Monday, December 17, 2012

Physicians and Status: "A Certain Mystique About Their Judgment"

From Philip Tetlock, emphases mine.

One of the reactions to my work on expert political judgment was that it was politically naïve; I was assuming that political analysts were in the business of making accurate predictions, whereas they're really in a different line of business altogether. They're in the business of flattering the prejudices of their base audience and they're in the business of entertaining their base audience and accuracy is a side constraint. They don't want to be caught in making an overt mistake so they generally are pretty skillful in avoiding being caught by using vague verbiage to disguise their predictions.

...Things that bring transparency to judgment are dangerous to your status.  You can make a case for this happening in medicine, for example. In so far as evidence based medicine protocols become increasingly influential, doctors are going to rely more and more on the algorithms–otherwise they're not going to get their bills paid. If they're not following the algorithms, it's not going to be reimbursable. When the healthcare system started to approach 20 to 25 percent of the GDP, very powerful economic actors started pushing back and demanding accountability for medical judgment.  The long and the short of the story is that it's very hard for professionals and executives to maintain their status if they can't maintain a certain mystique about their judgment. If they lose that mystique about their judgment, that's profoundly threatening.

Of course there's the counterargument from most medical professionals, which in so many words is, "We're special and economics doesn't apply to us.  It just doesn't."  We're finding out.

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