Review of Chance and choice in health care: A review of Anupam B. Jena and Christopher Worsham's "Random acts of medicine".

Abstract

Reviews the book, Random Acts of Medicine: The Hidden Forces That Sway Doctors, Impact Patients, and Shape Our Health by Anupam B. Jena and Christopher Worsham (2023). In an era increasingly defined by calls for value-based care and health care equity, this book offers timely and significant insights. By using randomness as an investigative lens, the book uncovers otherwise hidden inefficiencies and disparities in health care systems, making a strong case for reform that is both evidence-based and equitable. Blending empirical rigor with accessible prose, the authors offer a data-driven exploration of medical randomness, drawing on natural experiments to reveal both vulnerabilities and opportunities within health care delivery. Jena and Worsham define medical randomness to be any unpredictable or variable moment or chance event that affects the medical care physicians give and receive. The authors then design natural experiments from these events, including examining the effect of a child's birthdate on families' influenza incidence and the impact of major medical conferences on patient care outcomes. Chapters are organized thematically, with each section presenting lenses through which to view how natural experiments can be analyzed to expose and learn from systemic flaws in health care delivery. A few of the themes explored include physician decision making and training variability, structural and financial inequities in care, and barriers to acquiring timely and convenient care. The intended audience includes clinicians, health systems leaders, and policymakers interested in optimizing health care through empirical inquiry. However, the book's clarity and real-world examples make it equally valuable to students in public health and economics, as well as a broader lay audience interested in how health care operates behind the scenes. While technical in scope, the work remains grounded in real-world implications, making it a compelling read for clinicians, policymakers, and system-level leaders alike. (PsycInfo Database Record (c) 2026 APA, all rights reserved).