The Diagnostic Problem (pt 2)

I mentioned that repairpersons used to be studied regularly. People who take their vehicles or appliances or electronic gadgets to be repaired would like to think that the repairpersons are all competent and honest, but research by newspapers many years ago revealed that, while many were honest and competent, there were some who were incompetent and could not find the best repair, and some were dishonest, and always sold customers the most expensive repair.

This research was socially acceptable and cheap: there was usually no charge for the diagnosis and repair estimate.

Obviously, there are diagnosticians who diagnose other things than problems with vehicles, appliances, and electronic gadgets, but it is neither socially acceptable nor cheap to investigate to see if they are honest and competent. Like clerics under Thomas á Becket who insisted that only clerical discipline could be applied to clerics, and clerics were not subject to the secular legal authorities.

Today, clerics have been stripped of this immunity, but not physicians. The law agrees that only licensed physicians have the expertise to judge licensed physicians, so they must be responsible for disciplining their own profession, and they charge high fees for diagnosing problems, whether or not the patient allows them to perform their recommended procedure. So we have no empirical evidence that there is a single physician who is not scrupulously honest and competent, only the fact that they are human, and suffer the same moral hazard as the repairpersons who diagnose vehicles and gadgets and whose fallibilities have been repeatedly exposed.

Farook has a cousin who has had a medical problem for five years, and isn't getting any better, even though the physicians they have seen have assured them they are providing the very best medical care.

So Farook asked me to take his cousin's medical records and go to a medical library and do the necessary research.  Farook says he is convinced that many physicians prescribe the most expensive treatment rather than the most effective treatment, and wanted me to go check on what they were doing to his cousin.

I've taken some medical courses, but am not a physician, but I said I could at least go to the library and find out what I could to help.