5 ms·

Unless you are a trained medical professional in this particular area of study, you have absolutely no business making up your own mind.

Alex3917 16y ago
Most doctors get their information about medical issues by reading the marketing pamphlets from drug companies. If you actually read the relevant journal articles then you'd be significantly more knowledgeable about any given topic than the average doctor.
- Locke1689 16y ago
  That's just not true. Is it necessary for me to say any more about this?
  - patrickgzill 16y ago
    I dunno, it squares with my experience, at least until you reach a specialist. Admittedly this is anecdotal evidence, but ... I have diagnosed several medical issues with myself and my wife by web research, only to have to pay to go to a family doctor, who hems and haws, then gives a referral to a specialist, who agrees with what I have already stated. Specialists in my area will not take you in without a referral from the family doctor, so basically the family doctor is collecting a fee for being a gatekeeper, since he/she adds zero value. Something similar occurred many years ago with an eye problem I had (tear in retinal wall) - the regular eye doctor had me coming back week after week, collecting his fee each time, until I specifically asked for a referral. The specialist saw in 3 minutes, the tear that the doctor had missed from the beginning and on each subsequent visit - the reason - the specialist had me recline to flat on my back and used a very powerful magnifying glass, while the hack ^H^H^H^H regular doctor did not. The symptoms (large eye blockage in one eye due to large black cloudy thing that appeared one morning) clearly pointed to only this cause.
    - Locke1689 16y ago
      Think about it this way: you want someone to design a website for you so you go off and find someone to do it. Now, you don't know how to program, don't really know anything about computers aside from how to perform a few functions (certainly nothing about how they actually work), and don't really have a professional frame of reference for evaluating the developers skill level. This is basically what you have to deal with with doctors. There are doctors who are very, very good and doctors who are just barely bright enough to continue to practice. The major problem is how you distinguish between the two or, in other terms, how do you find a good programmer if you don't really know anything about programming? Honestly, I don't have an easily cut-and-dried answer. I generally rely on my family (a large subset of my family are highly skilled physicians) to use their professional expertise and circles to find a very highly respected physician in the area. Similarly, I generally help in evaluating technical issues for them.
  - Alex3917 16y ago
    This is what I found within a couple minutes of Googling. Do you have any contrary information suggesting that the majority of doctors are in fact up-to-date with the latest academic journal articles published within their fields? "One New England Journal of Medicine study found that patients get only 55 percent of the care that's recommended for the leading causes of death and disability. Similar research in children showed they get just 47 percent—and a mere 41 percent of preventive steps that are proved to help."[1] "Despite 15 years of advances about what is known of [sinusitis], the information isn't making its way to internists because it is not been published in journals or other sources often reviewed by internists, who most often treat sinusitis. For instance, many internists are unaware that chronic sinusitis can cause serious chronic fatigue, Chester says."[2] "It’s unrealistic to expect the majority of physicians to go back to the original literature or even to go back to systematic reviews of the original literature,” said Gordon Guyatt, MD, of McMaster University in Hamilton, Ontario, who is credited with coining the term “evidence-based medicine."[3] "In a 2005 systematic review in the Archives of Internal Medicine, most studies found a correlation between increasing years in practice and decreasing quality of care."[3] [1]http://www.rd.com/living-healthy/is-your-doctor-out-of-date/article166346.html http://www.rd.com/living-healthy/is-your-doctor-out-of-date/... [2] http://www.upi.com/Health_News/2010/08/17/Doctors-need-more-sinusitis-research/UPI-32811282018763/ http://www.upi.com/Health_News/2010/08/17/Doctors-need-more-... [3] http://www.kevinmd.com/blog/2009/12/doctors-stay-date-current-medical-information.html http://www.kevinmd.com/blog/2009/12/doctors-stay-date-curren...
    - burgerbrain 16y ago
      "the information isn't making its way to internists because it is not been published in journals or other sources often reviewed by internists" Implying that doctors do keep up to date with peer reviewed journals, and that if all you're doing is trying to read journals with none of the medical background require to understand them, you're certainly not going to be any more informed than your average doctor. Gordon Guyatt, MD, of McMaster University in Hamilton, Ontario, who is credited with coining the term "evidence-based medicine." You quote him, yet you are so quick to discredit all evidence that you don't agree with.
      - 16y ago
cynicalkane 16y ago
A sufficiently intelligent and reasonable person should be able to, with enough consideration, make up his mind about just about anything that lives in a knowledge domain. It's not like the medical profession emerged fully-formed from the head of Zeus.
- duncanj 16y ago
