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I think doctors aggravate this problem of people believing they're ill even when the clinical evidence doesn't support it. I can't tell you how many doctors I'

by smeej 5y ago

I think doctors aggravate this problem of people believing they're ill even when the clinical evidence doesn't support it. I can't tell you how many doctors I've had tell me, explicitly, within 15 minutes of having met me that they know my body, symptoms, and experience better than I do. It used to come much later in the process, after I'd spent months following their instructions to the letter and having my symptoms only get worse because they had completely overlooked or ignored some important piece of information I'd given them, so now I just ask in the very first appointment before I consider hiring that doctor to help me. I think I understand why they do it. I have to imagine the overwhelming majority of people they see have only a grade school-level understanding of science, and a social media-level understanding of research. And doctors are used to being assumed to be the smartest person in the room (by themselves and everybody else, fairly or not). But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me. I remember well my classmates who became doctors. A few of them were brilliant. Most of them were very good at repeating back information and not terribly good at forming their own insights. That's fine in many contexts. I just don't assume someone in a white coat is smarter than I am, much less knows me "better than I know myself," just because they got their advanced degree in a different field than I did.

guerrilla 5y ago
> I just ask in the very first appointment before I consider hiring that doctor to help me. Ask what?
- lupire 5y ago
  > [if] they know my body, symptoms, and experience better than I do.
- sumtechguy 5y ago
  Maybe that is the question (doubt it). Think about it. Its brilliant. You say 'I always ask this one question to my doctors' then ramble off on some other tangent. See if they come back to that question. It means they are paying attention and are inquisitive.
- twobitshifter 5y ago
  I had to read 3 times to get it: They’re asking within 15 minutes of meeting the doctor about their symptoms and providing their personally identified cause and seeing what the doctor does. Whereas before they would go through the long drawn out process of following the doctors recommendations and getting no progress because the doctor misdiagnosed them.
raziel2p 5y ago
I think it's too much to ask that every doctor (or any professional in any field, really) make an accurate individual judgement on who of their clients are able to do their own research or not. That's a luxury you might be able to afford if you're offering high-end (and thus expensive) services, but not when serving a large amount of customers.
- makeitdouble 5y ago
  The issue is we’re not “customers”, it’s a regulated profession so you don’t get to pick and choose ad infinitum, and it’s also not like you could bypass them and directly receive treatments you think you need. If you’ve done your homework when coming to them, I don’t think it’s too much to expect to have them at least pay attention to what you bring to the table.
  - raziel2p 5y ago
    I think it is, actually - especially if 90% of people who "do their homework" actually end up with the wrong conclusions, and 50% of those are too stubborn to admit that they are wrong. It can be a massive waste of trained professionals' time.
    - makeitdouble 5y ago
      “Doing their homework” means learning enough about a subject to be able to explain in details what they are seeing/feeling and understanding what the doctor has to say about it. It’s the difference between “my poo is weird” and “here’s my temperature during the last three days and each feces according to the Bristol scale”. A doctor just telling you to shove your observations in indecent places isn’t sparing anyone’s time. They might be missing the mark or unreliable, but that’s not what the parent was talking about. On patients that think they know what they need and won’t budge an inch, you’ll have them anyway. Recognizing and properly dealing with these cases is part of being a doctor. You won’t see many 6 yo kid naturally sold on getting intramuscular injections.
MisterTea 5y ago
The trope that doctors are very smart isn't one Ive ever understood. A funny story was my shop teacher (Electrician class in high school) told us after he was sued by a customer who's doctor son attempted to rectify a "mistake" the electrician made. I forget the details but the doctor wound up blowing out or damaging something in his botched attempt to play electrician. Doctors father sues electrician for doing a faulty job when it was clearly his idiot "doctor" son who blew it all up. The mans argument in all this was summed up by his plea to the judge to understand why he thought the electrician was wrong: "Your honor, my son is a doctor." The judge laughed and dismissed the case.
- TheCoelacanth 5y ago
  That seems more like a demonstration of arrogance and lack of wisdom than lack of intelligence.
bena 5y ago
But on the flip side of this, you don't know your internal workings better than they do. Just because you live in your body doesn't mean you know how it works. I drive a Civic, it doesn't make me a mechanic. Diagnosis is tricky. Especially in a system as complicated and interconnected as the human body. People often have a bad tendency to misattribute effects to recent events. And let's say your conjecture of why they dismiss you is true. That it's because everyone else is an idiot and they're not accustomed to dealing with the brilliance that is you. Everyone thinks like that. Everyone thinks they're the bright shining star who knows medicine better than the doctor. You were not the first person and you won't be the last who walks in with reams of printed out papers on the very thing they're sure is the problem. They have no way of knowing if you actually know what you're talking about unless they put in the work of figuring out what's up with you. So yes, you could be right, but you could also be wrong. And the work is the same either way.
- rajin444 5y ago
