5 ms·

General doctors aren't trained for problem solving, they're trained for memorization. The doctors that are good at problem solving aren't general doctors.

by nomel 10mo ago

deleted 10mo ago
[deleted]
risyachka 10mo ago
This. I wouldn't be surprised if AI was better than going to GP or many other specialists in majority of cases. And the issue is not with the doctors themselves, but the complexity of human body. Like many digestive issues can cause migraines or a ton of other problems. I am yet to see when someone is referred to gut health professional because of the migraine. And a lot of similar cases when absolutely random system causes issues in seemingly unrelated system. A lot of these problems are not life threatening thus just get ignored as they would take too much effort and cost to pinpoint. AI on the other hand should be pretty good at figuring out those vague issues that you would never figured out otherwise.
- throwaway12093 10mo ago
  And speaking of migraines, even neurological causes can apparently be tricky: Around here, cluster headaches would go without proper diagnosis for about 10 years on average. In my case, it also took about 10 years and 3 very confused GPs before one would refer me to a neurologist who in turn would come up with the diagnosis in about 30 seconds.
- zimpenfish 10mo ago
  > AI on the other hand should be pretty good at figuring out those vague issues that you would never figured out otherwise. Not least because it almost certainly has orders of magnitude more data to work with than your average GP (who definitely doesn't have the time to keep up with reading all the papers and case studies you'd need to even approach a "full view".)
gmadsen 10mo ago
You still need 2 deviations above the average college student to get to med school. As a rough proxy for intelligence. The bottom threshold for doctors is certainly higher than lawyers
- HPsquared 10mo ago
  It doesn't matter how intelligent they are, if they only have 5 minutes to spend on your case.
- unsupp0rted 10mo ago
  [flagged]
  - kulahan 10mo ago
    Huh? So your complaint is that you keep getting black doctors? That’s dumb, but whatever - why not just… get a white doctor? Or Asian or whatever you think is the smart one?
    - unsupp0rted 10mo ago
      [flagged]
    - nomel 10mo ago
      This is where their perspective comes from: https://www.thecollegefix.com/med-schools-still-accept-black-students-with-lower-mcats-than-rejected-asians-whites https://www.thecollegefix.com/med-schools-still-accept-black... This has been going on for 20 years: https://pmc.ncbi.nlm.nih.gov/articles/PMC1120616/ https://pmc.ncbi.nlm.nih.gov/articles/PMC1120616/ Black students (among other minorities) with unacceptable MCAT (as in, if another race had them they would be rejected) are accepted, at a rate 6-10x more likely to be admitted with similar scores. The motivation is that doctors should match the demographic they treat, and minority doctors are underrepresented, so should be accepted at higher rates: https://www.uclahealth.org/news/article/clinical-outcomes-patients-surgeons-concordance https://www.uclahealth.org/news/article/clinical-outcomes-pa... The obvious outcome is that minorities students, being less prepared as measured by MCAT and somewhat setup for failure, have a much higher failure rate, with black students being 85% more likely to leave medical school than white: https://news.yale.edu/2023/07/31/black-md-phd-students-experience-higher-rates-attrition-peers https://news.yale.edu/2023/07/31/black-md-phd-students-exper... USMLE scores have been changed to pass/fail, to hide the actual score, to help prevent rejection of minority students who previously would have been rejected: https://n-age.org/wp-content/uploads/A-Test-of-Diversity-—-What-USMLE-Pass_Fail-Scoring-Means-for-Medicine.pdf https://n-age.org/wp-content/uploads/A-Test-of-Diversity-—-W... https://www.sciencedirect.com/science/article/abs/pii/S0090429524000098 https://www.sciencedirect.com/science/article/abs/pii/S00904... The system was, as is the stated goal by all, setup to pass minority students that would have previously been rejected, at every step of them becoming a doctor, to provide a net positive for minority populations, since it's accepted that you'll get the best outcome if your doctor is the same race as you.
davedx 10mo ago
It's an incentives issue, not a training issue
Fnoord 10mo ago
My current one sure as hell is. My previous one was, too. The one I had as kid, well. He was old, stuck in old ways, but I still think he was decent at it. But seeing the doctor is a bit more difficult these days, since the assistants are backstopping. They do some heavy lifting / screening. I think an LLM could help with symptoms and then looking at the most probable cause, but either way I wouldn't take it too serious. And that is the general issue with ML: people take the output too serious, at face value. What matters is: what are the cited sources?
lvl155 10mo ago
