Jeremy Hunt On Collision Course As He Says No To Nhs Pay Rises

[hjcjb]

Work to rule would certainly kill patients, due to the handover chaos and the oncall teams being too stretched already

The strikes you have seen so far are not the real deal- we've been covering all the emergency work.

All-out strikes will bring a halt to elective work, and it'll soon be obvious that your sympathy is really not the key commodity here.

This is Jeremy Hunt's miner's strike, but he doesn't have any coal reserves.

[“Nasty Piece of work”]

Mmmmmmm...... A walking abortion that makes Shapps look normal, or Doctors.....

[Will!]

What I don't understand is why they don't just work to rule. It would be far more effective than threatening to strike. Just work exactly your contracted hours for your contracted salary. No overtime, no extra work, no work at home nothing. Then we'll see if the NHS starts to really collapse when doctor's don't do 96 hours a week, and if it does THEN you'll get the public sympathy.

Why skip straight to the strike?

The BMA is trying to find a form of industrial action that causes an unsustainable level of inconvenience for NHS employers without compromising patient safety. It's a difficult balance to strike and so far the BMA has leaned heavily towards the latter point, for obvious reasons.

[Guest eight]

The BMA is trying to find a form of industrial action that causes an unsustainable level of inconvenience for NHS employers without compromising patient safety. It's a difficult balance to strike and so far the BMA has leaned heavily towards the latter point, for obvious reasons.

You should tell your mate, upthread. He appears to be trying to hold us to ransom with our own health as the bargaining chip.

[Doesn't Commute Anymore]

I've enjoyed this thread more than any for a while. It's climaxed in tandem with the government's enforcement of the contract anyway and it has teased out the reasons for the strike not really catching the support of the public, and certainly not the policy-makers.

The cherry on the cake was hooking the god-complex, qualification-quoting "I think I am worth more" junior doctor on the fishing line, who seems to likes his sick patients, alongside their presumably stressed relatives, in a state of unconsciousness to avoid requiring care and compassion skills, and believes he will countenance any fall in wages by running off to GSK or Schroders or wherever else he sees a high salary, despite clearly lacking the analytical, regulatory or people skills to transfer to those sectors. That doctor has lost his mission in life and is not following the founding principles of the hippocratic oath. He is like an MP who hates his constituents, or a midwife who hates babies. He/she should take his wage bill to another country's taxpayers, I really welcome that outcome.

Here is why the junior doctors lost. Yes, its a daily mail article by a senior GP. But senior members of the profession have inherent values in their practice of medicine that the new generation, on the picketline, have lost. Plus, the daily mail readership is your client-base as an NHS worker, be them "illiterates" or not.

http://www.dailymail.co.uk/news/article-3446180/I-m-sick-striking-doctors-says-GP-Medic-REALLY-tough-delivers-damning-verdict-militant-colleagues.html

A few personal notes:

+ There is a general confusion in the junior profession between new and old values of practicing medicine, as I keep saying. As a profession, it was traditionally a calling to dedicate your life to the care of others, not an entitlement to earn high wages where you dictate when you are willing to care for the patient. If you want the latter, then fine, but you are subject to supply and demand wages like other regular contracted jobs. And in that case, lets have more medical schools to control supply better (The Open University medical school project needs re-starting).

+ the whole economy and workforce is stretched. Stop claiming you are more stretched. Its a broken record. PR mistake #1.

+ words like "care" and "compassion" need to be used around arguments involved patient care. They have not been used in this campaign. PR mistake #2.

+ Any argument about patient safety revolves around the patient's level of care. Not the practitioners wallet. PR mistake #3.

+ Modern medicine is interdisciplinary and team-based. If the argument is going to be "#juniorcontract - its everyone's fight", then it needs to be everyone's fight involving the out of hours contracts of these other professions, who incidentally conduct themselves with far more dignity. You need to be campaigning for those overworked midwifes and understaffed lab technicians not just BMA members. The salary of one profession within the hospital is not everyone's fight at all. This isn't just a PR mistake, its a breakdown in the relations between you and other healthcare professions.

