Stop revering doctors

Warning: Non-sports post. And, this is only tangentially related to the recent "should employers' insurance companies have to pay for employees' birth control" controversy, or Rush Limbaugh's response. My arguments do not depend on which side of that debate is correct. They apply to only one small aspect. (If you're not familiar with the debate, Google "Sandra Fluke".)

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A little while ago, Steven E. Landsburg decided to post about some of economic issues surrounding the question of employer coverage of contraceptives. He was critical of Fluke for demanding free birth control without providing a good economic reason why. He then got in trouble from the president of the University of Rochester, where he teaches.

Afterward, reporters started calling him for comment. One reporter asked him,

"Do you think that “reasons” accepted by an economist deserve more weight and respect than “reasons” a medical doctor might have for recommending that birth control be universally covered by medical insurance?"

Landsburg replied,

Yes, absolutely. Here’s why: Economists are trained to look at all the consequences of a decision before passing judgment; doctors tend to focus only on some kinds of consequences (those directly related to health) while ignoring others (for example, the many other effects that flow from raising people’s taxes or insurance premiums). ...

Economists have thought long and hard about how to make sure we do that. We don’t always get it right, but at least we’ve got a framework for it. Doctors don’t.

Landsburg is, of course, absolutely correct.

Why would this reporter, or, anyone, think that a doctor was as qualified to talk about an economic question as an economist is?

Because we respect doctors too much. We respect them well beyond the scope of their expertise. We somehow think that they're better and smarter than the rest of us, and we have this unspoken feeling that their opinions have extra weight, because of their higher class and status.

It's certainly not that we need their subject matter expertise to argue the question. Because, suppose Sandra Fluke had stepped up before Congress to demand that the car companies include oil changes in their warranty coverage. And economists disagreed that that was a good idea. And suppose the reporter had asked,

"Do you think that “reasons” accepted by an economist deserve more weight and respect than “reasons” an auto mechanic might have for recommending that oil changes be universally covered by warranty?"

That would be laughable. It's equally laughable when it's a doctor.

I think it's all a matter of pecking order. Doctors have high status, and auto mechanics have low status.

Economists have high status too, but significantly lower status than doctors. To see that, imagine the situation reversed, where Landsburg said something about medicine -- say, about why birth control works, biochemically -- and a doctor corrected him. And the reporter asked the doctor,

"Do you think that “reasons” accepted by a doctor deserve more weight and respect than “reasons” an economist might have for understanding how birth control works, biochemically?"

That question answers itself. The other one should have, too.

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P.S. A previous post about doctors overstepping their expertise is here.