Wednesday, July 27, 2005

If you want to drive the Bus...

Postponing my showdown with Dr. Hornig's autistic mice yet again, I would like to address a phenomenon that is nearly ubiquitous in the "alternative" medicine world. I am speaking of the concept that anybody - regardless of their education, training or experience - is qualified to speak knowingly and render expert opinion on scientific and medical matters, as long as they have personal experience of the subject under discussion.

This is a phenomenon that defies common sense - the very same people who take offense at being told they lack the proper education to make scientific and medical assertions are often "professionals" of another stripe - MBA's (and here), lawyers, and stock brokers - who would be aghast at the suggestion that a neophyte off the street could do their job with equal skill. Imagine their outrage (or amusement) if I, a humble biologist, announced that I was as competent as they were to, say, formulate a business plan for a multinational corporation, set up a tax-sheltered annuity or render an opinion on federal law.

The sad fact of the matter is that it takes a certain amount of education to be a scientist, or even a doctor. There are facts to learn, techniques to practice, skills to acquire and mental habits to develop. You can't get these from watching "ER", "CSI Miami" or even the Discovery Channel.

This is not unique to science. Lawyers, MBA's, stock brokers, plumbers, electricians, truck drivers, firefighters, bicycle racers, and even the folks flipping hamburgers all have to spend a certain amount of time learning how to do their job. If your education, training and experience is solely in business, law or marketing, then you have no more expertise in science than you have in firefighting - and what's your plan if the stove catches on fire tonight, eh?

So, why is it that people who wouldn't think about redoing the plumbing in their bathroom suddenly feel that they have innate skills in science? Part of it has to do with our education system, which gives everyone a small taste of "science" in the primary and secondary grades but fails to instruct them in the real methods of science. The average person thinks that a scientist is just a huge repository of "facts", since that was what their "science" classes in high school were all about. That couldn't be farther from the truth.

A real scientist has to learn a prodigious amount of information, true enough, but the real emphasis is on learning how to think. It is much easier to teach a student the Periodic Table than it is to teach them how to formulate a testable hypothesis. And it is far easier to teach the Kreb's Cycle than it is to teach how to draw an accurate and supportable conclusion from experimental data. This is probably why most college graduates with "science" degrees don't end up doing any research - they end up selling or being technicians or technical advisors.

Although there have been some excellent self-taught scientists in history, they are few and far between. And there haven't been too many of them since the middle of the last century. So, it seems pretty unlikely that someone is going to read a few semi-technical books and emerge able to compete head-to-head with an educated and experienced scientist when it comes to, say, critical evaluation of a scientific study. Yet there are numerous people who claim to be able to do this very thing.

I once witnessed an amazing exchange between a research physician and a parent of an autistic child. The parent had a degree in business and had been a fairly successful business person for many years. The physician had been researching autism for over thirty years. The discussion I overheard (and oversaw) was about - couldn't you just guess - whether or not autism was caused by mercury.

After the physician had explained the reasons why he felt that mercury didn't cause a majority of the cases of autism - along with the caveat that the research so far couldn't eliminate mercury as a minority cause, the parent said:
"Well, my assessment of the data is that mercury is the only cause of autism and that genetics has nothing to do with it."

The physician paused for a moment, clearly debating whether or not to reply, and finally said:

"You'll excuse me if I feel that you lack the qualifications to give that assertion much weight."

The parent then retorted, angrily:

"That's just typical physician arrogance - I'm just as qualified as you to decide what causes autism!"

I was stunned. Not because this parent "talked back" to a physician - I actually enjoyed that part - but I was stunned by the appalling ignorance of that statement. I was stunned that someone with no significant scientific education and a few years experience as a parent of an autistic child could honestly think that they were equal in qualifications to someone with an advanced degree inscience and thirty years of research in the field!

OK, this isn't "PC" - it's not "polite" to tell people that they don't know what they're talking about. But it's true! Just because someone has an autistic child does not make them an expert in the science of autism. Sure, they know a whole lot about raising an autistic child, but that does not give them any insight into the biochemistry or neurophysiology of autism.

In other words, if you want to drive the bus, you need to go to bus-driver school, first.


Prometheus.

15 Comments:

Blogger jaws said...

Very well put!

I especially agree with this statement of yours:
A real scientist has to learn a prodigious amount of information, true enough, but the real emphasis is on learning how to think.

As a "scientist in training", I couldn't agree more. I learned a lot of information to get my undergraduate degree, but during that time I was fortunate enough to have Profs who helped me begin to learn how to think

That's one of the problems with say science and the media, many in the media grab any study and tout it--even though a "real" scientist knows that the study may just be junk

28 July, 2005 17:26  
Blogger Orac said...

Great post!

