Hacker News new | ask | show | jobs
by Aurornis 110 days ago
> I do feel I actually biased the first doctors opinion with my "research."

This has been a big problem in medicine since the early days of WebMD: Each appointment has a limited time due to the limited supply of doctors and high demand for appointments.

When someone arrives with their own research, the doctor has to make a choice: Do they work with what the patient brought and try to confirm or rule it out, or do they try to walk back their research and start from the beginning?

When doctors appear to disregard the research patients arrive with many patients get very angry. It leads to negative reviews or even formal complaints being filed (usually from encouragement from some Facebook group or TikTok community they were in). There might even be bigger problems if the patient turns out to be correct and the doctor did not embrace the research, which can prompt lawsuits.

So many doctors will err on the side of focusing on patient-provided theories first. Given the finite time available to see each patient (with waiting lists already extending months out in some places) this can crowd out time for getting a big picture discussion through the doctor's own diagnostic process.

When I visit a doctor I try to ground myself to starting with symptoms first and try to avoid biasing toward my thoughts about what it might be. Only if the conversation is going nowhere do I bring out my research, and then only as questions rather than suggestions. This seems to be more helpful than what I did when I was younger, which is research everything for hours and then show up with an idea that I wanted them to confirm or disprove.

3 comments

> Each appointment has a limited time

A doctor is typically scheduled at 6 patients/hour. In that time they also have to chart, walk between rooms, make up time for the other patients that inevitably went over time, et cetera. The doctor you're seeing probably has a goal of only talking to you for 3 minutes.

> A doctor is typically scheduled at 6 patients/hour.

This is untrue. General practice physicians are usually at 3 patients per hour. Some specialists can get in the range or 5 or more per hour if assistants handle most of the prep and work.

The average across all specialties is around 3, though.

> In that time they also have to chart, walk between rooms, make up time for the other patients that inevitably went over time, et cetera. The doctor you're seeing probably has a goal of only talking to you for 3 minutes.

I've been through two different medical systems due to job changes/moving. Both of them gave me the option of a 20 minute or 40 minute appointment slot, with the latter requiring some pre-screening to be approved by the staff. I got the time every time I went.

If your doctor is only giving you 3 minutes you need to find a new one.

I know you qualified your assertion of three patients an hour with general practice, but there are plenty of specialty practices where six patients an hour is common. Dermatology and ophthalmology clinics often run at that pace (at least in the US). Some surgical clinics can run at that pace for follow up visits (not for initial visits)
That's exactly what I said in my 3rd sentence.
My aunt died from this (my opinion). She spend two years confusion her diagnosis and treatment, and borderline harassing her doctors, by thinking her own research was on point and interpreting all her symptoms through that lens. In the end it wasn't borrelia, parasites, 5G, or any of the other fancies, but just lung cancer that was only diagnosed when it was very well developed.
There’s a difference between mental illness and active participation.

People not suffering from mental illness will typically not blame 5G for their health concerns.

You're a lay person. You know there is a thing out there called 'foo'.

You've read things that compellingly claim that foo causes xyz symptoms. You also know that some people that have obviously palpable disdain for you claim that foo could never cause these symptoms.

You have xyz symptoms. Are you mentally ill if you think that foo could be the cause?

Are the compelling claims from experts in foo or xyz? Is the disdain?
Both present themselves to you as experts.
What’s “compelling”? I’d suggest that any medical theory that relies upon a vast global conspiracy to hide the truth about 5G cannot possibly be compelling.

If someone can’t tell the difference between what’s real and what’s not, they are not well.

> I’d suggest that any medical theory that relies upon a vast global conspiracy to hide the truth about 5G cannot possibly be compelling.

Except some vast global conspiracy isn't the only way you could arrive at 5g having some deleterious effects on some subset of people. Were xrays for shoe fitting some vast global conspiracy? Or leaded gasoline? Or any number of things that turned out to be more dangerous in hindsight?

Whether you feel this way or not, institutional trust is gone.

And as for what's real or what's not, you're probably decent within your areas of expertise. Once you get outside of that range, you probably don't know the difference between real and not for plenty of things. What the hell does your average person really know about things like 5g? It might as well be magic.

The issue is that the line between "silly conspiracy" and "ignored/suppressed actual problem" is not clear, especially when the topic is politicized even in the face of overwhelming one-sided evidence. "Compelling" is a subjective judgment by the speaker, and for that matter, so is "mental illness"
I'm annoyed enough by coworkers asking "is the server down?" that I try not to do the equivalent to other people at their jobs, particularly doctors.