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> As a senior developer, 25+ years, I have been thrown recently into a meeting "hey can you join in for 5 mins". This is a common thing doctors complain about.

by josephg 6mo ago

> As a senior developer, 25+ years, I have been thrown recently into a meeting "hey can you join in for 5 mins". This is a common thing doctors complain about. Patients come in, saying they just need a prescription for some drug or other. Good doctors often refuse to give any drugs or any advice until they understand the whole situation properly. If you're a senior developer, you're the one who has to push back against behaviour you don't like. You have the authority. "Hm, interesting question. I'm going to need more context before I can give you my point of view. Can you give me a quick overview of the system architecture / explain what actual problems you're trying to solve with this approach?"

komali2 6mo ago
> Can you give me a quick overview of the system architecture I think what the OP is saying is that it's the OP's job to know that, and didn't, because they over leverage the LLM. Like if a doctor was brought in on a cardio consult on their patient because they had a maybe unrelated heart condition, and the only thing they could answer to "why did you prescribe cemidine instead of decimine" is "lemme get back to you on that."
ryandrake 6mo ago
> This is a common thing doctors complain about. Patients come in, saying they just need a prescription for some drug or other. Off topic, but this must be a USA-specific problem, where prescription drugs are actually marketed at Joe consumer. I think there is maybe one other country where this insane practice is allowed. Nowhere else are patients told to “Ask your doctor about Procrapin for your irritable bowl syndrome!!”
- bigthymer 6mo ago
  While prescription drug marketing to consumers is an issue in the US, I think the actual problem in this situation is people Googling their issue then coming to the doctor with the conclusion of their investigation instead of letting the doctor do the investigation themselves.
  - josephg 6mo ago
    Yeah. Especially in the era of doctor ChatGPT. Sometimes patients will also have an expired prescription from a different doctor, and they want a top-up. Good doctors check. Just because some other doctor prescribed some drug 3 months ago doesn't mean its actually the right choice, or the right choice now. Its not just a US thing. I have a few GP friends here in Australia. They complain about it too.
  - DauntingPear7 6mo ago
    i think this is large part due to the horrific healthcare system we have here in the US. I have personally witnessed family struggle to get help from doctors because they don't interact with a patient's health outside of immediate action items like filling a prescription, writing a summary, charting, writing a referral, etc. They spend 0 time looking into what could actually be wrong with them outside of their immediate knowledge/guess. I would like to think this is due to the shortage of doctors we have here (self inflicted) and the high demands we place on them. It really just sucks to be told to take some med, wait 3 months, and then have to communicate for them between doctors while filling out the same form 3 times.
    - abalashov 6mo ago
      You stole what I was about to write out from under me. This is exactly it.
- skrebbel 6mo ago
  > Procrapin Perfect
- terseus 6mo ago
  I don't know in other countries, but in Spain you definitely don't go to the doctor asking for anything more complex than a paracetamol. You tell the doctor your symptoms, he explores you and perform any tests considered appropriate, and the doctor decides the prescription.
  - sshine 6mo ago