  If someone just has to make up his mind, then he needs to be neither intelligent nor reasonable. I suspect you mean that a person can come to some sort of opinion that would be "good" in the sense that they have chosen the one that most likely prolongs their life, prevents illness, etc. Perhaps that is true, if "enough consideration" is equivalent something like 2 years of basic medical education and 2 years of clinical experience. Instead, most people have to make do with their own trusts, biases, limited information, etc. I think it's unreasonable to think that an untrained person is going to catch up enough after reading a few articles that they are going to make an informed decision. That's why we have doctors, to help us make informed decisions about our health. We can use their synthesis of education and experience to guide our values to make decisions that are not only self-satisfying but also reasonably accurate.
- burgerbrain 16y ago
  Any sufficiently intelligent and reasonable person could decide for themselves if gravity exists, It's not like our understanding of physics emerged fully-formed from the head of Zeus. Any sufficiently intelligent and reasonable person wouldn't be questioning the established medical fact that vaccines provide an overwhelming net benefit. If they are, they almost certainly are not qualified to make an educated decision about it. It's fine and dandy to play expert without a formal education in almost every situation, but in this case the lives of people, _and not just your own children_ is in play.
  - deleted 16y ago
    [deleted]
  - pbhjpbhj 16y ago
    >Any sufficiently intelligent and reasonable person wouldn't be questioning the established medical fact that vaccines provide an overwhelming net benefit. The problem with your position is that people still die from taking medication. Low statistical significance of harm doesn't matter to you if you're one of the statistically few that ends up harmed. Statistics are valid over populations. Yes, if one looks simply at the greater good then vaccination to prevent epidemic is a good idea. However imagine a scenario where everyone else is vaccinated but you aren't - you're not exposed to the pathogen as the disease doesn't spread nor exposed to the risk of the vaccine, you win. This is of course not a scalable response. Disease control requires those involved to consider the population and not the individual it would be beneficial to this end to pretend the vaccine is perfect and incapable of harm, this produces the best results for the whole population. Looking further, you rightly say "vaccines" provide a net benefit. Of course one is being vaccinated with a particular vaccine which, by the nature of vaccines may not have been tested beyond cursory short term tests. We can't wait 5 years for the results of double blind experiments on a vaccine when it's been rushed in to mass production to match a particular strain of pathogen. Yes the variations may be small but small variations matter. >It's fine and dandy to play expert without a formal education in almost every situation, but in this case the lives of people, _and not just your own children_ is in play. Driving in the snow, say, would you do it without a formal education?
reedlaw 16y ago
That's an extremely funny statement if it's meant to be ironic. Almost like "unless you are a %w[Politician, Clergyman, Philosopher] you have no business making up your own mind about %w[politics, religion, the meaning of life]."
- notahacker 16y ago
  Unlike politicians, clergymen or philosophers, scientists have pretty universally established standards for establishing when "your own mind" about a causal relationship between x and y is almost certainly wrong; rejecting their approach to doing it (i.e. go to school and learn for several years so you can critique the research rather than basing your view on anecdotes collected by yellow journalists) is tantamount to rejecting science as a discipline. Yes, it's elitist, but there's a reason I don't ask the man on the street to prescribe me medicine whilst being perfectly willing to debate the merits of the current government with him.
  - Alex3917 16y ago
    The thing is that this article isn't about how the public was wrong, it's an example the rampant corruption in mainstream science. And it's one of hundreds of examples of how the current states of science, peer review, and publishing are horrifically broken. Let's look at the facts of this case. The author didn't cite his financial connections, but the journal failed to catch this. The author made up data, but the journal failed to catch this. The public demanded an investigation into the vaccines, but the government refused to start an investigation or even answer their questions. When the government finally did start an investigation many years later they did it behind closed doors, and the public wasn't even allowed to read the transcript of the conversation for several more years. The scientific establishment has been in the wrong here at literally every turn, and yet you're spinning the story and trying to use it as an example of how the general public shouldn't be allowed to make their own medical decisions. Yes, the anti-vaccine crowd was also in the wrong for putting excessive weight on this study in the first place, but this apologism for the scientific establishment is completely unwarranted.
    - 16y ago
SeanDav 16y ago
I have 2 words for you : Lorenzo's Oil

Alex3917 16y ago

Most doctors get their information about medical issues by reading the marketing pamphlets from drug companies. If you actually read the relevant journal articles then you'd be significantly more knowledgeable about any given topic than the average doctor.

