91–100 of 269 posts
There's a similar phenomenon when you look at fetal heart monitoring for otherwise healthy pregnant women going into labour. The two options are continuous monitoring, where the monitor is left in place for the entire hospital stay, and periodic monitoring, where a nurse installs it, takes a reading, and removes it about once an hour. Common sense would dictate that negative outcomes are reduced with continuous monit…
Onward and upward: I did eventually do a physical, after getting over the wreck. My blood work came back with crazy liver enzyme numbers, 4-9x higher than they should have been. My Dr thought I might have hepatitis and ordered a full hep screen. Before doing that, I did some research, and ran across a NIH paper saying "Hey, before you enroll anyone into drug trials, make sure they aren't working out regularly, because that causes hugely elevated liver enzymes and throws off the trial." Hmm... I mentioned this to my Dr and he said no, that's not it, but maybe get off your protein shakes 2 weeks before the blood test. I read about that, and protein shakes don't affect the liver enzymes. So I decided to stop workouts for 2 weeks AND stop protein shakes. Took the blood test and my liver values were completely normal, and negative for hepatitis.
While they may have good intentions, doctors don't always know or understand what they're looking at. I think I could have easily ended up with a liver biopsy had I not stopped my workouts before the 2nd blood test.
I call bullshit on this. I had a very rare heart condition that was discovered during one of my yearly check ups. Chasing the root cause led us to even more scarier findings.
Sure, if we are dropping anecdotes, my kids were over diagnosed/incorrectly diagnosed. It ended up costing me slightly under 1 thousand dollars before other doctors said 'no big deal'. The weirdest part about these, both of the diagnosis seemed like there was no possible solution, so even with the confirmatory tests, it wasn't like anything was going to change. However they were insistent of getting multiple speciali…
What bothers me is at least in the US we've forced doctors to adopt an MBA driven pop mass manufacturing system. Like they're some schmuck in a chicken factory.
You would think doctors would be able to collect data and then come up with statistical tables of “hey you may have xyz. The risk to look into this further has these possible complications with these success/failure rates. The risk of no intervention has these other set of outcomes with these likelihoods” All you get at a doctor is someone typically saying “eh you’re young don’t worry about it” until it’s too late. I…
Your expectations are unreasonable. Most doctors are practitioners, not researchers. They are applying existing care protocols rather than collecting data and coming up with statical tables. Good doctors will follow evidence-based medicine practices where applicable, but individual cases often diverge from the standards. There is a huge amount of medical research going on but the field is so complex that progress is…
That mindset is the mindset of an old company - “we just do things around here like that because that’s the way they’ve always been done.” The field should move forward with technology we shouldn’t settle for something because that’s the way it is.
I have a personal example of this. My father died largely because of his annual physical. He hated doctors, became nervous around them and thus expressed hypertension in-office. He did not have material hypertension but did defer to his physician. Over the long term, despite my best efforts, this killed him. His blood pressure medication regime was poorly managed and severely impacted his quality of life. He eventual…
I am ultimately in charge of my health, and it's my choice what I meds I take or test I do, or how I live.
Earlier quoted context omitted.
I think the idea is this: even accurate tests have false positives. For patients in a low-risk group, virtually all positive results in the checkup will be false positives. When the low-risk group is large (the entirety of a nation's healthy 20-30 year olds), the number of such false positives will also be large. The positive results, regardless of whether they are true or false, will have some sort of follow-up. May…
> whether it is ethical or worthwhile to expose patients to the risk of harming their health through the follow up So you seem to be saying that, in certain cases, if you have a positive test result, then the expected value of taking certain follow-up actions is negative. It follows that a rational actor, knowing this, would not take those actions in that situation. Then isn't the solution for doctors to update their…
Very few fields work this way.
Most primaries are useless. Having someone who works in healthcare in your family is of incredible value, and the general advice is to always see a specialist. We could likely do away with primary doctors in the US. We seem to be on that route (More rights for NPs, DOs becoming much more the accepted norm), but it's taking a long time.
Earlier quoted context omitted.
Your expectations are unreasonable. Most doctors are practitioners, not researchers. They are applying existing care protocols rather than collecting data and coming up with statical tables. Good doctors will follow evidence-based medicine practices where applicable, but individual cases often diverge from the standards. There is a huge amount of medical research going on but the field is so complex that progress is…
With all due respect, I think it’s unreasonable to call my expectations unreasonable. That mindset is the mindset of an old company - “we just do things around here like that because that’s the way they’ve always been done.” The field should move forward with technology we shouldn’t settle for something because that’s the way it is.
If you have a suggestion for improvement then be specific. Vague complaints aren't helpful.