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> 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

> 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
  I mean, I agree with this but also feel that pharmaceutical companies should not be advertising directly to the public.
  - teddyh 4y ago
    Note: Advertising prescription drugs to the public is only legal in the USA, and also New Zealand. Nowhere else.
  - Workaccount2 4y ago
    I think everyone agrees, but it is a first amendment nightmare to try and regulate.
    - fullstop 4y ago
      We already prohibit advertising for cigarettes (on broadcast TV and print), so this doesn't seem like that much of a stretch.
      - Workaccount2 4y ago
        Cigarettes have the "think of the children" special ability.
- warent 4y ago
  But why? Imagine your grandmother who knows nothing about computers or tech asking you about GPUs and which programming language is best because she's curious about buying Bitcoin vs investing in Ethereum. For someone who can't tell the difference between a screen saver and a computer virus, the discussion is meaningless, and only the illusion of control exists
  - SamBam 4y ago
    And to extend your analogy, instead of the grandmother talking to a helpful expert, all the information they are given comes from BitCoin salesmen, and she's expected to "do her own research."
    - warent 4y ago
      Side effects may include losing all your money, but those side effects are like really really rare
  - b112 4y ago
    "What's and adblocker" - my Grandma. Well, you know a phone book? And, you know how if you want to phone someone, you tend to look up their number in a phone book? "Yes" Well, computers are the same. They only know numbers, they're computers after all, and DNS maps the names you see for websites, to numbers, so computers can find the website. "Uh, OK" The adblocker I am going to install, makes it impossible for the computer to see the numbers for advetisers. It can't find them in its phone book any more. So, no ads! Now grandma understands how DNS works, and what some adblockers do. Some things are not as technically complex as we think they are.
    - warent 4y ago
      Maps names of websites? I don't know what that means. Timmy showed me The Amazon and the egg cooker from there worked wonderfully so I don't want an ad blocker.
      - 4y ago
- IneffablePigeon 4y ago
  I mean, I do see where you're coming from, and I have in the past second guessed some medical advice and asked if they'd considered a particular diagnosis I had a hunch on. On the other hand, they're a professional and they've usually spent the majority of their life training to be good at what they're advising you about. I don't demand to be involved in the design of planes I fly on or bridges I cross, because frankly I'd do a worse job than even a pretty bad qualified engineer.
mannykannot 4y ago
> WTF, shouldn't the doctor tell you what you need and not the other way around? The problem here is that it is the medical professional who is pushing the ineffective treatment.
- Spivak 4y ago
  It goes the other way too. If you have anything but the most common illnesses or conditions that you are likely more knowledgeable about your situation than your PCP since they're the tier 1 help desk of medicine. This kind of thing is totally fine and expected, it's why specialists exist but it's really frustrating because your PCP is often treated as a either a gatekeeper or unnecessary busywork to get to the more qualified person.
pram 4y ago
I think it's because the US is one of the few (only??) countries to allow advertisements for prescription drugs.
- teddyh 4y ago
  It’s technically not the only country, as it’s also legal in New Zealand. But nowhere else.
- Spivak 4y ago
  I'm not trying to condone terrible drug advertisements but man there has to be something to let people know that their "normal" suffering isn't normal or that there are new developments that your PCP for sure isn't gonna keep up with. I know the meme de jour is teens diagnosing themselves with ADHD because of TikTok but it's the perfect example of a whole bunch of people being like "holy shit it's not supposed to be this hard all the time? You can actually do something about it?"
  - alistairSH 4y ago
    there has to be something to let people know that their "normal" suffering isn't normal or that there are new developments that your PCP for sure isn't gonna keep up with. That should be the doctor's job. Doctors have too much financial pressure to pump patients through, so they have neither the time to get to know individual patients nor time to keep abreast of current trends in their speciality. Should MedicineX be allowed to have a website with a FAQ? Yes. Should MedecineX be pushing ads on TV/radio that make it seem like it's a cure for everything that ails you? Nope.
    - Auracle 4y ago
      Sure, but people need to first know what they're dealing with isn't normal before they can even ask about it. I have really, really bad fatigue. It took me years to figure out everyone else didn't feel that way. I was in high school and was able to skate by on intelligence alone.
  - refurb 4y ago
specialp 4y ago
> 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?" This was the case for many years where it was illegal to have advertisements for prescription medicines. They lifted this like 15 years ago. This was very favorable for the pharmacutical companies as now patients are going to go to doctors and ask exactly that. What is worse now IMO is these direct to patient ads on social media from Cerebral. They show a lot of common things that people do (Like slack off, not pay attention to something boring), and then encourage them to talk to them for ADHD treatement. While more awareness of mental disorders and health is great, it is a bit scary when people can get convinced they have a disorder that needs pharmaceutical intervention and shop these firms until they get a script.
- jonhohle 4y ago
  It’s been closer to 25 now. Bob Dole was shilling for Pfizer’s Viagra in the 90s.
lupire 4y ago
Broadly, it's because the US has a culture of individual sovereignty and not everyone being a ward of the state.
- alistairSH 4y ago
  That's not true. We have the drug ads in the US because legal precedent since the late-70s/early-80s (roughly) in the US now protects commercial speech.
  - prewett 4y ago
    Companies are legally considered persons, hence their speech is protected. This is consistent with individual sovereignty. If people are wards of the State, then the State would have the responsibility to police "harmful" speech; advocating untrained people to ask their doctor for a specific medication could be considered harmful speech (since apparently only two countries in the world allow it, and not even the US before the 70s-ish, apparently).

