A retired physician's take on epidemiologists

I am a retired physician.  Over my career, I've had some contact with epidemiology.  I'll be blunt here: I came away unimpressed with that field.  Here's why:

1. When a pandemic strikes, I've never once witnessed an epidemiologist get his hands dirty in providing actual patient care.  So where the rubber meets the road during a pandemic, they're useless.

2. Their models, and therefore their advice and counsel, are based upon best guesses from previous pandemics.  It's been pretty clear during COVID-19 that in any number of cases, their accuracy has been less than impressive.

3. Typically, the confidence ranges of their models are wide enough that you could drive a Mack truck through them.  Then, when actual outcomes fall somewhere within those massive ranges, they pat themselves on the back as though they've really accomplished something.  I honestly think you or I could come up with equally accurate models by throwing darts at a dartboard!

4. They get to have tunnel vision.  The concern of the epidemiologist is to focus on the disease and the disease only.  It is not their job to concern themselves with the economic, social, political, marital, and psychological devastation resulting from strict quarantines and lockdowns.

5. In fact, they have no personal economic skin in the game.  During any pandemic lockdown, the epidemiologists still receive their full salary and benefits.  I've always thought it would be interesting to suspend their pay and benefits during a lockdown and see how enthusiastic they'd be about continuing!  It's easy to make dire and sweeping pronouncements when you have no skin in the game.

6. They typically work in packs.  They're often employed by an academic or consulting center.  This gives them the comfort of never having to take personal and individual responsibility for their projections.  It's rare to have an individual epidemiologist step forward and say, "Yes, this is my model, and I'll accept responsibility for its accuracy."  And when's the last time you heard of an epidemiologist being sued for malpractice?  Answer:  never.

7. They commonly seem to think they're in charge of everything — that they've suddenly become the chief executive officer of a state or the entire nation.  They seem to forget that their job is simply to advise a governor or a president, not take over the executive role.

Bottom line: Basically, it's a well compensated occupation with little or no personal accountability for the outcome.  Nice work if you can get it!

Personally, I am currently in the middle of the high-risk group.  I'm over age 70 with co-morbidities.  Still, I'm willing to take responsibility for my own outcome.  Throughout this pandemic, I've consistently felt that it would be a reasonable approach to strongly urge the older high-risk population to take strict protective measures — even potentially up to self-quarantine. 

Meanwhile, let the younger healthy population go about their lives while observing reasonable precautions such as coughing into elbows, social distancing, frequent hand-washing, and possibly wearing masks if they desire.  To me, that seems a reasonable compromise for dealing with the pandemic without destroying the economy and people's lives.

I am a retired physician.  Over my career, I've had some contact with epidemiology.  I'll be blunt here: I came away unimpressed with that field.  Here's why:

1. When a pandemic strikes, I've never once witnessed an epidemiologist get his hands dirty in providing actual patient care.  So where the rubber meets the road during a pandemic, they're useless.

2. Their models, and therefore their advice and counsel, are based upon best guesses from previous pandemics.  It's been pretty clear during COVID-19 that in any number of cases, their accuracy has been less than impressive.

3. Typically, the confidence ranges of their models are wide enough that you could drive a Mack truck through them.  Then, when actual outcomes fall somewhere within those massive ranges, they pat themselves on the back as though they've really accomplished something.  I honestly think you or I could come up with equally accurate models by throwing darts at a dartboard!

4. They get to have tunnel vision.  The concern of the epidemiologist is to focus on the disease and the disease only.  It is not their job to concern themselves with the economic, social, political, marital, and psychological devastation resulting from strict quarantines and lockdowns.

5. In fact, they have no personal economic skin in the game.  During any pandemic lockdown, the epidemiologists still receive their full salary and benefits.  I've always thought it would be interesting to suspend their pay and benefits during a lockdown and see how enthusiastic they'd be about continuing!  It's easy to make dire and sweeping pronouncements when you have no skin in the game.

6. They typically work in packs.  They're often employed by an academic or consulting center.  This gives them the comfort of never having to take personal and individual responsibility for their projections.  It's rare to have an individual epidemiologist step forward and say, "Yes, this is my model, and I'll accept responsibility for its accuracy."  And when's the last time you heard of an epidemiologist being sued for malpractice?  Answer:  never.

7. They commonly seem to think they're in charge of everything — that they've suddenly become the chief executive officer of a state or the entire nation.  They seem to forget that their job is simply to advise a governor or a president, not take over the executive role.

Bottom line: Basically, it's a well compensated occupation with little or no personal accountability for the outcome.  Nice work if you can get it!

Personally, I am currently in the middle of the high-risk group.  I'm over age 70 with co-morbidities.  Still, I'm willing to take responsibility for my own outcome.  Throughout this pandemic, I've consistently felt that it would be a reasonable approach to strongly urge the older high-risk population to take strict protective measures — even potentially up to self-quarantine. 

Meanwhile, let the younger healthy population go about their lives while observing reasonable precautions such as coughing into elbows, social distancing, frequent hand-washing, and possibly wearing masks if they desire.  To me, that seems a reasonable compromise for dealing with the pandemic without destroying the economy and people's lives.