Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Why Doctors Reject Tools That Make Their Jobs Easier

blogs.scientificamerican.com

Post reply on HN
Print view View original

31–40 of 131 posts

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#31

Post by mamon »

Johnny555 wrote: post #15
tx21 wrote: post #5

Flashy article title clickbait. Doctors are not fools. If a tool truly made their job easier, it would not be rejected out of hand. Job security for physicians is rarely the issue, there are plenty of sick people.

And early thermometers weren't as practical as they are today, someone going to the doctor for a cold probably doesn't want to be sent to the hospital across town to wait in line for a 25 minute temperature rating when the doctor's hand is usually "good enough": The original thermometers were a foot long, available only in academic hospitals, and took twenty minutes to get a reading. And it's probably the same with C…

>> Now if I take the medicine and it's not better in a day or two, maybe then I will want that CT scan.

That's what most doctors in my country would do. Are you saying that US doctors will send you to CT right away, just to be sure?

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#32

Post by cf498 »

Fomite wrote: post #23
DrNuke wrote: post #17

The industry is annoyingly conservative but whizzkids pretending to have a better opinion about how to cure insert desease from isolated, mechanistic, non-standard observations of few markers are dangerous.

Yeah - I work a lot in healthcare associated infections, and a good 80% of the stuff I read about "We're from Silicon Valley and we're here to help..." just ends with me going "They're going to kill people."

I think this is something that isnt that present in our profession as it should be. If you are an electrical engineer, it is clear and present, that your products might kill someone if you screw up. The same goes for a mechanical engineer. And it will be your responsibility. If you screw up and should have known better, you might even go to jail for negligence.

We on the other hand have the Therac-25.

We claim to be on a level of engineering fields. We should also act that way.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#33

Post by throwaway287391 »

Swizec wrote: post #18
derefr wrote: post #12

Earlier quoted context omitted.

Seems like it'd make sense to go into your doctor at some point when you're perfectly healthy and let them measure a bunch of baseline values to put in your medical file.

It's like my bird's vet said once: If you start measuring, you're gonna find stuff. The more you dig, the more you find. Does it mean your bird is sick? Eh look at him, does he look like a sick bird? My girlfriend can be very ... concerned. We spent $1000 in vet bills before a real avian expert was like "Guys, he's fine. Look how happy he is. He just loves the attention." Apparently one of his tests for vet interns i…

> Apparently one of his tests for vet interns is to tell them "This bird is sick. Figure it out". Then he gives them a perfectly healthy bird. Their bias always makes them find something.

Seems like the "bias" in that case is likely due to an authority figure intentionally misleading them in the context of a "test", where one naturally assumes they're not being deceived by the very premise of said test? If an actual bird owner came in as a client and said the same (or if the test explicitly told them to assume this is the situation), the interns might very well still realize the client is wrong.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#34

Post by Johnny555 »

mamon wrote: post #31
Johnny555 wrote: post #15

Earlier quoted context omitted.

And early thermometers weren't as practical as they are today, someone going to the doctor for a cold probably doesn't want to be sent to the hospital across town to wait in line for a 25 minute temperature rating when the doctor's hand is usually "good enough": The original thermometers were a foot long, available only in academic hospitals, and took twenty minutes to get a reading. And it's probably the same with C…

>> Now if I take the medicine and it's not better in a day or two, maybe then I will want that CT scan. That's what most doctors in my country would do. Are you saying that US doctors will send you to CT right away, just to be sure?

That seems to be what the article is implying should happen, just like doctors of the past should have embraced expensive and inconvenient thermometers sooner, it seems that the article is implying that modern doctors should embrace modern diagnostic tools:

Modern CT scans, for example, perform better than even the best surgeons’ palpation of a painful abdomen in detecting appendicitis. As CT scans become cheaper, faster, and dose less radiation, they will become even more accurate.

Though Defensive Medicine is definitely happens in the USA and probably other countries as well:

https://en.wikipedia.org/wiki/Defensive_medicine

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#35

Post by onetimemanytime »

gowld wrote: post #29
pavlov wrote: post #13

Earlier quoted context omitted.

Surgical safety checklists were shown to lower 30-day post-operative mortality by 22%: https://www.cardiovascularbusiness.com/topics/coronary-inter... You'd imagine something as basic as checklists would be implemented as standard procedure in modern medicine -- yet this study was in 2013, not 1963. Most likely the majority of surgeons are still dragging their feet on this. It's a very conservative field with lots of…

Checklists make patient outcomes better; they don't make surgeons' work easier.

