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A new book critiques medicine

blogs.scientificamerican.com

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Re: A new book critiques medicine

#151

Post by rscho »

rhinoceraptor wrote: post #144
rscho wrote: post #136

Earlier quoted context omitted.

That's for basic med school education. Happily, medical education doesn't stop at the end of med school. It is more like, beginning just at that moment. Otherwise many more patients would die. So yes, on paper you're right. In practice, there are even clinical nutrition specialists and those are MDs.

In practice, nutritional interventions are much less favored over drug interventions. For example, a simple ketogenic diet intervention can be a very effective treatment for type 2 diabetes. But most doctors still favor the 1960s-era, discredited science saying dietary fat causes heart disease. So diabetics are given metformin and whatever fancy new insulin came out recently. And then in 20 years, those people will l…

Diet and lifestyle changes are first line as per current guidelines.

Drugs are initially optional, unless I am mistaken. However, you seem very optimistic regarding the ability of people to follow diets.

Re: A new book critiques medicine

#152

Post by m0zg »

yourMadness wrote: post #27

Modern medicine has some aspects that are miraculously good and it is easy to fall into the trap of thinking that those are representative for all of medicine. It's a kind of halo effect bias. In my opinion the most amazing thing still is antibiotics (and vaccination). Treatmeant of war/vehicle/sports injuries taking the second place (including anesthetics). Both can take people from a path of sure death within hours…

As someone who has had some less-acute sports injuries, I'd also break the injuries down into "shit's really fucked up" and "you could conceivably walk it off" categories. The former, modern US medicine excels at. The latter, I'm not sure the doctors are even trained to treat something less acute and not requiring expensive surgery. In fact, I strongly suspect they often prescribe a surgery anyway, just to make a buck. I had to decline a surgery once.

Re: A new book critiques medicine

#153

Post by meruru »

cheesymuffin wrote: post #146
flying_kiwi wrote: post #125

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.

And yet, in every 100 bullshit tech-bro commenters, there are 10 who are actually getting really interested in the subject and taking the time to check their old Bio notes, research opposing viewpoints, or maybe even bring something new to the table. Hating is easy. All you have to do is point fingers at people and tell them they know nothing. 100% of the time you'll be right.

I've always seem this kind of criticism of the "tech bubble" as a great endorsement of the tech community. Where else do you see people so interested in so many subjects that they have to be constantly reminded they are speaking outside their expertise?

Am I just not aware of the HN equivalent for medical doctors?

Re: A new book critiques medicine

#154

Post by m0zg »

dkarl wrote: post #52
astura wrote: post #11

>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…

I was actually surprised that antidepressants are prescribed for IBS quite often. My son used to suffer from IBS (grew out of it), and his doctor wanted to put him on, I kid you not, Prozac. That's for a still developing kid at like 10 years old. He said he prescribed Prozac pretty much all the time when he suspects that the cause of IBS is psychosomatic. Another unpleasant revelation was just how little is known about this presumably fairly common condition. Nobody knows how to diagnose it, and there's no cure. If you don't grow out of it, you're stuck with it for life, and many people don't grow out of it.

Re: A new book critiques medicine

#155

Post by bigred100 »

rscho wrote: post #130

I would like to make a personal statement to the tech community in view of this thread's comments: A vast majority of you drastically overestimate the information processing and retrieval of the healthcare system. We MDs can all see your superb AI/ML results in journals, and yes you can improve things with technology. What we can't see is how we're going to use it. In my day-to-day job, there are a myriad of new-supe…

I’d imagine the people writing these wonderful journal articles care more about writing journal articles than that stuff. In fact, they are probably employed to write those articles. Anyway I can’t really comment on why they would or would not masturbate on a scientific paper. You are the doctor.

Re: A new book critiques medicine

#156

Post by logicprog »

bedobi wrote: post #150
logicprog wrote: post #147

Earlier quoted context omitted.

Good solutions can often be left on the table, even by experts in $INDUSTRY, apart from whether they're experts or not; it's often a systemic thing. It's perfectly possible for an intelligent, rational person who is good at thinking about large and complex systems (who are overrepresented in the tech industry) to have an insight (that individuals in that industry might already have had) about things outside their own…

Your relevant article doesn't even get the first paragraph right. The Efficient Market Hypothesis doesn't mean eg that markets result in efficient use of resources or societally efficient/optimal outcomes, which the author seems to imply.

Well, the idea of the EMH (as I understand) is that the stock prices for things should be at an optimal price already and trying to beat market prices is basically a game of chance. Since one of the examples he gives is about the stock market and investing, I don't think his offhand statement is that far off.

More importantly, that's not really Central to the argument of the book he's reviewing or the argument of his post itself, it's a mostly irrelevant detail that you've picked on for no discernable reason.

Re: A new book critiques medicine

#158

Post by yura »

flying_kiwi wrote: post #125

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.

This theme is itself older than dirt. Socrates had already noticed this problem back in the day:

"At last I went to the artisans, for I was conscious that I knew nothing at all, as I may say, and I was sure that they knew many fine things; and in this I was not mistaken, for they did know many things of which I was ignorant, and in this they certainly were wiser than I was. But I observed that even the good artisans fell into the same error as the poets; because they were good workmen they thought that they also knew all sorts of high matters, and this defect in them overshadowed their wisdom (...)"

Re: A new book critiques medicine

#159

Post by TeMPOraL »

bedobi wrote: post #135
flying_kiwi wrote: post #125

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.

> Threads about Medicine and Economics are some of the worst

Compared to what? What you'd have on a forum of economists or doctors? Maybe. What you would be reading otherwise? Not quite.

> everyone here is apparently a Nobel grade expert.

Maybe not Nobel-grade, but there's plenty of actual doctors on HN.

Re: A new book critiques medicine

#160

Post by TeMPOraL »

logicprog wrote: post #156
bedobi wrote: post #150

Earlier quoted context omitted.

Your relevant article doesn't even get the first paragraph right. The Efficient Market Hypothesis doesn't mean eg that markets result in efficient use of resources or societally efficient/optimal outcomes, which the author seems to imply.

Well, the idea of the EMH (as I understand) is that the stock prices for things should be at an optimal price already and trying to beat market prices is basically a game of chance. Since one of the examples he gives is about the stock market and investing, I don't think his offhand statement is that far off. More importantly, that's not really Central to the argument of the book he's reviewing or the argument of his…

I'm going to quote the first paragraph here:

> Eliezer Yudkowsky’s catchily-titled Inadequate Equilibria is many things. It’s a look into whether there is any role for individual reason in a world where you can always just trust expert consensus. It’s an analysis of the efficient market hypothesis and how it relates to the idea of low-hanging fruit. It’s a self-conscious defense of the author’s own arrogance.

And then quote again the only reference to the EMH:

> It’s an analysis of the efficient market hypothesis and how it relates to the idea of low-hanging fruit.

How, just how can you say something 'bedobi upthread? It's frankly a "fake news" level comment. I hate those, because it looks legit enough that people will take the lie at face value.

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