When do hospitals contact potential donors? Research from Wharton professor Katy Milkman finds that asking at the right time is key. This episode is part of a series on “Charitable Giving.”

Transcript

When Do You Ask for a Charitable Donation?

Dan Loney: When is the right time for a charitable organization to make contact? Research looked at how hospitals contacted potential donors, especially ones who had been at their facility for treatment in the recent past. One of the people involved in that research is our guest, Katy Milkman, who is a professor of operations, information and decisions here at the Wharton school. Katy, how did this idea come about in the first place?

Katy Milkman: The team that did this work was led by [Michigan State University professor] Amanda Chuan and with [Wharton professor] Judd Kessler. We were interested in charitable giving because as behavioral scientists, we actually find it quite unusual that people give at all. Being generous, making donations to organizations is something that a strict rational actor model in economics might say should never happen, right? Unless you have a financial interest in the organization because you’ll somehow gain. This is a ripe area for behavioral science research. Many hospitals benefit immensely from charitable giving each year, so that seemed like an interesting place to study this.

Specifically, we’re interested in the speed at which an “ask” follows the receipt of service. This was something that we got interested in when we realized there’s a lot of different theories that might predict that you’d want to capitalize quickly on people’s emotions and gratitude. When it’s an organization — say an animal shelter or a hospital or a religious organization, or even an organization providing relief after a natural disaster— people may have a quick feeling of “warm glow,” to use the economic terminology of gratitude. And that might crater as time passes, so you may want to be quick to take advantage of those warm feelings that are going to arise right after this interaction.

On the other hand, there’s the risk of being perceived as too quick to ask, too quick to capitalize right after doing something that was generous and charitable, which is the nature of charitable organizations. If you quickly say, “Now, could you give us some money?” The person who received that positive encounter may feel, “This is kind of icky, and I don’t like being contacted by my hospital or by the shelter where I got my puppy so quickly after they did something nice for me. It feels like they’re trying to capitalize.” There could be reactants, which is the word we use for when it’s negative. We always love studying questions where you could imagine the result going in either direction. And that got us excited about this project.

Loney: But how do organizations formulate that plan, with the timing component being right near the top of importance in making contact with that person and getting the best positive outcome?

Milkman: We want to be top of mind and maximize the feelings of gratitude and minimize the sense that we’re being too grabby for money after a positive encounter. So, it seemed like a really interesting research question that would also tell us something about human nature. To what extent is gratitude a stable feeling? And to what extent does it decay quickly over time?

Loney: As we’re taping this, we’re a couple weeks from two massive hurricanes that hit the United States. In terms of donations, that timing really differentiates from what would be traditional paths of asking for donations because you have such an immediate, disastrous impact on so many communities.

Milkman: That’s right. Charitable giving goes up in response to need because people can empathize with victims. There’s some wonderful work that’s been done on how important it is to have identifiable victims. This is work by former Wharton professor Deb Small and George Lowenstein at Carnegie Mellon. When we think about a person and their suffering, we’re much more willing to open our wallets and give if we think we can impact them than if we think about statistical victims. These organizations know that. They wisely fundraise at times of need and do so in effective ways.

But what we’re studying in this project is those who were recipients of, say, rescue workers’ aid. What is the optimal time to think about asking them, “You’ve benefited. Now let’s think about turning around and asking would you give, because someone else in the future is going to also need help?” We didn’t study this in the exact context of hurricanes or disaster relief. We studied it with hospitals. But the idea is that there’d be a similar dynamic where you’d want to think about the right timing after someone has benefited from an organization to ask that recipient to give back.

Loney: With this work, you were finding out about individuals who had been at a hospital in the recent past. It is a very unique dynamic of that hospital having treated that person, having that interaction with that person, and asking them for a donation to support the operation of the hospital.

Milkman: That’s exactly right. These are first-time patients at a large hospital system. Within 20 to 130 days after their first patient encounter, they’re going to receive a letter from the hospital system asking them to make a charitable contribution to the organization. What’s interesting about this context is that this is a large hospital system that’s sending lots and lots of these asks for donations. A big part of how they can run the organization is the generosity of these donors. Both patients and nonpatients are contacted, but we’re focusing on the patients.

They send these mailings every few months in a batch. Basically, an administrator has time on their calendar, and they sit down and all this gets prepared, and the messages all go out at once. What that means is that there’s natural variation in how long after a person has their encounter with a hospital system — because maybe I came in for surgery and on April 1, and you came in on May 1, and the next batch goes out on June 1. You are going to have a much shorter follow-up period after your encounter with a hospital than I am. I’m going to have to wait 60 days for my ask. You’re only waiting 30.

We’re taking advantage of that natural variation to see over a period of many years, when these batches are happening erratically, is there a consequence? Can we identify a consequence of a faster versus longer lag time after that patient encounter, for the likelihood the patient says, “Yeah, I would like to donate?”

Finding the “Sweet Spot” of Gratitude

Loney: Were you able to determine what is that sweet spot?

Milkman: Yes. You talk about a sweet spot, and that’s because we talked about this tension between the two competing theories. That you don’t want to act too fast and seem grabby, right? Like, “Oh, this wasn’t done out of the goodness of the organization’s mission. It was just all ploy to get you to give us money as fast as possible. It’s almost like a payment.” And then the, “We want to capitalize on that feeling of gratitude.”

