My impression is that the article is based on the false premises: it starts with the number 5.25 years<p>"According to Bunker, the average person gains about 5.25 years due to medicine"<p>and then calculates "year of life the doctor saved" based on that. That's wrong.<p>The counterexample: the kid breaks the leg. The leg will "heal" even without the operation, but the form will be altered: the kid will never be able to walk normally, do the sport normally, anything you imagine (a). A few operations are performed on the kid's leg, afterwards he walks normally, lives the rest of his life normally (b). Now if the person having the problems in (a) lives the same number of years as the fully healthy (b) the statistics the whole article calculation is based don't show any contribution of the given operations, whereas these operations really did "save life" in the sense of giving somebody a healthy life that he otherwise wouldn't have.<p>There are immense number of equivalent examples and all are ignored in the article. Much more lives are effectively "saved" by the modern medicine than the author can see. We can also consider the lives of the family of the patient also effectively "destroyed" without the medicine.<p>(In short, the article appeared as (stereotypically said, more as the strong figure of speech not actually addressed at the specific author) written by 20-something male who hasn't first-hand experienced medical problems even in his family. I wasn't able to find more about "Gregory Lewis" who wrote it, but the whole "80,000 Hours" project site, on which this 2012 article was published was the result of the 2011 initiative of two Oxford students, and maybe that gives some idea about the setting.)
How many lives has the medical industry destroyed by artificially limiting the supply of physicians?<p><a href="http://pulitzercenter.org/reporting/north-america-united-states-residency-doctor-shortage-congress" rel="nofollow">http://pulitzercenter.org/reporting/north-america-united-sta...</a><p>How many lives has the pharmaceutical industry destroyed by selling harmful substances?<p><a href="http://www.amazon.com/Bad-Pharma-Companies-Mislead-Patients/dp/0865478007" rel="nofollow">http://www.amazon.com/Bad-Pharma-Companies-Mislead-Patients/...</a>
A person with medical qualifications once chose to pick up garbage for a living instead of practising medicine. When interviewed they said that they saved more lives in a month by working as a sanitation engineer than they would during their entire career as a doctor.
Related: how many lives does a doctor take? <a href="https://www.youtube.com/watch?v=X0xC7DCYHkM" rel="nofollow">https://www.youtube.com/watch?v=X0xC7DCYHkM</a>
"I want to study medicine because of a desire I have to help others, and so the chance of spending a career doing something worthwhile I can’t resist."<p>Let's get real--this is said over, and over again, and I've never bought it. I won't go into the mind of the typical pre-med student, but being altruistic is not a trait I have seen in U.S. Medical students, and their sense of altruism doesn't improve with age.<p>It's a short article, and I honestly didn't read it closely, but I'd rather have it titled "How many lives does a doctor improve?"<p>There are a few questions I ask myself, whenever I meet a new doctor, and it's these; "What is this doctor's estimated kill card(the patients who died under their care), and does this doctor make conditions worse?"<p>I do take external factors into account when I make this unscientific judgement call; like the doctor's willingness to take on the sickest patients. The socio-economic status of the doctor's patients. The real reason this person became a doctor(it's usually not that hard to figure out on first impressions). I can usually spot the soley financial ones, and run!<p>(I have met a few altruistic doctors, and will bend over backwards to help them, or make their practice easier. They are appreciated, and respected! They are few and far between these days though? I don't know if the profession changed, or I changed?)
Past a certain point, medicine doesn't seem to improve health: <a href="http://www.overcomingbias.com/2007/05/rand_health_ins.html" rel="nofollow">http://www.overcomingbias.com/2007/05/rand_health_ins.html</a> and <a href="http://www.overcomingbias.com/2007/05/rand_health_ins_1.html" rel="nofollow">http://www.overcomingbias.com/2007/05/rand_health_ins_1.html</a>
Consider the following individual when you think about this question:<p><a href="http://www.wwltv.com/videos/news/health/2015/07/28/trauma-surgeon-saved-countless-lives-before-his-death/30816011/" rel="nofollow">http://www.wwltv.com/videos/news/health/2015/07/28/trauma-su...</a><p>Norman McSwain was one man but through his work developing PHTLS (Pre-Hospital Trauma Life Support) and introducing modern EMS practices to numerous countries around the globe he truly did save countless lives. He has been credited for doing more to reduce the homicide in New Orleans than any mayor or police commissioner because he taught the trauma surgeons that increased survival from penetrating wounds and was an incredibly skilled surgeon himself. His work with the Tactical Combat Casualty Care Committee helped reduce battlefield fatality rates to historic lows.<p>The statistics don't take into account the kind of doctor you choose to be. If you choose to join a posh private practice and treat little old ladies who "just don't feel quite right" you may not save a lot of lives. But if you choose to be on the front lines, for instance one of the last doctors out of Charity hospital after Katrina, and spread knowledge far and wide you may just save more than "ninety lives".<p>We all get the same 24 hours in each day. Norman just used them better than most of us.
The webpage pops up a modal overlay that completely hides the article and asks for email list subscription. Well, trying to subscribe bounces over to a different subscription page that asks to fill out a name and university, but to leave the university blank if it does not apply. But trying to submit that form fails with a validation error that university field cannot be blank. <i>closes tab</i>
I would be more interested to see a life saving face-off between going to medical school and basic science. Since the golden era of physician/scientists ended, the vast majority of life improving technologies have come from science specifically, while medicine enjoys massive amounts of credit for science's advancements.<p>U.S. graduate schools are filled with people from other countries, because students know that compensation for scientific careers is awful. We squander enormous amounts of intellectual capital making physicians, while people involved in nobel-prize winning advancements often have to leave their careers for lack of funding (c.f. <a href="http://discovermagazine.com/2011/apr/30-how-bad-luck-networking-cost-prasher-nobel" rel="nofollow">http://discovermagazine.com/2011/apr/30-how-bad-luck-network...</a>). It's a horrible failure of our medical system that the incentives are so misplaced.
It's a super interesting topic to explore. Investigating how much bang we get for a buck in medicine is a touchy subject because when I'm ill I want the very best but while I'm fine I'm more willing to consider trade-offs.<p>Keeping that in mind I think that averaging numbers is not a great representation of doctors impact, the same way average latency isn't a great representation of what users see. What's the 95% percentile of QALYs? E.g. are doctors making one life (e.g. kid with a broken leg as mentioned in a comment here) better for 50 years when 9 people will just never break a leg?<p>If looking at shifts in distributions the story <i>might</i> (I could not find raw data) look very different.
A 51 year old man came into the hospital yesterday with chest pain. He was having a major heart attack. I watched the cardiologist catheterize and stent his coronaries. i saw the moment that the stent opened the coronary artery. I saw the blood flow restored to the left heart. The patient was 51, and that doctor, with the flick of his wrist, added decades to the mans life. That doctor does this everyday.
One thing that confuses me in the conclusion of the article is the assumption that you can either be a doctor, or you can donate to charity and get much more impact. Porque no los dos?<p>(i have no idea how much doctors are paid; is it not a good career path from a financial perspective?)
<i>Is medicine a good career choice for someone wanting to ‘make a difference’?</i><p>I wish people would stop using that phrase. Stalin "made a difference."