The way doctors accept new ideas is very different than in other fields, like engineering. Nowhere was this more apparent than Twitter in January through March, 2020. With the worst pandemic in the last 50-100 years spreading, you’d think epidemiologists and physicians would be the first to sound alarm. They weren’t, not even close. Worse yet, many public health experts derided those who were first because what they were saying contradicted officially sanctioned knowledge. This got me thinking, why would doctors be the last group to learn something which was within their own expertise?
Doctors face unusual risks practicing medicine. If they do something not professionally-sanctioned and it harms a patient, they can be sued for malpractice. If they fail to do something professionally-sanctioned that could have helped, they can be sued. They can also be sued for no reason at all, or due to rare, unpredictable events. A jury of your peers may reduce bias but they are not equipped to evaluate the quality of medical judgment. Juries are considered unpredictable and best avoided even at a high settlement price. Avoiding lawsuits is the game for doctors. These risks are typically not there in other fields, which allows other professions to embrace a culture of learning through failure and risk-taking.
Knowledge in medicine is propagated in a legal-risk-minimizing way. The topology is top-down hierarchical.
- Professional, official, and academic organizations (e.g. WHO, AMA, CDC, Harvard Medical School, etc.)
- Medical textbooks which are compilations of many research studies and meta-studies.
- Researchers studying the subject matter.
- Practicing physicians whose experience or training overlaps with the subject matter in question.
- Practicing physicians whose experience does not overlap with the subject matter.
This legal-risk-minimizing way of propagating knowledge doesn’t necessarily promote true information, but rather information that has the widest level of consensus among the most knowledgeable experts. If one doctor is wrong, that’s malpractice. If they’re all wrong, that’s just medicine. The way doctors acquire knowledge may be legally safe but predictably has negative secondary effects. Independent thinking is systematically discouraged which allows false information, even ideas which defy common sense, to persist much longer than necessary.