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Google almost convinced me to spend $400 on useless laser treatments

• h2odragon 4y ago
  Every time someone tells you the "science is settled" is likely to have just as many facts behind it.
• darkerside 4y ago
  This is the kind of marketing-driven content I can actually get behind, not joking. Glacier MD at least has the problem right.
  • imglorp 4y ago
    What's to stop Glacier from becoming the same as Google for the same reasons? That's a mountain of med ad cash on the table.
    • pineconewarrior 4y ago
      Dignity and resolve to their mission statement are what prevent it. Not exactly a strong hand to bet on, but it's better than nothing.
      • willhinsa 4y ago
        “Don’t Be Evil” turned out to not be better than nothing.
    • Nextgrid 4y ago
      Competition? If they become the equivalent of Google, why would anyone pay them to get the same kind of content they can get from Google for free?
    • darkerside 4y ago
      Google worked great for a long time. The beauty of capitalism is that a competitor that provides more valuable may supplant it. The day Glacier falls into the same short term cash trap, I hope someone else rises up in its place.
• geek_at 4y ago
  > In the pre-Szaszian era, medicine was something that happened to you. You would put your health in your doctor's hands and they would unilaterally decide your course of treatment. But in today's patient-centered world, doctors are more like consultants To be honest I've only seen this level of "patient-centered" stuff in the US. Never heard the phrase "Ask your doctor about xy" anywhere but on US TV. Sometimes pretty hard drugs like psychotropic drugs. When I first head it my response was "WTF, shouldn't the doctor tell you what you need and not the other way around?" I guess it comes down to the batshit crazy US healthcare system and people losing trust in doctors that give them 40k$ bills for simple treatments or short hospital stays
  • donatj 4y ago
    I would personally rather be involved in the decision making process related to my very existence rather than just told what to do.
    • matsemann 4y ago
      I "feel" like I would like that as well. But if I every get really ill with something longterm, I'm also afraid I'd spend too much energy on all the decisions and research. Giving patients options also gives them doubts.
      • bittercynic 4y ago
        I think individual patients have very different preferences on this. I've taken pets to a few different vets, and some say things like "There are many possible reasons for these symptoms. Let's try XYZ and see how it goes." Others are more like "Your dog has X. We'll do Y and it should clear up." My preference is for the one who I think is being honest with me about how certain they are about what's going on, and when a medical professional seems like they want to appear 100% certain all the time it makes me worry about their judgement. I think many people have the opposite preference, which seems to me is asking for dishonesty. Seems like an ethically tricky area.
    • fullstop 4y ago
• elteto 4y ago
  I have found that dental clinics in the US can be some of the shadiest health related businesses you have to deal with. There are few independent clinics around. Most of them belong to huge corporate conglomerates that push down shady treatments like this, or offer predatory financing for these “treatments”. I’ve had only two instances of a health professional outright lying to me and telling me I had a health condition that I didn’t have, and both times were dentists. One of those times was also about periodontal disease, so it seems like this is a common thing. A good heuristic is that if the treatment isn’t covered at all by insurance it very well might be worthless.
  • asdfasgasdgasdg 4y ago
    One thing I've found is that many doctors are willing to share the rationale for their decisions and recommendations if you question them on the state of the research. Some have even gone as far as to send me papers after we've met. Doctors in many cases are human body-nerds and are willing to talk with interested patients about their subject. Doctors who won't justify themselves can often be avoided at least in medium-sized and larger urban areas. The main observation is that in medicine you need to be your own advocate. The doctor is used to people who just want an answer or a cure. They're not going to break out the journals for every patient because most patients don't want that. This also goes for dentistry.
  • chrisdhal 4y ago
    Maybe that's regional? In my area (Minneapolis/St. Paul metro), there are tons of independent dentists and few conglomerates (at least that I know of). In my little-ish suburb (25k people) there are no corporate ones but about 6 independent ones. I go to an independent office (2 dentists) and I've never felt pressured by them and they've even said things like, "It looks like that may turn into a cavity, but we can wait and see what happens." Obviously I'm not saying it doesn't happen, but like anything, it's not everywhere.
• Zigurd 4y ago
  But... free speech!
• petesergeant 4y ago
  > Laser bacterial reduction (LBR) is just one example of the many high-stakes medical decisions Whether or not to drop $400 is not a "high-stakes medical decision". Also, expecting Google to give you high-quality medical advice when your actual, licensed, trained dental hygienest is not is asking a lot of a search engine. Personally I've found sticking "examine.com" on the end of most results to be very useful for anything supplement-related, and "reddit.com" as a suffix pretty good for anything else.
  • notamy 4y ago
    > Whether or not to drop $400 is not a "high-stakes medical decision". This just feels out-of-touch. $400 on a medical decision is a MASSIVE choice for many people -- it could be the difference between whether not they eat.
    • jcranberry 4y ago
      It could be a high stakes decision but perhaps not necessarily a high stakes medical decision?
      • gumby 4y ago
        The point is that by framing it as a medical decision they change the calculation, pushing it ahead of other important things the patient might spend on.
      • Karawebnetwork 4y ago
        It's still a laser focused at your gums based on limited studies. What if this ends up creating health issues? Looking at some studies on risks for that procedure, there's small issues like itching sensations that last for days but also more serious issues like badly fitted eye protection that could potentially end up causing blindness. All medical decisions are high stakes, even if they don't end up working. Even without effects and side effects, the confidence from the laser could mean the author stops flossing for example. Think sugar pills and homeopathy. If you end up trusting that the useless pill prevents cancer, you might stop going to your cancer screening appointments. It can also become very costly if the procedure is then added to all other appointments. In an economy 64% of the population lives paycheck to paycheck, this can open a can of worms when presented as a mandatory (or strongly encouraged) procedure.
