Doctors Don't Wash Their Hands Enough: Superfreakanomics by Steven Levitt and Stephen Dubner

There aren’t many books that I can honestly say changed the way I think, even in a small way and even fewer that I read once I was an adult. They are far more likely to reinforce what I already believe and help me formulate better arguments or if they are exceptional make me consider something from a different direction. Freakanomics didn’t make me a different person, but it gave me some foundation blocks missing from my worldview. Superfreakanomics as a sequel isn’t as revolutionary as the first book, especially after years of listening to Freakanomics podcast. But it is still an exceptional book with some fantastic stories that are hinted at on the front cover.

One of those stories, which uses the tagline suicide bombers, should buy life insurance. It catches your attention, but it’s a lot more in depth than it might seem. It’s not, as one might assume if you didn’t think about it, that they could cash in life support when blowing themselves up. As I am sure most people are aware life insurance companies are unlikely to pay out in that event. It is actually because of algorithms which have been able to determine how terrorists act so well that they can help the police locate at least some of them and one thing they are unlikely to do is buy life insurance.

This along with questions about car seats and TV lead into one of the major themes of the book, which is the concept of incentives. It’s a simple idea that is made far more complex in reality because the things we assume will incentivize people don’t always give us the results we are aiming for, and sometimes the observer effect is far greater than we assume.

One of those ways is whether humans are selfish or altruistic. Superfreakanomics examines the data on the assumption that humans are naturally altruistic because that was what their tests showed. But they didn’t sufficiently take into account the observer effect. Once it’s explained, it’s blindingly obvious that knowing that someone is testing you makes you more likely to act altruistically, especially if that person is a professor at the college you go to. Yet it’s not possible to say that humans are selfish because of this, because they really are acting altruistically and often do when people aren’t watching. Which takes us back to the center of the thesis incentives and hopefully how to use them to make the world better.

But the most interesting part of the book at this particular time was the section on hand washing and doctors. It turns out that most doctors don’t wash their hands enough, a fact which makes me feel better about myself and worse about the doctors. Hospitals naturally wanted to fix this, so they tried several incentives. The one that worked best was a picture of a petri dish filled with germs into screen savers. It turns out that even doctors can forget how many germs there are when they don’t see them, and with a constant reminder they brought up the amount of hand washing to the numbers they wanted. Which makes me wonder if we don’t need that on everything in 2020.

I doubt that anyone will be surprised by a positive review for Superfreakanomics. Or that I recommend both it and Freakanomics. It is rare for a book to be both educational and entertaining at the same time. But if you somehow avoided these books in the past give them a chance. They’re not as insane as the covers may make them seem, but they are as entertaining.