7 ms·

Excellent blog post, excellent advice. This part in particular: > When working with paid professionals, I think people tend to put them into one of two categor

by bambax 1y ago

Excellent blog post, excellent advice. This part in particular: > When working with paid professionals, I think people tend to put them into one of two categories: doctors or general contractors. > With doctors, if your oncologist says you have a lump that needs to come out, you pretty much do whatever they say. You’re the patient; they’re the expert leading the charge. > With general contractors doing home renovations, most people intuitively know that’s not the right approach. You stay on top of them, give clear instructions, try to understand the issues yourself, and assume you need to provide lots of direction and monitoring to get what you want done. > Most people—entrepreneurs included, certainly myself—put lawyers in the doctor category when they should really treat them more like general contractors. Except... I think if one has enough time, it's better to treat everyone like general contractors. Doctors make mistakes, often. You can and should challenge them.

ajsnigrutin 1y ago
Yep, i'm pretty sure every kind of patient, from a cancer patient to someone with an ingrown toenail has googled their condition, looked for alternatives (especially if the proposed treatment was subjectively bad for the patient, even if it was objectively good). People tend to skip the googling and verification process only if the problem is something simple or if the treatment is simple... eg. broken outlet, for legal reasons can't replace yoursefl, call contractor, outlet replaced... or in case of doctors, fever, infection, blood test, it's bacterial, antibiotics, two pills per day for 10 days, done.
- s1artibartfast 1y ago
  There is actually a significant portion of the population that wants nothing to do with it and wont even google their cancer diagnosis and leave it up to the experts.
  - cogman10 1y ago
    You should in that case at least get a second opinion. Also, just an FYI for anyone in here, there are people that call themselves doctors who will diagnose and cure cancer using magic. Any "clinic" that staffs a number of naturopathic doctors (NDs) and suggests that you can treat cancer with dietary changes is a grift that should be illegal. I'm dealing with cancer in my family and one such clinic was the first suggestion by family members. This isn't the place, but it what to watch out for [1]. Always be leery when you see clinics downplaying traditional medicine. Notice on their staffing page that they have exactly 1 doctor on staff (not even a nurse practitioner) and that this doctor doesn't have any credentials in oncology. And if you check out the billing section, notice that they instruct you on how to commit insurance fraud. There's a reason they don't take medicare/medicaid and it's because committing fraud there is a jail sentence for them and you. For a large insurance company, it's a lawsuit to you. Edit: Ah, found the actual place suggested to us [2]. You can see a lot of the same hallmarks on it vs the first link. [1] https://brio-medical.com/ https://brio-medical.com/ [2] https://www.envita.com https://www.envita.com
  - deleted 1y ago
    [deleted]
PunchTornado 1y ago
completely agree. there are doctors who were bottom of the class or who are not updated with the latest research.
- cogman10 1y ago
  My wife went through this. We had a doctor that had prescribed us a dangerous amount of medicine (we didn't know) without running any tests. The doctor was also doing procedures he didn't need to do and ultimately recommended a surgery that has been stopped since the 90s. We caught him because of the surgery. We sought a second opinion about it because the google was telling me "This surgery is no longer performed because it has serious negative consequences, and it rarely treats the symptom it's done for". I even double checked with the quack that it's the surgery he wanted to do because I was a bit flabbergasted he was suggested it (he was, of course, annoyed that I looked it up). We sought a second opinion and I've never seen a doctor angrier. First, he was livid that the doc had us on such a mega dose of the drug and wasn't doing bloodwork to confirm we even needed it. But also, he was furious the doctor wanted to do the surgery. I'm 90% sure he got the docs' license pulled because the quack sent out a sad "Sorry to inform everyone but we'll be closing up shop". Needless to say, always always look up the procedures and medications doctors want. Second opinions are also a good thing and good doctors will respond with "The more the merrier". And don't be like us, you should be thinking at all times "what test did the doctor do to determine we should be doing X". If a doctor is freeballing shit, you should be leery. Except maybe if they are throwing Tylenol at you for pain. [1] [1] https://www.youtube.com/watch?v=gD6olRJ8S3I https://www.youtube.com/watch?v=gD6olRJ8S3I
esafak 1y ago
It worked for Steve Jobs!
- kwertyoowiyop 1y ago
  Jobs didn’t do this part correctly: “try to understand the issues yourself” Your contractor is a skilled professional, not a drone. You need to exercise good judgment if you’re going to make decisions.
  - esafak 1y ago
    That's my point: are you sure you understand the issue better than your doctor, who has over a decade of training? In most cases, it's easier to find a good doctor than to learn enough to outguess your bad one. Devote your efforts to learning to select the doctor.
    - noworriesnate 1y ago
      You need to be informed to know which doctor is better. I generally try to follow the advice of my family doctor, but that’s because I’ve made an informed decision on past experiences where I double checked him. But that’s easy with a doctor you have a long term relationship with. I imagine it’s different eg. if you get cancer it’s probably going to just be a part time job to keep informed on all the doctor’s recommendations, and getting second opinions sounds like it would be time prohibitive. I don’t know of an easy way around this though.
      - const_cast 1y ago
        You don't need to be informed because the beauty of second opinions is that you have a statistical advantage. Meaning, if one dude is telling you something, he could be wrong. If two are... well you might want to listen. 3? 4? What are the odds they're all idiots?
