4 ms·

This doesn’t surprise me. I find most doctors are terrible at debugging root cause. They’re simply working through a protocol of most common symptoms/cause an

by aantix 3y ago

This doesn’t surprise me. I find most doctors are terrible at debugging root cause. They’re simply working through a protocol of most common symptoms/cause and if your ailment doesn’t fit these narrow requirements, you’re screwed. Your 10 minute consult has ended and they’re not thinking about the problem anymore.

mewpmewp2 3y ago
This is exactly what a doctor told me during my health check up as well. He casually hit up a monologue on how dumb doctors are. I didn't really ask, but I wonder if he does this monologue to every patient he has. It seemed like for years he had developed this theatrical and interactive comedy piece for all the patients he was doing the check up on.
RandomLensman 3y ago
Common things are common, so going through common things first doesn't strike me as wrong. If someone suffers from something really exotic then I'd argue that is what specialists are for. The 10 minute window is more an external/financial constraint, I'd say.
- wredue 3y ago
  One of the main issues doctors face today is that everyone is really fat, and being fat leads to every diagnosis under the sun. People don’t like being told that being fat is causing their problem (when it almost definitely is), and this is creating a lot of distrust in doctors. I mean, you see these examples of it being more than just overweight, but that’s the minority, and everyone being fat unfortunately contributes to increasing the rate of these misdiagnosis.
- aantix 3y ago
  I saw multiple cardiologists in Lincoln, NE, and San Francisco, CA. Multiple nephrologists throughout the 25 years. These are the "specialists" I was referred to from my general physician. I had to work side-by-side with them to manage my condition. I had lost significant weight in the past, but it never reduced my blood pressure medication intake. But there was nothing special about these doctors. They simply had no answers beyond the typical. The equivalent for software would be that a bug report comes in and the engineer responds with "have you tried rebooting the servers?" Just superficial, unhelpful recommendations.
  - RandomLensman 3y ago
    Why do you think your diagnosis was so difficult to get to (given that it wasn't something very exotic if I understand it correctly - not an expert of any sort there but just doing a quick search)?
    - aantix 3y ago
      Hyperaldosteronism is a disease of the adrenal gland, so its diagnosis would fall under an endocrinologist. Most people think of cardilogy when thinking about blood pressure. General physicians included. That's natural. Heartbeat ->blood pressure. Less think of a nephrologist. But they still get recommended by general physicians. The kidneys play a big role in BP regulation. I never had an endocrinologist recommended. Never. But aldosterone is produced in the adrenals. It regulates water/salt retention. I had been experiencing edema for many months after stopping spironolactone. I thought the weight gain was from me getting fatter. But it was water retention. My ankles were swollen. This should have been the first red flag. I was also responsive to spironolactone when I started it again. I lost 15 lbs immediately (lost the water retention). My BP dropped significantly. That should have been another indicator that it could be aldosterone-related. I don't think it's on the cardiologist/nephrologist's radar. They have different subsystem concerns entirely.
- magicalhippo 3y ago
  That's how I approach analyzing a software issue as well. Start with the basics, is the application even running, is it actually reading the file you think it's reading etc. So often it's not something weird.
resource_waste 3y ago
The most horrifying thing has been being an adult and seeing how terrible medical doctors are at diagnosis (of my kids). If there are no objective measurements, do your own research and get second opinions. Maybe this works because I come from a science background. Heck today, I'm getting closer and closer to trusting ChatGPT4 over a doctor. My wife has used it to help diagnosis patients and 2 of them had life changing success. (okay hold up before my keyboard warrior pals think we are using chatgpt4 like a magic 8 ball, closing our eyes and showing the patient the response. No it dosent work like that)
- aantix 3y ago
  I had blood pressure issues of 25 years. “Lose more weight”. “Less sodium.” “More medications. “ (four to control my BP at its peak) Four cardiologists. Three nephrologists. All have WebMD level recommendations at best. I do my own research. I see hyperaldosteronism as a possibility. Cardiologist didn’t think so. But reluctantly gives an endocrinologist referral. Yes, I have it. Had my left (overactive) adrenal gland removed because of it. Now, BP is normalized with significantly less medication. Your health is in your hands. Do your own research. No one else will save you, including the doctors.
  - RandomLensman 3y ago
    I wonder if these things are somewhat caused by systems that need referrals. Btw., you still needed someone to remove your gland, I take it, so at that point someone else actually did their job, no?
    - aantix 3y ago
      The surgeon did her job regarding the adrenal removal. Agree. But even with my consultation with her, I bring up the problematic adrenal and the possibility of it being a pheochromocytoma. She says "For that, I would have to see a scan about 10 years before to see if there's any growth." To which I responded, "You mean like my PET scan from 2008 of the same region mentioned in the first paragraph of your report?" She barely read my report. Sloppiness. Parallels with the software industry - I think doctors could benefit from being paired with a complimentary doctor to act as a team and to check each other's work. I think they simultaneously have a god complex for which their assessments are rarely checked. They need social pressure to probe further.
aantix 3y ago
I wonder how we get better physician ratings? Right now, all online reviews are superficial at best. "He listened to my questions." "She made my family feel at ease." "The front office followed up for my next appointment." I don't care how kind or rude the physician is. I want them to get my diagnosis correct. I'd like to see data on each physician - each patient's five- and ten-year follow-up data. Reveal to me if the diagnosis was correct. I understand the messiness of this data gathering. I know some patients may not want to reveal such sensitive data. Doctors would probably game the scoring system. There may be confounding conditions as well. But this would be my dream data scenario.
emporas 3y ago
They are also getting paid by the drugs they prescribe, not by the diseases they cure. Incentives guide actions of many people. Not saying their actions are dictated only by incentives and nothing else, but still, a strong influence there.

by aantix 3y ago

mewpmewp2 3y ago

This is exactly what a doctor told me during my health check up as well. He casually hit up a monologue on how dumb doctors are. I didn't really ask, but I wonder if he does this monologue to every patient he has. It seemed like for years he had developed this theatrical and interactive comedy piece for all the patients he was doing the check up on.