+ Just like we see elsewhere on HPC, junior doctors have the raw end of the intergenerational deal here. Your older GP and hospital consultant colleagues got too generous a contract last time, so that leaves the juniors to take a cut to balance the books. Where are those senior staff in the press pictures of protesting medicine? In their 6 bedroom detatched houses. They dont support junior doctors either.

+ BMA looks increasingly militant and willing to hold the public to ransom. Its like the train drivers. BMA reputation is in tatters. Patients are not pawns in a game.

[bankstersparadise]

+ Just like we see elsewhere on HPC, junior doctors have the raw end of the intergenerational deal here. Your older GP and hospital consultant colleagues got too generous a contract last time, so that leaves the juniors to take a cut to balance the books. Where are those senior staff in the press pictures of protesting medicine? In their 6 bedroom detatched houses. They dont support junior doctors either.

Yes this is the main point here in all of this. The BMA latched onto the general dissatisfaction of the 20-35 year old junor docs and politicised the whole thing.

[ZeroSumGame]

Looks like Mr Hunt will have to impose his contract on the NHS employers too.

http://www.itv.com/news/2016-02-12/more-nhs-bosses-withdraw-support-for-hunts-junior-doctor-contracts-imposition/

[spyguy]

Yes this is the main point here in all of this. The BMA latched onto the general dissatisfaction of the 20-35 year old junor docs and politicised the whole thing.

I know I sound like a stuck record but this is Brwns fault (again, again, again).

The one eyed goon ramped up health spending, that went on PFI + salaries for existing workers.

Economy tanked, tax base shrank and they cannot pull back what they've handed out so have to cut back from new starters.

[pig]

I've enjoyed this thread more than any for a while. It's climaxed in tandem with the government's enforcement of the contract anyway and it has teased out the reasons for the strike not really catching the support of the public, and certainly not the policy-makers.

The cherry on the cake was hooking the god-complex, qualification-quoting "I think I am worth more" junior doctor on the fishing line, who seems to likes his sick patients, alongside their presumably stressed relatives, in a state of unconsciousness to avoid requiring care and compassion skills, and believes he will countenance any fall in wages by running off to GSK or Schroders or wherever else he sees a high salary, despite clearly lacking the analytical, regulatory or people skills to transfer to those sectors. That doctor has lost his mission in life and is not following the founding principles of the hippocratic oath. He is like an MP who hates his constituents, or a midwife who hates babies. He/she should take his wage bill to another country's taxpayers, I really welcome that outcome.

Here is why the junior doctors lost. Yes, its a daily mail article by a senior GP. But senior members of the profession have inherent values in their practice of medicine that the new generation, on the picketline, have lost. Plus, the daily mail readership is your client-base as an NHS worker, be them "illiterates" or not.

http://www.dailymail.co.uk/news/article-3446180/I-m-sick-striking-doctors-says-GP-Medic-REALLY-tough-delivers-damning-verdict-militant-colleagues.html

A few personal notes:

+ There is a general confusion in the junior profession between new and old values of practicing medicine, as I keep saying. As a profession, it was traditionally a calling to dedicate your life to the care of others, not an entitlement to earn high wages where you dictate when you are willing to care for the patient. If you want the latter, then fine, but you are subject to supply and demand wages like other regular contracted jobs. And in that case, lets have more medical schools to control supply better (The Open University medical school project needs re-starting).

+ the whole economy and workforce is stretched. Stop claiming you are more stretched. Its a broken record. PR mistake #1.

+ words like "care" and "compassion" need to be used around arguments involved patient care. They have not been used in this campaign. PR mistake #2.

+ Any argument about patient safety revolves around the patient's level of care. Not the practitioners wallet. PR mistake #3.

+ Modern medicine is interdisciplinary and team-based. If the argument is going to be "#juniorcontract - its everyone's fight", then it needs to be everyone's fight involving the out of hours contracts of these other professions, who incidentally conduct themselves with far more dignity. You need to be campaigning for those overworked midwifes and understaffed lab technicians not just BMA members. The salary of one profession within the hospital is not everyone's fight at all. This isn't just a PR mistake, its a breakdown in the relations between you and other healthcare professions.

