I was referring to mistakes in epistemic and decision theory.
Lack of a FDA supervised double blinded placebo controlled study evaluating a treatment does not mean "there is no evidence" the treatment works.
Failure to reject the null hypothesis for a statistic of a particular positive outcome measure over a particular set of patients for a particular treatment for a particular treatment regime does not imply that "the treatment does not work" or that "the treatment should not be tried". Besides the multitude of ways this fails predictively for a particular case, it completely ignores cost and risk of both sides of treatment/no treatment, and so is crap as decision theory.
To briefly summarize, most doctors replace what could be an exercise in decision theory, including causal inference, process modeling, and decision theory tailored to the information relevant for a patient with an officially blessed lookup tables based on general population statistics.
I would probably feel better if doctors admitted this wasn't a proper way to heal patients, but just the most convenientl way for doctors, the health care industry, and their government regulators, to dole out treatments to patients while protecting their income and control of patients. But I think they earnestly believe in this wholly suboptimal for the patient paradigm.
I'm sure many doctors do as you describe, but in my experience, most specialists physicians don't fall into that trap. They will prescribe "un-proven" and un-approved treatments if they think the risk-benefit relationship is favorable. However, it takes significantly more knowledge about the disease, your specific patient, and all the latest research to make a decision like that. Furthermore, if you're wrong, it's your hide on the line. If your family doctor knows all that, then they're a specialist.
The cost of treatment/no treatment: I'm going t...
Today I Learned in Medical School:
Doctors have medical myths too! According to my prof, many doctors believe that aspiration (having stuff go down into the lungs) causes anaerobic pneumonia, but that is rarely the case. He says that myth is often taught resident-to-student, but it isn’t actually backed up by any research, and isn’t true. The kicker - if the doctor would stop to think about it, it should jump out as unintuitive – it would take some serious changes inside the *lung* to make an *anaerobic* infection – an infection of bacteria that thrive in areas with no oxygen. In reality it takes frequent aspirations over a long period of time to block off an area of the lungs.
I think the moral of this story (though this just may be preaching to the choir here at LW) – all people, be they doctors or kindergarteners, don’t usually check facts they’re taught, especially when being taught by an authoritative teacher. Unless they’re lead to discover/derive a fact themselves, they usually assimilate it into their network of beliefs as a brute fact – “carbon has four valence electrons,” “don’t end a sentence with a preposition,” “in 1492 Columbus discovered America.”
Now, you frequently don’t have enough time to “learn it the hard way” or derive an answer yourself. If I had to read every single research publication that populated the facts in my textbooks, I might not ever graduate. However, it is important to remember that you’ve taken shortcuts for most of your education (and religion/lack thereof, and life in general) – and if some fact ever later strikes you as being odd, look into it. Otherwise, we’re just playing the telephone game.