[itishappy]

> The lesson for me is that you must advocate for yourself and your loved ones in the medical system, because doctors will not do it for you; they may not even perform the most basic risk assessments. And you have to try to quantify risk yourself, because doctors will refuse to give you the slightest hint of any number attached to risk (I know, I've tried many times).

Doctors vary wildly, and that's part of the issue. For instance, my oncologist had zero problem rattling off mortality statistics. I've personally had doctors try to sell me surgery before identifying the issue, but I've also had doctors successfully talk me out of what would have been useful procedures by offering their risk/benefit assessment unprompted.

It's like any other field. If there are 10x and 0.1x engineers, you bet there are 10x and 0.1x doctors. A 1hr intake appointment isn't anywhere near enough time to judge even for folks in the field.

[qsera]

>you bet there are 10x and 0.1x doctors

But sadly, with doctors, someone who provides 10x value to the patient might not be the same ones that provide 10x value to the Hospitals that employ them. Which means real 10x doctors might be less and less visible.

At least in software, you don't need a certificate or association with an institution to practice the trade. So you can be self employeed while free to deliver 10x value to your customers..

[spwa4]

Also keep in mind that you get hip replacement surgery because of constant, quite intense, pain.

The doctors obviously also talked to the patient and he or she obviously felt that just reducing the pain was worth the risk (because a replacement hip will still be long-term painful, so it's an improvement, not a solution. This will have been discussed extensively with the patient) ...

Or the patient may even have felt that the risk was in fact also a solution to the pain. The patient may have chosen not to talk about this to their relatives.

When you're really young medicine can feel like it solves problems permanently, especially when you're still growing. This is almost never actually the case. Medicine mitigates, makes bad situations livable for longer, restores part of your previous health. If you treat it like a solution once you're ... say 50 ... you will be severely disappointed and that can lead to drastic decisions. Or if you live your life like some people do "medicine will fix it, let's JUMP" you're likely to be disappointed, suddenly.

[qsera]

Quite frankly, no one expects that and that is not where the disappointment comes from.

The disappointment comes from the fact that doctors are mostly clueless and follow checklists, and thus prescribes measures without having a deep understanding (or interest even) of the situation.

Why? Because these people (doctors) were never curious to begin with. 99% of the never cared to understand biology before they started Medical school. They are only in for the $$$ and status. And I will never trust a doctor, or even a programmer who is not curious about the specific situation or the problem that I am having. And such people are becoming rarer and rarer to find...

[kashunstva]

> 99% of the never cared to understand biology before they started Medical school. They are only in for the $$$ and status

This is a very cynical take on the subject and I can’t imagine it’s backed by any data. As a retired medical doctor, my observation differs; idealism and curiosity appear to me far more common among medical trainees than you give credit. I spent my entire career in teaching hospitals. I do despise the ostentatious display of amassed wealth among some doctors; but wouldn’t take a general message about the profession from that.

[qsera]

>This is a very cynical take on the subject and I can’t imagine it’s backed by any data.

Imagine if being a doctor did not pay as well. Imagine it only pays just enough to sustain a small family. What percentage of your trainees do you think would remain in the course, for the love of the trade?

[jmalicki]

So you're talking about doctors in Europe.

Europe has plenty of doctors.

[NuclearPM]

Most would. US is different because of the cost of school.

[spwa4]

There is a LOT of curiosity in the medical profession. And outside of the medical profession, even more. In fact, far too much. If you think this through I think you'll agree it has no place in the treatment of a patient, especially not where the condition is not life-threatening.

Trying medicine because "you've heard that ..." is a fancy way to commit suicide, or worse. And yes, a great deal of people want to do that, until of course, they have to face the consequences. Then they want it fixed, except there is no fix. No doctor should want to be part of that, and these Chinese "researchers" should be made to answer for manslaughter for what they did.

Surely the story we're talking about illustrates this problem? For all we know the gene-editing worked! That was NOT the problem that killed the girl. Congrats, your "curiosity-based treatment" would have made the girl 10% smarter in 10 years. Probably. Unfortunately, she's dead in less than a week. Congratulations!

Is that REALLY something you'd like to hear about anyone you know? Would that satisfy your curiosity? Big risks, even ones your not aware of, are NOT a reasonable price for trying out medical treatments.

