5 ms·

> "Thinking for yourself is untenable" Well, that's the best thing I've read all day.

by 5h 11y ago

paulojreis 11y ago
It might hurt to read that because it pinches on the untouchable tenets, I mean, who dares to admit not being a individual free-thinker? However, if you look behind the "smokes, you'll see he has a point. I proudly admit that I wouldn't think for myself on situations such as choosing a complex therapy. I know nothing about it; what would I do? Trust the Internet?
- arpa 11y ago
  Well the research has shown [too lazy to come up with a citation for that] that it is very beneficial for patients to be well informed and involved in the therapy process - with healthcare professional as an equal partner, not as a "god" in the matters of health. It's called "patient empowerment" and it's a big thing since 1994. And one of the best ways to inform the patient is a decision aid (which is ranging from fliers to IT systems with semantic webs with auto-updating medical evidence sources). This works, because you don't have to an expert on athletes' foot to manage your diabetes well, you just have to be an "expert" of your own case. And that, my friend, is the definition of individual free-thinker.
  - paulojreis 11y ago
    > Well the research has shown [too lazy to come up with a citation for that] that it is very beneficial for patients to be well informed and involved in the therapy process That's an irrelevant point: You won't see me advocating against having the patients fully informed and making decisions, after being given "alternatives" and respective pros&cons by their physicians. But what I was discussing was the knee-jerk reaction to the "thinking for yourself is untenable" argument. > This works, because you don't have to an expert on athletes' foot to manage your diabetes well, you just have to be an "expert" of your own case. I would say it's very oblivious to think you're an expert on your case. It means your emotions are way too much present: the fact that something is terribly relevant to you doesn't imply that you're an "expert" in it. > And that, my friend, is the definition of individual free-thinker. Quite a strange definition. But OK: if that's a very important point for you to make, great. Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision.
    - arpa 11y ago
      >I would say it's very oblivious to think you're an expert on your case. It means your emotions are way too much present: the fact that something is terribly relevant to you doesn't imply that you're an "expert" in it. I wouldn't discount emotions as being irrelevant for health. Patient involvement is very important in the empowerment process, and the patient is the expert in the ways that physician can never be: [s]he, not the physician, knows that drug A causes his/her skin itch; he, not the physician, cares for the quality of life, etc. And, sadly, you miss the point completely: experts have broad knowledge of the situation, while the "expert" patient knows (with the help of experts, of course, of course, of course) his exact case. And the "thinking" part is not done by physician all the time. Empowered patient does the majority of "thinking", the physician is there for support and information. Physician is the expert systems' knowledge base, while the empowered patient is the expert system doing the "thinking" and making informed/educated decisions. Edit: e.g. http://www.sciencedirect.com/science/article/pii/S0738399109003279 http://www.sciencedirect.com/science/article/pii/S0738399109... (emphasis mine) >Conclusion >Unlike the traditional approach, empowerment is not something one does to patients. Rather, empowerment begins when HCPs acknowledge that patient are in control of their daily diabetes care. >Empowerment occurs when the HCPs goal is to increase the capacity of patients to think critically and make autonomous, informed decisions. Empowerment also occurs when patients are actually making autonomous, informed decisions about their diabetes self-management. And this is not a new thing in heathcare either, there is a plethora of articles saying the same since 1994.
    - DanBC 11y ago
      There's a strong push to get patients to be more involved in their own care and to make decisions about their health and to be experts in their own health condition. There are expert patient programmes http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/expert-patients-programme.aspx http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/... There are expert patiet groups. Patient choice is (in the UK) written into law and into Department of Health, and NHS, and Clinical Commisioning Groups, and Trust guidance documentation. You might want to learn what people mean when they talk about expert patients because it's not going away and you seem to have some misunderstanding about it. > Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision. This assumes that doctors are not subject to the same cognitive biases that patients are. But doctors clearly are subject to those same biases. The RCT for knee arthroscopy shows us that.
andrepd 11y ago
Quoting out of context like that it sure seems pretty absurd. But I'm going to trust you understood GP's point? Any sane person wouldn't presume to thing for themselves on the best course of action in treating their cancer, for instance. The same thing goes for nutrition and health.
- 5h 11y ago
  Of course, I understand the parent post's point & the hazards of quoting out of context, it's just an amusing fragment. Talking of context though, I think any individual is capable of thinking for themselves when it comes to how much water a day to drink.
- dekhn 11y ago
  As the GP you're referring to: I'm a PhD scientist with deep knowledge in biology. I still wouldn't try to decide for myself on how to treat my own cancer; I can use my knowledge to evaluate what the experts tell me, but there are limits that even a knowledgeable scientist is susceptible to. Many people think otherwise: they second guess medical experts using their own engineering or scientific knowledge. Sometimes this "seems to work" but it's not clear that it does so in anything but an anecdotal way. Carefully controlled trials and meta-studies are much more effective.

> "Thinking for yourself is untenable" Well, that's the best thing I've read all day.

by 5h 11y ago

> "Thinking for yourself is untenable" Well, that's the best thing I've read all day.

