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Author Topic: number of lives saved - becoming a doctor vs donating 10000$
LetterRip
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Intesting analysis by a doctor on the number of lives saved by a typical doctor versus going into a different profession and donating 10% of his salary towards aleviating poverty,

quote:
So we’ve now got a much better estimate of how big a difference I will make working as a doctor: around 600 QALYs, or around 20 lives – one every two-and-a-bit years or so of my career. Giving 10% of my salary to effective causes that fight global poverty will add around 18 800 QALYs, a health impact about 30 times higher than what I do directly in my work.

I think my 17-year-old self would find that pretty galling. He’d signed up to medicine to save loads of lives, and he’d find it a bit of a downer to see this his entire medical career would likely do as much good as a £10 000 donation to the right charity. But that would be the wrong way of looking at things: instead, he should see that saving 17 lives is a vast amount of good, and being able to do 30 times more good on top of that is awesome.

https://80000hours.org/2012/09/how-many-lives-does-a-doctor-save-part-3-replacement-84/

Really interesting series, lots of food for thought.

[ September 03, 2015, 03:41 PM: Message edited by: LetterRip ]

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AI Wessex
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The power of a fulcrum over lifting dead weight.
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Pete at Home
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It also ignores the number of lives improved. The doctor who diagnosed me with add and got me treated brought me from cs to As in school, and made possible relationships and sevicce on my part that otherwise never would have been possible. The ripple effect of service is huge.

Also, if the doctor took hust a month every year volunteering in the Congo or East Timor, etc, he could save a hell of a lot more lives than a $10,000 fee would have saved.

There is also the issue of sustainability. Unselfish service is rewarding, habit forming, and liife changing. It also sets examples to others. Parents who serve the poor directly are more likely to instill a service ideaology in their kkidsi than paerents that fill envelopes.

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AI Wessex
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Money is given for all those things and many other humanitarian causes,as well.
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Pete at Home
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All what thtngs specifically?

Not against giving; I simply maintain that direct serrvice has some irreplaceable benefits to both giver and receiver.

Direct service among other things makes you into a better, more giving person. Checkwriting not as much, particularly when it isnt your money you are giving. ;

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Pete at Home
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The whole idea of money solving everything and supplanting direct service stinks of the medeival indulgences industry.

Are you an unfeeling ******* who wants to feel goos about yourself" did you file divorce4 when your ex wasw in chemo, and are you sick of your neighbors acting all superior because they spent that year in Haiti helping the lepers? For just $10,000 you can get certified proof that you are the best human being on your block. Aend your check or money order to the SWizard of Oz in Emerald City, Nigeria.

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AI Wessex
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??? Maybe I'm not as noble as you, but I can take some comfort knowing that I contribute money and goods to worthwhile causes that help people. When I retire I might have more time to contribute, as well.

I'm not going to bother responding after this since you've reacted with such hostility to what I thought were pretty innocuous comments.

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Seriati
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What I find less fascinating is the description of the lives saved by a doctor (which honestly, seems woefully undercounted - deliberately by methodology). He starts with a very minimal number and then qualifies further with everything he can think about (even some things that are fairly illogical), then aggregates the measure into "lives saved," which is a measure designed to discount massively the impact of lives improved.

The comparison to the power of donation is more interesting. There is a gross inflation of the power of the donation. He doesn't seem to be as rigorous in the application of discounts to the donations. The site specifically mentions for instance the amount of wasted donations, where's the discount for that? Where's the discount for donations improving on a single vector in environments where multiple vectors have to be corrected. The Malaria treatment example given, may be his strongest its a one off selector, but even there, there's no discount for the amount of value add (in terms of the measure he's using ) for the fact that Malaria is incredibly unlikely to be the only issue present and that people would still have incredibly crummy years. If it were discounted in the same way, it's very likely that the marginal gain would be far less that reported. If you looked at the improvement needed in a Malaria region by cost per person, how far would that donation realistically stretch? 20 people, less more? With a total impact per person greater than in a developed country, but by a large enough amount? Anytime you pick only the highest value add process in a complex situation to use for a comparison you're trying to manipulate someone's interpretation.

When you compare the idea that so many lives can be saved by the "price of a cup of coffee" to the actual aid budgets that hit most of the countries involved, you'd have a hard time explaining how there are lives still to be saved. There's a lot of double, triple, even 10 or 20 times counting for the same lives saved, which means the cup of coffee standard is a misrepresentation of reality. And a very good chunk of the funds donated are diverted and provide no aid, or even act as a detriment to the region. Personal service is very hard to divert.

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AI Wessex
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quote:
When you compare the idea that so many lives can be saved by the "price of a cup of coffee" to the actual aid budgets that hit most of the countries involved, you'd have a hard time explaining how there are lives still to be saved. There's a lot of double, triple, even 10 or 20 times counting for the same lives saved, which means the cup of coffee standard is a misrepresentation of reality. And a very good chunk of the funds donated are diverted and provide no aid, or even act as a detriment to the region. Personal service is very hard to divert.
I don't think personal service is always that efficient. Using your model to extrapolate (and exaggerate), you spend a lot of money to go to a remote area to help, but aren't given the proper resources, people aren't cooperative because you have no power to compel them to take your assistance, government services don't sustain best practices you might put in place, people resume unsafe behaviors as soon as you leave, so no lives are saved or salvaged. Then you come home with a lingering illness you picked up along the way. You accomplished nothing and now have money and care needs of your own. What a waste.

