[infra178]

I despise this attitude that people go to the doctor to figure out what is making them sick. Most of time, when people visit general practice doctors, they already know what's wrong with them. But we have to wait hours or days for an appointment, drive through traffic, sit in a waiting room for hours, and pay a bunch of money so that some jerk can spend five minutes typing our symptoms into his laptop.

I get it: they're gatekeepers to prevent people from abusing or misusing medicines. But wouldn't it be better to allow people access to medicine based on objective measurements taken over a long period of time rather than making people interview for it?

When I'm sitting in a waiting room, I'm thinking about what I need to say and do to convince the doctor that I'm sick. If I'm polite and smile is he going to believe me when I tell him I'm in pain? If I don't have a fever is he going to believe I had one two hours ago? I know that he gets paid whether he treats me or not and that he knows every treatment is a potential lawsuit if he makes a mistake. He has every incentive to play it safe and find some reason to avoid treating me.

The other day, I read an article about a woman in Houston. Emergency room doctors avoided treating her for a stroke because her boyfriend mentioned that she has occasionally smoked marijuana. Classifying her as a drug user allowed them to just give her some Zoloft, push her out the door, and collect the check. She'll never be the same again. And this happened in one of the best hospitals in one of the best medical centers in the world. The problem is systemic.

[conformal]

your characterization of visits to the doctor is spot on: they are gatekeepers to medication and treatment and they have a warped incentive structure that biases them to under-treat anyone they don't "believe".

on top of what you describe, i find most doctors to be biased towards "i know better than you" behavior. i have found that being an intelligent person makes dealing with doctors especially difficult since you need to be strategic to convince them and at the same time appear to not know too much about your own health problems. i have had incompetent resident doctors argue with me just because i know more about my illness than they do, and their ego is such that they cannot admit to themselves or me that they are wrong.

any technology that leads to me spending less time interacting with doctors is a huge win.

[Silhouette]

Classifying her as a drug user allowed them to just give her some Zoloft, push her out the door, and collect the check. She'll never be the same again. And this happened in one of the best hospitals in one of the best medical centers in the world.

Apparently not.

It's worth remembering as we discuss this that the US healthcare system is exceptionally poor by first world standards. There are all kinds of systemic corruption and perverse incentives that result not from clinical practice but from the legal and insurance systems, and no amount of computer assistance is going to fix those things alone.