Scott Alexander details the logistics of his new blog on Substack, including subscription options and content plans, while addressing reader concerns. Longer summary

Scott Alexander explains his transition to Substack, addressing concerns about the platform and discussing the logistics of his new blog. He outlines the subscription model, emphasizing that most content will remain free but subscribers will get some extra benefits. Scott also touches on his plans for a new medical practice, his stance on publicity, and updates on previous commitments like advertising refunds and the book review contest. Shorter summary

Scott Alexander examines seven cognitive traps that lead doctors to believe they're above-average, potentially applying to other client-choice professions. Longer summary

Scott Alexander explores why doctors often believe they're above-average practitioners. He presents seven cognitive traps that contribute to this belief: 1) Doctors mainly see patients who left worse doctors, 2) Patient retention creates a positively biased sample, 3) Patient departures are often unnoticed, 4) Long-term patients are usually success stories, 5) Doctors are aware of others' mistakes but not their own, 6) Successes are attributed to skill while failures are attributed to circumstances, and 7) Doctors excel at metrics they personally value. Scott suggests these biases might apply to other professions where clients choose their service providers. Shorter summary

Scott Alexander proposes a hypothetical low-cost psychiatric practice to combat medical cost disease, exploring its potential and the barriers to its implementation. Longer summary

Scott Alexander explores the idea of creating a low-cost psychiatric practice called 'Cheap-O Psychiatry' to combat cost disease in medicine. He outlines a model that would significantly reduce overhead costs through telemedicine, self-booking, and direct payment, potentially offering appointments for as low as $35. The post discusses why such practices aren't more common, speculating on factors like the shortage of doctor-entrepreneurs, the dominance of insurance in the mid-range market, and the exhausting nature of rapid patient turnover. Scott suggests that such a venture might need to be done as a political protest to demonstrate the potential for cost reduction in healthcare. Shorter summary

Scott Alexander explores two contrasting attitudes in psychiatry, discussing their merits and pitfalls, while reflecting on his own tendency to favor a more straightforward approach. Longer summary

Scott Alexander discusses two contrasting attitudes in psychiatry: Attitude 1, which takes patients' requests at face value, and Attitude 2, which seeks to unravel underlying complexities. He provides examples where Attitude 2 is clearly beneficial, but also highlights its potential for misuse. The author admits to leaning towards Attitude 1, partly due to personal preferences and social pressures. He expresses uncertainty about whether this approach is always correct and worries about potentially missing important underlying issues. The post reflects on the challenges of balancing these approaches in psychiatric practice. Shorter summary

Scott Alexander reflects on his first year of medical residency, contrasting reality with TV dramas and describing the complexities of hospital care. Longer summary

Scott Alexander reflects on his first year of medical residency, contrasting his experiences with the expectations set by medical TV dramas and his medical school education. He describes the reality of hospital work as less about solving diagnostic mysteries and more about managing chronic conditions and dealing with an 'avalanche of disasters' that occur when patients enter hospitals. Scott uses analogies like Searle's Chinese Room to illustrate how hospital care often feels like a system where no individual fully understands the whole process. He concludes by noting his transition to psychiatry and expressing appreciation for the wider world of medicine. Shorter summary

Scott Alexander critiques the medical system's preference for expensive prescription sleep aids like Ramelteon over cheaper alternatives like melatonin, while sharing interesting facts about melatonin's uses. Longer summary

Scott Alexander discusses Ramelteon, a prescription sleep medication that mimics melatonin. He compares it to over-the-counter melatonin, highlighting the absurdity of the medical system that creates expensive prescription drugs when cheaper, effective alternatives exist. The post criticizes the pharmaceutical industry and medical practice for overlooking simple solutions like melatonin. Scott also shares interesting facts about melatonin, including its potential uses beyond sleep aid. Shorter summary