I know someone who volunteered in Sri Lanka and contracted a chronic blood disease that eventually killed him, so it's not really an exaggeration, just a description of what could happen to a well-intentioned volunteer.

You can make a case either way for individual or collective action, whether direct and immediate or through a more organized and possibly remote effort. It's a mistake to try to define what is or isn't the blessed way to make the world and people's lives better.

Do what you can in the best way you are able.

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The Drake
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I think the system only works with donors and volunteers. My skills don't translate well into volunteering effectively, and I don't care to spend my time in the jobs that don't require skills. I do take great pride in supporting those who do volunteer their time with my donations to a clinic that serves our homeless community. I don't see it as lesser.

I'm not going to delve into the articles quantitative analysis, but I do like the doctor's general theme that you aren't better than everyone else just because you're a doctor, and that if altruism is your goal there are a lot of ways to accomplish good things for your fellow human being.

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Seriati
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Al Wessex, I agree with what you said. Never claimed that personal service was necessarily efficient, it is harder to divert. And I tend to believe that most tourism volunteering is terribly inefficient (why is it that kids from every state go to a different state to help out the underpriviledged?).

But they were comparing the lifetime impact of being a doctor (including a career of practice in their home country) to a cash payment. They weren't using the least efficient model possible - tourism volunteering - to make their claim.

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scifibum
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Personal service probably makes the service provider a better person, relative to donating money. But the money can (potentially) do more net good.
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Pete at Home
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quote:
Originally posted by AI Wessex:
??? Maybe I'm not as noble as you, but I can take some comfort knowing that I contribute money and goods to worthwhile causes that help people. When I retire I might have more time to contribute, as well.

I'm not going to bother responding after this since you've reacted with such hostility to what I thought were pretty innocuous comments.

Hmm. To the extent that it was reasonable for you to infer that i was adresssing YOU, Al Wessex, when I used the generic you, then i can appreciate you feeling that way.

I was responding to the denigration of direct service. I absolutely and wholeheartedly approve of your donating money to good causes. Thank you for helping make this a better world.


In My better days, I made financial contributions where I could and did service where I could. In. My worse days I have received generous unselfish service and also generous donations and loans to help me out of problems, some but not all of which were self inflicted. In my own experience, I tended to make best use of the money when it was donated by people I knew and earmarked for something special. Donations made it possible for me to purchase a car when I was homeless, and now I have an apartment and kids coming over...

I apologize for miscommunicating. Clearly direct service cannot do some thingxs that financial donations can do. And, imo, vice versa. Thank you for clarifyin g your position and letting me kn ow how I had come off. perhaps it would be betteer to say that the article is like saying that breathing is "more important" than a beating heart. Society would lose out with no doctors, or with no donations.

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Pete at Home
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"I don't think personal service is always that efficient. Using your model to extrapolate (and exaggerate), you spend a lot of money to go to a remote area to help, but aren't given the proper resources, people aren't cooperative because you have no power to compel them to take your assistance, government services don't sustain best practices you might put in place, people resume unsafe behaviors as soon as you leave, so no lives are saved or salvaged. Then you come home with a lingering illness you picked up along the way. You accomplished nothing and now have money and care needs of your own. What a waste."

Ouch. Well argued, sir. I have no rebuttal, and yield the point.

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Pete at Home
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<Sad that Al has not accepted my apology>
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AI Wessex
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No worries, but even if the comments weren't addressed to me, the hostility didn't invite a polite response. I'd be happy to engage if we're talking about issues and ideas instead of venting personal anger.
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Pete at Home
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Agreed. Acknowledged. Appreciated.

I was hostile and suspicious of the "dont try to help, just send money, because I am an alcoholic and work with other addicts, and the messagw rings to my ears like a con.

About six months ago, a pregnant methead that I'd been trying to help, declihed my invitation to take her and her kid grocery shopping (my treat) because:

"Yea just was very tired and worried about getting food in the house and stuff like that"


I have no doubt the kid was hungry like she said but money given to her would have gone to meth; she didnt even have a car to pick up the groceries if given money. So she was too busy worrying about how to get groceries to let someone buy her groceries. So worketh the mind of a tweaker.

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AI Wessex
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The weakness of giving money is the lack of control over how it is used. Rather than give money for food to an addict who lacks common sense, give a gift card to a (healthy) fast food restaurant. They could always trade it away, but maybe the urge to eat will influence them, too.
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Pete at Home
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Agreed. The same girl had been very grateful when I brought her groceries on a day when apparently hunger exceeded meth crave.

A goodly and generous donor who took the time and research and investigation as to how to invest, could do a great deal of good in the world.

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