Iatrogenics / Iatrogenesis
Unnecessary medical care is harming patients physically and financially (2015)
141–150 of 256 posts
Re: Unnecessary medical care is harming patients physically and financially (2015)
#142I was preparing to make a long post asking for ideas/help (been saying that for weeks but it's ready and I was waiting to Monday since weekends are slower) This sort of thing ruined my life, cost me everything, and has finally brought me to the precipice. I was convinced 15 years ago to have surgery to "prevent later disability" and it ironically left me disabled and in severe pain. I later found out abroad from seve…
>> vague forms hurridly shoved in front of me as I was being prepped and legally he as allowed to
One of the many problems when the legal system has just become "formalities" that only get used by the powerful against everybody else. Last time we had a baby the hospital was so prepared they were able to bill us for the entire pregnancy when we arrived for our first prenatal check-up. But somehow they couldn't show my wife the forms that waived her right to sue the hospital, her agreement to pay whatever they billed her regardless of correctness of timeliness until she was dilated to an 8.
Re: Unnecessary medical care is harming patients physically and financially (2015)
#143In 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…
People are _really_ bad at self diagnosing. So who's to say that the risks of going to the doctor are greater than the risks of self diagnosing? Off the top of my head I know three family members who now suffer some disability because they didn't go to the doctor for symptoms they thought were non-threatening.
Are they though? In my lifetime the vast majority of my acute health issues went away on their own without any particular medical intervention. I mean well over 99.9%. I know what's "minor ache" feels like and I know what "this seems serious" feels like. I try to let my immune system take care illnesses when possible.
On the other hand I know someone who died from a complication of anesthesia during an (almost certainly) unnecessary surgery.
It's a multifaceted problem.
Patients (especially the kind that present to the doctors office for a cough) tend to want doctors to do something, they don't like hearing "rest up, you'll get better on your own." Doctors provide a service, patients want to feel like their time was worth it.
At the same time doctors don't want to put themselves in a position of missing something. Everyone remembers the time the doctor missed a serious disease but since we can't have alternative timeline where the treatment and/or tests weren't done then its very difficult to say, on an individual level, what was over treatment.
Sprinkle in a healthy dose of the placebo effect stir.
Judgement gets clouded by biases on all sides.
Not only all that, but sometimes the data just isn't there on what the best course of action is. The studies haven't been done so we just do what feels "right." And we've learned that what feels right might not lead to the best outcomes.
Re: Unnecessary medical care is harming patients physically and financially (2015)
#144Earlier quoted context omitted.
Perhaps you could share the procedures so others would know to be skeptical if they are in the same situation?
The nutshell is don't ever have foot surgery unless it's to repair a catastrophic injury/trauma and there is no choice if you want to save the foot. The risk/failure rates are so high and not honestly explained. I was left with ruined joints, damaged tendons, nerve damage, and RSD that spread up my legs and affects my whole body to a degree. I was misinformed and flat out lied to and have never met someone to this da…
For what it's worth, I have 2 friends who had knee replacement surgery a couple of years ago to address chronic knee pain, and despite being wealthy and committed enough that they were able to participate in all the recommend physical therapy for recovery, they are both still in more pain than they were before, and 1 of them has actually been getting worse in recent months, and was just told by doctors that based on the images from before his surgery, the surgery they performed was unnecessary and didn't address the root cause of his original pain, and that new imagery showed a lot of damage most likely CAUSED by the surgery.
I don't know enough to say, "don't have knee (or foot) surgery", but my limited anecdotal experience really makes me want to see data on such surgeries and how many people feel they are better of because surgery than they would have been with a lifestyle change that avoided a lot of stress on the knee (or foot).
Re: Unnecessary medical care is harming patients physically and financially (2015)
#145Earlier quoted context omitted.
Shouldn't a distinction be made between asserting this for a population vs. for an individual? Yes, for a population it results in overdiagnosis and over treatment. As a personal decision, though, I understand this and will choose how to proceed with that in mind.
>Shouldn't a distinction be made between asserting this for a population vs. for an individual? Yes, for a population it results in overdiagnosis and over treatment. We get overdiagnosis and overtreatment of the population precisely because it is done at an individual level.
