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HN is going to select for a very small subset of the population, so unfortunately people's experiences have to be interpreted in that light. A massive chunk of

HN is going to select for a very small subset of the population, so unfortunately people's experiences have to be interpreted in that light. A massive chunk of my caseload is the direct result of people not listening to basic instructions. Between people not listening and people who don't understand shockingly basic fundamentals of health, you become jaded. Add to that the active disincentives to doctors really digging into cases, and we end up where we are. It feels much of my knowledge goes unused and wasted. As an aside, I have messed around with chat gpt 4 for how well it can mimic what I know. My personal experience is that I can see how it would impress non-medically trained people, but to my eyes it has a long way to go. It struggles to accurately rank differentials. Also once you press deeper into decision making it gets really scary. It was consistently presenting treatment plans that would have killed patients if followed. I would love more than anything to have AI cut down some of our work but I was really disappointed with how it currently performs. Hopefully improvements keep coming.

xanderlewis 3y ago
> I can see how it would impress non-medically trained people, but to my eyes it has a long way to go I think this is spot on. It's easy (with this kind of technology and amount of data) to superficially mimic expertise. It looks impressive at first, but when scrutinised by a real expert it becomes clear how superficial it really is.
- TesterVetter 3y ago
  [dead]
caeril 3y ago
> people not listening to basic instructions. Unless the basic instructions are "put down the fork, you piece of shit fat fuck", you aren't doing your job. Presumably, you know that ~80% of medical costs are due to chronic illness, and you also know that ~80% of chronic illness is attributed to obesity, correct? Unless you are fat-shaming 64% of your patients, you are committing malpractice. Unless you are agitating for the hospital cafeteria to remove the Hostess cakes and sodas, you are committing malpractice. But that's not what you people do, is it? You prescribe metformin, statins, beta-blockers, and write angry posts on hackernews that they're not compliant with their medication schedule. You dance around the root cause of 64% of your patient visits because if you addressed the root cause, your billables would decline. Your entire profession is predicated on keeping your own patients sick, and prescribing workarounds to the root cause of 64% of them. And the remaining 36% of them, who are sick through no fault of their own, are waiting weeks just to see you, because you refuse to do the right thing and tell your patients that their wives are going to fuck the poolboy because they're too fat to see their own dick. "Patch Adams" has destroyed the medical industry. Your ridiculous concern for "bedside manner", and being nice and polite, is killing Americans in droves, and you guys are more than happy to scoop up the profits in drawing out the process as long as possible, but not fixing it.
- Zenzero 3y ago
  [flagged]
  - caeril 3y ago
    It's certainly unsurprising that a representative of the profession that misdiagnosed my mother's hematoma as a tumor - while she was bleeding internally at a rate of 1 unit per hour - would lack in both reading comprehension and math skills. I wish you luck, too. Keep murdering Americans at a rate of 240,000 annually due to your own mistakes while considering yourselves the good guys. NBC medical dramas will continue to carry water for you, so your public image will be forever untarnished as the Great American Heroes you were destined to be.
    - Zenzero 3y ago
      Ah the root cause is found. If you don't want your seething anger to continue to consume you into adulthood it would be best for you to seek extensive therapy. It's unfortunate how well-adjusted adults on HN seem to be increasingly outnumbered by angry children from reddit.
      - caeril 3y ago
        [flagged]
        tanseydavid 3y ago
        >> This may be shocking for you, but it is indeed possible for a person to experience justifiable anger in their forties. Justifiable does not make it a healthy obsession. Justifiable resentments destroy people.
        dang 3y ago
        You broke the site guidelines more than once in this thread. Flamewar comments will get you banned here, regardless of how wrong someone else is or you feel they are. If you'd please review https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and not do this again, we'd aprpeciate it.

xanderlewis 3y ago

> I can see how it would impress non-medically trained people, but to my eyes it has a long way to go I think this is spot on. It's easy (with this kind of technology and amount of data) to superficially mimic expertise. It looks impressive at first, but when scrutinised by a real expert it becomes clear how superficial it really is.

TesterVetter 3y ago
[dead]

caeril 3y ago

> people not listening to basic instructions. Unless the basic instructions are "put down the fork, you piece of shit fat fuck", you aren't doing your job. Presumably, you know that ~80% of medical costs are due to chronic illness, and you also know that ~80% of chronic illness is attributed to obesity, correct? Unless you are fat-shaming 64% of your patients, you are committing malpractice. Unless you are agitating for the hospital cafeteria to remove the Hostess cakes and sodas, you are committing malpractice. But that's not what you people do, is it? You prescribe metformin, statins, beta-blockers, and write angry posts on hackernews that they're not compliant with their medication schedule. You dance around the root cause of 64% of your patient visits because if you addressed the root cause, your billables would decline. Your entire profession is predicated on keeping your own patients sick, and prescribing workarounds to the root cause of 64% of them. And the remaining 36% of them, who are sick through no fault of their own, are waiting weeks just to see you, because you refuse to do the right thing and tell your patients that their wives are going to fuck the poolboy because they're too fat to see their own dick. "Patch Adams" has destroyed the medical industry. Your ridiculous concern for "bedside manner", and being nice and polite, is killing Americans in droves, and you guys are more than happy to scoop up the profits in drawing out the process as long as possible, but not fixing it.

Zenzero 3y ago
[flagged]
- caeril 3y ago
  It's certainly unsurprising that a representative of the profession that misdiagnosed my mother's hematoma as a tumor - while she was bleeding internally at a rate of 1 unit per hour - would lack in both reading comprehension and math skills. I wish you luck, too. Keep murdering Americans at a rate of 240,000 annually due to your own mistakes while considering yourselves the good guys. NBC medical dramas will continue to carry water for you, so your public image will be forever untarnished as the Great American Heroes you were destined to be.
  - Zenzero 3y ago
    Ah the root cause is found. If you don't want your seething anger to continue to consume you into adulthood it would be best for you to seek extensive therapy. It's unfortunate how well-adjusted adults on HN seem to be increasingly outnumbered by angry children from reddit.
    - caeril 3y ago
      [flagged]
      - tanseydavid 3y ago
        >> This may be shocking for you, but it is indeed possible for a person to experience justifiable anger in their forties. Justifiable does not make it a healthy obsession. Justifiable resentments destroy people.
      - dang 3y ago
        You broke the site guidelines more than once in this thread. Flamewar comments will get you banned here, regardless of how wrong someone else is or you feel they are. If you'd please review https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and not do this again, we'd aprpeciate it.