looked at negotiators to try to figure out what made certain negotiators

more successful. And they found that one simple trick led negotiators to be much more successful, to reach better outcomes and get a bigger slice of the pie. And that trick very simply was imitating their negotiating partner. Their negotiating partner crossed their legs, they did the same thing. Their negotiating partner rested their hand on their cheek on their hand, they did the same. Subtly imitating or mirroring the mannerisms, the words, the language used by someone else led negotiators to be more successful. Same thing actually in a sales context. So in a restaurant engagement, for example, if the waiter or waitress reads your

order back to you word for word, they just got a 70% higher tip. And so it's not just that certain people are naturally more influential than others. They use some of these tools that we ourselves can use. We don't just want to listen to others. We want to emulate them as well, whether their language or their mannerisms. The more we seem similar, the more likely they'll be to like us, to trust us, and the better those interactions will go. I imagine most people would think, gosh, that seems so simple and so elementary that it couldn't work. How could that be a way to be influential just by mirroring back? So there must be other ways that we don't think of that are kind of below the radar there that work, correct? Yeah, and you know, in this case, imagine you and I are chatting and we find out we have the same birthday, went to the same high school.

Suddenly we feel like we have more in common. We feel a kinship. We like each other more. We trust each other more, and our interactions go better. And that's exactly what mimicry does. But mimicry is only one of the dozens of subtle and often surprising tools that I talk about in the book. And another great one is the power of peers to motivate us. How can we use others to motivate us. How can

we use others to help us reach our goals? And it turns out that peers can be a great way to do things we couldn't do otherwise. People tend to work harder when others are around. Cyclists race faster. Runners run faster. People work harder when others are present. And so rather than trying to hit our goals by ourselves, we can use others to help us get there. Working out at the gym, for example, rather than at home or going running with someone else rather than running alone will help us run faster, work out harder, and as a result, be more successful. You talk about how new products should be different, but not too different. How does that fit into this discussion? Yeah, they're different flavors of

influence. Sometimes people do the same thing as others. Sometimes they do something different, and sometimes they do something in between. And this in between is really important when launching a new product or idea. I think a good way to think about it is pitching like Goldilocks from Goldilocks of Three Bears fame. Usually, we think it's all about being different. A new product or service, we want to talk about how different it is than something people have seen before. If they feel like it's different, they'll want it and will be successful. But if you look at actually successful companies and ideas, they tend not to be different. When you think about Google and Apple, for example, succeeding because they're different, but

Apple actually wasn't the first or Google wasn't the first to introduce the things they've become synonymous for. Google wasn't the first company to do online search. They just did it a little better than someone else. Apple wasn't the first to introduce the digital music player. They just did it better than someone else had done. And so if you actually look at the data, it's not about being different. It's about being optimally distinct, similar and different at the same time. You know, if something is too different, people think it's scary. I don't know how to use this. I don't know how to fit this in to my existing world. Why should I buy this if I don't know how I'm going to use it? At the same time, if something is too similar, exactly the same as what we're doing already, what's the

reason to switch? Why do we need to put the effort in to do something different? In between is just right. Just like Goldilocks and the three bears, one side's too hot, one side is too cold, but in the middle is just right. When we mix similar and different, we're optimally distinct. That's when companies and ideas end up being successful. Similar enough to feel familiar, so people understand it, they can see how it fits in their life, but different enough to feel novel, feel distinctive, and feel worth adopting. Give me some other examples of this, because there's so many in the book. You say that successful athletes have older siblings. Is that going back to the idea of having peers that push you along? It's both. It's actually being similar and different at the same time. When researchers looked at what makes elite athletes successful, what they have in common, they found that a lot of them had older brothers or sisters.

And you might think it's all about older brothers and sisters playing the same sport. So if your older brother or sister plays tennis, you sort of follow them along to their tennis lessons, and you pick up a racket earlier, and you play with them, and you learn, and you compete, and so you get better. But it turns out that actually wasn't the case. Elite athletes had older brothers and sisters, and those older brothers and sisters tended to play sports, but they were often a different sport from what the younger child ended up succeeding at. And so why was that helpful? Well, it turns out that older siblings do two things. One, they provide a guide, a person to follow to do something, a competitor to get better, but they also provide something to contrast yourself against. If your older brother and sister is really good at tennis, it's going to be hard to be better than them at tennis. They've

got a head start on you, they're taller, they're bigger, and they're probably going to be much better. And so younger siblings don't just follow. They also differentiate. They try to separate themselves and craft their own path. If their brother or sister is good at tennis, maybe they take up baseball. The same thing in our own families. If an older brother or sister is the smart one, we become the funny one. If they're the artsy one, we become the sporty one. And so those individuals in our lives, in this case, our siblings or our family members, shape our behavior often without us even realizing it. Well, it's interesting when we think about the choices that we make, and we don't really think why we make them. We pick this thing over that thing, or we do this

