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I don't understand why so many doctors seem incapable of doing research or accept research provided to them by their patients. If you have symptoms that match a

I don't understand why so many doctors seem incapable of doing research or accept research provided to them by their patients. If you have symptoms that match a condition documented in medical literature, and the doctor can't come up with a better fitting explanation, why would they reject it? It's like these people learned a subset of their field and then just refuse to ever learn anything new.

LudwigNagasena 5y ago
That’s because 99% of patients who do their own research come up with some crazy ideas.
- AuryGlenz 5y ago
  I find that if you go in to an appointment with a peer reviewed study printed out things will go better for you. It’s a good way to signal “I did my own research, but not on YouTube.”
  - deltaonetwo 5y ago
    This is ingenious and a incredible way to display how illogical a doctor (and people in general) can be. It's completely obvious that the doctor isn't going to really read the paper (he's too busy). You just present a paper and suddenly the doctor will trust you more. Literally it's deference to Authority being employed by the doctor here; nothing going on with rationality or logic. Don't present a single logical argument to the doctor. If that argument, however logical, goes against traditional medical knowledge you will be dismissed. The key is to forget about logic and use an authoritative approach. I'm betting the actual contents of those research papers don't even matter. You can print out a completely bogus study, just make sure it looks legit.
    - jhrmnn 5y ago
      Science is built on deference to authority. You cannot possibly derive all known physics laws yourself, or verify all the known biology yourself. You have to trust to a certain degree all the scientists that came before you, collectively. You can question some bits here and there but you don’t have time to question everything. The doctors cannot possibly evaluate all the arguments brought in by patients, they don’t have time or even expertise to do that. But they can trust (to a certain degree) a peer-reviewed article.
      - nomel 5y ago
        And, related, “ A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.” -Planck
      - deltaonetwo 5y ago
        I would say the logical thing to do for the doctor is Not to trust the patient peer until AFTER the doctor has actually read the article himself. The problem here is the doctor will likely trust the patient without ever reading the article. There has to be some degree of verification regardless of how complex the world is. At the very least he should read the paper. Because not doing so is hypocritical. Doctors treat patients as dimwitted idiots but suddenly the patient is smart because he has a paper? No, you can't make that judgement unless you read the paper.
  - tudorw 5y ago
    Yes, approach as teamwork and be humble about what you bring to the table, making it clear you are aware that you are a layperson, and that you are also not the first to go off and think you've found something googling, after that I brought spreadsheets to my appointment, summaries of abstracts and links together with the protocol for the test I believed I required. Eventually, after one GP moved on to study drug gene interactions and another retired I was able to get the gene test I had hypothesised may reveal an underlying cause and I was correct.
- deltaonetwo 5y ago
  This article is literally about patients who followed a crazy idea and the doctors who dismissed them. The crazy people here were the doctors. What the mother did here was more rational and logical then every doctor in the department of UCLA. Think on that, then think about the amount of money UCLA charges patients and whether or not this sort of incompetency justifies this high level of monetary compensation. I would say all people are irrational and biased. The issue is Doctors in general think they're better than everyone. They dismiss the fact that the biases and crazy ideas that effect all of humanity could effect them as well.
pintxo 5y ago
A) Think IT Support suddenly exposed to a knowledgeable user B) Just like IT Support, doctors abilities are distributed on a bell curve. We all hope that the curve is leaning to the right, but I think the jury is still out on that one.
- nappy 5y ago
  The filtering, testing requirements, and frankly unpleasantness involved in medicine (in the United States) not only drives the curve to the right, but also lops off a good portion of the left side of the curve of all of those who want to become physicians.
  - deltaonetwo 5y ago
    The problem with this is that there is zero evidence that the filtering and testing requirements correlate with actual doctoring skills. In fact there is evidence against this. Think of it this way; in Europe it is far easier to become a doctor then in the US due to significantly less stringent requirements. However in Europe and other 1st world countries treatment and other quantitative measures on quality of medical care beat the US by a far margin. It shows that the "unpleasantness" is pushing something to the right of the bell curve. However it is clearly not pushing "effective medical diagnosis and treatment" to the right of the curve as Europe is beating us on that front with far less stringent requirements.
