4 ms·

Much more likely, they know so much about this issue that they struggle with finding simple words. Similarly how I often overcomplicate answers to technical pro

Much more likely, they know so much about this issue that they struggle with finding simple words. Similarly how I often overcomplicate answers to technical problems of my family. What is more likely: that doctors are slackers that have no idea what they are doing, or that their education path prioritized doing things over explaining anatomy to laymen.

HPsquared 2y ago
I think the main issue with doctors is they only give each patient a few minutes of their time. There's not much "deep work" in the medical field.
- smallerfish 2y ago
  You really need to be your own advocate to get thorough treatment for anything non-routine from many primary care physicians.
- rqtwteye 2y ago
  That’s my theory. They are good at obvious things but if something is a little tricky nobody puts the time in to figure it out. And nobody talks to each other. I always read about “care teams” but I have never seen such a thing.
  - coliveira 2y ago
    There are care teams at specialized and high cost situations, main examples being a major surgery to treat well understood condition. But for normal folks living with non life threatening conditions, this is almost impossible to find unless you're very rich.
- freeopinion 2y ago
  It's interesting to characterize this as an issue. If 20% effort can solve 80% of the problems... Then there are the 5% of problems that could be solved with 20% effort, but there is enough money in it to convince the patient to pay for more attention even if they don't need it. Let's hope that 80% of doctors don't gravitate to the 1% of patients that can afford to pay for exclusivity. People with enough money to see 10 different specialists in search of a satisfying answer are probably already moving outside of the treadmill medicine realm.
  - deleted 2y ago
    [deleted]
adamsb6 2y ago
It’s not that they have no idea what what they’re doing, it’s that they typically are mapping patient problems to a set of scripts. I’m analogizing shell scripts, not using shorthand for prescriptions. In nearly all cases this works out pretty well, most people will have some improvement when the right script is applied, and doctors are pretty good at mapping problems to scripts. But for edge cases, that approach is not going to work. Human propensities to slack notwithstanding, the business model discourages doctors from spending all day debugging one patient that isn’t responsive to their scripts. We do this in software, too. “Really rare race condition, one in a million chance, not going to rathole, deprioritized.”
swatcoder 2y ago
They're just people working jobs and in what's become a pretty troubled industry. For reasonably smart, reasonably disciplined people, going to med school and getting licensed is not some transformative experience that forces them all to become brilliant diagnosticians and healers. It's just a bit of a long grind to score what's hoped to be a well-paying and traditionally respected job. And then once you finish that grind and have the job, you still need to balance it with a regular old life of resposinilities and crises and kids and vacations; and in fact, because of the grind many people necessarily shift their personal and mental focus towards those other things. Meanwhile, the job sucks in a lot of ways and doesn't deliver on the childhood fantasies of what it must be like. Colleages and administrators make it miserable quite often, and patiets sure do too. The upshot is that no: many doctors are not all that brilliant and attentive to start with, and many who may sometimes be so are slackers. Shortcuts win, knowledge outside routine/common stuff fades, etc Just like all jobs. It's great when you can find the diamond in the rough for your own care, but don't assume they're all diamonds just because they went to med school for a while.
- mindslight 2y ago
  The pisser is that doctors mostly continue to act authoritative rather than collaborative. Regardless of how much education one has received, someone that spends a total of 20 minutes thinking about something (starting from a context without specific details) really should not be sitting there asserting one prescriptive take-it-or-leave-it answer like they've got the whole situation all figured out. Rather they should be engaging with questions to explain their reasoning and inform you of the larger context, since your health decisions are ultimately your own responsibility to make, especially in this brave new world of the "nobody's fault" medical system.
- tightbookkeeper 2y ago
  A girl next to me on the plane was studying for med school interviews. I tried to imagine what questions they might ask, I looked over and the first question on her sheet was “why do you want to be a doctor. This is not an intellectual interview, it’s a class and commitment signaling exercise.
paddy_m 2y ago
Not on topic, but related. I made a video explaining my side project - Buckaroo for my less technical friends and family. In 6 minutes I give a high level overview of why data scientists use NumPy and Pandas, how they use Jupyter Notebooks, and why Buckaroo makes their life better. I'm proud of it. https://www.youtube.com/watch?v=pfAkz6L5rMI https://www.youtube.com/watch?v=pfAkz6L5rMI
coliveira 2y ago
I think the issue mentioned by parent comment is that doctors don't care to investigate the causes of what they're treating. They're trained to isolate and fix the issue at hand, not to think through what is causing the whole cascade of events.

