Totally agree. The practice of Medicine just isn't that deep. It's some pattern recognition (sick / not sick), extracting the right features from the patient (patient says "man my chest feels weird" and figuring out if they mean chest pain, shortness of breath, etc.), heuristics (this cluster of signs and symptoms matches this), and then a short decision tree (D-dimer --> CTA).
It turns out that at the end of that relatively shallow decision tree, if you can't figure it out, 99% of the time it's not because there's a Dr. House moment waiting on the other side, it's because nobody knows. Sometimes that's -- well we've discovered that you have stage IV pancreatic cancer. Here's a clinical trial but otherwise that's the end of human knowledge. Sometimes it's "well, I don't know why your chest feels weird, but we've ruled out the bad stuff so let us know if it gets worse!".
And obviously there's bad doctors who can't go through that without fucking something up along the way. Maybe there's even a lot of them? But outside of a small handful of surgical subspecialties (like you do open heart surgery on babies), I would guess that there's not much difference between an 90th percentile doctor and a 99th percentile doctor -- and almost certainly not between 99th percentile and 99.9th percentile.
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Totally agree. The practice of Medicine just isn't that deep. It's some pattern recognition (sick / not sick), extracting the right features from the patient (patient says "man my chest feels weird" and figuring out if they mean chest pain, shortness of breath, etc.), heuristics (this cluster of signs and symptoms matches this), and then a short decision tree (D-dimer --> CTA).
It turns out that at the end of that relatively shallow decision tree, if you can't figure it out, 99% of the time it's not because there's a Dr. House moment waiting on the other side, it's because nobody knows. Sometimes that's -- well we've discovered that you have stage IV pancreatic cancer. Here's a clinical trial but otherwise that's the end of human knowledge. Sometimes it's "well, I don't know why your chest feels weird, but we've ruled out the bad stuff so let us know if it gets worse!".
And obviously there's bad doctors who can't go through that without fucking something up along the way. Maybe there's even a lot of them? But outside of a small handful of surgical subspecialties (like you do open heart surgery on babies), I would guess that there's not much difference between an 90th percentile doctor and a 99th percentile doctor -- and almost certainly not between 99th percentile and 99.9th percentile.
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