Top Highlights

• Doctors have a reputation as do-gooders. So when I was a 17-year-old kid wanting to make a difference, it seemed like a natural career path. I wrote this on my medical school application: I want to study medicine because of a desire I have to help others, and so the chance of spending a career doing something worthwhile I can’t resist. Of course, ...
• Medicine was not my best option for helping others when compared to all the other work I could do instead. And I think that is not just true for me in particular, but for many able, altruistically minded people considering a medical career.
• Upshot: medicine as a whole, at least as practiced in most clinical settings, has been only a minor player in the dramatic improvements in human health over the last couple of centuries (relative to things like nutrition, safer jobs, and general scientific knowledge), so one should expect the impact of providing more of it now by working as a docto...
• UK1 life expectancy doubled from 40-ish in the 1800s to 80-ish now. The largest contributor was a reduction in infant and childhood mortality. For example, in the UK, around 15% of those born in 1900 died before their first birthday — now it is ~0.4%. But survival has improved in every age bracket. This trend is basically universal. There remains ...
• population learning the basics of public health — like germ theory or “smoking kills” — means individuals can better avoid disease. If rich enough, they can also afford public works like sanitation systems, curbs on air pollution, and fortifying common foods with micronutrients.

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