Cardiologists and Chinese Robbers

I.

It takes a special sort of person to be a cardiologist. This is not always a good thing.

You may have read about one or another of the “cardiologist caught falsifying test results and performing dangerous unnecessary surgeries to make more money” stories, but you might not have realized just how common it really is. Maryland cardiologist performs over 500 dangerous unnecessary surgeries to make money. Unrelated Maryland cardiologist performs another 25 in a separate incident. California cardiologist does “several hundred” dangerous unnecessary surgeries and gets raided by the FBI. Philadelphia cardiologist, same. North Carolina cardiologist, same. 11 Kentucky cardiologists, same. Actually just a couple of miles from my own hospital, a Michigan cardiologist was found to have done $4 million worth of the same. Etc, etc, etc.

My point is not just about the number of cardiologists who perform dangerous unnecessary surgeries for a quick buck. It’s not even just about the cardiology insurance fraud, cardiology kickback schemes, or cardiology research data falsification conspiracies. That could all just be attributed to some distorted incentives in cardiology as a field. My point is that it takes a special sort of person to be a cardiologist.

Consider the sexual harassment. Head of Yale cardiology department fired for sexual harassment with “rampant bullying”. Stanford cardiologist charged with sexually harassing students. Baltimore cardiologist found guilty of sexual harassment. LA cardiologist fined $200,000 for groping med tech. Three different Pennsylvania cardiologists sexually harassing the same woman. Arizona cardiologist suspended on 19 (!) different counts of sexual abuse. One of the “world’s leading cardiologists” fired for sending pictures of his genitals to a female friend. New York cardiologist in trouble for refusing to pay his $135,000 bill at a strip club. Manhattan cardiologist taking naked pictures of patients, then using them to sexually abuse employees. New York cardiologist secretly installs spycam in office bathroom. Just to shake things up, a Florida cardiologist was falsely accused of sexual harassment as part of feud with another cardiologist.

And yeah, you can argue that if you put high-status men in an office with a lot of subordinates, sexual harassment will be depressingly common just as a result of the environment. But there’s also the Texas cardiologist who pled guilty to child molestation. The California cardiologist who killed a two-year-old kid. The author of one of the world’s top cardiology textbooks arrested on charges Wikipedia describes only as “related to child pornography and cocaine”.

Then it gets weird. Did you about the Australian cardiologist who is fighting against extradition to Uganda, where he is accused of “terrorism, aggravated robbery and murdering seven people”? What about the Long Island cardiologist who hired a hitman to kill a rival cardiologist, ahd who was also for some reason looking for “enough explosives to blow up a building”?

Like I said, it takes a special sort of person.

II.

Given the recent discussion of media bias here, I wanted to bring up Alyssa Vance’s “Chinese robber fallacy”, which she describes as:

..where you use a generic problem to attack a specific person or group, even though other groups have the problem just as much (or even more so).

For example, if you don’t like Chinese people, you can find some story of a Chinese person robbing someone, and claim that means there’s a big social problem with Chinese people being robbers.

I originally didn’t find this too interesting. It sounds like the same idea as plain old stereotyping, something we think about often and are carefully warned to avoid.

But after re-reading the post, I think the argument is more complex. There are over a billion Chinese people. If even one in a thousand is a robber, you can provide one million examples of Chinese robbers to appease the doubters. Most people think of stereotyping as “Here’s one example I heard of where the out-group does something bad,” and then you correct it with “But we can’t generalize about an entire group just from one example!” It’s less obvious that you may be able to provide literally one million examples of your false stereotype and still have it be a false stereotype. If you spend twelve hours a day on the task and can describe one crime every ten seconds, you can spend four months doing nothing but providing examples of burglarous Chinese – and still have absolutely no point.

If we’re really concerned about media bias, we need to think about Chinese Robber Fallacy as one of the media’s strongest weapons. There are lots of people – 300 million in America alone. No matter what point the media wants to make, there will be hundreds of salient examples. No matter how low-probability their outcome of interest is, they will never have to stop covering it if they don’t want to.

