4 ms·

> if I wasn't asking ChatGPT, where would I go to get help? To an MD?

by hermanzegerman 10mo ago

cyral 10mo ago
Getting a potential answer right away is certainly temping over waiting weeks to get an appointment
- hermanzegerman 10mo ago
  You have to wait weeks to be seen by a family doctor?
  - hephaes7us 10mo ago
    If the GP can handle my problem, I probably didn't need to go to the doctor anyway. A lot of care is done by specialists, and it can _easily_ take weeks or months to get an appointment with one. This is strongly dependent on one's insurance network though.
    - hermanzegerman 10mo ago
      That's just a very arrogant take, from many patients that couldn't be more wrong. Obviously a GP refers to specialists when necessary, but he is qualified to triage issues and perform initial treatment in many cases.
      - hephaes7us 10mo ago
        Ok, to be fair, they _can_ probably handle my problems better than I can. But, presumably for liability and out of a genuine attempt to get me the best care possible, they _prefer_ to send me off to a specialist. Either way I'm not being treated until the specialist has time, which take a couple months at least.
  - Flere-Imsaho 10mo ago
    In the uk, yes. And then 6⁺ months to be seen be a specialist.
  - davidmurdoch 10mo ago
    In the US, yes.
  - cyral 10mo ago
    Yes, in my area if you need to find a new doctor you literally can't. This is a major city. The online booking for any major hospital network literally shows no results because the next appointment would be 90+ days out. If you have an existing relationship maybe you can get in in two weeks.
tombert 10mo ago
If the symptoms are severe enough, sure. For better worse, even before the advent of LLMs, people were simply Googling whatever their symptoms were and finding a WebMD or MayoClinic page. Well, if they were lucky. If they weren't lucky, they would find some idiotic blog post by someone who claimed that they cured their sleep apnea by drinking cabbage juice.
vasusen 10mo ago
Under non-urgent cases this sometimes takes 3-4 months in the US every time I experience the need to "ask an MD"
silotis 10mo ago
Unless you're paying for a concierge doctor, MDs frequently will not spend the time to give you useful advice. Especially for relatively minor issues.
- hermanzegerman 10mo ago
  I've googled what a "concierge doctor" is, and it just sounds like a fancy term for a family doctor.
  - vanc_cefepime 10mo ago
    It’s a physician who gets paid a subscription by a small panel of patients. Pros: more time spent with patients, access to a physician basically 24/7, sometimes included are other amenities (labs, imaging, sometimes access to rx at doctors office for simple generics, gym discounts, eye doctor discounts, etc) Cons: it’s an extra cost to get access to that physician yearly ranging from a few hundred US dollars per year to sometimes thousands $1.5k-3k (or tens of thousands or more), those who aren’t financially lucky to be that well off don’t get such access. —- That said, some of us do this on the side to augment our salary a bit as medicine has become too much of a business based on quantity and not quality. Sad that I hear from patients that said a simple small town family doc like myself can spent 20-30mins with a patient when other providers barely spend 3 mins. My regular patients get usually 20-30mins with me on a visit unless it’s a quick one for refills and I don’t leave until they are done and have no questions. My concierge patients get 1 hour minimum and longer if they like. I offer free in-depth medical record review where I get sometimes boxes of old records to review someone’s med history if they are a new concierge patient. Had a lady recently deal with neuropathy and paresthesias for years. Normal blood counts. Long story short. She had moderate iron deficiency and vitamin b 6 deficiency from history of taking isoniazid in a different country for TB and biopsy proven celiac disease. Neuropathy basically gone with iron and b6 supplements and a celiac diet after I recommended a GI eval for endoscopy. It takes time to dig into charts like this and CMS doesn’t pay the bills to keep the clinic lights open to see patients like that all the time and this is why we are in such a bad place healthcare wise in the USA were we have chosen quality than quantity and the powers that be are number crunchers and not actual health care providers. It serves us right for let’s admins take over and we are all paying the price. So much more I want to say but I don’t think many will read this. But if you read this and don’t like your doctor, please look around. There are still some of us out there that care about quality medicine and do try our best to spend time with the patient. If you got one of those “3 minute doctors” look for one or consider establishing care with a resident clinic at an academic center were you can be seen by resident doctors and their attending physicians. It’s not the most efficient but can almost guarantee those resident physicians will spend a good chunk of time with you to help you as much as they can.
tgma 10mo ago
soon(?) mostly a proxy for LLM
drusepth 10mo ago
This isn't feasible for a huge swathe of the USA, often because of costs/insurance but sometimes literally just accessibility/availability. A few years ago it took me nearly 8 months to find a PCP in my city that was accepting new patients (and, wee, they dropped my insurance less than a year after).
- blipvert 10mo ago
  Maybe time to ask AI why you’re looking for a technical solution rather than addressing the gaslighting that has left you with such piss-poor medical care in the richest country on earth?
  - thunky 10mo ago
    Already know the answer, don't need AI for that one.
  - AstroBen 10mo ago
    Everyone knows this is a problem. No-one it effects has enough power to change it
  - simianwords 10mo ago
    Maybe time to use a genuinely useful tech instead of trying to solve an actual hard problem by handwaving difficult problems?
    - ndsipa_pomu 10mo ago
      Seems to me like the "difficult problem" is solved in pretty much every other rich country in the world.
      - simianwords 10mo ago
        if its not solved in the richest country maybe its not so easy to solve unless you want to hand wave the diffuclt parts and just describe it as "rich people being greedy"
tnel77 10mo ago
While you are technically correct, we live in the real world. People are busy and/or broke. Many cannot afford to go to the doctor every time they get the sniffles or have a question. Doing some preliminary research is fine and, I’d argue, responsible.

