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> Are we're all so afraid of our own shadow that heroes at the FDA need to protect us? Hi, physician here. No, that's not why you need the FDA. You need the F

> Are we're all so afraid of our own shadow that heroes at the FDA need to protect us? Hi, physician here. No, that's not why you need the FDA. You need the FDA to protect you for all sorts of reasons. It is not possible for a non-physician to be an informed healthcare consumer. Everything from not marketing methamphetamine to high school students, to ensuring your brain doesn't get cooked by a bug in a CT scanner's software. There are a lot of ways to die. But on a scale of 1 to 10, death is an 8. Wait till it's your kid. I had a conversation with a libertarian friend of mine recently: Me: "If you like libertarianism so much, why not just move to Somalia?" Him: "Hey, just make sure you're the one with an AK" Me: "Who's standing watch when you sleep? Where are they looking?"

COMS 13y ago
How does Somalia represent classical liberalism? (If you assume that libertarianism is a subset of classical liberalism.) Also, how does saying that the federal government doesn't have the authority to create the FDA or manage healthcare imply that I'm against traffic lights? (To reference another commonly said argument.) I like the FDA and federal healthcare services but I believe, technically, there should be an amendment to the Constitution for them to exist.
IanDrake 13y ago
>It is not possible for a non-physician to be an informed healthcare consumer. Are you sure, because I used webMD to diagnose my spontaneous pneumothorax. Went to the clinic told them as much, they laughed. Finally ended up doing a chest x-ray after which a very stern faced doc walked up to me and said, "Sorry, we've never seen this here before. You need to go to the hospital right now." That was the longer part of the story about the ct scan which was done post-recovery to look for blebs.
- ogreyonder 13y ago
  Same thing here. Personal story short, I discovered--thanks to the internet--that having hypothyroidosis and taking L-Carnitine [1] can cause rhabdomyolysis and acute kidney damage. 3 doctors completely missed huge warning signs and prescribed strong antibiotics in spite of the fact that there was no evidence of infection. It was only thanks to my being an informed healthcare consumer that I prevented a very bad weekend. I think it's possible for non-physicians to make informed decisions. I would also say that many want to have someone to blame. In my case, though, blaming someone doesn't help much when your kidneys die. I'd argue that a $100 DNA test is not a diagnosis tool. It's like a friend looking at your skin and saying 'hey, you should get that mole checked out'. [1] In the form of Pantothen, the "Natural Acne Cure". Yeah.
  - aaronem 13y ago
    >I'd argue that a $100 DNA test is not a diagnosis tool. I'd argue the same. But that's not in the slightest how 23andme presents itself.
- jasonlotito 13y ago
  Your story only reinforces his point. You still went to the hospital. You still had test and what not done. Sure , you were informed about a specific part, but after that, you went to professionals you trusted.
- oijaf888 13y ago
  Marfans Syndrome?
aaronem 13y ago
> It is not possible for a non-physician to be an informed healthcare consumer. I never fail to find myself astonished that people in a highly technical field, which is extremely refractory to the layman, nonetheless commonly feel themselves perfectly competent to operate in another highly technical field, entirely orthogonal to their own. The Renaissance man, made obsolete by complexity, is one with history; specialization is the order of the day. There is no controversy in the statement that not everyone is, or can be, equipped to serve as his own programmer or systems administrator; indeed, the very existence of the field in which most of us find our vocation suffices to demonstrate that fact. Yet many of these very same people consider the mere suggestion, that the same should be true of the field of medicine, as nigh unto an insult direct -- as though it carried some imputation of essential incompetence, rather than being a statement of trivially evident fact. I despair of ever understanding why this should be, live however long I might.
cperciva 13y ago
> It is not possible for a non-physician to be an informed healthcare consumer It's also not possible for a physician to be informed about every possible condition. I have type 1 diabetes, and I know a lot more about it than my GP does -- odds are she's only going to see a handful of T1Ds in her career. When I'm talking to her about my diabetes, I'm educating her rather than vice versa. (So she sends me to an endocrinologist, and he's as far ahead of me as my GP is behind me in knowledge of diabetes.)
- niels_olson 13y ago
  > It's also not possible for a physician to be informed about every possible condition. You are absolutely right. The one thing we definitely know is that we're still a long ways off from even having the books written on it all, let alone any one human having even majority of the information in their brain. I'm in pathology, sort of the end of the diagnostic road. We have the molecular tests and microscopes. And we still don't know. In fact, we're best positioned to see the vast ocean of unknown before us. We can't even see the other side. Sorry to hear about the diagnosis, you've done extraordinary things despite it and I hope more patients can emulate your success. I am constantly educated by my patients. You're not Canadian, are you? The GP vs endocrinologist issue is actually well-studied there. Unsurprisingly, the specialist-treated patients fair better.
  - cperciva 13y ago
    Yes, I am Canadian -- although I had the luck to be diagnosed while I was at Oxford. Having one of the world's leading research institutions in the field (OCDEM) in your back yard helps a lot where clinical care is concerned...
sirsar 13y ago
>"If you like libertarianism so much, why not just move to Somalia?" This is a bit offtopic, but how about "because it was terrible before the collapse of their government, and still is terrible?"
- jellicle 13y ago
  No, it's an excellent, beautiful place. Because it has no government, and therefore must be, by libertarian definition. Don't you understand? There is no Somalian FDA - which means all you have to do if you want to consume safe food or drugs is to enlist a local food and drug testing company to test things on your behalf. Perfect capitalism! No government interference! And yet libertarians don't move there. It's baffling. Every single U.S. libertarian talks a great game, but not one of them is willing to put their money where their mouth is.
  - mseebach 13y ago
    Just like North Korea. It's a perfect, magical place. Confiscatory taxes and monetary policy ensures near perfect equality. Full employment. Free government health care. All state run media, no Murdochs or FOX News. All businesses run by the state, no exploitation. The lowest domestic carbon emissions in the industrialised world. A vibrant cultural scene that is free of corrupting American imperialistic influences. And yet leftists don't move there. It's baffling. Every single U.S. big government liberal talks a great game, but not one of them is willing to put their money where their mouth is.
    - mikeash 13y ago
      That is actually a great argument to use on anyone who espouses the virtues of a totalitarian, all-controlling state. The difference is that you can actually find people with some frequency who espouse the virtues of extremely small or entirely absent government, while it's pretty hard to find someone who espouses the virtues of a totalitarian, all-controlling state.
      - 13y ago