• matsemann 4y ago
  Why are dentists so scammy? In Norway I've seen documentaries about them sending the same people to multiple dentists, and some of them receive wildly different advice. Some of that can be ascribed to some being in the school of pro-active, so they want to fix your teeth at the first glance of issues. But in the end, most of the things being quoted were unnecessary. They all seemed very intent on removing wisdom teeth, even when they pose no problems. They re-did the experiment recently, and I think one of the guys they sent got his teeth cleaned and tartar removed from 10 dentists in a week or so. No one stopped to see if it was actually needed, they all just do it by default and charge you for it.
  • donatj 4y ago
    I went to a new dentist for a broken filling and they tried to tell me I had 14 cavities and set me down with a finance person to set up a payment plan for how I was going to pay for them over the next 5 years. I went to a second dentist, they fixed the broken filling and said my teeth were otherwise fine. I have the paperwork to back this up. I’d been seeing another dentist for a while and he suddenly wanted to crown 3 of my teeth. Again I got a second opinion, and again they were like “That’s probably not necessary”. I think a lot of dentistry comes down to how much money they need that month. It certainly doesn’t feel very scientific.
    • tomxor 4y ago
      Unnecessary medical procedures are extremely immoral, do you mind sharing what country/practice this was in?
      • donatj 4y ago
        United States. Here’s my yelp review of the first place. https://www.yelp.com/biz/shamblott-family-dentistry-hopkins?hrid=3kR-ZmEnxx-skLw0-tt3LQ https://www.yelp.com/biz/shamblott-family-dentistry-hopkins?...
      • ceejayoz 4y ago
        Not OP, but there's been a lot of this in the US. https://www.pbs.org/wgbh/frontline/article/patients-pressure-and-profits-at-aspen-dental/ https://www.pbs.org/wgbh/frontline/article/patients-pressure... > Former employees say Aspen Dental trained them in high-pressure sales. Corporate management scrutinizes the production of dentists and staff daily. And internal documents show that dentists get paid bonuses as key production targets are met. https://www.elpasotimes.com/story/news/health/2018/01/10/kool-smiles-pay-23-9-million-accused-unnecessary-dental-work-children/1023083001/ https://www.elpasotimes.com/story/news/health/2018/01/10/koo... > "Especially when that fraud involves performing unnecessary procedures on kids —here, unnecessary baby root canals and tooth extractions, among other procedures —we will not hesitate to use every tool at our disposal to punish those who break the law," Bash said. > The accusations against Kool Smiles included prohibiting parents from being present during root canals "to keep hidden the child's suffering" and retaliation against "unproductive" dentists, according to a federal complaint filed in San Antonio in 2013.
• yellow_lead 4y ago
  I'm interested in an update on the author's startup. Last time I heard he was shutting it down, but at the end of the article I realized this was content marketing for it.
  • pineconewarrior 4y ago
    It says "Check back on August 1, 2022 for the public launch!". So, perhaps we shall do just that
• jcranberry 4y ago
  Sounds like Google Scholar saved the author from being swindled into spending $400 by their dentist. The old thing to do was to get a second opinions. I wonder how that would have fared comparatively in this case.
  • Zigurd 4y ago
    Thing is, the misinformation was prioritized to the top of the search. Is it the place of online platforms to filter out misinformation?
    • crdrost 4y ago
      I mean in the broadest sense that's a cultural question and most big online platforms have decided that it is their place—Facebook and Twitter in particular—because of pressures from the public. In a much, much narrower sense, we are talking about Google and not an online platform. Google's explicit mission is, “to organize the world's information and make it universally accessible and useful.” Like, filtering out misinformation is literally the thing that Google says is its purpose.
• Pelam 4y ago
  Btw these small brushes regularly applied _as instructed by professionals_ fixed this problem for me. I understand it can get really bad and can actually require more drastic measures. https://www.tepeusa.com/collections/tepe-interdental-brushes-original https://www.tepeusa.com/collections/tepe-interdental-brushes... (The brush is basically applied to the space between teeth and touching the gums, but see a pro please first.)
• eismcc 4y ago
  I had almost the exact same experience. Sitting in the chair prepped for a cleaning and the DH dives into this tale about “bad bacteria” and how if it gets into my stomach during the cleaning I could have all kinds of problems including heart disease and so on. Then the follow up treatment plan had other “beneficial” procedures not covered by insurance - platelet treatment to improve healing. I called the insurance company to ask about the plan and discovered the uncovered items were more than the actual procedure itself. The dentist wouldn’t negotiate or change to a code the insurance company recommended.
  • Zigurd 4y ago
    Imagine a health care system where the insurance company is, relatively at least, the "good guys." That's how badly off we are. I personally have a story of a great doctor who went to the effort to try a less-well-known (but still entirely conventional) treatment that resulted in a much better outcome for me. But that just highlighted the fact that great treatment outcomes are a haphazard occurrence in a sea of crud where neither the insurer nor the provider prioritize the patient over maximizing revenue. What this story illustrates is that paying out of pocket, which presumably put greater market based pressure on health care providers, is even worse. Not all parts of the economy work bast when least regulated and maximally market driven. Without information from disinterested parties, and without oversight from outside the profit-driven parties, you just get farmed by crooks.
• dr_dshiv 4y ago
  I wish Google Scholar was mainstreamed. It makes me sad that there is so little public capacity to read chains of evidence across scientific papers.
