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I respect doctors (and people in general), but I don’t give the medical profession a passing grade. To speak in generalities (there are exceptions), their train

by xpe 1y ago

I respect doctors (and people in general), but I don’t give the medical profession a passing grade. To speak in generalities (there are exceptions), their training is somewhat insane: long hours, sleep deprivation, knowledge cramming, and more. Their daily practice leaves little time or incentive for keeping up with studies. Most were not adequately taught statistics in the first place. To vent a bit more, I don’t think it is unfair to say the system is crap. If we could redesign it from scratch, understanding human nature, how people learn, and the need for ongoing learning, and evidence-based medicine, it would not be this. None of this is meant to assign blame to individuals.

thfuran 1y ago
>Their daily practice leaves little time or incentive for keeping up with studies. Their certification requires it, at least to some extent.
- xpe 1y ago
  Two responses. First, CME is criticized as being largely influenced by industry rather than primarily intended to advance medical learning. [1] Second, assuming medical continuing education is something like 20 to 40 hours depending on the region [2], this feels meager and insufficient. In contrast, think of how much learning a software developer does during a year -- perhaps close to 5+ hours per week on average! [3] Very different contexts, very different incentives. [1]: https://www.chronicle.com/article/lessons-from-a-professors-10-year-fight-to-rein-in-pharmaceutical-promotion/ https://www.chronicle.com/article/lessons-from-a-professors-... [2]: Based on very quick research: could be off -- corrections are welcome [3]: There are many differences, of course. Just to pick one example: to what degree does a software developer's continuing exploration into an area (such as a specific business process that their application needs to understand) help their craft? Does it improve their skill level? Does it result in transferable skills? Does it improve the quality of their work?
  - thfuran 1y ago
    A software developer is not required to do any continuing education at all.
    - xpe 1y ago
      Ok, but you are moving the goalposts relative to my original quote: “Their daily practice leaves little time or incentive for keeping up with studies.” My first point is that software developers (generally, more often than not) have the time and incentive to learn on an ongoing basis. Second point: if continuing education has to be mandated, it is likely a symptom of a system that lacks proper incentives. On the positive side, as more patients educate themselves and press doctors for statistical understanding and synthesis across studies, “Dr. Expert’s” stale knowledge will no longer fly.
      - thfuran 1y ago
        Mandated continuing education isn't a sign of missing incentives, it is the incentive. Being required to do something to keep working in the field seems like a pretty strong incentive to me. But I certainly won't dispute that doctors in most systems in the US are overworked starting at least in residency.
        xpe 1y ago
        We both know there is a difference between intrinsic and extrinsic incentives. This difference underlies so many things, including: (i) justification for regulatory frameworks; (ii) individual motivation; and (iii) likelihood of follow-up / compliance.
      - JumpCrisscross 1y ago
        > if continuing education has to be mandated, it is likely a symptom of a system that lacks proper incentives I’m a pilot and work in finance. They both have continuing-education requirements. The ones in the former are practical and helpful. The ones in the latter are mostly performative. (In some cases, arguably counterproductive.) The existence of continuing-education mandates per se tells you almost nothing about the system as a whole.
- kjkjadksj 1y ago
  It is a rubber stamp cert. I’ve been to a continuing medical education talk. It is your bog standard visiting scholar giving a 45 min talk of their research. Lecture hall is sleepy aside from the usual suspects. Sheet pizza from the cheapest place in town is being served. People are nodding off in the back. About the only way you can tell this is a continuing medical education event is the clipboard and pen being passed around for MDs to sign their name along with a signature. It is a far cry from actual class. Learning isn’t required only saying you were there.

by xpe 1y ago

thfuran 1y ago

>Their daily practice leaves little time or incentive for keeping up with studies. Their certification requires it, at least to some extent.

xpe 1y ago
Two responses. First, CME is criticized as being largely influenced by industry rather than primarily intended to advance medical learning. [1] Second, assuming medical continuing education is something like 20 to 40 hours depending on the region [2], this feels meager and insufficient. In contrast, think of how much learning a software developer does during a year -- perhaps close to 5+ hours per week on average! [3] Very different contexts, very different incentives. [1]: https://www.chronicle.com/article/lessons-from-a-professors-10-year-fight-to-rein-in-pharmaceutical-promotion/ https://www.chronicle.com/article/lessons-from-a-professors-... [2]: Based on very quick research: could be off -- corrections are welcome [3]: There are many differences, of course. Just to pick one example: to what degree does a software developer's continuing exploration into an area (such as a specific business process that their application needs to understand) help their craft? Does it improve their skill level? Does it result in transferable skills? Does it improve the quality of their work?
- thfuran 1y ago
  A software developer is not required to do any continuing education at all.
  - xpe 1y ago
    Ok, but you are moving the goalposts relative to my original quote: “Their daily practice leaves little time or incentive for keeping up with studies.” My first point is that software developers (generally, more often than not) have the time and incentive to learn on an ongoing basis. Second point: if continuing education has to be mandated, it is likely a symptom of a system that lacks proper incentives. On the positive side, as more patients educate themselves and press doctors for statistical understanding and synthesis across studies, “Dr. Expert’s” stale knowledge will no longer fly.
    - thfuran 1y ago
      Mandated continuing education isn't a sign of missing incentives, it is the incentive. Being required to do something to keep working in the field seems like a pretty strong incentive to me. But I certainly won't dispute that doctors in most systems in the US are overworked starting at least in residency.
      - xpe 1y ago
        We both know there is a difference between intrinsic and extrinsic incentives. This difference underlies so many things, including: (i) justification for regulatory frameworks; (ii) individual motivation; and (iii) likelihood of follow-up / compliance.
    - JumpCrisscross 1y ago
      > if continuing education has to be mandated, it is likely a symptom of a system that lacks proper incentives I’m a pilot and work in finance. They both have continuing-education requirements. The ones in the former are practical and helpful. The ones in the latter are mostly performative. (In some cases, arguably counterproductive.) The existence of continuing-education mandates per se tells you almost nothing about the system as a whole.
kjkjadksj 1y ago
It is a rubber stamp cert. I’ve been to a continuing medical education talk. It is your bog standard visiting scholar giving a 45 min talk of their research. Lecture hall is sleepy aside from the usual suspects. Sheet pizza from the cheapest place in town is being served. People are nodding off in the back. About the only way you can tell this is a continuing medical education event is the clipboard and pen being passed around for MDs to sign their name along with a signature. It is a far cry from actual class. Learning isn’t required only saying you were there.