3 ms·

Rather than merely putting this whole unpleasantness behind us and moving on, I think the medical establishment (Doctors in particular) needs to take a serious

Rather than merely putting this whole unpleasantness behind us and moving on, I think the medical establishment (Doctors in particular) needs to take a serious look at why the public was so ready to distrust them and assume the worst. Medicine in this country is a rotten business. Hospitals have shoddy billing practices, routinely gouging their patients ($5 for a single Tylenol) and giving them vague, indecipherable bills. Doctors engage in protectionism, limiting the supply of doctors by restricting the accreditation of medical schools, ensuring that they earn more than their counterparts in any other developed nation by at least a factor of 2. Practicing physicians are also if not outright in bed with, then certainly far too close to the drug companies. I went to see a dermatologist a few years ago, and in the waiting with me and the other patients were two attractive pharmaceutical reps waiting to see the Doctor who owned the office. Doctors need to realize that trust must be earned, and can easily be lost. As of late, they haven't been doing a whole lot to deserve it. Until the medical establishment cleans up its act, you can expect many more debacles like this one to occur.

yummyfajitas 16y ago
...routinely gouging their patients ($5 for a single Tylenol)... Items like this quickly vanish from your bill when you tell the hospital you don't have insurance. It's the insurance companies they are trying to gouge, not the patients.
- tjmaxal 16y ago
  I think it is silly how people are so quick to blame the doctors and the hospitals, when the prices are set by the insurance companies 90% of the time. Where is the public outcry that insurance companies are price gouging and making millions off of denying sick people treatment.
  - yummyfajitas 16y ago
    What evidence do you have that the insurance companies are price gouging? FYI, insurance companies have very low profit margins.
    - tjmaxal 16y ago
      Try the congressional committee tasked with investigating Insurance company profits prior to the latest health care bill which was really just insurance regulation. Low profit margins compared to what exactly? Is it right for any company to make a profit off of the suffering of another human being?
      - yummyfajitas 16y ago
        Try a PR event created by politicians seeking soundbites and justification to expand their authority? As for whether it is right for any company to profit off the suffering of another human being, absolutely not. It's also not right for people to do so. That's why I hate those doctors, nurses and EMTs, always profiting from other people's suffering.
        tjmaxal 16y ago
        You are right I should have been more specific insurance companies profit by denying you access to life saving treatments, doctors, et al, profit from giving you life saving treatments. Clearly those are exactly the same thing and you are completely correct. Clearly.
jerf 16y ago
A much simpler theory that explains why the public doesn't trust public health pronouncements is that people have been both crying wolf in the doctor's name and declaring various unsafe things safe in doctor's names for a very long time now. The corruption of the doctor down the street may be a hobbyhorse of yours but I don't think that's what most people are thinking of when they consider a public health question; they're thinking about the fact that eggs are a mortal menace, then good for you, then eat the white but not the yolk, then eat the yolk but not the white, then good for you again, then a mortal menace, then good for you again. Then take that and multiply it across numerous issues. Medical journalism's credibility is pretty low. (Although whether it is lower than journalism's in general I don't know... that's a high bar, or perhaps rather a low bar, to meet. And I don't mean that sarcastically, I mean that measured public trust in journalism is extremely low and sinking.) I don't think that has much to do with the stuff you talk about, which is not widely recognized.
arethuza 16y ago
Except that doctor was in the UK working for the NHS. I've never heard of anyone feeling that they were ripped off financially by a doctor in the UK, so that doesn't explain the problem.
pinko 16y ago
Upvote for this. The reason people are so quick to distrust real life-saving medical advice (e.g., about vaccinations) is because the medical world spouts with implied certainty so much garbage that later turns out to be false--nutritional advice being the most obvious example.
- tjmaxal 16y ago
  could you give a more specific example?
  - pinko 16y ago
    http://news.ycombinator.com/item?id=1332954 http://news.ycombinator.com/item?id=1332954
- xsmasher 16y ago
  When you talk about "the medical world," do you mean popular news reporting on medical topics? Populars news is frequently wrong or sensational (or both) about science news. A small study about fat absorption becomes "What doctors are saying about your diet - more details at 11." That's not the fault of "the medical world." News orgs are no better prepared to disseminate accurate medical news than they are accurate news about computers and tech.
  - pinko 16y ago
    Much of the bad nutrition advice of the past few generations (e.g., the food pyramid, "good" vs. "bad" fats, etc.) was regularly propagated by family physicians. That is the very definition of most people's interaction with the medical world.
nollidge 16y ago
All of the things in your second paragraph are true enough of U.S. medicine, but not so much in the U.K., where there was just as much (or more) public acceptance of the vaccine-autism link.
tokenadult 16y ago
Doctors engage in protectionism, limiting the supply of doctors by restricting the accreditation of medical schools You might want to check the number of physicians per capita in a lot of different countries http://www.dartmouth.edu/~mss/data%20analysis/Volume%20I%20pdf%20/122%20On%20the%20Average%20I%20P%20per%20.pdf http://www.dartmouth.edu/~mss/data%20analysis/Volume%20I%20p... (the first listed source has a good discussion of methodology) http://www.forbes.com/2009/07/02/health-care-costs-opinions-columnists-reform.html http://www.forbes.com/2009/07/02/health-care-costs-opinions-... (the second source gets into a lot of related issues) http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physi... (the third source shows data reported to the United Nations by national governments, some of which I find implausible) http://www.infoplease.com/ipa/A0934558.html http://www.infoplease.com/ipa/A0934558.html (the fourth source shows extreme cases from the U.N. data) and look at their mortality and morbidity statistics http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy http://en.wikipedia.org/wiki/List_of_countries_by_life_expec... http://en.wikipedia.org/wiki/Mortality_rate http://en.wikipedia.org/wiki/Mortality_rate http://www.who.int/whosis/whostat/2010/en/index.html http://www.who.int/whosis/whostat/2010/en/index.html to see how much that matters in cross-national comparisons. Some comments about the recent medical insurance reform bill in Congress suggest that differences between the United States and other countries in health outcomes have more to do with population lifestyle differences than with medical-care differences. http://www.washingtonpost.com/wp-dyn/content/article/2007/08/12/AR2007081200113.html http://www.washingtonpost.com/wp-dyn/content/article/2007/08... http://www.granttribune.com/index.php?option=com_content&view=article&id=2417:united-states-could-be-healthiest-nation-&catid=37:lifestyle&Itemid=57 http://www.granttribune.com/index.php?option=com_content&#38... http://www.cardiologytoday.com/view.aspx?rID=64007 http://www.cardiologytoday.com/view.aspx?rID=64007 And see also http://www.indypendent.org/2010/05/12/prevention/ http://www.indypendent.org/2010/05/12/prevention/ for a critique of useless medical interventions.
isleyaardvark 16y ago
The reason some members of the public are so ready to distrust them is because many members of the public are conspiracy-theorizing morons. They can clean up billing practices as much as they want, it won't do anything to convince the tin foil hat crowd who will distrust them solely on the basis of the doctors' rightful authority. In the case of vaccines you'd have to believe that nearly the entire medical profession was willing to kill children just to keep profits on one particular vaccine, instead of just the one ethically challenged doctor: Andrew Wakefield.

