7 ms·

This is Nassim Taleb's “Surgeon Paradox”: “If you're choosing between two surgeons of equal merit, choose the one who DOESN'T look the part, because they had to

This is Nassim Taleb's “Surgeon Paradox”: “If you're choosing between two surgeons of equal merit, choose the one who DOESN'T look the part, because they had to overcome more to get to where they are.”

optimalsolver 3y ago
[flagged]
- deleted 3y ago
  [deleted]
- hef19898 3y ago
  Sometimes, every number should come with error margin bars...
- caslon 3y ago
  A tall person would likely have to lean over more, and on average, will tend to have bigger hands. A small, geeky-looking person, on the other hand, is likely to have smaller hands. Why we wouldn't be using a robot for such a delicate surgery, I have no clue. Personally speaking, though, if I get brain cancer, I will not optimize for a tall surgeon.
talldatethrow 3y ago
This was true IMO until diversity agendas, like the ones that make it harder for an Asian student to get into med school than an African American one. So now if you have to choose between an Asian doctor and an African American one, you'd have to be pretty foolish to pick the African American one. In the 80s, I would have totally believed the African American doctor must be amazing to make it through. Now we know he was possibly let into medschool with scores that would have gotten an Asian doctor rejected.
- space_fountain 3y ago
  Have there been follow up studies finding this?
  - Dig1t 3y ago
    https://twitter.com/eyeslasho/status/1706319646176227391 https://twitter.com/eyeslasho/status/1706319646176227391 >The magnitude of Systemic Antiracism in medical school admissions: A black applicant with a 3.2–3.39 GPA and a 24–26 MCAT had almost a ten times greater chance of admission than an Asian-American with the same scores. I don't know about studies on actual patient outcomes, but there are good data WRT admissions, which I think is relevant to OP's point about overcoming obstacles.
    - deleted 3y ago
      [deleted]
    - space_fountain 3y ago
      I think disputing the predictive power of things like GPA is pretty common. I'm not sure many people dispute this effect where I think downstream impacts are harder to quantify
    - light_hue_1 3y ago
      This says nothing at all. The story is exactly the opposite of the one that you're telling! We first found out that GPA and GRE scores mean nothing. Neither GPA nor GRE scores are predictive of grad school performance! Same with LSAT. It has no predictive validity for your quality as a lawyer. Just about 0.5% of your abilities as a lawyer are related to your LAST score. (not 50%, less than 1%) https://www.alanet.org/legal-management/2023/february/columns/the-lsat-and-its-lack-of-relevance-to-lawyering https://www.alanet.org/legal-management/2023/february/column... MCAT scores are a bit more predictive, but only in the stupidest way. Very low MCAT scores are very predictive that you will be terrible and fail out. MCAT is only predictive at the bottom, above the lowest 25% of scores, all MCAT scores are the same. We don't have a good way of scoring people to get them into these positions. So instead of blindly following a score that we know is meaningless, we try to have some equity of opportunity in society. And, we try to make sure that people have doctors, scientists, etc. that they feel comfortable with and that represent their communities too.
- KittenInABox 3y ago
  I'm surprised you'd base a doctor's capacity to do medicine off their MCAT score. It'd be like judging a staff software engineer by their highschool GPA. If a doctor survived the rigors of medical school and the years of near-poverty (if not actual poverty) wages of residency, why would you care at all about what their initial score on a test was over 5 years ago?
  - gotoeleven 3y ago
    If you think the affirming actions end once the admittance decision is made I have a bridge to sell you. Holding favored minorities to lower standards has permeated every institution, including medical schools, at every level because people are afraid of being called racist. "Racist medical school fails african americans at higher rate than asians!" would be the headline and there would be no defense the critical race theory mob would accept.
  - nextworddev 3y ago
    There’s probably a high correlation between software engineer seniority and GPA
    - SkyPuncher 3y ago
      Heavily doubt that one.
  - readthenotes1 3y ago
    Because medical schools do everything in their power nowadays to keep someone in and get them to graduate. You have the wrong analogy as well, MCAT is extraordinarily thorough, so instead of evaluating on someone's high school GPA, it would be like evaluating them on an all-day entrance interview on which you evaluate them on their knowledge of software engineering, hardware, various programming languages, and their libraries. And many questions from TAoCP.