• macinjosh 4y ago
  Unless you have a specific issue dentists offer mainly preventative care. The thing with preventative care is that you can never really prove what is working and what is not. Also, you can never really know when you've done enough. I think of it kinda like a car wash. You can pay extra for the fancy spray on waxes or you can just get a basic wash. How much does wax quickly sprayed on by a machine do for your car in the long run? Not much. But it makes you feel like you're taking care of your ride. Sub in teeth (a part of the body) for a car and they can charge almost whatever they like for shining bright lights in your pie hole.
• snemvalts 4y ago
  The biggest problem with Google and medicine are the summary boxes and QA widgets up top, matching a search term to an excerpt. It's hilariously bad, it pulls misleading info out of context. It is probably responsible for more than zero deaths worldwide.
  • SamBam 4y ago
    It's really weird. One of the widget boxes rephrases some of your search into explicit questions, and then the result is an out-of-context snippet that is definitely not answering the question.
    • nullc 4y ago
      It's the best when it manages to give exactly the opposite advice to the source.
  • wara23arish 4y ago
    This is 100% true. While attending an NLP class in college, a speaker from Google came and spoke about how they evolved their systems etc. He admitted himself that results from those QA excerpts are hilariously wrong.
  • jcranberry 4y ago
    Sometimes they're alright but the new feature where if you open one ten more appear is annoying.
• jnovek 4y ago
  “ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to move the process forward. It’s always me, reading articles on PubMed and coming up with ideas. I’m not medically trained nor am I scientist. It’s a lot of legwork for me normally, but the ways that being sick limits me make it much harder. Further, the emotional and intellectual overhead required to negotiate with medical professionals is high. Back when I could afford to, I saw a neurologist at an office that didn’t accept insurance. She choose to see fewer patients and give them more time, as well as spend time doing research to look for new clues and ideas. This worked really well and I made progress with her. The rest of the American medical system? Gatekeepers that block access to potential treatment pathways until you can convince them it’s worth a try.
  • rr808 4y ago
    I have noticed the same. My wife has some chronic problems. I figured going to a specialist would be able to give some good advice. For a few thousand in fees you'd think the hospital would be able to give you a book or at least a link to some reputable websites, instead we got a photocopied page and told to google it.
  • arbitrage 4y ago
    You experience is similar to mine. It goes even further than that, though. I have seen the relief in a specialists eyes when I present them with research and tell them the decision that they should make for me. I am essentially designing my own treatment and care plans. I am not a medical professional, nor have I any training, either. The United States' healthcare system is fundamentally broken. As it stands, it's probably completely irreparable, as well.
    • refurb 4y ago
      I live in a system where doctor's aren't questioned, everyone just assumes they get the best care. It's terrible because people get sub-optimal care. Patients who are proactive in their own treatment are a positive, not a negative.
• robertlagrant 4y ago
  I love that at the end it turns out to be an advert for GlacierMD! Did M Night consult on this blog post?
  • zaroth 4y ago
    Reading blog posts from founders ranting about exactly the problem that their startup is trying to solve is kind of par for the HN course, is it not?
• Veuxdo 4y ago
  This kind of seems to reduce to Google's inability, or unwillingness, to do anything about SEO.
• kcplate 4y ago
  I have two “Cadillac” dental insurance plans. When I sit down in the chair I just inform them that I am not interested in any service that is not fully covered by my insurances, and if its partially covered, I want a pretty detailed breakdown of why I need it before I will agree to the service. Usually this stops the service upselling.
  • asdff 4y ago
    Dental insurance is sort of crappy in that what we think might be important treatments are sometimes classified as cosmetic and not covered (like implants). This is why there is a cottage industry of dentists doing implants for cheap in Tijuana.
    • kcplate 4y ago
      My insurances do a good job of covering things that are related to my oral health. If I want a cosmetic improvement over a covered service, I dont have a problem paying for it. I’d rather the occasional outlay than my dental insurance being prohibitively expensive to account for a possible expensive covered cosmetic change.
      • asdff 4y ago
        What I'm saying is when you have a bad tooth, what do you expect to happen? Insurance pays for you to look like the toothless geezer spitting into the spittoon in old western films. That's the minimum standard of oral care they provide. If you want something as simple as a fake tooth, something i think anyone who gets a tooth extracted would opt to get, its not covered. Why can't I get insurance that covers this? Implants can be a lot of money and as a result there is this cottage industry of people going to other countries for lower priced implants vs having that dental care done where they get all their other dental care done. Just in terms of the carbon footprint alone that's a terrible solution.
        • kcplate 4y ago
          Actually…you probably can, but it’s going to be more expensive that you…or your group (if it’s employer provided) will be willing to pay. So in those cases it’s not even offered. My wife sells dental insurance to businesses. These brokers are doing plan designs that specifically exclude certain services to get monthly costs down to the expected competitive floor pricing. Think of it this way, you have 100 people in your group. 5 are willing to pay for implant coverage at $100/mo, but to get that rate, you need 75% participation of the group. 95 people will not participate if it’s more than $20 a month. Your plan design is going to be designed to appeal to the 95 over the 5 and that broker is going to bring in a plan that is as close to $20/mo without going a penny over…and hope like hell that their competition isn’t lower with a similar plan design.
• josefresco 4y ago
  Reminds me of my old dental hygienist who would "threaten" me with a more invasive (and expensive) cleaning process every time I'd visit. Switched dentists, mentioned my "gums" and the concerns of my old dentist, and they were like "no, your gums are fine". Also reminds my of my experience with my disease "specialist" and my GP. Specialist is concerned about my cholesterol, puts me on meds, schedules regular (now expensive) blood tests. I mention it to my GP and he's says "your cholesterol is fine, don't worry about it" Who do I trust exactly?
