BiasedBayes comments on Welcome to Less Wrong! (8th thread, July 2015) - Less Wrong

13 Post author: Sarunas 22 July 2015 04:49PM

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Comment author: hyporational 14 September 2015 02:51:47AM 5 points [-]

Welcome! I'm an MD and haven't yet figured out why there are so few of us here, given the importance of rationality for medical decision making. It's interesting that at least in my country there is zero training in cognitive biases in the curriculum.

Comment author: Anders_H 14 September 2015 04:16:31AM *  7 points [-]

I have the Irish equivalent of an MD; "Medical Bachelor, Bachelor of Surgery, Bachelor of the Art of Obstetrics". This unwieldy degree puts me in fairly decent company on Less Wrong.

I may be generalizing from a sample of one, but my impression is that medicine selects out rationalists for the following reasons:

(1) The human body is an incompletely understood highly complex system; the consequences of manipulating any of the components can generally not be predicted from an understanding of the overall system. Medicine therefore necessarily has to rely heavily on memorization (at least until we get algorithms that take care of the memorization)

(2) A large component of successful practice of medicine is the ability to play the socially expected part of a doctor.

(3) From a financial perspective, medical school is a junk investment after you consider the opportunity costs. Consider the years in training, the number of hours worked, the high stakes and high pressure, the possibility of being sued etc. For mainstream society, this idea sounds almost contrarian, so rationalists may be more likely to recognize it.

--

My story may be relevant here: I was a middling medical student; I did well in those of the pre-clinical courses that did not rely too heavily on memorization, but barely scraped by in many of the clinical rotations. I never had any real passion for medicine, and this was certainly reflected in my performance.

When I worked as an intern physician, I realized that my map of the human body was insufficiently detailed to confidently make clinical decisions; I still wonder whether my classmates were better at absorbing knowledge that I had missed out on, or if they are just better at exuding confidence under uncertainty.

I now work in a very subspecialized area of medical research that is better aligned with rational thinking; I essentially try to apply modern ideas about causal inference to comparative effectiveness research and medical decision making. I was genuinely surprised to find that I could perform at the top level at Harvard, substantially outperforming people who were in a different league from me in terms of their performance in medical school. I am not sure whether this says something about the importance of being genuinely motivated, or if it is a matter of different cognitive personalities.

In retrospect, I am happy with where this path has taken me, but I can't help but wonder if there was a shorter path to get here. If I could talk to my 18-year old self, I certainly would have told him to stay far away from medicine.

Comment author: BiasedBayes 14 September 2015 12:15:30PM 3 points [-]

Thanks hyporational ! It is exactly same here. Cognitive biases, heuristics, or even Bayes Theorem (normative decision making) is not really taught here.

Also I once argued against some pseudoscientific treatment (in mental illnesses) and my arguments were completely ignored by 200 people because of argumentum ad hominem and attribute substitution (who looks like he is right vs. looking the actual arguments). Most people dont know what is a good argument or how to think about the propability of a statement.

Interesting points Anders_H, I have to think about those littlebit.

Comment author: hyporational 14 September 2015 04:39:41PM 5 points [-]

We were taught bayes in the form of predictive values, but this was pretty cursory. Challenging the medical professors' competence publicly isn't a smart move careerwise, unless they happen to be exceptionally rational and principled, unfortunately. There's a time to shut up and multiply, and a time to bend to the will of the elders :)

Comment author: Lumifer 14 September 2015 04:47:01PM 7 points [-]

Challenging the medical professors' competence publicly isn't a smart move careerwise

Reminds me of:

One day when I was a junior medical student, a very important Boston surgeon visited the school and delivered a great treatise on a large number of patients who had undergone successful operations for vascular reconstruction.

At the end of the lecture, a young student at the back of the room timidly asked, “Do you have any controls?” Well, the great surgeon drew himself up to his full height, hit the desk, and said, “Do you mean did I not operate on half the patients?” The hall grew very quiet then. The voice at the back of the room very hesitantly replied, “Yes, that’s what I had in mind.” Then the visitor’s fist really came down as he thundered, “Of course not. That would have doomed half of them to their death.

”God, it was quiet then, and one could scarcely hear the small voice ask, “Which half?”

Comment author: BiasedBayes 14 September 2015 05:36:35PM 2 points [-]

Yep :) You are definetely right career wise. Problem for me was the 200 other people who will absorb completely wrong idea of how the mind works if I wont say anything. Primum non nocere.

But yeah, this was 4 years ago anyway...just wanted to mention it as an anecdote of bad general reasoning and biases :)