paulcole 1y ago
I agree with you. I think it comes down to the fact that you have to “live in the house.” Whether it’s a doctor (where the house is your body) or a general contractor (where the house is a house), at the end of the day, nobody cares about the house more than you do.
mustache_kimono 1y ago
I read the same and came to the opposite conclusion. I said: "Yikes. The balls on this guy.": > Some lawyers bristle at clients setting strategic direction. They believe there’s a “correct way” to do things, they know it, and they’ll fight you if you disagree. In that case, get different lawyers. The thing is -- there are correct ways to do things in the legal sphere. Litigation is highly professional and highly formal, and has only become more so. While sub rosa it's fine to ask an AI for advice, and to engage it in draft brief writing, summarization to bullets, etc., it's wild not to realize how much of litigation and the law is wrapped up in people and experience and intricate formal processes. Such as this court has local rules, and this judge likes his briefs this length and the arguments just so, this needs to be filed here, stamped by the clerk, and filed again over there. AIs may be exceptionally clever, but they may misunderstand the theatre of a trial. They may overweight the importance of the law and then underweight human factors, like the importance of assigning blame, or the lack of credibility of certain witnesses, or the bad faith of certain actors. AIs may fail to give credence to the ordinary meaning of terms, or fail to emphasize that these are two sophisticated businesses which understand the technical terms. AIs are still very poor at actual "reasoning", that is, a deep consideration of the multitude of ways of looking at any one set of facts and/or words on the page. One area in which this article is entirely right is -- one must manage attorneys, and you must make certain that legal costs don't become leverage against you. But there are points at which you say: Can this guy keep it all straight? Does he know how to be useful to his own defense and then does he know how to get out of his own way?
- Marsymars 1y ago
  > The thing is -- there are correct ways to do things in the legal sphere. The legal sphere is highly professional and highly formal, and has only become more so. In some ways. OTOH, my wife works in the legal sphere, and after spending most of her career at a small boutique firm before being subsumed by a larger one, she was kinda dismayed to discover that there’s no singular “right way” to do things, and that different lawyers kind all do their own thing in a multitude of different ways.
  - mustache_kimono 1y ago
Xeoncross 1y ago
Often, you get out of something what you put into it. People who don't try to understand their own health/relationships/finances often end up where they didn't want to be. If you won't advocate for yourself, why should you expect a 3rd party do it?
onlyrealcuzzo 1y ago
> Doctors make mistakes, often. You can and should challenge them. The problem with challenging doctors is that the body is incredibly complex, and is not really under any obligation to "make common sense" / be bro-science-y. The vast majority of the time you're going to be wrong and annoying, even if you're consulting LLMs first. If a doctor is making a mistake, and you're a lay-person, you're not likely to spot it. But you are likely to challenge a bunch of things that the doctor is right and just be an annoying back-seat driver. You're better off trying to get a doctor you can trust than treating your doctor like someone who isn't good at their job. There are bad and shady doctors to be sure, but they are extreme outliers. Doctors, unlike lawyers, typically care about your care - whereas lawyers are mostly interested in extracting as much of your money into their pocket as possible. Unless you're going to some elective surgeon, most doctors are so busy, they don't need to make up pretend bs to have you come back and get work. Lawyers on the other hand...
- umvi 1y ago
  Not true in my experience. Just because a doctor has gone to medical school doesn't mean they are good at debugging/troubleshooting. I've had many doctors try to diagnose my chronic issues with guesswork and hunches instead of methodically eliminating possibilities with tests. I had to switch doctors many times to find one good enough to diagnose my condition (LADA aka type 1.5 diabetes). I actually asked the first doctor if it could be LADA and he said "nah, I don't think so", so then I asked if we could test for it to rule it out and again he declined and confidently encouraged me to exercise more and eat fewer carbs.
  - SoftTalker 1y ago
    So you found a doctor to agree with your preconceived diagnosis and he's the one who is right, while the others were wrong?
    - deleted 1y ago
      [deleted]
    - collingreen 1y ago
csomar 1y ago
> Doctors make mistakes, often. You can and should challenge them. It is worse. Many doctors will administer against your interest if it boost their bottom line. There is, also, very little legal recourse against doctors.
- 0x1ceb00da 1y ago
  This. Doctors have to work in a system. The hospitals are institutions that have quarterly quotas to hit, and they want doctors to maximize profit. How much the doctor will oblige depends on the individual doctors but the pressure is always there.
deleted 1y ago
[deleted]
paul_h 1y ago
Topical: "How I Built an Open Source AI Tool to Find My Autoimmune Disease (After $100k and 30+ Hospital Visits) - Now Available for Anyone to Use" --> https://www.reddit.com/r/OpenAI/comments/1ij6619/how_i_built_an_open_source_ai_tool_to_find_my/ https://www.reddit.com/r/OpenAI/comments/1ij6619/how_i_built... I'm in the UK. As well as doctors making mistakes, they can be under direction diagnosing critera. The UK has had a multi-year struggle for people with ME/CFS, (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome). It falls under neurology in the UK, and a sub-chapter neuro-psychiatry has the ear of the national health service's supremos, and has historically entertained an "all in the mind" approach. I digress. Back to AI and medicine again: https://x.com/vipintukur/status/1931049593535627417 https://x.com/vipintukur/status/1931049593535627417 - insights can come from that quarter, and medicine is going to have to play catch up at times.

