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Last year, I just about stopped wearing my Panerai.
For as long as I could afford them, I had gravitated toward traditional mechanical Swiss watches. Like many people I know in pharma business or social circles, I appreciated the craftsmanship, the engineering, and the heritage behind them. Over time I accumulated a few watches that I genuinely enjoyed wearing, including a Panerai, a Rolex and a Breitling. They are beautiful masterpieces, and I still appreciate everything they do and represent.
But these days, if you happen to run into me, you'll almost certainly find a black Garmin Instinct on my wrist instead. And what surprised me in this shift wasn't the technology. It was what the technology did to me.
Almost without realizing it, I've begun to pay closer attention to my sleep, my recovery, my resting heart rate, my daily steps, and my weekly mileage. Running fifty or sixty miles each week had always felt like something I thought I was doing. Now I could actually see it visualized in bar charts. Even more interestingly, I found myself comparing notes with friends. How did you sleep? What's your "body battery" look like today? How many miles have you logged this week? There is something surprisingly satisfying about watching your efforts accumulate, like a bank account, into visible progress. The watch wasn't simply collecting data. It was like a silent motivator changing my behavior.
Once I noticed it in myself, I began seeing the same phenomenon everywhere. Friends who once wore beautiful Swiss watches now rarely take off their Apple iWatches. Others have become devoted wearers of WHOOP or Oura. People compare sleep scores almost as regularly as they once compared golf handicaps. In the dark SoulCycle studio, you can catch the green flickering of these devices on peoples' wrists and fingers.
At first glance, this feels like a story about technology. I don't think it is.
Behavioral psychologists have understood for decades that information and feedback are not the same thing. Information tells us what we should do. Feedback tells us how we're actually doing. That's basically a summary of Nir Eyal, James Clear and Charles Duhigg.
We've never lacked information about healthy living. We all know we should exercise regularly, sleep more consistently, manage stress, and maintain a healthy weight. Yet information, by itself, rarely changes behavior. If it did, New Year's resolutions would last much longer than they do.
Feedback operates differently because it closes the loop between action and consequence. Today's run is crystallized as a score, a colorful green bar in the Garmin app. A good night's sleep becomes a number, a grade, like in school. A 93 is basically an A minus, and that's a really good thing to know going into your morning. A week of consistent exercise becomes visible progress rather than a vague impression. What was once invisible is suddenly measurable, and what is measurable becomes surprisingly motivating to one's brain. Wearables don't simply quantify our behavior; they acknowledge it. They reward consistency, reinforce effort, and make improvement tangible.
That's why I think wearables work.
The Garmin on my wrist doesn't motivate me because it records what I've done. It motivates me because every healthy decision is met with immediate reinforcement.
That was the perspective I brought to reviewing the American Medical Association's recently published international survey examining physician attitudes toward consumer wearables. (https://www.ama-assn.org/practice-management/digital-health/international-physician-survey-consumer-wearables). The study surveyed more than 2,200 physicians across six countries and reached an important conclusion: physicians are already interested in wearable data. Most review it in some capacity. Most use wearable devices themselves. Large majorities believe the data offer at least some clinical value.
Yet, notably, no country reported more than six percent of physicians having fully integrated wearable data into routine clinical workflows. The report concludes, quite appropriately, that the barriers are largely structural. Physicians point to workflow, reimbursement, liability concerns, confidence in interpreting the data, and implementation challenges as the primary obstacles to broader adoption.
All of that is true. But I found myself asking a slightly different question.
Why have consumers embraced wearables so enthusiastically while physicians have incorporated them so cautiously?
I don't think the answer lies simply in technology. I think it lies in psychology.
Consumers, like me with my Garmin, obtain an immediate cognitive prompt from wearables. Every morning the device tells you how you slept. Every afternoon it nudges you to move. Every evening it celebrates a goal you've reached...or gently reminds you that you haven't. Every interaction creates a small feedback loop between behavior and reward.
However, physicians experience almost the opposite.
Reviewing wearable data often means opening another application, interpreting another stream of information, worrying about false positives, documenting clinical decisions, weighing liability, and somehow fitting all of that into an already hectic clinic schedule. The AMA study makes this point repeatedly: the obstacles aren't primarily a lack of awareness or enthusiasm. They're concerns about workflow, feasibility, trust in the data, and the practical realities of incorporating another source of information into clinical practice.
From a behavioral perspective, that's a very different environment. One behavior is continuously reinforced. The other is continually burdened with friction, especially in relation to time and trust.
That distinction makes a difference because behavioral economics and habit science has taught us that people naturally gravitate toward behaviors that are rewarding, convenient, and immediately reinforced. Even highly motivated professionals are not immune to those same psychological forces.
This is where I think the conversation becomes particularly relevant for those of us working in pharma, especially commercial strategy, promotions, and I&A.
Over the past several years, pharmaceutical companies have invested heavily in what many now call the "digital ecosystem" surrounding their therapies. Patient support applications, adherence tools, symptom trackers, connected devices, remote monitoring, digital biomarkers, platforms, and AI-enabled coaching are no longer experimental ideas. They're becoming an increasingly important part of the treatment experience itself.
Lilly's recent equity investment in Oura strikes me as a prime example of this broader shift. Oura has already developed experiences specifically for people using GLP-1 therapies, connecting biometric trends with medication use to help individuals assess how sleep, recovery, activity, and physiology evolve throughout treatment. That investment feels less like a bet on wearable hardware than a recognition that medicines increasingly live within behavioral ecosystems rather than in isolation.
Perhaps that's the real opportunity for our industry.
For decades, pharmaceutical innovation focused primarily on developing better therapies. Increasingly, it may also involve designing better (i.e., more satisfying) feedback loops that help patients remain engaged, adhere to treatment, and see the benefits of healthy behaviors unfolding in real time. Not just thinking outside of the pill, as many of us have talked about for years, but embracing the behavioral loop surrounding the pill.
One finding from the AMA report especially caught my attention. Patients aren't yet asking physicians to review wearable data on a routine basis. But when they do ask, physicians generally respond.
That observation suggests something larger may be happening.
Traditionally, we've thought about healthcare as information flowing from physician to patient. The physician diagnoses, recommends, educates, and treats. Wearables introduce a different dynamic. Increasingly, the patient notices something first. The patient brings the data into the conversation. The physician interprets it. The healthcare system gradually adapts. The flow begins to look something like this:
Wearable -> Patient → Physician → Health System
That may prove to be one of the most important behavioral shifts occurring in healthcare today.
I've come to think that we sometimes underestimate wearables because we mistake them for devices. They aren't really devices. They're actually feedback machines.
They take behaviors that once disappeared into the background of everyday life and make them visible. They reward consistency. They encourage reflection. They transform vague intentions and aspirations into measurable progress (or lack thereof). And, almost without our noticing, they help people become more active participants in their own health.
For those of us who spend our professional time trying to understand and influence behavior -- whether it's designing commercial strategy, building patient support programs, or developing digital health care or DTC platforms -- that may be the most important lesson of all.
The future of healthcare won't be shaped solely by better medicines or more sophisticated technology. It will also be shaped by the quality of the feedback loops we build around them.
This is a clear case of where the most powerful innovation isn't discovering a new treatment. It's helping people see yesterday's behavior clearly enough that they choose to do a little better tomorrow.
