521–530 of 677 posts
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Seems to me like the "difficult problem" is solved in pretty much every other rich country in the world.
if its not solved in the richest country maybe its not so easy to solve unless you want to hand wave the diffuclt parts and just describe it as "rich people being greedy"
Going to a probabilistic system for something that can/should be deterministic sets off a lot of red flags. I’ve worked medical software packages, specifically a drug interaction checker for hospitals. The system cannot be written like a social media website… it has to fail by default, and only succeed when an exact correct solution was determined. This result must be repeatable given the same inputs. The consequence…
Human doctors are probabilistic systems.
My uncle had an issue with his balance and slurred speech. Doctors claimed dementia and sent him home. It kept becoming worse and worse. Then one day I entered the symptoms in ChatGPT (or was it Gemini?) and asked it for the top 3 hypotheses. The first one was related to dementia. The second was something else (I forget the long name). I took all 3 to his primary care doc who had kept ignoring the problem, and asked…
I've heard a lot of such anecdotes. I'm not saying its ill-intentioned, but the skeptic in me is cautious that this is the type of reasoning which propels the anti-vax movement. I wish / hope the medical community will address stories like this before people lose trust in them entirely. How frequent are mis-diagnosis like this? How often is "user research" helping or hurting the process of getting good health outcome…
I hear you but there are two fundamentally different things:
1. Distrust of / disbelief in science 2. Doctors not incentivized to spend more than a few minutes on any given patients
There are many many anecdotes related to the second, many here in this thread. I have my own as well.
I can talk to ChatGPT/whatever at any time, for any amount of time, and present in *EXHAUSTIVE* detail every single datapoint I have about my illness/problem/whatever.
If I was a billionaire I assume I could pay a super-smart, highly-experienced human doctor to accommodate the same.
But short of that, we have GPs who have no incentive to spend any time on you. That doesn't mean they're bad people. I'm sure the vast majority have absolutely the best of intentions. But it's simply infeasible, economically or otherwise, for them to give you the time necessary to actually solve your problem.
I don't know what the solution to this is. I don't know nearly enough about the insurance and health industries to imagine what kind of structure could address this. But I am guessing that this might be what is meant by "outcome-based medicine," i.e., your job isn't done until the patient actually gets the desired outcome.
Right now my GP has every incentive to say "meh" and send me home after a 3-minute visit. As a result I more or less stopped bothering making doctor appointments for certain things.
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You still need 2 deviations above the average college student to get to med school. As a rough proxy for intelligence. The bottom threshold for doctors is certainly higher than lawyers
It’s 120 to 130 which is similar to engineers. They aren’t that much smarter. The selection criteria is more about the ability to handle pressure than it is about raw intelligence. Tons of bottom feeders go to medical schools in say Kansas, so there’s a lot of leeway here in terms of intelligence.
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Well the issue here is that the bug can cause you to die or can fuck up your entire life. A software bug generally doesn’t do anything to you and you actually don’t pay much money for software. One false diagnosis from a doctor costs you thousands of dollars and fucks up your life. Remember mcas? The bug on the 737 max that forced Boeing to pay reparations? That’s the level of bullshit people are dealing with for doc…
Legally speaking, why should the rules for important services be different than unimportant services. The price paid for the services is proportional to its value, if there are no consequences for a bug in your code, it was worth less and you should have paid less for it, the refund would be commesurate. It's worth noting that you framed the discussion in terms of refunds, so any extra human life uncalculable value i…
I’m not talking about that. What I’m talking about is fucking simple. A doctor gives you advice and you pay him thousands for it. That advice is completely fucking wrong.
In what universe does that payment make sense? In what universe is giving wrong information deserving of thousands of dollars of payment for services rendered. It’s bloody simple: it’s not deserved and a refund is in order.
Gemini helped diagnoze me with eosinophilic esophagitis. I have had problems with swallowing all my life and doctors kept dismissing it as a psychological problem. I think there is a great space with ai medical help.
And how do you threat that ?
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I'm married to a provider. It is absolutely insane what she has to do for insurance. She's not a doctor, but she oversees extensive therapy for 5-10 kids at a time. Insurance companies completely dictate what she can and can't do, and frequently she is unable to do more in-depth, best-practice analysis because insurance won't pay for it. So her industry ends up doing a lot of therapy based on educated guesswork. Ever…
> Insurance companies completely dictate what she can and can't do, and frequently she is unable to do more in-depth, best-practice analysis because insurance won't pay for it. The distinction between "can't do" and "can't get paid for" seems to get lost a lot with medical providers. I'm not saying this is necessarily what's happening with your wife, but I've had it happen to me where someone says, "I can't do this t…
Tell me you've never lived in poverty without telling me.
An unexpected expense of several hundred to a couple thousand dollars, for most of my lived life both as a child and a young adult, would've ruined me. If it was crucial, it would've been done, and I would've been hounded by medical billing and/or gone a few weeks without something else I need.
This is inhumanity, plain as.
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> I wish / hope the medical community will address stories like this before people lose trust in them entirely. Too late for me. I have a similar story. ChatGPT helped me diagnose an issue which I had been suffering with my whole life. I'm a new person now. GPs don't have the time to spend hours investigating symptoms for patients. ChatGPT can provide accurate diagnoses in seconds. These tools should be in wide use t…
GPs don't have time to do the investigation, but they also have biases. My own story is one of bias. I spent much of the last 3 years with sinus infections (the part I wasn't on antibiotics). I went to a couple ENTs and one observed allergic reaction in my sinuses, did a small allergy panel, but that came back negative. He ultimately wanted to put me on a CPAP and nebulizer treatments. I fed all the data I got into C…
Now, obviously none of this math would actually hold up to any scrutiny, and there's a bevy of reasons that the quality of those interactions would not be random. But just as a sense of scale, and bearing in mind that a lot of people will easily remember a single egregious interaction for the rest of their life, and (very reasonably!) be eager to share their experience with others, it would require a frankly statistically impossibly low error rate to not be able to fill threads like these with anecdotes of the most heinous, unpleasant, ignorant, and incompetent anecdotes anyone could ever imagine.
And this is just looking at the sheer scale of medical care, completely ignoring the long hours and stressful situations many doctors work in, patients' imperfect memories and one-sided recollections (that doctors can never correct), and the fundamental truth that medicine is always, always a mixture of probabilistic and intuitive judgement calls that can easily, routinely be wrong, because it's almost never possible to know for sure what's happening in s given body, let alone what will happen.
That E.N.T. wasn't up to date on the latest research on allergies. They also weren't an allergy specialist. They also were the one with the knowledge, skills, and insight to consider and test for allergies in the first place.
Imagine if we held literally any other field to the standard we hold doctors. It's, on the one hand, fair, because they do something so important and dangerous and get compensated comparitively well. But on the other hand, they're humans with incomplete, flawed information, channeling an absurdly broad and deep well of still insufficient education that they're responsible for keeping up-to-date while looking at a unique system in unique circumstances and trying to figure out what, if anything, is going wrong. It's frankly impressive that they do as well as they do.
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I understand enough about these systems to know they’re not perfect but I agree some people might be misled. But I don’t know if I should be denied access because of those people.
I just had a deja vu, I'm sure I read this some months ago Did you previously write this exact comment before?