[specialist]

I think of Western doctoring (diagnosis) as running an expert system. Like a game of twenty questions. If your specific conditions aren't found in your doctor's knowledge base, too bad. Maybe try another doctor, who has different experiences, different training.

I've been lucky in that two of my doctors treated my rare conditions as mysteries, puzzles to be solved. Not much like House MD, which requires an explicit explanation. But more like "Hmmm. That didn't work. Let's try this other thing I've been reading about." Instead of summarily dismissing my experience because there was not "hit" in their knowledge base.

FWIW, in the USA, at least, the combo of fee-for-service and compensation model discourages sleuthing. (But does encourage more testing, ironically.) IMHO.

[maeil]

> I've been lucky in that two of my doctors treated my rare conditions as mysteries, puzzles to be solved. Not much like House MD, which requires an explicit explanation. But more like "Hmmm. That didn't work. Let's try this other thing I've been reading about." Instead of summarily dismissing my experience because there was not "hit" in their knowledge base.

My current goal in life is to save up enough that I can afford paying a private doctor to treat my chronic condition in exactly this way. Possibly in India or another place where it won't run into many hundreds of thousands of dollars. I still have no idea how I'm going to try and find one but your description has put it into words so aptly that I'm going to take it a8nnd run with it.

My condition has left me unable to use any kind of keyboard-like device except for MacBooks and any kind of mouse-like device with physical buttons (i.e. not trackpad). Using anything else hurts both my finger joints and wrist to the point that within minutes I need to stop using them. Yet with all the doctors I've seen here it's the same; 1. Do the scans and test 2. "Well we can see some inflammation in the wrist, you need to rest more. Here, we'll prescribe some NSAIDs.". Completely ignoring the absurdity of the suggestions given that it happens within minutes and having tried resetting things completely by disavowing keyboards/mouses for a few months to little effect when resuming usage.

> FWIW, in the USA, at least, the combo of fee-for-service and compensation model discourages sleuthing. (But does encourage more testing, ironically.) IMHO.

While that may be the case, I think you're still more likely to find a doctor willing to sleuth in the US than anywhere else. The cultural factor having an even bigger impact than the profit model. Having spent many years in both East-Asia and Western-Europe, each of them have cultural factors working very strongly against it even if their compensation models should be more favorable. For the former, a big aversion against debate/answer searching in general and particularly questioning an authority while doctors are as big as an authority as you can get, ranked at the very top of the hierarchy. For the latter, a big distrust of patients and high degree of expected "self-reliance".