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You are here: Home / Anderson On Health Insurance / Do we need more hobbits in medicine?

Do we need more hobbits in medicine?

by | 12 Comments

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I just saw a nifty little study that looked at how doctors prescribed antibiotics as a function of meal time distance.

This reminded me of the 2011 study that looked at judges sentencing decisions:

Researchers at Ben Gurion University in Israel and Columbia University examined more than 1,000 decisions by eight Israeli judges who ruled on convicts’ parole requests. Judges granted 65 percent of requests they heard at the beginning of the day’s session and almost none at the end. Right after a snack break, approvals jumped back to 65 percent again.

So as a society, do we need more hobbits in highly complex decision making roles?

Reader Interactions

12Comments

  3. 3.

    dr. bloor

    Can’t get through the paywall, but if they’re not factoring out practice patterns for scheduling same-day visits and/or who sees them, they’re overlooking potentially important information.

  4. 4.

    Another Scott

    I’m not an MD, but isn’t it quite often the case that bacterial infections often accompany viral infections? E.g.:

    Key points about acute bacterial rhinosinusitis

    ABRS happens when bacteria infect the lining of the nasal cavity and paranasal sinuses.

    – Most cases of rhinosinusitis are caused by viruses, not by bacteria.
    – ABRS sets in when your nasal cavity and sinuses first become inflamed from another cause, usually a viral infection.
    – You might have symptoms like facial pain and fever.
    – You might have yellow or greenish discharge from your nose.
    – Your healthcare provider might or might not use an antibiotic to help treat you. Other treatments may help make you feel better.
    – ABRS rarely causes serious complications.

    It’s easy to say that antibiotics are prescribed too often, and maybe that’s true, but in my case at least, over the last few years changes of the seasons play havoc with my sinuses and about all that seems to help is a course of antibiotics.

    On the general point – yeah people are human and are affected by much more than raw data. Maybe the Glorious AI Future will help minimize these “time of day” variations, but I wouldn’t count on it.

    Cheers,
    Scott.

  6. 6.

    DHD

    @Another Scott: Antibiotics also have anti-inflammatory effects, which is the explanation I was given when prescribed them for acute probably viral sinusitis. What really helps is nasal rinsing possibly accompanied with corticosteroids.

  7. 7.

    Wag

    Interesting study. The really interesting thing to think about though is why did Forbes do a write up in 2018 on a research letter published in JAMA in 2014?

  8. 8.

    Wag

    @dr. bloor:

    There were 21 867 ARI visits to 204 clinicians in 23 practices that met our inclusion criteria; 44% resulted in antibiotic prescriptions

    This from the methods section of the JAMA paper. Given the sample size I suspect the findings are fairly robust.

  10. 10.

    dr. bloor

    @Wag: Perhaps, although the key number there is the number of practices, as clinicians don’t do scheduling.

    Would also be interesting to look at time per patient over the day. You’d hypothesize shorter visits for patients being given meds and the bum’s rush when the docs are trying to get to their sammiches.

  12. 12.

    WHatsMyNym

    Also need to look at the type of patient coming in at what time of day. Before lunch/End of day, could be folks who called that day and couldn’t be fit into the schedule until then. Folks that are displaying more symptoms.

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