FYSIOTERAPEUTEN 5/23 83 © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions (https://creativecommons. org/licenses/by-nc/4.0/). Published by Fysioterapeuten. Kort sagt • Nudges and incentives appear to be prevalent in current physiotherapy practices. In this study, we hope to help practitioners in considering why and how they apply nudges or incentives in treatment situations, and in determining when they might (not) be appropriate. The motivation behind this paper is not to have individual physiotherapists radically change their practices but rather to spark debate about the appropriateness of nudges and incentives in certain situations. nudging, Richard H. Thaler and Cass R. Sunstein, call this the ‘choice architecture’ (8, p. 3). According to their line of thought, it is impossible not to nudge people, be it intentionally or not, and the best we can hope for is therefore to nudge well (8, p. 255). However, in an ethical sense, it seems meaningful to distinguish between intentional and inadvertent nudges, and to save the term ‘nudge’ for the intentional and deliberate use of insights into cognitive biases for achieving desired outcomes through influencing people’s behaviour in predictable ways (5, 9, 10). Importantly, nudges are usually viewed as ‘soft’ interventions, because they should, per definition, operate ‘[…] without forbidding any options or significantly changing [patients’] economic incentives. To count as a mere nudge, the intervention must be easy and cheap to avoid’ (8, p. 6). According to Thaler and Sunstein, this means that, if a person has strong preferences for an option or a certain behaviour, they are still entirely free to choose against following the decision that the nudge is designed to promote. However, because of phenomena such as inertia, procrastination, indifference and social conformity, many people are influenced in predictable ways by how options are framed (11, pp. 20–1). Since a plethora of different cognitive biases have been described in psychology and behavioural
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