by bambax 1y ago

ajsnigrutin 1y ago

Yep, i'm pretty sure every kind of patient, from a cancer patient to someone with an ingrown toenail has googled their condition, looked for alternatives (especially if the proposed treatment was subjectively bad for the patient, even if it was objectively good). People tend to skip the googling and verification process only if the problem is something simple or if the treatment is simple... eg. broken outlet, for legal reasons can't replace yoursefl, call contractor, outlet replaced... or in case of doctors, fever, infection, blood test, it's bacterial, antibiotics, two pills per day for 10 days, done.

s1artibartfast 1y ago
There is actually a significant portion of the population that wants nothing to do with it and wont even google their cancer diagnosis and leave it up to the experts.
- cogman10 1y ago
  You should in that case at least get a second opinion. Also, just an FYI for anyone in here, there are people that call themselves doctors who will diagnose and cure cancer using magic. Any "clinic" that staffs a number of naturopathic doctors (NDs) and suggests that you can treat cancer with dietary changes is a grift that should be illegal. I'm dealing with cancer in my family and one such clinic was the first suggestion by family members. This isn't the place, but it what to watch out for [1]. Always be leery when you see clinics downplaying traditional medicine. Notice on their staffing page that they have exactly 1 doctor on staff (not even a nurse practitioner) and that this doctor doesn't have any credentials in oncology. And if you check out the billing section, notice that they instruct you on how to commit insurance fraud. There's a reason they don't take medicare/medicaid and it's because committing fraud there is a jail sentence for them and you. For a large insurance company, it's a lawsuit to you. Edit: Ah, found the actual place suggested to us [2]. You can see a lot of the same hallmarks on it vs the first link. [1] https://brio-medical.com/ https://brio-medical.com/ [2] https://www.envita.com https://www.envita.com
- deleted 1y ago
  [deleted]

