For those of you familiar with the book Rethink, the core idea is the “how” trap that we all fall prey to, and I have witnessed a lot of “how” traps over the years, but I think I may have found the king of all time – this one is almost 1,700 years old.
I recently read 
“Magic By Numbers” by Daniel Gilbert and as interesting and entertaining as the article was, talking about how we get attached to certain numbers, like 24 (hours in a day), 10 (for roundness of stock price), and so forth, one of the core ideas in the piece is that we are at least 16% over medicated when it comes to prescription antibiotics. My back of the cocktail math was that if the US Pharma industry was $315B in 2007 (fact), and a third of that was antibiotics (that’s a guess), then if 16% of what we are spending is too much, then that’s about $16B in spend we could stop right now. Maybe it’s $10B, maybe it’s $30B, it’s a big, big number.
You can read the article, but the gist of it is that doctors have been prescribing a course of medicine for a week for a long long time, and the only real reason for that traces back to 321 A.D. when Constantine established the seven day week. There is no scientific evidence that seven days is the right treatment. In fact, Gilbert says that recent testing has shown that six days of antibiotics is no less effective than seven days, and if that’s the case, then we are at LEAST over medicating and thus over spending by 16%.
16% is a huge number in any industry, and when you have a number that hasn’t been seriously questioned for over 1,600 years, you have to wonder what other big opportunities are lurking out there, where we have gotten so attached to how we do everything that we can’t see the obvious need to test out assumptions about “how” we do it.
Beyond that, assuming Gilbert’s evidence is scientifically accurate, and I have no reason to believe it isn’t, then why isn’t this front page news? Why isn’t Anderson Cooper talking about this right now? Why is this buried on the op-ed page of the Sunday New York Times? If we have the evidence, why don’t we start making the change to dial back the over-medication of America? Even if this isn’t considered hard science yet, isn’t it worth a few million in spending just to test if it is right, to see if we can cut spending by that much?
-Ric
P.S. The other big takeaway from this article was learning what the Fibonacci series is. I can’t wait to use that in conversation.
why isn’t this front page news?
Because what sounds good on the back of a cocktail napkin often does not work so well once applied to the messy, real world situation of human beings.
For example: failing to take the antibiotics long enough contributes to the development of strains of disease that are immune to those antibiotics. On a less world-threatening note, it can also mean getting better enough to feel well but not better enough not to relapse. Both failures are fantastically expensive at a rate of at least double the original illness.
Many people fail to finish a course of antibiotics, but they generally attempt to follow directions. The larger the margin for error (for example if the advised course is 7 days and they only need 5) the lower the risk of fail.
That’s just one idea “why”. My main point is that over the past 30 years, decision-making power has increasingly been removed from experts dealing directly with the situation (ie teachers and doctors) and placed in the hands governing bodies (ie law and insurance companies) who make decisions like this one exactly the way that you did. More importantly (as demonstrated by the fact that you posted this) it’s widely by the public to be a good idea.