4 ms·

Holy false equivalences batman! You can find 999 doctors who help and 1 bad apple who prescribes Oxy willy-nilly. That doesn't mean you trust them all equally

Holy false equivalences batman! You can find 999 doctors who help and 1 bad apple who prescribes Oxy willy-nilly. That doesn't mean you trust them all equally, that means that trusting doctors works out pretty well 99.9% of the time, which are good odds and WAY better odds then every idiot out there trying to figure out medicine on their own and/or listening to random talking heads (which has a WAY lower hit rate). Once you just focus on general policies that lead to better outcomes, and everyone stops thinking they are so exceptional that they can become an expert in all fields, then recognizing true expertise and following its advice becomes an obviously more generally optimal path.

andrewzah 6y ago
Their point is those "bad apples" lead to people not trusting doctors as a whole. Over-prescribing opioids is one aspect. Not taking women seriously is another aspect. Does every doctor do this? Obviously not. But enough people have had bad experiences that overall I see people innately trusting doctors less and less. And it's not "1 bad apple". America is in the middle of an opioid epidemic. " everyone stops thinking they are so exceptional that they can become an expert in all fields" People don't think they can become experts in all fields. This is different from not blindly trusting someone, due to reasons mentioned above, etc.
- HunterWare 6y ago
  Wiki says there are 950k docs in the US. I'll start with thinking that since I don't have better numbers, that is a good initial estimate. I'll next estimate that there are less that 1k doctors wildly prescribing Oxy to patients and wind back up at my 1:999 ratio. I bet, frankly the odds are actually way BETTER than that. And I'll just finish by pointing out I didn't say "1 bad apple", I said "1 in 999 doctor apples are bad for the sake of this argument. On the expert in all fields: actually I just disagree here. I get your point but I think my summary is right. Let's again take the doctor sub-argument. If I decide that because my nephew's college roommate's friend had a doctor who was a bad apple (bad call? Oxy abuser? whatever) that I won't trust doctors anymore then the result will be that I become the medical expert in my life. As I am no longer delegating that competency and expertise to doctors, I have now assumed that role. Then add to that my assuming all the other roles that the top post used as examples and I'm now (in my world) the export (for me) on all those subjects. I don't know about you, but I have a life and just don't have the time to be an expert on geopolitics, all fields the press is covering, all house repairs, my car, science, my health, and everything else mentioned... (1) For my part? Thank god for qualified experts. 1 - from top post: "Politicians, journalists, contractors, car mechanics, scientists, all experts and all professionals with with trust issues."
  - andrewzah 6y ago
    Out of all things, one should take time to trust and verify about one's health and body. And at least some knowledge about car mechanics and home repair/contracting. The latter two are just a reality of life if you don't want to get scammed and/or have a really bad job done by contractors. It's not really fair, but also we don't -make- time to understand our bodies. It's a total choice. Preventative care is so important, yet hardly anyone takes the time to do it, only going in once issues develop. It's not about totally rejecting anything an expert says. It's more about trust, but verify, and take the lead yourself to be on top of things. In my personal experience, I am the one who has had to try to figure out my diagnosis so far because my GP, Dermatologist, and Immunologist haven't been very helpful. Most of my sessions over the last year were about 10-15 minutes, I answer some questions, and here are some pills, come back in a month. There hasn't been much testing after the initial battery of tests in the first ~2 months. I'm the one who has had to take the lead and be