You should submit it to the Skeptics' Circle.

Plug, plug.

29 July, 2005 07:59  
Anonymous HCN said...

There was an article posted that related to this subject:
http://www.baltimoresun.com/news/health/bal-hs.pediatrician29jul29,1,5342075.story?coll=bal-health-headlines

29 July, 2005 14:49  
Anonymous emh said...

I have a PhD in finance and run into this sort of thing all the time with respect to the financial markets. In my case, it's usually MDs (or airline pilots) who've read some investment book or newsletter and think they can beat the market.

There's a recent study (B. Shiv et al, 2005, Psychological Research, 16:6, p435) that might shed some light on this behavior. (I just happen to have it on my desk at the moment.) The study compared the investment decisions of a group of patients with brain injuries in regions mediating emotion to a normal control group. The emotion impaired group performed better!

The authors suggest that risk aversion affected the performance of the control group, but not the impaired group which failed to make an emotional connection between prior losses and the evaluation of expected future outcomes. To a financial economist this isn't surprising because we routinely use risk neutral frameworks to develop asset pricing models. Market traders probably learn to do something similar through years of experience.

The encounter between the physician in your example and the parent seems to me to be operating on the same level in the sense that the parent is probably making evaluations using structures in the emotional system. Through training and experience, the physician has learned to filter the information through higher cortical structures that lead to a better evaluation of the data. But, put the same physician in a market situation and he/she may make the same sort of mistake as the parent.

31 July, 2005 14:46  
Anonymous JonBuck said...

One thing I'd like to add...

In defense of the non-expert, someone from the outside looking in can sometimes see what they cannot. As a scientist, or a librarian, or a financial analyst, you're trained to think in a certain way. If you're not careful it can become dogma. You get tunnel vision, unable to see outside of your training.

The fault with that parent was her own certainty that she knew more than the doctor. It was not that she had suggested another cause for her child's autism.

31 July, 2005 15:57  
Anonymous Anonymous said...

When your child is diagnosed as autistic, or with Asperger's Syndrome, it's as though the earth has stopped spinning on its axis. You worry that your child will never learn to communicate, that they won't bond with others, or ever be able to function on their own. When the rest of your kids are normal, you tend not to think of genetics as the primary cause.

That parent has probably googled for every link related to autism, and read some of the pseudo-research conducted on the mercury link. Living with the issue day in and day out can leave a parent all too ready to blame whatever outside agency may be suspect.

A little knowledge is a dangerous thing . . .

31 July, 2005 16:58  
Anonymous Anonymous said...

Regarding Mr. Buck's comment about "dogma" and "tunnel vision" on the part of experts, nonsense. Some individuals of any variety of training might be dogmatic, but in general experts are not, especially in the sciences where doubt and evidence matter so much. It's a myth, a stereotype of the expert. It's one of those things that enables the layman to think he's entitled to draw his own unsupported conclusions and dismiss the expert opinion, but it's simply not true in general.

31 July, 2005 19:51  
Anonymous Anonymous said...

Don't think this only infects Science or Medicine.

There is a disturbing anti-learning anti-intellectual tone running through society, where anyone with a magazine subscription or an internet connection is an expert on everything. As an Architect, I have had to deal with clients believing the advice of thier golfing partner trumping years of experience of a trained professional and a contractor with years of successful projects under thier belt.

01 August, 2005 07:50  
Anonymous Steve said...

I agree wholeheartedly with the overall sentiment of this article. I've expressed a similar view on my own blog.

I'd like to address something mentioned above - where Anon. Y. Mous said that the stereotype of 'scientific dogmatism' is (essentially) hogwash. I would suggest that Mr. Mous has probably not attended college anytime recently, or, failing that, has not read the stuff written by the actual scientists doing the research. Spending a few days reading findings from scholar.google.com will shed some light.

There is very little consensus in the Scientific Community (roughly defined as the loose group of people 'qualified to comment on scientific matters by dint of education or direct experience'); As the post mentions, the vast majority of those who get degrees in science end up doing something that is less than... cutting edge. Those people tend to express things to the world as 'facts', when they may or may not know that scientific facts are generally percieved as the most commonly held veiws of the scientific community - which is theoretically the veiw with the most experimental and methodological analysis and supporting evidence, but is often political - and never mention that there is a significant division in the 'scientific community', and some significant portion of the scientists involved in research about said 'fact' would disagree.

