7 ms·

As an MD I'm not sure why anyone would take medical advice from a medical student. They think they know everything but lack clinical (practical) experience. It'

As an MD I'm not sure why anyone would take medical advice from a medical student. They think they know everything but lack clinical (practical) experience. It's a bit like a developer saying he knows C++ after reading "Teach yourself C++ in 21 hours".

pjc50 8y ago
Look, these days people don't want advice from actual experts, because it might be laden with ambiguity and qualification, or require them to do actual work. What they want is a strong, unambiguous promise of a cure, preferably from someone young, beautiful, and slightly anti-establishment. They want the advice doctors won't tell you!
- manuelflara 8y ago
  Things rings painfully true
- exelius 8y ago
  Brawndo, the thirst mutilator. It’s got electrolytes!
- Waterluvian 8y ago
  I generally agree. But experts could also stand to improve their ability to give meaningful actionable advice, separated from all the various information that may be useful as part of the broader discussion/treatment. I asked a handyman community the other day if my furnace running 22 hours a day during the winter is normal and how furnaces work. I got about a dozen "it depends..." answers that enumerated all the factors involving a house heating and cooling until someone basically said, "no it doesn't really depend. That's very much not normal regardless of any factors. You'd have to be in a really unusual situation for this to be normal and not warrant further investigation."
  - tcbawo 8y ago
    If the fear of being publicly proven wrong or held liable causes people to hedge/water down their advice, maybe this creates a space that allows frauds, charlatans, and confident fools to thrive.
    - wonthegame 8y ago
      I think any professional that takes on liabilities should have this view. Confidence fools many people.
  - pixl97 8y ago
    > That's very much not normal regardless of any factors. See, this is the problem with you not being an expert in the field. For example, if your house had terrible insulation and it was -10 out. Yea, that thing is going to run all day. If you had a new house, but left all your windows open, yea it will run all day too. So, yea, "it depends' is a perfectly cromulent answer without you giving lots of information. People that don't have much experience are the ones that will say "yep, it's broke" right off the bat. When I was younger and you asked "Can you make my software stack faster", I'd have answered yes. These days "It depends", probably followed by "How much money do you want to spend". TL:DR; The complexity of reality doesn't give a damn how simple you want your problem to be.
    - cglace 8y ago
      But both of those situations are not normal. He did not ask if it was possible for an AC to run for 22 hours a day. He asked it was normal. If someone asked if it was normal for a page to take 10 mins to load I would say no. However, I would then list circumstances where that would make sense.
      - Waterluvian 8y ago
        Right. I'm not discarding the value of the details. But right now I just want to know, "does it seem like I might have a problem?" As a non expert I wouldn't have been surprised if someone said, "yeah it's pretty common for furnaces to run non stop in cold winters. That's their design."
        dsfyu404ed 8y ago
        >As a non expert I wouldn't have been surprised if someone said, "yeah it's pretty common for furnaces to run non stop in cold winters. That's their design." This was not uncommon in rich (big houses) older (built up before WW2) towns in MA because the houses are big and old and state law regarding who can perform plumbing/electrical/hvac work greatly drive up costs and are a massive incentive to always minimum amount of work possible so tons of people would have poorly insulated houses with smaller than ideal heating systems. For the coldest days in the winter many people's furnaces would run all day to keep the house warm (whereas poor people just turn down the heat). This has changed recently because the state is pumping a ton of money into incentives for people to make their homes energy efficient now basically every old house has had insulation blown in everywhere because with state subsidies the cost to do so is now justifiable in the overwhelming majority of use cases.
- neuronic 8y ago
  As a "these-days person" I would generally like doctors with better bed side manners more than anything else. In Germany, the healthcare system is readily accessible for people who are insured by one of the providers of national health insurance [1]. However, doctors need to process a large amount of patient per day to make ends meet. Note, I chose the word "process" with intent, because that's what it feels like with 9 out of 10 doctors in Germany's cities nowadays. Go in, have a less than 1min chat about your health, get screened with a medical move set that rivals street food artists in Bangkok, then get a run-of-the-mill answer with little effort to personalize treatment according to your medical history. The younger the doctors, the more intense is this issue. This isn't because younger doctors are less empathetic or something. The system simply demands this or else. People are more cattle than anything... Oh and fitting right in with the Instagram fame, young medical professionals are all moving to the fun cities in Germany. Smaller towns and villages are hemorrhaging doctors. They are just not attractive in any way, especially with Germanys catastrophically bad Internet and mobile infrastructure. [1] https://en.wikipedia.org/wiki/National_health_insurance https://en.wikipedia.org/wiki/National_health_insurance
