4 ms·

The Futility of Doctors

13 points by DantesKite 4y ago

manuelabeledo 4y ago
For such a horribly critical piece, the author doesn't seem to understand the bare minimum about the medical profession. > Doctors become unwilling to take any risk out of fear of losing their license. Perhaps because mistakes are paid in human lives?
- WheelsAtLarge 4y ago
  True, so they have to be very careful. But what he describes has been my experience. Every time I've seen a doctor for a physical my doctors(more than one) have spent the majority of time typing on a keyboard looking up information, going thru a list and filling out forms. Rarely has it been a situation of analyzing the situation and giving advice on their own. They are just going thru the motions, some of them robot like. Those visits could have easily been done by assistants (AI?). At some point a lot of it will be replaced by automation with a few superstar doctors that act as managers at scale rather than what we would hope doctors should be. The article is on point.
  - edmcnulty101 4y ago
    This is the model of a lot of work of the future in my opinion with automation. One 'wizard behind the curtain' and a bunch of automation with lower tier support staff. Think truck drivers driving huge trains of trailers with the aid of self driving technology keeping the train in line. A single Lawyer stamping off on support teams with legal automation, able to handle most of the cases a team would have done previously. A single medical doctor stamping off on support teams work and automation, handling entire clinics.
    - CTDOCodebases 4y ago
      In other words automation will start from the bottom up.
    - WheelsAtLarge 4y ago
      Very true. If you take the current manufacturing process as an example, every product is broken down to the simplest process. At that point it's analyzed and automation is put in place where possible. With the automation possible now, even without general AI, the same process will see a huge impact on white-collar jobs. It's only a matter of time.
anondr 4y ago
This is poorly written in stream of consciousness. Insurance companies and CMS make the irrelevant questions necessary. They also dictate how long one actually has to spend with a patient without losing money. When you arrive at a hospital with a fever, I sure hope you have a doctor to help you figure out whether it is a deadly bacterial infection, malignancy, autoimmune, or just a common virus. There are many things that medical science doesn’t understand, but that doesn’t mean that doctors aren’t trying. Do a little research before you write such a scathing piece?
- majkinetor 4y ago
  Its way more valid then your opinion. You are talking about acute illness, while he is talking mostly about chronic. Modern medicine doesn't cure chronic disease - or it wouldn't be chronic by definition. I am grateful that we don't die from a bacterial infection any more but those are replaced by hosts of civilization diseases for which there are next to 0 remedies, effort and patience. And the system is made in such way to prevent anything like that, in many countries.
  - anondr 4y ago
    > Its [sic] way more valid than your opinion. Can you elaborate on what you mean by valid? My only opinion was that the piece was poorly written. There are several fact-based statements in my original comment. People do still die from bacterial illnesses. The original author basically said we should do away with doctors. That also means people who know when and which antibiotics to use. Also, I commented on acute conditions in only one paragraph. I specifically admitted that there are limitations to modern medicine. There are many chronic illnesses that we can’t diagnose or don’t understand. There are also illnesses that are chronic because we have ways to keep people alive, even if we can’t cure the disease (HIV, several cancers). If we are going to discuss validity, let’s do it with facts. Overall, just pointing out that not all physicians are arrogant jerks or uncaring idiots. Many really try to be helpful, but are overworked and constrained by administrators, insurance, etc.
therealbigblue 4y ago
ivraatiems 4y ago
I didn't get much farther than the author describing how doctors "prescribe Ibuprofen." Ibuprofen is an over the counter medication. No doctor actually writes a script for it; they just say "hey try this for your pain." They make no money off saying that, or recommending ibuprofen over tylenol or whatever, because these are not prescription medications and doctors aren't being courted by pharma companies to push OTC drugs everyone already likes and knows about. They actually recommend this because Ibuprofen and Tylenol are widely available, cheap, and very safe. (Unless you take too much Tylenol, which, seriously don't.) Most people already have a bottle of one or the other or both. There are actual drugs doctors sometimes get rewarded for prescribing, in various ways, but OTC pills are rarely it. See opioids, for example: https://www.healthline.com/health-news/is-your-doctor-getting-paid-to-prescribe-painkillers-for-you#How-to-know-if-doctor-is-being-paid-to-prescribe-you-certain-drugs https://www.healthline.com/health-news/is-your-doctor-gettin...
- MathMonkeyMan 4y ago
  The article mentions selling ibuprofen, not prescribing it, so it's even worse. My dad practiced dentistry for ages, and would write prescriptions for ibuprofen. It's about the dose, frequency, and duration. You can of course buy the pills without a prescription.
- DantesKite 4y ago
  > No doctor actually writes a script for it; they just say "hey try this for your pain." Author here. I don't mind criticisms of my essay, but that is factually incorrect. Doctors do in fact write prescription for over the counter ibuprofen in the United States and often do so as a remedial solution to various ailments, which may or may not benefit from pain relief.
  - bobthebuilders 4y ago
    Do you have any evidence for this? As an American who's been to many doctors, this just seems wrong.
  - ivraatiems 4y ago
readonthegoapp 4y ago
This seems very weird to me The US medical system is trash But damn if I'm not usually very impressed with doctor expertise Just seems like a hot take without much or any evidence Starts talking about 'the system' I always read the Dr column in the NYT that has doctors and other medical experts diagnosing the craziest illnesses Computers, by comparison, are kindergarten-level play blocks or something And new medical breakthroughs on an almost daily basis To each their own
th3o6a1d 4y ago
> Why do they recommend plant-based foods when study after study has consistently shown how bad the effects are? > Why do doctors still prescribe statins when their efficacy has already been proven to be less useful than a diet change? Can OP elaborate?

