Semiannual Social Media is Terrible PSA

Here’s a little exercise adapted from “You Really Need to Quit Twitter” in The Atlantic:

Step 1: Take the Simone Weil essay  “On the Abolition of All Political Parties” and replace the word “parties” with something that maybe shouldn’t exist, like social media:

The mere fact that social media exists today is not in itself sufficient a reason for us to preserve it. The only legitimate reason for preserving anything is its goodness. The evils of social media are all too evident; therefore, the problem that should be examined is this: Does it contain enough good to compensate for its evils and make its preservation desirable?

Step 2: (Oh well I still have my Twitter account).

The Limitations of Copy and Paste

From “To Kickstart a New Behavior, Copy and Paste” by Kathy Milkman, author of the new book, How to Change, which suggests the best way to master a new skill is to emulate the methods of someone successful.

Happily, it’s easy to turn yourself into a deliberate copy-and-paster. The next time you’re falling short of a goal, look to high-achieving peers for answers. If you’d like to get more sleep, a well-rested friend with a similar lifestyle may be able to help. If you’d like to commute on public transit, don’t just look up the train schedules—talk to a neighbor who’s already abandoned her car. You’re likely to go further faster if you find the person who’s already achieving what you want to achieve and copy and paste their tactics than if you simply let social forces influence you through osmosis.

Kinda maybe sorta.

There is a big, big difference between emulating psychosocial habits (like vegetarianism or fashion) or noncomplex skills (like a workable commute route or some forms of regular exercise) and achieving success in a skill-based habit like practicing medicine or playing an instrument.

For low-stakes or low-commitment behaviors, sure. It’s reasonable to try to save time and give yourself the boost of something that has worked for someone. Copy-paste saves you from analysis paralysis.

But copy and paste is also a guaranteed way to fully embrace survivorship bias. You don’t know if the people you are emulating succeeded because of their methods or despite them. You don’t know if those methods are optimal for you or if the most important aspects of said methods are even those which are externally visible or consciously retrievable from the expert.

A lot of people don’t know why they’re successful, and their attempts to craft a narrative about their successes are fiction.

And when it comes to experts instead of peers, one of the common difficulties for many is that it’s been so long since they’ve been a novice that they literally don’t know what it’s like anymore. Their memories of their early growth are fuzzy and often out-of-date to boot.

As we are back in the middle of USMLE Step season for the medical students among you, I am reminded of this post I wrote in 2014 about the Methods to Success Fallacy.

Underwriting is Noisy

An example a brief essay “Bias Is a Big Problem. But So Is ‘Noise.” about noise and decision-making in the NYT by Daniel Kahneman and his co-authors in support of their new book Noise: A Flaw in Human Judgement:

Consider another noisy system, this time in the private sector. In 2015, we conducted a study of underwriters in a large insurance company. Forty-eight underwriters were shown realistic summaries of risks to which they assigned premiums, just as they did in their jobs.

How much of a difference would you expect to find between the premium values that two competent underwriters assigned to the same risk? Executives in the insurance company said they expected about a 10 percent difference. But the typical difference we found between two underwriters was an astonishing 55 percent of their average premium — more than five times as large as the executives had expected.

This is why you don’t buy an insurance policy from a captive agent; you purchase through an independent agent who can get quotes from multiple companies. Every decision is subject to bias and noise, and they are separate and independent problems (i.e. both inaccurate and imprecise).

The easiest way to push both in your favor is through multiple independent attempts.

Student loan debt predicts burnout

From “Predictors Between the Subcomponents of Burnout Among Radiology Trainees” by Le et al. in JACR.



In summary:

Debt level < $200,000 was associated with lower [emotional exhaustion] scores among upper-level trainees and was the only predictor of burnout that significantly affected multiple years of training.

I suspect there is a dose-response above that debt level as well.

Uncertainty breeds despair. Make sure you develop a student loan action plan.

Regulatory controls and not-so-free markets

Not just doctors but all sorts of students and professionals scrambled to figure out how to deal with their high-stakes exam during the pandemic. Lawyers were no exception. Some states had new lawyers take the bar remotely. But a few states just got rid of it altogether and allowed diplomas from accredited schools to stand on their own.

NPR’s Planet Money, “Most People Can’t Afford Legal Help. 1 Reformer Wants To Change That” is an interesting quick discussion of slowly changing legal regulations that has plenty of parallels with medicine:

The National Conference of Bar Examiners, which helps states administer the bar, argues that the bar remains important in protecting the public. “Every high-stakes profession, including engineering, medicine, aviation, and others, relies on licensure to ensure that practitioners meet minimum standards of fundamental competency, and the practice of law is no exception,” the organization said in a statement.

But Gillian Hadfield, a law professor and economist at the University of Toronto, argues there’s no evidence that the bar actually protects the public. She thinks not only it is time we reevaluate use of the bar exam — it’s time to completely revamp how we regulate the practice of law in the United States.

The bar exam, she says, is one part of a broader system that raises the cost of legal services and contributes to an “access to justice crisis” in the United States. “My estimate is well over 80% of Americans who need legal help can’t get it because it’s too expensive,” Hadfield says. “And the main reason for that is a crazy regulatory system. The bar exam is part of that.”

It’s kinda like cafe baristas getting control of the coffee market by using the regulatory system to prevent restaurants, Keurig machines, and gas stations from providing you coffee. They’re like, “It’s for your safety! You could get burned or poisoned! The coffee will be worse!” Meanwhile, a cup of coffee costs $20.