site banner

Culture War Roundup for the week of February 27, 2023

This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.

Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.

We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:

  • Shaming.

  • Attempting to 'build consensus' or enforce ideological conformity.

  • Making sweeping generalizations to vilify a group you dislike.

  • Recruiting for a cause.

  • Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.

In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:

  • Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.

  • Be as precise and charitable as you can. Don't paraphrase unflatteringly.

  • Don't imply that someone said something they did not say, even if you think it follows from what they said.

  • Write like everyone is reading and you want them to be included in the discussion.

On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.

10
Jump in the discussion.

No email address required.

Disagree somewhat.

You go into the hospital with trouble breathing, your doctor comes to see you. Your heart rate is elevated. Do you have a growing infection? Are you nervous talking to the doctor? Were you trying to work out because you have a date next week? Is this a side effect from the breathing medication we gave you? Were you just fucking your girlfriend? One of these requires immediate start of antibiotics, and patients can have more than one of them happening at the same time (and in my experience, have).

Yes, this gestalt reasoning, this gut feeling, "does the patient look sick?" is important, but significantly this is now a thing that machines can do, and are continuously improving at.

Current decision support tools can't even read an EKG

Yes the interpretations that are printed out on those machines are shit. But this is not state of the art. It is possible to do better

We develop an algorithm which exceeds the performance of board certified cardiologists in detecting a wide range of heart arrhythmias from electrocardiograms recorded with a single-lead wearable monitor.... We exceed the average cardiologist performance in both recall (sensitivity) and precision (positive predictive value).

I absolutely agree it will get there, and this update that we have the technology to read EKGs correctly now is profoundly unshocking, but the fact that it isn't in use is telling (healthcare has tons of barriers including the regulatory) and the ability to form a good gestalt is a very complicated and hard skill.

AI will come for us - motivation is high because of the cost (in dollars) but the level of care is high because of the cost (in lives). We'll probably be one of the later manifestations and docs won't get cut out.

This topic irks me so much because one of the strongest patterns in American healthcare is outside industries thinking it is easy, rolling in, failing miserably, and leaving behind a trial of broken lives (especially coming in from tech and finance). Winners do exist (see like PE in EM and HCA) but mostly do so through illegal activity and profoundly unethical behavior.