[brianwawok]

What do they call the guy that got the lowest grade in medical school? Doctor

[gamblor956]

They actually don't call them doctor, because the lowest grade in medical school is an F and plenty of wannabe doctors flunk out every year.

[a_e_k]

"What do you call the person who graduated bottom of their class in medical school?"

(At least that's how I've heard it phrased before.)

[gamblor956]

A passing grade in a U.S. medical school is a 70% and they don't grade on a curve.

[khazhoux]

What do they call the guy who got the lowest possible passing grade in medical school?

[ricardobayes]

Anecdotal, but the passing grade is much higher in medical school than other programmes, like 70-75%. But interestingly, it's often pass/fail instead of grades.

[schainks]

> If there are 10x and 0.1x engineers, you bet there are 10x and 0.1x doctors.

This is a false equivalency, as the 10x engineer is measured differently than a great doctor. A 10x doctor in your analogy should mean "this doctor is least likely to kill you during surgery", or "is better at following checklists".

The "best" doctors I've met have off the charts systems analysis skills, and they were in all kinds of specializations. Human physiology can be quite counter intuitive at times, and great doctors have great observability skills.

[khazhoux]

It was an analogy, not an equivalency. There are any number of differences one can find.

[itishappy]

This applies to engineers as well! The ability to connect specialties is what separates the outstanding from the great.

[antisthenes]

> If there are 10x and 0.1x engineers, you bet there are 10x and 0.1x doctors.

So if we already have a massive doctor shortage, including 0.1x doctors, you can begin to guess how awful the medical system is in the US.

You could be paying exorbitant rates only to end up with a 0.1x doctor, because there was literally no one else within 30 miles in a rural area.

Pretty depressing to think about.

[Analemma_]

It’s one reason why I will absolutely not move to a rural area, no matter what the benefits are to cost-of-living and getting away from the city. Rural America is getting completely emptied of all its medical providers, because it’s impossible to provide medical services at a profit. Doubly-so if you need any kind of specialist care; in rural areas, forget about it.

[thruway515]

No it's not like any other field. There's no such thing as a 10x doctor. A '10x' doctor is just as likely to kill you as any other especially when it comes to experimental never before done procedure. In fact a 10x doctor like Qiu is more likely to take risks. This is medicine not a software shop where we measure productivity by number of commits or number of surgeries per hour except by 10x you mean 10times more likely to be careful and ethical

[exmadscientist]

I think there absolutely are 10x doctors! When every doctor or specialist you meet in a field says "yeah, Dr X is a massive asshole and I kind of hate him personally but if I ever need [not-particularly-rare procedure Y], I want him to be the one to do it", I think Dr X counts.

[itishappy]

Yeah, I don't mean it literally, nor do I necessarily agree with the concept of 10x engineers in general, but it's a useful shorthand. I would bet doctors vary somewhat less than other fields, but my family has been surprised and burnt by the variance still there, and I'm the only non-doctor!

On the topic of 10x surgeries per hour, the 1800s were an interesting time! This guy in particular:

https://en.wikipedia.org/wiki/Robert_Liston

[nickff]

What exactly do you mean by "10x doctor"?

Some surgeons have a 10x higher 'revision rate' than others, and from what I understand, that may be an understatement. Many of the statistics which would indicate the ones to avoid are not tracked, precisely because the doctors do not want them tracked.

[red-iron-pine]

doctor stats are also misleading af, since the busiest times often require the best, most reliable docs, and they also have the highest rates of fatalities

7pm-2am on friday is when all of the nasty cases come in, and the best surgeon in the world ain't gonna save many of them.

[thruway515]

You'll have to ask the OP what they meant by 10x. I assume they meant it in the programmer/hacker sense of producing more work in the same amount of time than their peers or being a 'rockstar'

[solumunus]

Obviously they simply mean highly talented compared to their peers.

[foco_tubi]

The point is, there are excellent doctors, good doctors, bad doctors, and awful doctors who should probably have their licensure revoked; just like engineers, or any other profession, there is a spectrum to the quality of service/talent/care.

[eaxregister]

Yep, this.

[ButlerianJihad]

https://youtu.be/6h6dhevlb0w?is=t-cLAwe5vBuKx_fZ

Your Coworker Who's a 10× Engineer