They’re not even trained for memorization. They’re trained for mitigation and I don’t really blame them for the crap pay they receive. Over the course of a 40-year career they basically make what a typical junior dev makes. It’s fast becoming a rich man’s hobby career.
- weatherlite 10mo ago
  What ? In most countries, including the U.S, they are a very highly paid profession (I'm not talking about the internship phase)
  - otabdeveloper4 10mo ago
    "Rich doctor" is a thing only in the U.S., and that's due to collusion and price fixing, not because American doctors are better somehow. In the rest of the world doctors are basically like white-collar car mechanics, and often earn less money and respect.
    - adventured 10mo ago
      That's false. One example: "According to the Government of Canada Job Bank, the median annual salary for a General Practitioner (GP) in Canada is $233,726 (CAD) as of January 23, 2024." That's roughly $170,000 in the US. If you adjust for anything reasonable, such as GDP per capita or median income between the US & Canada, that $170k figure matches up very well with the median US general practitioner figure of around $180k-$250k (sources differ, all tend to fall within that range). The GPs in Canada may in fact be slightly better paid than in the US.
      - otabdeveloper4 10mo ago
        Canada and the US is literally the same thing, obviously I didn't mean Canada.
    - weatherlite 10mo ago
      This is a reach. Can you share a few examples of Western countries where that is the case?
rl3 10mo ago
That's a sweeping generalization unsupported by facts. In reality you'll find the vast majority of GPs are highly intelligent and quite good at problem solving. In fact, I'd go so far as to say their training is so intensive and expansive that laypeople who make such comments are profoundly lacking in awareness on the topic. Physicians are still human, so like anything there's of course bad ones, specialists included. There's also healthcare systems with various degrees of dysfunction and incentives that don't necessarily align with the patient. None of that means GPs are somehow less competent at solving problems; not only is it an insult but it's ridiculous on the face of it.
- vidarh 10mo ago
  Maybe they are, but for most of my interactions with GP's in recent years, and several with specialists, for anything much beyond the very basics, I've had to educate them, and it didn't require much knowledge to exceeds theirs on specific conditions. In one case, a specialist made arguments that were trivially logically fallacious and went directly against the evidence from treatment outcomes. In other cases, sheer stupidity of pattern matching with rational thinking seemingly totally turned off. E.g. hearing I'd had a sinus infection for a long time, and insisting that this meant it was chronic and chronic meant the solution was steroids rather than antibiotic, despite a previous course having done nothing, and despite the fact that an antibiotic course had removed most of the symptoms both indicating the opposite - in the end, after bypassing my GP at the time and explaining and begging an advance nurse practitioner, I got two more courses of antibiotic and the infection finally fully went. I'm sure all of them could have done better, and that a lot of it is down to dysfunction, such as too little time allotted to actually look at things properly, but some of the interactions (the logical fallacy in particular) have also clearly been down to sheer ignorance. I also expect they'd eventually get there, but doing your own reading and guiding things in the right direction can often short-circuit a lot of bullshit that might even deliver good outcomes in a cost effective way on a population level (e.g. I'm sure the guidance on chronic sinus issues is right the vast majority of time - most bacterial sinus infections either clear by themselves or are stopped early enough not to "pattern match" as chronic), but might cause you lots of misery in the meantime...
markh1967 10mo ago
I can attest to this from personal experience. After undergoing stomach surgery 8 years ago I started experiencing completely debilitating stomach aches. I had many appointments with my GP and a specialist leading to endoscopies, colonoscopies, CAT scans, and MRI scans all to no avail and they just kept prescribing more and more anti-acids and stronger painkillers. It was after seven years of this that I paid for a private food allergy test to find that I am allergic to Soya protein. Once I stopped eating anything with Soya in it the symptoms almost completely vanished. At my next GP appointment I asked why no-one had suggested it could be an allergic reaction only to be told that it is not one of the things they check for or even suggest. My faith in the medical community took a bit of a knock that day. On a related note, I never knew just how many foods contain Soya flour that you wouldn't expect until I started checking.
- jacquesm 10mo ago
  Soy is in just about everything it is a staple food. You're unlucky, really. You're in good company though, it is one in three hundred or so.

