They are promoting an anti-establishment, private, non-supervised spinoff version of medicine
That’s an excellent idea and I endorse it :-P Particularly the “non-supervised” part. I am not quite sure what do you mean by “spinoff”, though. What is spun off what?
as practiced in legally supervised hospitals and medical establishments
What exactly is a “legally supervised hospital” and who’s doing the supervising?
There is a reason why healthcare professionals have to go through certain legal procedures before they are allowed to give medical advice.
By spinoff I mean that this company takes medicine’s research results and then say they can handle and aggregate it better than the doctors who are licensed to do exactly that and then they start to do at least a part of it (giving certain limited kinds of advice or certain limited kinds of health reports that aren’t legally considered medical advice).
Playing with medicine is a dangerous field. For example this post induces distrust in legally-professed medicine at a time when “alternative medicine” is getting more and more popular (homeopathy, Chinese traditional “medicine”, etc.). Dismissing experts and starting your own better version of the field without actually formally, academically challenging the status quo and showing how your method would be better, seems very wrong to me. They should go and reform medicine to be the way it should be (if it really is broken) from the inside and by taking the legal burden of giving out actual medical advice. If their method works, they should publish their superior results in peer-reviewed medical journals and get their methods into regular practice. Have they done such a thing? I couldn’t find such a thing on their website.
They essentially say that they will give some non-medical advice but the real weight of potential legal ramifications still has to lie on the (according to this post) incompetent licensed medical professional. If he disagrees with the company, the patient may get angry for having wasted the money, so they may look for a licensed doctor who is willing to do the stuff that the company’s literature review might indicate.
The way this post dismisses medical experts reminds me of the way Scientology dismisses psychiatry.
Do tell. Is it to make lawyers rich?
No, for patient safety.
(Certainly, MetaMed doesn’t endanger patient safety by giving out reports that have to be acknowledged by a licensed doctor, but they make it look as if the doctor couldn’t decide himself and needed external help. This in turn decreases the trust in medicine and could potentially increase the trust in all of the alternative crap like homeopathy and faith healing, too.)
It’s somewhat like hiring legally-not-responsible people who’d keep telling civil engineers who are experts at bridge design how they should change stuff here and there and that they don’t really know what they are doing.
this company takes medicine’s research results and then say they can handle and aggregate it better than the doctors who are licensed to do exactly that
Doctors are not licensed to “handle and aggregate” research results. They are licensed to treat people as best as they can and keeping up with the latest academic research is not a requirement for keeping their license. In fact, most doctors are too busy treating people to allocate enough time to read research.
this post induces distrust in legally-professed medicine
I consider this a good thing and I say this as someone who has doctors in the family and doctors among friends. Medics are not gods and not even engineers—an attempt to make medicine “evidence-based” is proceeding over a lot of screaming and dragging heels. In some areas—like e.g. surgery—contemporary medicine is pretty good. In other areas—like e.g. nutrition—it’s pretty bad.
And what’s up with your obsession with “legally-professed”? Getting a license doesn’t magically grant you smarts and competence. There are a lot of different doctors and some of them are really not good doctors.
...without actually formally, academically challenging the status quo
I believe their advice is based on published medical research which is precisely what you are asking for.
I think the bigger issue with metamed is that they are trying to fill a role that already exists in the market. UpToDate is a bigger, more ambitious company (instead of generating per-patient reports they have a huge database of research summaries curated by actual experts for each disease) that almost all academic medical centers already pay for.
My obsession over legally-professed is that it’s a lot easier to give actionable options if there is no legal risk for doing so. Why won’t they take all the legal risks of giving actual medical advice instead of just actionable options?
Really? You consider MetaMed unethical and dangerous. Robin Hanson considers it a useful source of second opinions but thinks it may not be all that much better than second opinions from other sources (e.g. doctors).
You say “I find this absolutely shocking and reading the endorsement of this company on this website”
Robin Hanson says “Even so, I would very much like to see a much stronger habit of getting second opinions, and a much larger industry to support that habit. I thus hope that MetaMed succeeds.”
if there is no legal risk for doing so
MetaMed has been granted immunity from lawsuits..?
The legal risks are lesser if you are a licensed MD.
Upon more reflection, I’m not able to defend my point and my thoughts are confused and therefore I’m gravitating towards the established and mainstream viewpoint that only licensed and authorized doctos should do doctor stuff. On uncertain territory it’s better to stick to well-known landmarks. Since I’m not confident in my capability of a deep enough analysis of the pros and cons, I feel that the way to convince me would be to first convince people who are experts of the medical field and of the regulations, towards whom I already have an established chain of trust.
I would recommend to continue with even more reflection, now about that chain of trust you say you have established. Ioannidis would probably be helpful and you can google up his actual papers.
Yes I’m familiar with his most famous paper and what he says about medical research findings. Has he ever endorsed MetaMed in particular? If peer reviewed research finding are often false, how can MetaMed tell the difference without trying to replicate them? Different research papers use different assumptions, differently calibrated measurements, different subjects, it seems very hard to aggregate this in practice, although I’m not a medical researcher. Why should I believe that a company started by futurists and entrepreneurs would be up to this task? Where is the evidence for the actual efficacy of their particular methodology, as evaluated by independent third-parties?
Yes, it is. However there is, for example, the Cochrane Collaboration which is dedicated to exactly that.
Why should I believe that a company started by futurists and entrepreneurs would be up to this task?
You should not. I am not arguing that MetaMed is better than everyone else or even that it is very good. I am arguing that it’s not evil, not dangerous (relative to the usual baseline), and a useful thing to have around.