yummyfajitas 16y ago

...routinely gouging their patients ($5 for a single Tylenol)... Items like this quickly vanish from your bill when you tell the hospital you don't have insurance. It's the insurance companies they are trying to gouge, not the patients.

tjmaxal 16y ago
I think it is silly how people are so quick to blame the doctors and the hospitals, when the prices are set by the insurance companies 90% of the time. Where is the public outcry that insurance companies are price gouging and making millions off of denying sick people treatment.
- yummyfajitas 16y ago
  What evidence do you have that the insurance companies are price gouging? FYI, insurance companies have very low profit margins.
  - tjmaxal 16y ago
    Try the congressional committee tasked with investigating Insurance company profits prior to the latest health care bill which was really just insurance regulation. Low profit margins compared to what exactly? Is it right for any company to make a profit off of the suffering of another human being?
    - yummyfajitas 16y ago
      Try a PR event created by politicians seeking soundbites and justification to expand their authority? As for whether it is right for any company to profit off the suffering of another human being, absolutely not. It's also not right for people to do so. That's why I hate those doctors, nurses and EMTs, always profiting from other people's suffering.
      - tjmaxal 16y ago
        You are right I should have been more specific insurance companies profit by denying you access to life saving treatments, doctors, et al, profit from giving you life saving treatments. Clearly those are exactly the same thing and you are completely correct. Clearly.

