Authoritah! wars

There has been a terribly pedantic interesting debate going on around here about the nature of authority in science.

I won’t bore you with the origins of this debate. OK, maybe I will a little, but I’ll try to make this foray into meta-blogging interesting.

First, blogging is not scientific writing as such. It isn’t peer reviewed, it isn’t a systematic presentation of research—it’s whatever the author feels like writing about that day. Now for various reasons, many bloggers write under a pseudonym. There are many reasons for this. First, most of us are not professional writers by trade, so we don’t care as much about being identified with our work. Second, given our fields, many of us wish to avoid having our colleagues or patients identified serendipidously. Lastly, some of us are early in our careers and might not wish to be identified with our non-professional writing.

This leads to some interesting conflicts. In my field (internal medicine), we often revere our older, smarter colleagues for their diagnostic and therapeutic acumen. Their skills may arise from experience, reading, research, or, more likely, all of the above. Many physicians improve with age and experience—diagnosis, in particular, relies on pattern recognition, and experience may improve this. And while we may respect our elders for these abilities, we temper this with the knowledge that most medical decision making must be viewed through the lens of evidence-based medicine—just because Dr. X, said it, that doesn’t make it so—but it may improve the likelihood of it being true. Still, show me the evidence! Of course, when you first see a patient, you form diagnostic impressions without the help of evidence-based diagnostic procedures. These impressions help you decide how to proceed. When you read something by a pseudonymous blogger, you don’t have any clear idea of the level of authority of your source.

(OK, I said I’d try to make this interesting. Sorry.)

Experience counts for a lot in medicine. Authority figures mean something. If someone says to me, “I think he might have lupus…that’s what Dr. Random Guy thinks,” I’m less likely to care than if they say, “Dr. Landsberg thinks the guy’s got lupus.” I know that Landsberg has the judgment, experience, and knowledge to make good diagnoses. I know that he wouldn’t just throw a disease name out there.

But I know this because I knew the man, I read his writings, I saw him work. I knew him to be good based on what he did. I accepted him as an authority, and if I asked his opinion, I’d be willing to believe it.

In medicine, no one specializes in everything. We rely on our colleagues in various sub-specialties to help us out with our patients. We don’t check up on every decision they make, every bit of data they collect, because we can’t.

And here is one of the core issues about authority and science on the web. When you write about science, “because I said so” is not useful evidence. But in transmitting these ideas in writing, no one expects to know everything you do. It’s just not possible.

There is a balance in scientific blogging between giving evidence for every fact we jot down and saying, “hey, I’m a doctor, trust me on this one.” This intersects with some of the principles behind denialism—the reliance of fake experts, and the logical fallacy of “appeal to authority”.

If you don’t trust your source, no amount of evidence they give may convince you. If you trust your source too much, you may be lulled into a false sense of fact-security. But we all must rely on experts at some point.

We all must beware of what we read, and judge its content based partly on the source. If the source agrees with other reputable sources, that is a mark in its favor. It it is sitting alone in the woods crying “Conspiracy!”, well, the trust level drops a bit.

This has nothing to do with qualifications, pseudonyms, or any other blogorrhea. It’s about how to read science. Read as much as you can, from as many reliable sources as you can, and if you are interested in a particular topic, keep up on it, as facts will change.