Superfreakonomics_ global cooling, patri - Steven D. Levitt [37]
For the most part, our findings aren’t very surprising. An excellent doctor is disproportionately likely to have attended a top-ranked medical school and served a residency at a prestigious hospital. More experience is also valuable: an extra ten years on the job yields the same benefit as having served a residency at a top hospital.
And oh yes: you also want your ER doctor to be a woman. It may have been bad for America’s schoolchildren when so many smart women passed up teaching jobs to go to medical school, but it’s good to know that, in our analysis at least, such women are slightly better than their male counterparts at keeping people alive.
One factor that doesn’t seem to matter is whether a doctor is highly rated by his or her colleagues. We asked Feied and the other head physicians at WHC to name the best docs in the ER. The ones they chose turned out to be no better than average at lowering death rates. They were, however, good at spending less money per patient.
So the particular doctor you draw in the ER does matter—but, in the broader scheme of things, not nearly as much as other factors: your ailment, your gender (women are much less likely than men to die within a year of visiting the ER), or your income level (poor patients are much more likely to die than rich ones).
The best news is that most people who are rushed to the ER and think they are going to die are in little danger of dying at all, at least not any time soon.
In fact, they might have been better off if they simply stayed at home. Consider the evidence from a series of widespread doctor strikes in Los Angeles, Israel, and Colombia. It turns out that the death rate dropped significantly in those places, anywhere from 18 percent to 50 percent, when the doctors stopped working!
This effect might be partially explained by patients’ putting off elective surgery during the strike. That’s what Craig Feied first thought when he read the literature. But he had a chance to observe a similar phenomenon firsthand when a lot of Washington doctors left town at the same time for a medical convention. The result: an across-the-board drop in mortality.
“When there are too many physician-patient interactions, the amplitude gets turned up on everything,” he says. “More people with nonfatal problems are taking more medications and having more procedures, many of which are not really helpful and a few of which are harmful, while the people with really fatal illnesses are rarely cured and ultimately die anyway.”
So it may be that going to the hospital slightly increases your odds of surviving if you’ve got a serious problem but increases your odds of dying if you don’t. Such are the vagaries of life.
Meanwhile, there are some ways to extend your life span that have nothing to do with going to the hospital. You could, for instance, win a Nobel Prize. An analysis covering fifty years of the Nobels in chemistry and physics found that the winners lived longer than those who were merely nominated. (So much for the Hollywood wisdom of “It’s an honor just to be nominated.”) Nor was the winners’ longevity a function of the Nobel Prize money. “Status seems to work a kind of health-giving magic,” says Andrew Oswald, one of the study’s authors. “Walking across that platform in Stockholm apparently adds about two years to a scientist’s life span.”
You could also get elected to the Baseball Hall of Fame. A similar analysis shows that men who are voted into the Hall outlive those who are narrowly omitted.
But what about those of us who aren’t exceptional at science or sport? Well, you could purchase an annuity, a contract that pays off a set amount of income each year but only as long as you stay alive. People who buy annuities, it turns out, live longer than people who don’t, and not because the people who buy annuities are healthier to start with. The evidence suggests that an annuity’s steady payout provides a little extra incentive to keep chugging along.
Religion also seems to help. A study of more than 2,800 elderly Christians and Jews found that they