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Your last point isn't correct. While that is the result I think emphasizing that it isn't made easier is important. Electricians need to install high voltage

Your last point isn't correct. While that is the result I think emphasizing that it isn't made easier is important. Electricians need to install high voltage wires that are safe in the home for untrained individuals for potentially a century. Plumbers need to install water tight pipes that can withstand significant pressure without leaking (which can be difficult to detect and very quickly devastating damage wise) Doctors are expected to be able to catch nearly any disease in their specialty based on an honest consultation. Lawyers need to know a phenomenal amount of information to meaningfully know what o research when it comes to prepping for court cases. All of these jobs are hard to prepare for and their is value to everyone else that you can prove you actually prepared. The problem is the incentives for encouraging more people to prepare are backwards (those supporting the newbies benefit from fewer of them) which causes no real help to be given and the labor shortages. But it isn't made up boundaries just to benefit existing members.

s1artibartfast 3y ago
>The problem is the incentives for encouraging more people to prepare are backwards (those supporting the newbies benefit from fewer of them) which causes no real help to be given and the labor shortages. >But it isn't made up boundaries just to benefit existing members. I would argue that it largely is just made up boundaries to benefit existing members. That is to say, regulatory capture has increased the barriers so far that any benefit from additional quality of service is far outweighed by the increased scarcity. It doesn't matter if you have the best doctors and electricians in the world, if they are so few and expensive that the public does not have access to them. The fundamental problem is that is both easy and popular to error on the side of "caution", creating increasingly stringent licensing requirements. These benefit established interests and sound attractive to the public.
- Guvante 3y ago
  I don't disagree but I like to distinguish between "there shouldn't be barriers" and "there should be fewer barriers" and the verbiage I responded to felt like the former.
cameronh90 3y ago
I don’t think you can reasonably draw a comparison from medicine to home electrics and plumbing. My dad was a plumber and I’m preparing to pass the certification that permits me to work on home electrics. They are, to be blunt, easy. An average person can pick up most of it in a couple of months. Electrics and gas plumbing carry a certification requirement because an error can kill someone, but it’s easier than passing a driving test. Obviously, there are higher tiers of those trades that require a lot more training, but even those aren’t really comparable to the level of knowledge and study needed to become a qualified doctor, let alone a consultant. In the UK, shortages of tradespeople are less to do with the difficulty of training, or lack of course capacity, and more to do with people really just not wanting to do the job, for various reasons.
- lesam 3y ago
  Medicine has more barriers to entry at least partly because we’ve decided to erect them. Doctors learn all kinds of things outside their direct specialty that they don’t really need to know, but nobody inside the system has an incentive to streamline medical education or to encourage more and earlier specialization. For example, we force most doctors to take a 4 year degree before medicine (sometimes pre-med, but often an arts or non-biological science degree). Wasting 4 years of a future doctor’s prime career on an expensive and often irrelevant screening program is extremely wasteful for society as a whole.
  - alephnerd 3y ago
    > Wasting 4 years of a future doctor’s prime career on an expensive and often irrelevant screening program is extremely wasteful for society as a whole I have a cousin who's doing his residency right now and he has an interesting take on this. You don't want to have a 21 year old in a cancer ward directly treating patients. They may lack the personal skills and life experience needed to convey empathy. In addition, they will not be taken seriously by patients due to their youth. He is speaking from experience as someone who is doing his residency at a slightly younger age than average.
    - 3y ago
rqtwteye 3y ago
"Doctors are expected to be able to catch nearly any disease in their specialty based on an honest consultation." From my experience they don't. If you have any problem off the beaten path you may spend years and multiple doctors to figure out what's going on.
- anonymouskimmer 3y ago
  That makes more sense. I interpreted the "catch" quote to mean that doctors are expected to literally come down with any contagious disease within their specialty.
- Guvante 3y ago
  I agree that happens, my point is about the intersection of speciality and expected. Aka it doesn't always happen but that is the goal. Honestly disease diagnosis is the one area I could see AI being super helpful in which might lower this burden from extreme memorization to facilitating collecting data for analysis and being a guard on false positives.
  - rqtwteye 3y ago
    Agree about AI. It would be way more patient and take its time to talk to the patient than doctors have these days.
  - haldujai 3y ago
    AI has had the opposite effect on false positives. Statistically, most patients aren't (that) sick and don't have zebras. Taking radiology as an example (because that's my specialty) ~90% of studies are normal and some types (e.g. CT for pulmonary embolism, CT for transient ischemic attack/vertigo) are closer to 98-99% normal. Every diagnostic AI application I've seen implemented as of 2023 that merely replicates the work of a human has done nothing but increase false positives. The extreme class imbalance makes this a non-trivial problem.
- SkyPuncher 3y ago
  I've heard a quip from my wife, "When you hear hoofbeats behind you, don't expect to see a zebra." Essentially, you need to know that booth horses and zebras make hoofbeats, but zebras are rare (in the US). It'd be foolish to look for a zebra until you've ruled out the possibility of a horse. In fact, it even has a wikipedia page: https://en.wikipedia.org/wiki/Zebra_(medicine) https://en.wikipedia.org/wiki/Zebra_(medicine)
amluto 3y ago
> Plumbers need to install water tight pipes that can withstand significant pressure without leaking (which can be difficult to detect and very quickly devastating damage wise) There is no shortage whatsoever of licensed plumbers who will do incompetent work. Fortunately there is a decent collection of companies making excellent plumbing products that are quite robust. Current personal favorite failure modes: Use of inappropriate water-insoluble flux. This usually doesn’t cause a leak, at least not quickly. It is, however, disgusting (petroleum crud and not-very-good salts being released slowly over months to years in cold water pipes) and is a code violation. Use of copper in boiler condensate pipes. Use of essentially arbitrary mixes of pipe tape and pipe dope. Overtightening of plastic threaded connections. Incorrect combinations of tapered threaded fittings and gasketed straight threaded fittings.
- PH95VuimJjqBqy 3y ago
  I once moved into a house and had a plumber come out to connect the fridge to the water (there was some custom work that needed to be done). There was a plastic line there already and that line hadn't been used in atleast a year (previous tenants kept their fridge in the garage). I remember asking the plumber if we should replace that plastic line and he said no, I even told him it hadn't been used in over a year. A week or so after he did this work I'm walking through my living room and my socks are getting wet. At first I couldn't figure out what was going on until I realized that line had split (as I expected it to) and was leaking, said leak having moved into the living room where it was making the wood floors damp. To this day I don't understand why that plumber thought that would be ok when I, as a complete layman, understood what happens to plastic lines that go unused for that long (they dry and crack).
  - amluto 3y ago
    What kind of plastic line? I've used a decent amount of name brand LLDPE tubing, and I've never seen it fail or even appear to degrade. I have had issues with compression connectors at the ends (they don't like to be too loose or too tight), and I've seen plenty of failures of the really crappy washers that get used in "female compression" connectors.

