Mantra: The Patient Is Not Like Me

Class Mantra, HCI Methods, 8/25/03, see Whitney Hess » Pleasure & Pain » The User Is Not Like Me

This weekend, I had the pleasure of meeting Candace Thille, who is the Director of the Open Learning Initiative at Carnegie Mellon University, and who is now serving with me on a task force looking at the periodic assessment of internal medicine physicians (aka recertification) through the American Board of Internal Medicine.

Candace is an expert in open web-based learning environments and as we talked about the potential MOOCs in medical education and in my own experiences to date (mostly positive), she shared with me an expression that has its roots from the Carnegie Mellon Computer Human Computer Interaction Institute:

The user is not like me

Candace told me that she’s adopted this expression in her own work, with a poster in her environment that says

The student is not like me

I love this.

I have periodically struggled to explain to my (well educated, with access to everything) peers why they must not be the people they are designing things for, (my last attempt, with the help of @SusannahFox is here: Involving Patients: Her (Diana Forsythe’s) paper should be inscribed on cubicle walls… | Ted Eytan, MD), and yet this version is so easy. I looked it up online and fortunately Whitney Hess recounted her exposure to it as a student at CMU in this blog post:

Whitney Hess » Pleasure & Pain » The User Is Not Like Me

The user is not like me. So long as you acknowledge that you are not your user, you will not make the mistake of designing for yourself. You will not assume that you know everything about your target audience. You will study them until you do. You will strive to gain understanding in an effort to make informed design decisions that are not based on your own preconceived notions and perceptions of the world. You will build empathy for your users, within yourself and amongst your team. You will slowly train your intuition to embody what the user needs. The user will be inside of you, but they won’t be you. You won’t be them. Empathic consciousness is achievable.

In health and health care especially, we are dealing with this issue, with the discussion of mHealth apps and approaches to behavior change. What happens when we/I are quantitative people, thrive on measurement, have the latest mobile devices that help keep us healthy, in neighborhoods with choice architecture geared toward health, and we design for ourselves?

Back to the MOOCs, when I told Candace how they had worked well for me so far, that I was uninhibited in my curiosity and ability to participate, she told me that yes, for someone like me, with an advanced degree, they work well. And then I put myself in the shoes of someone  without a degree who might be enrolling in a MOOC with a dream of getting an advanced education. What would it be like for them to enter a discussion forum on social networking analysis where student after student from all over the world are posting dazzling mathematical formulas and probabilities? I don’t understand all of that stuff either, but I have the ability to say, “I’m educated in something else, this isn’t relevant to me right now.”

In health care in general, I see systems that are designed well for the people who designed them, and when patients actually attempt to use them, the flaws are apparent.

With this mantra, in mind, it’s easy to mitigate problems.

The patient I am serving is not like me.

(therefore I will go to where they are, and invite them to participate with me to design a system that they can use so that they can achieve their life goals)

Thanks Carnegie Mellon University HCII for the cross-pollination.

Pleasure & Pain (Whitney Hess) / CC BY-SA 3.0


The Doctor is Not Like Me, that’s what I think about when I work in our mutual initiative. This takes it a bit further which really helps me see it from a deeper perspective. Thanks for the great post, I got a lot of value out of it!!

IntrovertLDR Hey Oscar, glad you liked it, and that you already adopt the “user is not like me” mantra. Nice thing about localizing things to the patient is that it’s something you and doctors have in common – you/we will eventually become them,

Ted Eytan, MD