This is a complex issue.  
 
For one thing, according to the figures I have seen, the vast majority (maybe 80+%) of antidepressants (ADs) are prescribed by non-psychiatrists. With the advent of Prozac, which has very few significant or life-threatening side effects compared to the tricyclics like Elavil, it became a lot easier to prescribe an AD to anyone who complained of depression. 
 
Depression is a symptom, not a disease per se, and it seems to be responsive to ADs a lot of the time. Whether or not this is placebo is up in the air as ADs are not that effective in general but are very helpful for severe depressions. 
 
If you look at the studies (especially the ones that are not funded by Big Pharma) you will see that patients show a "significant" improvement maybe 60% of the time with each drug while placebo shows a 25-20% improvement. While these changes are statistically significant, they don't usually represent a complete return to a normal mood, rather they show a change for the good on subjective scales like the HAM-D and the patient may end up still feeling depressed. 
 
The increase in the usage of ADs therefore has two main causes: the newer ADs are a lot easier to take and continue taking (although there is still a significant dropout rate in studies), and the safety issues switched the primary prescribers to family doctors and away from psychiatrists. There are a lot more family doctors out there so the chances of your getting an AD when you complain of depression are a lot higher. 
 
As to whether or not this is overprescribing, that is still up in the air, but I believe that it is.

I think that the home schooling for IQs over 150 plan, while it has a certain appeal, is a little too simplistic.  
 
School serves a lot of purposes besides education, especially the K-12 part. While there are a lot of problems in our school systems at both the low end and high end of achievement, these can be fixed but only if those high achievement students and their families remain in contact and lobby for what they need.  
 
The socialization aspects of school are, to my mind, just as important as the education. My experience in the dark ages (1961 graduate of HS) was outstanding. I was taught calculus after parents lobbied for it and I basically taught myself chemistry because the class was too slow and would not be done in time for the Chemistry SAT. I had teachers who were willing to put up with my seeming flouting of the rules because they knew I could do the work. 
 
But the real education was learning how to deal with others, especially those who did not share my views on learning and knowledge. It allowed me to learn when to fight back (literally) and when to run, lessons that have served me well the rest of my life. In addition I was able to bounce ideas off of peers and teachers and learned how to present these ideas in a fashion that would not automatically cause a knee jerk reaction. (I joined the wrestling team automatically placing a number of otherwise indifferent athletes on my side. I helped them with homework, they beat up anyone who thought I was a nerd.) 
 
Granted, this is anecdotal, but I have heard the same thing from others. Yes, a bright student can learn on his or her own but they miss the interactions with teachers and other students. Home schooling will put such a student at a social disadvantage no matter how bright they are unless there is some compensating factor which is missing in the formulation above.

Razib, 
 
You are clearly a fan of Alexis de Tocqueville who thought that the Southerners were "men without character" (mostly due to the introduction of slavery) while the Northern English were "the first in enlightenment, in power and in happiness" with the possible exception of their trying to wipe out the Indians who lived there. I happen to agree that the opportunity to own land and become wealthy is a basic reason for the success of the United States and that the NE version of this idea (versus the one that promoted slavery) is the one that predominated and shaped our society.  
 
But that is not all that our culture is. You will say that without the base provided by this polity our society would never have developed the way it is now, and I agree, but I suspect that our culture evolved in spite what the New Englanders wanted. If you look at the other cultural issues that they introduced such as state religion in all the NE states except RI, refusal to allow immigrants to be taught in public schools, etc., you will can surmise that the egalitarian society de Tocqueville saw was farthest from their minds. Other cultural values from other places changed all that.  
 
The NE English were insular if nothing else and did not invite others to join. In fact it was only the influx of the Irish and others that forced their hand to accept changes in MA and then they delayed it as much as possible. 
 
If you assume that the political philosopy of the NE prevailed forming the skeleton of our culture you also have to admit that the rules changed once the Civil War occurred and those outsiders had to be incorporated. While the original rules often favored the originators, culture was forever changed by the immigrants and continues to be changed as groups contribute to the mix.  
 
Ironically it was NE that changed the slowest, mostly MA, as the elite fought as long as they could. One of de Tocqueville's observations in 1835 was that the States was not an intellectual and educational meritocracy. Instead there was a buffering force that ignored superior intellect or education in favor of earning power and hard work. While those NE elites were educated, the schools they attended (Yale, Harvard, etc.) were more like boy's clubs whose purpose was to improve the lot of the attendees most of whom came from wealth to begin with, not necessarily to improve the intellect. It was a way of perpetuating the status quo. It wasn't until the 60s or 70s that the "Jewish quota" and other means of avoiding the underclasses were eliminated (only to be re-instituted later on as an intellectual meritocracy) that the full result of the founder's philosophy came to light in NE. 
 
I think that the culture you see in the United States now was an unintended consequence for which we are all forever grateful.