General doctors aren't trained for problem solving, they're trained for memorization. The doctors that are good at problem solving aren't general doctors.

by nomel 10mo ago

General doctors aren't trained for problem solving, they're trained for memorization. The doctors that are good at problem solving aren't general doctors.

deleted 10mo ago

[deleted]

risyachka 10mo ago

This. I wouldn't be surprised if AI was better than going to GP or many other specialists in majority of cases. And the issue is not with the doctors themselves, but the complexity of human body. Like many digestive issues can cause migraines or a ton of other problems. I am yet to see when someone is referred to gut health professional because of the migraine. And a lot of similar cases when absolutely random system causes issues in seemingly unrelated system. A lot of these problems are not life threatening thus just get ignored as they would take too much effort and cost to pinpoint. AI on the other hand should be pretty good at figuring out those vague issues that you would never figured out otherwise.

throwaway12093 10mo ago
And speaking of migraines, even neurological causes can apparently be tricky: Around here, cluster headaches would go without proper diagnosis for about 10 years on average. In my case, it also took about 10 years and 3 very confused GPs before one would refer me to a neurologist who in turn would come up with the diagnosis in about 30 seconds.
zimpenfish 10mo ago
> AI on the other hand should be pretty good at figuring out those vague issues that you would never figured out otherwise. Not least because it almost certainly has orders of magnitude more data to work with than your average GP (who definitely doesn't have the time to keep up with reading all the papers and case studies you'd need to even approach a "full view".)

gmadsen 10mo ago

You still need 2 deviations above the average college student to get to med school. As a rough proxy for intelligence. The bottom threshold for doctors is certainly higher than lawyers

HPsquared 10mo ago
It doesn't matter how intelligent they are, if they only have 5 minutes to spend on your case.
unsupp0rted 10mo ago
[flagged]
- kulahan 10mo ago
  Huh? So your complaint is that you keep getting black doctors? That’s dumb, but whatever - why not just… get a white doctor? Or Asian or whatever you think is the smart one?
  - unsupp0rted 10mo ago
    [flagged]
  - nomel 10mo ago
    This is where their perspective comes from: https://www.thecollegefix.com/med-schools-still-accept-black-students-with-lower-mcats-than-rejected-asians-whites https://www.thecollegefix.com/med-schools-still-accept-black... This has been going on for 20 years: https://pmc.ncbi.nlm.nih.gov/articles/PMC1120616/ https://pmc.ncbi.nlm.nih.gov/articles/PMC1120616/ Black students (among other minorities) with unacceptable MCAT (as in, if another race had them they would be rejected) are accepted, at a rate 6-10x more likely to be admitted with similar scores. The motivation is that doctors should match the demographic they treat, and minority doctors are underrepresented, so should be accepted at higher rates: https://www.uclahealth.org/news/article/clinical-outcomes-patients-surgeons-concordance https://www.uclahealth.org/news/article/clinical-outcomes-pa... The obvious outcome is that minorities students, being less prepared as measured by MCAT and somewhat setup for failure, have a much higher failure rate, with black students being 85% more likely to leave medical school than white: https://news.yale.edu/2023/07/31/black-md-phd-students-experience-higher-rates-attrition-peers https://news.yale.edu/2023/07/31/black-md-phd-students-exper... USMLE scores have been changed to pass/fail, to hide the actual score, to help prevent rejection of minority students who previously would have been rejected: https://n-age.org/wp-content/uploads/A-Test-of-Diversity-—-What-USMLE-Pass_Fail-Scoring-Means-for-Medicine.pdf https://n-age.org/wp-content/uploads/A-Test-of-Diversity-—-W... https://www.sciencedirect.com/science/article/abs/pii/S0090429524000098 https://www.sciencedirect.com/science/article/abs/pii/S00904... The system was, as is the stated goal by all, setup to pass minority students that would have previously been rejected, at every step of them becoming a doctor, to provide a net positive for minority populations, since it's accepted that you'll get the best outcome if your doctor is the same race as you.

davedx 10mo ago

It's an incentives issue, not a training issue

Fnoord 10mo ago

My current one sure as hell is. My previous one was, too. The one I had as kid, well. He was old, stuck in old ways, but I still think he was decent at it. But seeing the doctor is a bit more difficult these days, since the assistants are backstopping. They do some heavy lifting / screening. I think an LLM could help with symptoms and then looking at the most probable cause, but either way I wouldn't take it too serious. And that is the general issue with ML: people take the output too serious, at face value. What matters is: what are the cited sources?

