Alex Tabarrok asks “Why is Medicine so Primitive?”
One reason is that medicine is the largest area of the economy still dominated by artisanal production. I will be blunt: We need assembly line medicine, medicine that is routinized, marked and measured. As I have argued before I would much prefer to be diagnosed by a computerized expert system than by a physician. The HMOs, Kaiser in particular, have done good work on measuring the effectiveness of different procedures but much more needs to be done to bring medicine into the twentieth century let alone the twenty first.
He argues that “The number of treatment regimes supported only by tradition and authority is very high.”
But isn’t this even more true of education than medicine? Could not Alex’s arguments apply even more strongly to education?
I have written on this in A Preference for Ignorance. In preference-for-ignorance fields, the practitioners insist that measurement is impossible, and the customers go along with this insistence.
READER COMMENTS
Caliban Darklock
Oct 16 2006 at 2:16pm
I have a slightly different perspective.
Experts prefer their clients to be ignorant when ignorance renders those clients more likely to accept the expert’s services.
I’m a computer guy. My services are very technical. I like my clients to have technical knowledge for two reasons: first, so they can understand why my services are the right solution; second, so they can understand why my competitors are NOT offering the same thing for less money, and are in fact offering a very different service that provides my clients with zero real benefit. An ignorant client simply does not see the superiority of my services, because he doesn’t understand them – so I can’t compete effectively.
My competitors, on the other hand, would really like their clients to stay ignorant. An ignorant client doesn’t know that the service they bought is doing nothing of any real value, and can be easily told that the service *I’m* offering is essentially the same thing.
I think the same general situation would apply to pretty much any expert field.
Mr. Econotarian
Oct 16 2006 at 3:35pm
One of the biggest problems with medicine is that each person is an individual. Often people with the same disease respond differently to different medicine. Also side effects of one drug may be acceptable to some, but not others.
There are clearly some economies of scale in medicine, but individual treatment remains individual.
Dr. T
Oct 16 2006 at 8:08pm
When patients can walk into the auto-doc, precisely describe their problems, symptoms, drug use, supplement use, past medical history, and family history using standardized nomenclature in a rigidly defined format; when patients can sit and lie in exactly the right positions on the auto-exam table and hold still while the auto-doc scans, thumps, pokes, and prods them; when patients will listen to a computer-generated voice rattling-off a diagnosis, prognosis, and therapeutic regimen; then we can have the assembly line medicine Mr. Tabarrok desires.
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