Everyone Knows the Doctor Who Acts...

...as his own doctor, has a fool for a patient.

And this is true a fortiori for the patient who self-diagnoses and self-prescribes. In today's New York Times we read:

For a sizable group of people in their 20's and 30's, deciding on their own what drugs to take - in particular, stimulants, antidepressants and other psychiatric medications - is becoming the norm. Confident of their abilities and often skeptical of psychiatrists' expertise, they choose to rely on their own research and each other's experience in treating problems like depression, fatigue, anxiety or a lack of concentration. A medical degree, in their view, is useful, but not essential, and certainly not sufficient.

Well, I would recommend that anyone contemplating flying an F-16 be trained as a pilot. In my view, such training is both useful and essential. As to whether it is "sufficient," one should first ask, "Sufficient for what?"

The level of sophistication in both the subjects and the writer of this piece is perhaps best captured in the following paragraph:

"If a person is having a problem in life, someone who is 42 might not know where to go - 'Do I need acupuncture, do I need a new haircut, do I need to read Suze Orman?' " said Casey Greenfield, 32, a writer in Los Angeles, referring to the personal-finance guru. "Someone my age will be like, 'Do I need to switch from Paxil to Prozac?' "

Before asking myself that question, I would "be like:"

(1) Do I have any idea even what my diagnosis is?

(2) Am I even aware that Paxil and Prozac, though they are both classified as "(Selective) Serotonin Reuptake Inhibitors," have significant chemical, pharmakokinetic and therapeutic differences, some of which are subtle and not easily discerned by the person taking them, and that it is possible for me to get quite sick making this switch in the wrong way?

(3) What am I going to do for myself if, already significantly depressed, I develop akathisia in making this switch and am pushed over the edge, and I have no relationship with a physician who can help me?

And so on. Ms. Greenfield though, who is, as the article's title tells us, "young and assured," continues:

"I would never just do what the doctor told me because the person is a doctor," said Ms. Greenfield, who dictates to her doctors what to prescribe for her headaches and sleep problems, and sometimes gives her pills to friends. "I'm sure lots of patients don't know what they're talking about. But lots of doctors don't know what they're talking about either."

Well, no doubt "lots of doctors don't know what they're talking about."

Might be a good idea to look around for one who does.

A study, reported also in The New York Times, in an article entitled "Why The Ignorant Are Blissful," revealed that:

People who do things badly, [says Dr. David Dunning, the Cornell researcher who conducted the study, along with graduate student Justin Kruger] ... are usually supremely confident of their abilities -- more confident, in fact, than people who do things well.

Moreover, Dr. Dunning's work suggests:

One reason that the ignorant also tend to be the blissfully self-assured, the researchers believe, is that the skills required for competence often are the same skills necessary to recognize competence.

The incompetent, therefore, suffer doubly, [the researchers] suggested in a paper appearing in ... the Journal of Personality and Social Psychology.

"Not only do [the incompetent] reach erroneous conclusions and make unfortunate choices, but their incompetence robs them of the ability to realize it," wrote Kruger, now an assistant professor at the University of Illinois, and Dunning.

Food for thought as you write yourself your next prescription. When one reads remarks like that of "Rich," quoted near the end of the article, however, one despairs:

"My initial experience with physicians who are supposed to be experts in the field was disappointing," Rich said. "So I concluded I can do things better than they can."