thing over that thing. But if we stop and think, well, if we stop and think, you know, why we pick one can of pasta sauce over another, would we be able to figure it out? Or is it all just happening behind the scenes? It often happens below our awareness, often in a way we don't even realize. We did a bunch of research on baby names, looking at why people pick a given name for their child. And if you ask people, they'll give you an answer. People say, oh, I picked this name because it's similar to my aunt's name. Or, oh, it was similar to a friend's name that I had growing up.

And yet, when we all have these idiosyncratic individual reasons for picking names, when our kids get to kindergarten, they often end up having the same name as two or three other kids in their class. And so if it's all about being different, how do everyone end up being the same? We're all trying to separate ourselves. How do we end up being similar? Well, it turns out that without our awareness, we're subtly influenced by what names are popular at the moment. If, let's say, Lisa's popular, for example, we may not name our child Lisa, but we're more likely to name them Lindsay or Larry, other names that begin with that L sound. Similarly, hurricanes. Hurricane Katrina comes around. You'd think no one would name their child Katrina after that. If Hurricane Katrina has a big, significant impact on naming patterns, 10% more babies were born with K names after Hurricane Katrina. Again, not the same name as Katrina, but a slightly different name, because hearing Katrina more often made those K names sound better, and as a result,

we adopted them. And so even simple things like how good something sounds is not just driven by our own personal preferences. Sometimes it's driven by the things we hear and see in our surrounding environment. Well, what about once you have a personal preference, is it pretty hard to move people away from that, even with all the things we know or that, well, that you know? I don't know them yet. But because people have latched onto something, once they have, then it's tough to move them? You would think so, but it's actually surprisingly easy

to change people's behavior. You know, imagine you're out to dinner, for example, with a group of friends. You're hungry, so you start perusing the menu. You figure out what entree you like, and your stomach starts rumbling. You can't wait for the waiter to come over. Finally, after a couple minutes, they come over. They start taking orders, your friend of yours' orders, and they end up ordering the same entree that you were thinking of getting,

the exact same thing. And then it comes to you. Do you pick the same thing or do you pick something different? And, you know, as individuals, as people who think they're independent, we'd love to say, well, yeah, I'll stick with the same entree. Of course, you know, why would I change my choice? Yet we don't. Overwhelmingly, people end up changing what they were going to pick, picking something else because their friend chose it. And it makes them less happy as a result. They end up being less satisfied with the entree they chose. And so even in this

case, it's not just about following others. Sometimes it's about differentiating ourselves, and that's why I find influence so interesting. You know, they're different flavors. Sometimes we're similar. Sometimes we're different. Sometimes we're optimally distinct, right in the middle. Sometimes others motivate us. Sometimes others demotivate us. And by understanding these subtle and often surprising influences, we can take advantage of their upsides and avoid their downsides. You know, that's an interesting example, one I've often wondered about. If you're going to have the whatever dish and somebody else orders it first, why should that influence your choice now? They should get what they want,

and you should get what you want. And yet, you're right, people change because they don't want to look like a copycat, I guess, or something. Yeah, I mean, imagine your neighbor bought the car you were thinking of getting. You'd say, well, I should still buy that car. It's the car I like. Yet the fact that they bought it makes us a little less likely to buy it. We're worried we're going to look like a copycat. We're worried we're going to look like exactly the same as them. And so we don't imitate and we actually avoid doing what we already liked to try to be different, to try to be distinct. What can cockroaches teach us about motivation? So a great study was done by a number of researchers looking at what motivates people to action. In this case, they didn't look at people.

They looked at cockroaches. They had cockroaches run little races. So they ran down a track trying to hide away from light, and they timed how fast they ran. What they found is that cockroaches ran faster when other cockroaches were around. A little cockroach ran faster down the track if other cockroaches were watching that cockroach. Indeed, decades of research has shown the same thing for people. We do things, many things, but not all things, faster and better when other people are around. If you're tying your shoes, for example, you're faster to tie your shoes if someone's watching

you. And similarly, if you're running in a race or biking, we're faster to run or bike when other people are around. The mere presence of others, we don't have to be competing with us, but the mere presence motivates us to work harder. But not always. We've often had that experience, for example, where you're trying to parallel park and someone else is in the car and you find yourself having more trouble than you usually do. If you've ever tried to tie a bow tie, it's difficult to begin with, but it's even more difficult when a bunch of people are watching you. So when do others make us work faster and harder and when do others make it more difficult for us to get stuff done? Turns out it depends on the type of task we're doing. For things that are easy to begin with, things that we've done a number of