- throwaway_l33t 3y ago
  Yeah, and there’s at least anecdotal evidence here: > The admission to medical school of Patrick Chavis, one of the black doctors admitted under the medical school's affirmative action program instead of Bakke, was widely praised by many notable parties, including Ted Kennedy, the New York Times, and the Nation. As an actual medical doctor, Chavis's many actions of incompetence and negligence were broad and widespread. The large number of patients that he harmed, the amount of pain and suffering that he caused, the video recordings of his many major mistakes, the huge number of malpractice lawsuits against him, and the eventual loss of his medical license, were all reported by the media. https://en.m.wikipedia.org/wiki/Regents_of_the_University_of_California_v._Bakke https://en.m.wikipedia.org/wiki/Regents_of_the_University_of...
- waychukucha 3y ago
  I have seen this argument against African Americans made several times (mostly by asians). As an outsider , I cant stop thinking how shallow the argument is. Here is a counter argument. First, am not American. Am from Kenya. When kids join highschool in kenya, they need to sit a nationwide exam. Total score out of 500. For kids in Nairobi and other well established cities, they will need to get at least 400 marks out of the 500 to get a spot in a national highschool (which are the top of the top public schools) while kids from “rural” and marginalised areas, the cut off point for them can be as low as 350 marks. These are the kids who have pastoralists families that probably move constantly, or stay in areas where its too hot they only attend classes for 4 hrs a day. They most likely dont have electricity, no water etc. Its therefore only fair for their cutoff point to be different from a child who grew up in the city (like me) with access to all modern day life necessities including luxuries like private tuition. Now back to America, would the same argument not be made for black Americans (or any other ethnic groups or even people from other “rural” regions that are marginalised to have their cut off point be different from people from well established regions? That’s what equality is all about. Being able to identify such disparities and create solutions as permanent solutions are sort after.
  - Jensson 3y ago
    It is the opposite case here, black students in medical school are more likely from higher income families than the Asian students. So they are accepting people with more resources and lower scores. This is the problem with racial affirmative action, it takes resources from worse off kids and give them to well off kids, if it was based on family resources like in Kenya people wouldn't object as much. First % is from upper income families, second is from lower, Asian has better representation from lower income families than any other racial group among med students. > Asian: RI, 2.3 [21.7% vs 9.5%]; > Black: RI, 5.3 [9.1% vs 1.7%]; https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790107 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
  - achates 3y ago
    I don't really care about being "fair" to the applicant, I care about getting the most competent doctor I can. Being a doctor is position of grave responsibility, it shouldn't be a reward that we give to people who deserve it because they tried really hard and had a tough life.
- jstarfish 3y ago
  > So now if you have to choose between an Asian doctor and an African American one, you'd have to be pretty foolish to pick the African American one. In the 80s, I would have totally believed the African American doctor must be amazing to make it through. Now we know he was possibly let into medschool with scores that would have gotten an Asian doctor rejected. I don't know if this was necessarily ever true, diversity quotas or not. It's a marketing narrative that "feels" good (which is how they get you) but I've always gotten the impression that minority candidates are more likely to take extreme risks to make a name for themselves. The west has never really valued craftsmanship as much as we value showmanship. It was Ben Carson's "illustrious" career that put me off the idea of blindly choosing the underdog; he and Josef Mengele must have taken the same ethics class. Nobody can say shit about the black surgeon who fucks up high-risk, experimental surgeries-- after all, he had to work so hard to get to where he is. Dr. Roxy too. I was disappointed to learn she wasn't actually a cocaine-addicted clown, but she's had her medical license revoked nonetheless.
- fshafique 3y ago