lvl155 10mo ago

They’re not even trained for memorization. They’re trained for mitigation and I don’t really blame them for the crap pay they receive. Over the course of a 40-year career they basically make what a typical junior dev makes. It’s fast becoming a rich man’s hobby career.

weatherlite 10mo ago
What ? In most countries, including the U.S, they are a very highly paid profession (I'm not talking about the internship phase)
- otabdeveloper4 10mo ago
  "Rich doctor" is a thing only in the U.S., and that's due to collusion and price fixing, not because American doctors are better somehow. In the rest of the world doctors are basically like white-collar car mechanics, and often earn less money and respect.
  - adventured 10mo ago
    That's false. One example: "According to the Government of Canada Job Bank, the median annual salary for a General Practitioner (GP) in Canada is $233,726 (CAD) as of January 23, 2024." That's roughly $170,000 in the US. If you adjust for anything reasonable, such as GDP per capita or median income between the US & Canada, that $170k figure matches up very well with the median US general practitioner figure of around $180k-$250k (sources differ, all tend to fall within that range). The GPs in Canada may in fact be slightly better paid than in the US.
    - otabdeveloper4 10mo ago
      Canada and the US is literally the same thing, obviously I didn't mean Canada.
  - weatherlite 10mo ago
    This is a reach. Can you share a few examples of Western countries where that is the case?

rl3 10mo ago

That's a sweeping generalization unsupported by facts. In reality you'll find the vast majority of GPs are highly intelligent and quite good at problem solving. In fact, I'd go so far as to say their training is so intensive and expansive that laypeople who make such comments are profoundly lacking in awareness on the topic. Physicians are still human, so like anything there's of course bad ones, specialists included. There's also healthcare systems with various degrees of dysfunction and incentives that don't necessarily align with the patient. None of that means GPs are somehow less competent at solving problems; not only is it an insult but it's ridiculous on the face of it.

vidarh 10mo ago
Maybe they are, but for most of my interactions with GP's in recent years, and several with specialists, for anything much beyond the very basics, I've had to educate them, and it didn't require much knowledge to exceeds theirs on specific conditions. In one case, a specialist made arguments that were trivially logically fallacious and went directly against the evidence from treatment outcomes. In other cases, sheer stupidity of pattern matching with rational thinking seemingly totally turned off. E.g. hearing I'd had a sinus infection for a long time, and insisting that this meant it was chronic and chronic meant the solution was steroids rather than antibiotic, despite a previous course having done nothing, and despite the fact that an antibiotic course had removed most of the symptoms both indicating the opposite - in the end, after bypassing my GP at the time and explaining and begging an advance nurse practitioner, I got two more courses of antibiotic and the infection finally fully went. I'm sure all of them could have done better, and that a lot of it is down to dysfunction, such as too little time allotted to actually look at things properly, but some of the interactions (the logical fallacy in particular) have also clearly been down to sheer ignorance. I also expect they'd eventually get there, but doing your own reading and guiding things in the right direction can often short-circuit a lot of bullshit that might even deliver good outcomes in a cost effective way on a population level (e.g. I'm sure the guidance on chronic sinus issues is right the vast majority of time - most bacterial sinus infections either clear by themselves or are stopped early enough not to "pattern match" as chronic), but might cause you lots of misery in the meantime...

markh1967 10mo ago

I can attest to this from personal experience. After undergoing stomach surgery 8 years ago I started experiencing completely debilitating stomach aches. I had many appointments with my GP and a specialist leading to endoscopies, colonoscopies, CAT scans, and MRI scans all to no avail and they just kept prescribing more and more anti-acids and stronger painkillers. It was after seven years of this that I paid for a private food allergy test to find that I am allergic to Soya protein. Once I stopped eating anything with Soya in it the symptoms almost completely vanished. At my next GP appointment I asked why no-one had suggested it could be an allergic reaction only to be told that it is not one of the things they check for or even suggest. My faith in the medical community took a bit of a knock that day. On a related note, I never knew just how many foods contain Soya flour that you wouldn't expect until I started checking.

jacquesm 10mo ago
Soy is in just about everything it is a staple food. You're unlucky, really. You're in good company though, it is one in three hundred or so.