COMS 13y ago

How does Somalia represent classical liberalism? (If you assume that libertarianism is a subset of classical liberalism.) Also, how does saying that the federal government doesn't have the authority to create the FDA or manage healthcare imply that I'm against traffic lights? (To reference another commonly said argument.) I like the FDA and federal healthcare services but I believe, technically, there should be an amendment to the Constitution for them to exist.

IanDrake 13y ago

>It is not possible for a non-physician to be an informed healthcare consumer. Are you sure, because I used webMD to diagnose my spontaneous pneumothorax. Went to the clinic told them as much, they laughed. Finally ended up doing a chest x-ray after which a very stern faced doc walked up to me and said, "Sorry, we've never seen this here before. You need to go to the hospital right now." That was the longer part of the story about the ct scan which was done post-recovery to look for blebs.

ogreyonder 13y ago
Same thing here. Personal story short, I discovered--thanks to the internet--that having hypothyroidosis and taking L-Carnitine [1] can cause rhabdomyolysis and acute kidney damage. 3 doctors completely missed huge warning signs and prescribed strong antibiotics in spite of the fact that there was no evidence of infection. It was only thanks to my being an informed healthcare consumer that I prevented a very bad weekend. I think it's possible for non-physicians to make informed decisions. I would also say that many want to have someone to blame. In my case, though, blaming someone doesn't help much when your kidneys die. I'd argue that a $100 DNA test is not a diagnosis tool. It's like a friend looking at your skin and saying 'hey, you should get that mole checked out'. [1] In the form of Pantothen, the "Natural Acne Cure". Yeah.
- aaronem 13y ago
  >I'd argue that a $100 DNA test is not a diagnosis tool. I'd argue the same. But that's not in the slightest how 23andme presents itself.
jasonlotito 13y ago
Your story only reinforces his point. You still went to the hospital. You still had test and what not done. Sure , you were informed about a specific part, but after that, you went to professionals you trusted.
oijaf888 13y ago
Marfans Syndrome?

