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Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

nytimes.com

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Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#71

Post by nicolashahn »

mychael wrote: post #70

I have zero medical expertise, but it sounds like this situation could be improved with software. Given a database that contains an exhaustive list of every illness and symptoms: illness symptom diagnosis_symptom_set ------- ------- ---------------------- id id id name name symptom_id (FK->symptom.id) illness_id (FK->illness.id) (Pseudo SQL) SELECT diagnosis.name as name FROM diagnosis_symptom_set diagnosis_sympt JOI…

Much easier said than done. There are several startups out there attempting to achieve something like that. The issue isn't in the technical difficulty, but the bureaucracy and red tape involved in getting the patient data, getting enough illness/symptom data to make diagnoses possible (which is a lot), proving to the hospital that it's worth the effort to adopt the platform, and making a solution agnostic enough to extrapolate to enough hospitals to turn a profit.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#72

Post by ac2u »

GordonS wrote: post #69
kqr wrote: post #13

> Huls hadn’t heard of Schnitzler syndrome, either. He came upon it by using the database PubMed to look for a disease that matched the patient’s symptoms. He made a list of her symptoms and abnormalities. To get the full picture, he combed through her earlier electronic medical records, now archived in an old electronic warehouse, and found that her symptoms had started maybe a decade earlier. Then he looked for a d…

> Is this database open? If so, anyone in the same situation as the daughter in this article could spend the hours, rather than hoping a professional will. I've done this with various doctors, trying to figure out what the hell is wrong with me. In my experience, as soon as you start telling them they just think you're a crazy hypochondriac who sends too much time on the internet.

I'm guessing they're just pattern matching as most of the time, they'd probably be correct.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#73

Post by influx »

goblins wrote: post #67
arkades wrote: post #7

Earlier quoted context omitted.

Unfortunately, no. Your doctor is contractually bound to the insurer’s fee structure; they can’t take an extra penny off of you. You’d have to go to someone that doesn’t take your insurance at all (or just don’t tell them you have that insurance). The side effect of all this, honestly, is that doctors stop learning how to turn off 7-minute-mode. When it comes to very serious problems, it pays to go to a practice that…

Glad I live in a country with a free health service.

What country is that which doesn’t pay doctors?

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#74

Post by jacquesm »

influx wrote: post #73
goblins wrote: post #67

Earlier quoted context omitted.

Glad I live in a country with a free health service.

What country is that which doesn’t pay doctors?

Did you really link 'free healthcare' with 'a country that does not pay doctors'?

Clearly healthcare can be free to the recipients while doctors still get a good salary.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#75

Post by majos »

arkades wrote: post #2

> As for Huls, he is finishing up his fellowship at the hospital this summer. Wherever he ends up, he is certain he will find new cases to challenge his curiosity, cases he hopes to solve. No, he won’t, because only early stage residents are given the freedom from economic realities to spend hours digging and thinking through records. Docs aren’t paid for their time, nor even for results - and their employers (read:…

For some time my read on this situation has been that the "doctor shortage" that produces 7-minute diagnoses stems from a restricted number of residency slots, which is set (I believe?) by the federal government. I had thought the AMA was influential in lobbying to keep the number of such slots low to prop up doctors' salaries, but with some research it's unclear how true this is. Anyone know? How strong a lobbying force is the AMA, anyway?

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#76

Post by jessaustin »

netheril96 wrote: post #54
jessaustin wrote: post #46

Earlier quoted context omitted.

You're right that it's difficult for physicians to "turn it off". The contractual requirements you reference, however, are basically unenforced. The only way a physician will get "caught" charging more than agreed is if the patient calls the insurer to complain. Presumably you wouldn't do that to her after she saved your life.

> Presumably you wouldn't do that to her after she saved your life. Oh, you grossly underestimate what people are capable of. At least in China there are many reported cases of such horrible patients. Maybe US being a developed country have fewer these people, but definitely not zero.

You're right of course, and this isn't limited to the Chinese. It's best to have physicians in the family; marry one if there isn't one already! This isn't practical for everyone, so perhaps it's best to choose a capable young physician early in life, so that by the time such trust is required it has already formed.

Probably there are other professions in which one gets better service if one has an inside connection, but this situation really speaks ill of how medicine is practiced.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#77

Post by Someone »

Surprisingly, if I google ”hives elevated levels of IgM” or ”hives elevated IgM”, ”hives fever elevated IgM” or several variations, the top hit is https://rarediseases.org/rare-diseases/schnitzler-syndrome/.

For ”hives elevated level of IgM” and ”hives IgM”, that’s the second hit.

Does Google react that fast to nytimes articles?

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#78

Post by mychael »

nicolashahn wrote: post #71
mychael wrote: post #70

I have zero medical expertise, but it sounds like this situation could be improved with software. Given a database that contains an exhaustive list of every illness and symptoms: illness symptom diagnosis_symptom_set ------- ------- ---------------------- id id id name name symptom_id (FK->symptom.id) illness_id (FK->illness.id) (Pseudo SQL) SELECT diagnosis.name as name FROM diagnosis_symptom_set diagnosis_sympt JOI…

Much easier said than done. There are several startups out there attempting to achieve something like that. The issue isn't in the technical difficulty, but the bureaucracy and red tape involved in getting the patient data, getting enough illness/symptom data to make diagnoses possible (which is a lot ), proving to the hospital that it's worth the effort to adopt the platform, and making a solution agnostic enough to…

Agree 100%. I never claimed it would be easy, just that software could help.

Re: Her Various Symptoms Seemed Unrelated, Then One Doctor Put It All Together

#79

Post by always_good »

mychael wrote: post #70

I have zero medical expertise, but it sounds like this situation could be improved with software. Given a database that contains an exhaustive list of every illness and symptoms: illness symptom diagnosis_symptom_set ------- ------- ---------------------- id id id name name symptom_id (FK->symptom.id) illness_id (FK->illness.id) (Pseudo SQL) SELECT diagnosis.name as name FROM diagnosis_symptom_set diagnosis_sympt JOI…

Someone give this guy a nobel peace prize!
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