We don’t wanna hear it

Posted on August 21, 2008. Filed under: Everything you wanted to know about doctors, Self-deception |

I have an investment partner whose gainful employment, unlike mine, cannot be succinctly described. Truly he is an entrepreneur. He uses his superior intelligence and education to take an entity’s high-potential, low-performance business, reorganize it, and sell it for enormous profit. He manages the affairs of people who have marketable talent, but no financial skills (popular bands). He buys onto the boards of tech companies that have wonderful products and no knowledge of how to sell them. He buys small oil and gas companies whose owners have no idea of the actual worth of their companies (plus or minus), and resells them. He wears a lot of hats. He is a gazillionaire.

I met him because he realizes that doctors have very marketable skills, which are always in demand, but virtually no business expertise (because of the channeled educational curriculum they followed), and who are so arrogant about their abilities to handle anything, in any field, that they will run into bankruptcy most of their personally-managed investments outside their own practice  post haste. Our acquaintance occurred when a number of my colleagues (doctors) decided to start a private, for-profit cardiovascular hospital. This businessman could never be productive, in the sense of directly generating income (he has no license to practice medicine), but his non-productive (again, business definition) efforts are the only reason we are viable. The resistance of the other doctors (never me) to his involvement in our our project is part of a future post. Suffice it say, it never occurred to me in college simply to obtain my diploma, and then use my intellectual ability to make a living by thinking better than the competition. In fact, my first senior surgical partner told me, “Just do the work. The money will take care of itself.”

Recently, the businessman and I were having a conversation about my current status: professionally disabled. I sustained an injury about three years ago that prevents me from continuing as a surgeon. I was relating this sad story, along with details of a nearly concomitant divorce for which I was not liable in any moral way, yet lost my shirt, and the necessity to sell my house in a down real-estate market for the division of the equity. I wasn’t looking for sympathy (I probably was), but the effect on him was immediate and total. He said, “I admire you for what you went through to get your credentials, and for your skills. It’s too bad the way things have turned out. But don’t ever tell that story to anyone again. The average man does not want to hear about the rough life of a surgeon. You’re living far better than 99% of the people, and the business world will reject you if you make that story your mantra.” This is the first time I’ve mentioned it since.

In recent times, chasing a better understanding of the quest for the technological Singularity, I began reading (and unwisely commenting) on the posts at Overcoming Bias. This has brought about several realizations, unfortunately all later in life:

  • Most branches of true science rely heavily on math as the language. Some mathematical concepts literally cannot be put into words, yet another mathematician knows exactly what they say.
  • Medicine is not a true science; doctors are not mathematicians.
  • Scientists base all their conclusions on falsifiable evidence; doctors, for the most part, are not even familiar with the methods for evaluating evidence in their own fieldsSee this, for example. I didn’t come close to the correct reasoning.
  • Anecdotal experience, to a scientist, is no different from lies; anecdotal “experience” plays a major role in the decisions doctors make about patient management.
  • Doctors have an incredibly positive influence on the health of some individuals, at some particular times, but for the most part they are unaware of, or unwilling to accept the statistical evidence for, their ineffectiveness regarding the health of the American populace as a whole. See the evidence here and here, for instance. I have been in medicine for 38 years, and I was unfamiliar with these statistics. As Eliezer Yudkowsky chided one doubtful responder about this information: “I don’t think you understand what statistics mean. They are not a sort of weak extra argument that you weigh in addition to your much more reliable personal experience; statistics are a stronger, more reliable way of looking at the world that summarizes far more evidence than your personal experience, even though it just looks like a little number on paper while all that other experience weighs so heavy in your mind.” Elegant, and a statement that I guarantee most of my colleagues would reject.

Of course, I’m not yet aware of what, if at all, studies have to say about the marginal value of professions other than medicine. I suspect another post will follow addressing that. But for now, I’m reminded of the original United Negro College Fund ads that asserted, “A mind is a terrible thing to waste.” American physicians are smart; the selection system almost guarantees it. But, we’re not the smartest of the professions, and much of our smartness is wasted by our undisciplined thinking.

I think I know one very good reason for this, and I’ll discuss it soon.

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Your comment about doctors bankrupting themselves reminded me why I never took a personal check from any doctor.


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    The director of the Sexual Medicine Center leaves penile implants behind, and launches a quest for knowledge about Artificial Intelligence, extended life, and the issues inside the health-care industry.

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