  A diversity agenda is only flawed if it mindlessly picks applicants without academic and other considerations. A 95th percentile scoring black student raised in the projects with no societal or peer pressure to succeed, could be just as successful as a 99th percentile Asian student raised in a distraction-free, parental-pressured and peer-pressured environment. In fact, maybe the black student could be better suited to handle the stressful study and work period that medical interns go through. And that's just the medical field. There's plenty of stories of tech companies and technologies being built by people that weren't high academic overachievers.
- scyzoryk_xyz 3y ago
  Or… one could just cringe and make the effort not to think any of these thoughts about people IRL. As a patient, or ever really. There are usually plenty other criteria available to base decisions on with available medical practitioners. I find it’s usually a pretty good idea to not get smart with doctors, and I take the one that shows up. As for medical admissions, I’ve spent a good few years working collaborating with surgeons. And good grades, like looks, are a distant starting point for such people. Not one particularly relevant to one’s ability to navigate the actual decision making in job or the long-winding process of actually getting to that point.
  - talldatethrow 3y ago
    You do you, but when my life is on the line, I'm going to choose the person that wasn't pushed through by some quota.
    - scyzoryk_xyz 3y ago
      Judgements about whether a doctor was pushed through by a quota at the beginning of their education based on the color of their skin - that’s a straight up racist thing to share. You simply don’t know whether someone was an A+ student at 18, or whether this made them somehow more capable at improving your outcome. Personally, I find it much more useful to simply look up whether a doctor is recently pursuing medical publications or research in their work. That’s usually a hallmark of someone who is actually up to date about their specialty outside of daily practice. Just like a dev with an active GitHub page or side projects is better than someone who scored well on their SAT’s to get into a CS program because dad told them to.
      - talldatethrow 3y ago
        It's not racist of me to react to a racist med school enrollment system.
        scyzoryk_xyz 3y ago
        Well, I only said that this was a racist thing to contribute to the conversation. It’s one thing to be privately making racist decisions (based on flawed racist logic), but it’s another to be describing them openly as the right thing to do for your health IRL. And sorry but no, flawed institutional policies somewhere out there don’t make a racist reaction any less racist. It is what it is.
- jack_riminton 3y ago
  I think the key thing you’re missing is “of equal merit” and practically speaking if you’re picking a surgeon you’re not going to be choosing between two new graduates. Let’s say your choice is between two senior consultants who have the same position, then you’re better off picking the one who least fits the bill visually.
Aaargh20318 3y ago
I’ve noticed a similar effect with women in IT. I’ve worked with only a few female software engineers but all of them were above average developers. It’s such a male dominated profession that it acts as a sort of filter.
- Jensson 3y ago
  Maybe you only worked at sexist places. If you work in a place that prioritizes hiring women you get the opposite effect. I've seen both.
  - MichaelZuo 3y ago
    Both can be true. Any organization that does zero virtue signalling but still nonetheless have women working in substantial positions strongly suggests they're genuinely an enlightened organization and/or found lots of way above average candidates somehow. For any organization that does some amount of signalling, no strong inferences can be made on either direction. For any organization that signals 24/7, a pretty strong inference can be made in the opposite direction.
  - Aaargh20318 3y ago
    I’ve never worked at a place that had to prioritize at all. Every company I’ve worked for was growing fast enough that hiring more people was a bottleneck and we would hire anyone who was qualified, at least for developer positions. We do have quite a few women working for us in significant positions but female applicants for developer positions specifically are still extremely rare.
bsder 3y ago
Actually, I would choose the female because she punched her way through a mess of obstacles to get where she is. In addition, she is likely to pay fucking attention. It's well documented that female doctors tend to do things like follow checklists and prodcedure instead of just half-assing it. Every single specialist female surgeon I have dealt with has been way above average. The male surgeons have been a mixed bag. Some good--some not so much.
- readthenotes1 3y ago
  I believe there are studies that show that if you are a woman patient, you do much better with a woman doctor. Iirc, the outcome doesn't matter if you are a man.