+ Just like we see elsewhere on HPC, junior doctors have the raw end of the intergenerational deal here. Your older GP and hospital consultant colleagues got too generous a contract last time, so that leaves the juniors to take a cut to balance the books. Where are those senior staff in the press pictures of protesting medicine? In their 6 bedroom detatched houses. They dont support junior doctors either.

+ BMA looks increasingly militant and willing to hold the public to ransom. Its like the train drivers. BMA reputation is in tatters. Patients are not pawns in a game.

Wow - that's a whole haystacks worth of straw men !

There are probably a fair few reasons why the public are generally behind the doctors, but I think key has got to be Hunt himself.

The implementation of the idea I supported at the outset has been utterly misconceived, And his one main asset, that air of cheery (albeit eerie!) unflappability works horribly against him when standing in the middle of a self-induced political carnage visited literally where it hurts.

The reverse doesn't work btw. Trying to pick out individual doctors to try to demonise them all in some irrelevant way or digging up the classic rent-an-apostate article from the Mail is hardly going to distract from said carnage is it ?

[frozen_out]

Work to rule would certainly kill patients, due to the handover chaos and the oncall teams being too stretched already

The strikes you have seen so far are not the real deal- we've been covering all the emergency work.

All-out strikes will bring a halt to elective work, and it'll soon be obvious that your sympathy is really not the key commodity here.

This is Jeremy Hunt's miner's strike, but he doesn't have any coal reserves.

Public sympathy is the only commodity that matters in public sector strikes. If nobody cares about your 'battle' you've already lost. Same as the teachers and police.

[SpectrumFX]

If someone is better placed and more experienced (maybe even more intelligent, who knows) to determine the most useful path to a desired result, yet someone worse placed and less experienced (and maybe even less intelligent) deigns to tell them they're wrong, you would have the person who knows they are better qualified defer to the worse qualified?

All so that you could could get a fuzzy feeling that everyone is magically equally qualified to pontificate on anything at all?

That's anti-intellectual stupidity! If you're not a doctor, a doctor is probably better placed to determine how to efficiently practice medicine than you. If you're a not a plumber, you're probably going to do a worse job of re-routing your soil pipe than an actual plumber.

By all means be willing to offer suggestions to the professionals, some of the really ground-breaking stuff in any area can come from out of left field from an unbiased pair of eyes. But accept that those suggestions, and your judgements of them, are most probably going to be worse than someone specialised in the field.

Straw man.

How the NHS is structured and funded is a political rather than medical decision.

[dgul]

Work to rule would certainly kill patients, due to the handover chaos and the oncall teams being too stretched already

The strikes you have seen so far are not the real deal- we've been covering all the emergency work.

All-out strikes will bring a halt to elective work, and it'll soon be obvious that your sympathy is really not the key commodity here.

This is Jeremy Hunt's miner's strike, but he doesn't have any coal reserves.

Hj - I value your input here as it is good to have a view from the coalface - thanks.

But be careful with the above sentiment. For a large % of the population, when things get bad they blame the direct source of the 'badness' - in the case of strikes they blame the strikers. Every death will be blamed at 'those militant doctors that have destroyed the system', not those whose changes have brought about the strikes. This might sound like nonsense to you (with your knowledge of the impact of the proposed changes), but it is an emotional, rather than logical response.

Going down the route of absolute unconditional strikes is a dangerous path (from the point of your public support).

[Clarky Cat]

Hj - I value your input here as it is good to have a view from the coalface - thanks.

But be careful with the above sentiment. For a large % of the population, when things get bad they blame the direct source of the 'badness' - in the case of strikes they blame the strikers. Every death will be blamed at 'those militant doctors that have destroyed the system', not those whose changes have brought about the strikes. This might sound like nonsense to you (with your knowledge of the impact of the proposed changes), but it is an emotional, rather than logical response.

Going down the route of absolute unconditional strikes is a dangerous path (from the point of your public support).

