Segment#
21
Location
Date 10/26/2006
Story Name CLEAN BILL OF HEALTH? DOES MY DOCTOR WASH UP?
Notes
08:33:01
Prepared by The Transcription Company, www.transcripts.net, (818) 8486500
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08:33:01
DIANE SAWYER
(OC) Okay. Thanks, Sam. Well we love it when our pals from
'Freakonomics" come in.
GRAPHICS: FREAKONOMICS
08:33:05
DIANE SAWYER
(VO) You know, that best-selling book now updated and revised, still,
the best-seller list, I'm happy to say. But they come in, they're
coming
to tell us why we really do what we do and how to change behavior when
we
really want to change it but we don't. And this morning,
'Freakonomics"
co-author Stephen DUBNER is back to talk about hand washing?
08:33:25
STEPHEN DUBNER, 'FREAKONOMICS"
Yeah. Afraid so.
08:33:26
DIANE SAWYER
(OC) Now, it sounds like, you know, a nice thing to do.
08:33:29
STEPHEN DUBNER
Yeah. Yeah.
08:33:29
DIANE SAWYER
(OC) Wash your hands, as we know, get your kids to wash your hands for
germs, wash your hands when you leave the restroom. But it's also
critical in hospitals, you say...
08:33:37
STEPHEN DUBNER
Yeah.
08:33:37
DIANE SAWYER
(VO) ...where half the time, they, the hospital personnel wash their
hands only half?
08:33:41
STEPHEN DUBNER
Yeah. It's kind of tragic, yes. So hand washing in hospitals is
particularly important because there's bacterial infections obviously.
GRAPHICS: CLEAN BILL OF HEALTH?
GRAPHICS: DOES MY DOCTOR WASH UP?
08:33:48
STEPHEN DUBNER
And doctors have been shown to be the worst culprits, worse than
nurses,
worse than aides. A number of studies over the years have shown this.
And it's, and it's a real problem. So hospitals need to figure out how
to
solve this. So that's what we explore.
08:33:57
DIANE SAWYER
(OC) Right. So how do you get a doctor to wash his hands? Now, you
say
they started out with memos and lectures.
08:34:03
STEPHEN DUBNER
Yeah.
08:34:04
DIANE SAWYER
(OC) Did it work?
08:34:04
STEPHEN DUBNER
No. It didn't work at all. This was Cedar Sinai in LA. And they,
they
did, you know, in our meeting culture, they had meetings, sent out
memos,
didn't work. Then they got creative and they had posses of the chief
of
the, chief of staff of the hospital go around to the wards to watch
doctors whether they were washing or not. And when a doctor did wash
properly, they would jump out and give him a $10 Starbucks gift card,
which you would think for somebody who's earning a lot of money
wouldn't
matter. But nobody turned it down. So never underestimate the power
of
free no matter how much somebody is making.
08:34:31
DIANE SAWYER
(OC) However, that only brought compliance up to how, how?
08:34:34
STEPHEN DUBNER
About, about 80%.
08:34:35
DIANE SAWYER
(OC) 80%? And they needed 100% to be safe.
08:34:37
STEPHEN DUBNER
They did. And then they got wacky, which is the epidemiologist of the
hospital asked the senior staffers to lay their palms in a petri dish
with
an agar plate and she sent it to the lab to be cultured. And they took
photographs of the cultures and they were disgusting. There we're
seeing
it. Those are just colonies of microbes that are from one of the most,
that's from the senior staff who's telling everybody to wash. Then
they
got really creative and made that image the screen saver on every
computer
in the hospital. When confronted with this disgusting visual data,
compliance changed. It went up to about 100%.
08:35:09
DIANE SAWYER
(OC) So the message from this is, in your own family, in your own
life,
it can help somewhat, to have incentives like little bribes, like a
little
amount of money, a little Starbucks, whatever it is?
08:35:20
STEPHEN DUBNER
Yeah.
08:35:20
DIANE SAWYER
(OC) But if you really wanna get full compliance, you have to have
some
graphic visual...
GRAPHICS: REMEMBER: WASH YOUR HANDS AFTER REMOVING GLOVES
08:35:25
STEPHEN DUBNER
You have to scare the crap out of somebody, apparently to, get full
compliance. But, but, no, it's, yeah, right. Some incentives that
seem very sensible don't work or they may even backfire, whereas
others, you
have to try. That's, it's really a, a lesson in trial and error
incentives, yeah.
08:35:38
DIANE SAWYER
(OC) Right. So, even with your children, you could show them
something
graphic, the difference between doing it right and not doing it right?
08:35:44
STEPHEN DUBNER
Children might respond to bribes a little bit better than, you know,
it,
it, it's hard to say. The, the point is, is that - human behavior is
pretty unpredictable. And what we try to explore is what are the
incentives that end up working? And it's often surprising when, and
often, it's someone like this epidemiologist having a, a crazy idea but
out of desperation they were willing to give it a try.
08:36:02
DIANE SAWYER
(OC) Well, there it is right on the screen saver when you turn it on.
And you say for voting, you can extrapolate some of these things to
voting
as well? Does that mean Starbucks for a vote?
08:36:11
STEPHEN DUBNER
You know, in the old days, they used to give people a barrel of whisky
or
a live pig if you vote. Now, that came with strings attached. You had
to
vote a particular way when they, when they paid you like that. But we
looked at why people vote and why they don't. And, in, in Switzerland,
they, they changed the procedure. They send mail-in ballots to every
citizen so you didn't have to go to the polls.
08:36:28
DIANE SAWYER
(OC) Make it easy.
08:36:29
STEPHEN DUBNER
It seems easy. You would think voter turnout would go through the
roof.
In fact, it went down. And the conclusion is a very counterintuitive
one.
It seems that a lot of people vote because they want to be seen voting
at
the polls by their friends or, or colleagues or family.
08:36:43
DIANE SAWYER
(OC) So, the end message to get us all to turn out at the polls in
greater number is?
08:36:47
STEPHEN DUBNER
If I could tell you that, you know, I'd be making a lot of money as a,
as
a voting consultant of some kind. The, the point is that, people vote
out
of the sense of civic duty but what's even stronger is being seen as
someone who has civic duty. I will say this, if and when you vote,
hopefully when you vote, remember that a voting booth is also a place
where there're probably an awful lot of germs. So, wash your hands
after
or even better, figure out, like, you're gonna vote for somebody that
nobody else has voted for so you still get a clean lever when you pull
it.
08:37:13
DIANE SAWYER
(OC) But it seems to me that, the friends that you want to impress
should come to you and say, 'Hey, let's all vote together." And if you
start that...
08:37:21
STEPHEN DUBNER
I think you're on to something.
08:37:22
DIANE SAWYER
(OC) I may be. Anyway, why we really do what we do. Step