The Twilight of Expertise (part 7: education experts)

The education improvement program — merit pay for teachers as part of a larger package — promoted by the Milken Family Foundation received a big public boost last week with this NY Times article about a similar program in Minnesota.

A consensus is building across the political spectrum that rewarding teachers with bonuses or raises for improving student achievement, working in lower income schools or teaching subjects that are hard to staff can energize veteran teachers and attract bright rookies to the profession. . . Minnesota’s experience shows . . . that an incentive plan created with union input can draw teacher support.

The plan that is gaining support was devised by Lowell Milken, according to Jana Rausch, who works for the Milken Family Foundation on this initiative. Before he started the foundation, Lowell Milken was a lawyer. As far as education goes, he is self-taught. Yet the program he devised seems to be working better than other programs. Of course many people have proposed merit pay for teachers; but it is the Milken Family Foundation that has managed to make it work. We need engineers to build a better plane. But we do not need education experts, apparently, to build better schools.

The Twilight of Expertise (part 6: psychotherapy, continued)

Among the community of psychotherapists, according to Dr. Marion Arom, a psychotherapist friend of mine, “it is common knowledge that in many traditional therapies, if the therapy fails — if the desired change doesn’t occur — it’s due to client resistance or lack of motivation to change or unconscious motivation. The role or skill of the therapist is not examined, ever.”

Dark Age Ahead by Jane Jacobs has a chapter about the failure of highly-respected professions to police themselves.

of Twilight of Expertise posts.

The Twilight of Expertise (part 5: psychotherapy)

In The Starfish and the Spider (2006), a book about decentralized organizations, one of the examples is Alcoholics Anonymous, started in 1935, in which local chapters are almost entirely autonomous from headquarters. Of course AA led to many similar programs: Narcotics Anonymous, Overeaters Anonymous, and so on. All of these twelve-step programs offer therapy without therapists — for free. A little like the Protestant Reformation, which I mentioned earlier.

At a recent party I met a woman who runs an outpatient program for persons with mental disorders, including major depression. She asked me what I would suggest. Based on my faces research, I suggested early morning face-to-face meetings, especially for persons with depression. Very interesting, she said, AA folk wisdom is that morning meetings have the best success rates.

If you want to attend an early morning meeting (non-twelve-step), and you live in San Francisco, you may have a communal breakfast ($5 plus tax, served 8:30-9:30 am) at OneTaste (1074 Folsom at 7th St.), an “Urban Retreat Center”. If you can do this, I’m jealous. OneTaste is a group of 50 people who live and work together. They appear to support themselves by teaching yoga and giving other classes. They have been at their SF location for two years; before that they were at many different locations. The receptionist told me it was a “sensual community.” What’s that? I asked. “We try to activate our sensuality” etc., she said. I didn’t know what she meant. Is this on the website? I asked. Yes, she said, so I didn’t bother to take careful notes. I wish I had. The website puts it more bluntly: “Our purpose at OneTaste is to return to connection by researching our relationship to orgasm.” A recruitment video, to prepare for breakfast.

The Twilight of Expertise (part 4)

I was interviewed today by a writer for Wired Online. She said the Shangri-La Diet forums resembled open-source software. It’s a good point; at the SLD forums, a large number of people from all over the place are slowly but surely improving the diet (which is essentially an engineering problem). Because of their improvements, the paperback is about 10% different from the hardback. I’m not a weight-control expert; the people who contribute to the SLD forums are even less so.

The SLD forums can also be compared to a clinical trial of the diet. A large chunk of SLD forum posts are about how well the diet is working, which is what clinical trials are about. A clinical trial of the Shangri-La Diet (or almost anything) requires experts. Only weight-control experts could raise the money (hundreds of thousands of dollars) and have access to the necessary facilities. Anyone can start a forum.

Which is better? In two ways, a clinical trial is better than forums evaluation: 1. (major) You keep track of everyone who starts the trial. 2. (minor) Better measures. More accurate scales, blood tests, standardized food tracking. In six ways, forums evaluation is better than a clinical trial. 1. (major) More realistic. For example: the diet is more flexible, each dieter uses his or her own brain power to figure out what to do. 2. (major) Better reporting of side effects (both positive and negative). With forums, more brainpower goes into their detection. 3. (major). More transparent. Anyone can read the forums to find out what happened. Raw data from clinical trials is almost never available. 4. (major) Speed. Forums are much faster. 5. (major) Cost. Forums are much cheaper. 6. (major) Openness. Anyone can report his/her results on the SLD forums. Clinical trials, on the other hand, are closed to almost everyone.

