Why Smart People Ignore Good Tools, And What It Takes to Change That
Two studies. Ten years apart. Same pattern: professionals not using the tools they’re given.
It’s easy to assume that non-compliance is the result of poor training or bad attitude. But in practice, the reasons are usually more nuanced and more systemic.
Let’s take a look at what we can learn from a real-world case where adoption fell short, even after a decade of updates.
A Quick Look at the Studies
In two studies in 2011 and 2021, researchers interviewed Australian general practitioners (GPs) to understand how they assess cardiovascular risk, and why they often don’t follow national guidelines recommending the use of absolute risk (AR) tools.
Both studies used qualitative interviews and thematic analysis to explore how GPs made decisions, and both revealed the same five patterns of tool use (or avoidance).
Despite improvements in the tools and updates to the guidelines, the strategies hadn’t changed much. Here’s what the researchers found:
Five Strategies GPs Use: Then and Now
| Strategy | 2013 Findings | 2024 Findings |
|---|---|---|
| AR-focused | GPs trusted calculators to guide decisions | Still used, but GPs wanted more nuance (e.g., social or cultural context). Tools worked best when embedded in systems. |
| AR-adjusted | GPs overrode results based on lifestyle or intuition | Still common. GPs were frustrated that calculators missed lived experience and family history. |
| Clinical Judgement | Many relied on their own judgment rather than the tool | Still widespread, especially in complex, low-resource contexts. |
| Passive Disregard | Time, access, or workflow friction led some to skip the tool altogether | Persisting issue. Time pressure and lack of follow-through remain major barriers. |
| Active Disregard | Some chose not to use the tool at all, feeling it was irrelevant or unhelpful | Still evident. Tools used more to support conversations than as a true source of guidance. |
“It’s useful if I want to show scary numbers… but I don’t trust the actual output.” – GP, 2021
These Behaviours Aren’t Unique to Healthcare
If you’ve ever led a process change, launched a new tool, or rolled out a campaign template, this probably sounds familiar.
- A marketer who skips the planning tool because “it’s faster to just do it manually.”
- A sales rep who ignores the playbook and goes off-script because they “know what works.”
- A manager who never opens the dashboard because it “doesn’t reflect what’s really happening.”
These aren’t isolated incidents or character flaws. They’re predictable behaviours that show up in any system where people are expected to follow a guideline or adopt a new tool.
What Drives This Behaviour?
Across both studies, three drivers emerged, matching what behavioural scientists call the COM-B model:
Capability
- Do users know how to use the tool?
- Do they understand why it matters?
- Can they distinguish when and how to apply it in context?
In the 2021 study, some GPs still lacked up-to-date knowledge on managing lifestyle risks; not just how to use the tool, but how to interpret it effectively.
Opportunity
- Is the tool actually available when and where it’s needed?
- Is it embedded into the workflow, or does it require a workaround?
- Is there time and support to apply it in practice?
Several GPs in both studies cited practical issues: tools not integrated into systems, or not accessible in time-limited appointments.
Motivation
- Do users believe the tool is credible?
- Does it support their judgment, or replace it?
- Does it align with their values and professional identity?
Many GPs preferred relying on their clinical judgment, particularly when tools seemed oversimplified or misaligned with patient needs.
So What Can We Learn?
Whether you’re rolling out a new campaign process, a learning platform, or a CRM update, the same behavioural dynamics apply.
You might find:
- Tools are used inconsistently because training didn’t feel relevant (capability).
- Processes are bypassed because they’re not embedded into existing workflows (opportunity).
- People revert to old habits because they don’t trust the system or see its value (motivation).
If adoption is low, it’s rarely because people are lazy or resistant. It’s because something in the system is missing or misaligned.
What Shifts Behaviour?
To drive adoption that lasts, you need to go beyond the tool itself. Behaviour changes when three conditions are met:
- Capability → Training that’s timely, practical, and context-aware
- Opportunity → Tools that are embedded in systems and supported by process
- Motivation → Guidance that feels credible and allows space for judgement
It’s never just a checklist or training problem. It’s often a systems problem.
Final Thought
The GP case studies are a helpful reminder: even highly trained professionals don’t always follow best practice, and it’s not because they don’t care.
If we want guidelines, processes, and tools to be used well, we have to design for the reality of how people think, work, and decide.
The solution isn’t just a better tool. It’s a better system around the tool.
We’ve put together a quick guide on the 5 behavioural patterns to watch when rolling out new guidelines, tools, or policies.
