Google almost convinced me to spend $400 on useless laser treatments • Hacker News Board

Re: Google almost convinced me to spend $400 on useless laser treatments

#251

Post by derefr » Wed, Apr 27, 2022, 3:21 PM UTC

Afforess wrote: post #207

ironmagma wrote: post #128

Earlier quoted context omitted.

Depends on which doctor you are going to. We have some of the world’s best doctors but they might be in hospitals or doing a concierge service. You get what you pay for.

> You get what you pay for. But you don't... that's the whole problem with the American Healthcare industry!

No, with the American health system, you do get what you pay for (i.e. more money ⇒ access to better medicine); but you don’t necessarily pay (the right amount) for what you get (i.e. !(worse medicine ⇒ costs less)).

Which is to say: standard-of-care treatments can cost far too much relative to other countries; but also, if you’re willing to throw millions of dollars at private clinics, you can opt your own way into experimental treatments that don’t exist anywhere else in the world.

Re: Google almost convinced me to spend $400 on useless laser treatments

#252

Post by 323 » Wed, Apr 27, 2022, 3:22 PM UTC

JamesAdir wrote: post #238

323 wrote: post #222

I once asked the dentist why are there so many different toothbrush head shapes, with the bristles at all kind of angles and patterns, rubber inserts and so one. Surely by now we know what's the optimal shape? And the answer was that yes, the optimal head shape is known, but since it's not that consequential this is not regulated as other medical stuff and basically everyone does weird shapes just for marketing and d…

What's the optimal shape?

From my research the most important thing is for it to have soft bristles with round bristle heads (obviously you can't check bristle heads with your eyes, too small). Most you find in supermarkets have medium or hard bristles.

The head shouldn't be too big, so that it can reach even in the back.

Rubber inserts are not recommended, as they tend to irritate the gum.

Typically the better ones look more plain - no multi colored bristles or spaceship looks. However, since this becomes more known, it becomes a marketing signal in itself - like "plain brown paper package" chocolate, etc.

Re: Google almost convinced me to spend $400 on useless laser treatments

#253

Post by anotherman554 » Wed, Apr 27, 2022, 3:22 PM UTC

jonhohle wrote: post #109

jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

Are there any laws that treat medical providers as fiduciaries? That seems like a minimum bar that insurance companies would want to enforce (at least in the short term when premiums could remain high while treatment cost plummets).

A doctor's job is to worry about your health, not not how wealthy you are.

Quite literally. If a more expensive treatment has a better chance of saving your life, or a more expense test has a better chance of detecting a disease, the Doctor could be sued for malpractice for not ordering it if you die.

Re: Google almost convinced me to spend $400 on useless laser treatments

#254

Post by ccwilson10 » Wed, Apr 27, 2022, 3:23 PM UTC

donatj wrote: post #17

matsemann wrote: post #12

Why are dentists so scammy? In Norway I've seen documentaries about them sending the same people to multiple dentists, and some of them receive wildly different advice. Some of that can be ascribed to some being in the school of pro-active, so they want to fix your teeth at the first glance of issues. But in the end, most of the things being quoted were unnecessary. They all seemed very intent on removing wisdom teet…

I went to a new dentist for a broken filling and they tried to tell me I had 14 cavities and set me down with a finance person to set up a payment plan for how I was going to pay for them over the next 5 years. I went to a second dentist, they fixed the broken filling and said my teeth were otherwise fine. I have the paperwork to back this up. I’d been seeing another dentist for a while and he suddenly wanted to crow…

Wife is a dentist. There certainly are practices where treatments are recommended as a function of money and cashflow (laser treatment and other "optional" treatments are a great example of this). However, crown / cavity recommendations are largely dependent on how aggressive that particular dentist's philosophy is. E.g. my wife only goes to her father for treatment because he focuses on saving teeth whenever possible.

Unlikely that a dentist would ever recommend filling cavities if they didn't believe it was necessary – they're not very profitable for practices. Crowns are sometimes recommended when a filling will suffice, but that's usually because crowns last ~10 years and fillings only delay the inevitable crown for a few years.

Re: Google almost convinced me to spend $400 on useless laser treatments

#255

Post by cm2187 » Wed, Apr 27, 2022, 3:23 PM UTC

jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

Not saying that you are wrong, there are bad doctors like any other profession.

