8 ms·

> On the other hand, a lot of what I do doesn't require 12 years of training What, besides surgery, really requires 12 years of training? I've found I have a g

> On the other hand, a lot of what I do doesn't require 12 years of training What, besides surgery, really requires 12 years of training? I've found I have a greater success rate with self diagnosis and treatment than I have with seeing my physician, and I've found a very good internist. An hour spent with ChatGPT and Google and I always find a couple options that fit what I'm experiencing as well as detailed descriptions on how to narrow it down. And since I'm the one experiencing the symptoms, there's no chance of a communications breakdown between me and the doctor who is trying to diagnose me.

nharada 3y ago
I think where this breaks down is when you have something rare that requires immediate attention. My impression is that a lot of that medical training is being able to say "oh that's unusual, you need to see a specialist".
SOLAR_FIELDS 3y ago
A recent occurrence I will share related to this was having to convince my doctor that I had Lyme disease. I Googled the symptoms, saw the trademark bullseye, and of course concluded that I had Lyme disease. It was right where I got the tick bite, 8 weeks later. My doctor refused to believe me. He told me to see a dermatologist about it, thinking it was some skin rash, even though it was exactly where the tick had bit me and it was a bullseye. I shortly thereafter went to an urgent care center where fortunately an RN happened to be from Maryland (I live in the South, where Lyme disease is not really a thing) and she immediately saw my rash and prescribed me the appropriate antibiotics. The reason my doctor did not believe me? It took 8 weeks for the bullseye to develop. I had gotten the tick bite in Europe (which of course I informed the doctor of very first thing). Typically American Lyme disease displays symptoms much faster (days instead of weeks). The doctor did not bother to do any research to discover what I had found in a few minutes of Googling: that European Lyme disease takes much longer to display symptoms (and I had told him as such as well). He was happy to simply assume that all Lyme disease takes only days to display symptoms instead of weeks, because that's what he knew of, and since mine had taken weeks, well, I just must simply be wrong. My doctor did have a small redemption: once he was confronted with evidence and did the research himself on what I was saying (after the RN had already treated me), he did call me and apologize. But still. This is a daily occurrence, especially for people that are of underserved genders and races. I realize this turned into a bit of a rant, but in essence I just want to affirm what you're saying. A lot of doctors, especially PCP, are often not much more than glorified technicians. Combine that with the ego problems that typically accompany being an MD and you get a recipe for people getting subpar care, especially women and minorities. In the end, unfortunately, only you are responsible for your own medical care and getting the best outcome. It is not sufficient to just trust someone else because they have the words MD after their name.
- slily 3y ago
  You have a point but need to drop the identity politics bullshit. Since when are women "underserved"? Men are far more likely to "tough it out" i.e. refuse to see a doctor when they have symptoms of illness, so by your logic they are the "underserved minority" in terms of gender. Claiming women are disadvantaged in literally everything ever is a groundless cliché. The racial angle may be less false (though not for the reasons you imply) but is still irrelevant to this story.
  - AaronM 3y ago
    https://physicians.dukehealth.org/articles/recognizing-addressing-unintended-gender-bias-patient-care https://physicians.dukehealth.org/articles/recognizing-addre... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=lk_inline_enhanced-template https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=l... https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/ https://www.americanbar.org/groups/crsj/publications/human_r...
    - x-complexity 3y ago
      > https://physicians.dukehealth.org/articles/recognizing-addressing-unintended-gender-bias-patient-care https://physicians.dukehealth.org/articles/recognizing-addre... The article uses a survey about personal opinions as the source for its judgement. Right in the first paragraph (emphasis mine): > A *survey* conducted in early 2019 by TODAY found that more than one-half of women, compared with one-third of men, *believe* gender discrimination in patient care is a serious problem. One in five women *say they have felt* that a health care provider has ignored or dismissed their symptoms, and 17% say they feel they have been treated differently because of their gender—compared with 14% and 6% of men, respectively. This does not address GP's complaint regarding men being more likely to refuse to see a doctor in the first place. Does patient gender discrimination occur in the medical space? Probably. But nothing in this article addresses GP's claim of "Men are far more likely to 'tough it out' i.e. refuse to see a doctor when they have symptoms of illness". ------ > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=lk_inline_enhanced-template https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=l... This journal article discusses gender disparities regarding coronary heart disease (CHD) diagnoses, with doctors believing that their male diagnoses are more confident than their female diagnoses. Disregarding the fact that the article still doesn't address GP's aforementioned complaint, the sample size used (n=128) is too small to make a firm judgement, with the ideal being at least n > 1000 to reduce potential statistical noise. The study also doesn't disprove the possibility of men being overdiagnosed with CHD. ------ > https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/ https://www.americanbar.org/groups/crsj/publications/human_r... This article addresses lower quality of healthcare received by minorities as opposed to white people. No links or direct references to cited studies/articles are given anywhere within the article, and the one time they do reference a source is to a book ("Just Medicine: A Cure for Racial Inequality in American Healthcare (2015)"), with no page citations to the aforementioned book made in the article. This article also doesn't address the GP's complaint at all. ------ Personal opinion: This type of shotgun-style link posting is a variant of the Gish Gallop, wherein the link poster forces participants to "do the research" via the cited links, only to waste their time by not directly addressing the concerns and complaints of the parent comment. AaronM, at least spend a few minutes to find articles supporting: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/ https://archive.is/fF4ND https://archive.is/fF4ND (Source: https://www.nytimes.com/2023/03/03/well/live/men-doctor-visits.html https://www.nytimes.com/2023/03/03/well/live/men-doctor-visi...) https://www.cdc.gov/nchs/data/series/sr_13/sr13_149.pdf https://www.cdc.gov/nchs/data/series/sr_13/sr13_149.pdf (page 17) And opposing GP's claim: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104816/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104816/
Danjoe4 3y ago
What, is that you likely have an IQ ~2 standard deviations above average. Most doctors are similarly intelligent. While he/she possesses more medical domain knowledge, you are able to problem solve with similar accuracy with a little research. Most people do not possess the domain knowledge nor the problem-solving ability.
singleshot_ 3y ago
In my experience, no one who has not dedicated a great deal of time to the study of their area of expertise is worth seeking out for help. If they haven’t been taking it seriously for long, I don’t take them seriously. I wouldn’t consult a first year mechanic, a second year doctor, a third year pilot… regardless of how long it takes to be functional in an area, I’m entitled to expertise and the signifier for expertise is time.

