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The quality of the American medical system has deteriorated to such a point that if the Doctors are not the grifters they may at least be culpable for enabling

by dleink 2y ago

The quality of the American medical system has deteriorated to such a point that if the Doctors are not the grifters they may at least be culpable for enabling the grift.

s1artibartfast 2y ago
That hasn't been my experience. I have never experienced or heard of a doctor deceiving or lying in real life. I dont think I can think of an example from hospitals either.
- jklinger410 2y ago
  My dental surgeon refuses to design or install an implant. They will only put in the screw for the implant. Why? Because of a pyramid scheme. That might not be a direct "lie," but it is misleading. Doctors mislead constantly. They tend to accept norms that are harmful because they are systems outside of their control.
  - nradov 2y ago
    I don't think you understand what a pyramid scheme is. There are some unethical providers who optimize for their own profit rather than the patient's best interests but those are a small minority. And it is entirely normal to separate implant design from installation; those things take different skills and equipment.
  - s1artibartfast 2y ago
    I think there is a conflation occurring between harm and sub-optimal behavior (from your perspective). Is the doctor harmful or simply less helpful than you would like? Would you be better off with no dental work or healthcare? Zero harm is being done in this case IMO. If Im alone in the desert dying, I dont think others are harming me for my lack of water and food. That is simple neutrality and indifference.
- influx 2y ago
  I've had dentists discover that I needed a filling after they found out how good my dental insurance was. Their justification was that the tooth seemed "soft". They never took an X-ray or provide any other data than that.
  - s1artibartfast 2y ago
    Do you think they lied and completely made it up? If so, I hope you refused to buy the filling.
    - influx 2y ago
      I don't know, but in hindsight I would have asked for an X-Ray. I think it was a borderline call and they went on the side of doing it because I had good insurance.
      - s1artibartfast 2y ago
        I don't see anything wrong or nefarious with deciding a borderline call based on ability to pay. Better preventative medicine and proactive treatment is one of the perks of having good insurance, so I would expect a recommendation from a good dentist to take it into account. Ideally there is some discussion, but at the same time, the idea that someone with great insurance would want to use it seems a reasonable assumption.
- autoexec 2y ago
  > I have never experienced or heard of a doctor deceiving or lying in real life. Meet Dr. Stella Immanuel who tells her patients that medications are made from alien DNA and that their illnesses are caused by demon sperm. In the USA she gets to keep her medical license/practice. (https://en.wikipedia.org/wiki/Stella_Immanuel https://en.wikipedia.org/wiki/Stella_Immanuel) See also: every doctor that accepted bribes from Purdue Pharma in exchange for knowingly prescribing excessive amounts of opioids to people who never needed them.
  - s1artibartfast 2y ago
    I included real life as an intentional qualifier. I know that quacks, grifters, and criminals exist. The fact that they exist doesn't bother me. Some will always exist. What matters is how common it is and what the average experience is. I don't think most doctors treat their patients the same as Stella Immanuel. Same for the two doctors that perdue was convicted of bribing
    - autoexec 2y ago
      Half of all doctors in the US accept money or gifts from drug and device companies. (https://www.statnews.com/2020/12/04/drug-companies-payments-gifts-affect-physician-prescribing/ https://www.statnews.com/2020/12/04/drug-companies-payments-...)
      - s1artibartfast 2y ago
        I actually really liked that article and how it at least tried to present both sides. However, I tend to agree with the opposing side, but think there are some edge cases that could be improved. I have spent my career working in drug and device development so I probably have a more nuanced view informed by my experience. I have payed millions to doctors, and think my actions are justified. One thing that the article touched on that I like is the role of non-industry associations, which I think could do a lot more to spread information. However, there's no one that will pay them to do it.
- kelipso 2y ago
  There are a large number of cardiologists who advocate patients for invasive surgeries they don't require so that they can make a bit more money.
- salad-tycoon 2y ago
  Work with one and you’ll see. Many are burnt out, it’s not even malice just indifference. Little lies here and there. Adds up.

