[exstudent]

You can definitely feel this as a patient. If I could give my vitals to an app and have it diagnose and prescribe remedies, I would do it in a heart beat and never visit a doctor again (of course you would need robot surgeons too :).

I've never seen a doctor research anything either (although I'm sure they do behind the scenes). They seem to be pulling from whatever information cache they have in their head which I often suspect is horribly outdated.

I'd take a crowd sourced db of health info over a doctor's personal knowledge any day of the week.

[khungus]

> I've never seen a doctor research anything either

That's a little surprising to me. One of the coolest things about practicing medicine today is that I can pull out my phone in front of a patient and find guidelines that I'm not familiar with, medication side-effects, and other point-of-care resources that really do enhance my clinical ability in real-time.

Granted, I work in a hospital setting. Maybe it's different in the clinics.

BTW, though I feel I'm underpaid for what I do (which many outsiders would find ridiculous), I'm overall pretty happy with being a physician.

> I'd take a crowd sourced db of health info over a doctor's personal knowledge any day of the week.

So would I. But what you'd learn in the first week of hanging out with a doctor in a typical clinical setting is that most patients are frankly too uneducated to be able to use that kind of tool. When I did residency, I suspect most of the patients I saw didn't have internet. Many were illiterate and a disturbing number simply didn't care about their own well-being.

I'd love to build up a practice with patients like you, but people like you tend to be pretty healthy.

[w1ntermute]

> When I did residency, I suspect most of the patients I saw didn't have internet. Many were illiterate and a disturbing number simply didn't care about their own well-being.

> I'd love to build up a practice with patients like you, but people like you tend to be pretty healthy.

There's also the factor that teaching hospitals tend to get a lot of poor and uneducated patients. Private clinics have a different clientèle, and there are definitely plenty of individuals out there who are not in perfect medical condition, yet are educated/informed enough for doctors to interact with on a higher level than they currently do.

[toomuchtodo]

How would you feel about IBM's Watson providing a second opinion to help with your care delivery?

Watson thread from <1 week ago: https://news.ycombinator.com/item?id=8237618

[wisty]

> So would I. But what you'd learn in the first week of hanging out with a doctor in a typical clinical setting is that most patients are frankly too uneducated to be able to use that kind of tool.

Yep. There's apps to do your taxes. But the average person isn't able to understand double entry accounting without doing a year of study on it.

[exstudent]

You sound like a really good doctor, but alas I'm pretty healthy (thankfully!).

[mikeleeorg]

I've never seen a doctor research anything either (although I'm sure they do behind the scenes).

Yup, they do it behind the scenes. They worry that too many patients would complain and feel insecure about a doctor having to do research in front of them, since the majority of patients want to feel that their doctor is the expert on all matters of their health. If a patient feels the care he/she wasn't up to par, and there are any complications, there is generally a very high risk of a lawsuit. So to prevent that, most doctors will do research outside of the view of the patient.

To be fair, they aren't sitting at their desks pulling up Wikipedia. Their research often consists of consulting with a specialist (or multiple specialists), consulting with colleagues, and searching through the volumes of medical periodicals and databases.

Most do this not just to be thorough and careful, but also because they know they need to practice defensive medicine and, well, cover their butts in case anything goes wrong.

[im3w1l]

I wonder if in the future, doctors will become more like bearucracts. You go to the internet, find out what you have. Then you fill out the appropriate form, go to a doctor who stamps the decision with a red mark of approval, granting you access to medication / surgery.

[danieltillett]

This is exactly how I interact with the medical monopoly. I don't think I have been to the doctor for the last 10 years without knowing my diagnosis and treatment in advance. My job has then been to guide the doctor to the correct diagnosis in a way that keeps their ego intact.

[mikenuman]

A physician who treats himself has a fool for a patient. Osler. (Even more so for a lay person)

[aianus]

I couldn't have said it better myself.

[k-mcgrady]

>> "I've never seen a doctor research anything either"

I have. It's terrifying. I recently went to the GP, told them my condition (which had been diagnosed by a different GP) and their first response was to look it up on Wikipedia. Seriously. I understand that a GP isn't going to know every condition you come in with but Wikipedia as the reference material?

[vacri]

It shouldn't be terrifying at all. GPs are not specialists. And even specialists don't know everything. I used to work as a neuro tech and I remember a patient came in announcing that he had some particular syndrome (I can't recall the name). I stayed quiet about it, never having heard it, but needed to get a neurologist in for the test anyway. In comes the specialist, one whose skill I greatly respected, and the patient proudly announces the syndrome. The neurologist had no qualms about directly asking what that was. The thing is, if your syndrome only has five people in the country that are affected by it, it's not reasonable to expect every doctor (even specialist) to know what it is off the top of their head. There are hundreds of thousands of maladies that can affect the human body. Many of them go by multiple names.

To top this all off, a GP is a General Practitioner. Their main role is to filter out the sniffles and the rashes, and keep an eye out for the more serious stuff, which gets passed on to an appropriate specialist. In the GP's case, going to Wikipedia gives a good, quick baseline on what the disease is. A GP shouldn't be prescribing drugs from WP, but if you say you've got McGrady's Syndrome, the GP looks it up quickly on WP (which is a very quick, concise resource), and finds out it's a liver problem of a certain type, the GP now has a base to work with. Liver problems mean X, Y, or Z in general, start looking at those avenues of inquiry.

The other thing is that while it should not be a canonical reference, when it comes to scientific topics, WP is very well written, concise, and quick to access. If you've ever used medical software, you'd know the high variety of quality there is - some is just plain awful when it comes to looking things up. And textbooks by their very nature go out of date.

[DanBC]

Being charitable the GP wanted to know what misinformation the patients come in with.

Being realistic: yes, it's terrifying. GPs are subject to the same biases and prejudices as everyone else.

[ArkyBeagle]

You can always tell the premeds as an undergrad - they are the ones who ask "will this be on the test?"

[esfandia]

> I'd take a crowd sourced db of health info over a doctor's personal knowledge any day of the week.

I think it's a great idea, and so I went looking for a StackExchange forum for it. It turns out there is one that is in the staging phase:

http://area51.stackexchange.com/proposals/66048/health

Obviously caveat emptor, YMMV etc. would apply to such a forum, and the other issue is that a patient posting there doesn't have access to all the diagnosis tools that doctors do.

[secabeen]

Every doctor is different. If you show a desire to engage with a doctor, and get the right one, you can have one that does research. When I started on cholesterol-managing medication, my physician emailed me three recent journal articles on the effectiveness of different options and the dosing considerations. It all depends on who you have, and how they run their practice.

[exstudent]

I agree that there are good doctors, but I'd rather not have it be such a crap shoot. The consistency and depth of knowledge provided by an expert system of some sort seems like the way to go.

[jrapdx3]

I'd imagine the proportion of "good" doctors might be about the same as good programmers, or good teachers, though probably exceeds the supply of "good" politicians.

Point is medical care is only as good as the quality of the "team" consisting of the doctor and the patient. It's a partnership, an expression of the doctor-patient relationship. Not every two people will form a natural team, after all, many marriages fail.

It's kind of a cliche, but still true, find a doctor you can work with, someone you can trust and relate to. More likely than not, that's the the definition of a "good" doctor.