4 ms·

To provide a counterpoint, I've seen a number of situations where doctors simply refused to investigate properly, instead assuming that symptoms were the result

by Zak 17y ago

To provide a counterpoint, I've seen a number of situations where doctors simply refused to investigate properly, instead assuming that symptoms were the result of the most common disorder capable of causing them. I'm firmly on the side of patients having access to whatever sort of tests they want without the aid of a doctor. Should they draw the wrong conclusions from those tests, well, you already said it: caveat emptor. I am not, however opposed to some restrictions on what labs can claim about their tests.

phren0logy 17y ago
There's a saying we learned in medical school: "When you hear hoof-beats, think horses not zebras." Ordering tests for every possible condition that could cause presenting symptoms is usually not the right idea. It's a difficult problem, because sometimes it really is a zebra. That's part of the art of medicine. But not every child with a bloody nose needs a bone-marrow biopsy. That means that a child with serious blood coagulation problem may not get one with the first nose bleed. Is that a bad call? If you are that kid, you might think so. There's no easy answer, only thoughtful trade-offs.
- Zak 17y ago
  I'm not saying you're wrong. What I am saying is that putting more power in the hands of patients is a good thing. I'm also saying that in my experience, there seems to be a tendency for doctors to ignore the patient saying "but it has stripes". For a case in point, see http://news.ycombinator.com/item?id=668195 http://news.ycombinator.com/item?id=668195
  - carbocation 17y ago
    I disagree that letting people order lab tests for themselves is, on balance, a good thing for the population's health. I agree that it is something that should nevertheless be allowed, in many cases, under the aegis of individual freedom.
  - carbocation 17y ago
    As an aside, in the heavy bleeding described in the post that you linked to sounds like classical endometriosis, particularly since it was resolved by GnRH. If so, it is rather surprising that your doctors did not figure this out; most medical students could.
Devilboy 17y ago
I think in a case where you're unhappy with the doctor's investigation the correct response is to get a second opinion.
- Zak 17y ago
  In the case of non-socialized health care, that's cost-prohibitive for many people. In the case of socialized health care, it often involves an unreasonable wait.
  - Devilboy 17y ago
    Unreasonable wait to see a doctor? Why would the wait be longer just because you've seen one already? I'm just asking because here in Australia it doesn't happen like that at all. You can see five doctors a day if you want. Specialists may have a waiting time (a week or two on average I guess) but they don't make you wait any longer if you've already seen someone, and you can always find another specialist with a shorter waiting list.
lmkg 17y ago
My major problem is that there's a lot of easy money to be made with FUD. I was going to write more, but most of it is implied in that statement, so I'll just say it again: there's a lot of easy money to be made with FUD. There are some second-order effects as well, some good, some bad. On the bad side, larger demand for tests means more waiting for everybody. On the good side, more pressure on the testing industry could lead to better techniques as well as more consumer awareness about medical testing. However the limit case still seems to be "less bad" and not actually "better than current conditions."
- jerf 17y ago
  "On the bad side, larger demand for tests means more waiting for everybody." Absolutely false. Larger sustained demand for testing means the supply will be grown by market forces. Larger sustained demand could under some circumstances actually cut waiting for everybody if it meant being able to grow the supply past a useful economy-of-scale boundary. The market is not a static entity. (At least until the government comes in and makes it a static entity, which I hear they're getting pretty close to. So, buck up! Soon you'll be right!)

by Zak 17y ago

phren0logy 17y ago

There's a saying we learned in medical school: "When you hear hoof-beats, think horses not zebras." Ordering tests for every possible condition that could cause presenting symptoms is usually not the right idea. It's a difficult problem, because sometimes it really is a zebra. That's part of the art of medicine. But not every child with a bloody nose needs a bone-marrow biopsy. That means that a child with serious blood coagulation problem may not get one with the first nose bleed. Is that a bad call? If you are that kid, you might think so. There's no easy answer, only thoughtful trade-offs.

Zak 17y ago
I'm not saying you're wrong. What I am saying is that putting more power in the hands of patients is a good thing. I'm also saying that in my experience, there seems to be a tendency for doctors to ignore the patient saying "but it has stripes". For a case in point, see http://news.ycombinator.com/item?id=668195 http://news.ycombinator.com/item?id=668195
- carbocation 17y ago
  I disagree that letting people order lab tests for themselves is, on balance, a good thing for the population's health. I agree that it is something that should nevertheless be allowed, in many cases, under the aegis of individual freedom.
- carbocation 17y ago
  As an aside, in the heavy bleeding described in the post that you linked to sounds like classical endometriosis, particularly since it was resolved by GnRH. If so, it is rather surprising that your doctors did not figure this out; most medical students could.

Devilboy 17y ago

I think in a case where you're unhappy with the doctor's investigation the correct response is to get a second opinion.

Zak 17y ago
In the case of non-socialized health care, that's cost-prohibitive for many people. In the case of socialized health care, it often involves an unreasonable wait.
- Devilboy 17y ago
  Unreasonable wait to see a doctor? Why would the wait be longer just because you've seen one already? I'm just asking because here in Australia it doesn't happen like that at all. You can see five doctors a day if you want. Specialists may have a waiting time (a week or two on average I guess) but they don't make you wait any longer if you've already seen someone, and you can always find another specialist with a shorter waiting list.

lmkg 17y ago

My major problem is that there's a lot of easy money to be made with FUD. I was going to write more, but most of it is implied in that statement, so I'll just say it again: there's a lot of easy money to be made with FUD. There are some second-order effects as well, some good, some bad. On the bad side, larger demand for tests means more waiting for everybody. On the good side, more pressure on the testing industry could lead to better techniques as well as more consumer awareness about medical testing. However the limit case still seems to be "less bad" and not actually "better than current conditions."

jerf 17y ago
"On the bad side, larger demand for tests means more waiting for everybody." Absolutely false. Larger sustained demand for testing means the supply will be grown by market forces. Larger sustained demand could under some circumstances actually cut waiting for everybody if it meant being able to grow the supply past a useful economy-of-scale boundary. The market is not a static entity. (At least until the government comes in and makes it a static entity, which I hear they're getting pretty close to. So, buck up! Soon you'll be right!)