  - SlowRobotAhead 8y ago
    As much as Europeans love to crap on USA health care I have a polar opposite accedcdote. Last time I was at my general doctor, I was in the room for an hour with Doc and nurse. Talking about how I’m eating, how I feel after running long distance, if this blemish has changed shape, how I’ve been sleeping, etc etc. It took 10 days to make an appointment which is annoying, but I have never once felt rushed or that staff was rushed. Like I said. Annecdote, but polar opposite.
    - neuronic 8y ago
      Usually specialists are more like this, but not general practitioners. Also if you are privately insured you get premium service because the physician earns multiple times as much as from national health insurance. He now has time for you without jeopardizing his ability to pay off his office location. Not too long ago, I still had my general physician who could sit down and talk it all through. He retired... and another one in another city did as well. Younger ones seem under much higher economic stress. Maybe also stress from peers? It seems more of an emergent problem to be honest.
- BeetleB 8y ago
  From an earlier post[0] of mine: "The further you are from mainstream medicine, the greater the confidence signaling. Doctors tend to express the least confidence, and crackpots the most. This is why alternative medicine thrives." [0]https://news.ycombinator.com/item?id=17614882 https://news.ycombinator.com/item?id=17614882
- avgDev 8y ago
  I just want to expand on the "unambiguous promise of a cure". It is a huge problem especially for incurable diseases. I have a relative that was diagnosed with EDS, it is a very serious disease with no cure. This relative has spent $20k+ on prolotherapy. There is 0 scientific evidence that prolo works, and 0 evidence that it works on this specific disease. Those doctors just make up claims and for sources link to their site. But what they sell is hope, which is really saddening considering that person will be unable to afford housing/food soon. Just thinking about it makes me angry that people like that exist. People simply have a hard time accepting their fate. REAL doctor will tell you what you don't want to hear, a doctor that sells snake oil will promise BENEFICIAL treatments based on bs.
mettamage 8y ago
No, I recently graduated CS. I think I know enough to be productive. I also know developers that disagree and believe experience is the most important thing. That would be a more fair comparison. I still think they're wrong though since (1) experience is a too crude metric, (2) development is such a broad profession that IMO any competent CS grad is able to make a CRUD app and that's still the rage today and (3) they are not taking into account that people are able to learn (especially uni students). But I digress, sorry about that :)
- thrower123 8y ago
  > IMO any competent CS grad is able to make a CRUD app and that's still the rage today and (3) they are not taking into account that people are able to learn (especially uni students). But I digress, sorry about that :) If only this were universally true. I've so far had lackluster results actually hiring CS grads compared to self-taught people that moved in from the trades.
  - IdiocyInAction 8y ago
    That's why they qualified it with 'competent'. I could hardly believe that a CS grad that actually did all the work couldn't crank out a basic CRUD app; now, whether they can do it with your framework of choice is maybe a different question. I do have to agree that a lot of CS grads are unfortunately not competent and that quality varies a lot though.
- thomasfedb 8y ago
  Faculty at my CS school had a term "CCCC" that was used to describe some students who would not meet your CRUD app criteria: Can't Count, Can't Code
- rootusrootus 8y ago
  It really depends on the person. I've had interns come work for me who were in the middle of their CS master's program, but unable to write complete software. How we've gotten to the point where you can actually earn a bachelor's with just theory and math and no coding is beyond me. Conversely, the best developer I know is self-taught. All I'd ask from a new grad (other than coding) is to keep in mind that experience teaches you more about what NOT to do, and keep your ego under control. I can hire coders right out of high school if that's all I want, engineers take a little bit of seasoning to be valuable ;-)
saturdaysaint 8y ago
