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> The doctors were completely dismissive of and uninterested in the symptoms -- it really shook my faith in medical practice. I had a similar experience as a c

> The doctors were completely dismissive of and uninterested in the symptoms -- it really shook my faith in medical practice. I had a similar experience as a child, where a textbook case of a reasonably common disease went undiagnosed for 2 years by doctors before a toll booth worker at an airport diagnosed me. She recognized the symptoms because her dog had it. Sure enough, after my mother brow-beat a doctor into running the absurdly simple blood test she was proven right. On the one hand, I want to chalk this up to them being like everyone else: 90% of them are just shit at their jobs. On the other hand, I have it on good authority from nearly every nurse I've ever met that doctors are indeed arrogant, dismissive, and often mistaken.

mariodiana 6y ago
> 90% of them are just shit at their jobs. As the joke goes, "What do you call the person who graduated last in his or her class in medical school? Doctor."
- tartoran 6y ago
  Funny joke but I really don't believe a good test taker does make a good doctor. It might in fact make for more arrogant doctors.
  - killjoywashere 6y ago
    Real life impact of Dunning Krueger indeed.
tartoran 6y ago
Doctors do save many lives but I fully agree a whole lot of them are indeed terrible at edge cases and what's worse is the arrogance they display when one tries to explain the symptoms clearly. Some of them go as far as recommending a psychiatrist when it is really not called for (sure, there are instances of hypochondriacs but how about the rest who aren't? ).
adkadskhj 6y ago
> On the one hand, I want to chalk this up to them being like everyone else: 90% of them are just shit at their jobs. On the other hand, I have it on good authority from nearly every nurse I've ever met that doctors are indeed arrogant, dismissive, and often mistaken. I think there's an extra layer. Any public facing jobs tend to take a toll on you, too. Some more than others. With doctors patients lie to you constantly, for a variety of reasons. Some drug seeking, some simply not wanting to admit it. Yea, i imagine they're like everyone else (shit), but i also imagine it is very easy become very dismissive in that line of work. It's a fine line to know what to filter and what to ignore, i imagine.
- wavepruner 6y ago
  I think the issue is more that the healthcare industry makes doctors gatekeepers to healthcare, which can breed tremendous amount of resentment between doctors and patients. A doctor is pressured/forced to provide service to patients, and patients are not legally allowed to seek healthcare from other types of professionals, like biochemists for example, which often have a much better understanding of some diseases than doctors. When there is so much coercion and lack of consent, people get very frustrated.
rectang 6y ago
Doctors operate in an environment of extreme uncertainty, because human biology is so complex and so poorly understood. At the same time, doctors are rewarded for acting as though they are certain. Not unlike internet commenters rewarded with karma for condemning doctors across the board with certainty. Humans crave certainty in an uncertain world.
- ctrlp 6y ago
  The consequences of being wrong in the comments section is significantly less, imho. Plus, doctors are paid a lot for their expertise. It's really not about craving certainty. It's a question of a system that disincentivizes thinking through a problem that doesn't slot well into the diagnostic framework taught in medical schools to students selected for their ability to think inside the box, with little requirement, or really, possibility, to be very deep in biochemistry, pharmacology, research science, or a host of other inputs. Oh, and they're often very arrogant.
goda90 6y ago
>brow-beat a doctor into running the absurdly simple blood test I feel like I see this story all the time: "a simple test found the issue that they denied I had". What we should be examining are the incentives for the doctor to resist running tests. Are they too invasive? Some can be, but blood tests certainly aren't. Are they too expensive? Ah, there's the ticket. The doctors are either losing money on tests that find nothing, or they are getting berated by the managers for wasting money on tests that find nothing, or the insurance company is saying no when they ask to run tests. We have the technology to have proactive medicine. We could be catching cancers in early stages all the time with some standard sets of annual tests. But the economic incentives are all out of whack, and we're waiting until the last minute to do these tests.
- l33tman 6y ago
  Many tests are simply not that good. It's not that simple, like pay $1 for a test that with absolute certainty tells you if you have disease X or not. It would be good if that was the case because then it WOULD have been just a question of money. But if you have a test that is wrong 20% of the time, and you take this on all your patients every year, you will end up with a huge amount of mental suffering or possibly physical side-effects (unnecessary biopsies, or even surgery). You might end up giving people long runs of unnecessary meds. OTOH, you might end up missing some diagnoses if you don't do some tests. Balancing all of this is difficult. Of course this is not news to the medical profession, this is a big input to the standard flowcharts. And you can always find anecdotal edge-cases that think their particular case was crystal clear and should have immediately been diagnosed. But don't assume that medical diagnosis and treatment is as trivial as doing a blood test and some googling.
  - AnIdiotOnTheNet 6y ago
    > Many tests are simply not that good. It's not that simple, like pay $1 for a test that with absolute certainty tells you if you have disease X or not. I will note that in my case the test is routine and reliable and has been since before I was born.
  - goda90 6y ago
keithwhor 6y ago
Out of curiosity, was it Parvovirus? Somebody I knew dealt with a bout recently and I never realized how common it was.
Arete314159 6y ago
Well done, tollbooth worker!

