Scrooge is out Early This Year

Robin Hanson has his Scrooge hat on:

A student told me the other day he wanted to be a doctor, so he could help
people.  I thought, "What, as opposed to the rest of us who hurt people?" 
Contrary to the smug self-righteousness assumptions of those in "helping"
professions, like child care, teaching, counseling, or emergency services, it is
far from obvious that these professions are any more helpful than the rest…

Read the whole thing if you are not already convinced.  I agree with Robin.  Let me add that I am an equal opportunity Scrooge, I also really dislike those TIAA-CREF ads which make professors out to be saints.   



You know perfectly well that the only reason TIAA-CREF treats professors as angels is to get their money for its investments and insurance. Why should you be against that?

With best regards for the holidays,


I totally agree. (Of course, it's ok for an undergrad to mouth empty bromides like that.)

There is a cultural component to the helping professions. In the US, nurses and nannies are often imported from poor catholic countries to some extent because they grew up in an anti-materialistic culture that values helping people.

Doctors are probably a somewhat different issue because they make so much money. Here is a good article on doctors that is pretty clear eyed about what the fact that some doctors are better than others should mean:

“By participating in a society we all help each other.†

Prostitutes help people by reducing their stress level, but they also spread STDs.

Drug dealers help people deal with pain yet they reduce the productivity of addicts.

Lawyers fight for justice and sometimes let people get away with murder.

Teachers enlighten students and sometimes they indoctrinate and make people more narrow-minded and arrogant.

Doctors help people to heal and they often overcharge (and on occasion unintentionally goof up)†¦.In all the above professions, people are also overcharged. What else do doctors do that makes them as much a liability as the above mentioned?

Chairman Mao,

I agree, doctors are better than drug dealers and prostitutes.

Great, and easily missed, point.

People often act as though health care providers help them more than other professionals. Doctors and
nurses working in intensive care wards often receive heart felt thanks from patients and families and
often receive large numbers of flowers and other gifts. Even hightly skilled, competitively priced
carpenters rarely receive such thanks. With people acting this way perhaps it's not too surprising that
doctors consider themselves to be more helpful than the average worker.

It is interesting to note that sex workers also often also receive heartfelt thanks and gifts. However
they may also receive more abuse than health care professionals.

I'm an engineer because I like solving problems. My wife's a nurse because she like working with ("helping") people. I'd be bored out of my mind "helping people" if it meant doing the same thing every day. For her, each person is different so it's not the same thing each day...though it would be for me.

I think your negative comments say more about you than about "helping professions"...

I agree that in the vast majority of cases, "I want to help people" means "I want to feel superior to others," but sometimes it's true. Consider someone who wants to help people. If this person didn't have that drive, he might become an investment banker, but if HE thinks the social worth of i-banking is pretty low, he might decide to become a doctor instead. The only scenario I can think of where this is a legitimate argument is when the supply of qualified people for the philanthropic job is low or seen to be low enough that the social benefit of switching is high (so doctors working in the first world can't say this), like math teachers in inner city schools (Teach for America) or the military (supply question debatable, I'm thinking of a Tillman type example).

Michael Foody might want to have a look at the diamond water paradox of value before asserting that it should be clear the doctors are more valuable than professors because of their having a higher wage. Are diamonds, overall, more useful than water?

the diamond water doesn't work because medicine is less of a luxury than education not more. Doctors and teachers are made from the same resource, people. My argument was incomplete because it was a comment on a blog. But that is now excuse to be just silly.

eriks: "There are quite a number of jobs (well-paying and prestigious even) that are net negatives on society."

If a job is well paying (and assuming that it's not illegal and that people aren't forced to pay for it (such as the jobs of congressmen or heads of regulatory agencies)), how can it be a net negative?


Thanks. Just to be clear: Do you, personally, expect the motivations of your physician to be similar to that of someone buying your house?

It's not a trick question, and I am not supposing that you are wrong if you answer 'Yes.' However, I think you will be in a very small minority if that is your answer. Not that that makes the answer wrong.


I just don't base morality on motivations.

JP and Josh,

Thanks for responding. I am not trying to argue that clinicians are better morally. For a host of reasons, I see no way to make such comparisons. In particular, I don't think motivations are a sufficient basis for judging actions (I expect Josh agrees with that much).

