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Playing devil's advocate... doctors are neither omniscient nor perfect. > Shouldn't my doctor morally and by default be suggesting the best treatment for what

by umvi 7y ago

Playing devil's advocate... doctors are neither omniscient nor perfect. > Shouldn't my doctor morally and by default be suggesting the best treatment for what I have? Shouldn't programmers by default be suggesting the best algorithm/programming language/design patterns for the problem at hand? In a perfect world, yes. But we live in an imperfect world where sub-optimal choices are made due to time constraints, lack of knowledge/experience, etc. Doctors are not exempt from this same phenomenon, in fact it may be amplified because there's just so much more knowledge you need to index and access compared to programming. Just as you don't know about every web framework in existence, doctors don't know about every medicine in existence. "Ask your web designer to see if using Svelte is right for you."

bigbob2 7y ago
> Shouldn't programmers by default be suggesting the best algorithm/programming language/design patterns for the problem at hand? In a perfect world, yes. But we live in an imperfect world where sub-optimal choices are made due to time constraints, lack of knowledge/experience, etc. I don't understand. Are you saying you frequently have non-technical customers of your software business asking for specific languages, design patterns and frameworks which end up being the optimal choices? In my personal experience this has never been the case. Also somehow I feel like it would be even worse if they heard about them from TV instead of from a generic blog post somewhere.
- mark-r 7y ago
  Do the vendors of these languages, design patterns and frameworks have billions of dollars riding on your choice? If so, you'd better believe your non-technical customers would be seeing ads pushing them to advocate for one over another. The more non-technical the better, because technical deficiencies become less of a barrier. You already see this today with products pitched at the bosses rather than the underlings that are getting the work done.
  - Uehreka 7y ago
    Agreed. I think the point is that this is bad, and that if “patients asking their doctors to prescribe particular drugs” is an analogous situation, then it too is bad.
  - bigbob2 7y ago
    I wasn't arguing that those things aren't pushed, but rather that they're rarely pushed with technical merit. See: "...which end up being the optimal choices?"
- jacobr1 7y ago
  This happens all the time with "buzzword trends" more so than specific languages/frameworks. Does your product have "big data / AI / ML / IoT / blockchain" etc ...
mumblemumble 7y ago
>Playing devil's advocate... doctors are neither omniscient nor perfect. There's been some research into this subject, and, in this case, it would seem that you are indeed advocating for the devil. I haven't read any of the papers myself, but the stories I've heard via channels such as the Science-Based Medicine blog or PusCast suggest that drug advertising - both to doctors and direct to consumers - tends to result in both higher health care costs and poorer patient outcomes, because it increases the odds that a doctor will prescribe a more expensive and less safe or less effective (or at least no more safe or effective) drug. It's supposedly down to the drug companies' incentive structures. Once a patent expires, they often start tweaking the molecule to come out with new drugs that behave similarly, but are chemically different enough to qualify for a new patent. They then sink a lot of money into trying to convince doctors to prescribe it instead. Their avenue for doing this is advertising, which doesn't have to clear nearly as high an evidentiary bar as any of the scientific channels for disseminating information.
- deleted 7y ago
  [deleted]
banads 7y ago
>>shouldn't my doctor morally and by default be suggesting the best treatment for what I have? >Shouldn't programmers by default be suggesting the best algorithm/programming language/design patterns for the problem at hand? Are you implying non technical users would somehow be able to make a crucial technical design decision because they saw an ad somewhere? That seems quite absurd. In my professional experience, every time a non technical stakeholder has tried to force a specific technology to solve a complex problem, it has been disastrous.
- umvi 7y ago
  > Are you implying non technical users would somehow be able to make a crucial technical design decision because they saw an ad somewhere? ... In my professional experience, every time a non technical stakeholder has tried to force a specific technology to solve a complex problem, it has been disastrous. No, and in fact I am against TV advertisements of prescription medications. However, what I am challenging is the attitude Europeans (and some Americans) have that doctors should never be questioned, for they always know what's best and you should just shut up and follow their advice. See, general practitioners have a very small amount of time to understand and diagnose your problem, draw the correct solution from their vast stores of knowledge, and prescribe something before moving to the next patient. In most cases they don't have time to stew about what your disease might be for hours and hours on end. But guess who does have time to stew and research for hours, days, and months? The patient. And in the cases of chronic diseases, the patients can often become more expert in their disease (and related medicines and side-effects) than your average general practitioners. So in summary, I believe: - No, we should not allow TV adverts for prescription drugs - Yes, patients should do online research about their diseases, including potential treatments and drugs - Yes, patients should ask their doctor questions and make suggestions, presenting findings they've gathered - Yes, patients shouldn't hesitate in getting a second opinion from a different doctor. Not all doctors have the same experience level. - No, doctors should not bristle at this but encourage research, correcting misconceptions and answering their patients' questions. It's their body, after all
  - banads 7y ago
    We are in agreement. Doctors advice should definitely not be unquestionable. In fact, there are a number of studies which show iatrogenesis as being one of the leading causes of death in the US.