PunchTornado 1y ago

completely agree. there are doctors who were bottom of the class or who are not updated with the latest research.

cogman10 1y ago
My wife went through this. We had a doctor that had prescribed us a dangerous amount of medicine (we didn't know) without running any tests. The doctor was also doing procedures he didn't need to do and ultimately recommended a surgery that has been stopped since the 90s. We caught him because of the surgery. We sought a second opinion about it because the google was telling me "This surgery is no longer performed because it has serious negative consequences, and it rarely treats the symptom it's done for". I even double checked with the quack that it's the surgery he wanted to do because I was a bit flabbergasted he was suggested it (he was, of course, annoyed that I looked it up). We sought a second opinion and I've never seen a doctor angrier. First, he was livid that the doc had us on such a mega dose of the drug and wasn't doing bloodwork to confirm we even needed it. But also, he was furious the doctor wanted to do the surgery. I'm 90% sure he got the docs' license pulled because the quack sent out a sad "Sorry to inform everyone but we'll be closing up shop". Needless to say, always always look up the procedures and medications doctors want. Second opinions are also a good thing and good doctors will respond with "The more the merrier". And don't be like us, you should be thinking at all times "what test did the doctor do to determine we should be doing X". If a doctor is freeballing shit, you should be leery. Except maybe if they are throwing Tylenol at you for pain. [1] [1] https://www.youtube.com/watch?v=gD6olRJ8S3I https://www.youtube.com/watch?v=gD6olRJ8S3I

esafak 1y ago

It worked for Steve Jobs!

kwertyoowiyop 1y ago
Jobs didn’t do this part correctly: “try to understand the issues yourself” Your contractor is a skilled professional, not a drone. You need to exercise good judgment if you’re going to make decisions.
- esafak 1y ago
  That's my point: are you sure you understand the issue better than your doctor, who has over a decade of training? In most cases, it's easier to find a good doctor than to learn enough to outguess your bad one. Devote your efforts to learning to select the doctor.
  - noworriesnate 1y ago
    You need to be informed to know which doctor is better. I generally try to follow the advice of my family doctor, but that’s because I’ve made an informed decision on past experiences where I double checked him. But that’s easy with a doctor you have a long term relationship with. I imagine it’s different eg. if you get cancer it’s probably going to just be a part time job to keep informed on all the doctor’s recommendations, and getting second opinions sounds like it would be time prohibitive. I don’t know of an easy way around this though.
    - const_cast 1y ago
      You don't need to be informed because the beauty of second opinions is that you have a statistical advantage. Meaning, if one dude is telling you something, he could be wrong. If two are... well you might want to listen. 3? 4? What are the odds they're all idiots?

paulcole 1y ago

I agree with you. I think it comes down to the fact that you have to “live in the house.” Whether it’s a doctor (where the house is your body) or a general contractor (where the house is a house), at the end of the day, nobody cares about the house more than you do.

mustache_kimono 1y ago

I read the same and came to the opposite conclusion. I said: "Yikes. The balls on this guy.": > Some lawyers bristle at clients setting strategic direction. They believe there’s a “correct way” to do things, they know it, and they’ll fight you if you disagree. In that case, get different lawyers. The thing is -- there are correct ways to do things in the legal sphere. Litigation is highly professional and highly formal, and has only become more so. While sub rosa it's fine to ask an AI for advice, and to engage it in draft brief writing, summarization to bullets, etc., it's wild not to realize how much of litigation and the law is wrapped up in people and experience and intricate formal processes. Such as this court has local rules, and this judge likes his briefs this length and the arguments just so, this needs to be filed here, stamped by the clerk, and filed again over there. AIs may be exceptionally clever, but they may misunderstand the theatre of a trial. They may overweight the importance of the law and then underweight human factors, like the importance of assigning blame, or the lack of credibility of certain witnesses, or the bad faith of certain actors. AIs may fail to give credence to the ordinary meaning of terms, or fail to emphasize that these are two sophisticated businesses which understand the technical terms. AIs are still very poor at actual "reasoning", that is, a deep consideration of the multitude of ways of looking at any one set of facts and/or words on the page. One area in which this article is entirely right is -- one must manage attorneys, and you must make certain that legal costs don't become leverage against you. But there are points at which you say: Can this guy keep it all straight? Does he know how to be useful to his own defense and then does he know how to get out of his own way?

