A new book critiques medicine

Reducing fevers is a mixed bag. Yes, the higher temperature may help fight the disease (or might do nothing, totally dependent on the diseases suitability for reproduction at higher temperature). Yes, it can also damage your body if it gets out of control. And yes, sleep is also good for fighting off illness, and a fever can get in the way of that. Just because it is your bodies natural response doesn’t mean it’s going to help you. Allergies are a great example of the body taking totally inappropriate counter-measures.

Maybe so, but can you please not post unsubstantive comments here?

https://news.ycombinator.com/newsguidelines.html

> But if the problem doesn't fit those known processes, isn't mechanical, and you are relying on doctor for real troubleshooting of problems, that is where it falls short.

I mean, you're not wrong, but...

No one pays docs to do this. The overpriced insurance that's squeezing you dry pays the doc peanuts for his time on your case. Most docs get allotted something like 15 minutes, all-in, per patient: see you, talk to you, examine you, write up their notes, send out their scripts and billing. If you're a really well paid specialist and don't mind not maximizing your income, call it 30 minutes. This has gotten worse with the rise of EMRs, because they're slow as hell. They have a UI designed by an insurance company billing agent. It's terrible.

And being the guy that spends more time is just a matter of pride/ego. I know an amazing doc who spent 40 hours going through boxes of old records on a patient. Figured out what years of previous docs hadn't, and solved - solved! - the lady's problem. He got paid 350$. Less than my niece makes per-hour selling iphone cases at the mall. You can't keep a practice open that way, not even a famous, "people fly in from wherever to see you" kind of practice (unless you're a surgeon - solve someone's problem with a 90 minute operation and people will cough up 30k$; solve their problem with 90 minutes of careful thinking and they're like, you didn't actually do anything, and now you want multiple hundreds of dollars?)

But if someone wants to go ahead and pay me to spend 10 hours on a patient rather than 10 minutes, so I can analyze your symptoms and history and prior reports to hell and back, do some research, iterate a few hypotheses, wrangle phone battles with laboratories to get weird-ass custom tests done, etc. well, yes. I would be happy to do that. That's most docs' dream job. Seriously, and I kid you not even a little bit. Pay me per-unit time the same peanuts that the insurance company pays out, for the amount of time it takes to be your custom biochemical sleuth, and I'll happily do that over seeing a million patients a day.

But as long as you and I are operating inside of the system where I'm squeezed on every side to get you in and out of the exam room in 10 minutes.

Really? That's an interesting example to choose, since John Carreyrou didn't have any medical training and almost singlehandedly brought Theranos to its abrupt end.

Later, because it was bugging me

There's also distinctions to be made between a "generalist" and a "practitioner". Beat reporters are specialists, not generalists. They've cultivated sources and, over their careers, expertise. Roger Ebert wasn't a filmmaker, but he sure as hell knew more about films and their language and idiom than a WSJ business reporter (who in turn knows more about collateralized debt than Ebert). Extending the analogy further: I'm capable of critiquing cryptosystems and finding/exploiting vulnerabilities in them, but I'm not a cryptographer and am not qualified to build them myself.

Do you need an example of a non-programmer tech reporter worth reading? Happy to provide one.

> No. It's pretty clear, even if the anti-vaxxer lunatics were not wrong (which they are, they are wrong, they are perniciously wrong, in the face of all evidence they are wrong), that vaccines would be a net benefit.

Are the "anti-vaxxer lunatics" arguing that vaccines are not a net benefit? When you refer to "anti-vaxxer lunatics", who is it, exactly, are you referring to? Are you referring to specific people (everyone within the "anti-vaxx" "community"), or are you referring to an abstract mental model, of questionable accuracy, held in your own mind?

> even if vaccines did cause autism (which they do not)

These sorts of comment lack epistemic humility/awareness. We do not know that vaccines do not cause autism. Science does not say this.

However, this isn't to say that science says vaccines do cause autism.

What causes autism is unknown. The final knowledge of an association between vaccines and autism is unknown.

To some degree, the "pro-vaxx" message is based on propaganda (here I am referring to the lesser pejorative meaning of the word). Many within the "anti-vaxx" community can see this, and it is used in various ways as leverage. Which is, of course, also propaganda (the more pejorative kind - typically, but not always).

This approach has been sound in the past, but there are increasing signs that it is becoming less effective. Time will tell if that trend continues.