It might hurt to read that because it pinches on the untouchable tenets, I mean, who dares to admit not being a individual free-thinker? However, if you look behind the "smokes, you'll see he has a point. I proudly admit that I wouldn't think for myself on situations such as choosing a complex therapy. I know nothing about it; what would I do? Trust the Internet?

arpa 11y ago
Well the research has shown [too lazy to come up with a citation for that] that it is very beneficial for patients to be well informed and involved in the therapy process - with healthcare professional as an equal partner, not as a "god" in the matters of health. It's called "patient empowerment" and it's a big thing since 1994. And one of the best ways to inform the patient is a decision aid (which is ranging from fliers to IT systems with semantic webs with auto-updating medical evidence sources). This works, because you don't have to an expert on athletes' foot to manage your diabetes well, you just have to be an "expert" of your own case. And that, my friend, is the definition of individual free-thinker.
- paulojreis 11y ago
  > Well the research has shown [too lazy to come up with a citation for that] that it is very beneficial for patients to be well informed and involved in the therapy process That's an irrelevant point: You won't see me advocating against having the patients fully informed and making decisions, after being given "alternatives" and respective pros&cons by their physicians. But what I was discussing was the knee-jerk reaction to the "thinking for yourself is untenable" argument. > This works, because you don't have to an expert on athletes' foot to manage your diabetes well, you just have to be an "expert" of your own case. I would say it's very oblivious to think you're an expert on your case. It means your emotions are way too much present: the fact that something is terribly relevant to you doesn't imply that you're an "expert" in it. > And that, my friend, is the definition of individual free-thinker. Quite a strange definition. But OK: if that's a very important point for you to make, great. Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision.
  - arpa 11y ago
    >I would say it's very oblivious to think you're an expert on your case. It means your emotions are way too much present: the fact that something is terribly relevant to you doesn't imply that you're an "expert" in it. I wouldn't discount emotions as being irrelevant for health. Patient involvement is very important in the empowerment process, and the patient is the expert in the ways that physician can never be: [s]he, not the physician, knows that drug A causes his/her skin itch; he, not the physician, cares for the quality of life, etc. And, sadly, you miss the point completely: experts have broad knowledge of the situation, while the "expert" patient knows (with the help of experts, of course, of course, of course) his exact case. And the "thinking" part is not done by physician all the time. Empowered patient does the majority of "thinking", the physician is there for support and information. Physician is the expert systems' knowledge base, while the empowered patient is the expert system doing the "thinking" and making informed/educated decisions. Edit: e.g. http://www.sciencedirect.com/science/article/pii/S0738399109003279 http://www.sciencedirect.com/science/article/pii/S0738399109... (emphasis mine) >Conclusion >Unlike the traditional approach, empowerment is not something one does to patients. Rather, empowerment begins when HCPs acknowledge that patient are in control of their daily diabetes care. >Empowerment occurs when the HCPs goal is to increase the capacity of patients to think critically and make autonomous, informed decisions. Empowerment also occurs when patients are actually making autonomous, informed decisions about their diabetes self-management. And this is not a new thing in heathcare either, there is a plethora of articles saying the same since 1994.
  - DanBC 11y ago
    There's a strong push to get patients to be more involved in their own care and to make decisions about their health and to be experts in their own health condition. There are expert patient programmes http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/expert-patients-programme.aspx http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/... There are expert patiet groups. Patient choice is (in the UK) written into law and into Department of Health, and NHS, and Clinical Commisioning Groups, and Trust guidance documentation. You might want to learn what people mean when they talk about expert patients because it's not going away and you seem to have some misunderstanding about it. > Just don't say that this is "thinking by yourself". You may have made the decision yourself, but the "thinking" part was on the physician all the time. He had the knowledge, he presented it to you, alongside the pros&cons, and he was there to warn you if you by chance made a wrong/worst decision. This assumes that doctors are not subject to the same cognitive biases that patients are. But doctors clearly are subject to those same biases. The RCT for knee arthroscopy shows us that.

andrepd 11y ago

Quoting out of context like that it sure seems pretty absurd. But I'm going to trust you understood GP's point? Any sane person wouldn't presume to thing for themselves on the best course of action in treating their cancer, for instance. The same thing goes for nutrition and health.

5h 11y ago
Of course, I understand the parent post's point & the hazards of quoting out of context, it's just an amusing fragment. Talking of context though, I think any individual is capable of thinking for themselves when it comes to how much water a day to drink.
dekhn 11y ago
As the GP you're referring to: I'm a PhD scientist with deep knowledge in biology. I still wouldn't try to decide for myself on how to treat my own cancer; I can use my knowledge to evaluate what the experts tell me, but there are limits that even a knowledgeable scientist is susceptible to. Many people think otherwise: they second guess medical experts using their own engineering or scientific knowledge. Sometimes this "seems to work" but it's not clear that it does so in anything but an anecdotal way. Carefully controlled trials and meta-studies are much more effective.