The really cynical view is that this is the plan. Bring down the system. Privatise. Blame the staff.

The Conservatives struggle because ideologically they'd want to privatise, but this would be electoral suicide.

If the NHS is destroyed from within by "greedy doctors" they side-step this particular difficulty.

[bankstersparadise]

I know I sound like a stuck record but this is Brwns fault (again, again, again).

The one eyed goon ramped up health spending, that went on PFI + salaries for existing workers.

Economy tanked, tax base shrank and they cannot pull back what they've handed out so have to cut back from new starters.

Agree

[rxe]

A very unfortunate story, but I thought I'd shed some light on how this sort of thing happens, as it's what I do for my day job.

There are many reasons why a scan might be mis-read. These are not binary results, they require quite a lot of interpretation and subjective opinion, and there are some diagnoses which are genuinely "borderline". Some doctors might say it's probably normal, and some might say it's probably abnormal, and they might both be right, particularly if it is something where a technique has been used which is not optimal.

For example, hollow-organs are a notorious problem. They can look very different when full than when empty, and the range of normal appearances is so wide, that even large tumours can be quite well hidden, unless you know exactly what to look for.

Another reason is that for whatever reason, the region of the abnormality didn't get looked at. A competent interpreter will have a well rehearsed check-list that they go though. In the case of an abdominal scan, they will tick off every single organ. Some interpreters will write in the report "normal liver. normal kidneys. normal pancreas. normal bladder. normal colon....." so that when they proof-read the report, they can go back and double check. However, historically UK training has been to try and provide a briefer interpretation which is easier and clearer to read for the receiving doctor. The way scan reports are written in places like the US is almost useless, because every single little scar or irrelevant spot gets written up with a list of 20 different possible diagnoses. This is ideal for the radiologist writing the report, because they get to do a whole bunch of follow-up tests, each one paid for. However, managing this takes an extreme amount of resources.

Failing to look at a specific region (or looking but failing to see an obvious abnormality) of a scan is a recognised pattern of error. In some cases it is simply due to incompetence, they didn't know to look. In some cases, it is a case of being careless, and skipping looking at a region, or it could be a matter of insufficient experience and not recognising what they are seeing. There is a psychological issue here, where you tend only to see what you are looking for. There was a recent study where a chest scan was given to a group of radiologists who were asked to find the lung cancer (which was quite well hidden). However, the scan had been edited to incorporate a cartoon of a gorilla. The results showed excellent accuracy for detection of the lung cancer, but virtually no detection of the gorilla. (compare this to the gorilla basketball video experiment).

To an extent, there is an issue with working practice. Interruptions are a major problem, because it can take 15-20 minutes to review a scan in detail and go through the checklist. This requires considerable concentration, and interruptions are a hazard, because they introduce a risk that things get skipped in the checklist, or things get spotted and forgotten. Of course, what should happen, is that you start over from a clean slate. In practice, management demands for productivity can interfere with this. To illustrate, at one of my old jobs, management insisted that any scan from A&E had a report within 1 hour. This was fine, but I would typically get about 70-100 phone calls per day, which worked out at about 3-4 interruptions per scan. That sort of environment is not conducive to accurate reporting.

To illustrate, just today, I was asked to second read a scan which had caused concern. The original radiologist had spotted the abnormality, and saved a screenshot with a big arrow pointing at it. The only problem was that there was no mention of this in the written report. I would presume that there was an issue with distraction in that case.

My colleagues who have gone to the US, tell me that that sort of thing just is not tolerated. A reporting radiologist, when they are timetabled to be reporting, is not to be disturbed under any circumstances. No phone calls, no knocks on the doors. The IT works, and doesn't constantly crash or have serious usability problems. Not only that, in many centres they double report everything, so every report is double checked before it goes out. An alternative used in big centres, is for each radiologist only reports on their specific specialism. So, an abdominal scan would go to a liver radiologist, a GI tract radiologist, a urology radiologist and a skeletal radiologist. And of course, each radiologist can also take a holistic look at the whole scan. This is very good for accuracy, but the cost is astronomical, although this is partially offset by higher levels of productivity and staff morale.

