Random Acts of Medicine is a Malcolm Gladwell style book applied to health care systems. The authors — both physicians and public health researchers at Harvard Medical School — propose to explore the “hidden, but predictable ways in which chance affects our health and our healthcare system” through the use of “Natural Experiments,” that is observational studies that make use of naturally occurring differences in the world and measuring the impact. The two (along with colleagues) have used the approach to explore and answer a number of questions such as: does stress really age you? How does the month of a child’s birth impact their health and life success? What happens when all the cardiologists leave town? How does a marathon impact our health? Does your doctor’s politics affect the care they give? For each question (and there are many, many, more than the ones I have listed), the authors carefully explain the natural experiment, the sources of data, results, and what use can be made of the results (possible policy changes, or greater awareness of our own biases at work).
I found the book got better (more interesting to me) as it went on. The authors are careful not to assume that the reader knows anything about natural experiments, statistics, counterfactuals, etc. and they explain the (possibly new) concepts carefully, but not tediously. Still, if you are already familiar with the concepts it can get a little dull and I enjoyed all the actual experiments (many with surprising results) more than the introduction.
An easy read full of fun “I never thought about that” insights. Plenty of notes and references for those who want to investigate further. I always appreciate the kind of “popularized” topic books when they actually show their work, clearly separating them from the whopping pile of self help books that make claims without an iota of scientific support.
Thank you to Doubleday and NetGalley for providing an advance copy of this book in exchange for my honest review. The book will be published on July 11th, 2023