7 ms·

I downvoted because there are a lot of assertions here without sources or context. My anecdotal experience, where my wife is in the doctor's office routinely d

by msg 18y ago

I downvoted because there are a lot of assertions here without sources or context. My anecdotal experience, where my wife is in the doctor's office routinely due to Hashimoto's disease, is that your mileage may vary. We went to an immunologist who sat on his hands and waited for several months for her thyroid to get enough out of whack before he ordered more testing. We've had several incompetent doctors who failed to diagnose conditions that harmed her health and the health of our son. On the other hand, since we've moved and had to find new doctors, we've gotten some really helpful doctors who really know their business and have been clearing up longstanding immune problems. The right doctors have really been great for us, the wrong doctors have really been bad. The first close citation I found for your argument was here: http://www.washingtonpost.com/wp-dyn/content/article/2007/12/03/AR2007120301771.html http://www.washingtonpost.com/wp-dyn/content/article/2007/12... There was a study that most doctors have high standards, but they would fail to report colleagues who didn't meet those standards. However, they appear to claim that reporting would not solve the problem, just lead to its own set of headaches. I would say that America needs to follow the money to get to the bottom of this problem. The prices of medical care just aren't commensurate with the costs anymore. Ease the financial pressure and the whole system will probably improve.

kingkongrevenge 18y ago
> there are a lot of assertions here without sources or context. I don't have time to build the full case. The nutshell version is that modern medicine is dominated by pharmaceuticals. Doctors are largely in the pill dispensing business. Problem is, the pills don't work. Spend more than fifteen minutes reading about the cholesterol and statin racket for just one example, and this is a huge billion dollar thing. It's a big chunk of what doctors do to earn a living. My familiarity with the business comes from the software side of pharma sales. For another example read about long term efficacy of many kinds of chemo and heart surgery. The stuff just doesn't really work, but it sure costs a lot. Doctors are something like the fifth leading cause of death. Malpractice is rife. Modern medicine is great for trauma, injuries, and various acute diseases. But the financial reality of health care is that most of the spending and most of what doctors do is about lifestyle diseases, and the treatments are useless. They give pills and order tons of tests for people who should really just be told that there's nothing to be done other than better diet and exercise, or maybe bed rest. They also blow millions on people who are simply in the process of dying, mostly of old age, and the treatments are empirically known to do nothing.
- arn 18y ago
  "Doctors are largely in the pill dispensing business." You do realize that doctors don't make any more money based on medications they prescribe. "Problem is, the pills don't work. ..... and the treatments are empirically known to do nothing." I don't really want to get into a big discussion about it because I know I won't be able to convince you. But this is just wrong. Many pills do work. Modern medicine is based on the scientific method and millions on dollars are spent on studies to prove that therapies work. Strnagely enough, insurance companies are part of the gatekeepers for this, since they don't want to pay out of their pockets to provide expensive care for things that don't work. On the other hand, much of "natural" medicine and homeopathic medicine are based in anectodal evidence and not on any large scale scientific evidence.
  - kingkongrevenge 18y ago
    > Modern medicine is based on the scientific method and millions on dollars are spent on studies to prove that therapies work. Sure. Take Ambien, for example. The studies show it works! People who take it fall asleep a whole 15 minutes sooner than placebo! For thousands of dollars and unquantified long term consequences you can have something pathetically less effective than lifestyle changes or some cognitive therapy sessions, so ask your doctor about Ambien. Same for the cholesterol statins. They work! They really do lower serum cholesterol, just as advertised. However, they have absolutely no affect on mortality rates in the typically prescribed case, and are implicated in serious neurological disease... This kind of nonsense is pervasive in the medical industrial complex. Doctors, for the most part, dispense treatments pushed on them. But the stuff is largely a waste of money. With a whole lot of these cancer therapies you statistically buy an extra year of life. But the person who took the therapies felt like shit for four years and blew all their savings. The person who just let it be died a year earlier but spent a lot more time feeling ok and saved a lot of money. You can just go on and on with stuff like this. The medical industrial complex is deeply dysfunctional, and at the end of the day there are way too many doctors and they do too much. This is why health care spending and number of doctors per capita is uncorrelated to lifespan and health across regions of the US.

by msg 18y ago

kingkongrevenge 18y ago

> there are a lot of assertions here without sources or context. I don't have time to build the full case. The nutshell version is that modern medicine is dominated by pharmaceuticals. Doctors are largely in the pill dispensing business. Problem is, the pills don't work. Spend more than fifteen minutes reading about the cholesterol and statin racket for just one example, and this is a huge billion dollar thing. It's a big chunk of what doctors do to earn a living. My familiarity with the business comes from the software side of pharma sales. For another example read about long term efficacy of many kinds of chemo and heart surgery. The stuff just doesn't really work, but it sure costs a lot. Doctors are something like the fifth leading cause of death. Malpractice is rife. Modern medicine is great for trauma, injuries, and various acute diseases. But the financial reality of health care is that most of the spending and most of what doctors do is about lifestyle diseases, and the treatments are useless. They give pills and order tons of tests for people who should really just be told that there's nothing to be done other than better diet and exercise, or maybe bed rest. They also blow millions on people who are simply in the process of dying, mostly of old age, and the treatments are empirically known to do nothing.

arn 18y ago
"Doctors are largely in the pill dispensing business." You do realize that doctors don't make any more money based on medications they prescribe. "Problem is, the pills don't work. ..... and the treatments are empirically known to do nothing." I don't really want to get into a big discussion about it because I know I won't be able to convince you. But this is just wrong. Many pills do work. Modern medicine is based on the scientific method and millions on dollars are spent on studies to prove that therapies work. Strnagely enough, insurance companies are part of the gatekeepers for this, since they don't want to pay out of their pockets to provide expensive care for things that don't work. On the other hand, much of "natural" medicine and homeopathic medicine are based in anectodal evidence and not on any large scale scientific evidence.
- kingkongrevenge 18y ago
  > Modern medicine is based on the scientific method and millions on dollars are spent on studies to prove that therapies work. Sure. Take Ambien, for example. The studies show it works! People who take it fall asleep a whole 15 minutes sooner than placebo! For thousands of dollars and unquantified long term consequences you can have something pathetically less effective than lifestyle changes or some cognitive therapy sessions, so ask your doctor about Ambien. Same for the cholesterol statins. They work! They really do lower serum cholesterol, just as advertised. However, they have absolutely no affect on mortality rates in the typically prescribed case, and are implicated in serious neurological disease... This kind of nonsense is pervasive in the medical industrial complex. Doctors, for the most part, dispense treatments pushed on them. But the stuff is largely a waste of money. With a whole lot of these cancer therapies you statistically buy an extra year of life. But the person who took the therapies felt like shit for four years and blew all their savings. The person who just let it be died a year earlier but spent a lot more time feeling ok and saved a lot of money. You can just go on and on with stuff like this. The medical industrial complex is deeply dysfunctional, and at the end of the day there are way too many doctors and they do too much. This is why health care spending and number of doctors per capita is uncorrelated to lifespan and health across regions of the US.