Locke1689 16y ago
That's just not true. Is it necessary for me to say any more about this?
- patrickgzill 16y ago
  I dunno, it squares with my experience, at least until you reach a specialist. Admittedly this is anecdotal evidence, but ... I have diagnosed several medical issues with myself and my wife by web research, only to have to pay to go to a family doctor, who hems and haws, then gives a referral to a specialist, who agrees with what I have already stated. Specialists in my area will not take you in without a referral from the family doctor, so basically the family doctor is collecting a fee for being a gatekeeper, since he/she adds zero value. Something similar occurred many years ago with an eye problem I had (tear in retinal wall) - the regular eye doctor had me coming back week after week, collecting his fee each time, until I specifically asked for a referral. The specialist saw in 3 minutes, the tear that the doctor had missed from the beginning and on each subsequent visit - the reason - the specialist had me recline to flat on my back and used a very powerful magnifying glass, while the hack ^H^H^H^H regular doctor did not. The symptoms (large eye blockage in one eye due to large black cloudy thing that appeared one morning) clearly pointed to only this cause.
  - Locke1689 16y ago
    Think about it this way: you want someone to design a website for you so you go off and find someone to do it. Now, you don't know how to program, don't really know anything about computers aside from how to perform a few functions (certainly nothing about how they actually work), and don't really have a professional frame of reference for evaluating the developers skill level. This is basically what you have to deal with with doctors. There are doctors who are very, very good and doctors who are just barely bright enough to continue to practice. The major problem is how you distinguish between the two or, in other terms, how do you find a good programmer if you don't really know anything about programming? Honestly, I don't have an easily cut-and-dried answer. I generally rely on my family (a large subset of my family are highly skilled physicians) to use their professional expertise and circles to find a very highly respected physician in the area. Similarly, I generally help in evaluating technical issues for them.
- Alex3917 16y ago
  This is what I found within a couple minutes of Googling. Do you have any contrary information suggesting that the majority of doctors are in fact up-to-date with the latest academic journal articles published within their fields? "One New England Journal of Medicine study found that patients get only 55 percent of the care that's recommended for the leading causes of death and disability. Similar research in children showed they get just 47 percent—and a mere 41 percent of preventive steps that are proved to help."[1] "Despite 15 years of advances about what is known of [sinusitis], the information isn't making its way to internists because it is not been published in journals or other sources often reviewed by internists, who most often treat sinusitis. For instance, many internists are unaware that chronic sinusitis can cause serious chronic fatigue, Chester says."[2] "It’s unrealistic to expect the majority of physicians to go back to the original literature or even to go back to systematic reviews of the original literature,” said Gordon Guyatt, MD, of McMaster University in Hamilton, Ontario, who is credited with coining the term “evidence-based medicine."[3] "In a 2005 systematic review in the Archives of Internal Medicine, most studies found a correlation between increasing years in practice and decreasing quality of care."[3] [1]http://www.rd.com/living-healthy/is-your-doctor-out-of-date/article166346.html http://www.rd.com/living-healthy/is-your-doctor-out-of-date/... [2] http://www.upi.com/Health_News/2010/08/17/Doctors-need-more-sinusitis-research/UPI-32811282018763/ http://www.upi.com/Health_News/2010/08/17/Doctors-need-more-... [3] http://www.kevinmd.com/blog/2009/12/doctors-stay-date-current-medical-information.html http://www.kevinmd.com/blog/2009/12/doctors-stay-date-curren...
  - burgerbrain 16y ago
    "the information isn't making its way to internists because it is not been published in journals or other sources often reviewed by internists" Implying that doctors do keep up to date with peer reviewed journals, and that if all you're doing is trying to read journals with none of the medical background require to understand them, you're certainly not going to be any more informed than your average doctor. Gordon Guyatt, MD, of McMaster University in Hamilton, Ontario, who is credited with coining the term "evidence-based medicine." You quote him, yet you are so quick to discredit all evidence that you don't agree with.
    - 16y ago

cynicalkane 16y ago

A sufficiently intelligent and reasonable person should be able to, with enough consideration, make up his mind about just about anything that lives in a knowledge domain. It's not like the medical profession emerged fully-formed from the head of Zeus.

