Summary: Most areas of knowledge are so big and complex that most people will never know anything about them. This includes some areas that affect everyone every day, like health/medicine. Non-experts have a hard time making good decisions.
In Part 1 (this article) I describe the problem, using health & medicine as an example area of life which is hard to master.
In Part 2 I explore some detailed aspects of the problem, including examples of "good" experts.
Making good choices in health & medicine
You make health-related choices every day. What you eat, how you relate to others, career choices you make, how much you exercise -- all this influences your well-being.
But medicine is a huge body of knowledge. It's also constantly evolving. Even doctors have trouble keeping up; some doctors don't even try to keep up, thus indirectly harming their patients when they apply old methods of treatment and give advice based on old research when there are already more effective ways to help patients. There are also many parts of medicine which are simply controversial because there is no conclusive research to date, so different experts will tell you different things.
What’s particularly hard, some critical health effects are only visible in the long-term. A single “bad” day in terms of bad diet, lack of exercise, smoking or drinking too much alcohol do not result in any immediate problems. Long-term effects remain intractable. So we don’t learn from “mistakes”, because mistakes are in the habits, not individual behaviors.
Online information is hard to find, often incomplete or simply wrong. It’s hard to evaluate without expert knowledge. You’ll find conflicting information of pretty much any medical topic. It’s not just that there’s lots of bad medical information on the Internet, even the parts that are good are scattered and hard to tell apart from the “bad” information.
Moreover, doctors and pharmaceutical companies don't really have economic incentives to "solve" the problem of unhealthy lifestyle. Why? Because they are mostly in the "treatment" business, not in the "prevention and education" business. Think about it. If everyone lived a healthy lifestyle, doctors and those companies would lose majority of their income. They would still be needed to diagnose and treat some conditions, but many products and many consultation hours would simply be unnecessary, and many conditions would be avoided altogether.
Note: I don't think that complexity issue or incentive issue is specific to medicine. However, health is a major area for everyone in which problems may have dramatic effect on well-being. In the worst case, when individuals consistently make bad medical decisions throughout their life it leads to huge financial costs and great suffering.
Where does the problem come from?
Humans are learning a lot very quickly through science and business specialization; the world is very complex. So our civilization gets more and more advanced, and we get more and more “ignorant” compared to the experts. In that sense we get more "ignorant" over the years, even if on an individual level we are learning. And we keep being ignorants in all the areas except the few in which we specialize.
- It's very hard to check if given piece of advice or information is “true” if it’s from a field we’re not experts in.
- Results of our decisions are often delayed past the point of “no return”, so learning from our own experience is impractical
- Man is weak. We like sugar. Cookies taste well. It's biology (see post on hyperbolic discounting, though the issue is... yeah, more complex)
- Typically, the fields which are less scientific are more prone to error and speculation
- More money => more FLP issues (business thrives on sales, not on helping people make good choices)
- We live on “autopilot” (heuristics, biases). It minimizes effort on our part, but it leads to poor choices when non-obvious knowledge is out there
- Personal experimentation is very difficult. It’s impossible to run proper experiments on ourselves, e.g. how do you experiment with diet without ruining your normal life? How do you control for emotions, stress, weather, other foods you ate recently etc. when trying to figure out the effect of, say, sugar on your well being?
- Lack of competition, especially in form of cartels or monopolies, will probably aggravate the situation regardless of the field
- In the end, sometimes even experts get it wrong, i.e. experts make bad decisions, too.
A note on incentives and ethics of experts
Doctors and pharmaceutical companies are "experts". But they are not really that “good” for us. It’s not their business to educate us. They want us to keep coming back for what they are selling. It's true for most professionals. Again, doctors are in the “treatment” business, not in the “education” business.
So if you are an expert in any field, what do you do?
Do you try to get the same client again and again, or do you help the client become self-sufficient?
In my own experience as a teacher or trainer I always strived to provide the learners with enough understanding and tools to make them independent; but I'm not kidding myself; most people are not as benevolent.
So when you are paying for the services of an expert, keep this in mind:
- Experts are paid for what they know - so they don’t have such a great incentive to educate everyone. You need to remain your expert status to be worth something in the market.
- It’s easier to remain being an expert by NOT helping others become experts than it is by learning NEW (better) information all the time. This leads to entrenched systems.
- Some people pretend to be experts and we just get fooled. It can work if such a ‘fake’ expert gets many new clients quickly and if they can’t warn each other. Also, often you get paid for something before the result is visible.
You may need to ask lots of questions to get the "most" of your interaction with an expert; they won't just tell you all they know.
In part 2 of the article I'm showing examples of "good" experts, and a few ways I use to solve the problem.