What Behavioral Science Can Teach Healthcare About Patient Follow-Through — A Conversation with Sarah Waters, PhD

On this episode of the MGMA Insights Podcast, host and senior editor Daniel Williams sits down with Sarah Waters, PhD, founder of 50 West and a behavioral scientist trained at the London School of Economics. They explore how behavioral science can reshape patient engagement, reduce no-shows, improve medication adherence, and drive meaningful change in clinical outcomes. Sarah shares practical strategies for identifying patient barriers, reframing communication, and designing systems that help both patients and care teams follow through.

Key Takeaways:

• Knowing isn’t enough — design for doing: Patients (and clinicians) often know what they should do, but behavior change requires intentional system design, not just more information or reminders.
• No-shows are predictable — and preventable: Long scheduling lead times increase no-show risk. Practices can reduce this by tightening scheduling windows, analyzing patterns by day/time, and proactively addressing barriers at booking.
• Ask better questions upfront: Instead of asking “When are you available?”, ask “What days don’t work for you?” — this subtle shift prompts patients to consider real-life constraints earlier.
• Move beyond “corporate nagging”: Repetitive reminders without context lead to disengagement. Understanding why a patient isn’t showing up (transportation, fear, misunderstanding) enables more effective, targeted outreach.
• Small barriers become big obstacles: Minor uncertainties — like not knowing what a procedure involves — can feel overwhelming. Address emotional and logistical friction early to prevent dropout.
• Stories outperform statistics: Data may inform, but narratives stick. Sharing relatable patient experiences can help demystify procedures like colonoscopies and mammograms.
• Habit formation drives long-term outcomes: Programs that reduce ER visits and hospitalizations focus upstream — building simple, repeatable behaviors (e.g., daily monitoring) that compound over time.
• Medication adherence needs systems, not willpower: Pair medications with existing routines (like brushing teeth) and create backup plans for disruptions to improve consistency.

Resources:

• Connect with Sarah Waters, PhD, on LinkedIn
• 50 West Consulting
• MGMA Insights Podcast Network
• "Patient no-shows in 2025: What’s changing and what to do about it" (MGMA Stat article)
• MGMA Events: Conferences and Webinars
• Register for the MGMA Annual Conference (September 27-30, 2026 | San Antonio, TX)

Email us at dwilliams@mgma.com if you would like to appear on an episode. If you have a question about your practice that you would like us to answer, send an email to advisor@mgma.com. Don't forget to subscribe to our network wherever you get your podcasts!