M.Ds know things, that's the point! Have we been trained for scientific thinking? Absolutely, totally not. Test your mother on basic statistics and scientific reasoning, and you will quickly see the limits. This has absolutely nothing to do with being a decent doctor or not. Now, you are going to tell me she can read the scientific literature and make sense of it? Medicine is caring for patients, meaning applying knowledge. Knowledge applied in the clinics is mostly passed through practical training from generation to generation. Arguably, the decisive factor of change in medicine has up to now always been technology: a stent in an artery, ether anesthesia, organ transplant, etc. A certain base of irrefutable knowledge is present, of course, but it is proportionally small compared to the amount of downright false information we get from clinical trials.

We could debate for hours on that subject, but I dare say that someone who believes that most M.Ds can do real science is very wrong. Statistics done by M.Ds is akin to a junkie cooking meth. He knows how to make it, but has no idea why sometimes it goes wrong. Moreover, you drastically underestimate the dishonesty of the "experts" you are citing.

She doesn't do statistical studies, no. But I think she has good sense of the relative confidence she can have in "new discoveries" and older institutional knowledge (which also isn't 100%). And sometimes she puts in more time and attention than a few previous doctors did, considering all the symptoms and previous attempted treatments, to come up with an accurate diagnosis and effective treatment. By not being dogmatic, and spending a bit more time, she can fix some things.

I don't usually "do science" the statistical way either, I usually come up with a plausible theory for a bug, fix it, and use the results to confirm or refute my theory of that one bug. Usually it's something dumb, simple, and obvious in hindsight, not a whole new algorithm or technique.

MDs are not the only ones doing medical research.

That is indeed a valid point. Unfortunately, most of biology can also be qualified of "soft science". I however expect that a new age is coming for medicine: the age of science (the real one, this time). We are already seeing the birth of sizable databases exploited by professional scientists, but this is still a very minor part of the research output, and the signal-to-noise ratio is currently dismal. Additionally, the progress of medicine is somewhat parallel to the progress of hard science. What is lacking the most, is solid data and the methods to collect them.

Ironically enough though, "hard scientists" wandering into biology and medicine and going "Right, time to show you lot how real science is done..." are notorious for producing really awful research.

>medicine is often like debugging a large complicated messy system...

A system, that you didn't write and don't have access to the source, Now, try fixing a large and complex software system only by observing inputs and outputs only.

This is not even going into the fact that how every one will be running a slight different version, which might also be influenced by a million factors such as environment, food habits and past and current medications....

It is virtually impossible, even for moderately large software, even without considering the latter..

Problem is that if she screws up, someone might die. I would be terrified if someone approached the medical profession the way people do software development.

Doctors are human too. Medical error is pretty common. It's not just doctors, either; every healthcare professional is affected.

Recognizing this fact led to studies in patient safety.

https://www.ncbi.nlm.nih.gov/books/NBK2673/

It's a really interesting read, especially the chapter "Basic Concepts in Patient Safety".

I find it notable that greater safety is achieved by avoiding reliance on memory. The amount of memorization in medicine is astounding. When I tell my friends there's no shame in looking something up, they look at me like I'm some kind of madman. "What will the patient think? If you can just look something up, why have doctors at all?" Yet this article clearly advocates the use of checklists to make sure nothing is forgotten.

You're right, there are differences - medicine is more rigorous (in a sense), processes are more regulated, there's more "standard procedure" which is more specifically taught and widely followed.

But doctors screw up all the time. Sometimes it's dumb mistakes like instruments left in the body after surgery, or the wrong limb operated on. (Like failing to check length when copying a buffer perhaps? Sometimes it's just a bit embarrasing, sometimes catastrophic.) More often, it's just not finding the real cause of the "bug", applying a "fix" or "cleanup" that doesn't fix it.

But applying the same logic to other professions does not work in my opinion.

For example, if a pilot screws up, people die, lots of people die.

Unfortunately, there are a whole bunch of professions where it's not really ok to be "Oops, my bad". And those are the professions that I would say need the most rigor (yet with enough flexibility to catch unknown corner cases) in general.

So it's not really debug but more likely post-mortem. =(