*STS Circle at Harvard* *[image: line.gif] * * * *David Jones* *STS, MIT* * * on
*"Strange Facts," Evocative Maps, and the Puzzles of Geographic Variation in Medical Practice* ** Monday, February 14th 12:15-2:00 p.m. 124 Mt. Auburn Street, Suite 100, Room 106 [image: line.gif] Lunch is provided if you RSVP. Please RSVP to sts <[email protected]>@hks.harvard.edu<[email protected]> by 5pm Thursday, February 10th. * * *Abstract:* A puzzling phenomenon, long known to medical researchers, has recently risen to prominence: unwarranted geographic variation in medical practice. I will trace the history of this problem in order to illustrate three points. First, practice variation only emerged as a problem in the late twentieth century as new expectations of universal, scientific practice, enforced through the discipline of evidence-based medicine, created an expectation of geographic uniformity in therapeutic practice. Second, novel techniques of mapping and visual representation played a key role in the emergence of the idea of unwarranted variation: researchers deployed them strategically to motivate a policy response. Third, efforts to stamp out unwarranted variation have been stymied by the fundamental irreducibility of the problem. The causes of local variation in medical practice themselves vary locally, something that disrupts simple policy interventions. Burgeoning calls for global health equity pose even greater challenges for those committed to eradicating geographic variation in access to medical resources. *Biography*: David Jones studied medicine and history of science at Harvard University and then trained in psychiatry at Massachusetts General Hospital and McLean Hospital. He joined the MIT faculty in 2005 where he is now Associate Professor of the History and Culture of Science and Technology. He also teaches at Harvard Medical School, where he directs the educational programs of the Department of Global Health and Social Medicine. He has published extensively on health inequalities and medical research. His current research, funded by the Robert Wood Johnson Foundation and NSF, explores the history of decision making in cardiac therapeutics. A complete list of STS Circle at Harvard events can be found on our website: http://www.hks.harvard.edu/sts/events/sts_circle/
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