mariodiana 6y ago

> 90% of them are just shit at their jobs. As the joke goes, "What do you call the person who graduated last in his or her class in medical school? Doctor."

tartoran 6y ago
Funny joke but I really don't believe a good test taker does make a good doctor. It might in fact make for more arrogant doctors.
- killjoywashere 6y ago
  Real life impact of Dunning Krueger indeed.

tartoran 6y ago

Doctors do save many lives but I fully agree a whole lot of them are indeed terrible at edge cases and what's worse is the arrogance they display when one tries to explain the symptoms clearly. Some of them go as far as recommending a psychiatrist when it is really not called for (sure, there are instances of hypochondriacs but how about the rest who aren't? ).

adkadskhj 6y ago

> On the one hand, I want to chalk this up to them being like everyone else: 90% of them are just shit at their jobs. On the other hand, I have it on good authority from nearly every nurse I've ever met that doctors are indeed arrogant, dismissive, and often mistaken. I think there's an extra layer. Any public facing jobs tend to take a toll on you, too. Some more than others. With doctors patients lie to you constantly, for a variety of reasons. Some drug seeking, some simply not wanting to admit it. Yea, i imagine they're like everyone else (shit), but i also imagine it is very easy become very dismissive in that line of work. It's a fine line to know what to filter and what to ignore, i imagine.

wavepruner 6y ago
I think the issue is more that the healthcare industry makes doctors gatekeepers to healthcare, which can breed tremendous amount of resentment between doctors and patients. A doctor is pressured/forced to provide service to patients, and patients are not legally allowed to seek healthcare from other types of professionals, like biochemists for example, which often have a much better understanding of some diseases than doctors. When there is so much coercion and lack of consent, people get very frustrated.

rectang 6y ago

Doctors operate in an environment of extreme uncertainty, because human biology is so complex and so poorly understood. At the same time, doctors are rewarded for acting as though they are certain. Not unlike internet commenters rewarded with karma for condemning doctors across the board with certainty. Humans crave certainty in an uncertain world.

ctrlp 6y ago
The consequences of being wrong in the comments section is significantly less, imho. Plus, doctors are paid a lot for their expertise. It's really not about craving certainty. It's a question of a system that disincentivizes thinking through a problem that doesn't slot well into the diagnostic framework taught in medical schools to students selected for their ability to think inside the box, with little requirement, or really, possibility, to be very deep in biochemistry, pharmacology, research science, or a host of other inputs. Oh, and they're often very arrogant.

goda90 6y ago

>brow-beat a doctor into running the absurdly simple blood test I feel like I see this story all the time: "a simple test found the issue that they denied I had". What we should be examining are the incentives for the doctor to resist running tests. Are they too invasive? Some can be, but blood tests certainly aren't. Are they too expensive? Ah, there's the ticket. The doctors are either losing money on tests that find nothing, or they are getting berated by the managers for wasting money on tests that find nothing, or the insurance company is saying no when they ask to run tests. We have the technology to have proactive medicine. We could be catching cancers in early stages all the time with some standard sets of annual tests. But the economic incentives are all out of whack, and we're waiting until the last minute to do these tests.

l33tman 6y ago
Many tests are simply not that good. It's not that simple, like pay $1 for a test that with absolute certainty tells you if you have disease X or not. It would be good if that was the case because then it WOULD have been just a question of money. But if you have a test that is wrong 20% of the time, and you take this on all your patients every year, you will end up with a huge amount of mental suffering or possibly physical side-effects (unnecessary biopsies, or even surgery). You might end up giving people long runs of unnecessary meds. OTOH, you might end up missing some diagnoses if you don't do some tests. Balancing all of this is difficult. Of course this is not news to the medical profession, this is a big input to the standard flowcharts. And you can always find anecdotal edge-cases that think their particular case was crystal clear and should have immediately been diagnosed. But don't assume that medical diagnosis and treatment is as trivial as doing a blood test and some googling.
- AnIdiotOnTheNet 6y ago
  > Many tests are simply not that good. It's not that simple, like pay $1 for a test that with absolute certainty tells you if you have disease X or not. I will note that in my case the test is routine and reliable and has been since before I was born.
- goda90 6y ago

keithwhor 6y ago

Out of curiosity, was it Parvovirus? Somebody I knew dealt with a bout recently and I never realized how common it was.

Arete314159 6y ago

Well done, tollbooth worker!