4 ms·

I think the ultimate answer is that people must take responsibility for their own health and that of their children and loved ones. That includes research and d

by jtbayly 10mo ago

I think the ultimate answer is that people must take responsibility for their own health and that of their children and loved ones. That includes research and double-checking your doctors. True, the result is that a good number of people will be convinced they have something (eg. autism) that they don't. But the anecdotes are piled up into giant mountains at this point. A good number of people in my family have had at least one doctor that has been useless in dealing with a particular problem. It required trying to figure out what was wrong, then finding a doctor that could help before there were correct diagnoses and treatments.

mcny 10mo ago
But we are idiots. There's a reason why flour has iron and salt has iodine, right? Individual responsibility simply does not scale.
- nostrademons 10mo ago
  We are idiots who will bear the consequences of our own idiocy. The big issue with all transactions done under significant information asymmetry is moral hazard. The person performing the service has far less incentive to ensure a good outcome past the conclusion of the transaction than the person who lives with the outcome. Applies doubly now that many health care interactions are transactional and you won't even see the same doctor again. On a systemic level, the likely outcome is just that people who manage their health better will survive, while people who don't will die. Evolution in action. Managing your health means paying attention when something is wrong and seeking out the right specialist to fix it, while also discarding specialists who won't help you fix it.
  - estearum 10mo ago
    > We are idiots who will bear the consequences of our own idiocy This is just factually not true. Healthy people subsidize the unhealthy (even those made unhealthy by their own idiocy) to a truly absurd degree.
    - ericd 10mo ago
      Well, the biggest consequences aren't financial, they're losing your quality of life, or your life itself.
      - estearum 10mo ago
        Sure?
        ericd 10mo ago
        So they do end up bearing most of the brunt of their own decisions. But you're also right, it's not entirely on them.
        deleted 10mo ago
        [deleted]
      - SketchySeaBeast 10mo ago
        But the effects aren't just financial, look in an ER. People who for one reason or another haven't been able to take care of themselves in the emergency room for things that aren't an emergency, and it means your standard of care is going to take a hit.
        ericd 10mo ago
        Ah yeah, good point.
- smeej 10mo ago
  Neither does collective responsibility, for the same reason, particularly in any sort of representative government. Or did you expect people to pause being idiots as soon as they stepped into the ballot box to choose the people they wanted to have collective responsibility?
ethbr1 10mo ago
Patients should always advocate for their own care. This includes researching their own condition, looking into alternate diagnoses/treatments, discussing them with a physician, and potentially getting a second opinion. Especially the second opinion. There are good and bad physicians everywhere. But advocating also does not mean ignoring a physician's response. If they say it's unlikely to be X because of Y, consider what they're saying! Physicians are working from a deep well of experience in treating the most frequent problems, and some will be more or less curious about alternate hypotheses. When it comes down to it, House-style medical mysteries are mysteries because they're uncommon. For every "doc missed Lyme disease" story there are many more "it's just flu."
- qiine 10mo ago
  > Patients should always advocate for their own care. This includes researching their own condition I believe you do not fully appreciate how long and exhausting this is especially when sick...
  - pardon_me 10mo ago
    Nothing he stated suggests this. Not giving a nod to how difficult it is doesn't mean people don't care. Unfortunately it is still true, we all have to advocate for our own care and pay attention to ourselves. The fact that this negatively affects the people who need the most care and attention is a harrowing part of humanity we often gloss over.
    - ethbr1 10mo ago
      A boxing referee says "Protect yourself at all times." They do this not because it isn't their job to protect fighters from illegal blows, but because the consequences of illegal blows are sometimes unfixable. An encouragement for patients to co-own their own care isn't a removal of a physician's responsibility. It's an acknowledgement that (1) physicians are human, fallible, and not omniscient, (2) most health systems have imperfect information sync'ing across multiple parties, and (3) no one is going to care more about you than you (although others might be much more informed and capable). Self-advocacy isn't a requirement for good care -- it's due diligence and personal responsibility for a plan with serious consequences. If a doc misses a diagnosis and a patient didn't spend any effort themselves, is that solely the doctor's fault? PS to parent's insinuation: 20 years in the industry and 15 years of managed cancer in immediate family, but what do I know?
glenstein 10mo ago
>But the anecdotes are piled up into giant mountains at this point This is disorganized thinking. Anecdotes about what? Does my uncle having an argument with his doctor over needing more painkillers, combine with an anecdote about my sister disagreeing with a midwife over how big her baby would be, combined with my friend outliving their stage 4 cancer prognosis all add up to "therefore I'm going to disregard nutrition recommendations"? Even if they were all right and the doctors were all wrong, they still wouldn't aggregate in a particular direction the way that a study on processed foods does. And frankly it overlooks psychological and sociological dynamics that drive this kind of anecdotal reporting, which I think are more about tribal group emotional support in response to information complexity. In fact, reasoning from separate instances that are importantly factually different is a signature line of reasoning used by alien abduction conspiracy theorists. They treat the cultural phenomenon of "millions" of people reporting UFOs or abduction experiences over decades as "proof" of aliens writ large, when the truth is they are helplessly incompetent interpreters of social data.
- jtbayly 10mo ago
  You can tell me that I'm as crazy as people who believe they've been abducted, but I'm still going to be my own health advocate. :)
  - uncletaco 10mo ago
    They’re not saying you’re crazy they’re saying you may be helplessly incompetent when it comes to interpreting social data. You probably aren’t a good reader either if crazy was your takeaway.
  - BobaFloutist 10mo ago
    As of course you should be. Doctors, who are generally pretty caring and empathetic humans, try to invoke the mantra "You can't care about your patient's health more than they do" due to how deeply frustrating it is to try to treat someone who's not invested in the outcome. It's when "being your own health advocate" turns into "being your own doctor" that the system starts to break down.
- 10mo ago

by jtbayly 10mo ago

mcny 10mo ago

But we are idiots. There's a reason why flour has iron and salt has iodine, right? Individual responsibility simply does not scale.

