The Intellectual-Yet-Idiot (IYI) Physician


The term Intellectual-Yet-Idiot (IYI) has been popularized by the modern day philosopher/author Nassim Nicholas Taleb as a descriptor for those with many years of education that parlay titles from esteemed universities to form a useless layer of “academico-bureacrats” as unplugged from reality as they are certain of how you should live your life.  It is with regret that I find many physicians to be in this most embarrassing of categories.  For some reason the male instagram model turned doctor that amassed a large social media following on the strength of photogenic pec shots and the cardiologist son of a doctor that went to the best schools imaginable and knows about hardships from reading about it in a book, have very strong opinions that range from what you should eat to how society’s resources must best be allocated.  

That they have little useful practical knowledge of how society works stems from the perch many of them occupy as employees of edifices that see fit to charge $97,000 for an hour’s worth of work to change the battery of a pacemaker.  (Medicare re-imbursed a still ungodly $38,000).  Many of these dilettantes are poor at the craft of their choosing, but even those with depth in their narrow technical specialty have grand opinions on which political party has the best Syrian foreign policy though they couldn’t find Syria on a map, and think an Alawite must be a dessert at the local lebanese restaurant they happen to be gentrifying.  One would think they would have more insight in the realm of health care policy, but many prefer aspirational slogans over hard conversations those slogans should prompt.

The reward, of course, for having the insight of a freshly concussed pigeon in medicine is to fail upwards and be rewarded with an administrative title. Chief Medical Officer or Chairman of Medicine is a prime landing spot for this onerous group. From this perch, these self important twits can lead by rapping the knuckles of physicians who haven’t documented in a complete enough manner to get those extra medicare dollars, or haven’t completed the latest online professionalism module.  

Amusingly, some in this group had quite a few opinions about how they would have run the pandemic response to perfection by “following the science”.  Yet it surprises absolutely no one that knows this class of clowns that they couldn’t even manage a COVID vaccine rollout.  This would be why hospital CEOs that have ridden out the pandemic making seven figure salaries while doing zoom wearing underpants are getting their vaccine while 86 year old grandma is on a waiting list. Not to be outdone, the CDC has quite a few administrative units that are a product of failing upwards for years all too willing to ride the politically correct winds to come up with a race based vaccine allocation scheme that would result in more deaths than an age based scheme.  Yes, that’s right, enough people at the CDC actually rationalized a scheme that would cause more deaths now because of historical white privilege.  

The elite seal team keystone cop members of this group are so arrogant they have actually convinced politicians they have grand solutions for healthcare problems that face the nation. All that needs to be done is to put them in charge.  This works out for everyone involved. Politicians get to say they did something, the administrative physician class that hates seeing actual patients get a cushy non patient facing job for some years , and win or lose the post becomes a stepping stone to the next con.  Its not surprising that Politicians are an easy mark because they generally are a naive bunch when it comes to healthcare, easily swayed by empty vassals with fancy titles from America’s top universities.  One would think the heads of America’s top corporations were smarter, but the magnetic pull of the physician grifters in this space proves too strong even for titans of industry

A word to the wise for my dear fellow politicians and CEOs : the doctors who are employed by the health systems that charge a $100,000 for changing the battery on a pacemaker have not a clue about ‘fixing healthcare’.  What they want is control and a cushy job as head of some new bureaucratic venture that is destined to fail. When it does fail, it will of course be everyone else’s fault. They will be punished by either becoming a chair of medicine or start some useless company that relies on their deep knowledge of the government regulatory swamp. 

That these con artists every move is met with applause from the masses of IYI physicians is a constant reminder that clapping seals has more insight than this group. Never mind that these seals are the same ones who knew in January of 2020 that travel bans were racist, that knew in March of 2020 masks were useless, that knew gathering in large groups was dangerous in pandemics except when protesting for politically correct causes, and that think anyone not keeping pace with their constantly shifting views isn’t just wrong, but evil. 

As a result, I can think of no group less suited to have opinions on the world outside of their profession than doctors. Complex medical decisions frequently involve some back and forth between patient and doctor so the path chosen aligns with what the patient may want.  This is forgotten by the ilk of doctors being discussed here who nonsensically blunder into complex social problems to tell Americans what they should think and how they should live their lives to make “everything all better”.

Want to improve things in America? Stop listening to doctors with pie-in-the sky plans.  The kids, and maybe the world will thank you for it. 

Anonymous, MD is a physician in Somewhere, USA. 

4 thoughts on “The Intellectual-Yet-Idiot (IYI) Physician

  1. Interesting. Its a good take on the problems of listening to not-at-risk employees (including execs) in places that don’t make waves during a time when a solid evaluation of risk/ ability to make controversial bets is the key issue.

    Docs aren’t all like that, however.

    1. Reminds me of a project I was discussing for a transplant wing at a major AMC. Huge backup. Death by wait list.

      Told I wasn’t a good fit because my path required rocking the boat to get the job done. Not good to ruffle feathers.

      1. Agree.

        I too am optimistic about docs, many super smart people, but I think there is a group of DINOs who have lost sight of what medicine is about.

      2. That’s the right debate. What is medicine about? There is a “ivory tower vs real world impact” lane, “population vs individual” lane, “meds/ procedures vs. everyday activities” lane, “p > .05 vs cost benefit” lane. And always institution (dr as cog in wheel) vs. entrepreneurial (dr able to scope price and services) debate.

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