  > and the work is the same either way I think I that’s the issue. Not all doctors are the same. I’ve been to many that just gave me a surface level amount of thought and sent me on my way. I’ve been to others that took time to really dig in and try to solve the problems. People resort to self research because (for whatever reason, some valid) too many doctors are the former. Operating in a system where regression to the mean is so prevalent rewards doing the bare minimum with the added benefit of generally reducing your liability.
- mistermann 5y ago
  > Everyone thinks like that. Everyone thinks they're the bright shining star who knows medicine better than the doctor. This seems more truthy than True.
  - bena 5y ago
    It may be an exaggeration for effect, but in any walk-in clinic, you're going to get at least one of those a day.
    - 5y ago
twobitshifter 5y ago
I find that doctors are somewhat like a frustrating computer form, making patients jump through the procedural hoops to finally get to anything of value. There’s no way around it, patients can tell them what’s been tried before, their family history, what else is going on, but they will always defer to the simplest most common condition without fail, and ignore any association. That’s because that’s what they’re trained to do and it will work in many situations. However, when someone has something that is not a simple condition they fail to piece together the multiple conditions and other circumstances which tell them that a nose bleed may be more serious than dry air. There’s also the complication of overdiagnosis. I’ve had a doctor not refer me to others because he believed that if I am referred to certain doctors and tested, they will find something wrong with me, but that condition may have not been serious and caused many problems, but the treatment could be worse. I don’t think this “ignorance is bliss” philosophy is unique to my doctor.
ChicagoBoy11 5y ago
I think a corollary to this is that no one will CARE as much about your health than you, even your doctor. It is perhaps scary to realize it fully, but no one is as invested in getting to the root cause of your issues, and no one has as. much intimate information about how it feels/manifests itself etc. than you. I think taken together this surely spells out that you ought to have a much more active role in your care than you may otherwise think to do, especially in situations where those factors may be more pronounced. I speak from experience. I was born with serious congenital issues which are non-evident from looking at me or a simple examination. Switching doctors, for instance, is quite the ordeal, and it is always a few sessions before I get someone to be "leveled" up to where I need them to. My parents have a remarkable story related to me being born that ties into this as well. Apparently my mother suffered from severe pain later acknowledged to be polyhydramnios. They went to several doctors, did many ultrasounds, etc. From the first to the forth doctor, she got anything from needing to stress, to rest, to this is normal, etc. But luckily one hinted just slightly that he thought there MIGHT be something, and suggested she go see this other specialist who was at the tail end of his career. Apparently a minute or two into the ultrasound, he apparently mentioned it with utter certainty: It could be one of two things, either anencephaly or esophageal atresia; I'd either be stillborn or would need surgery shortly after birth. Guess there's not much suspense for the reader for which one of these it turned out to be, but I always remember that story -- and my parents relentless pursuit to find someone until they were convinced they had it "right" -- whenever folks bring up searching for medical advice.
dec0dedab0de 5y ago
But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me. I agree, but this has happened less and less as I have gotten older. I'm not sure if there is newer training, or they just give me the benefit of the doubt because I'm a decade older than them. Either way, I have found that older doctors are more likely to talk down to me, even when they clearly do not know what they're talking about.
- didericis 5y ago
  This is an overgeneralization, but I’ve experienced this most often with affluent baby boomers, across all disciplines. I don’t think it’s purely an age gap issue, as I generally don’t get that sense from generations older than baby boomers. It could have less to do with your age and more to do with baby boomers aging out of the workforce. The most arrogant and least approachable managers, teachers, doctors, etc I’ve encountered always seem to be from that generation. Maybe I’m just a “spoiled millennial”… this kind of generational generalization is almost definitely unproductive, but I can’t help myself from thinking it has some validity.
amiantos 5y ago
> But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me. To my eye, this reads quite a bit like the same sort of thing anti-vaccine and Flat Earther types think. Just because you think you're smart in some area, or even in general, doesn't mean you've got a natural aptitude for anything else. Maybe you're the exception to the rule, (probably not) but you can't blame other people for not taking your layperson confidence as gospel truth that you're smart and not at all being misled by your own or others hubris.
boublepop 5y ago
> But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me. It’s not that doctors think you unintelligent, but you are not a doctor. It doesn’t matter how many YouTube videos you’ve watched on a subject or how many hours you’ve spent reading about your current symptoms to convince yourself that your special intellect justifies doctors paying closer attention to your opinion, if you haven’t gone through the 7 years of education and passed the exams, then you are not a doctor and you will not be treated as one. Patients should be more accepting of this fact. It does not make sense in general to have doctors ask their patients to self-diagnose, even if their patients are intelligent, it doesn’t add value. The problem is that every gambler will tell a statistician that actually their odds are abnormally high. And it’s true, if you pull 5 cards from a deck, the odds of getting exactly the cards you drew are incredibly small… no matter what you draw, so when you try to post rationalize events that have already occurred you even feel that statistics will back up your claim, but that’s not how it works, you can’t do that, just like patients being correct occasionally does not mean they should be treated as doctors because they don’t have the required education and experience.
mbrodersen 5y ago
The average doctor is an expert in memorising text books but has no ability to think.

