A new book critiques medicine

citation very fucking needed.

This may be true of some indigenous medicines, discovered by trial-and-error and careful observation over multiple generations. These are disappearing fast, and remain largely unsystematised.

But treatments from the major medievalist 'systems' are different - their very strong derivation from fictional rubrics has resulted in their use being insulated from disconfirming observation (as was medieval 'Western' medicine). I'm not a specialist, but results I've seen from contemporary studies of Indian and Chinese treatments seem to show they don't work.

And then there's the more impressionistic evidence from history. The populations of premodern India & China were horrifically unhealthy from all accounts I've read. Their medical systems did nothing for them.

Second, unless you are extremely rich and can privately employ a doctor like a saudi prince would do, I do not know of any (non-forbidden) way to directly pay your doc for his time. Hopefully I'll stand corrected.

Third, and that's the most important, primarily allocate your money to proven treatment. Clinical trials are not designed to help participants. Be weary of what people try to sell you. But if you've been dealing with the healthcare system for long enough, you probably know all about it already.

I realize that's not very original, but godspeed nevertheless!

The first: an excellent question. It's hard to actually pay a doc for their time. We're all up to our eyeballs in the current system, including contracts with insurers that say things like "if this person is covered, you're bound to take what we are willing to pay, this person can't pay you extra to buy extraordinary services." It's not trivial at all to buy a doc's time. That said, the best method is to call their office and ask to speak to their practice manager. That's the person who is usually tasked with keeping an eye on finances, and has enough time and attention left over to hear things like "I need a non-clinical medical opinion, I am willing to pay for the doctor's time for an interview." That is assuming you are paying them like a consultant, and not paying them to provide an actual medical opinion for your wife. The latter gets gutted by insurance contracts (unless your insurer has absolutely no relationship with this doc, in which case, yes, you can pay them for their services. Some docs misread some state statutes as not allowing cash services for patients that aren't insured with them, which is both wrong and ridiculous.)

The second: how to find a clinical trial for your wife. Honestly, our job is to keep up with clinical trials once they're published. Clinical trials in recruitment aren't on anyone's radar - there's no convenient way of finding them (inconveniently: clinicaltrials.gov) and no value to clinicians to read such a list even if it existed. The only ones we are aware of are the ones that, as you said, are recruiting patients at our location. The people that benefit from publishing trial availability most are the pharmaceutical companies that will ultimately reap a financial reward, so they try to reach out to patients directly via advocacy groups and things like centerwatch. So,if I really needed to find one, I'd:

(0) Check www.centerwatch.com

(a) Call major centers specializing in my issue, since they're the ones that most trials will pull into recruitment and/or they're the ones originating the trials. For cancer, that means contacting the relevant physicians at Dedicated Cancer Centers such as Dana-Farber Cancer Institute (full list: http://www.adcc.org/).

(b) Most cancers have patient advocacy groups, and they're often aware of major trials underway for their relevant cancer. For instance, for Sarcoma, you'd check out something like curesarcoma.org (who have a dedicated clinical trials resource page (https://www.curesarcoma.org/patient-resources/sarcoma-clinic...).

A vast majority of you drastically overestimate the information processing and retrieval of the healthcare system.

We MDs can all see your superb AI/ML results in journals, and yes you can improve things with technology. What we can't see is how we're going to use it. In my day-to-day job, there are a myriad of new-super-devices-that-automatically-do-that-thing but NONE are integrated into my workplace. NONE make my job less painful. NONE make me gain time instead of losing it.

You want to help. Cool, then stop masturbating on the results of your unusable new oncology deep-learning thingy and push for WORKPLACE INTEGRATION of technology, damn it!

Maybe if the tech community comes to understand how it can really help clinicians, things will start to change the way you fancy and we can finally end the age of rote memorization and criminal overtime for MDs.