It’s goal is not to provide you with THE TRUTH, it’s goal is to give you a digestible summary of the current research on topics of particular interest to you. Often this summary functions as a second opinion, or it could provide the context for making medical decisions. It is as fallible as the rest of contemporary medicine.
That’s an excellent idea and I endorse it :-P Particularly the “non-supervised” part. I am not quite sure what do you mean by “spinoff”, though. What is spun off what?
What exactly is a “legally supervised hospital” and who’s doing the supervising?
Do tell. Is it to make lawyers rich?
By spinoff I mean that this company takes medicine’s research results and then say they can handle and aggregate it better than the doctors who are licensed to do exactly that and then they start to do at least a part of it (giving certain limited kinds of advice or certain limited kinds of health reports that aren’t legally considered medical advice).
Playing with medicine is a dangerous field. For example this post induces distrust in legally-professed medicine at a time when “alternative medicine” is getting more and more popular (homeopathy, Chinese traditional “medicine”, etc.). Dismissing experts and starting your own better version of the field without actually formally, academically challenging the status quo and showing how your method would be better, seems very wrong to me. They should go and reform medicine to be the way it should be (if it really is broken) from the inside and by taking the legal burden of giving out actual medical advice. If their method works, they should publish their superior results in peer-reviewed medical journals and get their methods into regular practice. Have they done such a thing? I couldn’t find such a thing on their website.
They essentially say that they will give some non-medical advice but the real weight of potential legal ramifications still has to lie on the (according to this post) incompetent licensed medical professional. If he disagrees with the company, the patient may get angry for having wasted the money, so they may look for a licensed doctor who is willing to do the stuff that the company’s literature review might indicate.
The way this post dismisses medical experts reminds me of the way Scientology dismisses psychiatry.
No, for patient safety.
(Certainly, MetaMed doesn’t endanger patient safety by giving out reports that have to be acknowledged by a licensed doctor, but they make it look as if the doctor couldn’t decide himself and needed external help. This in turn decreases the trust in medicine and could potentially increase the trust in all of the alternative crap like homeopathy and faith healing, too.)
It’s somewhat like hiring legally-not-responsible people who’d keep telling civil engineers who are experts at bridge design how they should change stuff here and there and that they don’t really know what they are doing.
Doctors are not licensed to “handle and aggregate” research results. They are licensed to treat people as best as they can and keeping up with the latest academic research is not a requirement for keeping their license. In fact, most doctors are too busy treating people to allocate enough time to read research.
I consider this a good thing and I say this as someone who has doctors in the family and doctors among friends. Medics are not gods and not even engineers—an attempt to make medicine “evidence-based” is proceeding over a lot of screaming and dragging heels. In some areas—like e.g. surgery—contemporary medicine is pretty good. In other areas—like e.g. nutrition—it’s pretty bad.
And what’s up with your obsession with “legally-professed”? Getting a license doesn’t magically grant you smarts and competence. There are a lot of different doctors and some of them are really not good doctors.
I believe their advice is based on published medical research which is precisely what you are asking for.
I think the bigger issue with metamed is that they are trying to fill a role that already exists in the market. UpToDate is a bigger, more ambitious company (instead of generating per-patient reports they have a huge database of research summaries curated by actual experts for each disease) that almost all academic medical centers already pay for.
I just found Robin Hanson’s critique and it’s almost the same as my opinion.
My obsession over legally-professed is that it’s a lot easier to give actionable options if there is no legal risk for doing so. Why won’t they take all the legal risks of giving actual medical advice instead of just actionable options?
Really? You consider MetaMed unethical and dangerous. Robin Hanson considers it a useful source of second opinions but thinks it may not be all that much better than second opinions from other sources (e.g. doctors).
You say “I find this absolutely shocking and reading the endorsement of this company on this website”
Robin Hanson says “Even so, I would very much like to see a much stronger habit of getting second opinions, and a much larger industry to support that habit. I thus hope that MetaMed succeeds.”
MetaMed has been granted immunity from lawsuits..?
The legal risks are lesser if you are a licensed MD.
Upon more reflection, I’m not able to defend my point and my thoughts are confused and therefore I’m gravitating towards the established and mainstream viewpoint that only licensed and authorized doctos should do doctor stuff. On uncertain territory it’s better to stick to well-known landmarks. Since I’m not confident in my capability of a deep enough analysis of the pros and cons, I feel that the way to convince me would be to first convince people who are experts of the medical field and of the regulations, towards whom I already have an established chain of trust.
Yay for more reflection! :-)
I would recommend to continue with even more reflection, now about that chain of trust you say you have established. Ioannidis would probably be helpful and you can google up his actual papers.
Yes I’m familiar with his most famous paper and what he says about medical research findings. Has he ever endorsed MetaMed in particular? If peer reviewed research finding are often false, how can MetaMed tell the difference without trying to replicate them? Different research papers use different assumptions, differently calibrated measurements, different subjects, it seems very hard to aggregate this in practice, although I’m not a medical researcher. Why should I believe that a company started by futurists and entrepreneurs would be up to this task? Where is the evidence for the actual efficacy of their particular methodology, as evaluated by independent third-parties?
Yes, it is. However there is, for example, the Cochrane Collaboration which is dedicated to exactly that.
You should not. I am not arguing that MetaMed is better than everyone else or even that it is very good. I am arguing that it’s not evil, not dangerous (relative to the usual baseline), and a useful thing to have around.
It’s goal is not to provide you with THE TRUTH, it’s goal is to give you a digestible summary of the current research on topics of particular interest to you. Often this summary functions as a second opinion, or it could provide the context for making medical decisions. It is as fallible as the rest of contemporary medicine.