I think that we better define what is meant by the term "culture." If we mean legal and educational trends unique (maybe too strong a word) to the States then the concept of British influence has some validity, but if you mean music, food, fads, sports, and a host of other pursuits that make Americans different, then the contributions of Irish, Blacks, Germans and a host of other immigrants probably outshines those of the Puritans and Lowland English.  
 
On the other hand, the influence of the Scots-Irish is pretty broad and often defines the character of Americans, especially in the eyes of non-Americans. Webb's book points out the Jacksonian influence in out politics, music, and life style that still exists and is a formidable force in politics. Popular music from the minstrel period on (about 1830 or so) was dominated by Irish, Blacks and Jews until the 1940s while Rock and Roll is easily the venue of Black and Scots-Irish. Country music and Rock are archetypes of American culture, but I doubt that any Puritan Harvard graduate had much to do with it. 
 
Of course there are British influences in our culture, we speak English after all, but to say that theirs is the main influence is wishful thinking on the part of those remaining Eastern snobs. :Grin:

Voyageur Occidental sez: 
 
"What in the world is a non-mathematical science? Do you mean social sciences? Even biology needs math, often in addition to just basic statistics." 
 
As razib has pointed out numberous times in the past, physicians don't use math. That's because medicine is not a science, more like "son/daughter of science." While there are plenty of research scientists in the field of medicine (a four year medical degree is one of the best ways to get into biological research) most physicians apply the results of the science on a one to one basis with their patients. Hence the lack of statistical sophistication since the highest level of math most physicians use was ground into their brains in the fourth grade. 
 
Women are now slightly dominate in medical schools and residency programs because they are capable of sustaining the high work rate and good grades needed to get into medical school and have had the chance to get in over the past 30 years. This is a factor of change in our society, not something inherent to men. When I applied to medical school in 1965, 10% of medical students were women. The trick was to beat out all those white males. When my son applied in 2000, he was applying to about 40% of the seats available (you subtract 50% women and 10% misc. including 6 year students, and other considerations.) It was probably a lot harder for him to get in. 
 
But the math requirements for med students remain the same: you take a statistics course for a few weeks and promptly forget it. 
 
There have been alterations in the demographic make-up of students since I was matriculated but the quality does not seem to have changed based on my experience teaching in medical schools.  
 
But they still don't teach you to be a scientist.

Abebooks and Amazon make it easier to get books and to get them cheaply, but for me, going to a bookstore is an exploration. I never go into a bookstore looking for a specific book (it is a lot cheaper to go online) but I know that I will be able to find books, usually to the tune of $100 or so, that I will enjoy. 
 
I read over 300 books a year, mostly mind candy, to keep up my reading chops and to relax. This is a traid from my family and is most likely inherited as we seem to have the genetic stuff for eulexia (high reading and comprehension rates) or dyslexia. It is an either/or situation for at least three generations now. All of us are compelled to read, even those with dyslexia. 
 
The result is a lot of books (we gave away 5000 duplicates once), a lot of trivia, and a lot of fun reading. 
 
Bookstores are there to feed this compulsion.

David Boxenhorn 
 
That blood type map doesn't look anything like a map of malaria infestation 
 
Malaria used to be world wide. The last malaria epidemic in North America was less than a century ago and it was as far north as MN and WI at one time. 
 
The same is true in Europe but modern vector control and the recognition of the way malaria is passed on eliminated it in these venues. 
 
The last Yellow Fever epidemic (another mosquito born disease) was in New Orleans in 1912. When I was a medical student in the late 1960s I met some of the survivors. People used to move north of NO in the summer to avoid these diseases.

OK, 
 
I went here (http://yudkowsky.net/bayes/bayes.html) for the explanation and it wasn't all that hard. In fact I got the first problem more or less correct (I didn't do the math, but 10% was a close estimate based on the facts given in the first presentation of the question.) Pretty good stuff and what I have advocated to medical students without the knowlege of being Bayesian. 
 
Thanks for the tip.

razib, 
 
I don't dispute anything that you say and I was asking the question about data on physicians because I was not aware of the research. 
 
I would love to take a class in bayesian operations, I'll have to google it up. 
 
I did do an informal ( and I am sure non-Bayesian) survey of my younger colleagues, and most of them were familiar with the concepts of genetics that you refer to (unlike us old farts) but the universal comment was: "I bet the insurance companies would love to get their hands on that information." The reason for this is the universal distrust of medical insurance companies who have open access to all medical records (if you don't agree, no insurance) and will no doubt use this information to their economic advantage unless there is a fundamental change in privacy laws. 
 
Another aspect is that many patients don't want to know if they are genetically vulnerable since they equate this with a death sentence. Good education of patients will help this, but I have several patients whose parent have a devastating genetically transmitted disease and to a person they don't want to know if they carry the gene. While it is clear to me that they should know this information (transmission, future planning, etc.), they all saw how their parent progressed, realize that the disease is not curable or even treatable, and freak out.  
 