aggressive about trying to figure out a diagnosis, and now, about getting a referral to a tertiary/quaternary center with better immunologist experts to hopefully figure out the cause of this damn thing. It's not that I don't trust doctors- it's the opposite! But this whole situation has made me wary about blindly trusting anything or sticking to their timelines. My Immunologist emphatically stated that "it can't be gluten"- well guess what? So far, not eating gluten is appearing to help. It's only been ~1.5 weeks so we'll need to see. Of course I recognize that diagnosing skin issues/dermatitis is totally different than other types of issues.
    - HunterWare 6y ago
      I suspect that we aren't so far apart on this as one might think. The more central an issue is to your life, the better the rewards for developing some local expertise are. One can imagine that this is why some people develop into the domain experts they are, that field was central to their life. I think, however, this is a different discussion. The article was about the value of domain experts and trust in them, and I feel it's sad this is somehow contentious (although thankfully less so on this forum). I believe another article could be written about the need to improve access to relevant domain experts (your premise I believe) and the need to increase accountability of experts/professionals (another person's premise). Both are worthy areas to examine once we acknowledge the importance of domain experts and offloading/delegating to them...
vsareto 6y ago
I think it's deceptive to put it at 99.9%. That might be true for oxycontin abuse now since law enforcement started acting, but not necessarily so for doctors that brush away minority concerns or women's concerns or are just ignorant of those and then won't admit to it. There's probably other concerns which are not as obviously illegal as oxy abuse, but those still cause you to lose trust.
- HunterWare 6y ago
  Well, my specific counter-point was to a specific argument so this feels a bit like goal-post shifting. But on that note: whatever the ratio of good:bad is in any field it is always still important to improve it. I hope noone would disagree that all your examples of bad behavior are, in fact, bad... and society should work to improve on them through culling the bad actors and enforcing standards of behavior and expertise. I might note thought that this article was about expertise which is a different issue than "do you trust general law enforcement". Again I think we are at risk of mixing two separate but important issues. At the risk of further blurring the lines though, in this separate case I still suspect the answer is to specifically address the underlying problem of untrustworthy law enforcement when that problem is identified, rather than accepting a world were we have to take that responsibility on ourselves at all times. ie I suspect the policy of better controls and accountability on the people we trust is better than a policy of not trusting.
Chris2048 6y ago
> trusting doctors works out pretty well 99.9% of the time assuming random selection. What if that one bad doctor is selected more than 0.1% of the time though? https://www.legalaffairs.org/issues/March-April-2003/review_marapr03_moss.msp https://www.legalaffairs.org/issues/March-April-2003/review_...
cassac 6y ago
You could say the same thing about police officers. People think that because a small percent are bad we’d be better off letting society police itself into utopia. #DefundTheDoctors?
coding123 6y ago
About 10 years ago you had 998 doctors prescribing Oxy willy-nilly so... what are you saying?
sharemywin 6y ago
Your missing the point. I'm not arguing you shouldn't trust most doctors. I'm arguing corruption is causing trust issues with experts in many fields. I don't have a solution, but I imagine the solution does involve managing corruption better. Same with institutions. corporations are spending lots of money undermining institutions and experts for "for profit" ends. More corruption. Not saying the other points aren't relevant just the solutions also needs to deal with corruption better.