by smeej 5y ago

guerrilla 5y ago

> I just ask in the very first appointment before I consider hiring that doctor to help me. Ask what?

lupire 5y ago
> [if] they know my body, symptoms, and experience better than I do.
sumtechguy 5y ago
Maybe that is the question (doubt it). Think about it. Its brilliant. You say 'I always ask this one question to my doctors' then ramble off on some other tangent. See if they come back to that question. It means they are paying attention and are inquisitive.
twobitshifter 5y ago
I had to read 3 times to get it: They’re asking within 15 minutes of meeting the doctor about their symptoms and providing their personally identified cause and seeing what the doctor does. Whereas before they would go through the long drawn out process of following the doctors recommendations and getting no progress because the doctor misdiagnosed them.

raziel2p 5y ago

I think it's too much to ask that every doctor (or any professional in any field, really) make an accurate individual judgement on who of their clients are able to do their own research or not. That's a luxury you might be able to afford if you're offering high-end (and thus expensive) services, but not when serving a large amount of customers.

makeitdouble 5y ago
The issue is we’re not “customers”, it’s a regulated profession so you don’t get to pick and choose ad infinitum, and it’s also not like you could bypass them and directly receive treatments you think you need. If you’ve done your homework when coming to them, I don’t think it’s too much to expect to have them at least pay attention to what you bring to the table.
- raziel2p 5y ago
  I think it is, actually - especially if 90% of people who "do their homework" actually end up with the wrong conclusions, and 50% of those are too stubborn to admit that they are wrong. It can be a massive waste of trained professionals' time.
  - makeitdouble 5y ago
    “Doing their homework” means learning enough about a subject to be able to explain in details what they are seeing/feeling and understanding what the doctor has to say about it. It’s the difference between “my poo is weird” and “here’s my temperature during the last three days and each feces according to the Bristol scale”. A doctor just telling you to shove your observations in indecent places isn’t sparing anyone’s time. They might be missing the mark or unreliable, but that’s not what the parent was talking about. On patients that think they know what they need and won’t budge an inch, you’ll have them anyway. Recognizing and properly dealing with these cases is part of being a doctor. You won’t see many 6 yo kid naturally sold on getting intramuscular injections.

MisterTea 5y ago

The trope that doctors are very smart isn't one Ive ever understood. A funny story was my shop teacher (Electrician class in high school) told us after he was sued by a customer who's doctor son attempted to rectify a "mistake" the electrician made. I forget the details but the doctor wound up blowing out or damaging something in his botched attempt to play electrician. Doctors father sues electrician for doing a faulty job when it was clearly his idiot "doctor" son who blew it all up. The mans argument in all this was summed up by his plea to the judge to understand why he thought the electrician was wrong: "Your honor, my son is a doctor." The judge laughed and dismissed the case.

TheCoelacanth 5y ago
That seems more like a demonstration of arrogance and lack of wisdom than lack of intelligence.

bena 5y ago

But on the flip side of this, you don't know your internal workings better than they do. Just because you live in your body doesn't mean you know how it works. I drive a Civic, it doesn't make me a mechanic. Diagnosis is tricky. Especially in a system as complicated and interconnected as the human body. People often have a bad tendency to misattribute effects to recent events. And let's say your conjecture of why they dismiss you is true. That it's because everyone else is an idiot and they're not accustomed to dealing with the brilliance that is you. Everyone thinks like that. Everyone thinks they're the bright shining star who knows medicine better than the doctor. You were not the first person and you won't be the last who walks in with reams of printed out papers on the very thing they're sure is the problem. They have no way of knowing if you actually know what you're talking about unless they put in the work of figuring out what's up with you. So yes, you could be right, but you could also be wrong. And the work is the same either way.