nharada 3y ago

I think where this breaks down is when you have something rare that requires immediate attention. My impression is that a lot of that medical training is being able to say "oh that's unusual, you need to see a specialist".

SOLAR_FIELDS 3y ago

A recent occurrence I will share related to this was having to convince my doctor that I had Lyme disease. I Googled the symptoms, saw the trademark bullseye, and of course concluded that I had Lyme disease. It was right where I got the tick bite, 8 weeks later. My doctor refused to believe me. He told me to see a dermatologist about it, thinking it was some skin rash, even though it was exactly where the tick had bit me and it was a bullseye. I shortly thereafter went to an urgent care center where fortunately an RN happened to be from Maryland (I live in the South, where Lyme disease is not really a thing) and she immediately saw my rash and prescribed me the appropriate antibiotics. The reason my doctor did not believe me? It took 8 weeks for the bullseye to develop. I had gotten the tick bite in Europe (which of course I informed the doctor of very first thing). Typically American Lyme disease displays symptoms much faster (days instead of weeks). The doctor did not bother to do any research to discover what I had found in a few minutes of Googling: that European Lyme disease takes much longer to display symptoms (and I had told him as such as well). He was happy to simply assume that all Lyme disease takes only days to display symptoms instead of weeks, because that's what he knew of, and since mine had taken weeks, well, I just must simply be wrong. My doctor did have a small redemption: once he was confronted with evidence and did the research himself on what I was saying (after the RN had already treated me), he did call me and apologize. But still. This is a daily occurrence, especially for people that are of underserved genders and races. I realize this turned into a bit of a rant, but in essence I just want to affirm what you're saying. A lot of doctors, especially PCP, are often not much more than glorified technicians. Combine that with the ego problems that typically accompany being an MD and you get a recipe for people getting subpar care, especially women and minorities. In the end, unfortunately, only you are responsible for your own medical care and getting the best outcome. It is not sufficient to just trust someone else because they have the words MD after their name.

