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by JudgeWapner 2508 days ago
> the physicians who treat garden-variety diseases can be trained much less expensively.

So, how do you make sure that only garden variety patients see the medical assistant, while seriously sick ones or those who have only telltale signs of a 1-10k illness see the real doctor? If those rare ones don't get to the doc they die.
3 comments
greedo 2508 days ago
Seeing a GP isn't necessarily a guarantee that you will get diagnosed properly. Most PAs know their limits and will consult with a doctor if they're not comfortable. Doctors complain about malpractice insurance, but the rates are high for a reason. I was misdiagnosed when I had cancer, my wife was mis-prescribed when doing fertility treatments. Hell, being rich doesn't help; look at Bill Paxton and Neil Armstrong.
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JudgeWapner 2508 days ago
> Seeing a GP isn't necessarily a guarantee that you will get diagnosed properly.

so, because even the best make mistakes, that's a good reason to let under-trained (relative to an MD) people with even less skill make mistakes? Not following your logic here.

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greedo 2508 days ago
Seeing a PA for relatively normal issues frees up doctors for more serious cases. A triage system if you will. Doctors don't like this because it will hurt them financially. They want people to think of PAs as second rate, and that doctors are infallible.

In my case, my doctor felt that because colorectal cancer (at the time) was relatively unusual for my age demo, that he didn't really need to consider it. Instead of doing an actual DRE, or a fecal occult blood test, he simply dismissed it out of hand (pun intended) as internal hemorrhoids. A year later, I was having a full resection, chemo, radiation treatment, and a permanent colostomy. Thanks!

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programmertote 2508 days ago
It is already happening. NYU Langone has been pushing hard on people to 'see' the doctors online for small stuff like allergies and fever. I wouldn't be surprised if this practice eventually extends to replacing doctors with a semi-automated (human-computer based) system .

For what is worth, a physician assistant can diagnose quickly (and they can be assisted with a ML/rule-based diagnosis system that is trained on something like "Pocket Medicine: The Massachusetts General Hospital", which is what most doctors in training use as a handbook) and escalate the difficult ones to the specialist doctors.

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austhrow743 2508 days ago
You accept that a greater number of people with a 1-10k illness die than whatever the current rate is.
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