s1artibartfast 3y ago

>The problem is the incentives for encouraging more people to prepare are backwards (those supporting the newbies benefit from fewer of them) which causes no real help to be given and the labor shortages. >But it isn't made up boundaries just to benefit existing members. I would argue that it largely is just made up boundaries to benefit existing members. That is to say, regulatory capture has increased the barriers so far that any benefit from additional quality of service is far outweighed by the increased scarcity. It doesn't matter if you have the best doctors and electricians in the world, if they are so few and expensive that the public does not have access to them. The fundamental problem is that is both easy and popular to error on the side of "caution", creating increasingly stringent licensing requirements. These benefit established interests and sound attractive to the public.

Guvante 3y ago
I don't disagree but I like to distinguish between "there shouldn't be barriers" and "there should be fewer barriers" and the verbiage I responded to felt like the former.

cameronh90 3y ago

I don’t think you can reasonably draw a comparison from medicine to home electrics and plumbing. My dad was a plumber and I’m preparing to pass the certification that permits me to work on home electrics. They are, to be blunt, easy. An average person can pick up most of it in a couple of months. Electrics and gas plumbing carry a certification requirement because an error can kill someone, but it’s easier than passing a driving test. Obviously, there are higher tiers of those trades that require a lot more training, but even those aren’t really comparable to the level of knowledge and study needed to become a qualified doctor, let alone a consultant. In the UK, shortages of tradespeople are less to do with the difficulty of training, or lack of course capacity, and more to do with people really just not wanting to do the job, for various reasons.

