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Freakonomics, M.D.

68. The E.R. Doctor’s Dilemma

Freakonomics, M.D.

Freakonomics Radio + Stitcher

Society & Culture, Science

4.81.1K Ratings

🗓️ 13 January 2023

⏱️ 30 minutes

🧾️ Download transcript

Summary

Figuring out which patients to hospitalize and which to safely send home can be tricky. Is there a way to make this decision easier for doctors — and get better outcomes, too?

Transcript

Click on a timestamp to play from that location

0:00.0

There's a set of decisions that you have to make right off the bat, which is am I really

0:10.8

worried about this person or not?

0:13.1

Sometimes it's obvious if they're unconscious, if they're vital signs are completely abnormal,

0:18.1

but a lot of the things that we worry about the most in the emergency department are things

0:22.7

that can actually look pretty subtle at first.

0:25.1

Dr. Ziat Obermeyer is an emergency medicine physician and a professor at UC Berkeley.

0:31.0

So everyone's first image of a heart attack is a middle-aged man clutching his chest

0:35.6

and saying something about an elephant, but most heart attacks don't look like that.

0:39.0

Most heart attacks are a little bit of nausea or a tinge of chest pressure.

0:43.7

The stakes are high in the emergency department.

0:46.6

People arrive with symptoms that could be life-threatening or benign or anywhere in between.

0:52.5

There's approximately billions of tests and combinations of tests that you could order

0:57.2

for any given patient, so you need to narrow down to the ones that are going to help you

1:00.8

figure out what to do with this person right now.

1:03.7

A lot of Ziat's research is focused on tests and how to make sure we're testing the right

1:08.9

people for the right things at the right time to get the right information.

1:14.1

In emergency medicine, that means making choices that help you answer one big question.

1:20.5

How do I do with this person next?

1:22.6

Do I bring them into the hospital or do I send them home?

1:26.7

And that's a really hard one.

1:33.4

In 2020, there were more than 33 million hospital admissions in the US.

1:38.8

That number is down slightly from prior years, probably because of the pandemic.

...

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