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Unnecessary medical care is harming patients physically and financially (2015)

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Re: Unnecessary medical care is harming patients physically and financially (2015)

#91

Post by grondilu »

dharmapure wrote: post #38

In the book Antifragile Nassim Taleb cautions against medical care unless it's truly necessary. He argues that since so many things can go wrong in a hospital (you could get sick from someone else, mistakes could be made, etc), only go if the benefits outweigh the risks. And so if you have cancer, it's probably worth the risk. But if you have something that could just go away naturally, that's got a higher expected v…

> But if you have something that could just go away naturally,

isn't that the case for most diseases?

Re: Unnecessary medical care is harming patients physically and financially (2015)

#92

Post by CaptainZapp »

s3nnyy wrote: post #85
DanBC wrote: post #71

Earlier quoted context omitted.

He's just regurgitating conventional medical wisdom that's routine in countries that aren't the US. We've been talking about the risks of over-testing, over-diagnosis, and over-treatment for many years. Mostly in the context of full body MRI scans for healthy people, or early testing for prostate cancer, but also many other things.

What's the problem with full body MRI scans for healthy people? They don't cause any harm, just cost money.

Apart from the fact that it costs a lot of money. What do you want to achieve with a full body MRI scan?

Re: Unnecessary medical care is harming patients physically and financially (2015)

#93

Post by ams6110 »

manjushri wrote: post #52
kreco wrote: post #45

For the physical harming, Nassim N. Taleb wrote a book called "Anti-Fragile" desribing the concept of iatrogenic illness. https://en.wiktionary.org/wiki/iatrogenic An alarming fact was less dying patients when an hospital workers were in a strike action (during 2 weeks).

Johns Hopkins study suggests medical errors are third-leading cause of death in U.S. https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-...

And yet we're all wound up about so-called assault weapons and the NRA.

Not meaning to take this on a political tangent, just using that as a current-events example of things we worry about and spend political capital on, that have really very little statistical impact. Compare the much, much larger number of deaths due to medical error, automobile accidents, etc.

Re: Unnecessary medical care is harming patients physically and financially (2015)

#94

Post by maxerickson »

westbywest wrote: post #83
maxerickson wrote: post #67

Earlier quoted context omitted.

A huge percentage of the US population lives within a 10 minute drive of an urgent care facility. Same day appointment, billed similarly to a GP office visit.

Billing is not always similar. Many urgent care facilities are outright predatory in pricing, to the extent they begin to look like the payday lenders of medical care. It would be a poverty to consider these kinds of operations part of the solution. https://www.nbcnews.com/health/health-care/you-thought-it-wa...

Go tell the Texas legislature about it.

In any case, I was talking about places that advertise themselves as urgent care and do care in the style of a basic office visit, not about facilities licensed as freestanding emergency rooms.

Actual urgent care facilities are a fine option if you don't have a PCP or can't get an appointment.

Re: Unnecessary medical care is harming patients physically and financially (2015)

#95

Post by notfromhere »

ycombonator wrote: post #24

Ivory tower elite have usually all the time to pontificate. Tell that to this girl who did not see the light of the day. https://nypost.com/2018/02/26/girl-dies-hours-after-doctor-t...

both things being true is possible.

Re: Unnecessary medical care is harming patients physically and financially (2015)

#96

Post by jartelt »

s3nnyy wrote: post #85
DanBC wrote: post #71

Earlier quoted context omitted.

He's just regurgitating conventional medical wisdom that's routine in countries that aren't the US. We've been talking about the risks of over-testing, over-diagnosis, and over-treatment for many years. Mostly in the context of full body MRI scans for healthy people, or early testing for prostate cancer, but also many other things.

What's the problem with full body MRI scans for healthy people? They don't cause any harm, just cost money.

MRIs should be safe. It's the unnecessary CT scans you want to avoid. Those blast you with x-rays and increase your risk of cancer by a non-negligible amount.

Re: Unnecessary medical care is harming patients physically and financially (2015)

#97

Post by astura »

s3nnyy wrote: post #85
DanBC wrote: post #71

Earlier quoted context omitted.

He's just regurgitating conventional medical wisdom that's routine in countries that aren't the US. We've been talking about the risks of over-testing, over-diagnosis, and over-treatment for many years. Mostly in the context of full body MRI scans for healthy people, or early testing for prostate cancer, but also many other things.

What's the problem with full body MRI scans for healthy people? They don't cause any harm, just cost money.

They cause harm due to overdiagnosis and over treatment.

https://sciencebasedmedicine.org/a-skeptical-look-at-screeni...

Re: Unnecessary medical care is harming patients physically and financially (2015)

#98

Post by soVeryTired »

dharmapure wrote: post #38

In the book Antifragile Nassim Taleb cautions against medical care unless it's truly necessary. He argues that since so many things can go wrong in a hospital (you could get sick from someone else, mistakes could be made, etc), only go if the benefits outweigh the risks. And so if you have cancer, it's probably worth the risk. But if you have something that could just go away naturally, that's got a higher expected v…

Great advice but how do you know ahead of time whether the medical care is necessary?

Re: Unnecessary medical care is harming patients physically and financially (2015)

#99

Post by dagw »

dharmapure wrote: post #38

In the book Antifragile Nassim Taleb cautions against medical care unless it's truly necessary. He argues that since so many things can go wrong in a hospital (you could get sick from someone else, mistakes could be made, etc), only go if the benefits outweigh the risks. And so if you have cancer, it's probably worth the risk. But if you have something that could just go away naturally, that's got a higher expected v…

The doctor proposed surgery. He just waited and his back healed itself

Isn't that when you should actually go talk to the surgeon?

I've had two occasions when a doctor proposed surgery, I went to the surgeon, and the surgeon said "Let's give it 6 month and see if the gets better", which it did in both cases. And one case where I ignored the doctor, lived in growing discomfort for a couple of years, ended up in the emergency room for emergency surgery and the surgeon going "couldn't you tell something was obviously wrong with you? Why didn't you come a year ago when this would have been trivial fix?"

Re: Unnecessary medical care is harming patients physically and financially (2015)

#100

Post by s3nnyy »

CaptainZapp wrote: post #92
s3nnyy wrote: post #85

Earlier quoted context omitted.

What's the problem with full body MRI scans for healthy people? They don't cause any harm, just cost money.

Apart from the fact that it costs a lot of money. What do you want to achieve with a full body MRI scan ?

A friend of mine who wasn't even 30 years old had a serious brain tumour where they said "ouh, if we'd had done a MRI scan some years ago, it would have been much easier to fix."

So that is why it might be a okay'ish idea to do a MRI scan of the brain every 5 years or so? Depending where you live they are actually cheap and can be paid out of pocket.

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