3 ms·

Yes, the system is horrendous and broken. There should be complete oversight and full transparency for self-regulation purposes, which includes ongoing learning

by loceng 9y ago

Yes, the system is horrendous and broken. There should be complete oversight and full transparency for self-regulation purposes, which includes ongoing learning and education, and get lawyers involved once the self-regulating is found to be inadequate - such as a surgeon who repeatedly makes the same mistakes and hasn't bothered to learn or care to improve their skills, or prevented from continuing. From my own struggles of trying to find healing for chronic pain I have, I have realized that doctors/professionals are selected for for their memorization and not for critical thinking skills.

salawat 9y ago
This is one thing that still amazes me to this day. It's like doctor's stop thinking after they get their degree. Whenever I've visited a doc within the past few years I have noticed that instead of actually getting to know someone as a patient, many act as if they are a quick reference book. This is especially horrifying when you consider that there is a non-trivial portion of the population that exist outside of the medical literature. Every one of the best Doctors I've ever had has ALWAYS been a researcher at heart. They observe, take notes, treat what they can now, and come back later and can clue me in on the latest research they've come across. Nowadays, I'm usually making Doctors aware of advancements in their field... Scary stuff.
- viraptor 9y ago
  > Nowadays, I'm usually making Doctors aware of advancements in their field... Scary stuff. Are you taking about your cases? Because keeping on top of the narrow score that's currently relevant to you is a different level of time investment than keeping on top of everything happening in the field, after already learning a large part of it, and keeping in mind current treating guidelines which lag behind research.
  - salawat 9y ago
    Alright, I'll concede that one. I admit, things become a lot simpler once you limit your scope to issues immediately relevant to you as a patient. However, I do still believe that when made aware of something new from a patient, a good physician should actively tackle the topic if only to be able to give a realistic assessment of where it falls on the risk/outcome spectrum. NOTE: This may be assuming an above average level of patient investment. I in no way condone of wasting a physician's time having them wade through quackery. Nobody has time for that.
- stordoff 9y ago
  > Nowadays, I'm usually making Doctors aware of advancements in their field... Scary stuff. I don't find that to be too surprising. I can be hyper-aware of my own ailments, but keeping up with an entire field is more difficult. Furthermore, treating to research runs the risk of using treatments where the outcomes haven't been replicated, or there are long-term complications. Unless you've exhausted more conventional treatments/the treatment guidelines, there's something of an advantage of not being right at the bleeding edge.
  - salawat 9y ago
    >I don't find that to be too surprising. I can be hyper-aware of my own ailments, but keeping up with an entire field is more difficult. I do not find the above to be sufficient justification to practice in ANY field without trying to stay aware of the state-of-the-art. Yes, in medicine in particular, there is a justifiable bias toward applying more conservative treatments first. "Hear hoof beats, think horse first, not Zebra," is the axiom I believe is most frequently ground into new physicians. The problem comes in when a physician becomes so conditioned to conservative treatments working that they become blind to the extremes. Running with the Zebra analogy, just because you hear hoof beats, you see a horse-like silhouette, and in this lighting you can't tell the color, does not mean you should IGNORE the possibility of Zebra. As a practicing physician, you are DEPENDED upon to be the layman's gateway to the entirety of the collective medical knowledge base we've been able to accrue, verify, and are in the process of verifying. You owe it to your patients, just as an Engineer owes it to the public, to become as well acquainted with the medical literature as it pertains to them as possible. I may be being a bit normative here, but an M.D. should be seen as a commitment to spending your life on the pursuit of the means by which to provide the highest quality of care for your body of patients. That at times means being ready to help the a patient access and navigate the less charted waters of the state-of-the-art if necessary. I agree completely that state-of-the-art should not be the first hammer pulled from the toolbox, but one should not actively avoid it either. At the end of the day, data doesn't get generated out of thin air, and if the patient understands and accepts the risks after you have provided them the best guidance you can, you have done all that can be expected of you, have you not?
mjfl 9y ago
Or maybe this attitude you have, that doctors should be sued for vague ideas like lack of "critical thinking skills" is exactly the reason why doctors are incredibly risk averse and the system is messed up to begin with.

by loceng 9y ago

salawat 9y ago

This is one thing that still amazes me to this day. It's like doctor's stop thinking after they get their degree. Whenever I've visited a doc within the past few years I have noticed that instead of actually getting to know someone as a patient, many act as if they are a quick reference book. This is especially horrifying when you consider that there is a non-trivial portion of the population that exist outside of the medical literature. Every one of the best Doctors I've ever had has ALWAYS been a researcher at heart. They observe, take notes, treat what they can now, and come back later and can clue me in on the latest research they've come across. Nowadays, I'm usually making Doctors aware of advancements in their field... Scary stuff.

viraptor 9y ago
> Nowadays, I'm usually making Doctors aware of advancements in their field... Scary stuff. Are you taking about your cases? Because keeping on top of the narrow score that's currently relevant to you is a different level of time investment than keeping on top of everything happening in the field, after already learning a large part of it, and keeping in mind current treating guidelines which lag behind research.
- salawat 9y ago
  Alright, I'll concede that one. I admit, things become a lot simpler once you limit your scope to issues immediately relevant to you as a patient. However, I do still believe that when made aware of something new from a patient, a good physician should actively tackle the topic if only to be able to give a realistic assessment of where it falls on the risk/outcome spectrum. NOTE: This may be assuming an above average level of patient investment. I in no way condone of wasting a physician's time having them wade through quackery. Nobody has time for that.
stordoff 9y ago
> Nowadays, I'm usually making Doctors aware of advancements in their field... Scary stuff. I don't find that to be too surprising. I can be hyper-aware of my own ailments, but keeping up with an entire field is more difficult. Furthermore, treating to research runs the risk of using treatments where the outcomes haven't been replicated, or there are long-term complications. Unless you've exhausted more conventional treatments/the treatment guidelines, there's something of an advantage of not being right at the bleeding edge.
- salawat 9y ago
  >I don't find that to be too surprising. I can be hyper-aware of my own ailments, but keeping up with an entire field is more difficult. I do not find the above to be sufficient justification to practice in ANY field without trying to stay aware of the state-of-the-art. Yes, in medicine in particular, there is a justifiable bias toward applying more conservative treatments first. "Hear hoof beats, think horse first, not Zebra," is the axiom I believe is most frequently ground into new physicians. The problem comes in when a physician becomes so conditioned to conservative treatments working that they become blind to the extremes. Running with the Zebra analogy, just because you hear hoof beats, you see a horse-like silhouette, and in this lighting you can't tell the color, does not mean you should IGNORE the possibility of Zebra. As a practicing physician, you are DEPENDED upon to be the layman's gateway to the entirety of the collective medical knowledge base we've been able to accrue, verify, and are in the process of verifying. You owe it to your patients, just as an Engineer owes it to the public, to become as well acquainted with the medical literature as it pertains to them as possible. I may be being a bit normative here, but an M.D. should be seen as a commitment to spending your life on the pursuit of the means by which to provide the highest quality of care for your body of patients. That at times means being ready to help the a patient access and navigate the less charted waters of the state-of-the-art if necessary. I agree completely that state-of-the-art should not be the first hammer pulled from the toolbox, but one should not actively avoid it either. At the end of the day, data doesn't get generated out of thin air, and if the patient understands and accepts the risks after you have provided them the best guidance you can, you have done all that can be expected of you, have you not?

mjfl 9y ago

Or maybe this attitude you have, that doctors should be sued for vague ideas like lack of "critical thinking skills" is exactly the reason why doctors are incredibly risk averse and the system is messed up to begin with.