From what I've seen, this has nothing to do with medical advice - it's lifestyle advertising driven by the fact that these are popular/attractive/respected 24-year oldswith a big built-in social network of other high achieving young people. My wife is a recent med school graduate, so I have some exposure to this from seeing her IG timeline. She was also explicitly recruited by one of her more shameless influencer friends to try to make some side cash with some scheme.
thomasfedb 8y ago
So, I'm a medical student and I'm baffled by the number of people who come asking for medical advice. It's difficult not to try when you know they're not actually going to go see a doctor if you refuse to help. Often the questions are fairly simple, or you can find a good summary on the problem to go off. Sometimes it's really common questions - e.g. I've got a cold, do I need ABs? I do comment on the odd medical post on HN. Usually trying to dispell myths or offer some evidence that helps the discussion - a Cochrane review, or a Lancet article, etc. Occasionally I try to defend the profession, or explain some of the difficulty that doctors are in that leads people to be frustrated with them. I also blog a little, as an outlet for all the crazyness and feelings that come with medical training. That said, you won't be seeing and product endorsements from me. I don't see any harm in offering reasonable advice or adding a little evidence to discussions. I'm always careful to point out my student status, and not to offer medical advice directly.
- qrbLPHiKpiux 8y ago
  As a fellow practitioner, it's reckless to offer any medical advice, opinion or not. You're not licensed and you don't know what you don't know.
  - thomasfedb 8y ago
    Interested to know if you mean "any" in the absolute sense? Is this viewpoint particularly American? Would it not be reckless not to offer advice if I though not doing so would be harmful? Real questions I've been asked: - Can I dissolve these tablets? Turns out the answer was in the Product Information - yes, you can. - What happens if I mix my SSRIs with illicit substances? I don't know, could be bad, please don't, if you do consider standard harm reduction strategies.
    - qrbLPHiKpiux 8y ago
      I'm coming from a legal angle. If you're giving advice without a license, and something happens, just because you gave advice opens you up to liability. I've been practicing a while and have been around the block a few times.
Insanity 8y ago
I am too much of a hypochondriac to trust my regular doctor, I can't imagine trusting a med student.. Having talked to a lot of med students, I just don't think it is the best idea. OTOH, better to ask at least someone who might refer you to an actual doctor than just keep it to yourself I guess!
- thomasfedb 8y ago
  Do you mean skeptic? Hypochondriacs often like to see doctors.
  - Insanity 8y ago
    Yeah I used to go often - but it's more that afterwards I thought their diagnosis was wrong. It is actually not as bad anymore now that I am older, somehow :)
decebalus1 8y ago
> I'm not sure why anyone would take medical advice from a medical student. Because it's often free. Getting proper medical advice has a barrier of entry (money) and if someone is on the edge (should I worry about this? It's probably fine but let me check with this person before spending money). An appointment with my PCP costs me at least $200 (insurance pays for 90% of it only after I max out my spending of over 3k) and a specialist will take at least $400. I'm lucky for my insurance and my paycheck but I can see how a lot of people would try to avoid paying that $200 especially when they have something kinda like medical advice available for free. In my opinion It's not the people, it's the high price of medical services.
- wstrange 8y ago
  Alberta created a free 1-800 number that you can call to discuss symptoms with a registered nurse. If there is any hint that the issue is serious they tell you to go your doctor (or emergency). But for many minor ailments advice over the phone is sufficient. I suspect the service cuts down a lot of unnecessary visits to emergency.
  - rootusrootus 8y ago
    My insurance company helpfully offers a service where you can video chat with a doctor or nurse for minor ailments. Then they charge you the full rate as if you had gone into the clinic.
    - decebalus1 8y ago
      My previous insurance had something like this, which I used 4 times. Every single time, the response was: "hmm... yeah.. that's.. hmm.. I recommend you go to a walk-in clinic. Here's a list of urgent care facilities close to you. Pick one and go there by the end of the day". Completely useless. I guess it has something to do with CYA policies.
      - ska 8y ago
        There is a selection bias problem here. Walk ins and emergency departments see a lot of people who really didn't need to be there but weren't confident about that. Such a call line could presumably clear most of those out easily. On the other hand, if you don't even call until you are very confident there is a problem that won't resolve itself or whatever, you'll get redirected every time.