lesam 3y ago
Medicine has more barriers to entry at least partly because we’ve decided to erect them. Doctors learn all kinds of things outside their direct specialty that they don’t really need to know, but nobody inside the system has an incentive to streamline medical education or to encourage more and earlier specialization. For example, we force most doctors to take a 4 year degree before medicine (sometimes pre-med, but often an arts or non-biological science degree). Wasting 4 years of a future doctor’s prime career on an expensive and often irrelevant screening program is extremely wasteful for society as a whole.
- alephnerd 3y ago
  > Wasting 4 years of a future doctor’s prime career on an expensive and often irrelevant screening program is extremely wasteful for society as a whole I have a cousin who's doing his residency right now and he has an interesting take on this. You don't want to have a 21 year old in a cancer ward directly treating patients. They may lack the personal skills and life experience needed to convey empathy. In addition, they will not be taken seriously by patients due to their youth. He is speaking from experience as someone who is doing his residency at a slightly younger age than average.
  - 3y ago

rqtwteye 3y ago

"Doctors are expected to be able to catch nearly any disease in their specialty based on an honest consultation." From my experience they don't. If you have any problem off the beaten path you may spend years and multiple doctors to figure out what's going on.

anonymouskimmer 3y ago
That makes more sense. I interpreted the "catch" quote to mean that doctors are expected to literally come down with any contagious disease within their specialty.
Guvante 3y ago
I agree that happens, my point is about the intersection of speciality and expected. Aka it doesn't always happen but that is the goal. Honestly disease diagnosis is the one area I could see AI being super helpful in which might lower this burden from extreme memorization to facilitating collecting data for analysis and being a guard on false positives.
- rqtwteye 3y ago
  Agree about AI. It would be way more patient and take its time to talk to the patient than doctors have these days.
- haldujai 3y ago
  AI has had the opposite effect on false positives. Statistically, most patients aren't (that) sick and don't have zebras. Taking radiology as an example (because that's my specialty) ~90% of studies are normal and some types (e.g. CT for pulmonary embolism, CT for transient ischemic attack/vertigo) are closer to 98-99% normal. Every diagnostic AI application I've seen implemented as of 2023 that merely replicates the work of a human has done nothing but increase false positives. The extreme class imbalance makes this a non-trivial problem.
SkyPuncher 3y ago
I've heard a quip from my wife, "When you hear hoofbeats behind you, don't expect to see a zebra." Essentially, you need to know that booth horses and zebras make hoofbeats, but zebras are rare (in the US). It'd be foolish to look for a zebra until you've ruled out the possibility of a horse. In fact, it even has a wikipedia page: https://en.wikipedia.org/wiki/Zebra_(medicine) https://en.wikipedia.org/wiki/Zebra_(medicine)

amluto 3y ago

> Plumbers need to install water tight pipes that can withstand significant pressure without leaking (which can be difficult to detect and very quickly devastating damage wise) There is no shortage whatsoever of licensed plumbers who will do incompetent work. Fortunately there is a decent collection of companies making excellent plumbing products that are quite robust. Current personal favorite failure modes: Use of inappropriate water-insoluble flux. This usually doesn’t cause a leak, at least not quickly. It is, however, disgusting (petroleum crud and not-very-good salts being released slowly over months to years in cold water pipes) and is a code violation. Use of copper in boiler condensate pipes. Use of essentially arbitrary mixes of pipe tape and pipe dope. Overtightening of plastic threaded connections. Incorrect combinations of tapered threaded fittings and gasketed straight threaded fittings.

PH95VuimJjqBqy 3y ago
I once moved into a house and had a plumber come out to connect the fridge to the water (there was some custom work that needed to be done). There was a plastic line there already and that line hadn't been used in atleast a year (previous tenants kept their fridge in the garage). I remember asking the plumber if we should replace that plastic line and he said no, I even told him it hadn't been used in over a year. A week or so after he did this work I'm walking through my living room and my socks are getting wet. At first I couldn't figure out what was going on until I realized that line had split (as I expected it to) and was leaking, said leak having moved into the living room where it was making the wood floors damp. To this day I don't understand why that plumber thought that would be ok when I, as a complete layman, understood what happens to plastic lines that go unused for that long (they dry and crack).
- amluto 3y ago
  What kind of plastic line? I've used a decent amount of name brand LLDPE tubing, and I've never seen it fail or even appear to degrade. I have had issues with compression connectors at the ends (they don't like to be too loose or too tight), and I've seen plenty of failures of the really crappy washers that get used in "female compression" connectors.