My point is narrower: a clinician's moral attitude toward the person she is dealing with is expected to be different, and often is different. You would not fault me for indifference toward your well-being following your purchase, so long as I bargained honestly in the business we transacted. You should fault your doctor if she is indifferent to your health, conditional on her having 'followed the appropriate procedures'.

Bill -- You're *paying* the doctor not to be indifferent to your health. That's part of the service he or she is selling. Similarly, you pay a structural engineer not to be indifferent to whether your office building stands or collapses. When you buy a good, what you're normally paying for is the object itself. Caring about your well-being is not part of the deal. I suppose it could be (as in the case of a mass card purchased from a church, where you pay for the card plus the prayers it represents on behalf of your designee). But since there's apparently not much of a market for goods + concern, most people presumably don't want that sort of thing.

In other words, in each case someone voluntarily agrees to do or deliver x in exchange for $y, and someone else voluntarily agrees to pay $y in exchange for x. I don't see a basis for finding any one exchange morally superior to the others.

Bill -- "When you are getting a service from someone, you are paying for qualities of character and intention that you expect the person to bring to the work."

I agree with that. What I don't see is how morality enters in (aside from the morality of honoring your promises/contracts and doing your job well, which seems to apply to all lawful lines of work). Doing a good job as a doctor is more *difficult* than doing a good job as a mechanic, and it's more *valuable* (judging from what people pay for medical services as opposed to car repairs), but it's hard to see how being a good doctor is different morally from being a good mechanic.

For the same reason, I object to calling the rules governing my own profession (lawyering) legal "ethics." They are just rules that lawyers are expected to follow, the violation of which can lead to civil damages, disbarment, and other penalties. The rules parallel certain traits that are considered morally positive, such as loyalty, honesty, and civility, but by following the rules I'm simply doing my job, for which I am (nicely) paid.

Gosh, I am the only teacher reading this thread, aren't I?

I can tell the person who thinks "wanting to help people" is the same as "wanting prestige" that that doesn't apply to my profession; teaching is hardly prestigious in our society (as this comment thread so thoroughly demonstrates). I could have done any number of more prestigious things with my skills.

I can tell the person who thinks "wanting to help people" is the same as "wanting to feel superior" that that's just wrong, too. Sure, probably right for some, but not right when painted with such a broad brush. The longer I teach the more humble I feel in the company of my students, many of whom at the age of thirteen easily are my betters in many ways.

Yes, I went into teaching in large part because I wanted to help people -- individual people in a face-to-face way with important things. My husband writes software for cell phones, and people have paid for that software, so I guess they feel their lives are better for it, and that's wonderful (particularly as it allows me to *afford* to be a teacher yet still own a house...). But you'll pardon me if I think that teaching people is qualitatively and quantitatively a different, and better, sort of benefit than having diversions on a cell phone.

Yes, he gets paid twice what I do for his benefit to society. But it is shallow to confuse monetary and moral value. He happens to produce the sort of thing that can be sold at modest per-unit cost to a large number of people at once. I happen to produce the sort of thing that can be sold to a very limited number of people at once, none of whom are personally capable of paying me for it (as they are only thirteen years old), no matter how much they may appreciate my service. And, no matter how much parents may appreciate and desire -- dare I say, value -- education, that doesn't make them automatically able to pay arbitrarily large tuition. My school can only jack up tuition so far while still attracting enough customers to be viable. Ergo, my salary. I accept this as a matter of economics, not as a judgment of my "value to society" or moral value or what-have-you.

I'll judge my moral value from my second-year students today, who realized that Friday is the last day they will see me for months as I will be going on maternity leave, and concluded they should throw a party, and were immediately arranging who brings soda, who brings cake ("Hey, what kind of cake do you like?" they ask me). My husband may make twice what I do, but I get chocolate cake. And Tyler's always saying you should invest, not in things, but in experiences.

Isn't anybody going to explain marginal utility to the proposer of the diamond-water "paradox"? Teachers as a whole may well be very valuable, but the social value of one more teacher is the little pay they get. And one more doctor is socially worth more than one more teacher, but not more than one more NBA player.

"If there are a fixed number of slots in medical school, you would just displace someone else. You then have to ask how much better are your services than that person's. And beware of overconfidence."

As being a doctor or a teacher involves unions that restrict entry, the marginal value of the last hiree over who would be the next hiree, might be expected to be slightly higher than in unregulated professions. Sure, the existance of these unions hurts people, but you're decision to become a doctor may acutally help people a little more than you other wise would have at least as far as this effect is concerned.

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