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Man saves wife’s sight by 3D printing her brain tumor

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Re: Man saves wife’s sight by 3D printing her brain tumor

#141

Post by collyw »

nhstanley wrote: post #35
jpmattia wrote: post #15

> Balzer used Photoshop to layer the new DICOM files on top of the old images, and realized that the tumor hadn’t grown at all — the radiologist had just measured from a different point on the image. Think about the some of the implications of that statement for a while. It really is no wonder that the softer sciences have a reproducibility problem.

> It really is no wonder that the softer sciences have a reproducibility problem. Even Further, I think it's also indicative of medicine being full of people that have a fatalistic, passive attitude towards their patients and medical care. Medicine and health is really hard, and so many health professionals essentially believe that the only thing they can do is wait until something horrible happens before doing anyth…

Like most professions, I am sure there are doctors who are like you describe as well as many others at they opposite end of the spectrum. Its wrong to generalize them all to be like this.

Re: Man saves wife’s sight by 3D printing her brain tumor

#142

Post by amedstudent1 »

nhstanley wrote: post #35
jpmattia wrote: post #15

> Balzer used Photoshop to layer the new DICOM files on top of the old images, and realized that the tumor hadn’t grown at all — the radiologist had just measured from a different point on the image. Think about the some of the implications of that statement for a while. It really is no wonder that the softer sciences have a reproducibility problem.

> It really is no wonder that the softer sciences have a reproducibility problem. Even Further, I think it's also indicative of medicine being full of people that have a fatalistic, passive attitude towards their patients and medical care. Medicine and health is really hard, and so many health professionals essentially believe that the only thing they can do is wait until something horrible happens before doing anyth…

I think the other reply covers it a lot, but I find posts like yours to be very demeaning. You're essentially doing the same as someone who doesn't understand programming making declarations of how programs should be made. There is a lot going on behind the scenes and modern medicine is based on evidence, so please take the arm-chair commentary away

Re: Man saves wife’s sight by 3D printing her brain tumor

#143

Post by amedstudent1 »

parennoob wrote: post #121
entropydude wrote: post #118

Earlier quoted context omitted.

I'm a doctor and former software programmer, so let me offer a counterpoint: I would disagree with your statement that medical people have a fatalistic passive attitude. In this case the decision is between 1) watching and waiting to see if the tumor grows and 2) acting immediately to take it out. The tumor in question is a meningioma, a relatively common tumor of the skull (meninges, to be precise) whose natural beh…

I understand your rationale for the "wait and watch" option, and agree fully with it. > "well maybe they do, but it is out of carelessness rather than a problem with there software." I think this statement precisely illustrates the point that the parent commentator has with much of the medical community. Think about what the "carelessness" of a radiologist that you're talking so flippantly about means for a family –…

On the point of 2 radiologists checking, as a routine that would be too uneconomical, so if you wanted 2 people check you'd have to get a second opinion. Most likely on your own cash, since (as far as I am aware) everywhere medicine is in more demand than supply.

However you can be assured before an actual surgery, the same films will be reviewed by many doctors. Meaning that a mistake falling through everyone's mind is less likely.

I do agree with your point that sometimes a mistake can have a large impact on people. It's one of the challenges of medicine I'm not sure anyone has a solution to. On the flip side there would be many who are properly told the correct analysis, but i guess sometimes you get unlucky and a human error is made.

Re: Man saves wife’s sight by 3D printing her brain tumor

#144

Post by amedstudent1 »

digi_owl wrote: post #126
parennoob wrote: post #121

Earlier quoted context omitted.

I understand your rationale for the "wait and watch" option, and agree fully with it. > "well maybe they do, but it is out of carelessness rather than a problem with there software." I think this statement precisely illustrates the point that the parent commentator has with much of the medical community. Think about what the "carelessness" of a radiologist that you're talking so flippantly about means for a family –…

Welcome to modern society. Likely the radiologist etc see so many people that caring about each and every one would result in a early retirement for exhaustion or similar.

That was the most succinct summary of the attitude i've seen many times amongst doctors. I'm saving that :D

It's always funny when someone thinks they're the center of attention... yes in a perfect world I'd remember everything and care only about you but if I do that I won't be finished my job. After a while I've noticed even as a student (and certainly picked up that a few doctors) that if you try care on a more personal level about every person, you'll be knocked down more and it'll be harder to function. Hence why I think a middle ground or even lack of care is what you see.

