[zarzavat]

Doctors may have 10 years of medical training but they have very little time to apply that knowledge to any particular patient.

If you come to a doctor’s appointment with zero research then you will not be able to push back if your doctor attempts to misdiagnose you. It will be a unidirectional conversation.

If you have prepared for your appointment then the following conversation is more likely to happen:

Patient: I have symptoms X and Y

Doctor: You probably have condition A

Patient: But I don’t have Z, is it really likely that I have A?

Doctor: It’s also possible that you have condition B

In a perfect world, patients would get hour long appointments and doctors would explore the entire fault tree. For rich people this may actually be reality. But for us proles, every minute we get with a doctor is precious so we’d better study up so we can use them as medical oracles.

[haldujai]

As stated, being informed is encouraged. Self-diagnosis is not for anyone to do.

I think another issue here is your expectations out of a medical visit may be unrealistic. Physicians aren’t supposed to arrive at the correct diagnosis from the initial visit (for most things). We start with a suspected diagnosis and differential and refine it with investigations and multiple visits for temporality/evolution.

Note that in your hypothetical that probably and possible are not mutually exclusive. It’s entirely possible patient A’s right upper quadrant pain is a gallbladder cancer but it is also probably gallstones even if you tell me the pain isn’t triggered by fatty meals. Just because a preliminary diagnosis is stated as probable it doesn’t mean other potential causes aren’t being simultaneously investigated with that ultrasound. I also don’t need to be telling the patient about all of the potential possibilities from the get go as it may cause anxiety, this is a patient-specific judgement call.

> In a perfect world, patients would get hour long appointments and doctors would explore the entire fault tree.

Honestly, outside of counseling type visits or complex oncology I’m not sure what I would spend an hour talking about. Why do feel we need to explore the entire fault tree in a single visit with missing investigations?

As a hypothetical: 50 y/o male patient comes in with first time rectal bleeding, I’ll ask a few questions and perform a physical exam but regardless of the fault tree or why this happened, this patient is getting a colonoscopy. Until we’ve excluded cancer and inflammatory bowel disease further discussion is moot.