    - crooked-v 5y ago
      For example, the current residency process in the US demands regular 80-100 hours weeks[1] for years, and was designed by a man who was basically high on cocaine 24/7 and expected the same out of all doctors. [1] It's supposed to be legally limited to 80, but ask around and it's obvious that even that limit isn't properly enforced.
      - ptsneves 5y ago
        Not only in the US, Europe is the same(Portugal and Spain at least). It is absolutely ridiculous to expect life critical care from people who are working those hours. No other critical profession would even dare having those hours(pilots, drivers, etc) yet it is expected that doctors are somehow super humans. I think that is what they want to imply, as well as get boatloads of money on demand due to pay per hour.
bserge 5y ago
Yes, it's a job. Very few actually care about their field. And if they started accepting their patients' research (most of which will be riddled with errors, sadly), they wouldn't get anything done. It sucks, but as with any human system, the majority has priority, minorities have to wait for their turn (and/or actively fight for it).
trainsplanes 5y ago
I've done this and had a doctor that was kind enough to consider it. I had some mysterious symptoms and managed to find some things that I thought might fit it, and it helped him get a better idea of what I was dealing with. He also went through and dismissed most of the more worrying possibilities, which set my mind at ease, and narrowed it down to a more likely condition. So basically, I threw in a bunch of options and most of them were wrong. Thankfully I didn't walk in convinced that any one of them was absolutely the cause, but I imagine some patients do, and it can be a pain for the doctor.
rscho 5y ago
Doctors are not here to do research. It's not their job. Yes, this means usual care always lags behind research by years or at least the time to formulate guidelines. No, you'll accomplish nothing trying to force the hand of clinicians in doing stuff they're not educated to do or understand. Have a weird condition? Sorry, but most of the time you'll be out of luck. And there isn't really anything planned in our healthcare systems to help you. And frankly, people coming into my practice wielding science papers often understand neither what they read, nor that they are asking for an impossible thing. The best I could do if your claim seems realistic is to refer you to a specialist in the matter, but never ever would I act solely on the basis of research papers. And that's because I am a researcher myself, so I know how unreliable that is.
- sterlind 5y ago
  wait, if you're a researcher, and a doctor, but you say doctors are not here to do research.. isn't that a contradiction? I think you're right that most doctors don't do research, but doctors publish papers all the time. if I look at a surgery journal I'll see articles by surgeons. my doctor isn't like, in the lab running tissue assays, but he'll try experimental things when no clear-cut treatment exists, see if they succeed or fail, and adjust his practice accordingly. also, dismissing people with "weird conditions" as "out of luck" is a pretty crappy thing to do. I can understand not having enough time or background to handle those cases, but I sure hope you're referring those people to someone who can rather than giving up on your patients because you can't be bothered.
  - rscho 5y ago
    One can have 2 jobs. I'm not saying that no docs do research, but I'm insisting that caring for people and doing research are two different jobs that have nothing in common. The fact that the two are so poorly separated in practice is damaging to both science and patients. What people don't understand is that modern medicine is not centered around the practitioners but around precise guidelines that are both medically and legally binding. When I say that you're out of luck, it's not to spite anyone. If a competent clinician specialist examined a case and sees no way out, going to the big fish professor will not benefit you otherwise than maybe entering a study, because from a reasonable clinical pov there are really many conditions for which we can only offer support. So sometimes, no one "can". But clinicians are not expected to use creative thinking, and that's the very best medical evolution since the past century. It's the job of researchers to read science papers and formulate the guidelines to be transmitted to clinicians. You REALLY should not be doing that all by yourself as a practitioner.
Slaminerag 5y ago
A lot of doctors don't listen to their patients. Go to almost any forum where they discuss a story like this, and you can get a ton of stories of patients (usually women) who suffered for years until they found a doctor who treated their symptoms seriously. And then you have stories like this one.https://www.thecut.com/2018/09/what-if-the-doctors-had-listened-to-our-sister-becky.html https://www.thecut.com/2018/09/what-if-the-doctors-had-liste... Know what a "double 0 doctor" is? They've got a license to kill. (I picked that up in a book by a doctor, btw.)

