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It seems to me that there's something wrong with medicine, but I haven't quite figured it out yet. My recent submission [0] was about how the system defaults t

It seems to me that there's something wrong with medicine, but I haven't quite figured it out yet. My recent submission [0] was about how the system defaults to expensive treatments that are marginally effective, and that doctors frequently have no ability to provide what patients actually need. My one grandfather died soon after his pacemaker was replaced - the wounds from his IVs became infected. I like to say that when he heard the doctor ask him if wanted his pacemaker replaced, he said to himself "this is my chance": If not for the surgery he certainly would have lived many more months while the battery gave out... [0] https://news.ycombinator.com/item?id=21728864 https://news.ycombinator.com/item?id=21728864

trevyn 7y ago
A thread to pull on: How does medicine work outside of developed countries?
- BurningFrog 7y ago
  Yeah, there are many alternative medical systems in the world today, but Americans usually know nothing of them.
- hycaria 7y ago
  Yep I'm always astonished at how these things are taken for granted.
throwaway5752 7y ago
I hate to be short with someone, but did you bother to read this? I mention it because of, Moreover, living longer is not older people’s only concern, or even their primary one, Dr. Rosenthal pointed out. “We don’t ask patients often enough, ‘What’s important to you?’” The primary though should be understanding what the patient wants. The patient might accept risk of death for quality of remaining life. That is a classical dilemma for a pacemaker in the eldery. And it is simply a calculated, rational risk. The problem is when patients are not given the all their options and realistic risk for each (including the risk of no action). edit: and I take this for granted, but a pacemaker can improve quality of life substantially. When it corrects a heartbeat it can prevent vertigo, falls, broken bones, and any other number of incidental effects of irregular rhythm. It is not a defibrillator.
tyri_kai_psomi 7y ago
What if this is medicine working as intended? "Frail older patients" wasn't even a word in anyone's vernacular 50 years ago, you just died if you were in that state. This is a result of us pushing the boundaries of what current modern medicine is capable of doing. Now there are more people living longer that, quite frankly, wouldn't have in earlier environments. In a way we are bypassing selection for "strong older people"

trevyn 7y ago

A thread to pull on: How does medicine work outside of developed countries?

BurningFrog 7y ago
Yeah, there are many alternative medical systems in the world today, but Americans usually know nothing of them.
hycaria 7y ago
Yep I'm always astonished at how these things are taken for granted.

throwaway5752 7y ago

I hate to be short with someone, but did you bother to read this? I mention it because of, Moreover, living longer is not older people’s only concern, or even their primary one, Dr. Rosenthal pointed out. “We don’t ask patients often enough, ‘What’s important to you?’” The primary though should be understanding what the patient wants. The patient might accept risk of death for quality of remaining life. That is a classical dilemma for a pacemaker in the eldery. And it is simply a calculated, rational risk. The problem is when patients are not given the all their options and realistic risk for each (including the risk of no action). edit: and I take this for granted, but a pacemaker can improve quality of life substantially. When it corrects a heartbeat it can prevent vertigo, falls, broken bones, and any other number of incidental effects of irregular rhythm. It is not a defibrillator.

tyri_kai_psomi 7y ago

What if this is medicine working as intended? "Frail older patients" wasn't even a word in anyone's vernacular 50 years ago, you just died if you were in that state. This is a result of us pushing the boundaries of what current modern medicine is capable of doing. Now there are more people living longer that, quite frankly, wouldn't have in earlier environments. In a way we are bypassing selection for "strong older people"