Marsymars 1y ago
> The thing is -- there are correct ways to do things in the legal sphere. The legal sphere is highly professional and highly formal, and has only become more so. In some ways. OTOH, my wife works in the legal sphere, and after spending most of her career at a small boutique firm before being subsumed by a larger one, she was kinda dismayed to discover that there’s no singular “right way” to do things, and that different lawyers kind all do their own thing in a multitude of different ways.
- mustache_kimono 1y ago

Xeoncross 1y ago

Often, you get out of something what you put into it. People who don't try to understand their own health/relationships/finances often end up where they didn't want to be. If you won't advocate for yourself, why should you expect a 3rd party do it?

onlyrealcuzzo 1y ago

> Doctors make mistakes, often. You can and should challenge them. The problem with challenging doctors is that the body is incredibly complex, and is not really under any obligation to "make common sense" / be bro-science-y. The vast majority of the time you're going to be wrong and annoying, even if you're consulting LLMs first. If a doctor is making a mistake, and you're a lay-person, you're not likely to spot it. But you are likely to challenge a bunch of things that the doctor is right and just be an annoying back-seat driver. You're better off trying to get a doctor you can trust than treating your doctor like someone who isn't good at their job. There are bad and shady doctors to be sure, but they are extreme outliers. Doctors, unlike lawyers, typically care about your care - whereas lawyers are mostly interested in extracting as much of your money into their pocket as possible. Unless you're going to some elective surgeon, most doctors are so busy, they don't need to make up pretend bs to have you come back and get work. Lawyers on the other hand...

umvi 1y ago
Not true in my experience. Just because a doctor has gone to medical school doesn't mean they are good at debugging/troubleshooting. I've had many doctors try to diagnose my chronic issues with guesswork and hunches instead of methodically eliminating possibilities with tests. I had to switch doctors many times to find one good enough to diagnose my condition (LADA aka type 1.5 diabetes). I actually asked the first doctor if it could be LADA and he said "nah, I don't think so", so then I asked if we could test for it to rule it out and again he declined and confidently encouraged me to exercise more and eat fewer carbs.
- SoftTalker 1y ago
  So you found a doctor to agree with your preconceived diagnosis and he's the one who is right, while the others were wrong?
  - deleted 1y ago
    [deleted]
  - collingreen 1y ago

csomar 1y ago

> Doctors make mistakes, often. You can and should challenge them. It is worse. Many doctors will administer against your interest if it boost their bottom line. There is, also, very little legal recourse against doctors.

0x1ceb00da 1y ago
This. Doctors have to work in a system. The hospitals are institutions that have quarterly quotas to hit, and they want doctors to maximize profit. How much the doctor will oblige depends on the individual doctors but the pressure is always there.

deleted 1y ago

[deleted]

paul_h 1y ago

Topical: "How I Built an Open Source AI Tool to Find My Autoimmune Disease (After $100k and 30+ Hospital Visits) - Now Available for Anyone to Use" --> https://www.reddit.com/r/OpenAI/comments/1ij6619/how_i_built_an_open_source_ai_tool_to_find_my/ https://www.reddit.com/r/OpenAI/comments/1ij6619/how_i_built... I'm in the UK. As well as doctors making mistakes, they can be under direction diagnosing critera. The UK has had a multi-year struggle for people with ME/CFS, (Myalgic Encephalomyelitis/Chronic Fatigue Syndrome). It falls under neurology in the UK, and a sub-chapter neuro-psychiatry has the ear of the national health service's supremos, and has historically entertained an "all in the mind" approach. I digress. Back to AI and medicine again: https://x.com/vipintukur/status/1931049593535627417 https://x.com/vipintukur/status/1931049593535627417 - insights can come from that quarter, and medicine is going to have to play catch up at times.