Re: Dr. Jain, please explain why you disputed another Dr.'s diagnosis of ADHD

[Wgreen]

Well, under normal circumstances, I would imagine patient-doctor confidentiality rules might preclude Dr. Jain from answering a question like this. But he testified in open court (which would seem to waive confidentiality.) Still, I’m not sure it’s pukkah for a psychiatrist publicly to discuss, much less defend, any individual diagnosis. But, of course, I’m speaking out of school.

Having said that, this case you dredged up certainly illustrates one thing: that “expert” opinion is just that—opinion. Nothing more. Here we have two credentialed doctors examining the same evidence, then reaching two completely different conclusions.

After the lively debate on “ADD: gift or curse” we just had on a different string, I went back to read David H. Freedman’s book, “Wrong: Why Experts Keep Failing Us — And How to Know When Not to Trust Them.” The book had its genesis in a conversation the author had in a Boston coffee shop with John Ioannidis, a doctor, researcher, and expert statistician whose specialty is calculating the chances that scientific studies’ results are false. (He does a lot of work for drug companies and the National Institutes of Health.) His work has revealed that most (2 out of 3) scholarly studies come to erroneous conclusions. By extension, he posits that most “experts” are simply… wrong. http://www.nytimes.com/2010/06/11/books/excerpt-wrong.html?adxnnl=1&adxnnlx=1313877335-dI7Hhu9eoXGpnPpZQq5hrQ&pagewanted=1

From the book’s introduction:

“The facts suggest that for many, if not the majority, of fields, the majority of published studies are likely to be wrong,” [Ioannidis] says. Probably, he adds, “the vast majority.”

Medical and other scientific expertise aren’t exactly the bottom of the barrel when it comes to expert wisdom. Yes, much-heralded drugs get yanked off the market, we get conflicting advice about what to eat, and toxic chemicals make their way into our homes. But you don’t have to dig far in pretty much any other field to see similar, or worse, arrays of screwups. I could fill this entire book, and several more, with examples of expertise gone wrong — not only in medicine but in physics, finance, child raising, the government, sports, entertainment, and on and on. […] The fact is, expert wisdom usually turns out to be at best highly contested and ephemeral, and at worst flat-out wrong.

Of course, compiling anecdotes and quoting experts about expertise doesn’t prove that experts usually mislead us. Actually, proving expert wrongness isn’t really the point of this book. I’ve found that most people don’t need much convincing that experts are usually wrong. How could we not suspect that to be the case? We constantly hear experts contradict one another and even themselves on a vast range of issues, whether they’re spouting off on diets, hurricane preparedness, the secrets to being a great manager, the stock market, cholesterol-lowering drugs, getting kids to sleep through the night, the inevitability of presidential candidates, the direction of home values, the key to strong marriages, vitamins, the benefits of alcohol or aspirin or fish, the existence of weapons of mass destruction, and so on.”

So. There we have it. When it comes to coping with our problems, it appears we’re basically on our own. That should brighten up our day! I think I’m going to go lose my keys, lose my temper, and bump into a wall…

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