Read through this thread while keeping in mind that "going to the doctor" (iatrogenic injury) is the third biggest cause of death in the USA https://twitter.com/gorskon/status/1380491816143888385

An engineer may not be a "scientist" in the sense that they don't publish peer reviewed research but an engineer has to test hypotheses every day by building things that work. If the things break, you get fired.

Doctors can have patients die every day and blame it on the disease instead of their own decisions. Engineers and other people who solve problems in practice don't have the luxury of considering their failures to be existential.

Your doctor can say "everyone dies of something." If your roof leaks and the builders starts blaming the second law of thermodynamics, you fire them and find somebody else to do the work.

Real world failure is also a form of "peer review" in the sense that the laws of physics and social behavior of people are exposing the flaws in your work and forcing you to improve on the reasoning that led you to your decisions.

So yes, the tendency of engineers to try solutions that will probably work because that's what they do in their work. A smoking pile of rubble is the final judgement of a bad engineer.

For doctors, a trail of dead patients is not the sign of a bad doctor. Everyone dies eventually. What they have to worry about is censure from their peers - the medical review board, losing certification, getting written up for not doing "evidence based" treatment.

This isn't actually science. This is gatekeeping from institutions run by self-declared science doers who have accumulated large amounts of social capital.

It sucks that this whole last year and a half has just been dominated by revisionist sophistry calling itself "science." Mao called this one in a one page essay back in the 1960s.

I mean this twitter thread is almost longer than "Where Do Correct Ideas Come from" - if you haven't read it, read it.

https://www.marxists.org/reference/archive/mao/selected-works/volume-9/mswv9_01.htm

Keep in mind that CDC doesn't track iatrogenic injury as a cause of death like they do for heart attacks or cancer. There's no ticker on google that pops up for "iatrogenic injury death rate" like there is for covid. There's no new dot on a map for every fatal drug interaction.

The actual cause of death is still going to be "heart attack" (from fatal drug interaction) or multiple organ failure (from putting a healthy person on a ventilator for a month). Infections are just infections even if you picked up the C Diff from going in for a colonoscopy.

So the gatekeeping institutions that regulate medical practice, like the CDC, don't even make their success / failure rates easy to determine. Those numbers only emerge thru forensic studies.
https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-cause-of-death/

"Engineers are mere overeducated tradesmen, while I, a surgeon, come from a long and distinguished line of leech-handlers and corpse-snatchers."

There are plenty of buildings in the world that were built with 18th century engineering knowledge by 18th century engineers that still exist today and are still used for their intended purposes. But what of medical practice from that period? https://twitter.com/mmabeuf/status/1353437077304709120

The barber-surgeon emerged as a profession because the same tools were used for both jobs. Just like the mirror-maker and the painter both applied chemicals to surfaces to create objects to look at, the barber / surgeon was the guy who knew how to handle a sharp razor.

Abstract: We keep finding new ways to hurt people because we keep coming up with new reasons to stick things in people and call it medicine.
https://burnstrauma.biomedcentral.com/articles/10.1186/s41038-019-0155-2