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

People have stopped going to the doctor and most seem fine

nytimes.com

Post reply on HN
Print view View original

61–70 of 76 posts

Re: People have stopped going to the doctor and most seem fine

#61

Post by eyerony »

Delk wrote: post #58
eyerony wrote: post #7

If I could get antibiotics for strep or sinus infections without going to them, I'd pretty much never go. Those visits are really dumb because I already know what's wrong, and just need them to say "yep, it's the thing you already knew it was, here's a prescription and a bill for doing nothing useful" ... actually on reflection already knowing what's wrong and just needing a doctor to say it so treatment can proceed…

Genuine and slightly off-topic question out of curiousity: how often do you have strep, a sinus infection (that doesn't go away on its own), or some other condition that requires treatment with antibiotics? I think I've needed a course of antibiotics perhaps twice in the past ten or fifteen years (can't remember exactly; not often anyway), and one of them was in an exceptional situation. That leads me to somewhat dou…

Ages 0-22: zero times, basically never sick, never had strep or a sinus infection even once. Maybe, maybe had very mild cases of the flu once or twice when very young but then never got it again in that age range, despite never bothering with the vaccine or taking any precautions whatsoever. I'd get my "annual sniffles" when I felt slightly off and had a slightly runny nose for about 36 hours. That's as sick as I got.

After that, once a year in a good year, twice in a bad one, and I get the flu every other year or so, even with the vaccine. If I get the flu it also gives me a sinus infection more often than not. Nose slightly stuffy 100% of the time, now. Almost all my strep and sinus infections trend toward landing me in the ER, on saline, if I don't get antibiotics—rarely do they just go away. Haven't made it quite that far yet but I've been damn close.

All I can figure is HGH is a hell of a drug. I was also super-fit (looking, plus solidly healthy-range BP) until about the end of that age range, despite eating ~2x my on-paper "maintenance" calories of pure garbage food every day. Go figure. I eat much less and much better now, am fatter, and get sick sometimes rather than never getting sick. Getting old sucks.

Re: People have stopped going to the doctor and most seem fine

#62

Post by Sevrene »

JoeAltmaier wrote: post #8

The postponed dentist visits will have their fallout (!) eventually. Delayed annual visits to check for skin cancer, colon cancer etc will statistically hurt us. Mammograms put off, should have a definite downside in terms of early detection. Heck, even delaying car maintenance will cost folks hard cash later. The bill will definitely come due, for the slowdown.

Sometimes being too cautious can cause harm too. It's not so clear cut as you might think. For instance, pushing mammograms earlier in life causes over diagnosis (around 20% in one study), leading to invasive surgeries that were not actually required, and they're not without risk. It can be pretty intense having a cancer scare, too.

So if we spend more money on these and we do them more often yet they don't actually improve mortality, is it worth it? There's a trade up there which your doctor should be making.

Re: People have stopped going to the doctor and most seem fine

#63

Post by jeltz »

jjk166 wrote: post #33
tetromino_ wrote: post #25

Earlier quoted context omitted.

Counterexample from recent personal experience: I developed pain in my hand which made it difficult to type. Some googling revealed that my set of symptoms could be caused by 3 rather different underlying causes requiring very different treatments. Failing to treat the correct underlying cause could permanently damage my ability to use my hand, and thus my ability to earn a living. I _needed_ to go to a physician for…

And what are the odds you will encounter that situation again in the next 10 years? In the same time period, what are the odds you'll need a prescription for antibiotics for a common disease? No one is saying you should stop seeing doctors entirely, but several things that currently require a doctor's appointment probably shouldn't.

Anecdotally I have required antibiotics once the last 30 or 35 years so I doubt I would need it any time soon and if I need it I do not think I would be able to self diagnose reliably. Maybe I am an extreme outlier but I do not think taking antibiotics is common among my friends and family either, other than a friend who has chronic ear issues.

Personally I think antibiotics is one of the cases where having a gatekeeper is the most important since we must fight antibiotics resistance.

Re: People have stopped going to the doctor and most seem fine

#64

Post by JoeAltmaier »

Sevrene wrote: post #62
JoeAltmaier wrote: post #8

The postponed dentist visits will have their fallout (!) eventually. Delayed annual visits to check for skin cancer, colon cancer etc will statistically hurt us. Mammograms put off, should have a definite downside in terms of early detection. Heck, even delaying car maintenance will cost folks hard cash later. The bill will definitely come due, for the slowdown.

Sometimes being too cautious can cause harm too. It's not so clear cut as you might think. For instance, pushing mammograms earlier in life causes over diagnosis (around 20% in one study), leading to invasive surgeries that were not actually required, and they're not without risk. It can be pretty intense having a cancer scare, too. So if we spend more money on these and we do them more often yet they don't actually…

Hm. 'Getting scared' vs 'missing a cancer and dying'. There's a disparity in the cost of those two false results. I know which side I'm on.