HPsquared 2y ago

I think the main issue with doctors is they only give each patient a few minutes of their time. There's not much "deep work" in the medical field.

smallerfish 2y ago
You really need to be your own advocate to get thorough treatment for anything non-routine from many primary care physicians.
rqtwteye 2y ago
That’s my theory. They are good at obvious things but if something is a little tricky nobody puts the time in to figure it out. And nobody talks to each other. I always read about “care teams” but I have never seen such a thing.
- coliveira 2y ago
  There are care teams at specialized and high cost situations, main examples being a major surgery to treat well understood condition. But for normal folks living with non life threatening conditions, this is almost impossible to find unless you're very rich.
freeopinion 2y ago
It's interesting to characterize this as an issue. If 20% effort can solve 80% of the problems... Then there are the 5% of problems that could be solved with 20% effort, but there is enough money in it to convince the patient to pay for more attention even if they don't need it. Let's hope that 80% of doctors don't gravitate to the 1% of patients that can afford to pay for exclusivity. People with enough money to see 10 different specialists in search of a satisfying answer are probably already moving outside of the treadmill medicine realm.
- deleted 2y ago
  [deleted]

adamsb6 2y ago

It’s not that they have no idea what what they’re doing, it’s that they typically are mapping patient problems to a set of scripts. I’m analogizing shell scripts, not using shorthand for prescriptions. In nearly all cases this works out pretty well, most people will have some improvement when the right script is applied, and doctors are pretty good at mapping problems to scripts. But for edge cases, that approach is not going to work. Human propensities to slack notwithstanding, the business model discourages doctors from spending all day debugging one patient that isn’t responsive to their scripts. We do this in software, too. “Really rare race condition, one in a million chance, not going to rathole, deprioritized.”

swatcoder 2y ago

They're just people working jobs and in what's become a pretty troubled industry. For reasonably smart, reasonably disciplined people, going to med school and getting licensed is not some transformative experience that forces them all to become brilliant diagnosticians and healers. It's just a bit of a long grind to score what's hoped to be a well-paying and traditionally respected job. And then once you finish that grind and have the job, you still need to balance it with a regular old life of resposinilities and crises and kids and vacations; and in fact, because of the grind many people necessarily shift their personal and mental focus towards those other things. Meanwhile, the job sucks in a lot of ways and doesn't deliver on the childhood fantasies of what it must be like. Colleages and administrators make it miserable quite often, and patiets sure do too. The upshot is that no: many doctors are not all that brilliant and attentive to start with, and many who may sometimes be so are slackers. Shortcuts win, knowledge outside routine/common stuff fades, etc Just like all jobs. It's great when you can find the diamond in the rough for your own care, but don't assume they're all diamonds just because they went to med school for a while.

mindslight 2y ago
The pisser is that doctors mostly continue to act authoritative rather than collaborative. Regardless of how much education one has received, someone that spends a total of 20 minutes thinking about something (starting from a context without specific details) really should not be sitting there asserting one prescriptive take-it-or-leave-it answer like they've got the whole situation all figured out. Rather they should be engaging with questions to explain their reasoning and inform you of the larger context, since your health decisions are ultimately your own responsibility to make, especially in this brave new world of the "nobody's fault" medical system.
tightbookkeeper 2y ago
A girl next to me on the plane was studying for med school interviews. I tried to imagine what questions they might ask, I looked over and the first question on her sheet was “why do you want to be a doctor. This is not an intellectual interview, it’s a class and commitment signaling exercise.

paddy_m 2y ago

Not on topic, but related. I made a video explaining my side project - Buckaroo for my less technical friends and family. In 6 minutes I give a high level overview of why data scientists use NumPy and Pandas, how they use Jupyter Notebooks, and why Buckaroo makes their life better. I'm proud of it. https://www.youtube.com/watch?v=pfAkz6L5rMI https://www.youtube.com/watch?v=pfAkz6L5rMI

coliveira 2y ago

I think the issue mentioned by parent comment is that doctors don't care to investigate the causes of what they're treating. They're trained to isolate and fix the issue at hand, not to think through what is causing the whole cascade of events.