optimalsolver 3y ago

[flagged]

deleted 3y ago
[deleted]
hef19898 3y ago
Sometimes, every number should come with error margin bars...
caslon 3y ago
A tall person would likely have to lean over more, and on average, will tend to have bigger hands. A small, geeky-looking person, on the other hand, is likely to have smaller hands. Why we wouldn't be using a robot for such a delicate surgery, I have no clue. Personally speaking, though, if I get brain cancer, I will not optimize for a tall surgeon.

talldatethrow 3y ago

This was true IMO until diversity agendas, like the ones that make it harder for an Asian student to get into med school than an African American one. So now if you have to choose between an Asian doctor and an African American one, you'd have to be pretty foolish to pick the African American one. In the 80s, I would have totally believed the African American doctor must be amazing to make it through. Now we know he was possibly let into medschool with scores that would have gotten an Asian doctor rejected.

space_fountain 3y ago
Have there been follow up studies finding this?
- Dig1t 3y ago
  https://twitter.com/eyeslasho/status/1706319646176227391 https://twitter.com/eyeslasho/status/1706319646176227391 >The magnitude of Systemic Antiracism in medical school admissions: A black applicant with a 3.2–3.39 GPA and a 24–26 MCAT had almost a ten times greater chance of admission than an Asian-American with the same scores. I don't know about studies on actual patient outcomes, but there are good data WRT admissions, which I think is relevant to OP's point about overcoming obstacles.
  - deleted 3y ago
    [deleted]
  - space_fountain 3y ago
    I think disputing the predictive power of things like GPA is pretty common. I'm not sure many people dispute this effect where I think downstream impacts are harder to quantify
  - light_hue_1 3y ago
    This says nothing at all. The story is exactly the opposite of the one that you're telling! We first found out that GPA and GRE scores mean nothing. Neither GPA nor GRE scores are predictive of grad school performance! Same with LSAT. It has no predictive validity for your quality as a lawyer. Just about 0.5% of your abilities as a lawyer are related to your LAST score. (not 50%, less than 1%) https://www.alanet.org/legal-management/2023/february/columns/the-lsat-and-its-lack-of-relevance-to-lawyering https://www.alanet.org/legal-management/2023/february/column... MCAT scores are a bit more predictive, but only in the stupidest way. Very low MCAT scores are very predictive that you will be terrible and fail out. MCAT is only predictive at the bottom, above the lowest 25% of scores, all MCAT scores are the same. We don't have a good way of scoring people to get them into these positions. So instead of blindly following a score that we know is meaningless, we try to have some equity of opportunity in society. And, we try to make sure that people have doctors, scientists, etc. that they feel comfortable with and that represent their communities too.
KittenInABox 3y ago
I'm surprised you'd base a doctor's capacity to do medicine off their MCAT score. It'd be like judging a staff software engineer by their highschool GPA. If a doctor survived the rigors of medical school and the years of near-poverty (if not actual poverty) wages of residency, why would you care at all about what their initial score on a test was over 5 years ago?
- gotoeleven 3y ago
  If you think the affirming actions end once the admittance decision is made I have a bridge to sell you. Holding favored minorities to lower standards has permeated every institution, including medical schools, at every level because people are afraid of being called racist. "Racist medical school fails african americans at higher rate than asians!" would be the headline and there would be no defense the critical race theory mob would accept.
- nextworddev 3y ago
  There’s probably a high correlation between software engineer seniority and GPA
  - SkyPuncher 3y ago
    Heavily doubt that one.
- readthenotes1 3y ago
  Because medical schools do everything in their power nowadays to keep someone in and get them to graduate. You have the wrong analogy as well, MCAT is extraordinarily thorough, so instead of evaluating on someone's high school GPA, it would be like evaluating them on an all-day entrance interview on which you evaluate them on their knowledge of software engineering, hardware, various programming languages, and their libraries. And many questions from TAoCP.
throwaway_l33t 3y ago
Yeah, and there’s at least anecdotal evidence here: > The admission to medical school of Patrick Chavis, one of the black doctors admitted under the medical school's affirmative action program instead of Bakke, was widely praised by many notable parties, including Ted Kennedy, the New York Times, and the Nation. As an actual medical doctor, Chavis's many actions of incompetence and negligence were broad and widespread. The large number of patients that he harmed, the amount of pain and suffering that he caused, the video recordings of his many major mistakes, the huge number of malpractice lawsuits against him, and the eventual loss of his medical license, were all reported by the media. https://en.m.wikipedia.org/wiki/Regents_of_the_University_of_California_v._Bakke https://en.m.wikipedia.org/wiki/Regents_of_the_University_of...
waychukucha 3y ago
