[tpoacher]

I think this largely depends on the definition of "know".

E.g., when I used to work as a doctor in hospital, the last thing I would describe my colleagues as would be incompetent or un-knowing. They all "knew" stuff. Heck, they had to pass stringent exams, and were still accountable to several agencies to ensure being up to date.

The thing is, 50% of what they "knew" was wrong. And if you looked a bit under the surface, what one person "knew" was very different, and often contradicting what the other one "knew", even though they both "knew" stuff. And after many years, I've come to the conclusion that the number one cause of modern disease is iatrogenic, but most doctors seem not to want to admit this, and stick to what they "know" from textbooks instead. This is something I now "know".

And that doesn't even take the whole "is 'know' a binary or fuzzy concept, and if it's the latter, how much 'know' counts as actual 'know'" argument into account to begin with.

So, I hear the argument that "maybe OP is just an impostor projecting their views in a world full of experts" (wildly paraphrasing, obviously), but I also think you're perhaps being a bit too rigid here in discounting that expertise is a relatively fuzzy term.

[t-0]

I appreciate that you are using exageration to make a point, but it's worth noting for the record that iatrogenicity is hardley the number one cause of modern disease. Having a medical problem is a prerequisite to the chance of iatrogenic harm after all. Furthermore, a patient can suffer from iatrogenic harm even if everything was done correctly, and does not imply that someone didn't "know" something correctly.

[tpoacher]

It is not intended as an exaggeration. Though I fully admit I'm using 'iatrogenic' in the broader sense of "things people do or have done to themselves for the sake of treating or preventing a condition, perceived or otherwise". This includes alternative therapies, over the counter medications, etc. So I fully agree if your perception of iatrogenic was only things like "removed the wrong kidney", then I can see why you might have thought I was exaggerating, since that is indeed pretty rare, and there are safeguards in place for that kind of thing.

The statement is not intended as an attack against the medical professions or the effectiveness of medicine. It is intended as pointing out my observation that, typically, a doctor would list such iatrogenic causes very low on their list of differentials to consider, preferring to consider 'textbook' causes first. However, my own experience (which, is medical, but admittedly "anecdata") is that at present, iatrogenic causes are very relevant, and at least as likely, if not more, to yield a relevant diagnosis compared to textbook stuff in a high proportion of presentations.

A classic example of this is doctors treating symptoms by adding more medication/treatment options, rarely removing medications/treatments that may be causing those symptoms in the first place. Especially if that medication was started by a different specialist. It usually takes several rounds of inconclusive investigations and experimenting with treatments before altering an existing medication is even considered.

At the very least, having a "exclude iatrogenic causes first, before moving on to 'classic' stuff" is a good mindset to have.

> Furthermore, a patient can suffer from iatrogenic harm even if everything was done correctly, and does not imply that someone didn't "know" something correctly.

There's a popular quote often said to medical students when they start: "50% of what we'll be teaching you will have become obsolete or proven wrong by the time you graduate; unfortunately we don't know which 50%.".

[quickthrower2]

Doctors are great if you have a problem doctors are great at. Otherwise for something like CFS the best resources are CFS communities and a doctor without all the answers, willing to help you explore.

[geoduck14]

>Doctors are great if you have a problem doctors are great at.

This is tantological- but it has some great depth. I'd like to quote you on this, if I may.

[quickthrower2]

Almost tautological: because it is not “doctors are great at helping with any medical problem”. And by great I don’t mean cure anything, but give the best outcome possible with technology and budget for the person.

[einpoklum]

> , I've come to the conclusion that the number one cause of modern disease is iatrogenic

Do you have non-anecdotal evidence for this claim? It sounds rather far-fetched.

[platz]

what is an example of a modern disease whos main cause is iatrogenic

[mellavora]

I was also curious, so looked it up on Wikipedia:

> Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence.[1][2][3] First used in this sense in 1924,[1] the term was introduced to sociology in 1976 by Ivan Illich, alleging that industrialized societies impair quality of life by overmedicalizing life.[4] Iatrogenesis may thus include mental suffering via medical beliefs or a practitioner's statements.[4][5][6] Some iatrogenic events are obvious, like amputation of the wrong limb, whereas others, like drug interactions, can evade recognition. In a 2013 estimate, about 20 million negative effects from treatment had occurred globally.[7] In 2013, an estimated 142,000 persons died from adverse effects of medical treatment, up from an estimated 94,000 in 1990.[8]

https://en.wikipedia.org/wiki/Iatrogenesis

[platz]

I know the word has a definition.

I wanted to know what tpoacher's lived experience and personal observation was to cause him to make the statement.