The UK has traditionally employed radiologists as generalists - i.e. they are expected to be able to do everything. There is a gradual shift to sub-specialisation, but this is not always feasible except in the largest hospitals. A liver radiologist at a typical small hospital is going to be spending most of their time doing head, chest or general abdomen scans as these are the most common. At a big teaching hospital you can have someone who does only head, or a liver radiologist who spends 50% of their time doing livers, and the rest doing general abdomens.

The problem with this generalist approach is that some people may end up working outside of their field of competence: someone trained as a liver radiologist may struggle with head scans, or perhaps they may not do enough to ensure that they remain competent.

Mistakes will always happen, nevertheless. So there are ways to manage and mitigate them. A good working relationship between the ward doctors and the radiology department, means that cases can easily be brought to review meetings. In some places, these can be quite dysfunctional, whereas in others they are very effective. There is also pro-active quality control. In my current job, our IT system randomly selects a sample of 2.5% of reports from the last week, and automatically allocates them for a second opinion. The statistics are collected, and provide some degree of early-warning for a competence problem. In my last couple of jobs, I've worked at hospitals where the competence is excellent, and the typical error rates on pro-active QC are about 1% for a "meaningful" error, i.e. one which requires a correction to be sent out (as opposed to a typo or spelling error which doesn't affect intelligibility, or where the disagreement is about something trivial).

As there is currently a critical shortage of radiologists in the UK, there has been a sudden interest in private companies contracting with the NHS to do the reporting. The scans are sent from the NHS, pooled by the service provider, and sent out to radiologists for reporting privately. Many NHS hospitals now do this for their night cover, so any scan overnight is sent to a private provider (it's cheaper than paying on-call rates for a consultant or junior, especially if the hospital is not a busy one). I had noticed that the reports from some of these providers were "a bit dodgy" and there has recently been quite some discussion in the scientific journals about their performance. Alleged QC error rates for some of these companies have reached me on the grapevine; let's just say that they are significantly more than 1%.

The problem with have a major shortage of radiologists, is that many hospitals see QC as an unnecessary increase in workload. A 2.5% QA rate, represents a 2.5% increase in workload, which may not be viable. I know of a number hospitals where the backlog of scans for reporting may be 6 weeks. What if there is an unexpected cancer, or something on one of those? That's not an acceptable service, and indicates a catastrophic failure of management, from which further crises will develop (You've got overworked staff, providing a poor quality service, morale is falling, and the situation is so critical that you can't even institute pro-active monitoring - you don't have to be a genius to see that this has the potential to end badly).

The other problem is with a major shortage of doctors is that managers are under pressure to hire, as a result candidate selection may not be quite as rigorous, as you might hope.

Interesting reply, thank you. Just to be clear, I have no idea if the radiologists got it wrong or the oncologists - but he was told some very incorrect things over the last few weeks.

You make an interesting point on specialisation - I remember trying to solve this several years ago. The "use case" then was stroke - you had a radiologist on call, but he was at one hospital (or at home) and patients were showing up all over the region. We had some technology that could put a full quality/lossless image on his screen in seconds, regardless of location. I remember demoing it with a CT on a train using 3G - worked perfectly. You could use something like that to say "this team does <insert body part or choice" in the UK, for everyone. Report the image, fire the report into the scanning hospitals RIS, job done. At the time, it cost less per year than the company car the trust chief exec was driving. It went nowhere - simply didn't fit the purchasing model, and required trusts to co-operate. I think the biggest sticking point was that they couldn't work out how trust x got paid to read trust y's images. I got frustrated with the politics and went off and did something else!

[Will!]

Here is why the junior doctors lost. Yes, its a daily mail article by a senior GP. But senior members of the profession have inherent values in their practice of medicine that the new generation, on the picketline, have lost. Plus, the daily mail readership is your client-base as an NHS worker, be them "illiterates" or not.

