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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)

#161

Post by AnIdiotOnTheNet »

fpgaminer wrote: post #120
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…

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.

In my experience, your average doctor is really bad at diagnosis too, they just have way more confidence in their diagnosis than the average person has in their own.

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

#162

Post by tachyoff »

theseatoms wrote: post #114
notyourday wrote: post #102

Earlier quoted context omitted.

My wife professionally interacts with a lot of top level surgeons -- the ones that have institutes named after or created for. They universally say it is all about risk management and risk mitigation. Trauma and neuro and cardiac surgeons of today are likely to be able to fix amazing number of issues just to have patients become gravely ill from secondary infections/non-top-notch care after the surgeries.

That's the frustrating thing though. Doctors tend not to talk in probabilities of outcomes. Fortunately I haven't had a ton of experience trying to get them to do so.

That's because most Americans have no idea how probability or risk mitigation work. It's their body, dammit, and they want you to fix it!

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

#163

Post by [deleted] »

maccard wrote: post #153
hestipod wrote: post #131

Earlier 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…

While I'm sorry that this has happened to you, it's not fair to pin it on foot surgery. The same can be said for the majority of surgeries. I'm not in the US, FWIW. I've a family member who has had 3 surgeries on their hand (the last 2 to repair the damage done by the first one). Meanwhile, I have multiple friends who have had various surgeries for small sports injuries that are fully recovered. The risks and failure…

[deleted]

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

#164

Post by astura »

paulsutter wrote: post #140
astura wrote: post #108

Earlier quoted context omitted.

Scans directly cause overdiagnosis. It's very non-intuitive but scans and tests have the potential to cause more harm than good. From TFA: >Overtesting has also created a new, unanticipated problem: overdiagnosis. This isn’t misdiagnosis—the erroneous diagnosis of a disease. This is the correct diagnosis of a disease that is never going to bother you in your lifetime. We’ve long assumed that if we screen a healthy po…

Solution -> never show a scan to a doctor who will over-react to an incidentaloma

It's not "overreacting."

If you do a scan in someone asymptomatic and see a tumor it's oftentimes completely impossible to know if it's a "turtle" or a "bird." They can look exactly the same and we don't have a crystal ball.

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

#165

Post by tachyoff »

astura wrote: post #143
fpgaminer wrote: post #120

Earlier quoted context omitted.

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 certai…

> 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%.

To be fair, if they didn't, you might not be here to talk about it, so there's definitely some survivorship bias there. The people who waited and died obviously can't say anything because they're dead.

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

#166

Post by monocasa »

theseatoms wrote: post #125
kurthr wrote: post #70

Earlier quoted context omitted.

Really, you think there's a market for healthcare? Try walking into a hospital and asking how much something costs. I can tell you that you won't/can't get an answer in over 60%, specifically because the software they use does not show prices only billing codes! So the person providing care can not find out how much it costs... how are you supposed to choose? Try calling billing once you have the correct code. I can…

> Try walking into a hospital and asking how much something costs. I can tell you that you won't/can't get an answer in over 60%, specifically because the software they use does not show prices only billing codes! So the person providing care can not find out how much it costs... how are you supposed to choose? Exactly. This is exactly the problem. The current situation bears no resemblance to a market. Price can't s…

How do I shop for prices when I'm bleeding out in the back of an ambulance?

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

#167

Post by tinokid »

grzm wrote: post #149
vonmoltke wrote: post #147

Earlier quoted context omitted.

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.

Treating infectious disease than can cause cancer (H. pylori, HPV) has nothing to do with cancer treatment.

Treating, for example, thyroid or prostate cancers that would not have killed the person improves cancer survival statistics but nothing else.

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

#168

Post by monocasa »

westbywest wrote: post #75
whb07 wrote: post #42

Earlier quoted context omitted.

So much this! I broke my leg a decade ago and asked my doctor how much did it cost to get X done if I wanted to pay in cash. He didn’t know and looked dumbfounded by such a simple question. In what other profession can a professional perform a task not knowing what he’s charging for the services being rendered?

Plenty of professions, actually. Especially those where skills cultivated by individuals become highly specialized, and companies thus maintain a large number of employees to ensure their business requirements (including billing and bookkeeping) are met by dedicated staff of sufficient skill level. Not all medical practice can be done like sole-proprietor design shops.

Yeah, almost everything B2B has prices listed that no one actually pays; they're just meant as an initial negotiating position.

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

#169

Post by skybrian »

BeetleB wrote: post #139
mhb wrote: post #110

Earlier 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.

It seems possible to do better than average here? Just from reading this article, we learn about some "cancer" that is less scary than it sounds and unlikely to cause a problem.

I would be more skeptical if there were a study showing overtreatment still happens in a population informed and wary of overtreatment.

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

#170

Post by pjc50 »

TallGuyShort wrote: post #142
hestipod wrote: post #117

I 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…

> 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

This really ought to be illegal. It's continually amazing how the US has seemingly no effective consumer rights organisations.

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