In a recent column in the NY Times, David Brooks opined that there is "a common form of contemporary hubris — the belief that it is possible to solve political problems as if they were engineering problems, with rational planning." There is "a distinction between technical knowledge and practical knowledge. Technical knowledge is the sort of information that can be put in a recipe in a cookbook. Practical knowledge is the rest of what the master chef actually knows: the habits, skills, intuitions and traditions of the craft. Practical knowledge exists only in use; it can be imparted but not taught. Technocrats and ideologues possess abstract technical knowledge and think that is all there is. Their prefab plans come apart because they simplify reality, and don’t understand how society works and the rest of what we know." from David Brooks, Really Good Books.
This holds true for the practice of medicine as well. The “experts” often recommend cookbook approaches that just don’t work in the real world. These academic specialists often do not practice in the real world and their advice is based on hypotheticals. Sadly, there are few expert clinicians around who are available to share their hard-come-by experience.