I guess killing the patients as soon as the cut them open would be easier for the doctor :), but their job us to heal patients. Anything that improves on outcomes is good. The OP might have suggested that instead of new tools, just use the old checklist system.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#36

Post by Balgair »

Fomite wrote: post #23
DrNuke wrote: post #17

The industry is annoyingly conservative but whizzkids pretending to have a better opinion about how to cure insert desease from isolated, mechanistic, non-standard observations of few markers are dangerous.

Yeah - I work a lot in healthcare associated infections, and a good 80% of the stuff I read about "We're from Silicon Valley and we're here to help..." just ends with me going "They're going to kill people."

I've second hand experience with this. Though not a lethal situation (thank the heavens!) the mindset was dead on. A grad student in the BioEng lab was doing her PhD on a fall detection sensor for the elderly. Kinda like what the new Apple watch is supposed to do, but, you know, something that actually works. The lab was working with a device manufacturer that was looking to branch into medical devices as a new market and was partnered with the lab to do the initial PoC. Well, one day she came into the lab to discover that the company had shut down and remote bricked the devices overnight. They were still in early testing, so no people were harmed, which was really lucky. But if they had been under clinical trial already, there was a real possibility that real people out there would have been harmed severely (a 'bad' geriatric fall can become lethal).

All emails to the company were unanswered. All phone calls went to voicemail. Nothing could be done. She was 5 years into her PhD on this and had to restart the whole project (she wasn't much of a coder, more a clinical trials person).

In medicine, the SV mindset of 'move fast, break things' means that granny is breaking her hip and isn't going to last much longer. You CANNOT 'break things' in medicine. However, if you do get though clinical trials, hoooo baby! You essentially have a monopoly and will be rolling in it. MedTech investing is a lot like SV's VC investing, just a lot more careful.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#37

Post by Balgair »

cf498 wrote: post #32
Fomite wrote: post #23

Earlier quoted context omitted.

Yeah - I work a lot in healthcare associated infections, and a good 80% of the stuff I read about "We're from Silicon Valley and we're here to help..." just ends with me going "They're going to kill people."

I think this is something that isnt that present in our profession as it should be. If you are an electrical engineer, it is clear and present, that your products might kill someone if you screw up. The same goes for a mechanical engineer. And it will be your responsibility. If you screw up and should have known better, you might even go to jail for negligence. We on the other hand have the Therac-25. We claim to be…

Agreed. The Order of the Engineer is a good place to start and bringing that tradition down into comp-eng/sci would be a nice start.

https://en.wikipedia.org/wiki/Order_of_the_Engineer

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#38

Post by Thriptic »

onetimemanytime wrote: post #30
DrJaws wrote: post #21

Earlier quoted context omitted.

Plus radiation. Every CT scan increases your odds of cancer. Also, mammography or even colonoscopies have been proved for most of the population to do more harm than good. cochrane is full of meta-studies about it. The medical industry is very shady.

>> Plus radiation. Every CT scan increases your odds of cancer. If the doctor makes money from your CT Scan you are absolutely right to question the need. Conflict of interest and all. Sure you increase the chances of cancer but that has to be weighed by what can happen if you don't do the CT Scan.

Very few modern insurance plans pay per procedure and that will be done away with entirely as time goes on. Typically physicians are paid a flat rate per patient or a flat rate per diagnosis with a complexity multiplier. This creates an incentive to NOT perform imaging unless it's necessary.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#39

Post by wccrawford »

mamon wrote: post #31
Johnny555 wrote: post #15

Earlier quoted context omitted.

And early thermometers weren't as practical as they are today, someone going to the doctor for a cold probably doesn't want to be sent to the hospital across town to wait in line for a 25 minute temperature rating when the doctor's hand is usually "good enough": The original thermometers were a foot long, available only in academic hospitals, and took twenty minutes to get a reading. And it's probably the same with C…

>> Now if I take the medicine and it's not better in a day or two, maybe then I will want that CT scan. That's what most doctors in my country would do. Are you saying that US doctors will send you to CT right away, just to be sure?

I went to the ER complaining of stomach pains. They heard my description and immediately put me into a room. A few hours later, I had a CT scan confirming that I had appendicitis. I had surgery that same that and was out of the hospital 2 days later.

Had they sent me home, medicine or no, things could have gone a lot worse.

I'm glad they do the CT scan here and not just send people away until they get worse.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#40

Post by megy »

> From the thermometer’s invention onward, physicians have feared—incorrectly—that new technology would make their jobs obsolete

Is that true, or are doctors incredibly risk averse since they have seen what can happen when something goes wrong, and that is death.

Post reply on HN