13 points by DantesKite 4y ago

For such a horribly critical piece, the author doesn't seem to understand the bare minimum about the medical profession. > Doctors become unwilling to take any risk out of fear of losing their license. Perhaps because mistakes are paid in human lives?

WheelsAtLarge 4y ago
True, so they have to be very careful. But what he describes has been my experience. Every time I've seen a doctor for a physical my doctors(more than one) have spent the majority of time typing on a keyboard looking up information, going thru a list and filling out forms. Rarely has it been a situation of analyzing the situation and giving advice on their own. They are just going thru the motions, some of them robot like. Those visits could have easily been done by assistants (AI?). At some point a lot of it will be replaced by automation with a few superstar doctors that act as managers at scale rather than what we would hope doctors should be. The article is on point.
- edmcnulty101 4y ago
  This is the model of a lot of work of the future in my opinion with automation. One 'wizard behind the curtain' and a bunch of automation with lower tier support staff. Think truck drivers driving huge trains of trailers with the aid of self driving technology keeping the train in line. A single Lawyer stamping off on support teams with legal automation, able to handle most of the cases a team would have done previously. A single medical doctor stamping off on support teams work and automation, handling entire clinics.
  - CTDOCodebases 4y ago
    In other words automation will start from the bottom up.
  - WheelsAtLarge 4y ago
    Very true. If you take the current manufacturing process as an example, every product is broken down to the simplest process. At that point it's analyzed and automation is put in place where possible. With the automation possible now, even without general AI, the same process will see a huge impact on white-collar jobs. It's only a matter of time.

anondr 4y ago

This is poorly written in stream of consciousness. Insurance companies and CMS make the irrelevant questions necessary. They also dictate how long one actually has to spend with a patient without losing money. When you arrive at a hospital with a fever, I sure hope you have a doctor to help you figure out whether it is a deadly bacterial infection, malignancy, autoimmune, or just a common virus. There are many things that medical science doesn’t understand, but that doesn’t mean that doctors aren’t trying. Do a little research before you write such a scathing piece?

majkinetor 4y ago
Its way more valid then your opinion. You are talking about acute illness, while he is talking mostly about chronic. Modern medicine doesn't cure chronic disease - or it wouldn't be chronic by definition. I am grateful that we don't die from a bacterial infection any more but those are replaced by hosts of civilization diseases for which there are next to 0 remedies, effort and patience. And the system is made in such way to prevent anything like that, in many countries.
- anondr 4y ago
  > Its [sic] way more valid than your opinion. Can you elaborate on what you mean by valid? My only opinion was that the piece was poorly written. There are several fact-based statements in my original comment. People do still die from bacterial illnesses. The original author basically said we should do away with doctors. That also means people who know when and which antibiotics to use. Also, I commented on acute conditions in only one paragraph. I specifically admitted that there are limitations to modern medicine. There are many chronic illnesses that we can’t diagnose or don’t understand. There are also illnesses that are chronic because we have ways to keep people alive, even if we can’t cure the disease (HIV, several cancers). If we are going to discuss validity, let’s do it with facts. Overall, just pointing out that not all physicians are arrogant jerks or uncaring idiots. Many really try to be helpful, but are overworked and constrained by administrators, insurance, etc.

therealbigblue 4y ago

ivraatiems 4y ago

I didn't get much farther than the author describing how doctors "prescribe Ibuprofen." Ibuprofen is an over the counter medication. No doctor actually writes a script for it; they just say "hey try this for your pain." They make no money off saying that, or recommending ibuprofen over tylenol or whatever, because these are not prescription medications and doctors aren't being courted by pharma companies to push OTC drugs everyone already likes and knows about. They actually recommend this because Ibuprofen and Tylenol are widely available, cheap, and very safe. (Unless you take too much Tylenol, which, seriously don't.) Most people already have a bottle of one or the other or both. There are actual drugs doctors sometimes get rewarded for prescribing, in various ways, but OTC pills are rarely it. See opioids, for example: https://www.healthline.com/health-news/is-your-doctor-getting-paid-to-prescribe-painkillers-for-you#How-to-know-if-doctor-is-being-paid-to-prescribe-you-certain-drugs https://www.healthline.com/health-news/is-your-doctor-gettin...

MathMonkeyMan 4y ago
The article mentions selling ibuprofen, not prescribing it, so it's even worse. My dad practiced dentistry for ages, and would write prescriptions for ibuprofen. It's about the dose, frequency, and duration. You can of course buy the pills without a prescription.
DantesKite 4y ago
> No doctor actually writes a script for it; they just say "hey try this for your pain." Author here. I don't mind criticisms of my essay, but that is factually incorrect. Doctors do in fact write prescription for over the counter ibuprofen in the United States and often do so as a remedial solution to various ailments, which may or may not benefit from pain relief.
- bobthebuilders 4y ago
  Do you have any evidence for this? As an American who's been to many doctors, this just seems wrong.
- ivraatiems 4y ago

readonthegoapp 4y ago

This seems very weird to me The US medical system is trash But damn if I'm not usually very impressed with doctor expertise Just seems like a hot take without much or any evidence Starts talking about 'the system' I always read the Dr column in the NYT that has doctors and other medical experts diagnosing the craziest illnesses Computers, by comparison, are kindergarten-level play blocks or something And new medical breakthroughs on an almost daily basis To each their own

th3o6a1d 4y ago

> Why do they recommend plant-based foods when study after study has consistently shown how bad the effects are? > Why do doctors still prescribe statins when their efficacy has already been proven to be less useful than a diet change? Can OP elaborate?