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you put your conclusion first, and I must say I disagreed with it when I read your first couples of lines. Because medicine is actually hard - it's not that st

you put your conclusion first, and I must say I disagreed with it when I read your first couples of lines. Because medicine is actually hard - it's not that students have to "go through hell because that's what they had to go through." Medicine is really hard. I have a condition that affects my lifestyle, I have to learn about it, the more I learn the better my outcome. I'm not studying medicine and only "have to" learn one little part. All the same it is not easy. It would be as though all someone had to do in their entire life was (something specific) but computer science is so hard that this is not easy. I would say medicine is harder than computer science. DNA is 650 megabytes, not every underlying process is understood, drugs and their interractions have to be learned with tons of difficulty, even after you specialize you have to understand the entire system. But then I read the rest of your comment, and I must say - perhaps it is true that there is room for someone to "diagnose pneumonia" or something. Doctors are expert systems: but perhaps there is room for lesser expertise. (A small aside - it is certainly true that the long required training artificially reduces supply of doctors in the united states - however I think you are using an imprecise term "rent-seeking" and should pick a more specific term from economics since I think you are technically misusing it.)

jimmywanger 10y ago
I don't disagree with medicine being hard. I'm not going to get into the difference difficulty between learning medicine or computer science. I guess I should have mentioned my point first, which is that just like you don't need a star computer scientist to write an app for a restaurant, you don't need a doctor with all that training and theoretical knowledge to diagnose a sprained ankle. I'm sorry about your condition, but that condition probably is fairly rare. How many of your other health issues couldn't be diagnosed by somebody with less training? > however I think you are using an imprecise term "rent-seeking" I don't see how I am. Can you please elucidate? You have to pass boards to practice medicine in the US, which requires a huge investment of time and money, and after you do that, you want to restrict supply so that you're in high demand. That way for the rest of your career you can coast on your laurels and keep collecting a paycheck.
- logicallee 10y ago
  Regarding the rarety of my condition, it's diabetes treated with insulin, so not rare by any stretch of the imagination. With a positive diagnosis and in a fairly uncomplicated case, it's a huge burden on me to learn just the single condition. Now imagine doctors who don't have to deal with only a single, well-diagnosed condition. You say that a "sprained ankle" is easy to diagnose -- but is it really? On the differential, how many other conditions manifest similarly? What complications can a trained doctor see, what questions do they know to ask? In my interaction with the medical industry, in no case would I have been as well-served by a "lesser expert." Regarding the term rent-seeking. This is quite a specific term, that means causing payment to be made for something that would be free. For example, if I opened an institute to monitor air quality and make recommendations, and managed to get the government to force everyone to pay an "air tax" for my endeavors -- this is "rent-seeking", since, of course, air can be enjoyed without paying for it. From how I read your comment, you did not intend this usage. Rather, you meant to speak about the supply of trained doctors (not to speak about something that might be free otherwise), so it is more cartel-like behavior, at least as far as I read your argument. I assume you still want the lesser experts we're discussing to be regulated legally, etc, and weren't comparing with "free" opinions such as if I ask an aunt about herbal medicines that have worked for her. If the latter, then, sure, I would say it is rent-seeking to start charging people to discuss herbal medicines for which discussion is otherwise free.
  - aianus 10y ago
    People are being forced to go to an expensive doctor and pay for things that should be free or extremely cheap. A few things I've personally witnessed: going to the doctor for a sick note, going to the doctor for routine travel immunizations, going to the doctor for a birth control prescription, going to an optometrist for routine eye correction prescriptions.
  - jimmywanger 10y ago
    > You say that a "sprained ankle" is easy to diagnose -- but is it really? On the differential, how many other conditions manifest similarly? What complications can a trained doctor see, what questions do they know to ask? We're talking probabilities here. Most likely your illness is due to the most probable cause. And if it isn't, well, stuff happens. From wikipedia: In economics and in public-choice theory, rent-seeking involves seeking to increase one's share of existing wealth without creating new wealth. I believe that's what a lot of doctors do these days. After a weekend of tromping through the woods, I got a case of poison oak. I had to see a doctor and get a prescription for a steroid, because apparently it's a scheduled medication. There is a lot of overlap between a cartel and rent-seeking though. > In my interaction with the medical industry, in no case would I have been as well-served by a "lesser expert." Is that only from your diabetic condition, or other issues? I think the question I'm raising is that maybe sometimes "it'll do" is just as good "he's elite, I'm lucky to have him". > I assume you still want the lesser experts we're discussing to be regulated legally, etc No. I think you should be able to hang out your shingle without government regulation.
nradov 10y ago
There is room for clinicians who can diagnose pneumonia and other simple conditions: nurse practitioners and physician assistants. They don't need as much training as physicians.

