We, as patients, pass around these apocryphal stories around, but don't look at the opposite experience of doctors. Doctors constantly, and I mean multiple times per day, get patients in that tell them their symptoms are due to disease or condition or complex X. Time and again, the patient is completely wrong. No, you don't have cancer, your lymph node hurts because it is fighting off an infection, and besides if it was cancer, the node wouldn't hurt. No, you don't have lyme disease, you're sore because you started gardening again and you are 50. No, you don't have an ulcer, you're just eating too much ice cream before going to bed.
As humans, we forget about the times we were wrong, and also don't share those stories. "I went to the doctor thinking I was dying of cancer, but it turns out I'm allergic to mushrooms" is much less likely to be passed around as a story than, "No doctors would listen to me until one did and tested me and found out I have Lyme disease."
Hilarious you brought this up: "No, you don't have an ulcer, you're just eating too much ice cream before going to bed."
Reflux is a very common food allergy symptom and milk is one of the most common allergen, if not THE most common.
I've had 3 or 4 scopes that showed some mild inflammation, and GIs were simply lost. I've managed to locate a 90 year old allergist who probably began practicing before there was benadryl. After recounting the symptoms I was told "it's milk. it's always milk". I was taken aback, how can anyone be so sure? Literally 5 minutes later that was confirmed by a skin-prick test.
Most physicians are garbage. The allergist was quite thorough.
The billing rate to dismiss you in 30 seconds pays about the same as a 30 min appointment. The incentives just aren't there.
I agree with the systemic problem that our healthcare system doesn't want to get to the bottom of symptoms. It drives me crazy, especially the "most cancer is treatable if caught early, but no we won't give you a diagnostic test to actually catch cancer early". I have direct experience with this, pushing through multiple doctors that ended with my thyroid cancer diagnosis.
My doctor at the time was actually really good, not because he was good at diagnosing, but he had enough experience to recognize his inability to do so and would always send me to an expert. He literally was 100% wrong about all of my major diagnoses (my hurt knee actually was a torn ACL, my abdominal pain actually was a hernia, my throat nodule actually was cancer), but he always sent me to a specialist to be sure. And he knew really good specialists. "I don't think it is X, but lets have a specialist verify" was his common refrain.
A doctor's opinion on disease isn't merely an opinion, it's an educated guess based on experience and qualifications. New diseases and research are constantly appearing, thousands of articles are written each year. We can't expect doctors to know everything, but we can expect them to have more informed opinions, on average, than non-doctors.
I say this because there's a rising trend of anti-intellectualism and distrust of doctors in the US, which leads to massive self inflicted wounds in Covid and vaccines. Doctors aren't infallible, but they're far better than random online sources.
trend of anti-intellectualism and distrust of doctors
As someone who knows a practicing doctor who is also anti-vax, these are orthogonal issues. Sometimes, distrusting a specific doctor is the more intellectual approach.
You'd be surprised how many physicians and nurses refuse vaccination. You'll just never hear about it. AMA is one powerful beast, I wish I had a union like that.
However, sometimes fun little things like this happen that show their true colors:
"Starting in early 2003, the United States government started a program to vaccinate 500,000 volunteer health care professionals throughout the country. Recipients were healthcare workers who would be first-line responders in the event of a bioterrorist attack. Many healthcare workers refused, worried about vaccine side effects, and healthcare systems refused to participate. Fewer than 40,000 actually received the vaccine.[29]"
That doesn't mean distrust of vaccination in general - at least by doctors. It was for a potential bioterrorist attack. It perhaps more reflects the low likelihood or belief that there would be a small pox attack.
If you assume the low likelyhood of the attack was the reason, that means 90% of those physicians could be lying. The stated reason for refusal was concerns about side effects. It's in the quote.
What you stated as a fact, 96% vaccination rate, is actually a self-reported survey.
Why do a survey when public health CDC records could simply be matched with the physician licensing registrars?
Seems an automatic search like that would save physicians their valuable time, aren't they very busy with a pandemic right now? Instead of hard data from CDC, we get self-reported, likely anonymous, self-reported survey.
It's always cost-benefit. Relative risk of side effect directly relates to likelihood.
Risk of side effects vs benefit of vaccine.
I am not likely to take an HIV vaccine, since my personal chance of contracting HIV is incredibly low. So any side effect isn't "worth it" -- even a sore arm. But that doesn't mean I'm anti-vaccine.
I also don't wear a bullet proof vest around because it's too heavy ("side effect"). Does that mean I'm anti-bullet proof vest? No. But I would wear a bullet proof vest in a war zone -- even if it's heavy.
If there was a widespread small pox outbreak in the U.S., I'm certain more than 10% of physicians would take the vaccine. Does that mean they were lying before? No.
The stated reason for refusal was concerns about side effects.
