131–140 of 198 posts
> decades of massive use for us to even realize that some of our most common over-the-counter drugs were being used in dangerous ways (e.g. aspirin can cause Reye's syndrome in children, Tylenol with alcohol can damage the liver) Agreed, but then to some degree could this same argument not be made about vaccines?
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…
> Walking in the woods is probably as effective as the average anti depressant citation very fucking needed.
https://link.springer.com/article/10.2165/00007256-200939060...
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.
You really think endocrinologists have no training in diet and lifestyle? Well, what can I say. No?
https://health.usnews.com/wellness/food/articles/2016-12-07/...
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'Western' medicine though as opposed to what? Nostalgic prescientific systems such as Chinese, ayurvedic, etc don't do anything at all. So yes, scientific medicine definitely has huge lacunae. Given the relative slowness of progress in understanding complex systems science has had in general, they'll be there for a long to come. But it's not as if there's some other candidate 'system' that has a better understanding.
As opposed to something holistic but still scientific. By “holistic” I mean that western medicine divides specializations too much and anything that doesn’t fit one box just falls outside everyone’s field. Generalist doctors aren’t very holistic either - they tend to just treat very common things or refer to a specialist. Example: if you have abdominal pains, you will be referred to a gastrointestinal specialist. Aft…
What are you talking about? Referred pain is well known and any doctor and especially any specialist will have studied and be familiar with common and likely referred pain pathways in the same way that they're familiar with other common interactions between systems. If you're struck with left arm pain while seeing an orthapedic surgeon, they'll make sure that you're not having a heart attack rather than trying to rule out orthapedic causes first.
In your example, assuming an uncommon referred pain that your gastroenterologist is not familiar with, what more do you want from them than ruling out a gastrological cause? It's incredibly useful information that you and your primary care physician will be able to use to help track down the real cause. And if, after consulting multiple specialists, your primary care physician has no more ideas for pursuing the root cause of the issue, they'll help manage your chronic condition in consultation with a pain specialist and psychologist if required.
Bottom line, doctors think more holistically thank you realise. To the extent that isn't sufficient, the medical system as a whole should be treating the patient as a whole. If that's not happening because of a variety of perverse incentives that's the fault of how we structure and pay for our healthcare systems and not the fault of western medicine.
These comments just reek of the silicon valley tech-bro myth that because you're good with computers you must know better than the millions of brilliant smart people in $INDUSTRY. The absolute arrogance.
Earlier quoted context omitted.
You really think endocrinologists have no training in diet and lifestyle? Well, what can I say. No?
> On average, U.S. medical schools offer only 19.6 hours of nutrition education across four years of medical school https://health.usnews.com/wellness/food/articles/2016-12-07/...
So yes, on paper you're right. In practice, there are even clinical nutrition specialists and those are MDs.
>The New York Times reported that in 2014 physicians wrote 83,000 prescriptions for antidepressants and almost 20,000 prescriptions for antipsychotic medications for infants two years old and younger Wow... This seems very obviously inappropriate. I listened to the EconoTalk interview referenced in TFA after hearing about it on another HN thread. Highly recommended. I have to say that I have become skeptical of medic…
My brother-in-law, who has a mental disability, saw a gastroenterologist for abdominal pain. They found worms and prescribed him a drug to get rid of the worms. The doctor said the worms could cause abdominal pain, but then again in most cases they don't, so he also put him on a drug for irritable bowel syndrome. After a couple of weeks, the stomach pain went away, but meanwhile my brother-in-law was having issues wi…
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How do I pay a doc for their time? I just sent emails to 35 different PIs this morning trying to find the most suitable clinical trial for my wife. I’ve learned a bit in the process but I’m still funtionally illiterate. Both of the oncologists we are working with just look for trials out of their location. When i ask what else is out there they point me to clinicaltrials.gov and say Godspeed.
I'll answer both of your questions, spoken and unspoken: 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…
That is frustrating to hear. I'd gladly pay a doc to spend the time to really get into things with me. Although I've learned to manage my problems, I'd prefer an actual solution to the current state of things.
I'm intrigued by a couple other things you said:
1) That we might be able to work something out with the practice to pay for consultancy. With my specific problems, I'm not even sure what specialist I need to talk to. I've seen many. They all try a couple things then point at a different specialty. Do you think someone could consult to at least narrow down which specialist can really solve the problem, or is that too close to a medical opinion?
2) That if I talk to someone not on my insurance, I probably could hire them. That sounds completely feasible. Say I did find someone with no relationship to my insurer - how would you recommend approaching them? Calling up and scheduling an appointment sounds like they'd expect me to just be part of the machine.
These comments just reek of the silicon valley tech-bro myth that because you're good with computers you must know better than the millions of brilliant smart people in $INDUSTRY. The absolute arrogance.
Welcome to HackerNews! Threads about Medicine and Economics are some of the worst - everyone here is apparently a Nobel grade expert.
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"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…
> you have no friggen clue what you're talking about Please do better than this, regardless of how wrong or ignorant another comment is. Your post gives us no information other than about yourself. If you know more, please share some of what you know so the rest of us can learn. Please don't just name-call. This is in the site guidelines: https://news.ycombinator.com/newsguidelines.html .
I was not intending to name-call; to me, the entire comment was wrong and I posted a curt reaction.
I'll provide more info here:
"The level of legitimacy and respect that doctors and hospitals currently have is far too high..."
Ask any young doctor in the US whether their field has a lot of "respect". Medical residents work 80-100 hours per week in windowless, flourescently lit rooms, of which 40-60 hours is often spent doing clerical work at sub-minimum-wage to service private insurance and EMR overlords. Patients regularly tell these same doctors they don't trust them, don't respect them, think they're wrong, want to see the "real" doctor, can prove how wrong they are with WebMD, etc. My spouse is now doing her 13th and 14th year of post-secondary training toward the goal of being a specialized surgeon. She has done hundreds of successful surgeries/procedures already and saved countless lives. Yet, she is burnt out, and often ends her workdays completely destroyed by the humiliation of being a cog in the hospital machine. She is not alone; physician depression and suicide is at all-time highs.
"... and hinges on branding and the exclusivity of becoming a doctor."
Like I said, she is on her 13th and 14th year of post secondary training. Aside from this being a massive time investment, it also cost her dollars she didn't have (no support from parents) on order of $300k in post-secondary education, just in tuition. If becoming a doctor is "exclusive" and confers a "brand", I'd say the exclusivity is "extreme passion for helping humans at great personal sacrifice and cost", and the conferred "brand" is that you are allowed to practice medicine, at all.
"Once all of this data becomes available, it will be obvious how worthless and expensive most medical treatments really are."
Medicine -- and the tireless and ethical work of thousands of well-trained and professional doctors -- saves countless, countless lives every single day. Modern medical treatments are not "worthless" and your comment is honestly insulting to how effective and life-saving many treatments are. I think this part of your comment is what got the rise out of me: spreading this kind of misinformation is the closest thing HN commenting gets to "malpractice".
Society should respect and pay doctors much more for the sacrifice they put toward this profession. Patients should respect doctors a lot more for the benefit they provide society. Hospitals should give doctors a better work environment. Doctors are not perfect, nor is medicine. But to think the root cause of problems in the present medical system is an undeserving respect for doctors and modern medical treatments expresses a profound ignorance of reality.
The original comment is so wrong that it truly stunned me into an uncharacteristically curt ad hominem response, for which I apologize.