If you replace "medicine" with "treatment", "the best strategy for a specific case" or "the best trial strategy for a specific set of facts" seem like reasonable analogies when it comes to litigation. You are probably right that there isn't a good analogy in, say, contract law.

On another note, I am sad that you have left your ideas thread dormant. I wanted to hear more about the giant parachutes.

Most people would not think she meant what you are implying. You are saying that she meant "Since every clinical trial is scheduled to end after the election, I would be worried if somehow a vaccine was approved before the election because Trump's involved. However, after my initial reaction was worry, I would get past that as long as the people involved in that approval were the same ones who would approve it after the election." But then why didn't she just say that?

So, when AOC says that a judge came to the incorrect decision (not the immoral decision) she should be dismissed as someone who has no real right to have an opinion? Not talking about a legal right.

You conflated best treatment strategies" that doctors might argue about, with a specific drug the patient might try to persuade a doctor to use. The second case has no analogy in law because they don't have commercials for stuff a lawyer (or other specialists) need to be reminded to use.

I mentioned the airplane parachute as a way to point out that there would be a point where the downside of freeing innocents overcame the upside. But because I don't want you to be sad:



"The Ballistic Recovery System (BRS Parachutes | FAQ) canopy is designed to save light aircraft weighing up to 1,200 pounds -- it's about 2,400 sq ft in area, which works out to a diameter of about 55 feet. Magnum Ballistic Parachutes (Technology and product comparison) offers a 3200 sq ft canopy for emergency recovery of aircraft weighing up to about 2,646 pounds. (That's about the same diameter as a U.S. military specification G-12E cargo parachute, which is rated for a maximum of 3,500 pounds suspended weight.)

Both of these systems lower the aircraft suspended underneath them at more than 20 feet per second; this translates to a descent rate of more than 1,300 feet per minute, which is a pretty hard jolt but easily survivable, especially when an aircraft seat is doing some of the shock-absorbing. (As one astute commenter noted below, it also could be pretty uncomfortable for the occupants if the jet is hanging nose-down instead of more or less level.)

The biggest MILSPEC parachute is the G-11, which has a 100 foot diameter (which translates into about 31,000 square feet of area), and is rated to bring down about a 5,000 pound load by itself. When rigged in a cluster of 8 G-11s, the combined suspension weight that can be handled is about 42,000 pounds, under about 250,000 square feet of canopy. That's maybe a quarter of the weight of an aircraft in the Boeing 737/Airbus A320 weight class at takeoff, and maybe a tenth of the weight of a Boeing 767.

Assuming some kind of system could be set up to deploy 32 G-11 parachutes (weighing a minimum of 8,000 pounds of their own, which would cut into the useful load each airplane could carry), if they all fired off and opened successfully, you'd wind up hanging a modest-sized single-aisle airliner under about just shy of 1 million square feet of parachute canopies.

How much parachute material is that, really? The Superdome in New Orleans is 680 feet in diameter; covering it would require about 1.5 million square feet of material. That's a lot of fabric, but only about half again as much as the combined material used in 32 cargo parachutes.

So, taking into consideration the added complexity of design, installing and maintaining an emergency parachute system for a typical passenger jet, the amount of revenue lost by carrying at least 40-45 fewer passengers to compensate for installing such a heavy system, and the extremely unlikelihood such a recovery ever would be required, I can't see trying to scale up a parachute recovery capability for airliner use."

She was in the middle of a Presidential election and wanted to drive home the point of how bad having a POTUS who lies all the time like Trump is. Her statement was completely correct, rational in terms of healthcare and got in a good shot at her opponent. I imagine many middle of the road people being completely in agreement with the notion that Trump's opinions and advice on treating Covid is completely unreliable. A nice call back to the injecting disinfectants presser.

I don't even know what this means. There is no such thing as a doctor who is expert in all areas of medicine. If you go to a competent internist and report a bunch of uncommon neurological symptoms, that internist may not feel comfortable diagnosing what is wrong with you. To the contrary, your internist probably will suggest that you see a neurologist. That isn't a sign that your internist is a bad doctor. And it doesn't mean that the neurologist is a better doctor than the internist. It means that they have different areas of expertise. The important thing is that your internist be knowledgeable enough to send you in the right direction if you seem to have a problem that internists don't encounter very often.

What I described above is very analogous to law and many other professions.

I have no idea how often the bolded happens. Do you? I imagine that relatively few drugs are used to treat most medical conditions. My objection to pharma advertising is that I suspect that it induces a fair number of people who don't need medication to go badger their doctors for prescriptions. If you go ask your doctor whether you should be taking Lipitor for your high cholesterol, I don't think your doctor is going to think to himself or herself, "hmm, Lipitor, I've never heard of that drug. I'll go look it up on the internet."