We thought there might be sort of a U-shaped relationship. I should say an upside-down U. It might be better to wait a little while, but not too long. What we actually found is you can’t act fast enough. In our data, we never saw anyone getting a mailing asking for a donation faster than 23 days after their encounter. But faster was simply better. There was a pretty linear decline in giving. Basically, every extra 30 days after an encounter you wait to contact a patient leads to a 30% decline in the likelihood that they will make a donation in response to that ask. So, a really precipitous decline. And it continues over the whole course of the time that we were able to follow patients. You know, they don’t ask years later.

Loney: I think some people will react differently to being contacted, whatever the time is. Some people, no matter the time, will feel like, “Oh my God, it’s another ask from the hospital.” Or they’re like, “They did such a great job of taking care of me. Yes, let me write a check.”

Milkman: That’s right, not everyone is going to be affected. But it is remarkable that you’d see this 30% decay with every 30-day decline. That’s a pretty huge effect. It suggests that a lot of people are impacted by the time frame in which the ask is made.

I do want to be clear that the fastest that anyone got a letter was at least three weeks after their encounter. It’s not like what you should do is set up a Venmo and ask people to give 30 seconds after they leave your organization having received some sort of benefit. Maybe that would work. It’s possible, but that would require further research. But when you’re thinking about a range, three weeks or three months, you’re much better off with three weeks later because we do see this decline.

It suggests that the way we think about our gratitude towards organizations that help us, much like many things about human memory, just decays over time. When you have a positive encounter with an instructor in the classroom here at Wharton, when you have a positive interaction on the street with a friend, whatever it might be. We tend to feel really great right after them, and then pretty quickly all the other things going on in our lives take over and dominate our mind space. That strong positive feeling decays, so you just want to make sure that you don’t wait too long. You want to capitalize on that positive feeling.

Loney: How important does it become for the organization to have an understanding of this?

Milkman: Again, the effect sizes we saw were remarkably large. That suggests it really is important for the organization to get its act together and get these kinds of asks out quickly. I think organizations should be thinking more about timeliness, given how strong the effects are.

I think more research is warranted to try to figure out that sweet spot. Maybe there is a too fast. Maybe there’s not. Maybe every organization should be asking the day after. My guess is that that would be a little too fast. But again, more research would be warranted because a lot of organizations really do rely tremendously on donations to do their good work. Being more attentive to this issue of speed seems important to me.

Loney: Using the example that you studied with the hospital in comparison to, say, the SPCA or some other organization, the type of contact probably plays a factor in this as well.

Milkman: I appreciate you asking about that. Yeah, that’s absolutely right. One of the things we thought it would be interesting to look at in the hospital was the acuteness of the illness that brought the patient in. It’s a little bit tricky to say because we didn’t have detailed patient medical records. But we did know which portion of the hospital the patient had been seen in. There were 11 different divisions, and we asked a set of doctors who worked in the hospital system to classify which were the most severe types of patient encounters. There was 100% agreement that it was patients who came in for surgery, for oncology, or for cardiology. Those are the patients who are having the most significant health issues, according to these raters.

We took a look to see whether or not this decay was any larger for the patients who had those kinds of encounters than patients in other groups. We found that it was substantially larger, suggesting these more acute and emotional extreme encounters might show the biggest benefit to making sure that you follow up quickly before people have gone back to their normal lives and aren’t thinking so much about their gratitude for the potentially life-saving service that was provided.

The Element of Reciprocity in Charitable Giving

Loney: You talk a little bit in the paper about the element of reciprocity. Is there an expectation by an organization, whether intentional or not, that they should receive some sort of a donation because of the work they have done?

Milkman: I think reciprocity is a very fundamental human reaction. We see reciprocity in lots of contexts. When I scratch your back, you scratch mine. It’s very common. So, it is very natural for the strongest donor bases to organizations like hospitals, for instance, to be their former patients.

I think there is an expectation of that. Certainly, it’s going to be less extreme in cases where people don’t have the means to provide it. Asking donors who are very low-income and could barely afford the care would be seen differently than asking someone who has the financial means to be a contributor and received care at a reasonable rate, and maybe had their life saved. Then you’d expect to see a larger degree of reciprocity. It’s going to be on a scale depending on how much someone can give. But in general, that’s a major motive for donations to many organizations.

Loney: What is the message of this research?

Milkman: I think the main message is that timeliness matters. We don’t think enough about how time changes the way that people think about what decisions they’ll make. I’ve done a lot of research in this area. I have some work looking at something called “the fresh start effect,” where at the beginning of a new year or a new week or a new month, people are more motivated to pursue their goals. We see these ebbs and flows and motivation over time in a lot of parts of life.

I think it’s something that doesn’t get enough attention when we’re thinking about everything from fundraising to promoting employee well-being, is recognizing that every day we don’t wake up equally motivated to take action on behalf of another organization or on behalf of ourselves. There are moments when we feel more open to making a change in our life or expressing gratitude to another individual. We have to think about that time course of people’s feelings and people’s motivation more carefully in order to get the best results, if we’re an organization trying to motivate our workforce or an organization trying to motivate a donor base. Attention to timeliness, I think, is just a critical thing that all organizations need to keep top of mind.