The Tipping Point

The Tipping Point: How Little Things can make a Big Difference
Author: Malcolm Gladwell


The theme of this book, the spread of epidemics, will resonate with doctors. The book explores the similarities between the transmission of infections and the spread of ideas, products, messages, and behaviours. The author argues that social trends spread just like viral epidemics-when they cross a certain threshold, the Tipping Point, they propagate exponentially. Describing this as the moment of critical mass, the book discusses the factors which tip ideas across the edge to become epidemics (pages 12-14). The author shows how all epidemics follow a geometric progression, proliferating out of proportion to their forces impelling them; he says ‘the tipping point is not the result of large scale efforts, but the outcome of small changes which produce dramatic effects’ (pages 9 and 11). The book asserts that the tipping point is achieved, not by any improvement in the content of the ideas and messages, but as a result of minor modifications in their presentation (page 131).

Tipping Poit. matt Cornock on Flikr.
Tipping Poit. matt Cornock on Flikr.

The author discusses the factors which govern all social epidemics, referring to concepts such as the Law of the Few, the Stickiness Factor, and the Power of Context (page 19). He shows how new ideas are rapidly taken up by early adopters, and how sweep through the population until they are eventually accepted by the laggards (page 197). The book contends that attention to minor details dramatically enhances the ‘stickiness’ of messages, illustrating this with the examples of the children television programmes, Sesame Street and Blues Clues (page 97). We learn of the influence wielded by a ‘handful of exceptional people’ who he calls Mavens, Connectors, and Salesmen (pages 14, 21, and 59). Mavens, for example, start word-of-mouth epidemics by acting as ‘information brokers, sharing and trading what they know’ (pages 67 and 69).

By Arnold Lakhovsky -, Public Domain, Link
By Arnold Lakhovsky, Public Domain, Link

The author illustrates his arguments with many fascinating topics across a diversity of fields. His subjects range from the 1918 flu pandemic, to the spread of syphilis in present day America; from the rise of Hush Puppies, to the fall in New York crime rate. Some subjects are mundane, such as the infectiousness of yawning and the spread of rumours. Many topics are however serious issues, such as the contagion of suicide epidemics, and peer influence on teenage smoking.

By Uncredited photographer for St. Louis Post Dispatch - St. Louis Post Dispatch photo via [1], Public Domain, Link
By Uncredited photographer for St. Louis Post Dispatch – St. Louis Post Dispatch photo via [1], Public Domain, Link
The author uses very interesting stories to embellish his book. Many of these are  highly emotive events such as that of Kitty Genovese, the woman whose murder was witnessed by many people, none of whom acted to hinder it (page 28). Many stories focus on exceptional historical and modern day figures. One such example is John Wesley, whose personal character was fundamental to the spread of the Methodist movement in America (page 172). Another story is of Paul Revere, whose personality was crucial to mobilising resistance to British rule, a step that eventually led to American independence (pages 31).

By John Trumbull - US Capitol, Public Domain, Link
By John Trumbull – US Capitol, Public Domain, Link

The book is very well-researched, citing several experts and referencing key psychological concepts. Such experts include William Condon on the cultural microrhythms that typify social interactions (page 81), and Philip Zimbardo on the prisoner experiments which demonstrate the power of context (page 152). The author referred to Stanley Milgram and Mark Granovetter on social networkssix degrees of separation, and the strength of weak links (pages 34 and 55). Other key psychological concepts include the fundamental attribution error (page 160), channel capacity (page 175), the Dunbar number (page 179), and diffusion of responsibility (page 28).

By Katharinewillis. - Own work., Public Domain, Link
By Katharinewillis. – Own work., Public Domain, Link

This book explains the nature of social epidemics, highlighting the critical factors that influence them. The anecdotes are quite striking, and the presentation is exceptional. The author, characteristic of his style, pays meticulous attention to the details of all the stories he narrates; this occasionally makes some stories seem overdrawn. The arguments he makes are cogent although some factors may not be as influential in the digital age. The personality of individual people, for example, may not be crucial in the spread of ideas and messages in the age of online social media and easily accessible knowledge. The Tipping Point is however relevant of to all spheres of life, healthcare inclusive.

Overall assessment

This book explores how ideas and messages spread, and how little changes have a disproportionate impact on the uptake of behaviours and products. This is important in medicine where the adoption of health messages and treatments is essential. The topic is important to healthcare, and I recommend the book to all doctors.

Book details

Publisher, Place, Year: Abacus, London, 2000
Number of Chapters: 8
Number of Pages: 279
ISBN: 978-0-349-11346-3
Price: £6.99
Star rating: 4


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