Iatrogenic illness means "doctor-caused disease", from the Greek word for doctor, “ἰατρός”.* The disease is caused when doctors do things to patients that hurt them.
Historic examples of iatrogenic harm include the deaths of King Charles II of Britain as well as George Washington, both of whom died shortly after medical blood-letting. More recent examples include Elvis Presley and Michael Jackson, who died from drugs prescribed by their MDs.
In the vast majority of cases, iatrogenic harm is unwitting, at worst negligent. It can be explained by incompetence rather than malice (and complicated by the sheer variety of idiosyncratic reactions that patients have to drugs).
But I'm actually interested in how “iatrogenic disease” captures another dynamic, a positive feedback loop of sorts. Under certain circumstances, the disease that doctors purport to cure, but actually cause, leads to a greater demand for their services. That is, the caregiver cements their job security.
This is the case, for example, with doctors who overprescribe opioids. Addiction is the iatrogenic disease, and in our very recent past, doctors willing to cause addiction by selling temporary fixes could build a solid business of returning clients.
Sometimes the iatrogenesis of harm starts at the level of conceptualization; i.e. what we invent words for, and how we categorize the world. For example, people lobby for terms to enter the DSM 5, which are then assumed to be real medical conditions that require expensive treatments, themselves causing many side effects that require deeper intervention over a patient’s lifetime. An industry that sells "pills for problems" requires a steady stream of new problems, some of which may be invented from whole cloth.
Shirky’s Revenge
This phenomenon is actually a spin on the Shirky Principle, which states that “Institutions will try to preserve the problem to which they are the solution.”
Software sales are another special case. Turbo Tax, for example, has actively lobbied against streamlining the US tax code, whose complexity they fix. That is, they create and maintain a regulatory problem for which they sell the solution. The group providing the cure is also the group causing the illness. Iatrogenic dynamics.
The old chestnut says that "a consultant is someone who borrows your watch to tell you the time." While that’s true, an iatrogenic vendor steals your watch in order to sell you the time. In The Wolf of Wall Street’s great "sell me this pen" scene, DiCaprio and his crew should have gone further. Because in the wild, the best salesmen moonlight as muggers. And when you see them in daylight, their job title doesn’t say “sales.”
Cures to our social ills are promoted by politicians and activists, and both face heavy incentives to magnify the ills they claim to solve. One way they do that is by redefining common terms that once applied to narrow cases, and are now applied everywhere. Shifting “white supremacy” from its narrow meaning of KKK-adjacent activities to a broader range of behavior that includes punctuality was an admirable semantic mugging.
Another way is by failing to fix the root cause of an actual problem, instead multiplying it. Homelessness in San Francisco is the classic example of the NGO-industrial complex and its political enablers perpetuating a problem to keep the gravy train rolling (a $668 million annual budget). In armed conflicts, extremists on both sides can kick off escalatory and iatrogenic cycles, where their political and military solutions only serve to unleash cascades of further violence, which polarize the population and keep them in power.
Elsewhere in tech, AGI is one example of people inventing a problem in order to occupy the role of savior. The greater the risk, the more important the doctor. And when you invent an existential problem, your role and cure are existentially crucial. If you have ever wondered why so many AGI doomers work for companies bent on building superintelligence, this lens may be clarifying.
These groups thrive off their own failures, a perverse dynamic that should make all of us wary of their rhetoric of danger and salvation. They have taken "demand generation" to a new level in appealing to the dramatic frameworks by which we all make meaning.
Why All the Fancy Words?
I didn't coin the term "iatrogenic disease," I just think it has applications beyond medicine. (A semantic mugging!)
It condenses a complex idea into a few syllables, which makes that idea easier to think about and communicate. If you think "doctor-caused harm", "vendor-aggravated complexity", or "NGO-augmented homelessness" are more useful, please use those!
Every hit piece is a how-to. Think about how Michael Douglas’s “Greed is good” speech in the movie “Wall Street” became a cult hit among young investment bankers, or how Robert Cialdini’s book Influence taught a generation of sales folks how to grasp the levers of human reciprocity.
I realize that by making these common maneuvers explicit, I am probably promoting iatrogenic techniques instead of quashing them. But I hope that in the act of naming, I can raise awareness among the good people who are being sold Cayenne-peppered water as a solution to their thirst.
*A good mnemonic for iatros is “psychiatrist”, or “mind-doctor”, but you can find the same root in “pediatrics” and “geriatrics.”