LudwigNagasena 5y ago

That’s because 99% of patients who do their own research come up with some crazy ideas.

AuryGlenz 5y ago
I find that if you go in to an appointment with a peer reviewed study printed out things will go better for you. It’s a good way to signal “I did my own research, but not on YouTube.”
- deltaonetwo 5y ago
  This is ingenious and a incredible way to display how illogical a doctor (and people in general) can be. It's completely obvious that the doctor isn't going to really read the paper (he's too busy). You just present a paper and suddenly the doctor will trust you more. Literally it's deference to Authority being employed by the doctor here; nothing going on with rationality or logic. Don't present a single logical argument to the doctor. If that argument, however logical, goes against traditional medical knowledge you will be dismissed. The key is to forget about logic and use an authoritative approach. I'm betting the actual contents of those research papers don't even matter. You can print out a completely bogus study, just make sure it looks legit.
  - jhrmnn 5y ago
    Science is built on deference to authority. You cannot possibly derive all known physics laws yourself, or verify all the known biology yourself. You have to trust to a certain degree all the scientists that came before you, collectively. You can question some bits here and there but you don’t have time to question everything. The doctors cannot possibly evaluate all the arguments brought in by patients, they don’t have time or even expertise to do that. But they can trust (to a certain degree) a peer-reviewed article.
    - nomel 5y ago
      And, related, “ A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it.” -Planck
    - deltaonetwo 5y ago
      I would say the logical thing to do for the doctor is Not to trust the patient peer until AFTER the doctor has actually read the article himself. The problem here is the doctor will likely trust the patient without ever reading the article. There has to be some degree of verification regardless of how complex the world is. At the very least he should read the paper. Because not doing so is hypocritical. Doctors treat patients as dimwitted idiots but suddenly the patient is smart because he has a paper? No, you can't make that judgement unless you read the paper.
- tudorw 5y ago
  Yes, approach as teamwork and be humble about what you bring to the table, making it clear you are aware that you are a layperson, and that you are also not the first to go off and think you've found something googling, after that I brought spreadsheets to my appointment, summaries of abstracts and links together with the protocol for the test I believed I required. Eventually, after one GP moved on to study drug gene interactions and another retired I was able to get the gene test I had hypothesised may reveal an underlying cause and I was correct.
deltaonetwo 5y ago
This article is literally about patients who followed a crazy idea and the doctors who dismissed them. The crazy people here were the doctors. What the mother did here was more rational and logical then every doctor in the department of UCLA. Think on that, then think about the amount of money UCLA charges patients and whether or not this sort of incompetency justifies this high level of monetary compensation. I would say all people are irrational and biased. The issue is Doctors in general think they're better than everyone. They dismiss the fact that the biases and crazy ideas that effect all of humanity could effect them as well.

pintxo 5y ago

A) Think IT Support suddenly exposed to a knowledgeable user B) Just like IT Support, doctors abilities are distributed on a bell curve. We all hope that the curve is leaning to the right, but I think the jury is still out on that one.

nappy 5y ago
The filtering, testing requirements, and frankly unpleasantness involved in medicine (in the United States) not only drives the curve to the right, but also lops off a good portion of the left side of the curve of all of those who want to become physicians.
- deltaonetwo 5y ago
  The problem with this is that there is zero evidence that the filtering and testing requirements correlate with actual doctoring skills. In fact there is evidence against this. Think of it this way; in Europe it is far easier to become a doctor then in the US due to significantly less stringent requirements. However in Europe and other 1st world countries treatment and other quantitative measures on quality of medical care beat the US by a far margin. It shows that the "unpleasantness" is pushing something to the right of the bell curve. However it is clearly not pushing "effective medical diagnosis and treatment" to the right of the curve as Europe is beating us on that front with far less stringent requirements.
  - crooked-v 5y ago
    For example, the current residency process in the US demands regular 80-100 hours weeks[1] for years, and was designed by a man who was basically high on cocaine 24/7 and expected the same out of all doctors. [1] It's supposed to be legally limited to 80, but ask around and it's obvious that even that limit isn't properly enforced.
    - ptsneves 5y ago
      Not only in the US, Europe is the same(Portugal and Spain at least). It is absolutely ridiculous to expect life critical care from people who are working those hours. No other critical profession would even dare having those hours(pilots, drivers, etc) yet it is expected that doctors are somehow super humans. I think that is what they want to imply, as well as get boatloads of money on demand due to pay per hour.