I have seen this argument against African Americans made several times (mostly by asians). As an outsider , I cant stop thinking how shallow the argument is. Here is a counter argument. First, am not American. Am from Kenya. When kids join highschool in kenya, they need to sit a nationwide exam. Total score out of 500. For kids in Nairobi and other well established cities, they will need to get at least 400 marks out of the 500 to get a spot in a national highschool (which are the top of the top public schools) while kids from “rural” and marginalised areas, the cut off point for them can be as low as 350 marks. These are the kids who have pastoralists families that probably move constantly, or stay in areas where its too hot they only attend classes for 4 hrs a day. They most likely dont have electricity, no water etc. Its therefore only fair for their cutoff point to be different from a child who grew up in the city (like me) with access to all modern day life necessities including luxuries like private tuition. Now back to America, would the same argument not be made for black Americans (or any other ethnic groups or even people from other “rural” regions that are marginalised to have their cut off point be different from people from well established regions? That’s what equality is all about. Being able to identify such disparities and create solutions as permanent solutions are sort after.
- Jensson 3y ago
  It is the opposite case here, black students in medical school are more likely from higher income families than the Asian students. So they are accepting people with more resources and lower scores. This is the problem with racial affirmative action, it takes resources from worse off kids and give them to well off kids, if it was based on family resources like in Kenya people wouldn't object as much. First % is from upper income families, second is from lower, Asian has better representation from lower income families than any other racial group among med students. > Asian: RI, 2.3 [21.7% vs 9.5%]; > Black: RI, 5.3 [9.1% vs 1.7%]; https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790107 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
- achates 3y ago
  I don't really care about being "fair" to the applicant, I care about getting the most competent doctor I can. Being a doctor is position of grave responsibility, it shouldn't be a reward that we give to people who deserve it because they tried really hard and had a tough life.
jstarfish 3y ago
> So now if you have to choose between an Asian doctor and an African American one, you'd have to be pretty foolish to pick the African American one. In the 80s, I would have totally believed the African American doctor must be amazing to make it through. Now we know he was possibly let into medschool with scores that would have gotten an Asian doctor rejected. I don't know if this was necessarily ever true, diversity quotas or not. It's a marketing narrative that "feels" good (which is how they get you) but I've always gotten the impression that minority candidates are more likely to take extreme risks to make a name for themselves. The west has never really valued craftsmanship as much as we value showmanship. It was Ben Carson's "illustrious" career that put me off the idea of blindly choosing the underdog; he and Josef Mengele must have taken the same ethics class. Nobody can say shit about the black surgeon who fucks up high-risk, experimental surgeries-- after all, he had to work so hard to get to where he is. Dr. Roxy too. I was disappointed to learn she wasn't actually a cocaine-addicted clown, but she's had her medical license revoked nonetheless.
fshafique 3y ago
A diversity agenda is only flawed if it mindlessly picks applicants without academic and other considerations. A 95th percentile scoring black student raised in the projects with no societal or peer pressure to succeed, could be just as successful as a 99th percentile Asian student raised in a distraction-free, parental-pressured and peer-pressured environment. In fact, maybe the black student could be better suited to handle the stressful study and work period that medical interns go through. And that's just the medical field. There's plenty of stories of tech companies and technologies being built by people that weren't high academic overachievers.
scyzoryk_xyz 3y ago
Or… one could just cringe and make the effort not to think any of these thoughts about people IRL. As a patient, or ever really. There are usually plenty other criteria available to base decisions on with available medical practitioners. I find it’s usually a pretty good idea to not get smart with doctors, and I take the one that shows up. As for medical admissions, I’ve spent a good few years working collaborating with surgeons. And good grades, like looks, are a distant starting point for such people. Not one particularly relevant to one’s ability to navigate the actual decision making in job or the long-winding process of actually getting to that point.
- talldatethrow 3y ago
  You do you, but when my life is on the line, I'm going to choose the person that wasn't pushed through by some quota.
  - scyzoryk_xyz 3y ago
    Judgements about whether a doctor was pushed through by a quota at the beginning of their education based on the color of their skin - that’s a straight up racist thing to share. You simply don’t know whether someone was an A+ student at 18, or whether this made them somehow more capable at improving your outcome. Personally, I find it much more useful to simply look up whether a doctor is recently pursuing medical publications or research in their work. That’s usually a hallmark of someone who is actually up to date about their specialty outside of daily practice. Just like a dev with an active GitHub page or side projects is better than someone who scored well on their SAT’s to get into a CS program because dad told them to.
    - talldatethrow 3y ago
      It's not racist of me to react to a racist med school enrollment system.
      - scyzoryk_xyz 3y ago
        Well, I only said that this was a racist thing to contribute to the conversation. It’s one thing to be privately making racist decisions (based on flawed racist logic), but it’s another to be describing them openly as the right thing to do for your health IRL. And sorry but no, flawed institutional policies somewhere out there don’t make a racist reaction any less racist. It is what it is.
jack_riminton 3y ago
I think the key thing you’re missing is “of equal merit” and practically speaking if you’re picking a surgeon you’re not going to be choosing between two new graduates. Let’s say your choice is between two senior consultants who have the same position, then you’re better off picking the one who least fits the bill visually.

