On Twitter, [@joshginter](https://micro.blog/joshginter) responded to me by saying:
I realized Twitter didn't work for my response, and I decided I'd do it here (yes, Micro.blog is great!).
You know, as you say that, “Trust us, we know best” doesn’t work nearly as well in medicine as it does in finance. This almost needs a study of some sort.— Josh Ginter (@joshuaginter) April 14, 2021
Any idea why this would be?
I think medical practice is effective about creating a good care team with a patient, and a patient's family. Laying out medical options, potential consequences of those options, and realistic expectations as to outcomes. With hundreds of thousands of practitioners, there's wide variation, but I think it's better now than 30 years ago, where physicians laid out a plan, wrote the orders, and that was that. We're trained for that. Medical training is focused on treating the individual and addressing the immediate group around the individual.
When we start to look at public health, or medical decisions that affect public health, I think that's harder for medical professionals. You can't engage the public in the same way you engage the individual patient, or even a single family. There's no care conference for a city, a state, a province, a nation. In its place, there's a press conference. It makes sense that, when physicians (or nurses, respiratory therapists, epidemiologists, etc.) make proposals for a population, it feels more paternalistic because it IS more prescriptive and commanding. How do you address individual concerns, limitations of what we know, without speaking to an individual? Or without sounding wishy-washy?
From the medical professionals in front of the cameras right now, accomplished researchers, teachers, and caregivers like Anthony Fauci and Rochelle Walensky, it's a hard job. I think both (and many others) have leaned toward encouraging caution in the face of an ongoing pandemic. But picking the most cautious route has led to missteps and messaging that has gone back and forth without clarity. I'd like to see them be honest about what they don't know, what medicine doesn't know (or what it thinks it knows, but later turns out to be wrong).
Honesty about limitations is key to the effectiveness of those conversations with individuals, with families, and I think that's a component that needs to be shared more in the realm of public health.