rajin444 5y ago
> and the work is the same either way I think I that’s the issue. Not all doctors are the same. I’ve been to many that just gave me a surface level amount of thought and sent me on my way. I’ve been to others that took time to really dig in and try to solve the problems. People resort to self research because (for whatever reason, some valid) too many doctors are the former. Operating in a system where regression to the mean is so prevalent rewards doing the bare minimum with the added benefit of generally reducing your liability.
mistermann 5y ago
> Everyone thinks like that. Everyone thinks they're the bright shining star who knows medicine better than the doctor. This seems more truthy than True.
- bena 5y ago
  It may be an exaggeration for effect, but in any walk-in clinic, you're going to get at least one of those a day.
  - 5y ago

twobitshifter 5y ago

I find that doctors are somewhat like a frustrating computer form, making patients jump through the procedural hoops to finally get to anything of value. There’s no way around it, patients can tell them what’s been tried before, their family history, what else is going on, but they will always defer to the simplest most common condition without fail, and ignore any association. That’s because that’s what they’re trained to do and it will work in many situations. However, when someone has something that is not a simple condition they fail to piece together the multiple conditions and other circumstances which tell them that a nose bleed may be more serious than dry air. There’s also the complication of overdiagnosis. I’ve had a doctor not refer me to others because he believed that if I am referred to certain doctors and tested, they will find something wrong with me, but that condition may have not been serious and caused many problems, but the treatment could be worse. I don’t think this “ignorance is bliss” philosophy is unique to my doctor.

ChicagoBoy11 5y ago

I think a corollary to this is that no one will CARE as much about your health than you, even your doctor. It is perhaps scary to realize it fully, but no one is as invested in getting to the root cause of your issues, and no one has as. much intimate information about how it feels/manifests itself etc. than you. I think taken together this surely spells out that you ought to have a much more active role in your care than you may otherwise think to do, especially in situations where those factors may be more pronounced. I speak from experience. I was born with serious congenital issues which are non-evident from looking at me or a simple examination. Switching doctors, for instance, is quite the ordeal, and it is always a few sessions before I get someone to be "leveled" up to where I need them to. My parents have a remarkable story related to me being born that ties into this as well. Apparently my mother suffered from severe pain later acknowledged to be polyhydramnios. They went to several doctors, did many ultrasounds, etc. From the first to the forth doctor, she got anything from needing to stress, to rest, to this is normal, etc. But luckily one hinted just slightly that he thought there MIGHT be something, and suggested she go see this other specialist who was at the tail end of his career. Apparently a minute or two into the ultrasound, he apparently mentioned it with utter certainty: It could be one of two things, either anencephaly or esophageal atresia; I'd either be stillborn or would need surgery shortly after birth. Guess there's not much suspense for the reader for which one of these it turned out to be, but I always remember that story -- and my parents relentless pursuit to find someone until they were convinced they had it "right" -- whenever folks bring up searching for medical advice.

dec0dedab0de 5y ago

But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me. I agree, but this has happened less and less as I have gotten older. I'm not sure if there is newer training, or they just give me the benefit of the doubt because I'm a decade older than them. Either way, I have found that older doctors are more likely to talk down to me, even when they clearly do not know what they're talking about.

didericis 5y ago
This is an overgeneralization, but I’ve experienced this most often with affluent baby boomers, across all disciplines. I don’t think it’s purely an age gap issue, as I generally don’t get that sense from generations older than baby boomers. It could have less to do with your age and more to do with baby boomers aging out of the workforce. The most arrogant and least approachable managers, teachers, doctors, etc I’ve encountered always seem to be from that generation. Maybe I’m just a “spoiled millennial”… this kind of generational generalization is almost definitely unproductive, but I can’t help myself from thinking it has some validity.

amiantos 5y ago

> But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me. To my eye, this reads quite a bit like the same sort of thing anti-vaccine and Flat Earther types think. Just because you think you're smart in some area, or even in general, doesn't mean you've got a natural aptitude for anything else. Maybe you're the exception to the rule, (probably not) but you can't blame other people for not taking your layperson confidence as gospel truth that you're smart and not at all being misled by your own or others hubris.

boublepop 5y ago

> But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me. It’s not that doctors think you unintelligent, but you are not a doctor. It doesn’t matter how many YouTube videos you’ve watched on a subject or how many hours you’ve spent reading about your current symptoms to convince yourself that your special intellect justifies doctors paying closer attention to your opinion, if you haven’t gone through the 7 years of education and passed the exams, then you are not a doctor and you will not be treated as one. Patients should be more accepting of this fact. It does not make sense in general to have doctors ask their patients to self-diagnose, even if their patients are intelligent, it doesn’t add value. The problem is that every gambler will tell a statistician that actually their odds are abnormally high. And it’s true, if you pull 5 cards from a deck, the odds of getting exactly the cards you drew are incredibly small… no matter what you draw, so when you try to post rationalize events that have already occurred you even feel that statistics will back up your claim, but that’s not how it works, you can’t do that, just like patients being correct occasionally does not mean they should be treated as doctors because they don’t have the required education and experience.

mbrodersen 5y ago

The average doctor is an expert in memorising text books but has no ability to think.