andrewzah 6y ago

Their point is those "bad apples" lead to people not trusting doctors as a whole. Over-prescribing opioids is one aspect. Not taking women seriously is another aspect. Does every doctor do this? Obviously not. But enough people have had bad experiences that overall I see people innately trusting doctors less and less. And it's not "1 bad apple". America is in the middle of an opioid epidemic. " everyone stops thinking they are so exceptional that they can become an expert in all fields" People don't think they can become experts in all fields. This is different from not blindly trusting someone, due to reasons mentioned above, etc.

HunterWare 6y ago
Wiki says there are 950k docs in the US. I'll start with thinking that since I don't have better numbers, that is a good initial estimate. I'll next estimate that there are less that 1k doctors wildly prescribing Oxy to patients and wind back up at my 1:999 ratio. I bet, frankly the odds are actually way BETTER than that. And I'll just finish by pointing out I didn't say "1 bad apple", I said "1 in 999 doctor apples are bad for the sake of this argument. On the expert in all fields: actually I just disagree here. I get your point but I think my summary is right. Let's again take the doctor sub-argument. If I decide that because my nephew's college roommate's friend had a doctor who was a bad apple (bad call? Oxy abuser? whatever) that I won't trust doctors anymore then the result will be that I become the medical expert in my life. As I am no longer delegating that competency and expertise to doctors, I have now assumed that role. Then add to that my assuming all the other roles that the top post used as examples and I'm now (in my world) the export (for me) on all those subjects. I don't know about you, but I have a life and just don't have the time to be an expert on geopolitics, all fields the press is covering, all house repairs, my car, science, my health, and everything else mentioned... (1) For my part? Thank god for qualified experts. 1 - from top post: "Politicians, journalists, contractors, car mechanics, scientists, all experts and all professionals with with trust issues."
- andrewzah 6y ago
  Out of all things, one should take time to trust and verify about one's health and body. And at least some knowledge about car mechanics and home repair/contracting. The latter two are just a reality of life if you don't want to get scammed and/or have a really bad job done by contractors. It's not really fair, but also we don't -make- time to understand our bodies. It's a total choice. Preventative care is so important, yet hardly anyone takes the time to do it, only going in once issues develop. It's not about totally rejecting anything an expert says. It's more about trust, but verify, and take the lead yourself to be on top of things. In my personal experience, I am the one who has had to try to figure out my diagnosis so far because my GP, Dermatologist, and Immunologist haven't been very helpful. Most of my sessions over the last year were about 10-15 minutes, I answer some questions, and here are some pills, come back in a month. There hasn't been much testing after the initial battery of tests in the first ~2 months. I'm the one who has had to take the lead and be aggressive about trying to figure out a diagnosis, and now, about getting a referral to a tertiary/quaternary center with better immunologist experts to hopefully figure out the cause of this damn thing. It's not that I don't trust doctors- it's the opposite! But this whole situation has made me wary about blindly trusting anything or sticking to their timelines. My Immunologist emphatically stated that "it can't be gluten"- well guess what? So far, not eating gluten is appearing to help. It's only been ~1.5 weeks so we'll need to see. Of course I recognize that diagnosing skin issues/dermatitis is totally different than other types of issues.
  - HunterWare 6y ago
    I suspect that we aren't so far apart on this as one might think. The more central an issue is to your life, the better the rewards for developing some local expertise are. One can imagine that this is why some people develop into the domain experts they are, that field was central to their life. I think, however, this is a different discussion. The article was about the value of domain experts and trust in them, and I feel it's sad this is somehow contentious (although thankfully less so on this forum). I believe another article could be written about the need to improve access to relevant domain experts (your premise I believe) and the need to increase accountability of experts/professionals (another person's premise). Both are worthy areas to examine once we acknowledge the importance of domain experts and offloading/delegating to them...

vsareto 6y ago

I think it's deceptive to put it at 99.9%. That might be true for oxycontin abuse now since law enforcement started acting, but not necessarily so for doctors that brush away minority concerns or women's concerns or are just ignorant of those and then won't admit to it. There's probably other concerns which are not as obviously illegal as oxy abuse, but those still cause you to lose trust.

HunterWare 6y ago
Well, my specific counter-point was to a specific argument so this feels a bit like goal-post shifting. But on that note: whatever the ratio of good:bad is in any field it is always still important to improve it. I hope noone would disagree that all your examples of bad behavior are, in fact, bad... and society should work to improve on them through culling the bad actors and enforcing standards of behavior and expertise. I might note thought that this article was about expertise which is a different issue than "do you trust general law enforcement". Again I think we are at risk of mixing two separate but important issues. At the risk of further blurring the lines though, in this separate case I still suspect the answer is to specifically address the underlying problem of untrustworthy law enforcement when that problem is identified, rather than accepting a world were we have to take that responsibility on ourselves at all times. ie I suspect the policy of better controls and accountability on the people we trust is better than a policy of not trusting.

Chris2048 6y ago

> trusting doctors works out pretty well 99.9% of the time assuming random selection. What if that one bad doctor is selected more than 0.1% of the time though? https://www.legalaffairs.org/issues/March-April-2003/review_marapr03_moss.msp https://www.legalaffairs.org/issues/March-April-2003/review_...

cassac 6y ago

You could say the same thing about police officers. People think that because a small percent are bad we’d be better off letting society police itself into utopia. #DefundTheDoctors?

coding123 6y ago

About 10 years ago you had 998 doctors prescribing Oxy willy-nilly so... what are you saying?

sharemywin 6y ago

Your missing the point. I'm not arguing you shouldn't trust most doctors. I'm arguing corruption is causing trust issues with experts in many fields. I don't have a solution, but I imagine the solution does involve managing corruption better. Same with institutions. corporations are spending lots of money undermining institutions and experts for "for profit" ends. More corruption. Not saying the other points aren't relevant just the solutions also needs to deal with corruption better.