S35 E2: "Random Acts of Medicine: The Hidden Forces That Sway Doctors, Impact Patients, and Shape Our Health" by Anupam B. Jena & Christopher Worsham
Oct 3, 2023
16:12
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Medical professionals Anupam B. Jena and Christopher Worsham discuss the hidden side of medicine, exploring how random events can profoundly impact our health. Topics include the correlation between birth month and flu shot rates, the idea that less medical care can sometimes lead to better outcomes, factors affecting our perception of a good doctor, and the influence of left-digit bias in medical decision-making.
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Quick takeaways
Random events can act as natural experiments, offering insights into health outcomes.
Less medical care can sometimes be more effective, challenging the assumption that more care is always better.
Deep dives
The Influence of Randomness on Health
Randomness and chance occurrences can have a significant impact on our health, teaching us lessons that we can learn from. For instance, someone may be diagnosed with cancer or be involved in a car accident without any identifiable risk factors. These random events can act as natural experiments, offering insights into health outcomes. A study on the timing of annual physicals and flu shots found that children born in certain months were more likely to receive the flu shot and have better health outcomes. The study also highlighted how sometimes less medical care can be more effective, as evidenced by a strike in Israel where mortality rates remained the same during a period of reduced medical services.
The Paradoxes of Medicine
Medicine, though considered a rational discipline, exhibits significant randomness. Factors like the time of day for a surgery, the time of year a patient is admitted to the hospital, and the personal circumstances of a doctor can influence medical care and outcomes. Studies have shown that when doctors have fewer patients or do less for cardiac patients, the outcomes actually improve. This challenges the assumption that more medical care is always better. Additionally, the experience or age of a doctor does not always determine the quality of care. What matters is the number of patients a doctor sees to stay sharp.
Behavioral Economics in Medicine
Behavioral economics principles can also be observed in medical decision-making. Left-digit bias, where the mind focuses on the left-most digit in numbers, affects medical choices. For example, patients who were 79 years old and 50 weeks were more likely to receive a cardiac bypass surgery than those who were 80 years old and one week. This bias influences doctors to actively treat patients in their perceived 70s rather than 80s. The study demonstrated that the mortality rate at one year did not significantly differ between the two groups, suggesting that sometimes less aggressive treatment can be just as effective.
In their groundbreaking book, "Random Acts of Medicine," Anupam Jena and Christopher Worsham reveal the hidden side of medicine and how unexpected — but predictable — events can profoundly affect our health.
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