3 ms·

> 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

> 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?
- stordoff 9y ago
  > 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. It's not a justification of not _trying_ to stay aware of the state of the art, but you always (potentially) stay ahead if you are focused on a smaller sub-field. I doubt it's possible to be completely aware of every single advancement for every condition you might encounter as it happens, nor is it suggesting that you should ignore the chance of zebra - for me, the best doctors have been those who will say "_I_ don't know; I will consult others or the literature", recognising that it's not possible for a single doctor to have exhaustive knowledge.

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?

stordoff 9y ago
> 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. It's not a justification of not _trying_ to stay aware of the state of the art, but you always (potentially) stay ahead if you are focused on a smaller sub-field. I doubt it's possible to be completely aware of every single advancement for every condition you might encounter as it happens, nor is it suggesting that you should ignore the chance of zebra - for me, the best doctors have been those who will say "_I_ don't know; I will consult others or the literature", recognising that it's not possible for a single doctor to have exhaustive knowledge.