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A new book critiques medicine

blogs.scientificamerican.com

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Re: A new book critiques medicine

#31

Post by gtirloni »

agumonkey wrote: post #29

Let me extend the query, is "modern medicine" overrated. Modern technology + western like urban lifestyle changed how we live.. and how much medicine we think we need. Walking in the woods is probably as effective as the average anti depressant. Good physical activity too. But we sell that modern life is great and that ailments are normal and that thanks to the medical field we have all these solutions.. that we prob…

Sure, for that specific situation maybe physical activity is a good solution.

But what's next? Anti-vaxxer stupidity?

Re: A new book critiques medicine

#33

Post by wolco »

hannob wrote: post #23
codingslave wrote: post #9

I've long believed that once startups and tech companies get their hands on medical data (patient outcomes, medication treatment outcomes, mal practice rates, surgery outcomes) that a reckoning will take place on the medical industry. The level of legitimacy and respect that doctors and hospitals currently have is far too high, and hinges on branding and the exclusivity of becoming a doctor. Once all of this data bec…

> I've long believed that once startups and tech companies get their hands on medical data Honestly I think the last people that are going to improve anything in medicine are startups and tech companies. Quite the contrary. I know that quite a few people in evidence-based medicine are worried that Tech people who want to "disrupt" things come with their own poor scientific standards to undermine the minimum standards…

We've started with ubiome/23andme providing customers data previously not available.

Another area is improving existing processes. We see techniques where photos are being read more accurately and quickly compared to manual processes.

Medicine now resolves around tests. Those can be improved and automated.

We will see tools that will empower personal medicine and shift the power balance away from the family clinics.

Re: A new book critiques medicine

#34

Post by mLuby »

pixelmonkey wrote: post #20
codingslave wrote: post #9

I've long believed that once startups and tech companies get their hands on medical data (patient outcomes, medication treatment outcomes, mal practice rates, surgery outcomes) that a reckoning will take place on the medical industry. The level of legitimacy and respect that doctors and hospitals currently have is far too high, and hinges on branding and the exclusivity of becoming a doctor. Once all of this data bec…

"The level of legitimacy and respect that doctors and hospitals currently have is far too high, and hinges on branding and the exclusivity of becoming a doctor. Once all of this data becomes available, it will be obvious how worthless and expensive most medical treatments really are." I'm the spouse/partner of a recently-trained doctor, and I'm a programmer and startup founder with 2 decades of experience. With all r…

Would you kindly elaborate on that?

I have enormous respect for the difficulty of the training that doctors like your spouse have gone through, and yet I share the quoted sentiment. We assume that difficulty is essential to the work, and I think that's an assumption worth questioning, as the dental profession has been recently.

Re: A new book critiques medicine

#35

Post by lordnacho »

It's quite odd to dismiss better sanitation and nutrition as not medicine, isn't it?

I think the problem is that we take for granted the things that have been discovered, because they were found a long time ago. Washing surgeons' hands in carbolic acid help puerperal fever rates. Cholera has something to do with water. Vaccination works. All those things happened way before any living person remembers.

From what I hear among pharma friends, the problem is also that the low hanging fruit has been picked. A lot of lines of inquiry are variations of the same thing, and over time we've found what is there to be found.

If you think about it, it makes sense that it's like that. Something really powerful like vaccination is going to pop out of the stats immediately. Subtler effects require more trials to detect.

In any case, it's a greater danger that there are people who don't believe in evidence based inquiry at all pretending to be medical professionals. Look at anti-vaxxers, or the Goop type quackery.

Re: A new book critiques medicine

#36

Post by alyx »

RandomBacon wrote: post #7

The anti-vaxxers think it is. We need to be careful how we say this, because then you get generalities like the title and people who shun the basic of medicines such as neccessary vacinations.

Many "anti-vaxxers" are simply concerned parents.

Considering that vaccines (in general) have been deemed "unavoidably unsafe" at the Supreme Court level, they are not completely unjustified in their fears. [0]

Vaccine manufactures cannot be held liable.

Thus there is a "National Vaccine Injury Compensation Program" put in place to compensate those that have been damaged by vaccinations.

To date, over $4 billion dollars has been paid out in damages. [1]

Just as mentioned in this article, side effects are major deterrents of any medication. And significant efforts need to be made in order to ensure that side effects do not occlude positives effects.

[0]: https://www.supremecourt.gov/opinions/10pdf/09-152.pdf

[1]: https://www.hrsa.gov/sites/default/files/hrsa/vaccine-compen...

Re: A new book critiques medicine

#37

Post by klenwell »

codingslave wrote: post #9

I've long believed that once startups and tech companies get their hands on medical data (patient outcomes, medication treatment outcomes, mal practice rates, surgery outcomes) that a reckoning will take place on the medical industry. The level of legitimacy and respect that doctors and hospitals currently have is far too high, and hinges on branding and the exclusivity of becoming a doctor. Once all of this data bec…

> Once all of this data becomes available, it will be obvious how worthless and expensive most medical treatments really are. Most prescription drugs do nothing, and the ones that do something are more so just covering the symptoms.

I've read Bad Pharma (and will recommend it to anyone interested in this subject). And one way to summarize (perhaps oversimplify) it is: pharmaceutical corporations manipulate data to justify expensive drugs of questionable effectivness.

But to think "startups and tech companies" are going to help solve this problem... man, that's optimistic. And as Bad Pharma demonstrates, the data is already available. There's just not a lot of interest (economically or politically, especially where those two are strongly correlated) to seek it out or listen to it.

Also I don't think it was HIPAA's intention to hide data from well-meaning startups. That's just an unintended consequence perhaps. I'd like to think its primary motivation was to protect patient data from predatory insurance companies and unscrupulous marketing forces. (Does it succeed in doing that? I don't know. Are startups and tech companies going to help with that if it doesn't? Hmmm.)

Re: A new book critiques medicine

#38

Post by lukeschlather »

drcode wrote: post #18
lukeschlather wrote: post #14

Earlier quoted context omitted.

How would a startup make money by showing that treatments are worthless? Startups are going to have the same incentives as other pharmaceutical companies.

Well, the hope I have (and OP probably as well) is that machine learning techniques properly applied to the raw data could uncover a lot of statistical errors in the historical literature, which could be both profitable and disruptive. ... Unfortunately, this may happen first in countries with poor human rights records (i.e. China) because there is likely a greater availability of patient data under those circumstanc…

ML doesn't fix bad statistics. ML is really just a sexier way of saying real-time statistics with lots of data.

Re: A new book critiques medicine

#40

Post by rhinoceraptor »

Modern medicine is great when you get in a car crash, and it's horrific if you have type 2 diabetes.

Doctors get very little training in diet and lifestyle, because those are low-status and left to non-MD specialists, and many of them dogmatically cling to 1960s-era science.

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