In that informal survey each physician also said that they would love to have the genetic information to help develop health plans for patients but that the political and economic sequelae make them wary. I don't see the lack of use of this information being due to ignorance of the field as much as it is a concern about the non-medical uses of the information.

Let me make one other set of comments: 
 
I don't disagree with the statements about doctors and statistics nor do I disagree that a lot of doctors ignore evidenced based medicine (or even care about it.) But the problem with the suggestion that the body of medical genetics should be used in making treatment decisions (as good as it may be) is that no one will pay for it. In fact, the great concern about medical genetics becomes political. The problem of what will be done with the information comes down to who has the greatest economic interest in its use and who is the most organized to direct that interest. It won't be the patients unless there is a government imposed solution of not being able to use the genetic information to set insurance rates (or some other way is set up to pay for treatment and then you just switch overseerers.) 
 
I would love to have a set of inexpensive genetic tests that would help implement Dillenger's Law ("You rob banks because that is where the money is.") Any physician would. We are not Luddites after all, in fact are probably more accepting of technology than many other professions.  
 
Genetics takes a special knowledge and an interest to really understand it. It is simple if that is all you focus on and in a geeky way very sexy. But who has time to figure all the permutations or keep them all straight? I have a hard enough time with all the liver enzymes that effect the medicines I use. Computer based tools are very helpful, but not practical when you don't have enough information. Decision Matrices are quite good at making diagnoses but it is still a matter of GIGO and I alluded to the fact that we don't always get the best information to start with, especially if the patient is a drug abuser or an alcoholic who wants to hide that fact. 
 
Structured interviews work especially well in diagnosis but they take a lot of time to do, and time is often not available to make critical decisions, especially if the patient is not able to communicate well. 
 
In my mind, everyone who has commented has very good points. If these suggestions were more practical they would be a tremendous boon to the profession and to patients. Structuring and implementing these ideas is possible, but will require more thinking and planning - maybe not only should physicians get the Ph.D in genetics, but an MBA to boot. ;']

Excuse me, but where is the statistical proof of such statements as "(Doctors)have difficulty in dealing with odds of success, blowing it off with comments like "I'm not a bookie!"? It seems that the commentors are using anecdotes to make a point about how physicians don't use statistics in their practices. 
 
I have a bias, being a physician, but we do deal with individuals and the application of evidenced based medicine is helpful at best in the light of the problem of incomplete evidence that we have to deal with all the time. 
 
Take the example of dosage of medications. The FDA has "approved doses" that only reflect a mandated and structured set of experiments designed to provide information on safety and efficacy. They do not test what the limits are or what the broad range of receptor variants will accept. Drug testing's sole purpose is to get a drug on the market. As a result, 60% of drug usage (I think that is the figure) is "off label", uses that have no evidence per se yet seem to work pretty well. Most of the evidence gathered is after the fact when single case reports keep saying the same thing and someone (who usually does not have the BigPharma grants) runs a smallish study. 
 
The only truly reliable studies of human disease involve thousands of patients and decades of research. I read these studies and honor them even when my intuition says they are false (usually they are not, by the way) but there are not enough of these studies around to help the complex and often poorly defined illnesses that our patients bring to us. 
 
It is not a matter of ignoring the statistics as much as there not being that many reliable statistics around for all the problems presented (Not to mention difficulties with diagnosis, multiple illnesses, ignorance and lies that we meet all the time in the practice of medicine.

The main thrust of the article dealt with the leakage of information, not the conclusions or numbers which have not yet been finalized.  
 
One of the participants appears to be on the verge of being "struck off" (lose the license to practice) due to fraud and it may well be an effort to save this person that caused the draft to be released.

The two examples given are talking about different centuries and vastly different areas of the country.  
 
The Pilgrims excluded almost everyone who did not believe in their theocratic idea of paradise while the English in Jamestown invited many to join the party including African slaves and indentured Irish - all before Plymouth Rock. 
 
When the Irish really decided to come over, the old MA regime was overwhelmed as was most of the industrial north. These uneducated serfs (many of whom did not speak English) eventually added immensly to the worth of the United States as did subsequent migrants.  
 
The same will occur with the present influx of hard working motivated immigrants.  
 
Exclusion has never worked very well in this country but you are right, it has been tried continously even before the country was founded.

Our family rules (for the males) for marriage are: 
 
1) Marry a woman smarter than you. 
2)Marry a woman who can make as much money as you. 
3) Check for a family history of mental illness. 
4) Two out of three isn't bad but Number One is the most important. 
 
While this is said in jest, it has held true for our family for at least four generations. And all the genetic information I get on this site only verifies these rules for me.

I guess they didn't read the kerfuffle that erupted in the Kathy Coble case when the same bullying tactic was tried in Nashville. 
http://nashvillecitypaper.com/index.cfm?section=9&screen=news&news_id=55677