I use both Firefox (open source) and Internet Explorer (not open source). But I use Firefox far more.

Part 1. Part 2. Part 3.

The Twilight of Expertise (part 3)

Do you need to be an expert on Topic X to write a serious (i.e., non-celebrity) well-paid well-publicized book about it? Less and less. As I said earlier, I am not a weight-control expert. Mickey DeLorenzo, a Philadelphia “multi-media developer” (website designer?) is even less of a weight-control expert. However, he used his Wii to lose 9 pounds in six weeks (story and data) and is working with an agent from a well-respected agency to write a book about it. The publicity started with digg.

You already knew you no longer have to be an expert on Topic X to write a well-read encyclopedia article about it.

Part 1. Part 2.

Thanks to Elaine Smith.

The Twilight of Expertise (part 2)

The first experts were shamans, an occupational category that eventually divided into doctors and priests. As the Catholic Church became more and more powerful, abuses of priestly power became more and more apparent and upsetting, leading to the Protestant Reformation.

Now — half a millennium later — doctors are under much greater scrutiny. The results of that scrutiny are unfavorable — perhaps highly unfavorable. A RAND study suggested that the overall benefit of a substantial amount of health care was small, except in certain special cases such as eyeglass prescription. A large fraction of surgeries are unnecessary, says one critic–and by large he means large:

Stanford University urologist Thomas A. Stamey, M.D., generally regarded as the father of PSA testing, says that 90 percent of all the prostatectomies performed at the Stanford hospital over the past 5 years have been unnecessary.

Earlier post on this topic.

Addendum: According to Biotech Blog,

There’s been a shift in the past 50 years away from the doctor-centric model of healthcare to one in which patients expect, and demand, better information and control over their treatments.


A 70-293 is a much better choice than 70-296 for someone who plans to do 70-291 later. If the future plans revolve around 70-526, it is alright otherwise.

The Twilight of Expertise (part 1)

In a TED talk, Stewart Brand pointed out that all over the world, poor villages — the same villages that Jeffrey Sachs seems to want to preserve — are vanishing. The people who lived in them have moved to squatter cities, where, according to Brand, there is zero unemployment and a much better life. Because Jeffrey Sachs’ interest in poor African villages seems to be recent, I am not surprised that he may end up on the wrong side of the helped/didn’t help ledger.

This is the general pattern with experts today: Sometimes they help, but often they make things worse. In a comment on an earlier post, Dr. Erika Schwartz called modern medicine “a system that more often harms than helps.”

We are living in the twilight of expertise because we now have alternatives to experts — better alternatives. Squatter cities are a new thing. They solve a very difficult problem (poverty) because they combine three things: (a) People care about themselves and their children (far more than any expert will ever care). (b) The technological knowledge behind the many small businesses (e.g., hair dresser, copy center, pirated videos, cell phones) that allow squatter cities to exist. And (c) something that brings the first two things — caring and know-how — together, namely the cities themselves. Of course, squatter cities owe nothing to Sachs-type experts.

The self-help self-experimentation I have done is another new thing. I solved the difficult problems of how to control my weight, my mood, my sleep, and a few other things related to omega-3, such as my gums. None of which I am expert in — I am not a weight-control expert, a sleep expert, etc. I attribute my success to the combination of the same three elements that come together in squatter cities: (a) I cared. I care about myself far more than experts care about most of the people they try to help. (b) Scientific knowledge — both statistical methods (e.g., exploratory data analysis tools) and basic behavioral science (e.g., the rat experiments of Israel Ramirez). (c) The ability to combine (a) and (b). Self-experimentation was a big part of this, but not the whole thing. My job as a professor and the research library system allowed me the time and opportunity to learn the scientific stuff. The flexibility of my job helped a lot. For example, I almost never had to use an alarm clock to wake up, which allowed sleep self-experimentation. The solutions I discovered are quite different from conventional solutions, but no more different than squatter cities are from what Jeffrey Sachs has prescribed.

Addendum: More info about squatter cities here. A blog about them. More about foreign-aid experts doing more harm than good.