4 ms·

Why would you trust a local GP? They are almost certainly the least knowledgeable person in the chain of authority from which you could choose to trust. They wi

Why would you trust a local GP? They are almost certainly the least knowledgeable person in the chain of authority from which you could choose to trust. They will either follow the guidelines or their anecdotal experience. You could read the research papers and the guidelines yourself and have a better understanding of the issue than a given GP. For anything rare, you could probably read the subreddit about the diagnosis and get more trustworthy advice than from a GP.

jacquesm 5y ago
No, but he is in that chain of authority, and I'm not and if he passes on advice based on what he knows in general and what he knows about me I take it that he's not doing that because he wants to diminish the size of his practice. I could read the research papers and the guidelines, but for that I would first need a medical degree in the relevant (sub)fields, figure out who is and who isn't telling the truth/stacking the deck/fudging the data/angling for funding and so on and then finally I'd have to weigh those papers and all of their contradictions and arrive at some conclusion. The chances of me getting that wrong are just as high as the chances of my GP debugging a piece of software by reading papers about debugging. For rare diseases the job of a GP is not to diagnose but to pass you on to someone who can. You also have the right to a second opinion here in case you don't trust the advice that you are getting and finally, you can ask for arbitrage if you are then still not happy. That said, plenty of errors are made, but I don't think the software industry has any right to speak about mistakes made in other fields, our own house has been on fire for the last three decades in that respect and the only thing we've done to deal with it is to avow any responsibility.
- beagle3 5y ago
  > I take it that he's not doing that because he wants to diminish the size of his practice. But very likely (especially in the US, but also in other places), his considerations have to do with not increasing his malpractice insurance premium. Your and his interests are not aligned. And that chasm is larger than anyone likes to admit.
  - jacquesm 5y ago
    I'm not in the US and malpractice suits against doctors are extremely rare here.
    - beagle3 5y ago
      The divergence is not as big as in the US then, but your incentives are still not perfectly aligned. If you want to outsource your health decisions to someone else, who may be more knowledgeable in general, but may be less knowledgeable on any specific matter you dive into, and whose incentives are only generally aligned with yours - by all means do. I don't, and this has paid great dividends for me so far. People who are capable of reading and understanding research (not all are), and have the ability to reach far out to well informed people and consult with them (not all can), are also likely to be in this situation -- and those people potentially lose dearly for not doing so.

jacquesm 5y ago

No, but he is in that chain of authority, and I'm not and if he passes on advice based on what he knows in general and what he knows about me I take it that he's not doing that because he wants to diminish the size of his practice. I could read the research papers and the guidelines, but for that I would first need a medical degree in the relevant (sub)fields, figure out who is and who isn't telling the truth/stacking the deck/fudging the data/angling for funding and so on and then finally I'd have to weigh those papers and all of their contradictions and arrive at some conclusion. The chances of me getting that wrong are just as high as the chances of my GP debugging a piece of software by reading papers about debugging. For rare diseases the job of a GP is not to diagnose but to pass you on to someone who can. You also have the right to a second opinion here in case you don't trust the advice that you are getting and finally, you can ask for arbitrage if you are then still not happy. That said, plenty of errors are made, but I don't think the software industry has any right to speak about mistakes made in other fields, our own house has been on fire for the last three decades in that respect and the only thing we've done to deal with it is to avow any responsibility.

beagle3 5y ago
> I take it that he's not doing that because he wants to diminish the size of his practice. But very likely (especially in the US, but also in other places), his considerations have to do with not increasing his malpractice insurance premium. Your and his interests are not aligned. And that chasm is larger than anyone likes to admit.
- jacquesm 5y ago
  I'm not in the US and malpractice suits against doctors are extremely rare here.
  - beagle3 5y ago
    The divergence is not as big as in the US then, but your incentives are still not perfectly aligned. If you want to outsource your health decisions to someone else, who may be more knowledgeable in general, but may be less knowledgeable on any specific matter you dive into, and whose incentives are only generally aligned with yours - by all means do. I don't, and this has paid great dividends for me so far. People who are capable of reading and understanding research (not all are), and have the ability to reach far out to well informed people and consult with them (not all can), are also likely to be in this situation -- and those people potentially lose dearly for not doing so.