As another comment already mentioned, smallpox vaccines (at least historically) tended to have undesirable side effects, like permanent scars. Smallpox vaccination is probably not a good proxy for vaccination overall. It's not worth getting vaccinated for smallpox unless you expect a decent risk of exposure.
I'd qualify that: "...we can expect them to have more informed opinions, on average, _for any random condition_, than non-doctors."
The thing I think you're missing is that the resources to do good, deep research on a condition do exist, and the sufferer has very strong motivation to do that research and become very well informed in the etiology and treatment options. The doctor, less so. They have a lot of patients and a lot of demands on their time.
Will a good doctor put in the effort, do the research, and come up with a superior treatment plan? Certainly! But not all doctors will do this.
If you use the allegory of the pig and the chicken, the sufferer is the pig, the doctor is the chicken. It is reasonable that the average pig will put in more work and be better informed about their own condition than the average chicken.
The English language has a serious deficiency in the term "research".
You can do "research" by spending your days in a lab, formulating hypotheses, doing experiments, reading related academic work, drawing conclusions, publishing their findings.
You can do "research" by googling, reading blog posts and wikipedia articles, watching Youtube videos, following telegram links and possibly reading a popular-science book.
These two things are very different activities and produce very different bodies of knowledge. "Do your own research!" is a common sentiment in Covid skeptic circles. It doesn't mean being in a lab. It means following links in your Google bubble. That doesn't necessarily produce useful knowledge. Properly trained researchers are aware of things like confirmation bias, selection bias, recollection bias. The "I did my own research crowd" is not and suffers seriously from it.
Using the term with the doctor is blurring the line between both versions. They don't stand in the lab and "do their own research", but they are more educated in the medical field than the common patient and have context.
> they are more educated in the medical field than the common patient and have context.
Pompous credentialism.
This is a hacker forum. Are people outside of universities unable to learn computer science, applied math, sw dev? Sure, biomed is a different field, but that’s all it is. A different knowledge base, there are more and more biomed hackers out there too, not to mention quite a few patients are PhDs and MDs themselves.
Geez, from your words patients are simply all permanently dumb as bricks and unable to ever learn, where as MDs always know more than patients, despite having never ever done any actual research in their entire training and subsequent career.
Nice set of preconceived notions and biases there, fellow researcher.
> Geez, from your words patients are simply all permanently dumb as bricks and unable to ever learn, where as MDs always know more than patients, despite having never ever done any actual research in their entire training and subsequent career.
Wow, it's hard to misconstrue my post more than that. Impressive!
Of course there are patients with more clue than the average patient. And of course there are incompetent doctors. But the common doctor is more educated in the medical field than the common patient.
Don't believe that? Next time you have surgery, just demand that instead of the surgeon, the next patient in the waiting room does the surgery on you. That's roughly what you are babbling about. Nothing they couldn't learn with a bit of youtube, eh?
> despite having never ever done any actual research in their entire training and subsequent career.
The post you replied to literally contains the words 'They don't stand in the lab and "do their own research", '
Indeed, there is plenty of distrust. If they are doing such a great job though, why the distrust?
I don't know a single person with a significant chronic condition in the US who would say the health system and all their physicians are amazing and great. Usually you hear the exact opposite.
However, stories about that gem of a doctor they finally found over the years are very common. Most physician suck, not sure why.
Loss of trust is indeed very unfortunate, counterproductive and indeed leads to unnecessary suffering.
Physicians are highly educated professionals in a legally protected rent-seeking monopoly, backed by a powerful trade union, AMA, and the corresponding social status/wealth/authority that comes with all that. Seems to me it's only fair that the onus is entirely on them to win that trust back. I'm not holding my breath though.
Medicine is just another business. Remember that next time you see a doctor.
> I don't know a single person with a significant chronic condition in the US who would say the health system and all their physicians are amazing and great. Usually you hear the exact opposite.
> However, stories about that gem of a doctor they finally found over the years are very common. Most physician suck, not sure why.
Great example of reporting bias. Nobody goes around telling everybody "all is fine". That's not news and nobody wants to hear it. Something needs to be special, out of the ordinary, a sensation even. "All my doctors suck, listen to my 10-minute rant about my odyssey" is what people _think_ will be interesting.
Ever heard a news anchor say "Nothing remarkable happened today. Have a good evening." Of course not. They will report something, no matter how unimportant, ridiculous, sensationalist.
Yeah I think of it almost as a mathematical problem. There are simply more ways for a human body to go wrong than any number of doctors possibly can comprehend :) There is a very very long tail of diseases and disorders.
So it's not just easy to find something that ONE doctor has never heard of or seen, but you can find many that ALL doctors are unfamiliar with!
As humans, we forget about the times we were wrong, and also don't share those stories. "I went to the doctor thinking I was dying of cancer, but it turns out I'm allergic to mushrooms" is much less likely to be passed around as a story than, "No doctors would listen to me until one did and tested me and found out I have Lyme disease."