Russ Roberts and Emily Oster explain exactly why Economists should be the more trusted individuals for health decisions. Roberts also explains why doctors are particularly ill-suited to make health related recommendations. The reason is that doctors generally do not understand statistics and trade-offs. The entire EconTalk is statistics gold.
Russ: Let’s move away. One last thing about pregnancy in your book which fascinates me. I read an article when I was doing my background reading for this interview that–it was an angry screed; you may have seen it–suggesting that your book was awful because you are unqualified. You are the wrong kind of doctor; you are a Ph.D. in economics. You don’t know anything about medicine. And it’s irresponsible for you to go around making health recommendations. And people should ignore your book. What’s your response to that?
Guest: Um, yeah, I’m surprised you just found one like that.
Russ: Well, I stopped looking after that, Emily. I thought one was plenty.
Guest: One is enough. I think that if you read the book, it’s very clear this is a book about data. And this is a book about looking at data and evaluating causality and thinking about what’s a good study, what’s not a good study. That is exactly what my training is in. I’m a health economist; I have a lot of training in statistics. I think all the time about what’s causal, what’s not causal. And so I think in many ways my training is better than a doctor’s training for evaluating these kind of questions. The book is not going to deliver your baby for you, and so I think there’s no question that this is the kind of thing that women will read in conjunction with also going to their doctor. I assume. And so I think it really is complementary. But I also think there’s a very clear reason why someone who has a lot of training in statistics would be the person who writes it, a book which is all about data. So I think that’s the–I think if people actually read the book they will see very clearly why someone with my training will come at it in this angle.
Russ: I would–not only do I believe that your training is particularly well suited to the questions that you deal with, so I second your defense. But I would also say that doctors are particularly ill-suited for these kind of issues. They don’t typically–I think it’s changing, but they don’t typically get trained in data analysis. They are certainly not trained in statistics or decision-making. They don’t have a very good appreciation of uncertainty. And they are prone to say things, as a friend of mine heard when he was a motorcycle rider. He broke his leg and the doctor put his leg in a cast and then said, I hope you learned your lesson. And my friend said, Yeah, well as soon as I get off my cast I’m going to ride my bike again. And the doctor was mystified. The doctor couldn’t understand the idea that there might be a tradeoff. That life is dangerous; some things are dangerous. Sometimes it’s worth it even though it’s dangerous–this idea that economists have, that there is a continuum of risk, rather than safe-unsafe. And if you look at the pregnancy books and the guides and the other things you are reacting to, it’s that people of course want to know: Is it safe? And the answer is: No; and it’s not unsafe. It’s complicated. And people don’t like that. And doctors aren’t trained to think other than that.
Guest: Yeah. And some of what I get, like I get on the radio with doctors, you get: I just really care about the health of the baby. Yeah, well I really care about the health of the baby, too!
Russ: No kidding.
Guest: But I think we should also be making decisions which are correct. We shouldn’t just not be doing things because we enjoy them. We should understand. And by the way: Do you ever allow your patients to take a non-essential car trip? Because that is very dangerous.