But in general, the counterpoint to that view is that medicine is one of the only professions that never industrialised. You have to put a highly trained MD in front of every patient for every problem. It just doesn't scale. And some patients have the expectation that this MD should also cuddle them, provide emotional support and listen to their life. I am glad when I see a doctor for something and I am in and out within 5 minutes, it makes me feel that I resolved my problem without burdening a precious resource.

Re: Google almost convinced me to spend $400 on useless laser treatments

#256

Post by gnu8 » Wed, Apr 27, 2022, 3:26 PM UTC

the_only_law wrote: post #171

jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

At what point can I just purchase old medical machinery on eBay and run my own blood tests and stuff.

The cost and bureaucracy required to get one working will probably kill this idea. Those machines require consumables to run the tests, as well as for calibration and QA. The vendor might be willing to sell you the supplies and send a technician to get the machine set up to run a valid test, but it won’t be cheap, and they might be unwilling if it’s some guy trying to run the machine in his garage rather than a medical facility. Beyond that, there is a reason that the machine is on eBay and not being sold or donated. It could be obsolete and the supplies unobtainable, or simply beyond economic repair.

Re: Google almost convinced me to spend $400 on useless laser treatments

#257

Post by prewett » Wed, Apr 27, 2022, 3:28 PM UTC

alistairSH wrote: post #160

lupire wrote: post #111

Earlier quoted context omitted.

Broadly, it's because the US has a culture of individual sovereignty and not everyone being a ward of the state.

That's not true. We have the drug ads in the US because legal precedent since the late-70s/early-80s (roughly) in the US now protects commercial speech.

Companies are legally considered persons, hence their speech is protected. This is consistent with individual sovereignty. If people are wards of the State, then the State would have the responsibility to police "harmful" speech; advocating untrained people to ask their doctor for a specific medication could be considered harmful speech (since apparently only two countries in the world allow it, and not even the US before the 70s-ish, apparently).

Re: Google almost convinced me to spend $400 on useless laser treatments

#258

Post by jrockway » Wed, Apr 27, 2022, 3:34 PM UTC

cupofpython wrote: post #219

jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

>I can’t count on doctors _at all_ to move the process forward. This has been my experience as well dealing with fatigue. I was 25 when I finally got diagnosed with sleep apnea, after over a decade of symptoms. How something so common could go unnoticed by the adults and professional doctors in my life astonishes me still today. Eventually, thanks to ego, I questioned the narrative that I was just normal and lazy. Wi…

I think the situation has improved there in the last couple years. I had a friend who I suspected of having sleep apnea. She called her doctor and asked for a sleep study. They gave her a device to wear while sleeping and the diagnosis of sleep apnea came the next day.

Getting insurance to approve the CPAP, though... that is still an open problem. Weeks later, no treatment for diagnosed disease.

Re: Google almost convinced me to spend $400 on useless laser treatments

#259

Post by cupofpython » Wed, Apr 27, 2022, 3:36 PM UTC

loup-vaillant wrote: post #190

JKCalhoun wrote: post #137

Earlier quoted context omitted.

I thought expert systems were supposed to replace diagnosis, like three decades ago.

In an April's fool story where Eliezer Yudkowsky was pretending to come from a rationalist parallel world (or outer planet), he suggested a medical system with a different way to specialize people. Most notably, he suggested we separate diagnosticians and prognosticators from practicians . The former do their best to guess what you have, send you to the right kind of practician, and estimate your possible outcomes (w…

I only support this if I dont get charged for 2 visits

Re: Google almost convinced me to spend $400 on useless laser treatments

#260

Post by toast0 » Wed, Apr 27, 2022, 3:37 PM UTC

matsemann wrote: post #54

seanmcdirmid wrote: post #43

Earlier quoted context omitted.

Dentists don’t remove wisdom teeth, they just refer you to an oral surgeon. The problem with wisdom teeth is that they increase maintenance requirements, it’s hard to clean back there and they can affect adjacent teeth if they do go bad. So I get why many dentists default suggest to remove them (I still have mine but recently started running into problems at 47).

> they just refer you to an oral surgeon Perhaps in the US where they drug you down? Here the dentist just gives you a local anesthetic and pry them out, unless there is something extraordinary. Or perhaps it's a different person? But still the same company getting the money.

It would also depend a lot on what's going on with your wisdom teeth. If they haven't erupted at all and are causing trouble, that's oral surgery time. If they're fully erupted, a regular dentist may do it. In between, it depends.