• aaron695 4y ago
• loeg 4y ago
  A pretty obvious clue from the beginning here was: > your insurance won't cover it So to answer > So how do most patients make this decision? 0. Insurance won't cover it, so they don't get it ($), or 4. Insurance won't cover it, which is a signal it isn't an evidence-based intervention, so they don't get it.
  • pc86 4y ago
    Insurance doesn't cover adult orthodontia either but that doesn't mean it's not evidence-based (just elective). And a laser-based cleaning technique sounds pretty elective.
    • loeg 4y ago
      It's a signal, but not the only signal. Orthodontia are a cosmetic procedure with a pretty visible result. It's an exceptional case, not the rule. And for many people, see step 0.
• gumby 4y ago
  I’m quite critical about Google declining search quality but in this case I think pointing the finger at them is clickbait. The fact is that the dentists have “flooded the zone with shit” and google hasn’t much to work with. I would appreciate if google could elevate more “google scholar” results and also have a zone of clearly marked “likely low quality matches” but apart from the howls of outrage from the bullshitters, this would be very hard. Also note at the end the author pitches their alternative. == BTW the laser is a capital investment (or lease) for the provider so the laser manufacturers are always coming up with new ways to use the device and sending them to their customers (mainly dermatologists and dentists — people outside the managed care, and often insurance, infrastructures). These suggestions are typically worded in a way that doesn’t get them in trouble with the FDA. So even if a dermatologist buys a laser to remove birthmarks, most of the time it will just sit unused in the corner of the room. So they add tattoo removal. Next thing you know it’s a cosmetic liposuction alternative for the area around your mouth.
• drspock11 4y ago
  What the article author doesn't seem to realize is much of dentistry (and medicine in general) is not based on evidence. There is zero clinical evidence that flossing actually does anything beneficial. I wouldn't be surprised if there was a lack of evidence for 6-month cleanings actually being beneficial. Similarly, doctors make decisions based mostly on hunches and gut feelings unless you're actively bleeding from a gunshot wound. I look forward to the day when AI is sophisticated enough to take medical decisions out of the hands of fallible and emotional human beings. (We're not anywhere close to that day)
  • mbg721 4y ago
    Something is working, even if it may not be clear specifically what that is. My grandfather had a full set of false teeth by the time he was the age my parents are now. The other big change in that time would be diet, but I don't think more refined sugar improves tooth quality.
    • argonaut 4y ago
      I mean, some things that dentists believe in do have strong evidence, like water fluoridation and fluoride in toothpaste. And some things dentists believe in don't, like flossing.
  • someotherperson 4y ago
    Limited evidence doesn't mean it doesn't work. The reasoning behind flossing makes a lot of sense: 1. You remove food sources for streptococcus mutans 2. You avoid inflammation from teeth shifting 3. You disrupt biofilm (plaque) formation in the joints of your teeth I imagine the evidence is limited because genetics, diet and other oral hygiene routines significantly impact the outcome. There is a whole microflora system in your mouth, and the advice is to throw everything (floss, scrape tongue, mouthwash, brush) at it for everyone because personalising it is not worth the effort.
    • argonaut 4y ago
      Yeah, but these same arguments apply in favor to the diode laser treatment the original article talks about. There is biological and chemical reasoning behind it. There are favorable vitro studies. And a couple of the systematic reviews linked in the original article conclude there is weak evidence that it is weakly effective (same with flossing).
• noasaservice 4y ago
  The title is wrong: Dentist almost convinced me to spend $400 on useless laser treatments; Google results of search spam SEO cesspool
  • unpythonic 4y ago
    If you read through to the bottom, you'll see the article itself is just a call to action for yet another service which the author is starting. It's an ad. Seeing it buried so deep doesn't make me feel that the author has any better intentions than Google itself -- credibility already gone.
    • noasaservice 4y ago
      Well, yuck. I did completely miss that this was just a shitty advert complaining about other shitty adverts.
      • wackget 4y ago
        I'll ask you what I asked the other commenter: should articles which point out problems be written completely independently of the people creating solutions to those problems? Even if it is an advert, it's not a shitty one. It presents scientific arguments and is well-sourced. It's about as a good as an "advert" as you'd ever get. Really, what more do you want from people?
        • noasaservice 4y ago
          Frankly, I'm just done with advertisements and commercial "speech" being normalized everywhere, including in articles, regular speech amongst humans, and more. I've been done with commercialism fake "culture" for a LONG time. And the more we have, the worse the pollution is with genuine conversations. I think that's the real problem with articles like this. The moment I realized it was a commercial piece masquerading as a scholarly meta-article, I have to question all the previous discussion they have. Is it right? What are they trying to sell? What viewpoint are they trying to get me to follow? Advertising is codified monetary deceit. We've moved long past "Buy my soda cause its yummy", to an ever-present dread of "if you dont have this, you'll be sorry" in a round-about way. > should articles which point out problems be written completely independently of the people creating solutions to those problems? If there's a commercial motive to use/buy/rent their shhit, absolutely yes. > It presents scientific arguments and is well-sourced. Depends. What are the biases of their arguments that the underlying commercialism is modifying? It now needs its own analysis to see if they were trying to sell me something different on dread or FOMO.
• xyzzy21 4y ago
  This is a legal problem - allowing broadcast advertisements to the general public for pharma products is where the problem started. Before that, pharma had to advertise in targeting media directly addressing the medical profession only, e.g. JAMA, NEJM, various trade magazines, etc. That's how this should be fixed - return to those limits. In an online environment that would mean limiting ads to doctors et al. on sites that require password and professional identification/validation. Otherwise information on drugs et al. should be presented only neutrally and scientifically to the broader public - marketing should be banned from the process.
