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Sometimes it is exactly what they're doing. 15 years ago, shortly after surgery to remove a tumor from my femur, I ran into a physical therapy assistant whom I'
by Steuard 3y ago
Sometimes it is exactly what they're doing. 15 years ago, shortly after surgery to remove a tumor from my femur, I ran into a physical therapy assistant whom I'd been working with when my doctors thought my leg pain was a soft tissue problem. He said he'd heard about my surgery and was glad I was doing well, and then as we parted ways he cheerfully commented offhand that when I'd been working with him and his supervisor, "I thought you were making it all up!" (I still feel angry about that occasionally, all these years later.)
- flyinglizard 3y agoStatistically speaking, you were making that all up. Of course in your case it turned out to be serious, but think about how negligible the odds of that are when you're seeing dozens of patients a day during your career.
- sp332 3y agoWhy would any of those patients make up being in pain, let alone... most of them?
- codeTired 3y agoSo they can spend money on treatment and waste their time obviously. /s
- nradov 3y agoOpioid addicts frequently make up being in pain in order to obtain prescriptions. That's far less common in physical therapy patients but it does occasionally happen. https://my.clevelandclinic.org/health/diseases/9833-munchausen-syndrome-factitious-disorder-imposed-on-self https://my.clevelandclinic.org/health/diseases/9833-munchaus...
- robbintt 3y agoIt's not negligible, BECAUSE you are seeing dozens of patients a day. When you're a doctor, factoring the odds into your diagnosis will screw up your diagnosis BECAUSE you are exposed to the whole probability spectrum, not a quanta of it. Using "chance of occurrence" is a major logical fallacy for diagnosis identification and can ruin the whole practice.
- abecedarius 3y agoBesides the other responses so far, consider this: the consequences of mistakes about this are asymmetrical. A doctor could be exactly correct about the probability of "making it up", but the cost to the patient of a missed diagnosis is not balanced by the benefit of correctly dismissing other cases. A conscientious doctor could try to consciously account for this, but there's no feedback making them get it right (and pressures against, in our current reality). Also, when a patient succeeds in getting a correct diagnosis after trying multiple doctors, the previous doctors generally will not find out about their mistake, so there's a bias against them actually learning the right probabilities: you can expect them to be overconfident on this score.