aaronem 13y ago

> It is not possible for a non-physician to be an informed healthcare consumer. I never fail to find myself astonished that people in a highly technical field, which is extremely refractory to the layman, nonetheless commonly feel themselves perfectly competent to operate in another highly technical field, entirely orthogonal to their own. The Renaissance man, made obsolete by complexity, is one with history; specialization is the order of the day. There is no controversy in the statement that not everyone is, or can be, equipped to serve as his own programmer or systems administrator; indeed, the very existence of the field in which most of us find our vocation suffices to demonstrate that fact. Yet many of these very same people consider the mere suggestion, that the same should be true of the field of medicine, as nigh unto an insult direct -- as though it carried some imputation of essential incompetence, rather than being a statement of trivially evident fact. I despair of ever understanding why this should be, live however long I might.

cperciva 13y ago

> It is not possible for a non-physician to be an informed healthcare consumer It's also not possible for a physician to be informed about every possible condition. I have type 1 diabetes, and I know a lot more about it than my GP does -- odds are she's only going to see a handful of T1Ds in her career. When I'm talking to her about my diabetes, I'm educating her rather than vice versa. (So she sends me to an endocrinologist, and he's as far ahead of me as my GP is behind me in knowledge of diabetes.)

niels_olson 13y ago
> It's also not possible for a physician to be informed about every possible condition. You are absolutely right. The one thing we definitely know is that we're still a long ways off from even having the books written on it all, let alone any one human having even majority of the information in their brain. I'm in pathology, sort of the end of the diagnostic road. We have the molecular tests and microscopes. And we still don't know. In fact, we're best positioned to see the vast ocean of unknown before us. We can't even see the other side. Sorry to hear about the diagnosis, you've done extraordinary things despite it and I hope more patients can emulate your success. I am constantly educated by my patients. You're not Canadian, are you? The GP vs endocrinologist issue is actually well-studied there. Unsurprisingly, the specialist-treated patients fair better.
- cperciva 13y ago
  Yes, I am Canadian -- although I had the luck to be diagnosed while I was at Oxford. Having one of the world's leading research institutions in the field (OCDEM) in your back yard helps a lot where clinical care is concerned...

sirsar 13y ago

>"If you like libertarianism so much, why not just move to Somalia?" This is a bit offtopic, but how about "because it was terrible before the collapse of their government, and still is terrible?"

jellicle 13y ago
No, it's an excellent, beautiful place. Because it has no government, and therefore must be, by libertarian definition. Don't you understand? There is no Somalian FDA - which means all you have to do if you want to consume safe food or drugs is to enlist a local food and drug testing company to test things on your behalf. Perfect capitalism! No government interference! And yet libertarians don't move there. It's baffling. Every single U.S. libertarian talks a great game, but not one of them is willing to put their money where their mouth is.
- mseebach 13y ago
  Just like North Korea. It's a perfect, magical place. Confiscatory taxes and monetary policy ensures near perfect equality. Full employment. Free government health care. All state run media, no Murdochs or FOX News. All businesses run by the state, no exploitation. The lowest domestic carbon emissions in the industrialised world. A vibrant cultural scene that is free of corrupting American imperialistic influences. And yet leftists don't move there. It's baffling. Every single U.S. big government liberal talks a great game, but not one of them is willing to put their money where their mouth is.
  - mikeash 13y ago
    That is actually a great argument to use on anyone who espouses the virtues of a totalitarian, all-controlling state. The difference is that you can actually find people with some frequency who espouse the virtues of extremely small or entirely absent government, while it's pretty hard to find someone who espouses the virtues of a totalitarian, all-controlling state.
    - 13y ago