Eat your greens, get a biscuit
If you want to change someone’s behaviour, positive reinforcement is a great way to go.
Psychologists know this – and so does everyone else. Corporations give bonuses to motivate staff, and develop loyalty programs to keep their customers. Social media platforms push engagement through the dopamine bumps of likes and shares. Self-help gurus create habit shifts through rewards. Parents train kids – and dogs, and budgies – with small prizes. Positive reinforcement has become part of the human story.
So it’s surprising that when it comes to activism, we seem to have lost sight of it as a tool. In fact, our discourse is too often governed by the very opposite: scolding, shaming, penalties, complaining to the referee. I think it’s time to bring positive reinforcement back.
Here’s how it could work. But to set it up, allow me an anecdote.
An unsettling encounter
In 2012, I had an experience that left me bewildered and annoyed. An obstetrician, tasked with bringing my child into the world, casually asked me for an under-the-table payment.
It was my first encounter with corruption in Greece's medical sector, where small envelopes (called fakelaki in Greek) change hands to supposedly guarantee better care. This practice has pervaded the system.
On one level, the fakelaki is just a gift in exchange for better services. But the practice creates a perverse incentive structure, influencing decisions as critical as life-or-death operations. Patients aren’t happy giving the bribes, if they can afford them at all. Decent doctors feel guilty taking the money. And administrators and the government have no motivation to raise salaries. The customer pays, and everybody loses.
Successive governments know this situation sucks. And in the past decade, largely as a response to Greece’s economic crisis, they’ve raised the penalties for doctors who take tips. While citizens have set up websites dedicated to naming and shaming them.
The thing is, none of this has worked. As I learned last week from a friend whose grandmother just came out of hospital, the fakelaki system persists in Greece (and in other EU countries).
So as an activist, how can you undermine an ingrained culture, dislodge a negative habit... when doling out fines and humiliation have failed? Enter positive reinforcement.
Instead of exposing and penalising doctors who take bribes, you could reward those who publicly declare they never will.
Let’s say you draft a declaration for doctors. Something short and explicit, like:
I will do the best for all my patients, regardless of whether I am offered gifts. And I commit to refusing any gift offered to me in my capacity as a doctor, in any form.
Let’s call it the Blue Hippo Declaration, after the Hippocratic Oath. It’s blue because that colour symbolises trust and loyalty (OK, I’m reaching here).
Then you create an online, public database of every doctor in your town. And call every doctor on the list, asking if they will support it.
Every doctor who signs the declaration gets some small rewards. You list them in the public database as a signatory. Send them a sticker of a blue hippo for their office window, or a pin to wear, to broadcast to their patients that they signed. And give them a mention in any press release, whenever you reach out to media.
Doctors who don’t respond to your request to sign the declaration, or refuse, get an ominous “has not signed” next to their name in red.
For this project to build critical mass, you’d need some social cred before asking for signatures, to make doctors more likely to respond. You could start with a small group of established doctors, in a single town. Create a basic online presence with a logo. And try to generate some media coverage about your project which you can link to when you reach out. So when a doctor checks your background, they know you’re serious.
The goal of the project is to expand the circle of integrity and responsibility; the ‘ethical’ doctors who pledge never to take tips. As that circle grows, those outside it become more notable. Doctors who sign the declaration are granted some prestige points. Doctors who don't, or who delay, pay a moderate social cost. Bit by bit, through positive reinforcement, you might just make a dent in the corrupt practice, and shift attitudes.
‘To be sure’
Yes, an initiative like this does have challenges. It relies on social pressure and voluntary commitment from doctors. You won’t tackle systemic corruption through this method alone.
But the bigger picture is: positive reinforcement and public pledges offer an interesting – and underused – avenue for activism. You could apply it a whole range of activist projects to encourage ethical practices. So long as all members of a certain group of providers are invited to pledge, the dynamics of reward, and the light social pressure to behave ethically, stay the same.
For example, want to encourage sustainable practices in your area? “This restaurant only uses renewable energy sources.” To fight discrimination? “This bar welcomes LGBT people.” To promote better workplace ethics? “This company has fair labour practices and transparent business operations.” To drive voter turnout? “This district has had 70%+ turnout for three elections running.” Just make sure you ask every restaurant, bar, company or voting district, and have a public listing of all their responses.
A lighter touch in a harsh world
Activism is often characterised by radical, heavy-handed approaches. And sure, sometimes that is exactly what is needed for change. But while it won’t work for every issue, the power of positive reinforcement offers a refreshing alternative. By guiding people towards more ethical choices with small rewards and light social pressure, you could shift a culture, ignite a transformation. It’s worth a shot.