[BiteCode_dev]

Doctors are trained to be arrogant, dismissive of unknown unknowns, and with a terrible understanding of statistics.

Add to that:

    - They have a lot of patients and not enough sleep.
    - They need to pay back a huge student loan.
    - They hold terrible responsibilities and risk being sued.
    - They don't have much time for themselves, let alone update their knowledge.
    - Most patients are overreacting idiots, so it's a winning strategy to ignore what they tell you most of the time.
    - They are not trained nor selected for empathy or open-mindedness.

And you get so many medical errors.

Basically, you have to double-check everything they do, and endure their cynical rebuttal when you make suggestions, ask questions or try things they didn't request.

I had to face many such errors myself, two almost lethal.

When you can, shop for one that is both good and is open to discussion. But even then, there is a limit. At some point, your doctor WILL fail you, so you have to take responsibility, usually when you're weak and at a low point in your life.

And if you are wrong, people will tell you you should have listened to your doctor, but if the doctor is wrong, well, shit happens.

One of my practitioners is a friend of 15 years, I literally lived with him, he is considered top in his specialty. I'm surrounded by people working at the hospital.

He saved my life once.

Even that is not enough. I still have to double check stuff every time.

[VoidWhisperer]

> At some point, your doctor WILL fail you, so you have to take responsibility, usually when you're weak and at a low point in your life.

The two times I've been hospitalized in my adult life, I've been incredibly thankful for my parents stepping in to act as my patient advocates, including pushing back on doctors when necessary. (The first hospitalization was guilliane-barre and the other a rare hemotological condition, so i wasn't in a great place in either scenario to advocate for myself).

A pediatrician in my family has said that patients get significantly better outcomes when they have a patient advocate, because even if they are directly related to you (i.e. parents or sibling), they are going to be far better at being objective on the situation than you, the person being affected by it, is

[dev1ycan]

"Doctors are trained to be arrogant"

Says the programmer who is giving an opinion on a field that is not his...

[BiteCode_dev]

I'm not trained to be arrogant, I'm born that way.

[fuzzfactor]

It's purely anecdotal but does have some provenance going back at least to the 19th century, with one of the early liver specialists.

He was reportedly at a cocktail party one evening when a messenger burst in and informed the esteemed doctor that one of his patients appeared to be dying from a heart attack.

"My good man," he replied, "that can't possibly be true. When I treat a patient for liver disease he dies of liver disease."

[newyankee]

Makes you question, how bad could an all encompassing AI be at diagnosing given enough multimodal data

[Retric]

I suspect AI chosen by an organization trying to maximize profits could be really bad.

This is an industry that places people’s lives as vastly less important than minor scheduling issues as someone working 12+ hours is seen as perfectly normal.

[adventured]

One can debate its merit right now, the upside / downside equation. In 10-20 years? Game over. Doctors will largely be the physical space touch point. AI will in effect use meatbags to interact with the patients.

[pcthrowaway]

I think I'm feeling the effects of Gell-Mann amnesia here. The same is said about software engineers, but I'm not as confident as you that there won't be a need for the profession in 10-20 years.

[mec31]

Another perspective on the underlying issue—do you suppose that MDs will be more easily replaceable with AI than nurses will be?

[refurb]

It makes more sense when you realize most of the time it’s not <disease>. Doctors see thousands of patients per year and 99% of them have common conditions with straightforward diagnosis.

Add on top vague symptoms that can’t actually be measured and are subjective and you end up with challenging diagnoses.

I do agree that patients should educate themselves and advocate for themselves. Doctors aren’t perfect and they don’t know everything.

But it helps to have some perspective of what doctors deal with on a day to day basis.

[caycep]

I would say, it depends. I also have a lot of colleagues who overtest out of paranoia and risk avoidance.

[hilbert42]

"Basically, you have to double-check everything they do, and endure their cynical rebuttal when you make suggestions, ask questions or try things they didn't request."

I had frequent headaches and the student health service referred me to a well-known and very respected hospital for tests as an outpatient. The doctor to whom I was referred was a well-known neurologist with papers to his name—probably the most eminent neurologist in the country at the time (even now, some decades after his death, his name appears on Wiki as someone of eminence).

He then sent me for a series of tests at the hospital and they extended over a number of days although not consecutive (which was inconvenient). Those tests were rather exhaustive and included amongst others neurological tests, brain x-rays, electroencephalographs and testing my eyes including injecting fluorescein into my veins to improve the contrast of the photos they took of my eyes/retina—afterwards I was pissing out that brilliant florescent yellow dye for the better part of a day.

Keep in mind that those tests involved other doctors and clinicians who would have examined the neurologists report, so decisions weren't taken in isolation.

After all that and multiple visits to the hospital he said that they could find nothing wrong with me and suggested that I be admitted for at least three days for further tests! I declined as I was about to have uni exams and never did return to be admitted.

Several months later I visited a local GP practitioner because I'd had a bad dose of the flu and after he'd dealt with that I mentioned my ordeal at the hospital.

He was palpably furious and mumbled quietly under his breath which was just audible enough for me to hear "fucking idiots". Within a split second he went on to say "presumably during all this testing no one actually suggested that you might have migraine?" to which I replied "no". That made him even more annoyed.

He then prescribed a common Parke Davis formulation called Ergodryl, which, back then, was a common go-to drug for migraine, it's a formulation of egotamine tartrate, caffeine and diphenhydramine (a well-known antihistamine).

Problem solved, that drug completely killed my headaches. I've never forgotten that incident and although I've experienced similar inept performances I've never experienced one on that scale again. Ever since I've never fully trusted a medical diagnosis unless confirmed by second options and backed up with tests. It pays to be not only cautions but also to do one's own independent investigations.

From my experience, not all doctors are mediocre to the extent that I'd wished I'd seen another, some I've visited are quite exceptional and have an innate ability to cut to the core of a problem immediately, or at least start investigations on the right footing. Unfortunately, from my experience, they seem few and far between in numbers.

I was once introduced to a state director of health (the State's top medical officer) through a common interest outside of medicine and I got to know him relatively well. Some time later I mentioned that incident and he said to me without hesitation that he would not trust 90% of his profession to make a competent diagnosis, and he went on to say that if I were ever to be stricken by some dangerous life-threatening disease that I was to give him a call and he'd provide me with a short list of the competent ones who he'd trust—one's that he would go to if he became sick. Fortunately, to date I've never had need to take up his offer.

Frankly, for the lay person this has to be a significant worry. How on earth does one know who is competent and who is not, especially if it's at short notice?