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
I mean, I agree with this but also feel that pharmaceutical companies should not be advertising directly to the public.
- teddyh 4y ago
  Note: Advertising prescription drugs to the public is only legal in the USA, and also New Zealand. Nowhere else.
- Workaccount2 4y ago
  I think everyone agrees, but it is a first amendment nightmare to try and regulate.
  - fullstop 4y ago
    We already prohibit advertising for cigarettes (on broadcast TV and print), so this doesn't seem like that much of a stretch.
    - Workaccount2 4y ago
      Cigarettes have the "think of the children" special ability.
warent 4y ago
But why? Imagine your grandmother who knows nothing about computers or tech asking you about GPUs and which programming language is best because she's curious about buying Bitcoin vs investing in Ethereum. For someone who can't tell the difference between a screen saver and a computer virus, the discussion is meaningless, and only the illusion of control exists
- SamBam 4y ago
  And to extend your analogy, instead of the grandmother talking to a helpful expert, all the information they are given comes from BitCoin salesmen, and she's expected to "do her own research."
  - warent 4y ago
    Side effects may include losing all your money, but those side effects are like really really rare
- b112 4y ago
  "What's and adblocker" - my Grandma. Well, you know a phone book? And, you know how if you want to phone someone, you tend to look up their number in a phone book? "Yes" Well, computers are the same. They only know numbers, they're computers after all, and DNS maps the names you see for websites, to numbers, so computers can find the website. "Uh, OK" The adblocker I am going to install, makes it impossible for the computer to see the numbers for advetisers. It can't find them in its phone book any more. So, no ads! Now grandma understands how DNS works, and what some adblockers do. Some things are not as technically complex as we think they are.
  - warent 4y ago
    Maps names of websites? I don't know what that means. Timmy showed me The Amazon and the egg cooker from there worked wonderfully so I don't want an ad blocker.
    - 4y ago
IneffablePigeon 4y ago
I mean, I do see where you're coming from, and I have in the past second guessed some medical advice and asked if they'd considered a particular diagnosis I had a hunch on. On the other hand, they're a professional and they've usually spent the majority of their life training to be good at what they're advising you about. I don't demand to be involved in the design of planes I fly on or bridges I cross, because frankly I'd do a worse job than even a pretty bad qualified engineer.

mannykannot 4y ago

> WTF, shouldn't the doctor tell you what you need and not the other way around? The problem here is that it is the medical professional who is pushing the ineffective treatment.

Spivak 4y ago
It goes the other way too. If you have anything but the most common illnesses or conditions that you are likely more knowledgeable about your situation than your PCP since they're the tier 1 help desk of medicine. This kind of thing is totally fine and expected, it's why specialists exist but it's really frustrating because your PCP is often treated as a either a gatekeeper or unnecessary busywork to get to the more qualified person.

pram 4y ago

I think it's because the US is one of the few (only??) countries to allow advertisements for prescription drugs.

teddyh 4y ago
It’s technically not the only country, as it’s also legal in New Zealand. But nowhere else.
Spivak 4y ago
I'm not trying to condone terrible drug advertisements but man there has to be something to let people know that their "normal" suffering isn't normal or that there are new developments that your PCP for sure isn't gonna keep up with. I know the meme de jour is teens diagnosing themselves with ADHD because of TikTok but it's the perfect example of a whole bunch of people being like "holy shit it's not supposed to be this hard all the time? You can actually do something about it?"
- alistairSH 4y ago
  there has to be something to let people know that their "normal" suffering isn't normal or that there are new developments that your PCP for sure isn't gonna keep up with. That should be the doctor's job. Doctors have too much financial pressure to pump patients through, so they have neither the time to get to know individual patients nor time to keep abreast of current trends in their speciality. Should MedicineX be allowed to have a website with a FAQ? Yes. Should MedecineX be pushing ads on TV/radio that make it seem like it's a cure for everything that ails you? Nope.
  - Auracle 4y ago
    Sure, but people need to first know what they're dealing with isn't normal before they can even ask about it. I have really, really bad fatigue. It took me years to figure out everyone else didn't feel that way. I was in high school and was able to skate by on intelligence alone.
- refurb 4y ago

specialp 4y ago

> 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?" This was the case for many years where it was illegal to have advertisements for prescription medicines. They lifted this like 15 years ago. This was very favorable for the pharmacutical companies as now patients are going to go to doctors and ask exactly that. What is worse now IMO is these direct to patient ads on social media from Cerebral. They show a lot of common things that people do (Like slack off, not pay attention to something boring), and then encourage them to talk to them for ADHD treatement. While more awareness of mental disorders and health is great, it is a bit scary when people can get convinced they have a disorder that needs pharmaceutical intervention and shop these firms until they get a script.

jonhohle 4y ago
It’s been closer to 25 now. Bob Dole was shilling for Pfizer’s Viagra in the 90s.

lupire 4y ago

Broadly, it's because the US has a culture of individual sovereignty and not everyone being a ward of the state.

alistairSH 4y ago
That's not true. We have the drug ads in the US because legal precedent since the late-70s/early-80s (roughly) in the US now protects commercial speech.
- prewett 4y ago
  Companies are legally considered persons, hence their speech is protected. This is consistent with individual sovereignty. If people are wards of the State, then the State would have the responsibility to police "harmful" speech; advocating untrained people to ask their doctor for a specific medication could be considered harmful speech (since apparently only two countries in the world allow it, and not even the US before the 70s-ish, apparently).