by umvi 7y ago

bigbob2 7y ago

> Shouldn't programmers by default be suggesting the best algorithm/programming language/design patterns for the problem at hand? In a perfect world, yes. But we live in an imperfect world where sub-optimal choices are made due to time constraints, lack of knowledge/experience, etc. I don't understand. Are you saying you frequently have non-technical customers of your software business asking for specific languages, design patterns and frameworks which end up being the optimal choices? In my personal experience this has never been the case. Also somehow I feel like it would be even worse if they heard about them from TV instead of from a generic blog post somewhere.

mark-r 7y ago
Do the vendors of these languages, design patterns and frameworks have billions of dollars riding on your choice? If so, you'd better believe your non-technical customers would be seeing ads pushing them to advocate for one over another. The more non-technical the better, because technical deficiencies become less of a barrier. You already see this today with products pitched at the bosses rather than the underlings that are getting the work done.
- Uehreka 7y ago
  Agreed. I think the point is that this is bad, and that if “patients asking their doctors to prescribe particular drugs” is an analogous situation, then it too is bad.
- bigbob2 7y ago
  I wasn't arguing that those things aren't pushed, but rather that they're rarely pushed with technical merit. See: "...which end up being the optimal choices?"
jacobr1 7y ago
This happens all the time with "buzzword trends" more so than specific languages/frameworks. Does your product have "big data / AI / ML / IoT / blockchain" etc ...

mumblemumble 7y ago

>Playing devil's advocate... doctors are neither omniscient nor perfect. There's been some research into this subject, and, in this case, it would seem that you are indeed advocating for the devil. I haven't read any of the papers myself, but the stories I've heard via channels such as the Science-Based Medicine blog or PusCast suggest that drug advertising - both to doctors and direct to consumers - tends to result in both higher health care costs and poorer patient outcomes, because it increases the odds that a doctor will prescribe a more expensive and less safe or less effective (or at least no more safe or effective) drug. It's supposedly down to the drug companies' incentive structures. Once a patent expires, they often start tweaking the molecule to come out with new drugs that behave similarly, but are chemically different enough to qualify for a new patent. They then sink a lot of money into trying to convince doctors to prescribe it instead. Their avenue for doing this is advertising, which doesn't have to clear nearly as high an evidentiary bar as any of the scientific channels for disseminating information.

deleted 7y ago
[deleted]

banads 7y ago

>>shouldn't my doctor morally and by default be suggesting the best treatment for what I have? >Shouldn't programmers by default be suggesting the best algorithm/programming language/design patterns for the problem at hand? Are you implying non technical users would somehow be able to make a crucial technical design decision because they saw an ad somewhere? That seems quite absurd. In my professional experience, every time a non technical stakeholder has tried to force a specific technology to solve a complex problem, it has been disastrous.

umvi 7y ago
> Are you implying non technical users would somehow be able to make a crucial technical design decision because they saw an ad somewhere? ... In my professional experience, every time a non technical stakeholder has tried to force a specific technology to solve a complex problem, it has been disastrous. No, and in fact I am against TV advertisements of prescription medications. However, what I am challenging is the attitude Europeans (and some Americans) have that doctors should never be questioned, for they always know what's best and you should just shut up and follow their advice. See, general practitioners have a very small amount of time to understand and diagnose your problem, draw the correct solution from their vast stores of knowledge, and prescribe something before moving to the next patient. In most cases they don't have time to stew about what your disease might be for hours and hours on end. But guess who does have time to stew and research for hours, days, and months? The patient. And in the cases of chronic diseases, the patients can often become more expert in their disease (and related medicines and side-effects) than your average general practitioners. So in summary, I believe: - No, we should not allow TV adverts for prescription drugs - Yes, patients should do online research about their diseases, including potential treatments and drugs - Yes, patients should ask their doctor questions and make suggestions, presenting findings they've gathered - Yes, patients shouldn't hesitate in getting a second opinion from a different doctor. Not all doctors have the same experience level. - No, doctors should not bristle at this but encourage research, correcting misconceptions and answering their patients' questions. It's their body, after all
- banads 7y ago
  We are in agreement. Doctors advice should definitely not be unquestionable. In fact, there are a number of studies which show iatrogenesis as being one of the leading causes of death in the US.