• ada1981 4y ago
  Years ago I worked with a start-up called MetaMed, funded personally by Theil, to provide a team of private medical researchers. They didn’t make it, but the premise was sound / that standard of care is about 30 years behind research (at best). The mindset I learned there helped me overcome a diagnosis of Bipolar / schizoaffective by doing primary research and rejecting the medications of Standford Psychiatry… 8 years later, with a mix of shamanism, spiral dynamics, mens work, underground mdma therapy, 5meoDMT, somatic therapy, biomythic.com and coaching and I’ve finally got some place to stand within itself, no need for medicines, and no longer dealing w suicidal depression or manic psychosis.
• JRabo 4y ago
  > You're reading this in a year that starts with "2" so the only possible starting point is Google. LOL. Seriously? Google the biggest known data whore, worst privacy invader on the Internet, whoring personal data out to any john willing to pay. Yeah. The year starts with 2 and Goog has been pimping your data for 23 years now and people still haven't learned they are not your friend.
  • mort96 4y ago
    What is your point? Did the author write something which indicates they think Google is an ethical company?
    • JRabo 4y ago
      The point is obvious but I'll spell it out for you using HIS own words. "Google almost convinced me to spend $400 on useless laser treatments". He presents himself as "in the know" because the year begins with "2" and anyone in the know would use Google to research an issue. LOL. HE then proceeds to place trust in an unethical company to give him information he needs to make a wise financial decision. Doh!
      • JRabo 4y ago
        These are the same people driving around with WiFi sniffing equipment collecting terrabytes of data and then when caught claim it was not intentional. All that damned hardware got wired up by evolutionary means and the software got splatted onto the boot drive by a bird passing overhead. What crappy luck happening throughout the world like that.
      • JRabo 4y ago
        These are the same people who started a medical privacy records initiative to centralize your medical records, to "safeguard" your privacy.
      • JRabo 4y ago
        These are the same people who provide "free" CDNs, and that moronic developers use to ensure everyone's privacy is compromised.
• Mistletoe 4y ago
  This is a great article. How do we fix it? We are experiencing late stage capitalism at every turn in our lives. I don’t know where to start. Regulations? But Google has moles in every level of government. A real search competitor? It feels impossible to think it could happen at scale. There is a niche for a company that is like the original Google and that could grow. How can we help it succeed?
  • unpythonic 4y ago
    The article is just an ad. > This was my motivation for starting GlacierMD: I wanted to give consumers the information they needed to make evidence-based health decisions. And although I lost that battle (spectacularly) I'm still fighting the war! If this is a topic that interests you, I'd urge you to
  • stevehawk 4y ago
    I don't know that you can fix this. This is what people want. They need to feel like they've researched and made intelligent decisions, even when they haven't. After all, doctors aren't in it to make them feel better, it's all just some big conspiracy to make them more money (sarcasm). My wife is an oncology surgeon and it's absolutely mindblowing the things her patients tell her or later post on Facebook. One of her latest winners is someone that flew cross country to California to get things like 3D Bio-Scans. 3D you say? That sounds useful. It's a 3D image of you, your cancer, your organs, etc, right? No. I'm taking this straight from their website: > It has four FDA-approved technologies in one: Pulse Oximetry, Body Composition, Heart Rate Variability (HRV), and Galvanic Skin Response Devices; Not a damn one of those is going to tell you anything about cancer. And then there's thermagrams, where they basically check your skin temperature to try and diagnose internal medicine, like cancer, colitis, gluten allergies, etc. And people just buy this shit up. It really just reminds me of Steve Jobs' quote on television: When you’re young, you look at television and think, There’s a conspiracy. The networks have conspired to dumb us down. But when you get a little older, you realize that’s not true. The networks are in business to give people exactly what they want. That’s a far more depressing thought. Conspiracy is optimistic! You can shoot the bastards! We can have a revolution! But the networks are really in business to give people what they want. It’s the truth.
• maerF0x0 4y ago
  > My DH clearly pushes this LBR thing on all her patients Also for all our learnings' sake xrays often fall into this category. Dentists will basically demand xrays as often as the insurance will pay. This is not only a waste of money, but contributes to cumulative damage. Yes, if you have specific exceptional circumstances then the cost/benefit may be greater, but I understand that in the main and for better exceptional cases you every 3 years is fine.
• es7 4y ago
  Low-quality SEO content marketing has been taking up more and more of Google Search results in the past decade. Maybe it has always been this way, but anecdotally it feels like it has gotten so much worse in the last few years. The exception to the SEO spam rule seems to be a small subset of “highly trusted sources”, that at least for medical information seem to be biased pretty heavily towards “don’t say anything that can get us sued.” I don’t know the best solution to all of this, but I really think that content marketing is getting to a point where it has drowned out actual content. I wish Google would put a downvote button on their search results page that I can click to indicate that a highly-SEO’d result was not actually useful for my query.
  • 93po 4y ago
    It's about to become uncontrollably bad. With really powerful artificially generated writing available, spammers will develop it to be indistinguishable from real human writers when analyzed by google's own machines. We're going to have billions of websites that are 100% generated, with content that most humans can't distinguish as entirely generated, and a LOT of it is going to be wrong. It will completely drown out human written content to the point that websites using humans will give up, and there will only be spam left.
  • bartimus 4y ago
    It's always been bad. But Google has always been less bad then other search engines. Then also you need to ask the right question. Googling something like "Toyota RAV4" will give wildly different results than "common problems with Toyota RAV4". In this particular case the better question should've perhaps been something like: "scientific evidence effectiveness lazer bacterial reduction"
    • asdff 4y ago
      There are times when I just cannot come up with the terms to get past the SEO at all and just give up, not knowing the answer or finding the relevant source. It seems like it happens all the time these days. You end up with something like writers block coming up with new ways to frame the question to shake off the spam. The best I can hope for usually is appending site:usuallyrelevantinfo.com to a term but that requires a priori knowing these good sites for a given topic.