times, well, others help us do them faster and better. But for things that we're not so good at, things that are difficult, like parallel parking or tying a bow tie, the mere fact that others are present makes it harder for us to do them well. Isn't that interesting? But you're right, it's true. I mean, if you're having trouble with something, having somebody watch you makes it more difficult for some reason. And I guess you're more self-conscious of how you makes it more difficult for some reason. And you, I guess you're more self-conscious of how you're screwing this up or something, but you're right. Yeah. It's, it, it's really amazing. So knowing, knowing what you know and understanding that all these things are going on, well, what can we do with that information? How, how do you then corral all this

and start using it to your advantage? Well, the first thing is awareness, right? If we're aware of influences, we're often not, but if we become more aware, if we become attuned to how they're shaping us and how they're playing a role in our environment, we can take advantage of them. Influence is not a bad thing. Often it can be a good thing. It can help us make decisions faster and easier than we would otherwise. And it can motivate us like we talked about. It can encourage us to work harder and perform better than we would. Yet sometimes it leads us astray.

Sometimes we make worse decisions when others are around. So by beginning to understand influence, how it works, and how it shows up in the world, we can take advantage of its upsides and avoid its downsides. And that's really why I wrote Invisible Influence. There's lots of scientific research on influence, but most of us still don't see it. And if we can begin to see it, that's how we can use it. Well, going back to the idea that having people around helps you do better and faster and all that, what is it about that?

What's the magic ingredient that's causing that? What's going on in a person's head that says, people are watching me, I'll do this better? It's called social facilitation. That's the technical term for it. And whether it's a cockroach running down a race or whether it's a person working at the office, others get our competitive juices flowing and they also generate physiological arousal. They fire us up and they ready us to take action. They make it easier for us to engage in the dominant responses or the things that we're already good at. In some sense, others facilitate what we're already used to doing. But again, whether that's good or bad depends on the thing we're doing.

Others make it easier for us to do well-learned things, but more difficult to combat the stuff that we're often used to doing. Having other people around, for example, makes us stereotype more because we're used to the default tendency is to stereotype. And so others around makes us more anxious, and we default to those usual tendencies, which in some cases can make us worse off than we would be otherwise. I imagine, too, it depends on who's around, that something that you might do better with your peers around might be more difficult if your boss is standing there staring at you.

Certainly. And it also depends on where they are in relation to us. We did a bunch of research on NBA basketball and found that teams, that halftime affected their performance at the end of the game in a particular way. Being ahead was generally a good thing. But teams that were behind by just a little were more likely to win, not teams that were far behind. They were far behind. They'd get demotivated and give up. But teams that were behind by just a little got motivated more, they worked harder, and they closed the gap. And so thinking about the people we surround ourselves with is really important. If we're trying to motivate ourselves to work harder at the gym or at work

or lose weight or exercise, we need to surround ourselves with the right people, pick our peers carefully, and use that influence. It's really amazing because when you talk about this, there's all these things going on around us that are in some ways invisible, or at least the force field is invisible, and we don't make those connections, and yet it's happening to us like 24 hours a day. It's hard to think of a choice we make or a behavior we engage in that is not in some way, shape, or form affected by others. But again, if we understand it, if we can see it, if we can recognize it, that's how we can take advantage of it. Great. The book is Invisible Influence. It's

by Jonah Berger, and there is a link to the book and to his website on the show notes page of our website, somethingyoushouldknow.net. Thanks, Jonah. Thank you so much. Good to chat. Everyone knows, or most people know and agree, that Reese's peanut butter cups taste better frozen. And so do Snickers bars, in my opinion. But there are some other foods you would never guess also taste

better after some time in the freezer, according to the people at Prevention Magazine. Grapes, for example. Grapes taste like candy when they're frozen, and they're very refreshing. Same thing with strawberries. That frozen crunch makes strawberries taste even better. Birthday cake. While it can be quite dry at room temperature, freezing birthday cake makes it amazing. Avocado slices. Frozen with a little lime and chili powder and, well, you just have to try it. Pecans. Somehow they're just better frozen. And that is Something You Should Know. We're on Twitter.

Follow us at SomethingYSK. I'm Micah Ruthers. Thanks for listening today to Something You Should Know. Welcome to the small town of Chinook, where faith runs deep and secrets run deeper. In this new thriller, religion and crime collide when a gruesome murder rocks the isolated Montana community. Everyone is quick to point their fingers at a drug-addicted teenager,

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