duncanj 16y ago
If someone just has to make up his mind, then he needs to be neither intelligent nor reasonable. I suspect you mean that a person can come to some sort of opinion that would be "good" in the sense that they have chosen the one that most likely prolongs their life, prevents illness, etc. Perhaps that is true, if "enough consideration" is equivalent something like 2 years of basic medical education and 2 years of clinical experience. Instead, most people have to make do with their own trusts, biases, limited information, etc. I think it's unreasonable to think that an untrained person is going to catch up enough after reading a few articles that they are going to make an informed decision. That's why we have doctors, to help us make informed decisions about our health. We can use their synthesis of education and experience to guide our values to make decisions that are not only self-satisfying but also reasonably accurate.
burgerbrain 16y ago
Any sufficiently intelligent and reasonable person could decide for themselves if gravity exists, It's not like our understanding of physics emerged fully-formed from the head of Zeus. Any sufficiently intelligent and reasonable person wouldn't be questioning the established medical fact that vaccines provide an overwhelming net benefit. If they are, they almost certainly are not qualified to make an educated decision about it. It's fine and dandy to play expert without a formal education in almost every situation, but in this case the lives of people, _and not just your own children_ is in play.
- deleted 16y ago
  [deleted]
- pbhjpbhj 16y ago
  >Any sufficiently intelligent and reasonable person wouldn't be questioning the established medical fact that vaccines provide an overwhelming net benefit. The problem with your position is that people still die from taking medication. Low statistical significance of harm doesn't matter to you if you're one of the statistically few that ends up harmed. Statistics are valid over populations. Yes, if one looks simply at the greater good then vaccination to prevent epidemic is a good idea. However imagine a scenario where everyone else is vaccinated but you aren't - you're not exposed to the pathogen as the disease doesn't spread nor exposed to the risk of the vaccine, you win. This is of course not a scalable response. Disease control requires those involved to consider the population and not the individual it would be beneficial to this end to pretend the vaccine is perfect and incapable of harm, this produces the best results for the whole population. Looking further, you rightly say "vaccines" provide a net benefit. Of course one is being vaccinated with a particular vaccine which, by the nature of vaccines may not have been tested beyond cursory short term tests. We can't wait 5 years for the results of double blind experiments on a vaccine when it's been rushed in to mass production to match a particular strain of pathogen. Yes the variations may be small but small variations matter. >It's fine and dandy to play expert without a formal education in almost every situation, but in this case the lives of people, _and not just your own children_ is in play. Driving in the snow, say, would you do it without a formal education?

reedlaw 16y ago

That's an extremely funny statement if it's meant to be ironic. Almost like "unless you are a %w[Politician, Clergyman, Philosopher] you have no business making up your own mind about %w[politics, religion, the meaning of life]."

notahacker 16y ago
Unlike politicians, clergymen or philosophers, scientists have pretty universally established standards for establishing when "your own mind" about a causal relationship between x and y is almost certainly wrong; rejecting their approach to doing it (i.e. go to school and learn for several years so you can critique the research rather than basing your view on anecdotes collected by yellow journalists) is tantamount to rejecting science as a discipline. Yes, it's elitist, but there's a reason I don't ask the man on the street to prescribe me medicine whilst being perfectly willing to debate the merits of the current government with him.
- Alex3917 16y ago
  The thing is that this article isn't about how the public was wrong, it's an example the rampant corruption in mainstream science. And it's one of hundreds of examples of how the current states of science, peer review, and publishing are horrifically broken. Let's look at the facts of this case. The author didn't cite his financial connections, but the journal failed to catch this. The author made up data, but the journal failed to catch this. The public demanded an investigation into the vaccines, but the government refused to start an investigation or even answer their questions. When the government finally did start an investigation many years later they did it behind closed doors, and the public wasn't even allowed to read the transcript of the conversation for several more years. The scientific establishment has been in the wrong here at literally every turn, and yet you're spinning the story and trying to use it as an example of how the general public shouldn't be allowed to make their own medical decisions. Yes, the anti-vaccine crowd was also in the wrong for putting excessive weight on this study in the first place, but this apologism for the scientific establishment is completely unwarranted.
  - 16y ago

SeanDav 16y ago

I have 2 words for you : Lorenzo's Oil