slily 3y ago
You have a point but need to drop the identity politics bullshit. Since when are women "underserved"? Men are far more likely to "tough it out" i.e. refuse to see a doctor when they have symptoms of illness, so by your logic they are the "underserved minority" in terms of gender. Claiming women are disadvantaged in literally everything ever is a groundless cliché. The racial angle may be less false (though not for the reasons you imply) but is still irrelevant to this story.
- AaronM 3y ago
  https://physicians.dukehealth.org/articles/recognizing-addressing-unintended-gender-bias-patient-care https://physicians.dukehealth.org/articles/recognizing-addre... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=lk_inline_enhanced-template https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=l... https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/ https://www.americanbar.org/groups/crsj/publications/human_r...
  - x-complexity 3y ago
    > https://physicians.dukehealth.org/articles/recognizing-addressing-unintended-gender-bias-patient-care https://physicians.dukehealth.org/articles/recognizing-addre... The article uses a survey about personal opinions as the source for its judgement. Right in the first paragraph (emphasis mine): > A *survey* conducted in early 2019 by TODAY found that more than one-half of women, compared with one-third of men, *believe* gender discrimination in patient care is a serious problem. One in five women *say they have felt* that a health care provider has ignored or dismissed their symptoms, and 17% say they feel they have been treated differently because of their gender—compared with 14% and 6% of men, respectively. This does not address GP's complaint regarding men being more likely to refuse to see a doctor in the first place. Does patient gender discrimination occur in the medical space? Probably. But nothing in this article addresses GP's claim of "Men are far more likely to 'tough it out' i.e. refuse to see a doctor when they have symptoms of illness". ------ > https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=lk_inline_enhanced-template https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=l... This journal article discusses gender disparities regarding coronary heart disease (CHD) diagnoses, with doctors believing that their male diagnoses are more confident than their female diagnoses. Disregarding the fact that the article still doesn't address GP's aforementioned complaint, the sample size used (n=128) is too small to make a firm judgement, with the ideal being at least n > 1000 to reduce potential statistical noise. The study also doesn't disprove the possibility of men being overdiagnosed with CHD. ------ > https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/the-state-of-healthcare-in-the-united-states/racial-disparities-in-health-care/ https://www.americanbar.org/groups/crsj/publications/human_r... This article addresses lower quality of healthcare received by minorities as opposed to white people. No links or direct references to cited studies/articles are given anywhere within the article, and the one time they do reference a source is to a book ("Just Medicine: A Cure for Racial Inequality in American Healthcare (2015)"), with no page citations to the aforementioned book made in the article. This article also doesn't address the GP's complaint at all. ------ Personal opinion: This type of shotgun-style link posting is a variant of the Gish Gallop, wherein the link poster forces participants to "do the research" via the cited links, only to waste their time by not directly addressing the concerns and complaints of the parent comment. AaronM, at least spend a few minutes to find articles supporting: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/ https://archive.is/fF4ND https://archive.is/fF4ND (Source: https://www.nytimes.com/2023/03/03/well/live/men-doctor-visits.html https://www.nytimes.com/2023/03/03/well/live/men-doctor-visi...) https://www.cdc.gov/nchs/data/series/sr_13/sr13_149.pdf https://www.cdc.gov/nchs/data/series/sr_13/sr13_149.pdf (page 17) And opposing GP's claim: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104816/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104816/

Danjoe4 3y ago

What, is that you likely have an IQ ~2 standard deviations above average. Most doctors are similarly intelligent. While he/she possesses more medical domain knowledge, you are able to problem solve with similar accuracy with a little research. Most people do not possess the domain knowledge nor the problem-solving ability.

singleshot_ 3y ago

In my experience, no one who has not dedicated a great deal of time to the study of their area of expertise is worth seeking out for help. If they haven’t been taking it seriously for long, I don’t take them seriously. I wouldn’t consult a first year mechanic, a second year doctor, a third year pilot… regardless of how long it takes to be functional in an area, I’m entitled to expertise and the signifier for expertise is time.