Right, micromotives. But what's best for me, personally, may be different than what is best for a whole population.
Re: Unnecessary medical care is harming patients physically and financially (2015)
#146Earlier quoted context omitted.
More like, “what happens when the patient does not directly feel the financial bill and the doctor tries to charge/do unnecessary things to make more money”. This is a direct result of the laws and regulations distorting the market.
Have you heard of the high-complexity drug testing scam? It works like this: at the intake visit the physician has the patient piss in a cup and it gets sent off to a drug testing company somewhere. They run a GC/MS, and then a very substantial bill (~5 kUSD) shows up a few weeks later. It's a stroke of genius, no one is responsible. The physician says "you peed in the cup", the drug testing company says "services we…
And the patient should simply ignore the bill. Medical debt has become so irrelevant that mortgage companies don't even bother to take it into account
Re: Unnecessary medical care is harming patients physically and financially (2015)
#147Earlier quoted context omitted.
>Heath care has gotten vastly better over time. Look at 5 year cancer survival rates for example. No. These rates are affected by more screening procedures. Some nipped a potentially fatal cancer in the bud, others just found and removed something that wouldn't have killed the person. To first order there is no change in the effectiveness of cancer treatment as compared to 50 years ago.
That's demonstrably false. Early screening is useful, but that's also a medical procedure. Really what we care about is cancer deaths at a specific age AKA what % of 15 year old people die of cancer and that really has dropped. Even beyond that the absolute rate of cancer deaths in the US peaked in 1990 216 per 100k vs 2015 at 158 per 100k. Which is a massive drop even over 1950's pre screening and younger population…
You are referring to cancer prevention, while the GP is referring to cancer treatment.
Re: Unnecessary medical care is harming patients physically and financially (2015)
#148This article makes it sound like medical costs in the US could be halved if everyone understood this problem, and did their own research on proposed procedures.
Medical costs could also be halved while increasing distribution of care to the indigent and jobless via the implementation of single payer.
Re: Unnecessary medical care is harming patients physically and financially (2015)
#149Earlier quoted context omitted.
That's demonstrably false. Early screening is useful, but that's also a medical procedure. Really what we care about is cancer deaths at a specific age AKA what % of 15 year old people die of cancer and that really has dropped. Even beyond that the absolute rate of cancer deaths in the US peaked in 1990 216 per 100k vs 2015 at 158 per 100k. Which is a massive drop even over 1950's pre screening and younger population…
You are referring to cancer prevention , while the GP is referring to cancer treatment .
I'm not sure I follow. Screening detects cancer that is already there, hopefully in early stages when it might be treated more easily. In both cases, cancer is already present.
Re: Unnecessary medical care is harming patients physically and financially (2015)
#150Earlier quoted context omitted.
The nutshell is don't ever have foot surgery unless it's to repair a catastrophic injury/trauma and there is no choice if you want to save the foot. The risk/failure rates are so high and not honestly explained. I was left with ruined joints, damaged tendons, nerve damage, and RSD that spread up my legs and affects my whole body to a degree. I was misinformed and flat out lied to and have never met someone to this da…
For what it's worth, I have 2 friends who had knee replacement surgery a couple of years ago to address chronic knee pain, and despite being wealthy and committed enough that they were able to participate in all the recommend physical therapy for recovery, they are both still in more pain than they were before, and 1 of them has actually been getting worse in recent months, and was just told by doctors that based on…
I dont have references right now but I have continually heard that long term studies have proven that knee (which I have also had that made things worse) and back surgeries (those two common ones have been extensively studied) show no overall improvement in pain years on compared to those who skipped surgery. In fact it is often worse and precipitates new issues.
Surgery is a huge cash cow in the US. The ones that are my only option, but am terrified to have given the past, and dont have the stability or money for would cost something like 25,000usd minimum per foot in this country and take 6 months to a year each to recover from with high complication/failure rates AND are likely to exacerbate the RSD. I am guessing based on previous experience it would be maybe 10-15% of that in Poland where I lived before and got excellent care...and that is paying full cash private prices there. I dont want more surgery at all but I can't live like this either. This is what they did to me and the lack of options they left me with.
*@astura has linked some in this thread