Medicine is perhaps the only form of alchemy to survive the enlightenment (like all good alchemy, it is very good at appearances). I probably shouldn’t write that without a stronger stomach for the holy war that’s likely to follow, but there you go.

Where the alchemy intersects with field (as in battlefield) medicine, things have improved (though hardly by means of science). If your problem can be fixed with a knife, you’re in good shape. Wars are out of fashion, however, and our medicine utterly fails to meet the disease of an industrial (let alone an information) economy.

-Carl

Actually, Robin, medicine nowadays is a quite standardized science. Sientific knowlege is widely accessible in our time, when internet offers information at hand for any doctor who has a minimum of interest to search for it. On the other hand, many different groups of researchers, supported by industry or by government, are constantly producing information and receiveing feedback from the medical community after new information on treatment options are set in practise. This constant dialogue between scientifical community and practitioners give birth to many different guidelines to diagnosis and treatment in many different specialities. Rarely, some doctors do not want to apply decisions following the guideline. If there is not a very good reason for it, medicare, insurance companies or any other source of payment for the treatment will not authorize the payment, since the given treatment effectivity was not scientifically proven and peer-reviewed.

Giving medical advice when asked is the second part of it all. It is not something you can learn on stock market as a broker, or an investor. Giving medical advice is much more listening to what someone needs and, applying science and art (medicine is science, but it is art, too, and I am not talking about TV shows) trying to heal when possible and to ease every time. This can be taught, but probably not in the way you devise. If the doctor´s job was simply to process information without humanity, compassion and simpathy, and this resulted in good quality medicine, you bet that computers would be doing it by today – much better than humans.

Scientifical medical information is produced in the context of studies on large populations, since the effect to be measured, as you said, is often very small to appear in a handful of individuals studies. For example, the total effect of some chemotherapy treatments, in unselected populations, is a 2% difference in outcomes (be, for exemple, general mortality in five years). Basic statistics show that it is necessary at least 50 people reciveing the treatment for the effect to appear, in a five-years follow-up. A little bit more advanced statistics teach us that the groups – since a control group is needed – shall be much larger, to annulate the efects of biases (factors that we don´t know or cannot control) and to balance the odds that the effect was, after all, only good luck.

Finally, what you conceive is nothing more than the study of a population where n=1. Not much power to predict almost anything.

One caveat: unlike the human body, humans designed cars so we know every single thing about how cars are supposed to work. Sometimes, procedures don’t work for unknown reasons.

Floccina, check out this NYTimes article: “In Bid for Better Care, Surgery With a Warranty”

We could also treat doctors more like auto mechanics and insist that if the procedure does not work as described that they fix it again. With auto mechanics we do not always do this because sometimes there are additional thing that need to done to fix the problem but if a part that they replaced does not work we bring it back and they fix it free.