In health policy, service design, and personal change strategies, decisions are often framed in terms of reduction — of risk, of cost, of harm. The language of change tends to focus on what we need to stop, limit, or do less of.
While this framing has its place, it can obscure an equally important — and often more generative — question:
What could we amplify instead?
The Amplification Principle offers a simple but powerful reframe. It proposes that when we replace a low-value or misaligned input, behaviour, or decision with one that is values-aligned and generative, we don’t just remove harm — we multiply benefit.
This idea has broad application: from individual health decisions to complex system-level choices about workforce planning and resource allocation. And while its logic may seem intuitive, its implications are profound. It shifts the focus from discipline to alignment, from minimisation to amplification.
From subtraction to substitution
Much of health promotion is built around the concept of harm reduction: stop smoking, cut sugar, reduce alcohol, limit sedentary behaviour. These messages are typically framed in deficit terms, relying on individual willpower and discipline to achieve outcomes. But behaviour change research shows that people are more likely to sustain new behaviours when those behaviours are positive, rewarding, and identity-congruent — not just less harmful.
The Amplification Principle recognises this by shifting the focus from restriction to substitution.
Instead of asking, “What should I stop doing?” we ask, “What could I do instead that aligns better with what I value — and has flow-on benefits?”
The difference is subtle, but powerful. Consider the example of choosing a non-alcoholic drink at the end of the day. When I swapped my habitual glass of wine for a ginger beer and iced tea, I didn’t just avoid the wine. I slept better, woke up clearer, had more energy the next morning, and felt more grounded. One small decision generated compound returns.
This is what makes it different from typical substitution models. It’s not about choosing a “less bad” alternative. It’s about choosing something better — something with an amplification effect across multiple domains of wellbeing.
The metaphor and the mechanism
Dr Michael Mosley in The 8- week Blood Sugar Diet likened the body to a car: when you’re overweight, it’s like carrying too much fuel in the boot — while also putting poor-quality fuel into the engine. The body can still function, but inefficiently. You can keep patching it up, but it won’t run well until you change the fuel and lighten the load.
This metaphor resonates with the Amplification Principle. When we replace misaligned choices — whether in diet, behaviour, or policy — with aligned, regenerative ones, we improve performance across the system. The car runs better not because we patched the problem, but because we changed the inputs altogether.
We see this logic in nutrition science too. Dr David Jenkins, the Canadian researcher behind the Portfolio Diet, demonstrated that substituting plant-based foods (like soy, oats, and nuts) for animal-based foods could reduce cholesterol levels as effectively as statins. It wasn’t just about removing saturated fat — it was about adding high-impact foods that changed the body’s response.
What is the Amplification Principle?
The Amplification Principle holds that:
When we replace a low-value or misaligned input, behaviour, or decision with one that is more values-aligned, we don’t just remove harm — we amplify benefit.
It is grounded in four key concepts:
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Alignment: The new action must align with the person’s or system’s core values
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Substitution: Change is more sustainable when we replace, not just remove
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Ripple effect: One small swap often improves multiple downstream outcomes
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Scalability: It applies from the personal to the systemic level
It works because it is not punitive. It builds energy, momentum, and motivation by working with intrinsic values, not against them.
Systems-level applications: workforce and value-based care
This principle has powerful implications for health workforce design and value-based care.
Too often, policy decisions focus on reducing the burden — of cost, risk, or staff shortages — rather than considering what we could substitute or amplify.
For example:
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Instead of filling shortages reactively, we could amplify the role of prevention-focused, community-based allied health professionals — reducing downstream hospital admissions and increasing local workforce retention.
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Rather than investing in low-impact, reactive models of care, we can substitute high-value roles and services that promote autonomy, role clarity, and meaningful patient outcomes.
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In remote health, rather than funding fly-in-fly-out clinical services that may provide episodic care, we might invest in community health infrastructure, such as allied health assistants, pools, or accessible public health programs — amplifying physical, social, and cultural wellbeing in one decision.
This isn’t about idealism. It’s about smart trade-offs.
It’s not about spending more, but about spending in ways that return more — for people, systems, and outcomes.
Why this matters now
In the current climate of budget pressures, staff shortages, burnout, and chronic disease, we need frameworks that do more than reduce damage. We need models that support sustainable, generative, values-aligned decision-making.
The Amplification Principle doesn’t replace existing models — it enhances them. It adds a lens of aligned substitution that helps policy-makers, service designers, and leaders ask better questions:
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What are we currently doing that creates limited or low-value outcomes?
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What could we substitute that aligns better with our goals?
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What downstream effects might we amplify with a single, better choice?
What’s next: applying the framework
I’ll be using this principle in an upcoming workforce redesign project to explore how small, intentional substitutions can produce outsized impact in complex systems.
The Amplification Principle is also being developed into a decision-making matrix, which individuals, teams, and systems can use to explore opportunities for values-aligned change.
If you’re working in health workforce, system transformation, or service redesign, I’d love to hear how this resonates — and where you see amplification opportunities in your own context.
Conclusion
The Amplification Principle invites us to stop focusing solely on what we need to do less of — and start asking what we can do more of, that reflects who we are and what we value.
It’s not about behaviour change. It’s about alignment.
It’s not about sacrifice. It’s about return.
And it starts with a single, smart, intentional swap.
#amplification principle #health system reform #value-based care #health workforce #decision-making models #behaviour change #allied health #health innovation #health leadership
