why economists are more reliable than doctors on health issues

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.

About christopher fisher

The blog is meant for educational/entertainment purposes. All material can be used and reproduced in any length for any purpose as long as I am cited as the source.
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