I've known too many incompetent people who went to good schools to credit his statement simply because he went to Harvard. I suspect that there is a kernel of truth to what he said (many experienced nurses know a fair bit about medicine). But I'm sure he was exaggerating to a considerable degree.

The truly risible part of your post was your suggestion that patients who take the internet for a spin will be able to diagnose their own illnesses better than most doctors.

As a politician, she mostly approaches judicial decisions from a political perspective. Everyone has a right to their opinion. If you are asking whether I would consult AOC if I needed advice on litigation strategy for a typical litigation matter, the answer is definitely no. If you are asking whether I would consult her on whether an appellate court was likely to overturn a trial court's decision, the answer is definitely no.

That isn't a serious indictment of AOC. I am free to have and to air my opinions about international tax matters. But if you gave weight to my opinions on international tax matters, you would be making a huge mistake.

The problems with her statements were that she didn't make it clear that a pre election vaccine couldn't happen under the existing rules and that she implied, at first, that Trumps tendency to lie could be enough to render early approval (which could have happened if the disease got even worse) problematical even if the experts recommended it.

It's probably true of every field. If you can't beat a short session with a generalist by researching your specific problem then you're probably pretty dumb.

For what little it's worth I worked with a lot of doctors and would only personally trust a few. Then again the main job of a GP when it comes to anything serious is to refer you to a specialist. Generally spcialists are a lot better and most will struggle to help themselves with research. Apart from maybe researching which specialist to use.

Lawyers aren't great either. My main use of them has been buying and sellign property which is trivial legal work. I had enough experience to expect gross incompetence and insist on a letter confirming what we had agreed from the outset (which is very unsual in the uk beyond general terms and the price). The messups they made are staggering. That inluding forgetting they had put it in writing which always added to the amusement. Fortunately I do have the evidence.

Still as a wise professional once said. We dont succeed because we are good, we succeed because others are so bad.

The Harvard doctor was a known world class one. The internet comment was actually unrelated to my low opinion of doctors. Even great GPs are going to know less about a rare disease than a diligent researcher/patient who only has to care about that specific one.

But the drug commercial is a different story. If doctors didn't sometimes change their prescription from one med to another or from no med to the advertised med, the ads would stop. And if it does happen that the patient influences the doctor, it either means that the doctor was incompetent because he didn't prescribe it originally, or that he is unethical for prescribing a pill that he thought he should not.

AOC has every right to think a decision is bad for political or moral reasons. But not that it was "incorrect" considering her lack of knowledge. Not if one agrees with your stance. When Larry Flynt won his case Jerry Falwell said, "the justices must have been holding their noses when they made that decision." But he didn't have the temerity to say that the decision was incorrect. (Note: I chose a single judge for the example. A non-unanimous decision gives amateurs an excuse to disagree (the Flynt decision was unanimous.) But I agree with you that it's not a good enough excuse.

I'm pretty sure my theory extends to specialists as well. When the Mayo Clinic says they find flaws in 60% of other's first opinions I think they are usually talking about specialists.

I am guessing there could be a pretty precise test that would separate the good from the bad. The medicines they prescribe. What percent of doctors actually know how they work in some detail.? Not just whether they work. Surely that knowledge is sometimes valuable and was probably taught in med school. And I am guessing most doctors don't remember it as well as the good ones do.

Next time think through your argument before calling someone wrong, and then you won't have to waste your time justifying your position.

Finding flaws doesn't imply many people could do better with a bit of research. How many flaws do you estimate the Mayo clinic wuld find in the average's person assessment after research?

Flawless is also a very very high bar and often includes a high degree of opinion. I'd bet that if people from the Mayo clinc (whoever they are) did the diagnosis then the mayo clinic would still find lots of flaws in their work.

I'm sure this is true to a large extent as people who understand stuff well then 'remember' it better. But how well that translates into prescriptions I dont know. Some doctors just want the patient out of there asap, are more /less dismissive of hard to diagnose systems where sales people are much less of an influence on doctors.

Your initial reaction would be - what's the big deal, this is an ordinary personable bro blathering on in a mild way I guess some people relate to. Upon further reflection your reaction would be - this guy is an idiot.

I would guess I listen to around 1 in 20 Rogan podcasts. Lex Friedman, Andrew Huberman, Steve Pinker, those types. I think he's very good as what he does. In other words, he's happy to sit and listen to smarter people than him talk about stuff, and he's inquisitive enough to ask the kind of questions the average listener is probably thinking. He's not nearly as left as he thinks, but he's certainly not right wing. However, if I had to guess, he's voted more GOP than Dem in his lifetime.