bserge 5y ago

Yes, it's a job. Very few actually care about their field. And if they started accepting their patients' research (most of which will be riddled with errors, sadly), they wouldn't get anything done. It sucks, but as with any human system, the majority has priority, minorities have to wait for their turn (and/or actively fight for it).

trainsplanes 5y ago

I've done this and had a doctor that was kind enough to consider it. I had some mysterious symptoms and managed to find some things that I thought might fit it, and it helped him get a better idea of what I was dealing with. He also went through and dismissed most of the more worrying possibilities, which set my mind at ease, and narrowed it down to a more likely condition. So basically, I threw in a bunch of options and most of them were wrong. Thankfully I didn't walk in convinced that any one of them was absolutely the cause, but I imagine some patients do, and it can be a pain for the doctor.

rscho 5y ago

Doctors are not here to do research. It's not their job. Yes, this means usual care always lags behind research by years or at least the time to formulate guidelines. No, you'll accomplish nothing trying to force the hand of clinicians in doing stuff they're not educated to do or understand. Have a weird condition? Sorry, but most of the time you'll be out of luck. And there isn't really anything planned in our healthcare systems to help you. And frankly, people coming into my practice wielding science papers often understand neither what they read, nor that they are asking for an impossible thing. The best I could do if your claim seems realistic is to refer you to a specialist in the matter, but never ever would I act solely on the basis of research papers. And that's because I am a researcher myself, so I know how unreliable that is.

sterlind 5y ago
wait, if you're a researcher, and a doctor, but you say doctors are not here to do research.. isn't that a contradiction? I think you're right that most doctors don't do research, but doctors publish papers all the time. if I look at a surgery journal I'll see articles by surgeons. my doctor isn't like, in the lab running tissue assays, but he'll try experimental things when no clear-cut treatment exists, see if they succeed or fail, and adjust his practice accordingly. also, dismissing people with "weird conditions" as "out of luck" is a pretty crappy thing to do. I can understand not having enough time or background to handle those cases, but I sure hope you're referring those people to someone who can rather than giving up on your patients because you can't be bothered.
- rscho 5y ago
  One can have 2 jobs. I'm not saying that no docs do research, but I'm insisting that caring for people and doing research are two different jobs that have nothing in common. The fact that the two are so poorly separated in practice is damaging to both science and patients. What people don't understand is that modern medicine is not centered around the practitioners but around precise guidelines that are both medically and legally binding. When I say that you're out of luck, it's not to spite anyone. If a competent clinician specialist examined a case and sees no way out, going to the big fish professor will not benefit you otherwise than maybe entering a study, because from a reasonable clinical pov there are really many conditions for which we can only offer support. So sometimes, no one "can". But clinicians are not expected to use creative thinking, and that's the very best medical evolution since the past century. It's the job of researchers to read science papers and formulate the guidelines to be transmitted to clinicians. You REALLY should not be doing that all by yourself as a practitioner.

Slaminerag 5y ago

A lot of doctors don't listen to their patients. Go to almost any forum where they discuss a story like this, and you can get a ton of stories of patients (usually women) who suffered for years until they found a doctor who treated their symptoms seriously. And then you have stories like this one.https://www.thecut.com/2018/09/what-if-the-doctors-had-listened-to-our-sister-becky.html https://www.thecut.com/2018/09/what-if-the-doctors-had-liste... Know what a "double 0 doctor" is? They've got a license to kill. (I picked that up in a book by a doctor, btw.)