jerf 16y ago

A much simpler theory that explains why the public doesn't trust public health pronouncements is that people have been both crying wolf in the doctor's name and declaring various unsafe things safe in doctor's names for a very long time now. The corruption of the doctor down the street may be a hobbyhorse of yours but I don't think that's what most people are thinking of when they consider a public health question; they're thinking about the fact that eggs are a mortal menace, then good for you, then eat the white but not the yolk, then eat the yolk but not the white, then good for you again, then a mortal menace, then good for you again. Then take that and multiply it across numerous issues. Medical journalism's credibility is pretty low. (Although whether it is lower than journalism's in general I don't know... that's a high bar, or perhaps rather a low bar, to meet. And I don't mean that sarcastically, I mean that measured public trust in journalism is extremely low and sinking.) I don't think that has much to do with the stuff you talk about, which is not widely recognized.

arethuza 16y ago

Except that doctor was in the UK working for the NHS. I've never heard of anyone feeling that they were ripped off financially by a doctor in the UK, so that doesn't explain the problem.

pinko 16y ago

Upvote for this. The reason people are so quick to distrust real life-saving medical advice (e.g., about vaccinations) is because the medical world spouts with implied certainty so much garbage that later turns out to be false--nutritional advice being the most obvious example.

tjmaxal 16y ago
could you give a more specific example?
- pinko 16y ago
  http://news.ycombinator.com/item?id=1332954 http://news.ycombinator.com/item?id=1332954
xsmasher 16y ago
When you talk about "the medical world," do you mean popular news reporting on medical topics? Populars news is frequently wrong or sensational (or both) about science news. A small study about fat absorption becomes "What doctors are saying about your diet - more details at 11." That's not the fault of "the medical world." News orgs are no better prepared to disseminate accurate medical news than they are accurate news about computers and tech.
- pinko 16y ago
  Much of the bad nutrition advice of the past few generations (e.g., the food pyramid, "good" vs. "bad" fats, etc.) was regularly propagated by family physicians. That is the very definition of most people's interaction with the medical world.

nollidge 16y ago

All of the things in your second paragraph are true enough of U.S. medicine, but not so much in the U.K., where there was just as much (or more) public acceptance of the vaccine-autism link.

tokenadult 16y ago

Doctors engage in protectionism, limiting the supply of doctors by restricting the accreditation of medical schools You might want to check the number of physicians per capita in a lot of different countries http://www.dartmouth.edu/~mss/data%20analysis/Volume%20I%20pdf%20/122%20On%20the%20Average%20I%20P%20per%20.pdf http://www.dartmouth.edu/~mss/data%20analysis/Volume%20I%20p... (the first listed source has a good discussion of methodology) http://www.forbes.com/2009/07/02/health-care-costs-opinions-columnists-reform.html http://www.forbes.com/2009/07/02/health-care-costs-opinions-... (the second source gets into a lot of related issues) http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physi... (the third source shows data reported to the United Nations by national governments, some of which I find implausible) http://www.infoplease.com/ipa/A0934558.html http://www.infoplease.com/ipa/A0934558.html (the fourth source shows extreme cases from the U.N. data) and look at their mortality and morbidity statistics http://en.wikipedia.org/wiki/List_of_countries_by_life_expectancy http://en.wikipedia.org/wiki/List_of_countries_by_life_expec... http://en.wikipedia.org/wiki/Mortality_rate http://en.wikipedia.org/wiki/Mortality_rate http://www.who.int/whosis/whostat/2010/en/index.html http://www.who.int/whosis/whostat/2010/en/index.html to see how much that matters in cross-national comparisons. Some comments about the recent medical insurance reform bill in Congress suggest that differences between the United States and other countries in health outcomes have more to do with population lifestyle differences than with medical-care differences. http://www.washingtonpost.com/wp-dyn/content/article/2007/08/12/AR2007081200113.html http://www.washingtonpost.com/wp-dyn/content/article/2007/08... http://www.granttribune.com/index.php?option=com_content&view=article&id=2417:united-states-could-be-healthiest-nation-&catid=37:lifestyle&Itemid=57 http://www.granttribune.com/index.php?option=com_content&#38... http://www.cardiologytoday.com/view.aspx?rID=64007 http://www.cardiologytoday.com/view.aspx?rID=64007 And see also http://www.indypendent.org/2010/05/12/prevention/ http://www.indypendent.org/2010/05/12/prevention/ for a critique of useless medical interventions.

isleyaardvark 16y ago

The reason some members of the public are so ready to distrust them is because many members of the public are conspiracy-theorizing morons. They can clean up billing practices as much as they want, it won't do anything to convince the tin foil hat crowd who will distrust them solely on the basis of the doctors' rightful authority. In the case of vaccines you'd have to believe that nearly the entire medical profession was willing to kill children just to keep profits on one particular vaccine, instead of just the one ethically challenged doctor: Andrew Wakefield.