jimmywanger 10y ago

I don't disagree with medicine being hard. I'm not going to get into the difference difficulty between learning medicine or computer science. I guess I should have mentioned my point first, which is that just like you don't need a star computer scientist to write an app for a restaurant, you don't need a doctor with all that training and theoretical knowledge to diagnose a sprained ankle. I'm sorry about your condition, but that condition probably is fairly rare. How many of your other health issues couldn't be diagnosed by somebody with less training? > however I think you are using an imprecise term "rent-seeking" I don't see how I am. Can you please elucidate? You have to pass boards to practice medicine in the US, which requires a huge investment of time and money, and after you do that, you want to restrict supply so that you're in high demand. That way for the rest of your career you can coast on your laurels and keep collecting a paycheck.

logicallee 10y ago
Regarding the rarety of my condition, it's diabetes treated with insulin, so not rare by any stretch of the imagination. With a positive diagnosis and in a fairly uncomplicated case, it's a huge burden on me to learn just the single condition. Now imagine doctors who don't have to deal with only a single, well-diagnosed condition. You say that a "sprained ankle" is easy to diagnose -- but is it really? On the differential, how many other conditions manifest similarly? What complications can a trained doctor see, what questions do they know to ask? In my interaction with the medical industry, in no case would I have been as well-served by a "lesser expert." Regarding the term rent-seeking. This is quite a specific term, that means causing payment to be made for something that would be free. For example, if I opened an institute to monitor air quality and make recommendations, and managed to get the government to force everyone to pay an "air tax" for my endeavors -- this is "rent-seeking", since, of course, air can be enjoyed without paying for it. From how I read your comment, you did not intend this usage. Rather, you meant to speak about the supply of trained doctors (not to speak about something that might be free otherwise), so it is more cartel-like behavior, at least as far as I read your argument. I assume you still want the lesser experts we're discussing to be regulated legally, etc, and weren't comparing with "free" opinions such as if I ask an aunt about herbal medicines that have worked for her. If the latter, then, sure, I would say it is rent-seeking to start charging people to discuss herbal medicines for which discussion is otherwise free.
- aianus 10y ago
  People are being forced to go to an expensive doctor and pay for things that should be free or extremely cheap. A few things I've personally witnessed: going to the doctor for a sick note, going to the doctor for routine travel immunizations, going to the doctor for a birth control prescription, going to an optometrist for routine eye correction prescriptions.
- jimmywanger 10y ago
  > You say that a "sprained ankle" is easy to diagnose -- but is it really? On the differential, how many other conditions manifest similarly? What complications can a trained doctor see, what questions do they know to ask? We're talking probabilities here. Most likely your illness is due to the most probable cause. And if it isn't, well, stuff happens. From wikipedia: In economics and in public-choice theory, rent-seeking involves seeking to increase one's share of existing wealth without creating new wealth. I believe that's what a lot of doctors do these days. After a weekend of tromping through the woods, I got a case of poison oak. I had to see a doctor and get a prescription for a steroid, because apparently it's a scheduled medication. There is a lot of overlap between a cartel and rent-seeking though. > In my interaction with the medical industry, in no case would I have been as well-served by a "lesser expert." Is that only from your diabetic condition, or other issues? I think the question I'm raising is that maybe sometimes "it'll do" is just as good "he's elite, I'm lucky to have him". > I assume you still want the lesser experts we're discussing to be regulated legally, etc No. I think you should be able to hang out your shingle without government regulation.

nradov 10y ago

There is room for clinicians who can diagnose pneumonia and other simple conditions: nurse practitioners and physician assistants. They don't need as much training as physicians.