    I also come from a country where the doctor decides the prescription. But you might have prior experience and preference. A friend of mine always asks "Hey, can you bring antibiotics back?" when I go on vacation somewhere where access is easier. Doctors here will give you a hard time if you want it. I think that's how it should be. But sometimes you know you need antibiotics.
- matheusmoreira 6mo ago
  It's not exclusive to the USA. Happens every single day here in Brazil too. Prescriptions expire, but people still need their medications, so they come in for routine consults. Good opportunity to reevaluate the patient and make adjustments if necessary.
- backwardsponcho 6mo ago
  While I'm sure the US has its quirks, this is not a US-only "problem" (not a health expert so I'm not sure if it's even a problem to begin with). I live in Norway and have heard from lots of people (coworkers, friends, acquaintances) that doctors are very reluctant to prescribing anything at all - the running joke is that they'll advise you to "get some fresh air and go for a walk" even if you just broke your leg in half
  - yuye 6mo ago
    >the running joke is that they'll advise you to "get some fresh air and go for a walk" even if you just broke your leg in half Same in the Netherlands. Except it's not a joke and I've met enough people who've suffered avoidable long-term effects by apathetic doctors, including yours truly.
  - stingraycharles 6mo ago
    In The Netherlands, the joke (mainly amongst expats), well actually frustration, is that they just send you home with some paracetamol and come back after two weeks if the complaints don’t stop. As someone from The Netherlands myself, I’m fairly frustrated with our healthcare system being like this, optimizing for GPs being the gatekeeper to the specialist healthcare system, and as such being super reluctant to actually help us. To be clear: one of my siblings is a GP and they themselves are frustrated by this as well but can’t change the system. It’s the half privatized / half socialized toxic combination that stings here. I had to go to another country to get some of my symptoms taken seriously. To be clear: no amount of “but I’ll pay myself for this study” helps. It’s just not possible. It’s super moronic. Never mind the fact that specialist healthcare is super distributed, without any central oversight, and you have to behave like your own project manager when you’re being taken care of. Healthcare is a mess in most of the developed world, probably because it’s incredibly expensive.
stingraycharles 6mo ago
> If you're a senior developer, you're the one who has to push back against behaviour you don't like. You have the authority. Not just that, but it seems like the grandparent had issues understanding what they were talking about. This is absolutely fine, and they should have just asked to continue explaining more until the problem was fully understood. It’s obvious your opinion is important, but it’s not worth a lot if you don’t understand what the actual problem is. Also, I personally don’t like to appeal to authority (not sure if that is what you meant), and instead just use the Socratic method to keep asking questions until they themselves understand the weaknesses. It’s a very friendly way of doing things.
lelanthran 6mo ago
> If you're a senior developer, you're the one who has to push back against behaviour you don't like. You have the authority. "Hm, interesting question. I'm going to need more context before I can give you my point of view. Can you give me a quick overview of the system architecture / explain what actual problems you're trying to solve with this approach?" One of us misunderstood the GP; I understood him to mean that, because he did not write the code, he was not able to answer the questions based on that code. You seem to think he meant that he could not answer questions on someone else's code.
- deleted 6mo ago
  [deleted]