I see it happen like this: Brilliant Person does scientific research as a graduate student or professor; Extremely Bright But Not Brilliant Man studies with B.P.. He hears B.P. say "I think that *X* is probably the case!". E.B.B.N.B.M then goes on to become a professor at another University. Smart Man then attends said University; his Professor learned *X* at the Knee Of Wisdom, or B.P., and informs his students that B.P. said X was the case. Said students leave school with degrees, believing that "X is the Case" is a *fact*; Meanwhile, B.P. has gone on to a different explanation because the experimental data had some problems.

Knowledge is fluid, and a good scientist must be willing to abandon a 'belief system' when the evidence opposes it; Institutions are inertial and slow moving, and have no such internal conviction. It has been demostrated frequently over the years.

01 August, 2005 08:50  
Blogger TDG said...

"A real scientist has to learn a prodigious amount of information, true enough, but the real emphasis is on learning how to think."

Upon being told by a graduate school professor on the first day of Volcanology that he was going to teach me how to think, I was filled with all of the indignation that I now imagine non-scientists feel when being told they don't understand the thought processes of scientists.

Well, to this day, I don't know how he did it, but that professor was correct, and not arrogant at all. I try to remember my pre- Volcanology days when discussing scientific topics with non-scientists, who tend to consider me just an ornery skeptic - a misanthrope because they don't think the same way as a scientist.

Tunnel vision? Dogmatism? In poor scientists, perhaps. Scientists with an agenda, maybe (e.g., the climate change cartel at IPCC). An outsider seeing something a scientists hasn't? Well, certainly possible, but I would say more likely that they see something already considered from a viewpoint which is different than that of the scientist. But considering that most scientists walk around with multiple working hypotheses in their heads for each observed phenomenon at any given time, the liklihood of seeing something completely unthought of previously is on the low side.

One doesn't receive the title Doctor of Philosophy for being an ordinary thinker, in the snese of "the way the average person thinks about an issue."

01 August, 2005 10:14  
Anonymous JonBuck said...

The point I'm trying to make is that any institution is subject to groupthink and decay if it turns too far inwards on itself. Just because you've been taught how to think scientifically doesn't make you immune to these things.

01 August, 2005 10:18  
Anonymous Anonymous said...

Um. Individual SCIENTISTS may be subject to group think. Science as a whole....considerably less common.

The classic example is continental drift...where Wegner's notions were not rejected...they were not accepted until supporting evidence generated not only support, but an overarching theory that explained drift plus other phenomena.

01 August, 2005 10:32  
Anonymous Steve said...

" Um. Individual SCIENTISTS may be subject to group think. Science as a whole....considerably less common." -

How can an individual be subject to 'group think'?

I think that we agree - *research scientists* are not typically prone to dogma; as has been pointed out, they generally have multiple working hypotheses at any given time, that have different assessed probabilities in their heads.

However, institutions - the education system where most people get their exposure to science - can and are often subject to dogma and the dissemination of outdated scientific thoughts and models. I can tell you with some confidence that there are lots and lots of computer science programs teaching outdated and antiquated concepts to students who really don't know any better. Because the educators involved have had no cause to update their knowledge, not working in the 'real world' nor in 'research'. I have noted some similar events in biology and evolutionary research, where the researchers in the field have gone beyond the simplistic initial postulates to address some of the more complex consequences of evolutionary theory, while biology teachers still pass on an understanding of evolution acquired in the fifties.

You may reasonably object that these are not *scientists*, and be absolutely right; but remember that they are the very face of science to nearly all non-scientists in America. So, whilst I agree that it's extremely unlikely that a research scientist will evince dogmatic conviction, educators and practical scientists are not so immune from the demon dogma.

01 August, 2005 14:08  
Anonymous Anonymous said...

Scientists are a bit of a special case, since they are explicitly taught to think and base their conclusions on experimental research... the same cannot be said of other fields such as economics or political science, where it seems most 'experts' choose an ideology early on and then spend the rest of their careers defending it.

For an interesting take on how a non-expert can make an important dissenting contribution to a field of study, you might want to look up Terry Jones book "Chaucer's Knight", in which he applies his knowledge as an amateur historian to produce a reanalysis of the Knights Tale that both differed strongly from accepted opinion at the time and which provided a much better explanation of Chaucers text than was currently available.

02 August, 2005 06:31  
Blogger van.mojo said...

As a former journalist, I can relate a saying we used to have: "You don't talk to a plumber about laying bricks..."

mojo sends

03 August, 2005 16:34  

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