[BaculumMeumEst]

> The infantilization of the public in the name of “safety” is offensive and ridiculous.

It comes from dealing with the public.

> In many countries, you can get the vast majority of medicines at the pharmacy without a prescription. Amazingly, people still pay doctors and don’t just take random medications without consulting medical professionals.

I see people on this site of allegedly smart people recommending taking random medications ALL THE TIME. Not only without consulting medical professionals, but _in spite of medical professional's advice_, because they think they _know better_.

Let's roll out the unbelievably dumb idea of selling self-diagnosis AI on radiology scans in the countries you’re referring to and ask them how it works out. If you want the freedom to shoot from the hip on your healthcare, you've got the freedom to move to Tijuana. We're not going to subject our medical professionals to deal with an onslaught of confidently wrong individuals who are armed with their $40 AI results from an overhyped startup. Those startups can make their case to the providers directly and have their tools vetted.

[whamlastxmas]

Doctors give out wrong and bad advice all the time. Doctors in general make mistakes all the time to the point that there’s some alarming statistic about how preventable medical errors is a scary high percentage of deaths. People should absolutely question their doctors and get more opinions, and in a world where my last 10 minute doctor visit would have cost $650 without insurance, for a NP, I don’t blame them for trying to self diagnose.

[BaculumMeumEst]

You are proving my point talking about the percentage of deaths caused by medical errors. If you had 100,000 people receive medical care, 10 die, and 5 of them are due to medical errors, then sure, you could spin that as "50% of deaths were caused by medical errors". Never mind the context, never mind the fact that we are actually able to identify the errors in the first place!

So again, if you want to ignore the safeguards that we've built for good reason - take your business to Tijuana.

[rscho]

TBF, 'medical error' is a super wide definition. Most aren't diagnostic errors, and they encompass all healthcare professions, not only doctors. It makes a big difference in interpretation and potential solutions.

[ilaksh]

Well.. funny you say that.. I did move to Tijuana some years ago. One time while I was there, I was sick and a neighbor (Mexican) seemed to insist that I go to the doctor. She recommended a hole in the wall office above a pharmacy that looked like a little-league concession stand.

It was a serious 30 something woman who collected something like 50 pesos (around $3), listened to me for about 30 seconds, and told me to make sure I slept and ate well (I think she specifically said chicken soup). I asked about antibiotics or medicine and she indicated it wasn't necessary.

So I rested quite seriously and ate as well as I could and got better about a week later.

During the time that I was in Playas de Tijuana I would normally go to nicer pharmacies though, and they didn't ask for a prescription for my asthma or other medicine which was something like 800% less expensive over there. They did always wear nice lab coats and take their job very seriously if I asked for advice. Although I rarely did that.

I do remember one time asking about my back acne problems at a place in the mall and the lady immediately gave me an antibiotic for maybe $15 which didn't cure it but made it about 75% better for a few months.

Another time at the grocery store I asked about acne medicine and the lady was about to sell me something like Tretinoin cream for a price probably 1/4 of US price. She didn't have anything like oral Accutane of course. It was just a Calimax Plus.

There are of course quite serious and more expensive actual doctors in Tijuana but I never ended up visiting any of them. I was on a budget and luckily did not have any really critical medical needs. But if I had, I am sure it would have cost dramatically less than across the border.

EDIT: not to say the concession-stand office lady wasn't an actual doctor. I don't know, she may have had training, and certainly had a lot of experience.

[K0balt]

I live in the Dominican Republic. People here go to the doctor for things I never would have in the USA. If anything, people here self treat much less Than the USA, even though you can walk into any pharmacy or imaging center and ask for whatever you want.

They go to the doctor because the healthcare system here works, for the most part, and they value and respect the expert counsel in matters of their health.

[BaculumMeumEst]

That's interesting, thanks for the context. I think it takes a unique kind of arrogance to self-diagnose medical problems w/ no knowledge or understanding of what you are talking about, and while I love this country I think that arrogance is in high supply here. Many people here aren't aware that it creates a huge strain on physicians or don't care because they think the world revolves around themselves.

[pc86]

What is your specialty?

I'm curious what you think the problem is, concretely, with a tool like this in the hands of the public which you clearly have such disdain for. Let's assume I buy this thing (the horror). I have to actually get access to my scans, which despite being legally required to provide most providers will be loathe to actually do. So I get my scans, I get this AI tool, I ask it some questions. It's definitely going to get some answers right, and it's very likely going to get some answers wrong. I'd be shocked if it's much less accurate than a resident, and if they're commercializing it there's a decent chance it's more accurate than the average experienced attending.

What is your doomsday scenario now that I have some correct data and some incorrect data? What am I going to do with that information that is so "unbelievably dumb" that I need the AMA to play daddy and prevent me from hurting myself? I can't get medication based on my newfound dangerous knowledge. I can't schedule a surgery or an IR procedure. I can't go into an ER and say "give me a cast here's a report showing I need one."

[K0balt]

While I disagree fundamentally with the premise that people should be kept away from useful tools, I think that there is an understandable fear of dealing with the fallout of certain demographics having access to tools.

Unfortunately we have a lot of people that despite an abundance of ignorance are arrogant enough to think that they know better than most, but still are incapable of applying basic logic and critical thinking in their reasoning. (which if you think about it is sensible, since wisdom is largely a matter of comprehension of the depth of ones ignorance)

These people are a huge PITA to work with and every tool they wield inflicts pain on those trying to help them.

[BaculumMeumEst]

It's not about you.

[pc86]

I don't know what point you think that comment makes but it certainly doesn't answer any of the very legitimate questions I posed, including the first one since I'm willing to bet you have a pretty big conflict of interest here.