• faebi 4y ago
  I'm in a similar situation. I am looking for the right treatment of a vitamin b12 and folic acid deficiency, yet the amount of SEO spam and scams is just insane. I wish there was more signal in the noise of supplements, and further, in the field of medicine.
• camgunz 4y ago
  More or less every time I go to the optometrist or the dentist I get a hard upsell on things: frames, contacts, whitening, lasering. It's painfully obvious and I can't find a place that doesn't do it.
• steve76 4y ago
• deleted 4y ago
  [deleted]
• bsuvc 4y ago
  This is why I don't trust Google anymore, especially when it comes to anything medical I might buy. I always Google something and add "Reddit" to it to get better real, less-biased opinions on something. Or if there is a site dedicated to discussion of the topic (ie. an old school forum or message board), I'll go straight to that and search there.
• tlogan 4y ago
  Internet was always full of spam. But somehow Google was able to correctly categorize it. Now it seems like Google is not keeping with it. It seems like that sites which might provide trusted information are not ranked well. It is interesting that these sites do not have Google Adsense (since they are mainly run by schools, public institutions, etc.) The same is happening with YouTube. I think it is definelly possible to sort results better (pure engineering problem). But there is really no short term insentive for that. Maybe in long term this will help Google to stay on top but that is not 100% clear: it is hard to predict how content discover will look in the future.
  • pueblito 4y ago
    My guess is that having to dig through the results increases engagement time and clicks, so they probably have their AI test how long you’re willing to dig for an answer before giving up and calibrate results accordingly
• FactualActuals 4y ago
  I only use Google to learn more about procedures, not to convince me to get said procedure. When my coworker and I got into a conversation about LASIK vs PRK, I found a Hacker News thread on Google that had discussed SMILE surgery as an alternative to both. I'll defer to my optometrist when I speak to him later this year and see what he suggests and what he knows because I know I can't trust Google to give me the type of answers I am looking for.
• vmception 4y ago
  > So here's the bottom line: All ten search results are dental office marketing blogs and there isn't even a whiff of peer-reviewed evidence. This is how all the alarm bells went off for me about VPNs as I was forming some OPSEC ideas. My solution was to look up court cases.
• FollowingTheDao 4y ago
  Google is not a search engine. Google is an advertising platform. It's 2022 and people do not know this yet?
• orangepurple 4y ago
  Search google for the phrase "climate change" without quotes. About 4,010,000,000 results (1.01 seconds) Why don't the results go past page 5? (Only a few dozen exist) If the dead internet theory [1] is true a new search engine may eventually emerge which focuses on indexing verifiably human-generated content with high information value. I have no idea what is going on with Google search results. [1] https://forum.agoraroad.com/index.php?threads/dead-internet-theory-most-of-the-internet-is-fake.3011/ https://forum.agoraroad.com/index.php?threads/dead-internet-...
  • gs17 4y ago
    > verifiably human-generated content with high information value. I'm not sure that will be possible to implement without the "search engine" being more of a magazine.
• hoistbypetard 4y ago
  It's a nice story about the motivation behind GlacierMD. Which seems like something that should be marketed to health insurance companies, assuming it targets a US audience. That's who stands to benefit enough from people making better decisions about discretionary health spending to actually pay for it... marketing it here seems like spending effort on an incompletely learned lesson from v1.
• barrad0s 4y ago
  This is a great post.
• eithed 4y ago
  The cynic in me was thinking "ok, I've read the article, what product is the article selling? ok, here we go". Although to be honest, I was nodding as I was reading. It's not only about medical decision, but with most decisions where you want to buy the best X. Maybe medical decisions are less... selfish? I mean - if I want to buy a toaster, I'll look at Which, and won't splurge on the most expensive one, but will look at what other people are finding useful. With health however, you probably don't want to spare expenses, so the decision making process will be a bit different - we trust people from which we're getting health advice. I'm not in USA, and don't think this sort of thing is confined to USA
• erikerikson 4y ago
  > 1. Consumers make most of their own health decisions Actually, this is what efforts are attempting to shift in the industry. It goes by the name "value based care" and is a better solution.
• AlwaysRock 4y ago
  I've gotten to the point where if Insurance doesnt cover it then I don't get it. I can count on one hand the amount of non covered things that have been helpful in the past. This policy is what stopped me from getting a treatment from my dentist that involved grinding down my teeth. Google results were mixed on the benefits. Dentist pushed it very hard. It was like $500 so I said no. Teeth have been fine without it.
• SubiculumCode 4y ago
  I don't trust dentists. They push and push and push these extra treatments using guilt tactics and most of them are lies to empty your pocketbook. They are in no way like your doctor. Your doctor would never guilt you into a bypass surgery when you don't need it, but a dentist would.
• 323 4y ago
  I once asked the dentist why are there so many different toothbrush head shapes, with the bristles at all kind of angles and patterns, rubber inserts and so one. Surely by now we know what's the optimal shape? And the answer was that yes, the optimal head shape is known, but since it's not that consequential this is not regulated as other medical stuff and basically everyone does weird shapes just for marketing and differentiation purposes (like colored specks in powder detergent which do nothing)
  • JamesAdir 4y ago
    What's the optimal shape?
    • 323 4y ago
      From my research the most important thing is for it to have soft bristles with round bristle heads (obviously you can't check bristle heads with your eyes, too small). Most you find in supermarkets have medium or hard bristles. The head shouldn't be too big, so that it can reach even in the back. Rubber inserts are not recommended, as they tend to irritate the gum. Typically the better ones look more plain - no multi colored bristles or spaceship looks. However, since this becomes more known, it becomes a marketing signal in itself - like "plain brown paper package" chocolate, etc.