> if I wasn't asking ChatGPT, where would I go to get help? To an MD?

cyral 10mo ago

Getting a potential answer right away is certainly temping over waiting weeks to get an appointment

hermanzegerman 10mo ago
You have to wait weeks to be seen by a family doctor?
- hephaes7us 10mo ago
  If the GP can handle my problem, I probably didn't need to go to the doctor anyway. A lot of care is done by specialists, and it can _easily_ take weeks or months to get an appointment with one. This is strongly dependent on one's insurance network though.
  - hermanzegerman 10mo ago
    That's just a very arrogant take, from many patients that couldn't be more wrong. Obviously a GP refers to specialists when necessary, but he is qualified to triage issues and perform initial treatment in many cases.
    - hephaes7us 10mo ago
      Ok, to be fair, they _can_ probably handle my problems better than I can. But, presumably for liability and out of a genuine attempt to get me the best care possible, they _prefer_ to send me off to a specialist. Either way I'm not being treated until the specialist has time, which take a couple months at least.
- Flere-Imsaho 10mo ago
  In the uk, yes. And then 6⁺ months to be seen be a specialist.
- davidmurdoch 10mo ago
  In the US, yes.
- cyral 10mo ago
  Yes, in my area if you need to find a new doctor you literally can't. This is a major city. The online booking for any major hospital network literally shows no results because the next appointment would be 90+ days out. If you have an existing relationship maybe you can get in in two weeks.

tombert 10mo ago

If the symptoms are severe enough, sure. For better worse, even before the advent of LLMs, people were simply Googling whatever their symptoms were and finding a WebMD or MayoClinic page. Well, if they were lucky. If they weren't lucky, they would find some idiotic blog post by someone who claimed that they cured their sleep apnea by drinking cabbage juice.

vasusen 10mo ago

Under non-urgent cases this sometimes takes 3-4 months in the US every time I experience the need to "ask an MD"

silotis 10mo ago

Unless you're paying for a concierge doctor, MDs frequently will not spend the time to give you useful advice. Especially for relatively minor issues.

hermanzegerman 10mo ago
I've googled what a "concierge doctor" is, and it just sounds like a fancy term for a family doctor.
- vanc_cefepime 10mo ago
  It’s a physician who gets paid a subscription by a small panel of patients. Pros: more time spent with patients, access to a physician basically 24/7, sometimes included are other amenities (labs, imaging, sometimes access to rx at doctors office for simple generics, gym discounts, eye doctor discounts, etc) Cons: it’s an extra cost to get access to that physician yearly ranging from a few hundred US dollars per year to sometimes thousands $1.5k-3k (or tens of thousands or more), those who aren’t financially lucky to be that well off don’t get such access. —- That said, some of us do this on the side to augment our salary a bit as medicine has become too much of a business based on quantity and not quality. Sad that I hear from patients that said a simple small town family doc like myself can spent 20-30mins with a patient when other providers barely spend 3 mins. My regular patients get usually 20-30mins with me on a visit unless it’s a quick one for refills and I don’t leave until they are done and have no questions. My concierge patients get 1 hour minimum and longer if they like. I offer free in-depth medical record review where I get sometimes boxes of old records to review someone’s med history if they are a new concierge patient. Had a lady recently deal with neuropathy and paresthesias for years. Normal blood counts. Long story short. She had moderate iron deficiency and vitamin b 6 deficiency from history of taking isoniazid in a different country for TB and biopsy proven celiac disease. Neuropathy basically gone with iron and b6 supplements and a celiac diet after I recommended a GI eval for endoscopy. It takes time to dig into charts like this and CMS doesn’t pay the bills to keep the clinic lights open to see patients like that all the time and this is why we are in such a bad place healthcare wise in the USA were we have chosen quality than quantity and the powers that be are number crunchers and not actual health care providers. It serves us right for let’s admins take over and we are all paying the price. So much more I want to say but I don’t think many will read this. But if you read this and don’t like your doctor, please look around. There are still some of us out there that care about quality medicine and do try our best to spend time with the patient. If you got one of those “3 minute doctors” look for one or consider establishing care with a resident clinic at an academic center were you can be seen by resident doctors and their attending physicians. It’s not the most efficient but can almost guarantee those resident physicians will spend a good chunk of time with you to help you as much as they can.

tgma 10mo ago

soon(?) mostly a proxy for LLM

drusepth 10mo ago

This isn't feasible for a huge swathe of the USA, often because of costs/insurance but sometimes literally just accessibility/availability. A few years ago it took me nearly 8 months to find a PCP in my city that was accepting new patients (and, wee, they dropped my insurance less than a year after).

blipvert 10mo ago
Maybe time to ask AI why you’re looking for a technical solution rather than addressing the gaslighting that has left you with such piss-poor medical care in the richest country on earth?
- thunky 10mo ago
  Already know the answer, don't need AI for that one.
- AstroBen 10mo ago
  Everyone knows this is a problem. No-one it effects has enough power to change it
- simianwords 10mo ago
  Maybe time to use a genuinely useful tech instead of trying to solve an actual hard problem by handwaving difficult problems?
  - ndsipa_pomu 10mo ago
    Seems to me like the "difficult problem" is solved in pretty much every other rich country in the world.
    - simianwords 10mo ago
      if its not solved in the richest country maybe its not so easy to solve unless you want to hand wave the diffuclt parts and just describe it as "rich people being greedy"

tnel77 10mo ago

While you are technically correct, we live in the real world. People are busy and/or broke. Many cannot afford to go to the doctor every time they get the sniffles or have a question. Doing some preliminary research is fine and, I’d argue, responsible.