JN, you think that’s difficult, did you know that almost 50% of physicians are below average in skills? No known fix for that, either, unless Obama’s unicorn has given him one.
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Too bad we’re not back in the 1950s, or 1850s, when there was virtually no real medicine to know, so almost any doctor (or barber) was “qualified”. But, what about 2050? This is where the problem is (sort of) similar to the case of software developers. The public – and management – tends to have faith in “the technology” or “the science” and doesn’t believe the virtue of the individuals involved is nearly as important. And in this they are very wrong.

Obama seems to be case in point, believes all he has to do is ask for a solution, and voila, it will appear. He said this almost exactly as part of his campaign rhetoric. Seems to believe that’s all it would take to get the bill written and passed, too.

Science is difficult, is what I’m trying to say. The idea of calling medicine “practice” I find a horrible anachronism and a large part of the problem. I suppose computers will improve things over the next ten, twenty, fifty years. Yes, I know the debate about that, from back in the AI expert system days. The AI mostly sucked, and who has faith in cold Bayesian statistics? And yet, the computer can know all that is known, or apparently a lot more than your average practitioner.

So, I actually support a lot of what Obama is suggesting, but I wonder if it doesn’t leave out some critical items. That is, I’m certain it does.