nostrademons 10mo ago
We are idiots who will bear the consequences of our own idiocy. The big issue with all transactions done under significant information asymmetry is moral hazard. The person performing the service has far less incentive to ensure a good outcome past the conclusion of the transaction than the person who lives with the outcome. Applies doubly now that many health care interactions are transactional and you won't even see the same doctor again. On a systemic level, the likely outcome is just that people who manage their health better will survive, while people who don't will die. Evolution in action. Managing your health means paying attention when something is wrong and seeking out the right specialist to fix it, while also discarding specialists who won't help you fix it.
- estearum 10mo ago
  > We are idiots who will bear the consequences of our own idiocy This is just factually not true. Healthy people subsidize the unhealthy (even those made unhealthy by their own idiocy) to a truly absurd degree.
  - ericd 10mo ago
    Well, the biggest consequences aren't financial, they're losing your quality of life, or your life itself.
    - estearum 10mo ago
      Sure?
      - ericd 10mo ago
        So they do end up bearing most of the brunt of their own decisions. But you're also right, it's not entirely on them.
        deleted 10mo ago
        [deleted]
    - SketchySeaBeast 10mo ago
      But the effects aren't just financial, look in an ER. People who for one reason or another haven't been able to take care of themselves in the emergency room for things that aren't an emergency, and it means your standard of care is going to take a hit.
      - ericd 10mo ago
        Ah yeah, good point.
smeej 10mo ago
Neither does collective responsibility, for the same reason, particularly in any sort of representative government. Or did you expect people to pause being idiots as soon as they stepped into the ballot box to choose the people they wanted to have collective responsibility?

ethbr1 10mo ago

Patients should always advocate for their own care. This includes researching their own condition, looking into alternate diagnoses/treatments, discussing them with a physician, and potentially getting a second opinion. Especially the second opinion. There are good and bad physicians everywhere. But advocating also does not mean ignoring a physician's response. If they say it's unlikely to be X because of Y, consider what they're saying! Physicians are working from a deep well of experience in treating the most frequent problems, and some will be more or less curious about alternate hypotheses. When it comes down to it, House-style medical mysteries are mysteries because they're uncommon. For every "doc missed Lyme disease" story there are many more "it's just flu."

qiine 10mo ago
> Patients should always advocate for their own care. This includes researching their own condition I believe you do not fully appreciate how long and exhausting this is especially when sick...
- pardon_me 10mo ago
  Nothing he stated suggests this. Not giving a nod to how difficult it is doesn't mean people don't care. Unfortunately it is still true, we all have to advocate for our own care and pay attention to ourselves. The fact that this negatively affects the people who need the most care and attention is a harrowing part of humanity we often gloss over.
  - ethbr1 10mo ago
    A boxing referee says "Protect yourself at all times." They do this not because it isn't their job to protect fighters from illegal blows, but because the consequences of illegal blows are sometimes unfixable. An encouragement for patients to co-own their own care isn't a removal of a physician's responsibility. It's an acknowledgement that (1) physicians are human, fallible, and not omniscient, (2) most health systems have imperfect information sync'ing across multiple parties, and (3) no one is going to care more about you than you (although others might be much more informed and capable). Self-advocacy isn't a requirement for good care -- it's due diligence and personal responsibility for a plan with serious consequences. If a doc misses a diagnosis and a patient didn't spend any effort themselves, is that solely the doctor's fault? PS to parent's insinuation: 20 years in the industry and 15 years of managed cancer in immediate family, but what do I know?

glenstein 10mo ago

>But the anecdotes are piled up into giant mountains at this point This is disorganized thinking. Anecdotes about what? Does my uncle having an argument with his doctor over needing more painkillers, combine with an anecdote about my sister disagreeing with a midwife over how big her baby would be, combined with my friend outliving their stage 4 cancer prognosis all add up to "therefore I'm going to disregard nutrition recommendations"? Even if they were all right and the doctors were all wrong, they still wouldn't aggregate in a particular direction the way that a study on processed foods does. And frankly it overlooks psychological and sociological dynamics that drive this kind of anecdotal reporting, which I think are more about tribal group emotional support in response to information complexity. In fact, reasoning from separate instances that are importantly factually different is a signature line of reasoning used by alien abduction conspiracy theorists. They treat the cultural phenomenon of "millions" of people reporting UFOs or abduction experiences over decades as "proof" of aliens writ large, when the truth is they are helplessly incompetent interpreters of social data.

jtbayly 10mo ago
You can tell me that I'm as crazy as people who believe they've been abducted, but I'm still going to be my own health advocate. :)
- uncletaco 10mo ago
  They’re not saying you’re crazy they’re saying you may be helplessly incompetent when it comes to interpreting social data. You probably aren’t a good reader either if crazy was your takeaway.
- BobaFloutist 10mo ago
  As of course you should be. Doctors, who are generally pretty caring and empathetic humans, try to invoke the mantra "You can't care about your patient's health more than they do" due to how deeply frustrating it is to try to treat someone who's not invested in the outcome. It's when "being your own health advocate" turns into "being your own doctor" that the system starts to break down.
10mo ago