I really wish people would quit treating doctors as unquestionable authorities on health. Rather, they should be treated as consultants - expertise for hire - who should be able to give good answers to most questions, but should expect to have to defend their recommendations, and can sometimes be wrong.
Medical doctors are like auto-mechanics or, to make a more HN-relatable comparison, software engineers trying to debug a program. Except there's a little more schooling, a lot more rigor with boards examinations, and you don't really have the full source-code available to debug. Just like in any profession, you're going to have crappy auto-mechanics who'll just pull up the ODB-II code and perform patch-work without rigorous root-cause analysis, or have engineers who'll also perform similar patch-work to get it "good enough", you'll have the same hacks who make it through medical school. I'm with you 100% in that they're consultants offering their opinion, but I'll take your analogy a step further and say that some consultants are 27 year old kids fresh out of Wharton who can put together a pretty PowerPoint deck, and some consultants genuinely know their field.
... after getting a bachelor's degree (3-5 years) a general practitioner takes at the bare minimum 7 years of schooling and internship. Surgeon far more than that. One can work as a professional software engineer without ever attending any university.
Yes, I do believe I addressed that-- "<from MS3, through residency, then fellowship for most surgeons, ~7-8 years>". (Though I'd argue a residency is far more time-intensive than a traditional "internship", and after you pass USMLE S3 you're a board-certified Medical Doctor until your 10 year card comes up)
My point was that you're going to have hacks at any sort of field which involves operational mechanics, or for that matter any craft that involves a mastery of a skill. I'm a life-long tennis player. Competent enough to hold my own against a recreational player pretty safely, but cognizant enough to know I'm not Roger Federer. If we were to graph any trade/craft/art/profession practitioner, I'd imagine "good" (for any metric of good) can be depicted by a normal Gaussian plot. You'll have geniuses, hacks, and average folk.
Some doctors do that. Certainly not all do. Example: I went to see my GP recently, and as part of the conversation I brought up a drug he had me taking. I said I'd read up on it and noticed that it's considered highly addictive and not a very pleasant drug, and asked if there was any other option. He proceeded to rattle off a list of options and the implications of each, and said "what do you want to do?"
I said "let's try X for a few months and see how that works." He agreed that was a fine course of action.
Similar story: at a recent checkup, my cholesterol numbers had mysteriously shot up by a huge margin. He called and said I should double my dose of the statin blocker I'm on. Well, I don't even want to be ON a statin blocker, and I was doubtful about my cholesterol taking that big a jump for no reason. So I suggested it might be a bad test, or some kind of weird outlier, and suggested we wait a month and test it again. We did and my cholesterol was back to perfect. So no change in the statin dosage.
I can also ask him to order specific tests for things I'm interested in (c-reactive protein for example, or the NMR LipoScience lipid test) and he's fine with doing that.
Now maybe my doctor is really weird in this regard, but he really treats me as pretty much a peer when it comes to decisions concerning my health. Not "peer" in the sense that obviously I'm not a doctor, but as in it's my health, and he acknowledges that it's my health and my decisions, which I can make with his consultation.
