Tier B med school, but Board Certified
Tier A med school, but no Board Certification

An interested layman

Retired, a big part of the reason that the Medical College of Georgia is so much cheaper than Harvard is (I assume) that the former is a public school that is heavily subsidized by the state. It’s not anything like that much cheaper (though still probably a lot cheaper) when measured in the total cost per student.

I suppose another NBER paper showed that top financial advisors don’t beat the market but they can perform better first aid.

Image via Wikipedia Robin Hanson certainly thinks so.He has provocative post at Overcoming Bias about the relationship between expertise, credentials and rationality.”Yesterday I reported that top med…

retired urologist: I’ve been swimming in this cesspool a long time. Doctors are, or at least have been, net positives for society and the economy – and by a wide margin. Lawyers and law firms act either as protection rackets (think of criminal and divorce lawyers), guild agents and rent-seekers (corporate deal attorneys) or extortion rackets (litigation e.g. asbestos). I have seen things you cannot imagine. Fortunately, a little of it is finally beginning to come to light and some of the worst of the worst are heading off to prison. I see the profession as a net drag on the economy, a net corruptor of science and its perfection of sophistry a net negative for society – and by a wide margin.

We already know that doctors statistically suck, but just wait until Robin Hanson gets around to publishing his series on the marginal value of attorneys in the US economy.

Metabolic enzymes can catalyze reactions that would otherwise need extreme conditions if performed in a container in a lab. I know it is not the main point you are trying to make, but I think it is important to mention this.

When I started practicing doctors were still treated with great reverence. Under the law, if a doctor said it, it was admissible and could support any verdict – however absurd “it” was. In one of my very first trials, second chair (i.e. box carrier/gopher) I got to see an M.D. testify that a particular chemical made by our client was metabolized into a carcinogen and so caused the plaintiff’s cancer. I knew the testimony was coming and so had my Partner ready with Morrison & Boyd’s “Organic Chemistry” – the plan was to mount a theater of the absurd defense – demonstrating that the claimed reaction was highly unlikely since it would have required heating the plaintiff to 400 degrees and treating him with a platinum catalyst – a circumstance that should have proved fatal 25 years before – during his exposure. Instead the jury found in favor of the plaintiff – science be damned. Interviews with the jurors revealed their awe of doctors – doctors were to them modern day Gandalf’s blessed with a deeper knowledge than chemistry textbooks.

The next 15 years were spent helping to pull the curtain aside and revealing the men behind it. The revelation that a not insubstantial number of doctors were just making it up as they went along followed. The profession never recovered. The “evidence-based medicine” movement has only exacerbated the problem.

Now it’s pretty easy to narrow down your likely diagnosis and treatment before you go to the doctor. For example, my Dad was having problems with syncope recently. I googled his symptoms, past exams and treatments, and got him an appointment with the DeBakey heart folks here. I told my Dad the first thing they’d likely do would be a tilt table test and eventually recommend a dual chamber pacemaker unless they found something neurological. And danged if that’s not exactly what happened.

I don’t mean to dis an entire profession because God knows there are lots of doctors doing one helluva job out there. But more and more it’s like a medieval guild whereby the work ain’t all that hard, it’s getting the plumbers’ license what’s the hard part.