Aaargh20318 3y ago

I’ve noticed a similar effect with women in IT. I’ve worked with only a few female software engineers but all of them were above average developers. It’s such a male dominated profession that it acts as a sort of filter.

Jensson 3y ago
Maybe you only worked at sexist places. If you work in a place that prioritizes hiring women you get the opposite effect. I've seen both.
- MichaelZuo 3y ago
  Both can be true. Any organization that does zero virtue signalling but still nonetheless have women working in substantial positions strongly suggests they're genuinely an enlightened organization and/or found lots of way above average candidates somehow. For any organization that does some amount of signalling, no strong inferences can be made on either direction. For any organization that signals 24/7, a pretty strong inference can be made in the opposite direction.
- Aaargh20318 3y ago
  I’ve never worked at a place that had to prioritize at all. Every company I’ve worked for was growing fast enough that hiring more people was a bottleneck and we would hire anyone who was qualified, at least for developer positions. We do have quite a few women working for us in significant positions but female applicants for developer positions specifically are still extremely rare.

bsder 3y ago

Actually, I would choose the female because she punched her way through a mess of obstacles to get where she is. In addition, she is likely to pay fucking attention. It's well documented that female doctors tend to do things like follow checklists and prodcedure instead of just half-assing it. Every single specialist female surgeon I have dealt with has been way above average. The male surgeons have been a mixed bag. Some good--some not so much.

readthenotes1 3y ago
I believe there are studies that show that if you are a woman patient, you do much better with a woman doctor. Iirc, the outcome doesn't matter if you are a man.