by josephg 6mo ago

komali2 6mo ago

> Can you give me a quick overview of the system architecture I think what the OP is saying is that it's the OP's job to know that, and didn't, because they over leverage the LLM. Like if a doctor was brought in on a cardio consult on their patient because they had a maybe unrelated heart condition, and the only thing they could answer to "why did you prescribe cemidine instead of decimine" is "lemme get back to you on that."

ryandrake 6mo ago

> This is a common thing doctors complain about. Patients come in, saying they just need a prescription for some drug or other. Off topic, but this must be a USA-specific problem, where prescription drugs are actually marketed at Joe consumer. I think there is maybe one other country where this insane practice is allowed. Nowhere else are patients told to “Ask your doctor about Procrapin for your irritable bowl syndrome!!”

bigthymer 6mo ago
While prescription drug marketing to consumers is an issue in the US, I think the actual problem in this situation is people Googling their issue then coming to the doctor with the conclusion of their investigation instead of letting the doctor do the investigation themselves.
- josephg 6mo ago
  Yeah. Especially in the era of doctor ChatGPT. Sometimes patients will also have an expired prescription from a different doctor, and they want a top-up. Good doctors check. Just because some other doctor prescribed some drug 3 months ago doesn't mean its actually the right choice, or the right choice now. Its not just a US thing. I have a few GP friends here in Australia. They complain about it too.
- DauntingPear7 6mo ago
  i think this is large part due to the horrific healthcare system we have here in the US. I have personally witnessed family struggle to get help from doctors because they don't interact with a patient's health outside of immediate action items like filling a prescription, writing a summary, charting, writing a referral, etc. They spend 0 time looking into what could actually be wrong with them outside of their immediate knowledge/guess. I would like to think this is due to the shortage of doctors we have here (self inflicted) and the high demands we place on them. It really just sucks to be told to take some med, wait 3 months, and then have to communicate for them between doctors while filling out the same form 3 times.
  - abalashov 6mo ago
    You stole what I was about to write out from under me. This is exactly it.
skrebbel 6mo ago
> Procrapin Perfect
terseus 6mo ago
I don't know in other countries, but in Spain you definitely don't go to the doctor asking for anything more complex than a paracetamol. You tell the doctor your symptoms, he explores you and perform any tests considered appropriate, and the doctor decides the prescription.
- sshine 6mo ago
  I also come from a country where the doctor decides the prescription. But you might have prior experience and preference. A friend of mine always asks "Hey, can you bring antibiotics back?" when I go on vacation somewhere where access is easier. Doctors here will give you a hard time if you want it. I think that's how it should be. But sometimes you know you need antibiotics.
matheusmoreira 6mo ago
It's not exclusive to the USA. Happens every single day here in Brazil too. Prescriptions expire, but people still need their medications, so they come in for routine consults. Good opportunity to reevaluate the patient and make adjustments if necessary.
backwardsponcho 6mo ago
While I'm sure the US has its quirks, this is not a US-only "problem" (not a health expert so I'm not sure if it's even a problem to begin with). I live in Norway and have heard from lots of people (coworkers, friends, acquaintances) that doctors are very reluctant to prescribing anything at all - the running joke is that they'll advise you to "get some fresh air and go for a walk" even if you just broke your leg in half
- yuye 6mo ago
  >the running joke is that they'll advise you to "get some fresh air and go for a walk" even if you just broke your leg in half Same in the Netherlands. Except it's not a joke and I've met enough people who've suffered avoidable long-term effects by apathetic doctors, including yours truly.
- stingraycharles 6mo ago
  In The Netherlands, the joke (mainly amongst expats), well actually frustration, is that they just send you home with some paracetamol and come back after two weeks if the complaints don’t stop. As someone from The Netherlands myself, I’m fairly frustrated with our healthcare system being like this, optimizing for GPs being the gatekeeper to the specialist healthcare system, and as such being super reluctant to actually help us. To be clear: one of my siblings is a GP and they themselves are frustrated by this as well but can’t change the system. It’s the half privatized / half socialized toxic combination that stings here. I had to go to another country to get some of my symptoms taken seriously. To be clear: no amount of “but I’ll pay myself for this study” helps. It’s just not possible. It’s super moronic. Never mind the fact that specialist healthcare is super distributed, without any central oversight, and you have to behave like your own project manager when you’re being taken care of. Healthcare is a mess in most of the developed world, probably because it’s incredibly expensive.

stingraycharles 6mo ago

> If you're a senior developer, you're the one who has to push back against behaviour you don't like. You have the authority. Not just that, but it seems like the grandparent had issues understanding what they were talking about. This is absolutely fine, and they should have just asked to continue explaining more until the problem was fully understood. It’s obvious your opinion is important, but it’s not worth a lot if you don’t understand what the actual problem is. Also, I personally don’t like to appeal to authority (not sure if that is what you meant), and instead just use the Socratic method to keep asking questions until they themselves understand the weaknesses. It’s a very friendly way of doing things.

lelanthran 6mo ago

> If you're a senior developer, you're the one who has to push back against behaviour you don't like. You have the authority. "Hm, interesting question. I'm going to need more context before I can give you my point of view. Can you give me a quick overview of the system architecture / explain what actual problems you're trying to solve with this approach?" One of us misunderstood the GP; I understood him to mean that, because he did not write the code, he was not able to answer the questions based on that code. You seem to think he meant that he could not answer questions on someone else's code.

deleted 6mo ago
[deleted]