Jill StewartThe apocalypse won't be caused by war but by microbes. That's one fear as researchers fight the superbugs that humans have created through overuse of antibiotics.
Daniella Meeker, 38, is engaged in that battle, but she's not the sort of scientist who peers into Petri dishes – she's a systems engineer and information scientist at RAND Corp., a beautiful brainiac in cashmere who looks like a member of a girl band.
She grew up in Georgia, where she got hooked on science in a pre-Pinterest world and found she was as attracted to “the aesthetics of now-vintage laboratory glassware, equipment and specimens” as to scientific puzzles.
]She earned her undergraduate degree in neuroscience at the University of Chicago, where, she jokes, “The motto on the most popular school T-shirt was, 'Where fun goes to die.'?” Caltech granted her a Ph.D. in computation and neural systems in 2006.
Meeker flashes a grin as she explains that her work, conducted behind locked doors on the imposing RAND campus in Santa Monica, focuses on “how to leverage the existing system to improve health care by applying the principles of behavioral economics.” She laughs, shaking her long, dark hair. She realizes that's a mouthful – as is the paper she lead-authored in JAMA Internal Medicine, “Nudging Guideline-Concordant Antibiotic Prescribing.”
The idea is that doctors, along with the meat industry, are the worst pushers of “inappropriate antibiotics,” she says. In Los Angeles, 43 percent of doctors at sites her group studied were overprescribing antibiotics. It's worse elsewhere.
Those unnecessary drugs have fed an explosion in drug-resistant microbes, which now lurk in the crevices of even the best hospitals. Ultimately, they could kill billions of us. “If our antibiotics are no longer effective,” she says, “we could go back to where we were before penicillin.”
Yet one solution – paying doctors to stop overprescribing – had “mixed results at best,” Meeker says. Posters on walls, urging doctors to knock it off? That didn't work, either.
One principle of behavioral economics, Meeker says, is that “people respond better to public commitment – like StickK.com, where you promise your friends some goal you'll achieve, and pledge that if you fail you'll give money to a political party you don't favor.”
So she and other researchers, in a study funded by the National Institutes of Health, asked doctors to sign a public letter pledging to prescribe antibiotics only for bacterial disease – not for respiratory viruses. Or pain.
Their simple idea worked. Now the researchers are studying 300 doctors who, via electronic health records, will be told automatically of alternatives to antibiotics, asked to justify use of antibiotics and then sent feedback saying how wisely they behaved compared with their peers.
Meeker believes such engagement can save lives, and she hopes the study brings a major shift. But her work is far from done. She and her husband, a musician (he plays in a band called Magic Mirror, which is “dark rock & roll, like Leonard Cohen”), recently brought a puppy into their Silver Lake home. The decision, she says, has her pondering infectious disease “from a whole new canine vantage point.”
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