What's interesting is why some people have completely lost their minds over him. I think there is a certain amount of classism from the liberal elites in that he's got enormous pull among a similar demographic to him. This is compounded by the smarter people he talks to are the kind of people pushing back pretty hard against the more radical ideas emerging from college campuses.

Anyway, I probably listened to him more before he moved to Spotify, so if the liberal elites do get their way and he's kicked off, I can only see his audience growing.

He's pseudosmart. He makes bro types feel good about themselves. He validates their poorly thought out perspectives for them.

You previous comment didn't say anything about rare diseases. What you said was, "if a patient does some research about his disease, his opinion about what should be done is probably more likely to be right than the typical doctor." There is simply no way that is correct. Also, a lot of diagnoses can't be made authoritatively without testing.

The number of people currently addicted to prescription opioids makes it pretty clear that some doctors are susceptible to writing prescriptions that they should not write.

Again, I don't know what it means to talk about this issue in terms of rights. I have a "right" to have all sorts of opinions about how best to travel to Mars, even though I lack expertise in space travel.

Plenty of whiny liberal elites around here.

Rogan is an example of the cream rising to the top. He works hard but not inside the narrow boundaries of the would be elites who spent their formative years competing with each other on who could memorize school material better.

It's like that day the 40 year old with 3 kids and two college loans making 70k with his law degree realizes his 35 year old plumber is a millionaire.
He hates that prick. (and thinks he's racist)

As I have explained to people IRL many times, your right to voice your opinion is not my obligation to listen to it.

I have a couple of thoughts on this.

First, no matter what you think of doctors, the percentage of idiots in the general population surely is higher than the percentage of MDs who are idiots.

Second, I suspect that many people exhibit a form of hindsight bias when evaluating their doctors in the wake of a definitive diagnosis. Conclusions often seem more obvious in hindsight than they actually were.

Imagine that you go to the doctor with complaints about malaise, muscle weakness, joint pain, and mild loss of appetite. After three months of seeing various doctors, you eventually are diagnosed with a rare genetic disorder.

After you are diagnosed, Dr. Google confirms that your constellation of symptoms is extremely typical for people who have your rare genetic disease. Does it follow that the first doctor who told you, "it's probably some sort of seasonal viral infection," is a bad doctor? Does it follow that the specialist who ultimately figured out your problem is an extraordinary doctor?

Of course not. The constellation of symptoms that you reported is consistent with dozens or hundreds of diseases and infections, most of which are minor and most of which are far more common than your genetic disease. That's why the first doctor ordered blood work to check for a seasonal viral infection.

As your symptoms lingered, and as further testing ruled out the most common causes of your symptoms, the range of potential diagnoses narrowed. That's one of the main reasons why the specialist was able to figure out what was wrong with you. He was looking at your symptoms after the most likely explanations had been ruled out.

I don't see why Joe Rogan's voting habits or the voting habits of his listeners are especially relevant to whether he should be deplatformed by Spotify. That decision should be based on his behavior.

Well then isn't that comment kind of silly then as no is required to defend anything and the assumption or to posit that is silly.

Just as no one is required to attack Joe Rogan and i could write his same post with that same irrelevant slant as if they are required.

If someone jumps in and strips the context away from George Carlin's commentary and comedy to just count and cite the numbers of time he said the 'Nword' as part of a pile on to prove he is racist some people will jump in to defend him to try and make sure the context is properly considered and that in fact it is deliberate attempt to remove the context to smear him.

That his how things typically work.

But early approval, during the middle of a study with terms already set is an outlandish scenario. Equally outlandish as a midnight massacre of competent people at the FDA by Trump and replacement with political hacks. Even then, Harris’ statements outline she will be able to make the correct decision in each of those very different 0% situations. You’re straining really hard to make a simple, correct anti-Trump statement into something anti-vax and it just doesn’t make sense.

Grading on a curve to a large extent so calling a doctor dumb is compared to what we would expect from soemone as well educated a as a doctor.

The hindsight thing is always a risk. Not for me in this case as until very recently I had no need to go to a doctor and my recent experiences were very good if not particularly complicated. I did however work with a lot and yikes! I've worked with accountants and lawyers and IT professionals and scientists and many others - doctors stand out as yikes! (with some very notable exceptions). Could be my experiences are skewed in some way or I'm suffering some other sort of bias. Also the company I worked at only hired people with top qualifications - they were a bit snobby that way - makes it even more yikes.

No, it was a waste because you’re unable to think or engage on the details. When evidence is asked for and ignored, that’s just trolling.