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If medical treatment was actually as formulaic and fully-solved as you imply, we wouldn't take the best students of every generation and make them spend ten yea

If medical treatment was actually as formulaic and fully-solved as you imply, we wouldn't take the best students of every generation and make them spend ten years training to become doctors. We'd just have nurses, checklists, and diagnosis flowcharts.

rscho 4y ago
I'm precisely not implying that medicine is currently "fully solved". I'm implying that we should strive to gather more information, synthesize it better and study how to make it useful. As a clinician, I'd say yes to a bicycle for the mind. But currently, my job is already plenty full with worrying about applying what's known in a correct manner without seeking to break new ground while treating patients, which would be very dangerous and given the odds of success, very stupid. What I'm implying is that the general public has a completely skewed view about what really kills patients in the ICU: mundane infections and "medical errors", which are not really errors at all but in a large majority of cases failures and complications of usual procedures.
thaumasiotes 4y ago
Medical treatment is obviously not fully-solved, or anywhere close. But it is just as formulaic as described above. The doctors aren't trying to solve your issue. They're following a flowchart, and if that doesn't work for you, that's your problem, not theirs. Next time, be a better patient. I've had doctors tell me "Good news! You don't have a problem!" when they were testing me to see if they could explain the problem I have. It's good news for them, because their next step is to tell me to fuck off. It's not good news for me, but apparently they can't tell the difference.
barry-cotter 4y ago
General Practice medicine seems to come close enough. No differences in patient outcomes between physicians and nurse practitioners. > Randomised controlled trial comparing cost effectiveness of general practitioners and nurse practitioners in primary care > Results: Nurse practitioner consultations were significantly longer than those of the general practitioners (11.57 v 7.28 min; adjusted difference 4.20, 95% confidence interval 2.98 to 5.41), and nurses carried out more tests (8.7% v 5.6% of patients; odds ratio 1.66, 95% confidence interval 1.04 to 2.66) and asked patients to return more often (37.2% v 24.8%; 1.93, 1.36 to 2.73). There was no significant difference in patterns of prescribing or health status outcome for the two groups. Patients were more satisfied with nurse practitioner consultations (mean score 4.40 v 4.24 for general practitioners; adjusted difference 0.18, 0.092 to 0.257). This difference remained after consultation length was controlled for. There was no significant difference in health service costs (nurse practitioner £18.11 v general practitioner £20.70; adjusted difference £2.33, −£1.62 to £6.28). https://scholar.google.co.uk/scholar?hl=en&as_sdt=0%2C5&q=doctor+vs+nurse+practitioner+effectiveness&btnG=#d=gs_qabs&t=1668851171508&u=%23p%3DRafdM6k_aWQJ https://scholar.google.co.uk/scholar?hl=en&as_sdt=0%2C5&q=do... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27348/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27348/
- lostlogin 4y ago
  More tests isn’t a good things. The doctor was significantly quicker and could see 3 patients for every two the nurse saw. I’m not sure where this leaves us, as the cheaper training cost for the nurse is a factor too.

rscho 4y ago

I'm precisely not implying that medicine is currently "fully solved". I'm implying that we should strive to gather more information, synthesize it better and study how to make it useful. As a clinician, I'd say yes to a bicycle for the mind. But currently, my job is already plenty full with worrying about applying what's known in a correct manner without seeking to break new ground while treating patients, which would be very dangerous and given the odds of success, very stupid. What I'm implying is that the general public has a completely skewed view about what really kills patients in the ICU: mundane infections and "medical errors", which are not really errors at all but in a large majority of cases failures and complications of usual procedures.

thaumasiotes 4y ago

Medical treatment is obviously not fully-solved, or anywhere close. But it is just as formulaic as described above. The doctors aren't trying to solve your issue. They're following a flowchart, and if that doesn't work for you, that's your problem, not theirs. Next time, be a better patient. I've had doctors tell me "Good news! You don't have a problem!" when they were testing me to see if they could explain the problem I have. It's good news for them, because their next step is to tell me to fuck off. It's not good news for me, but apparently they can't tell the difference.

barry-cotter 4y ago

General Practice medicine seems to come close enough. No differences in patient outcomes between physicians and nurse practitioners. > Randomised controlled trial comparing cost effectiveness of general practitioners and nurse practitioners in primary care > Results: Nurse practitioner consultations were significantly longer than those of the general practitioners (11.57 v 7.28 min; adjusted difference 4.20, 95% confidence interval 2.98 to 5.41), and nurses carried out more tests (8.7% v 5.6% of patients; odds ratio 1.66, 95% confidence interval 1.04 to 2.66) and asked patients to return more often (37.2% v 24.8%; 1.93, 1.36 to 2.73). There was no significant difference in patterns of prescribing or health status outcome for the two groups. Patients were more satisfied with nurse practitioner consultations (mean score 4.40 v 4.24 for general practitioners; adjusted difference 0.18, 0.092 to 0.257). This difference remained after consultation length was controlled for. There was no significant difference in health service costs (nurse practitioner £18.11 v general practitioner £20.70; adjusted difference £2.33, −£1.62 to £6.28). https://scholar.google.co.uk/scholar?hl=en&as_sdt=0%2C5&q=doctor+vs+nurse+practitioner+effectiveness&btnG=#d=gs_qabs&t=1668851171508&u=%23p%3DRafdM6k_aWQJ https://scholar.google.co.uk/scholar?hl=en&as_sdt=0%2C5&q=do... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27348/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27348/

lostlogin 4y ago
More tests isn’t a good things. The doctor was significantly quicker and could see 3 patients for every two the nurse saw. I’m not sure where this leaves us, as the cheaper training cost for the nurse is a factor too.