pjc50 8y ago

Look, these days people don't want advice from actual experts, because it might be laden with ambiguity and qualification, or require them to do actual work. What they want is a strong, unambiguous promise of a cure, preferably from someone young, beautiful, and slightly anti-establishment. They want the advice doctors won't tell you!

manuelflara 8y ago
Things rings painfully true
exelius 8y ago
Brawndo, the thirst mutilator. It’s got electrolytes!
Waterluvian 8y ago
I generally agree. But experts could also stand to improve their ability to give meaningful actionable advice, separated from all the various information that may be useful as part of the broader discussion/treatment. I asked a handyman community the other day if my furnace running 22 hours a day during the winter is normal and how furnaces work. I got about a dozen "it depends..." answers that enumerated all the factors involving a house heating and cooling until someone basically said, "no it doesn't really depend. That's very much not normal regardless of any factors. You'd have to be in a really unusual situation for this to be normal and not warrant further investigation."
- tcbawo 8y ago
  If the fear of being publicly proven wrong or held liable causes people to hedge/water down their advice, maybe this creates a space that allows frauds, charlatans, and confident fools to thrive.
  - wonthegame 8y ago
    I think any professional that takes on liabilities should have this view. Confidence fools many people.
- pixl97 8y ago
  > That's very much not normal regardless of any factors. See, this is the problem with you not being an expert in the field. For example, if your house had terrible insulation and it was -10 out. Yea, that thing is going to run all day. If you had a new house, but left all your windows open, yea it will run all day too. So, yea, "it depends' is a perfectly cromulent answer without you giving lots of information. People that don't have much experience are the ones that will say "yep, it's broke" right off the bat. When I was younger and you asked "Can you make my software stack faster", I'd have answered yes. These days "It depends", probably followed by "How much money do you want to spend". TL:DR; The complexity of reality doesn't give a damn how simple you want your problem to be.
  - cglace 8y ago
    But both of those situations are not normal. He did not ask if it was possible for an AC to run for 22 hours a day. He asked it was normal. If someone asked if it was normal for a page to take 10 mins to load I would say no. However, I would then list circumstances where that would make sense.
    - Waterluvian 8y ago
      Right. I'm not discarding the value of the details. But right now I just want to know, "does it seem like I might have a problem?" As a non expert I wouldn't have been surprised if someone said, "yeah it's pretty common for furnaces to run non stop in cold winters. That's their design."
      - dsfyu404ed 8y ago
        >As a non expert I wouldn't have been surprised if someone said, "yeah it's pretty common for furnaces to run non stop in cold winters. That's their design." This was not uncommon in rich (big houses) older (built up before WW2) towns in MA because the houses are big and old and state law regarding who can perform plumbing/electrical/hvac work greatly drive up costs and are a massive incentive to always minimum amount of work possible so tons of people would have poorly insulated houses with smaller than ideal heating systems. For the coldest days in the winter many people's furnaces would run all day to keep the house warm (whereas poor people just turn down the heat). This has changed recently because the state is pumping a ton of money into incentives for people to make their homes energy efficient now basically every old house has had insulation blown in everywhere because with state subsidies the cost to do so is now justifiable in the overwhelming majority of use cases.
neuronic 8y ago
As a "these-days person" I would generally like doctors with better bed side manners more than anything else. In Germany, the healthcare system is readily accessible for people who are insured by one of the providers of national health insurance [1]. However, doctors need to process a large amount of patient per day to make ends meet. Note, I chose the word "process" with intent, because that's what it feels like with 9 out of 10 doctors in Germany's cities nowadays. Go in, have a less than 1min chat about your health, get screened with a medical move set that rivals street food artists in Bangkok, then get a run-of-the-mill answer with little effort to personalize treatment according to your medical history. The younger the doctors, the more intense is this issue. This isn't because younger doctors are less empathetic or something. The system simply demands this or else. People are more cattle than anything... Oh and fitting right in with the Instagram fame, young medical professionals are all moving to the fun cities in Germany. Smaller towns and villages are hemorrhaging doctors. They are just not attractive in any way, especially with Germanys catastrophically bad Internet and mobile infrastructure. [1] https://en.wikipedia.org/wiki/National_health_insurance https://en.wikipedia.org/wiki/National_health_insurance
- SlowRobotAhead 8y ago
  As much as Europeans love to crap on USA health care I have a polar opposite accedcdote. Last time I was at my general doctor, I was in the room for an hour with Doc and nurse. Talking about how I’m eating, how I feel after running long distance, if this blemish has changed shape, how I’ve been sleeping, etc etc. It took 10 days to make an appointment which is annoying, but I have never once felt rushed or that staff was rushed. Like I said. Annecdote, but polar opposite.
  - neuronic 8y ago
    Usually specialists are more like this, but not general practitioners. Also if you are privately insured you get premium service because the physician earns multiple times as much as from national health insurance. He now has time for you without jeopardizing his ability to pay off his office location. Not too long ago, I still had my general physician who could sit down and talk it all through. He retired... and another one in another city did as well. Younger ones seem under much higher economic stress. Maybe also stress from peers? It seems more of an emergent problem to be honest.
BeetleB 8y ago
From an earlier post[0] of mine: "The further you are from mainstream medicine, the greater the confidence signaling. Doctors tend to express the least confidence, and crackpots the most. This is why alternative medicine thrives." [0]https://news.ycombinator.com/item?id=17614882 https://news.ycombinator.com/item?id=17614882
avgDev 8y ago
I just want to expand on the "unambiguous promise of a cure". It is a huge problem especially for incurable diseases. I have a relative that was diagnosed with EDS, it is a very serious disease with no cure. This relative has spent $20k+ on prolotherapy. There is 0 scientific evidence that prolo works, and 0 evidence that it works on this specific disease. Those doctors just make up claims and for sources link to their site. But what they sell is hope, which is really saddening considering that person will be unable to afford housing/food soon. Just thinking about it makes me angry that people like that exist. People simply have a hard time accepting their fate. REAL doctor will tell you what you don't want to hear, a doctor that sells snake oil will promise BENEFICIAL treatments based on bs.

