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Physician, Disinfect Thyself

We spend a good bit of time in SuperFreakonomics writing about doctors’ hand hygiene: specifically, how important good hand hygiene is in order to cut down on hospital-acquired infections and yet how historically it has proven difficult to enforce. That’s because behavior change can be hard in general, but particularly so when it doesn’t necessarily benefit the people who are actually changing their behavior.
So it turns out that some of the most effective means of discouraging infections don’t rely so much on behavior change; as we write:

Among the best solutions: using disposable blood-pressure cuffs on incoming patients; infusing hospital equipment with silver ion particles to create an antimicrobial shield; and forbidding doctors to wear neckties because, as the U.K. Department of Health has noted, they “are rarely laundered,” “perform no beneficial function in patient care,” and “have been shown to be colonized by pathogens.”

If this topic interests you, then you certainly want to check out a recent Wall Street Journal article by Rebecca Smith, which offers a more in-depth examination of the role of the necktie in passing along germs. One new solution for doctors who just can’t bear to part with formal neckwear: the antimicrobial necktie. (Hat tip: Ted DiSante)
But here’s a much more interesting and broad-reaching suggestion, from a reader named Larry McColloch:

In the section on doctors washing hands, you apply economic theory and approach. It would be much better to view it as a “control systems” problem. In this regard, the doctors were operating “open loop” in that the germs on their hands are not visible. What really happened with the hand-culture experiment was that the results allowed the doctors to see the germs that were present; in control-loop theory, this is “closing the loop.”
You might want to apply the idea of feedback and control theory to many economics problems. No doctor would contaminate a patient with potentially killer germs if they knew they were contaminated regardless of economic implication. What is missing in the hospital is feedback. You are also pointing out a product for someone to make money with. If someone can make a device that easily lets doctors see germs on their hands, it will immediately change habits in the hospital.
The control systems perspective also applies to many of your other topics, such as climate change. What is lacking in both understanding and fixing climate change is some kind of feedback mechanism, although I don’t know how to get appropriate feedback.

I agree with Larry: feedback is hugely important in problem-solving and, unfortunately, a far-too-scarce commodity. That’s one reason the Internet is so powerful: if you can find a way to filter out the noise, the Internet is one of the greatest feedback loops imaginable, at least for certain kinds of problem-solving.


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