Trading and Medicine analogy (complexity, uncertainity, technology) - part 10

Iceland economy, and same globally, 2008 bubble, predicted by raghuram rajan in 2005 and similarly happened the dot-com bubble and many more.. One such bubble may be the hydroxychloroquine and similar eminence based, large scale and media promoted medications use for covid during the beginning which still being continued now to a great extent. The eminence based medicine even influenced official guidelines to a great extent and luckily the living guidelines /meta analysis got huge adoption to rule out the negative aspects.. The point to focus here is not the negatives of eminence medicine completely as when nothing was know about covid it was probably only way to go but as the world and research moved at super fast pace, it was more important to keep up with updates/data rather than keep playing blind and also to prevent misinformation based on updated information.

There are always some small/big bubbles, some eminence based guidance, biased eminence and evidence, and slow updates causing great damages. At an individual level overdiagnosis and overmedication is also one such problem to be managed actively by choosing wisely when to be a minimalist and when a maximalist, eg. In the recent flood of covid mild symptomatics, or hydroxychloroquine prophylaxis, etc. Where minimalist approach wouldn't have done any harm, specially when there was no data to support.

RB - 

"One way to implement rational minimalism is to first identify the "parachute" intervention (the one that hasn't been tested in an RCT and yet every physician knows they can't do without, for covid recently, it was oxygen) and then decide about the other interventions keeping wishes of all the stakeholders around the patient in mind rather than aim at covering all therapeutic targets with rational but marginal efficacies, all the while remembering that it's the trillion cells in the body that would be responsible for 80% of it's healing with time rather than the chemicals or molecules we deliver. 

In all this process the role of the doctor is very much like the man in this video 

https://youtu.be/klhOM2hxhRM,

who strapped a 100 year old US citizen onto his shoulders and jumped out of the plane along with him till he landed safely.

Rational minimalism may drastically summarize the three goals of medical care into one, which is to "be with the patient" till he lands safely. It would rely on strong and well designed complex empathy straps to hold the patient, doctor (and the family) together all through the plunge in regular best case scenarios."

ref - https://medicinedepartment.blogspot.com/2021/07/rational-minimalism-and-parachute.html