[ngngngng]

> On the other hand, a lot of what I do doesn't require 12 years of training

What, besides surgery, really requires 12 years of training? I've found I have a greater success rate with self diagnosis and treatment than I have with seeing my physician, and I've found a very good internist. An hour spent with ChatGPT and Google and I always find a couple options that fit what I'm experiencing as well as detailed descriptions on how to narrow it down. And since I'm the one experiencing the symptoms, there's no chance of a communications breakdown between me and the doctor who is trying to diagnose me.

[SOLAR_FIELDS]

A recent occurrence I will share related to this was having to convince my doctor that I had Lyme disease. I Googled the symptoms, saw the trademark bullseye, and of course concluded that I had Lyme disease. It was right where I got the tick bite, 8 weeks later.

My doctor refused to believe me. He told me to see a dermatologist about it, thinking it was some skin rash, even though it was exactly where the tick had bit me and it was a bullseye. I shortly thereafter went to an urgent care center where fortunately an RN happened to be from Maryland (I live in the South, where Lyme disease is not really a thing) and she immediately saw my rash and prescribed me the appropriate antibiotics.

The reason my doctor did not believe me? It took 8 weeks for the bullseye to develop. I had gotten the tick bite in Europe (which of course I informed the doctor of very first thing). Typically American Lyme disease displays symptoms much faster (days instead of weeks). The doctor did not bother to do any research to discover what I had found in a few minutes of Googling: that European Lyme disease takes much longer to display symptoms (and I had told him as such as well). He was happy to simply assume that all Lyme disease takes only days to display symptoms instead of weeks, because that's what he knew of, and since mine had taken weeks, well, I just must simply be wrong.

My doctor did have a small redemption: once he was confronted with evidence and did the research himself on what I was saying (after the RN had already treated me), he did call me and apologize. But still. This is a daily occurrence, especially for people that are of underserved genders and races.

I realize this turned into a bit of a rant, but in essence I just want to affirm what you're saying. A lot of doctors, especially PCP, are often not much more than glorified technicians. Combine that with the ego problems that typically accompany being an MD and you get a recipe for people getting subpar care, especially women and minorities.

In the end, unfortunately, only you are responsible for your own medical care and getting the best outcome. It is not sufficient to just trust someone else because they have the words MD after their name.

[bitcurious]

It’s intuitive that a patient who can spend an order of magnitude more time on his self care, and can self-articulate their symptoms, can occasionally self-diagnose better than a doctor. It’s not intuitive that a clinician with 4 years training and the same 30 minute window to diagnose you would do better than a physician with 12 years training.

[preommr]

The point is that it's easier for a service provider to spend 1-2 hours (or across multiple people) when they don't have to spend 12 years of training with high attrition rates. Both because it's more affordable, and because there's less scarcity.

[ttymck]

Would they do worse?

[tim333]

On the other hand I got a rash and tried to google diagnose and got in completely wrong whereas the doctor figured it in seconds (shingles). Probably best to try both approaches.

[slily]

You have a point but need to drop the identity politics bullshit. Since when are women "underserved"? Men are far more likely to "tough it out" i.e. refuse to see a doctor when they have symptoms of illness, so by your logic they are the "underserved minority" in terms of gender. Claiming women are disadvantaged in literally everything ever is a groundless cliché. The racial angle may be less false (though not for the reasons you imply) but is still irrelevant to this story.

[AaronM]

https://physicians.dukehealth.org/articles/recognizing-addre...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=l...

https://www.americanbar.org/groups/crsj/publications/human_r...

[x-complexity]

> https://physicians.dukehealth.org/articles/recognizing-addre...

The article uses a survey about personal opinions as the source for its judgement. Right in the first paragraph (emphasis mine):

> A *survey* conducted in early 2019 by TODAY found that more than one-half of women, compared with one-third of men, *believe* gender discrimination in patient care is a serious problem. One in five women *say they have felt* that a health care provider has ignored or dismissed their symptoms, and 17% say they feel they have been treated differently because of their gender—compared with 14% and 6% of men, respectively.

This does not address GP's complaint regarding men being more likely to refuse to see a doctor in the first place. Does patient gender discrimination occur in the medical space? Probably. But nothing in this article addresses GP's claim of "Men are far more likely to 'tough it out' i.e. refuse to see a doctor when they have symptoms of illness".