This has briefly gotten some coverage in the form of “the war on police”. As per AEI:

Is there a “war on police” in America today? Most Americans think so, and that’s understandable given all of the media coverage of that topic. A Google news search finds 32,000 results for the phrase “war on cops” and another 12,100 results for “war on police,” with sensational headlines like “America’s War on Cops Intensifies” and “Bratton Warns of Tough Times Ahead Due to ‘War on Cops’.” A recent Rasmussen poll found that 58% of likely US voters answered “Yes” to the question “Is there a war on police in America today?” and only 27% disagreed. But data on police shootings in America that were reported last week by The Guardian tell a much different story of increasing police safety.

According to data available from the “Officer Down Memorial Page” on the annual number of non-accidental, firearm-related police fatalities, 2015 is on track to be the safest year for law enforcement in the US since 1887 (except for a slightly safer year in 2013), more than 125 years ago. And adjusted for the country’s growing population, the years 2013 and 2015 will be the two safest years for police in US history, measured by the annual number of firearm-related police fatalities per 1 million people.

When politically convenient, it is easy to make Americans believe in a war on police simply by better coverage of existing murders of police officers. Given that America is a big country with very many police, even a low base rate will provide many lurid police-officer-murder stories – by my calculation, two murders a week even if officers are killed only at the same rate as everyone else. While covering these is a legitimate decision, it can be deceptive unless it’s framed in terms of things like whether the rate has gone up or down, whether the rate is higher or lower for the group involved than the base rate in the population, and it still seems scary when you explicitly calculate the rate.

But a Chomskian analysis would ask whether the talk of a “war on cops” is really a uniquely bad example of journalistic malpractice, or whether it is bog-standard journalistic malpractice which is unique only in being called out this time instead of allowed to pass.

Let’s stick with coverage of police for consistency’s sake. I’ve made a very similar argument before regarding claims of racist police shootings (see Part D here), but let’s avoid that particular rabbit hole and consider a broader and more unsettling point. We all hear anecdotes about terrible police brutality. Suppose, in fact, that we’ve heard exactly X stories. Given that there are about 100,000 police officers in the US, is X consistent with the problem being systemic and dire, or with the problem being relatively limited?

I mean, it’s hard to say. Quick Fermi calculation: if I can think of about one horrible story of police brutality a week, and assume there are fifty that aren’t covered for every one that is, then per year that makes…

But wait – what if I told you that number was a lie, and there were actually 500,000 police officers in the US? Suddenly the rate of police brutality has decreased five times from what it was a second ago. If you previously believed that there were 100,000 police officers, and that the police brutality rate was shameful but that decreasing the rate to only one-fifth its previous level would count as a victory, well, now you can declare victory.

What if I told you the 500,000 number is also a lie, and it’s actually way more cops than that? Do you have any idea at all how many police there are? Shouldn’t you at least have an order-of-magnitude estimate of what the police brutality rate is before deciding if it’s too high or not? What if I told you the real number was a million cops? Five million cops? Ten million? That’s a hundred times the original estimate of 100,000 – shouldn’t learning that the police brutality rate is only 1% of what you originally estimated (or, going the other direction, 10,000% of that) change your opinion in some way?

(No, I won’t tell you how many cops there actually are. Look it up.)

I feel this way about a lot of things. The media is always giving us stories of how tech nerds are sexist in some way or another. But we may suspect they want to push that line regardless of whether it’s true. How many tech nerds are there? A million? Ten million? How many lurid stories about harassment in Silicon Valley have you heard? Do we know if this is higher or lower than the base rate for similar industries? Whether it’s going up or down? What it would look like if we actually had access to the per person rates?

By now you’ve probably figured out the gimmick, but just to come totally clean – cardiologists are wonderful people who as far as I know are no less ethical than any other profession. I chose to pick on them at random – well, not quite random, one of them yelled at me the other day because apparently contacting the cardiologist on call late at night just because your patient is having a serious heart-related emergency is some kind of huge medical faux pas. I don’t think anyone has ever claimed that there’s any general issue with cardiologists, and as far as I know there’s no evidence for such.

If you read Part I of this post and found yourself nodding along, thinking “Wow, cardiologists are real creeps, there must be serious structural problems in the cardiology profession, something must be done about them,” consider it evidence that a sufficiently motivated individual – especially a journalist! – can make you feel that way about any group.