mettamage 8y ago

No, I recently graduated CS. I think I know enough to be productive. I also know developers that disagree and believe experience is the most important thing. That would be a more fair comparison. I still think they're wrong though since (1) experience is a too crude metric, (2) development is such a broad profession that IMO any competent CS grad is able to make a CRUD app and that's still the rage today and (3) they are not taking into account that people are able to learn (especially uni students). But I digress, sorry about that :)

thrower123 8y ago
> IMO any competent CS grad is able to make a CRUD app and that's still the rage today and (3) they are not taking into account that people are able to learn (especially uni students). But I digress, sorry about that :) If only this were universally true. I've so far had lackluster results actually hiring CS grads compared to self-taught people that moved in from the trades.
- IdiocyInAction 8y ago
  That's why they qualified it with 'competent'. I could hardly believe that a CS grad that actually did all the work couldn't crank out a basic CRUD app; now, whether they can do it with your framework of choice is maybe a different question. I do have to agree that a lot of CS grads are unfortunately not competent and that quality varies a lot though.
thomasfedb 8y ago
Faculty at my CS school had a term "CCCC" that was used to describe some students who would not meet your CRUD app criteria: Can't Count, Can't Code
rootusrootus 8y ago
It really depends on the person. I've had interns come work for me who were in the middle of their CS master's program, but unable to write complete software. How we've gotten to the point where you can actually earn a bachelor's with just theory and math and no coding is beyond me. Conversely, the best developer I know is self-taught. All I'd ask from a new grad (other than coding) is to keep in mind that experience teaches you more about what NOT to do, and keep your ego under control. I can hire coders right out of high school if that's all I want, engineers take a little bit of seasoning to be valuable ;-)

saturdaysaint 8y ago

From what I've seen, this has nothing to do with medical advice - it's lifestyle advertising driven by the fact that these are popular/attractive/respected 24-year oldswith a big built-in social network of other high achieving young people. My wife is a recent med school graduate, so I have some exposure to this from seeing her IG timeline. She was also explicitly recruited by one of her more shameless influencer friends to try to make some side cash with some scheme.