------

> https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2825679/?itid=l...

This journal article discusses gender disparities regarding coronary heart disease (CHD) diagnoses, with doctors believing that their male diagnoses are more confident than their female diagnoses.

Disregarding the fact that the article still doesn't address GP's aforementioned complaint, the sample size used (n=128) is too small to make a firm judgement, with the ideal being at least n > 1000 to reduce potential statistical noise. The study also doesn't disprove the possibility of men being overdiagnosed with CHD.

------

> https://www.americanbar.org/groups/crsj/publications/human_r...

This article addresses lower quality of healthcare received by minorities as opposed to white people. No links or direct references to cited studies/articles are given anywhere within the article, and the one time they do reference a source is to a book ("Just Medicine: A Cure for Racial Inequality in American Healthcare (2015)"), with no page citations to the aforementioned book made in the article. This article also doesn't address the GP's complaint at all.

------

Personal opinion:

This type of shotgun-style link posting is a variant of the Gish Gallop, wherein the link poster forces participants to "do the research" via the cited links, only to waste their time by not directly addressing the concerns and complaints of the parent comment.

AaronM, at least spend a few minutes to find articles supporting:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/

https://archive.is/fF4ND (Source: https://www.nytimes.com/2023/03/03/well/live/men-doctor-visi...)

https://www.cdc.gov/nchs/data/series/sr_13/sr13_149.pdf (page 17)

And opposing GP's claim:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3104816/

[yardie]

Women weren't even included in medical trials until the 70s[0].

[0] https://www.theguardian.com/lifeandstyle/2019/nov/13/the-fem...

[margalabargala]

"Underserved" here means that when they see a provider, they are less likely to be taken seriously; not that they are less likely to see a provider.

For example, while men may be more likely to "tough it out" of their own accord, a black woman describing her symptoms is much less likely to be taken seriously.

[slily]

Are they being taken less seriously when they have serious health issues, statistically? I'd like to see some data on outcomes, life expectancy is the best datapoint I've got and men are clearly disadvantaged there. If women are more likely to seek health care early then it makes sense that more of them don't actually need it, i.e. are "not taken seriously". Maybe there's "collateral damage" but I've also not been taken seriously as a male so I certainly can't agree that it's unique to women and I'll need more than anecdotes to believe that there's a gender discrepancy.

[bigbillheck]

Dude here. If you talk to women about their experiences with doctors and -- and this is important! -- actually listen you'll find that they're very different than ours.

[rovr138]

I've gone to appointments with my wife and have had to repeat what she's told the doctor to have them even pay attention. Then ask, what's the protocol to handle this? because while they listened, they weren't reacting.

She had to ask me to go with her because they weren't helping. And finding another doctor to go to would have taken weeks/months.

[slily]

I have a hard time taking self reports seriously particularly because identity politics are in vogue and that means a lot of people are eager to portray themselves as oppressed characters. I've spent time in clinics, hospitals, and ICUs, and have experienced condescension, not being taken seriously, being kept in the dark about my own health, etc., likely because I'm not very assertive by nature (as a male of course). "Just believe women!" is another example of bullshit identity politics and I don't think it's proven to be a good attitude since it became a catchphrase with #MeToo. Sorry if this comes off as blunt/rude and of course I sympathize with anyone getting mistreated by physicians but I really don't believe that women are disadvantaged in health care today, however if you have evidence that women have worse health outcomes due to mistreatment then I'd like to see it. Otherwise I'd rather trust my own experience and the data that I'm familiar with (e.g. life expectancy).

[Danjoe4]

What, is that you likely have an IQ ~2 standard deviations above average. Most doctors are similarly intelligent. While he/she possesses more medical domain knowledge, you are able to problem solve with similar accuracy with a little research. Most people do not possess the domain knowledge nor the problem-solving ability.

[nharada]

I think where this breaks down is when you have something rare that requires immediate attention. My impression is that a lot of that medical training is being able to say "oh that's unusual, you need to see a specialist".

[singleshot_]

In my experience, no one who has not dedicated a great deal of time to the study of their area of expertise is worth seeking out for help. If they haven’t been taking it seriously for long, I don’t take them seriously.

I wouldn’t consult a first year mechanic, a second year doctor, a third year pilot… regardless of how long it takes to be functional in an area, I’m entitled to expertise and the signifier for expertise is time.