That piece is a provocative mix of nostalgia, Monty Python's "Four Yorkshiremen" sketch and a fair number of half-truths with a general undertone of "I'm alright Jack." I do agree with this part though:

Perhaps something about the way the modern NHS is run is also to blame. It treats junior doctors as parts in a machine rather than individuals embarking on a career caring for the sick.

I think I've already answered all your other points, but in response to:

+ Any argument about patient safety revolves around the patient's level of care. Not the practitioners wallet.

Pay is the only effective brake on how many weekends and the total number of hours we can be made to work. That's why this argument is about is patient safety. We're not asking for more money.

[BlokeInDurham]

What you're missing is that this is now predominantly about politics not 'ideas'.

Look through these pages. Lefty outrage. Tory faithful nervous and spiteful. People smearing free market or socialist ideology on the NHS. People trotting out good / bad anecdotes.

There are some compelling facts. The big ones include how well the NHS has done for the money. Contrasting with spectacular market failure in housing and the rise of rentier culture.

Ultimately you can offer expert insight but you're at the mercy of a jury.

Straw man.

How the NHS is structured and funded is a political rather than medical decision.

My response was really to the concept of dismissing, for lack of "humility", the idea that those worse positioned to comment on a topic ought to listen to those better positioned.

In the particular case of the "junior doctors vs. Jeremy Hunt smackdown", I can't agree that is a political rather than a technical matter.

It seems that the BMA and Jeremy Hunt agree on all of the aims. The disagreement is about the best method to realise those aims. Both sides want a "seven day NHS". Neither side wants to reduce doctors' pay. Neither side wants doctors overworked on long hours. Both sides want a good service for patients.

The disagreement about how to achieve the common aims is a technical one, in which those experienced in the field ought to have valuable, expert input.

[SpectrumFX]

My response was really to the concept of dismissing, for lack of "humility", the idea that those worse positioned to comment on a topic ought to listen to those better positioned.

In the particular case of the "junior doctors vs. Jeremy Hunt smackdown", I can't agree that is a political rather than a technical matter.

It seems that the BMA and Jeremy Hunt agree on all of the aims. The disagreement is about the best method to realise those aims. Both sides want a "seven day NHS". Neither side wants to reduce doctors' pay. Neither side wants doctors overworked on long hours. Both sides want a good service for patients.

The disagreement about how to achieve the common aims is a technical one, in which those experienced in the field ought to have valuable, expert input.

Any way you look at it you're pushing the logical fallacy of argument from authority.

[Guest eight]

My response was really to the concept of dismissing, for lack of "humility", the idea that those worse positioned to comment on a topic ought to listen to those better positioned.

That was me, wasn't it.

I would have thought that being a member of this forum would have taught you all you need to know about vested interests, not to mention the often spurious nature of "expertise". Frankly some of the input I've seen from the medical profession on these issues has been little more nuanced than "Trust me, I'm a doctor".

[PopGun]

Squirming around accusing doctors of being overpaid toffs or threatening to distort the market just takes the trajectory from losing the argument to losing the entire plot.

+1

[PopGun]

Pay is the only effective brake on how many weekends and the total number of hours we can be made to work. That's why this argument is about is patient safety. We're not asking for more money.

This point has already been made countless times on this thread already. Minds have been made up regardless.

[pig]

My response was really to the concept of dismissing, for lack of "humility", the idea that those worse positioned to comment on a topic ought to listen to those better positioned.

In the particular case of the "junior doctors vs. Jeremy Hunt smackdown", I can't agree that is a political rather than a technical matter.

It seems that the BMA and Jeremy Hunt agree on all of the aims. The disagreement is about the best method to realise those aims. Both sides want a "seven day NHS". Neither side wants to reduce doctors' pay. Neither side wants doctors overworked on long hours. Both sides want a good service for patients.

The disagreement about how to achieve the common aims is a technical one, in which those experienced in the field ought to have valuable, expert input.

Of course its ulitmately a 'technical matter'. And of course doctors are (broadly speaking) best place to analyse and informa how best to achieve the agreed objectives. But ALL politics could be said to be based on some reality that some expert is better placed inform us on.

