Before I started working for a cancer center, I was not aware of the tension between science and medicine. Popular perception is that the two go together hand and glove, but that’s not always true.
Physicians are trained to use their subjective judgment and to be decisive. And for good reason: making a fairly good decision quickly is often better than making the best decision eventually. But scientists must be tentative, withhold judgment, and follow protocols.
Sometimes physician-scientists can reconcile their two roles, but sometimes they have to choose to wear one hat or the other at different times.
The physician-scientist tension is just one facet of the constant tension between treating each patient effectively and learning how to treat future patients more effectively. Sometimes the interests of current patients and future patients coincide completely, but not always.
This ethical tension is part of what makes biostatistics a separate field of statistics. In manufacturing, for example, you don’t need to balance the interests of current light bulbs and future light bulbs. If you need to destroy 1,000 light bulbs to find out how to make better bulbs in the future, no big deal. But different rules apply when experimenting on people. Clinical trials will often use statistical designs that sacrifice some statistical power in order to protect the people participating in the trial. Ethical constraints make biostatistics interesting.