RandomLensman 3y ago

Common things are common, so going through common things first doesn't strike me as wrong. If someone suffers from something really exotic then I'd argue that is what specialists are for. The 10 minute window is more an external/financial constraint, I'd say.

wredue 3y ago
One of the main issues doctors face today is that everyone is really fat, and being fat leads to every diagnosis under the sun. People don’t like being told that being fat is causing their problem (when it almost definitely is), and this is creating a lot of distrust in doctors. I mean, you see these examples of it being more than just overweight, but that’s the minority, and everyone being fat unfortunately contributes to increasing the rate of these misdiagnosis.
aantix 3y ago
I saw multiple cardiologists in Lincoln, NE, and San Francisco, CA. Multiple nephrologists throughout the 25 years. These are the "specialists" I was referred to from my general physician. I had to work side-by-side with them to manage my condition. I had lost significant weight in the past, but it never reduced my blood pressure medication intake. But there was nothing special about these doctors. They simply had no answers beyond the typical. The equivalent for software would be that a bug report comes in and the engineer responds with "have you tried rebooting the servers?" Just superficial, unhelpful recommendations.
- RandomLensman 3y ago
  Why do you think your diagnosis was so difficult to get to (given that it wasn't something very exotic if I understand it correctly - not an expert of any sort there but just doing a quick search)?
  - aantix 3y ago
    Hyperaldosteronism is a disease of the adrenal gland, so its diagnosis would fall under an endocrinologist. Most people think of cardilogy when thinking about blood pressure. General physicians included. That's natural. Heartbeat ->blood pressure. Less think of a nephrologist. But they still get recommended by general physicians. The kidneys play a big role in BP regulation. I never had an endocrinologist recommended. Never. But aldosterone is produced in the adrenals. It regulates water/salt retention. I had been experiencing edema for many months after stopping spironolactone. I thought the weight gain was from me getting fatter. But it was water retention. My ankles were swollen. This should have been the first red flag. I was also responsive to spironolactone when I started it again. I lost 15 lbs immediately (lost the water retention). My BP dropped significantly. That should have been another indicator that it could be aldosterone-related. I don't think it's on the cardiologist/nephrologist's radar. They have different subsystem concerns entirely.
magicalhippo 3y ago
That's how I approach analyzing a software issue as well. Start with the basics, is the application even running, is it actually reading the file you think it's reading etc. So often it's not something weird.

resource_waste 3y ago

The most horrifying thing has been being an adult and seeing how terrible medical doctors are at diagnosis (of my kids). If there are no objective measurements, do your own research and get second opinions. Maybe this works because I come from a science background. Heck today, I'm getting closer and closer to trusting ChatGPT4 over a doctor. My wife has used it to help diagnosis patients and 2 of them had life changing success. (okay hold up before my keyboard warrior pals think we are using chatgpt4 like a magic 8 ball, closing our eyes and showing the patient the response. No it dosent work like that)

aantix 3y ago
I had blood pressure issues of 25 years. “Lose more weight”. “Less sodium.” “More medications. “ (four to control my BP at its peak) Four cardiologists. Three nephrologists. All have WebMD level recommendations at best. I do my own research. I see hyperaldosteronism as a possibility. Cardiologist didn’t think so. But reluctantly gives an endocrinologist referral. Yes, I have it. Had my left (overactive) adrenal gland removed because of it. Now, BP is normalized with significantly less medication. Your health is in your hands. Do your own research. No one else will save you, including the doctors.
- RandomLensman 3y ago
  I wonder if these things are somewhat caused by systems that need referrals. Btw., you still needed someone to remove your gland, I take it, so at that point someone else actually did their job, no?
  - aantix 3y ago
    The surgeon did her job regarding the adrenal removal. Agree. But even with my consultation with her, I bring up the problematic adrenal and the possibility of it being a pheochromocytoma. She says "For that, I would have to see a scan about 10 years before to see if there's any growth." To which I responded, "You mean like my PET scan from 2008 of the same region mentioned in the first paragraph of your report?" She barely read my report. Sloppiness. Parallels with the software industry - I think doctors could benefit from being paired with a complimentary doctor to act as a team and to check each other's work. I think they simultaneously have a god complex for which their assessments are rarely checked. They need social pressure to probe further.

aantix 3y ago

I wonder how we get better physician ratings? Right now, all online reviews are superficial at best. "He listened to my questions." "She made my family feel at ease." "The front office followed up for my next appointment." I don't care how kind or rude the physician is. I want them to get my diagnosis correct. I'd like to see data on each physician - each patient's five- and ten-year follow-up data. Reveal to me if the diagnosis was correct. I understand the messiness of this data gathering. I know some patients may not want to reveal such sensitive data. Doctors would probably game the scoring system. There may be confounding conditions as well. But this would be my dream data scenario.

emporas 3y ago

They are also getting paid by the drugs they prescribe, not by the diseases they cure. Incentives guide actions of many people. Not saying their actions are dictated only by incentives and nothing else, but still, a strong influence there.