      • asdff 4y ago
        Are there any brands with these characteristics?
• CyanDeparture 4y ago
  > putrid, SEO-optimized landfill Well I've not heard my recent search results summerised better than that. What a perfect description.
• javajosh 4y ago
  Greedy doctors and dentists are the worst, because they are half looking at your health and half looking at what they can get out of you and your insurance company. It erodes trust, is highly unethical, and is extremely common in the US. We need a German style health care system in the US ASAP.
• CivBase 4y ago
  The title implies that Google is the culprit. The article paints a more nuanced picture. It blames Google for providing marketing results for a query about the validity of some dental procedure. It also shares some blame with the dentist for advising the procedure in the first place. However, consider the ending of the story. The author saw the marketing for what it was and turned to academic search engines for more reputable sources. Isn't that what we want? I dislike Google for many reasons and generally avoid their products and services, but are they really to blame here? Google is a general purpose search engine whose business model fundamentally relies on including marketing in its results. It isn't a flaw in the algorithm; it's a feature. It's how they make money - and a lot of it at that[0]. If you want academic results, go to an academic search engine. That's exactly what the author did and it worked out fine. I'm down for an argument that we need academic works to be more accessible and digestible, but that's not really a problem with Google. The other accused subject was the dentist, but I'm not so sure about that one either. There is a lack of consensus among medical professionals on many treatments and procedures, and this story could simply be another example of that. Medical professionals are humans, each with their own experiences and biases. Besides, it's not like the academic results cited by this article determined that the treatment was snake oil. Maybe the author's dentist had her own experience with the procedure and honestly concluded for herself that it was worth the $400. Maybe she was biased by anecdotal evidence or her own theories. Maybe she doesn't value $400 as highly as the author. Maybe she simply values dental hygiene more than the author. This is a great example of why it's important for medical professionals to act as consultants and for patients to make the final decision. IMO, the big problem here isn't Google or the dentist. The problem is how much trust people have in those two as sources of accurate, unbiased medical information. If you're making a significant medical decision, you shouldn't accept a single source of information - even if it is academic - and you certainly shouldn't trust marketing material. Get second opinions. Do a little academic research. It's easier than ever before. That said, if a $400 laser treatment for your gums isn't a "significant medial decision" to you, then feel free to just follow your dentist's advice. That's up to you. [0] https://news.ycombinator.com/item?id=31172475 https://news.ycombinator.com/item?id=31172475
• wackget 4y ago
  Disappointing to see the OP using Google Forms to collect data for their beta testing product waitlist. OP clearly knows Google is bad but supports their business by using their tools anyway :(
• denvaar 4y ago
  I have been dealing with "mysterious" pelvic pain (cpps) for about 8 months or so. No doctor has been able to figure out what is wrong with me. The process of working with doctors has been traumatizing to say the least. I once had trust in our medical system, but my perspective has changed. I now have little faith in most doctors ability to solve my medical problems. I recall someone on HN saying they are basically "chat bots", and sadly, I find that to be an accurate description. I've turned mostly to the internet for help. The internet has both helped and harmed me, though I would say overall has been less harmful than the experiences I've had with doctors. Doing my own research on the internet does make me feel like a "kook", but I would not even have a label for my condition if I had not done so. I can live with some discomfort if I can at least put a label on what I am feeling. It's also comforting to know there's people out there with the same condition as you. I have access to research and studies online, but if the doctor was not aware of it, they are quick to discredit it. The one thing I am grateful for about seeing doctors is their ability to rule out the common/serious conditions. That has been helpful, although I have found that simply "getting permission" for a procedure, or to see some specialist, is way too difficult. Often times specialists are booked out for months. It's so discouraging.
  • cowmoo728 4y ago
    My wife has a mystery condition that flares up every few months / years. Every time it gets bad enough, the doctor prescribes antibiotics and then runs some tests. When the test results come back 24hr later, the conversation is always the same: "I thought it was [a very common problem], but the test results ruled that out. Since you already started the antibiotics, you should finish the course. Call me again if the problem gets worse." So we're left without answers and with an unnecessary prescription for antibiotics, every time. It's pretty frustrating, to say the least. The internet has come up with "interstitial cystitis" as a possible culprit, but it's not much of a diagnosis with an unknown cause, no diagnostic test, and no peer reviewed treatments.
• albertzeyer 4y ago
  You could also argue that Google is actually doing a good job here. Simple heuristic: All results from the first two search result pages don't provide much/any evidence that LBR is helpful or worth is -> it is not. This simple heuristic is often quite good. If it would have been a useful method, I would expect to find some good serious pages, or maybe Wikipedia page on it.
• sliken 4y ago
  I read this whole thread, it seems to miss one major point. Insurance companies control treatments in the USA to an amazing degree. They push to overschedule doctors, literally down to minutes per visit, try to push as much as possible to lower paid staff (mostly nurses), and shape things for maximum profit. Nurses are handling things today that would have used doctors in the past. Much of the frustration people get is trying to convince doctors to go against insurance companies and order more tests, referrals, or treatments. This is also why a weekend on pubmed and similar gives you a better result than a doctor ... who spent 2 minutes reviewing your chart and comes into the room for a few more minutes to talk to you.
