I understand that feeling of incompetence when you watch them look up symptoms in front of you. But think of it like a programmer digging into a language’s documentation or a structural engineer looking up calcs in a load table. You can’t be expected to remember every single detail. And it requires tons of experience to trust the result you’ve chosen. In other words, would you rather have a practitioner that works purely from memory, or one that checks their assumptions against the corpus before making a diagnosis?

If I hire a web application developer who says they are proficient in JavaScript, I expect them to be able to get moving without checking documentation constantly. Certainly they should check it to confirm a hypothesis or to jog their memory on individual API calls, but any decent senior programmer need not check the docs for simple things, or at least they will start with an idea of what they are looking for "I know there's an API that does this..."

The doctors I encounter are the equivalent of a junior developer right out of code school, checking the docs for everything. That might be OK, if we were paying them commensurately with their value add.

Using the same analogy, when you hire a JavaScript developer they are going to know a ton about JS itself, but nothing about your internal libraries and system, and that's something they are going to catch up on when they can, and for a large enough system, they are going to probably gain domain knowledge in a specific portion of your code base. However, they will know how to make an array, class, subroutine, etc. (I'm not proficient in JS right now, and would probably have to look all this up - in perl I can do it without thought).

Similarly, my doctor _should_ know how human anatomy and microbiology work by default, but the person that they are speaking to is essentially a black box. When that black box is diseased, then it's as if the body has imported a library. They cannot easily check the source code to determine which library they have imported or what calls it is making, so they hunt through a bug database to determine which library they have imported and what the code is doing, and then they have to find a way to get that code out of the system, still without access to the source. Of course, they will probably know some things (sinus infection, flu) by default, but medical science is constantly updated. Still, that knowledge of anatomy, microbiology, etc., is tantamount in being able to accurately use that data for assessment.

> they are proficient in JavaScript, I expect them to be able to get moving without checking documentation constantly

You might need to adjust your expectations.

I check documentation all the time because I can't remember what language uses 'size', 'size()', 'length', 'length()', 'count', or 'count()'. I have no value in memorizing those facts because I can simply look them up.

To be fair, the web developer's work probably doesn't lead to someone else's health decline or death if they misremember something.

Yeah, if my bugfix was scheduled three months out and had to be figured out, implemented and merged during a half hour appointment without making things worse-- I would read the docs for literally everything, and probably copy-paste from them to avoid typos

I guess the point is that they're largely technicians drawing from "the literature" (doctoring books, research, as well as user manuals for drugs and instruments). With a ~first year grad school level of understanding bio/chem pretty much anyone can be a competent technician in 90 percent of cases, and literally anyone can implement a cure so long as they can read the instruction manual (and it isn't tricky surgery).

I dealt with an RSI issue and had a similar experience where traditional hospitals and MDs did not help. I needed to go outside that system to get help. The hospital system is simply not setup to deal with those things; it is setup to deal with people who are possibly going to die. Imagine this is your job: the city you live in collects all the people who are so seriously sick or injured that their families/friends are worried they might die and brings them to you. You have to deal with all of them. Any of the people you can't assist don't get treatment and their illness takes its natural course. Now imagine how much of your training is focused on RSI.

If you think of a modern hospital as a direct organizational descendant of a war triage hospital, albeit one that is dealing with the health issues that kill the American public (generally cancer, heart disease and other manifestations of our unhealthy lifestyles), then you will have a better idea of when to go there. i.e. your problem must be acute.

But I'm not talking about hospitals. I'm talking about clinics filled with general practitioners, dermatologists etc.

Reminds me of how software engineers just regurgitate what stack overflow says.

Second that. But those engineers are not paid anywhere as much as any doctor and there is no artificial limit on engineer supply.

Yes - but they start accumulating wealth in their early 20s. That gives them at 10+ year head start on the average physician who finishes paying off their debts at ~35.

However, few mediocre software engineers make 200k/yr. Most mediocre doctors do make >200k/yr.

Software engineers aren't $200k+ in debt at 32 either.

If you are an average salaried software engineer, you can accumulate more wealth than a doctor if you invest at recommended rates. The break even point is somewhere around 60-65 years of age.

Really, I'm curious care to share your calculations? What salaries are you using? What about cost of living?

A doctor can work in any city in the world, an engineers can work in less than 10 cities.

What a ludicrous statement. Pretty much any mid-size to large city has jobs for software engineers.

Not if you want to make $200k.

Maybe I should have said "guaranteed employment for life" instead of just work.

Irrelevant of the salary, most medium cities will only have a handful of tech roles available, at best. It's super hard to find and hold a job.

It's more difficult to gain admission to veterinarian school than medical school (in America).

Veterinarians pay about the same for their schooling (but they don't really have residencies) and vets make ~70k-80k/yr.

If we think of a job's salary as a function of the talents used by the job and the cost of admission to the job, it's unclear why doctors and vets should earn substantially different amounts of money.

But I agree that it's easier to accumulate wealth as a non-doctor than a doctor. Just treat the first couple years of your career like medical school and it shouldn't be too hard to crack 6 figures - if you live modestly outside a megaopolis, you can save 40k/yr and get a six figure headstart over a doctor.

What's your cross-industry metric for defining "mediocre"?

> some kind of medical Google

https://www.uptodate.com/home

Many Univ. alumni associations will provide access to UpToDate along with their regular academic journal access library. My Univ. was an upfront $200 lifetime fee or a $10/year fee. Compared to NetFlix, the benefits are insane and obvious.

I'd have to agree that they aren't very good at solving certain issues that aren't just acute and short-term. I had been developing worse and worse shoulder, neck, and back issues from sitting at desks and working on computers.

The doctor wanted to prescribe muscle relaxers and pain relievers, and suggested I try massage therapy. While those things helped some of the symptoms, what completely transformed my situation was hiking and doing yoga (especially yoga). I never have pain like I used to in my back, neck, and shoulders and any that does arise never lingers like it used to.

My doctor did not suggest yoga or hiking (or exercise in general) to solve the issues I was having. I know it's an anecdote, but in general in my life doctors seem to try to be experts on matters of health yet can't seem to help with basic beneficial suggestions for certain issues.

The medical equivalent to Google I see all the time is uptodate.com

Funny that you mention Mayo. Their doctors are paid mostly on a tenure basis and their income is not based on how many patients they see or what kind of procedures they decide to perform on them, unlike in most other places. It's still not cheap, but there's less of an incentive to milk the patient or the insurance company.