Jeremy Hunt isn't talking crap because he has no grasp of the technical issues (well ok, even if!). He is trying to talk over the heads of the BMA and the doctors to the general population. He needs the public onside. They aren't, hence the increasingly ludicrous spinning. And what of his peculiar, seemingly pointless instransigence during the 'negotiations' ?

What if, (and I stress in his head), killing a load more people now was justified as a practical step towards his ideal right-wing/neo-liberal whatever health-care system ? What if he has a spending gun to his head and this is an integral part of an across the board working conditions strategy ? What if the public will support doctors through short-term disruption but won't stand for long term disruption ? What if party donations and cushy jobs with private health-care companies wanting ease of access to start cannibalising the system await ? What if this was the government that introduced help-to-buy....?

What if, in other words the entirely correct boy-scout complaint about being better placed to advise means feck all in the overall political jungle ?

[BlokeInDurham]

That was me, wasn't it.

I would have thought that being a member of this forum would have taught you all you need to know about vested interests, not to mention the often spurious nature of "expertise". Frankly some of the input I've seen from the medical profession on these issues has been little more nuanced than "Trust me, I'm a doctor".

Absolutely there might be vested interests in play, or lies as to true intent on both sides. I wouldn't deny that possibility for a minute!

Which is why it is ridiculous to dismiss preferring particular viewpoints based on better expertise (which the riposte "that's not very humble" aims to degrade). Once you strip out all of those nasty hierarchical reasons for listening to someone, the only things you have left are the vested interests and the lies to which everyone is equally entitled and equally qualified!

(So to reinforce that, if you really meant: "Fine, you ought to be a person well qualified to make such decisions. But I suspect that your actual suggestions may be based on vested interest rather than expertise", then say that! But the argument "That lacks humility" attacks only the one possibility where you ought to be listening: that is to say where the suggestion is actually coming from being better positioned to assess, and not from vested interest as you expect.)

Edited February 14, 2016 by BlokeInDurham

[SpectrumFX]

Absolutely there might be vested interests in play, or lies as to true intent on both sides. I wouldn't deny that possibility for a minute!

Which is why it is ridiculous to dismiss preferring particular viewpoints based on better expertise (which the riposte "that's not very humble" aims to degrade). Once you strip out all of those nasty hierarchical reasons for listening to someone, the only things you have left are the vested interests and the lies to which everyone is equally entitled and equally qualified!

(So to reinforce that, if you really meant: "Fine, you ought to be a person well qualified to make such decisions. But I suspect that your actual suggestions may be based on vested interest rather than expertise", then say that! But the argument "That lacks humility" attacks only the one possibility where you ought to be listening: that is to say where the suggestion is actually coming from being better positioned to assess, and not from vested interest as you expect.)

Ipse dixit

If you need to invoke your academic pedigree or job title for people to believe what you say, then you need a better argument.

[BlokeInDurham]

Ipse dixit

If you need to invoke your academic pedigree or job title for people to believe what you say, then you need a better argument.

I think you are getting far too absolutist on this.

A job title does not prove anything. Neither does a qualification. They both suggest something though, which is to say expertise in particular field.

If one has some expertise in field, then it is just some weird kind of intellectual reverse snobbery to insist that such expertise will have no bearing on the usefulness of that person's suggestions. And of course such usefulness won't work on absolutist lines either, but rather people with greater expertise will tend to have more useful things to say. Not everything an expert says will be useful. And if you aren't an expert, it doesn't mean you can't make a useful contribution. But probabilistically, expertise will tend to be a beneficial thing.

The argument "Be more humble" speaks to that inverted snobbery. It says "Just because you are better positioned to answer this, doesn't mean that you should do anymore than anyone else."

There's nothing wrong with delineating expertise on more that a degree certificate or a job title (although you'll probably find that they tend to correlate fairly substantially). But dismissing the utility of expertise itself is madness. (If you want to get grandiose about it, it denies the efficiencies of the division of labour which stand behind civilisation itself!)

Edited February 14, 2016 by BlokeInDurham