Re: People have stopped going to the doctor and most seem fine

#65

Post by Delk »

eyerony wrote: post #61
Delk wrote: post #58

Earlier quoted context omitted.

Genuine and slightly off-topic question out of curiousity: how often do you have strep, a sinus infection (that doesn't go away on its own), or some other condition that requires treatment with antibiotics? I think I've needed a course of antibiotics perhaps twice in the past ten or fifteen years (can't remember exactly; not often anyway), and one of them was in an exceptional situation. That leads me to somewhat dou…

Ages 0-22: zero times, basically never sick, never had strep or a sinus infection even once. Maybe, maybe had very mild cases of the flu once or twice when very young but then never got it again in that age range, despite never bothering with the vaccine or taking any precautions whatsoever. I'd get my "annual sniffles" when I felt slightly off and had a slightly runny nose for about 36 hours. That's as sick as I got…

I see. I'm sorry you've seen such a drastic change.

I'm 37 now and went for years in my 20's without needing to visit a doctor more than a couple of times in total. I can see some of the changes that come with age but for me they're mostly related to slower physical recovery after exercise and some general wear on knees etc. Common colds might also make me feel somewhat worse than they would have 10 or 15 years ago, but I almost never develop any complications that would require anything else than time, and the change has been gradual enough to make it difficult to judge.

Re: People have stopped going to the doctor and most seem fine

#66

Post by Sevrene »

JoeAltmaier wrote: post #64
Sevrene wrote: post #62

Earlier quoted context omitted.

Sometimes being too cautious can cause harm too. It's not so clear cut as you might think. For instance, pushing mammograms earlier in life causes over diagnosis (around 20% in one study), leading to invasive surgeries that were not actually required, and they're not without risk. It can be pretty intense having a cancer scare, too. So if we spend more money on these and we do them more often yet they don't actually…

Hm. 'Getting scared' vs 'missing a cancer and dying'. There's a disparity in the cost of those two false results. I know which side I'm on.

22% unnecessary surgeries following mammograms[1] is not just 'getting scared' these are invasive surgeries with real risks. Are you strawmanning my point or just being hyperbolic? Again, I ask, hoping for a less flippant answer; if we spend money, time, effort on increasing mammograms that doesn't actually improve overall mortality and has it's own risks, should we still do it?

I'm not saying this because I think we should never investigate or search for cancer, I'm just stating that it's not as clear as 'mammogram always good'. We must weigh the risks with the benefits and we cannot just ignore the harm because we're scared of the possibility of death.

[1] https://www.bmj.com/content/348/bmj.g366

Re: People have stopped going to the doctor and most seem fine

#67

Post by hackeraccount »

My impression is that at a Public Health level most forms of medicine don't make much of an impression.

Antibiotics would probably be an exception. Vaccinations if you choose to call them medicine.

At the population level though most of the things that affect health and life expectancy are life style choices of one type or the other that Doctors have not show an ability to control.

My Dr. might be able to tell me that my smoking is bad. That I need to lose 10 lbs. That getting black out drunk every weekend isn't doing me any good. All of that and more. But Dr's aren't any good about doing anything about those things.

You could add clean water and clean air in that pile.

Compared to that cancer detection and extending the lives of people with cancer is a drop in the bucket. Of course if you fall into that category then it's a huge difference but overall I don't think it makes a huge difference.

Re: People have stopped going to the doctor and most seem fine

#68

Post by r00fus »

SpicyLemonZest wrote: post #19
burkaman wrote: post #9

> In a recent survey, only one in 10 respondents said their or a family member’s health had worsened as a result of delayed care during the pandemic. That's 30 million people. And in a fantasy world where going to the doctor in America was cheap and easy, I imagine most people would be happy to go regularly if they knew there was a 10% chance it would make them healthier. Also, how are people answering this survey? O…

And younger people's health is going to be generally better right now just because they're not getting colds all the time.

Yeah, like we had few colds/flus in the past year or two for our large-ish family, but now it's gone to zero for the past 4 months which is... impressive.

So does that mean when things come back on that we can expect a flurry of illnesses going around?

Re: People have stopped going to the doctor and most seem fine

#70

Post by ardy42 »

smnrchrds wrote: post #46
wincy wrote: post #30

Earlier quoted context omitted.

I recently started paying for Direct Primary Care. We signed up as seeing a doctor during COVID became even more difficult than usual. It’s definitely a luxury but I pay $100 a month and my wife and I can bug our respective doctors (she has a woman doctor that will only accept women and children patients; my male doctor only accepts male patients) whenever we want. Obviously we try not to bug them all the time and be…

> she has a woman doctor that will only accept women and children patients; my male doctor only accepts male patients Is that legal?

> Is that legal?

IIRC, gynecologists aren't even allowed to treat men, even though they're most qualified to treat certain diseases/problems that males can have (just far more rarely than women). I don't remember the specifics, though.

Post reply on HN