4 ms·

Most people have the belief that since you have an MD you are near god like. Few realize the large number of bad/average doctors & surgeons are out there. It

Most people have the belief that since you have an MD you are near god like. Few realize the large number of bad/average doctors & surgeons are out there. It would be great if there was published performance reviews for every time of doctor, including your primary care doc. Practically everyone on HN programs, but few came from MIT, work at Google, or could write a paper that would make Carmack question his choices. Think of programmers you have met that aren't self motivated or continually improving their craft. It's exactly the same with doctors. Some just get their degree (which albeit is a lot of work and money) and never self improve. They can be swayed by drug companies who give them a nice dinner without really understanding what they are prescribing or why. They do the bare minimum to get their CME and select the easiest path to get there. If you have something serious, that may or may not require surgery, it is in your best interest to seek out the absolute best you can afford. Look for institutions that get ranked high for those diseases/injuries which produce a lot of research on the subject. You are a startup and looking to hire a programmer, which do you select: * Guy who learned PHP 4 and has been writing everything in Dreamweaver since without changing * Guy who learns Go/Scala etc and enjoys reading other's research, * Guy who wrote Go/Scala etc You are someone sick and need advice/treatment: * MD who graduated from South Dakota State (no idea of they are bad/good, sorry SD) and practices in a town of 5,000 people * MD who works at a ranked institution and is always looking for the best treatment after evaluating new research * MD who invented the surgery There are obviously many shades in between... but treat your MD like you would a programmer you want to hire. It's not easy to figure that stuff out of course, but do your best in researching them. If you can't find much stuff on the MD/hospital then be cautious/take another opinion. The above is based on my wife's experience in 4 different ranked hospitals in major cities dealing with patients coming in from unranked hospitals who often was doing stuff out of date/not efficient or flat out got stuff wrong/harmed the patient. PS: For your furry friends, this is much harder as vet clinics arent ranked and typically your only choice is a ranked teaching vet hospital. Quiz your vet on where they got their degree and what conferences they attended this past year (this won't mean much other than they are actively seeking out new methods/research) You increase your chances of getting a good vet vs old Dr Bob who still ties the horse to the fence post. Look for a Vet from UC Davis if your are in the bay area.

nnq 13y ago
It doesn't work like that in the medical profession, MD's in general don't have the professional mobility of programmers, nowhere in the world, and surgeons have even less such mobility. You can have very skilled guys at "provincial" hospitals, either because they are stuck there or because the small town hospital actually gives them special incentives to stay there. It's less likely, but the probabilities have a very odd distribution varying from country to country so it's nothing near as easy to reason about as programmers. And at a university hospital, your life can end up in the hands of a very very smart surgeon-researcher with tens of published papers that may have revolutionized the entire field he works in and got him very highly ranked, but that super-surgeon-researcher might actually have quite poor surgical practical skills (think dexterity/speed) and although you may get a lower chance of complications in the end, you will mostly get it because of a better hospital with better post op care. DON'T compare healthcare with programming, or even with other "normal" professions where you can easily rank professionals... everything is complicated and "opaque" and medical professionals make as much as possibles to prop each other and "leak" as little information as possible to the patients and general population. Also, in surgery "a better surgeon" != "a smarter surgeon" != "a better educated surgeon". It's a complicated function of "natural talent", "capacity for performance under heavy workload", "motivation", experience, education and IQ (and unlike programming, here the last two factors tend to be least important imho, at least if they are above a certain threshold).

nnq 13y ago

It doesn't work like that in the medical profession, MD's in general don't have the professional mobility of programmers, nowhere in the world, and surgeons have even less such mobility. You can have very skilled guys at "provincial" hospitals, either because they are stuck there or because the small town hospital actually gives them special incentives to stay there. It's less likely, but the probabilities have a very odd distribution varying from country to country so it's nothing near as easy to reason about as programmers. And at a university hospital, your life can end up in the hands of a very very smart surgeon-researcher with tens of published papers that may have revolutionized the entire field he works in and got him very highly ranked, but that super-surgeon-researcher might actually have quite poor surgical practical skills (think dexterity/speed) and although you may get a lower chance of complications in the end, you will mostly get it because of a better hospital with better post op care. DON'T compare healthcare with programming, or even with other "normal" professions where you can easily rank professionals... everything is complicated and "opaque" and medical professionals make as much as possibles to prop each other and "leak" as little information as possible to the patients and general population. Also, in surgery "a better surgeon" != "a smarter surgeon" != "a better educated surgeon". It's a complicated function of "natural talent", "capacity for performance under heavy workload", "motivation", experience, education and IQ (and unlike programming, here the last two factors tend to be least important imho, at least if they are above a certain threshold).