Re: Man saves wife’s sight by 3D printing her brain tumor

#145

Post by amedstudent1 »

Normati wrote: post #105
DanBC wrote: post #89

Earlier quoted context omitted.

There are some useful questions patients can ask. "What happens if we do nothing? If we do watchful waiting?" "What happens if I don't take these meds?" "How likely is that bad event? Tell me in terms of numbers per 10,000 people rather than percentages".

Another useful one is to ask him to explain his reasoning. If he can't justify his decisions, then he's probably using instinct which is unreliable in the case of rare diseases, or he doesn't know how to diagnose known diseases which means he's incompetent. Some people are offended when you challenge them for reasons for their advice, but I think that's because they aren't confident in it themselves or feel superior.…

Whilst on the whole I agree with you, the amount of doctors I know that would react (quite strongly) negatively to that is quite high, so anyone who takes your advice should be prepared. The most common response I've seen to your question was the doctor reminding the patient "there is always something called a second opinion", a couple of times though I noticed them taking the time to explain it.

Re: Man saves wife’s sight by 3D printing her brain tumor

#146

Post by amedstudent1 »

autokad wrote: post #110
pixelcort wrote: post #108

Earlier quoted context omitted.

Couldn't this be argued of people in all professions, including software engineering? There are some who just don't care; people who just follow the process and procedure and aren't interested in the bigger picture. While I agree that technology and automation can help, in addition we should find ways to help professionals move beyond their routines.

but software engineers 'pretty much' make at most in the early 6 figures and doctors 'pretty much' start there. i'd love to give customers max 15 minutes to tell me how they want their website only to tell them this is what they are going to get because its the standard of care. why should a doctor care? they get paid weather you live or die. what happens to you basically has no bearing on their career. a doctor i kn…

Your post is a gold mine of potential points to attack but I'll save it and just focus on this:

>the supply of doctors is kept short purposefully to ensure they make money++

No. It's costly to train them, and it's hard for an average person to afford.

Re: Man saves wife’s sight by 3D printing her brain tumor

#147

Post by tsax »

toomuchtodo wrote: post #94
tsax wrote: post #70

Earlier quoted context omitted.

I come from a long line of docs, though I'm a software dev. Let me tell you that the vast majority of patients can easily be sorted into these pre-formed category bins. Rare conditions are rare by definition. Most of medicine is dreary repetition.

> Most of medicine is dreary repetition. Hence why we can automate away most of the problems with it.

Yes, which is also why The Checklist Manifesto was so successful.

Re: Man saves wife’s sight by 3D printing her brain tumor

#148

Post by gmarx »

zaroth wrote: post #84
gmarx wrote: post #51

Earlier quoted context omitted.

Medicine has a data problem. It is multifaceted and far more difficult to fix than it should be. I've worked on these problems for years and it is immensely frustrating. Incentives just aren't set properly to solve them. For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it.

Did not ACA put incentives in place specifically for outcome tracking? I was just talking with a guy at MIT working on post-stroke outcome tracking and automated scoring simply through the myriad of sensors on a high-end smartphone, and he mentioned ACA now or in the future will pin a significant portion of reimbursement on outcome tracking, forming the basis for his business model.

They are intended to. Even if ACA isn't the ultimate form, most healthcare reform involves paying for performance rather than procedures and this implies outcomes tracking of some kind. You've got some serious chicken/egg problems though

Re: Man saves wife’s sight by 3D printing her brain tumor

#149

Post by gmarx »

VikingCoder wrote: post #78
jpmattia wrote: post #75

Earlier quoted context omitted.

> For example with outcomes tracking, even if you had a good software system for it, you won't get reimbursed for it. It's worse than that: It would be sued out of existence by those people who rank badly (ie, exactly those bad practitioners that need to have their asses kicked.) In a related example: A friend wrote a book about first-hand experience in dealing with a nursing home for her aging parent. There were man…

You're not going quite far enough - Medical Practitioners and Medical Institutions should be required by law to document outcomes, provide information about disputed outcomes, and update the information on a periodic basis. And tampering with the information should carry heavy punishment, including jail time for the practitioner and officers of the institution. Actions like the recent cover-ups in the VA hospitals ab…

You'd need to take account of differences in patients lest you discourage doctors from treating the more unhealthy. You also need to alter the way we define and punish malpractice.
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