Posted by rndsignals 13 hours ago
In closing, my Redfin escapism has shifted to LLM medical escapism, I know better but if you don’t or you are in even more dire straits, it provides such an illusion of hope and that’s dangerous.
MD doctors poll at extraordinarily high levels of trust, over almost any other professional group in the United States. So it really isn't correct to directly link this article's topic to "distrust". The effect you're talking about may exist in science, but this article is essentially a counter example to the effect you propose: clinicians publishing bullshit, but retain a high level of public trust.
Especially because the article is basically entirely quoting practicing scientists who identified this problem in the first place! More real scientific training or collaborating for clinicians who want to (or have to) do research could potentially improve the situation.
People are people.
By your definition, every human endeavor is dismal and always has been - all are corrupted and flawed to some degree. Is there evidence that current science is more dismal than others or than before? You can look at any day in history and see people saying the same things about how it's so dismal and not like the good old days.
> No wonder the general public distrusts "the intelectual elite", we deserved it.
The general public has no idea about scientific publishing, publish or perish, or the distorted incentives it creates. Science has delivered at an incredible level for centuries, arguably more than any other human enterprise. Covid-19 vaccines were available in record time - it wasn't the science that caused it to go somewhat off the rails.
peer review is built to assume good faith work by people who are all part of a community of scholarship, it can partially hold up to people within the community gaming metrics. if people are just going to appear, game the system to publish some papers, and then disappear into their real careers, there's no hope of this working.
i don't understand why residencies want med students to publish papers anyway. it's very difficult to do good scientific research, it requires training, time, and almost always apprenticeship. none of this is part of the medical school curriculum, which is why we need special MD-PhD programs for people who want to do both. nobody expects that doing a PhD in biology or epidemiology would give you any clinical know-how, why is it reasonable to expect the reverse?
I'm mostly saying that being reproducible should become a higher badge of quality, right now reviewers in cartels can boost a researchers credibility by accepting each others articles to papers to let them become "influential" and money is then redirected even more to bullshit research (ie pure waste).
If up to 50% of research grants is spent on bullshit research based on fraud, spending 10% by earmarking it for reproduction to weed out irreproducible fraud is money well spent.
For certain specialties, the number of residency positions is so limited that medical students have to publish research to be competitive, even if they have no interest in doing so later in their career.
But altogether I sort of agree, the incentives are pretty maligned such that for many it's just easier to become a bad scientist with more publications than a good one with fewer.
But certainly we should always approach the literature critically, including the author list, journal of publication and its peer-review practices, and the methods.
How do you propose the interested public make the distinction between genuine engagement and forced encouragement? Isn't it the task of journals to make that distinction before publishing? I don't think you can fault the public for dismissing everything out of hand when both academia and the journals are actively turning scientific publishing into a market for lemons.
"I'm a software engineer, I'm sure if I had the time to study Neuroscience, I'd figure out what all of these researchers failed to realize all these decades! I (alone) have the magic of critical and logical thinking"
But I agree, when youre on the internet no ones knows you're a dog.
Would you publish if the head honcho of your double-blind study insists to know what treatment a certain patient is receiving?
You have this discussion about research ethics and subsequent beratement once, and then you either mentally check out or go to another hospital.
Do most medical students publish useless case studies trying to jockey for residency spots and signal hustle/devotion? No doubt!
But there are a good handful of medical students who are still (surprisingly) in it for the medicine and not the money. And that handful is exceedingly capable; no reason they can’t publish valuable work with the right collaborators and resources.
Despite h-index claiming to balance quantity and quality, it obviously incentives quantity over quality (no single publication can increment h-index as much as churning out a few worthless publications that cite each other); med students overwhelmingly follow those incentives trying to secure better residencies
Medicine was among the worst if not the worst according to him. Didn't really want much to do with it anymore. Basically a case of subpar statistical knowledge and bad incentives.
Totally different if someone's self image is that of a researcher for benefit of humankind or if they pick the career because they want to drive a Porsche.
Such obvious common sense appears not obvious after all.
If medical residents, or teaching hospitals, want people to do research, they should go get funding from established research funding sources that have standards and practices for funding and monitoring research.
It's medical students, not residents, who take research years, and that's only for extremely competitive specialties.
The lack of doctors, as it has always been, is because of the shortage of residency spots.
That cannot be addressed without Congress reversing 50+ years of neoliberalism trends and political failure and refusal to invest in public services and/or a communist revolution. Good luck fixing that.