by dleink 2y ago

The quality of the American medical system has deteriorated to such a point that if the Doctors are not the grifters they may at least be culpable for enabling the grift.

s1artibartfast 2y ago

That hasn't been my experience. I have never experienced or heard of a doctor deceiving or lying in real life. I dont think I can think of an example from hospitals either.

jklinger410 2y ago
My dental surgeon refuses to design or install an implant. They will only put in the screw for the implant. Why? Because of a pyramid scheme. That might not be a direct "lie," but it is misleading. Doctors mislead constantly. They tend to accept norms that are harmful because they are systems outside of their control.
- nradov 2y ago
  I don't think you understand what a pyramid scheme is. There are some unethical providers who optimize for their own profit rather than the patient's best interests but those are a small minority. And it is entirely normal to separate implant design from installation; those things take different skills and equipment.
- s1artibartfast 2y ago
  I think there is a conflation occurring between harm and sub-optimal behavior (from your perspective). Is the doctor harmful or simply less helpful than you would like? Would you be better off with no dental work or healthcare? Zero harm is being done in this case IMO. If Im alone in the desert dying, I dont think others are harming me for my lack of water and food. That is simple neutrality and indifference.
influx 2y ago
I've had dentists discover that I needed a filling after they found out how good my dental insurance was. Their justification was that the tooth seemed "soft". They never took an X-ray or provide any other data than that.
- s1artibartfast 2y ago
  Do you think they lied and completely made it up? If so, I hope you refused to buy the filling.
  - influx 2y ago
    I don't know, but in hindsight I would have asked for an X-Ray. I think it was a borderline call and they went on the side of doing it because I had good insurance.
    - s1artibartfast 2y ago
      I don't see anything wrong or nefarious with deciding a borderline call based on ability to pay. Better preventative medicine and proactive treatment is one of the perks of having good insurance, so I would expect a recommendation from a good dentist to take it into account. Ideally there is some discussion, but at the same time, the idea that someone with great insurance would want to use it seems a reasonable assumption.
autoexec 2y ago
> I have never experienced or heard of a doctor deceiving or lying in real life. Meet Dr. Stella Immanuel who tells her patients that medications are made from alien DNA and that their illnesses are caused by demon sperm. In the USA she gets to keep her medical license/practice. (https://en.wikipedia.org/wiki/Stella_Immanuel https://en.wikipedia.org/wiki/Stella_Immanuel) See also: every doctor that accepted bribes from Purdue Pharma in exchange for knowingly prescribing excessive amounts of opioids to people who never needed them.
- s1artibartfast 2y ago
  I included real life as an intentional qualifier. I know that quacks, grifters, and criminals exist. The fact that they exist doesn't bother me. Some will always exist. What matters is how common it is and what the average experience is. I don't think most doctors treat their patients the same as Stella Immanuel. Same for the two doctors that perdue was convicted of bribing
  - autoexec 2y ago
    Half of all doctors in the US accept money or gifts from drug and device companies. (https://www.statnews.com/2020/12/04/drug-companies-payments-gifts-affect-physician-prescribing/ https://www.statnews.com/2020/12/04/drug-companies-payments-...)
    - s1artibartfast 2y ago
      I actually really liked that article and how it at least tried to present both sides. However, I tend to agree with the opposing side, but think there are some edge cases that could be improved. I have spent my career working in drug and device development so I probably have a more nuanced view informed by my experience. I have payed millions to doctors, and think my actions are justified. One thing that the article touched on that I like is the role of non-industry associations, which I think could do a lot more to spread information. However, there's no one that will pay them to do it.
kelipso 2y ago
There are a large number of cardiologists who advocate patients for invasive surgeries they don't require so that they can make a bit more money.
salad-tycoon 2y ago
Work with one and you’ll see. Many are burnt out, it’s not even malice just indifference. Little lies here and there. Adds up.