thomasfedb 8y ago

So, I'm a medical student and I'm baffled by the number of people who come asking for medical advice. It's difficult not to try when you know they're not actually going to go see a doctor if you refuse to help. Often the questions are fairly simple, or you can find a good summary on the problem to go off. Sometimes it's really common questions - e.g. I've got a cold, do I need ABs? I do comment on the odd medical post on HN. Usually trying to dispell myths or offer some evidence that helps the discussion - a Cochrane review, or a Lancet article, etc. Occasionally I try to defend the profession, or explain some of the difficulty that doctors are in that leads people to be frustrated with them. I also blog a little, as an outlet for all the crazyness and feelings that come with medical training. That said, you won't be seeing and product endorsements from me. I don't see any harm in offering reasonable advice or adding a little evidence to discussions. I'm always careful to point out my student status, and not to offer medical advice directly.

qrbLPHiKpiux 8y ago
As a fellow practitioner, it's reckless to offer any medical advice, opinion or not. You're not licensed and you don't know what you don't know.
- thomasfedb 8y ago
  Interested to know if you mean "any" in the absolute sense? Is this viewpoint particularly American? Would it not be reckless not to offer advice if I though not doing so would be harmful? Real questions I've been asked: - Can I dissolve these tablets? Turns out the answer was in the Product Information - yes, you can. - What happens if I mix my SSRIs with illicit substances? I don't know, could be bad, please don't, if you do consider standard harm reduction strategies.
  - qrbLPHiKpiux 8y ago
    I'm coming from a legal angle. If you're giving advice without a license, and something happens, just because you gave advice opens you up to liability. I've been practicing a while and have been around the block a few times.

Insanity 8y ago

I am too much of a hypochondriac to trust my regular doctor, I can't imagine trusting a med student.. Having talked to a lot of med students, I just don't think it is the best idea. OTOH, better to ask at least someone who might refer you to an actual doctor than just keep it to yourself I guess!

thomasfedb 8y ago
Do you mean skeptic? Hypochondriacs often like to see doctors.
- Insanity 8y ago
  Yeah I used to go often - but it's more that afterwards I thought their diagnosis was wrong. It is actually not as bad anymore now that I am older, somehow :)

decebalus1 8y ago

> I'm not sure why anyone would take medical advice from a medical student. Because it's often free. Getting proper medical advice has a barrier of entry (money) and if someone is on the edge (should I worry about this? It's probably fine but let me check with this person before spending money). An appointment with my PCP costs me at least $200 (insurance pays for 90% of it only after I max out my spending of over 3k) and a specialist will take at least $400. I'm lucky for my insurance and my paycheck but I can see how a lot of people would try to avoid paying that $200 especially when they have something kinda like medical advice available for free. In my opinion It's not the people, it's the high price of medical services.

wstrange 8y ago
Alberta created a free 1-800 number that you can call to discuss symptoms with a registered nurse. If there is any hint that the issue is serious they tell you to go your doctor (or emergency). But for many minor ailments advice over the phone is sufficient. I suspect the service cuts down a lot of unnecessary visits to emergency.
- rootusrootus 8y ago
  My insurance company helpfully offers a service where you can video chat with a doctor or nurse for minor ailments. Then they charge you the full rate as if you had gone into the clinic.
  - decebalus1 8y ago
    My previous insurance had something like this, which I used 4 times. Every single time, the response was: "hmm... yeah.. that's.. hmm.. I recommend you go to a walk-in clinic. Here's a list of urgent care facilities close to you. Pick one and go there by the end of the day". Completely useless. I guess it has something to do with CYA policies.
    - ska 8y ago
      There is a selection bias problem here. Walk ins and emergency departments see a lot of people who really didn't need to be there but weren't confident about that. Such a call line could presumably clear most of those out easily. On the other hand, if you don't even call until you are very confident there is a problem that won't resolve itself or whatever, you'll get redirected every time.