• mdavis6890 4y ago
  Honestly I don't see anything really wrong here. In the long run, you'll have people that get the treatment and people who don't, and over time you can compare these groups and outcomes. People will naturally gravitate toward the correct answer. It would be nice if we could have an omniscient oracle to gate-keep us away from ineffective treatments - but we don't live in that universe. Instead we have (in the US) the FDA, which is staffed by smart, well-intentioned, and very fallible human beings, each with their own (well-intentioned) agenda. At the very least these folks are simply weeding out treatments with major negative outcomes, like killing the patient. So some placebos get through and called 'treatments' like LBR - unless there is some better treatment that you're forgoing, there's really not much harm except for the $400. The folks that do a lot of research will make better choices than those that don't - but they will also help all those others make better choices over time as they communicate their ideas and results to the masses.
• cleandreams 4y ago
  I just left my dentist because they kept pushing braces on me (invisalign). I am over 60. The old dentist didn't do these things. The new dentist was hard sell. They also wanted to replace a crown that was fine. I found a dentist with a less invasive approach (and associated with the local dental school). I think there is a problem with dental care. You have 1 dentist and it's hard to verify what they say.
• cptskippy 4y ago
  I feel at this point that dentistry is closer to chiropractics and homeopathy than actual science. Many years ago I wasn't in the best financial position and went to the dentist. He identified a number cavities needing filled and quoted a hefty sum, and I put off the procedures because I couldn't afford them. I diligently saved for 6 months to pay for them and when I went in for my next checkup, I asked about them. What cavities? No your mouth looks fine. I've had similar situations with my children, getting quotes for thousands of dollars worth of work. Getting second opinions and using different insurance changes those quotes and scope of work dramatically. At this point in my life, I don't trust dentists at all. I'm sure they're not all crooks but how do tell?
• hn_version_0023 4y ago
  Whenever I see an article about the US healthcare system, I’m forced to wonder: How is this system itself not a cruel and unusual punishment? Now obviously it’s because it isn’t applied as a punishment for a crime, which is I think the letter of the law. Still, it feels like we live in some Kafka-esque nightmare where a huge number of things the US government ought to take care of are outright cruel… and that the cruelty is the point.
• mguerville 4y ago
  My eye doctor a few years back tried to get me to get some kind of treatment (a device or some snake oil potion, can't recall) because I was allegedly not blinking enough and had dry eyes that could spiral into (insert mildly scary eye disease) if left untreated. Some googling helped me reach the same conclusion as this blogger. So it's not just dentists... at least my dermatologist is pretty transparent about all the aesthetic treatments that complement their medical services, though they seem to always find a mole that needs a biopsy and every year it turns out benign. I wonder how many times it was necessary, versus how many times it was just an easy money grab because my insurance covers it and it's very minimal of a procedure. I don't have a problem with for-profit healthcare, but fee-for-service is driving the insane cost inflation in the US
• renewiltord 4y ago
  Pretty good observation of the fact that it is hard to get actually good information on Google. You have to use `reddit.com` or something to actually get it since that's the one place with lots of user-history and good SEO.
• dillondoyle 4y ago
  There are tons of ethical issues in allowing medical ads to consumers as it creates perverse incentives (and just the for profit system in general, but let's not develve into that fight). I get tons of Testosterone replacement therapy ads. And also 'adhd' ads. These are real MDs, but they will give scripts to almost anyone. Many online only. I'm not judging people who want to use. People will use drugs legal or not and it is far better to get real stuff from real MDs. But advertising it? The whole point is to create / increase demand. This is not passively allowing safer use. These ads are misleading; TRT ads of young super fit people or getting people hooked on stims for no reason. How would people feel if there were FB ads targeting people who listen to EDM with dope or E ads? We are also inundated with alcohol already. All drugs aren't comparable or similar danger profiles, but just shows how prejudice and assumptions from a prohibition system are imho hypocritical. using a more extreme thought experiment can highlight this.
• deleted 4y ago
  [deleted]
• dmitrygr 4y ago
  TL;DR: Ad for GlacierMD
• betwixthewires 4y ago
  I have a huge gripe with the phenomenon being talked about in the article. First comes the idea that you can't make health decisions yourself, or treat yourself for health problems. Got a back ache? See (read: pay) a doctor. Got a wart on your toe? Got a sunburn? Go pay a professional for their services, this is the only solution. Adding to this is the lawsuit addled consumer climate of our society. Best not give anyone any sort of information about anything, lest they sue you for it. I actually googled a question and an article I read told me to talk to my healthcare team. Team? Each of us has to have an army of highly paid professionals to figure out why our head itches? You can't google anything health related anymore and actually get information about it. You get a little walkthrough of possible causes of anything followed by a "see your doctor." I just want to know what exercises to do to relieve back pain. Taking care of yourself shouldn't require you to visit a specialist for anything other than extreme circumstances. The information on how to take care of yourself is available online, hidden behind marketing funnels. Used to be I'd find a bunch of crystal healing blogs and the like, and I'd bitch about it, now I'm wishing for them back because in between the bullshit they're more helpful than being told to pay someone to (maybe) tell me.
• deleted 4y ago
  [deleted]
• ivan888 4y ago
  > How often has Google responded to your medical question with putrid, SEO-optimized landfill? Google has found 29,100,000 results for my query, but it's like an all-you-can-eat breakfast buffet that serves nothing but reconstituted eggs and Yoplait. You know there’s a gourmet, peer-reviewed omelet station around here somewhere, but you won't find it by wandering around the main rotunda of Google's sad smorgasbord. This expresses a lot of my feelings with the modern web experience really well. I feel like I'm constantly in "avoid" mode and it's becoming more and more difficult to get to content of actual substance and you are constantly being bombarded by garbage that is becoming more and more AI generated, making the volume higher and quality/relevancy even worse.
• MetroWind 4y ago
  “It’s Google’s fault!” (high five)