(2021-02-05) Alexander Webmd And The Tragedy Of Legible Expertise

Scott Alexander: WebMD, And The Tragedy Of Legible Expertise.

I started a small database of psychiatry information. In some sense I do appreciate all of this feedback; even when I don't take it, it helps compensate for my own biases. Still, there's a thin line between a compliment from an architecture connosseiur and a threat from a mafioso: "Nice house you have there, shame if something were to happen to it". In the same way, there's a thin line between helpful suggestions related to medicine and veiled threats of lawsuits, cancellation, and the like.

For each individual case, the temptation is to retreat

My fear is that if I do this enough, I become WebMD.

WebMD is the Internet's most important source of medical information. It's also surprisingly useless.

Consider drug side effects.

Drug 1 is aspirin. Drug 2 is warfarin, which causes 40,000 ER visits a year and is widely considered one of the most dangerous drugs in common use.

their ghosts might sue WebMD. WebMD solves this by never giving the tiniest shred of useful information to anybody.

This is actually a widespread problem in medicine. The worst offender is the FDA.

Moderna had to disclose to the FDA that one of the coronavirus vaccine patients got struck by lightning; after a review, this was declared probably unrelated.

For the more serious version of this, read Get Ready For False Side Effects. Why does the FDA keep doing this if they know it makes their label information useless? My guess is it's because they don't want to look like cowboys who unprincipledly consider some things but not other things.

Right now I think my database is better and more useful than WebMD. This isn't because I'm smarter or more of an expert than whoever WebMD employs. It's because I'm small enough to have a sort of security by obscurity.

If some lawyer with dollar signs in their eyes where the pupils should be reads my website, they know I'm not rich enough to be worth their time. WebMD is definitely rich enough to be worth their time.

If I think it's helpful to have a personal opinion on something (eg which antidepressants are scams), I can write my personal opinion without having a boss who can tell me to stop being a cowboy and devise a Procedure instead

The essence of Moloch is that if you want to win intense competitions, you have to optimize for winning intense competitions - not for some unrelated thing like giving good medical advice. (2014-07-30) Alexander Meditations On Moloch

Dr. Anthony Fauci is the WebMD of people.

He's a very smart and competent doctor, who wanted to make a positive difference in the US medical establishment, and who quickly learned how to play the game of flattering and placating the right people in order to keep power. In the end, he got power, sometimes he used it well, and other times he struck compromises between using it well and doing dumb things that he needed to do to keep his position.

I can't tell you how many times over the past year all the experts, the CDC, the WHO, the New York Times, et cetera, have said something (or been silent about something in a suggestive way), and then some blogger I trusted said the opposite, and the blogger turned out to be right

There are all sorts of places you could go with this.

Maybe expertise is a sham.

But I find myself settling on a different explanation, which is something like this:

When Zvi Mowshowitz asserts an opinion, he has only one thing he's optimizing for - being right - and he does it well.

When the Director of the CDC asserts an opinion, she has to optimize for two things - being right, and keeping power.

I realize it doesn't sound like it, but I'm trying to excuse the CDC here. I'm not just saying they're corrupt. I'm saying they have to deal with the inevitable amount of corruption which it takes to be part of a democratic government, and they're handling it as well as they can under the circumstances

The first reason I'm talking about this now is to respond to a point that came up in my discussions with Glen Weyl on technocracy

Experts are sometimes unbiased and not-corrupt, at least insofar as it's possible for anyone to be unbiased and non-corrupt in this world. If you expose the plan to politics, the politics will drag it in the direction of being worse. Every feedback channel you open up is a way for somebody to attack you.

If you're planning the coronavirus response, maybe the best thing you can do is lock Zvi in a cave completely incommunicado and make him write one for you. The moment there's a gap in the cave, thousands of lobbyists and activists and politicians will rush in

The second reason I'm writing this is because people keep asking me "should we listen to experts"?

As usual, the answer is "it depends who you mean by we

I can take Zvi's advice instead of the Director's advice, and benefit from it.

But someone else will decide to always trust their friend, a guy in a MAGA cap who says coronavirus is fake and Dr. Fauci is a Satanist. Compared to the median person who disagrees with the experts, the experts look pretty good.

My household locked down two weeks before the general shelter-in-place order went out

The experts successfully swooped in and saved us from all of that, figuring out which way the wind was blowing only two weeks later than competent amateurs. This was a useful service. Without the experts, things would have stayed open forever.

What's the best form of government? Benevolent dictatorship, obviously, just get the best person in the country and let her fix everything. But everyone realizes this is easier said than done; the procedure to pick the best person is corruptible. At one point we tried a very simple best-person-picking procedure that really should have worked and ended up choosing Donald Trump as the best person. I'm still not really sure what went wrong there, but apparently this is really hard.

In this model, Zvi is illegibly good

Dr. Fauci (and WebMD) are legibly good (or at least legibly okay). (Legibility)

Fauci will need to get and keep lots of powerful allies (plus be the sort of person who thinks in terms of how to get allies rather than being minimaxed for COVID-prediction).

This interferes with his COVID predicting ability, but in the current system there’s no alternative.

The third reason I'm writing this is to explain a sort of missing mood.

I think experts have failed terribly on easy problems. Shouldn't I be taking to the streets, pitchfork in hand, trying to burn down the system? (2020-04-30) Hunt Burn It The F Down

What I sometimes call Marx's Fallacy is that if we burnt down the current system, some group of people who optimized for things other than power would naturally rise to the top. Wrong. People who most brutally and nakedly optimized for power would gain power; that's what "optimize" means.

I think our system for producing legibly-mediocre people is a good start. It doesn't always pick the most trustworthy people. But it almost always gets someone in the top 50%, sometimes the top 25%. There are few biologists who deny evolution, few epidemiologists who think vaccines don't work, and few economists who are outright communists.

*The whole scientific-technocratic complex is a machine which takes Moloch as input and manages - after spending billions of dollars and the careers of thousands of hard-working public servants - to produce Anthony Fauci as output. This should be astonishing, and we are insufficiently grateful.

(but prediction markets would still be better)*