Your.MD raises $10M to grow AI-driven health information service and marketplace
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In the case that it can parse such questions, the big issue is whether it knows what it doesn't know when giving recommendations.
I can see this becoming a great advertising platform for massages, and "alternative" medical procedures like accupuncture or homeopathy, as these are very often bought privately (since they often aren't covered by nationalised health services as they are not always recognised as medecine).
Although Doctors are expensive resources, they are very heavily utilized, and are very good at what they do. That feels like a very hard problem to make any genuine headway on.
Granted, I'm writing from Canada, and while having free health care is lovely, what's usually overlooked is that it is very often second or third rate care, if you can even get it (free doesn't help much when there are multi-year waiting lists).
Although it's not easy to find a good doctor that you like, there are family doctors available for new patients even in busy cities like Toronto. Specialists might take a while to book (assuming it's not serious). Emergency rooms are always available (although you may have to wait a few hours if it's not really time-sensitive). Labs can be booked same day and may have a bit of a line up but you can get those for free too (for most types of tests).
First, every patient has very valuable knowledge for their physician: their symptoms. There's absolutely no substitute, and as a patient you are the definitive source for that information and the undisputed expert.
Second, I do find that it's very often helpful when my patients have done some reading about their condition. It shows engagement in their care and is a great way to jumpstart the conversation. And it gives me a good idea of the level of insight into their disease and the best way to approach the patient education part of my task.
However, to be clear, it is my responsibility ethically and legally to have the expertise to treat you and to apply that expertise in making an assessment and plan. If I find that I don't have the expertise that's necessary, I should be consulting with or referring you to another medical professional who does. It's your right to have your physician's thinking explained to you and to agree or disagree with the plan, and if you think your physician is wrong, it's also your right to ask for a second opinion. However, it is never ethical for me to rely on your medical judgment in formulating a plan.
So, please don't take it the wrong way when your physician limits the amount of research he or she will hear from you. I stick to strict boundaries even with patients who are physicians themselves--even when they are significantly more senior and experienced. And when I'm the patient, I try my hardest to describe only my symptoms, confident that I will receive better care that way.
> However, to be clear, it is my responsibility ethically and legally to have the expertise to treat you and to apply that expertise in making an assessment and plan. If I find that I don't have the expertise that's necessary, I should be consulting with or referring you to another medical professional who does.
It may be your "ethical and legal responsibility", but how is a doctor that sees patients 8 hours a day supposed to keep up with new discoveries, and how is the perfectly reasonable scenario of not knowing you don't know something supposed to be resolved for the good of the patient?
> However, it is never ethical for me to rely on your medical judgment in formulating a plan.
Is it ethical to have an ego so large that you literally refuse to listen when your patient is trying to inform you of something that you apparently have no knowledge of (arrogantly interpreting this as the patient making a "medical judgement" and patting them on the head for your incorrect assumption of their intellectual arrogance)?
This is why I am of the opinion that the broad medical establishment needs to be reminded that they are not omniscient, through no fault of their own.
Continuing medical education is now a requirement of continued licensure. All doctors are legally responsible for keeping up with new developments and offering treatment that meets the modern standard of care. If I am unwilling to use some of the other sixteen hours of the day to brush up (in the unlikely scenario that I have only eight hours a day of patient responsibilities), I am required to leave the profession.
Patients do not tolerate care that’s compromised by unknown unknowns–unless it’s truly unknown to all of medical science–and the medical and legal professions do not tolerate it either.
Let me ask you this: what are you hoping to achieve when you “try to inform” your doctor? Is it to share your personal preferences and values? Your doctor should definitely take those into account. Is it to share your experience of the illness? You’re right to expect an empathetic ear. Is it to add to your doctor’s fund of knowledge so as to change his or her assessment of your condition or the treatment that you are offered? This scenario is ethically impermissible for your doctor; it has nothing to do with ego.
And just as there's no realistic way for doctors to stay completely current (I expect specialists in a specific field would often have trouble staying current even there), I'd have to see some pretty extraordinary proof to get me to believe doctors are confirmed to be comprehensively up to date on all "modern standard of care" medical knowledge.
> Patients do not tolerate care that’s compromised by unknown unknowns–unless it’s truly unknown to all of medical science–and the medical and legal professions do not tolerate it either.
Good lord, if one is connected to the internet or reads the newspaper this is so obviously false it is shocking someone would make the claim. And in Canada, you take what little medical care you get and you like it.
Luckily, the vast majority of patients are utterly uninformed, so this theory would rarely be put to the test.
> Is it to add to your doctor’s fund of knowledge so as to change his or her assessment of your condition or the treatment that you are offered? This scenario is ethically impermissible for your doctor; it has nothing to do with ego.
Wow. So, you literally can't even believe a scenario can possibly exist where any patient might be aware of studies related to a particular ailment, and that upon informing the doctor of it's existence, the doctor could then go read the study for him/herself and incorporate the knowledge into their practice?
Please tell me this is a misunderstanding between us.
edit: fixed a backwards phrase
> The key phrase being "that meets the modern standard of care", as opposed to most current available knowledge. Aka "good enough".
This is a gross mischaracterization of what it means to provide the standard of care.
> And just as there's no realistic way for doctors to stay completely current (I doubt specialists in a field have trouble staying current there), I'd have to see some pretty extraordinary proof to get me to believe doctors are confirmed to be comprehensively up to date on all "modern standard of care" medical knowledge.
Each physician has their scope of practice. Outside of their scope of practice, they are expected to refer to or consult another professional. Within their scope of practice, they are absolutely required to be up-to-date in their knowledge. This includes the obligation to recognize when a patient's needs exceed their scope of practice.
> And in Canada, you take what little medical care you get and you like it.
More medical care is not better medical care. A number of pioneering efforts to use resources wisely first developed in Canada are now internationally recognized. They represent impactful advances in improving the quality of care. See, for example, the Ottawa Ankle Rules.
> Luckily, the vast majority of patients are utterly uninformed, so this theory would rarely be put to the test.
Contrary to your assertions, the majority of my patients ask pertinent questions and participate meaningfully in their own care. This has been the case regardless of their level of education and general health literacy.
> Wow. So, you literally can't even believe a scenario can possibly exist where any patient might be aware of studies related to a particular ailment, and that upon informing the doctor of it's existence, the doctor could then go read the study for him/herself and incorporate the knowledge into their practice?
Feel free to recommend studies for your doctor's reading list. There's no reason your doctor should be averse to that--it's no different from recommending a novel. However, if delivering appropriate care to you requires the reading of studies the existence of which your doctor is not even aware, then your doctor is no more qualified to provide that care after reading one or even a small number of studies. Have no expectation that your treatment will change after recommending a paper any more than it might after recommending a novel.
This must be where we've crossed wires - you're talking about how things should be, I'm talking about how they sometimes/often are.
> it's no different from recommending a novel
Except one can result in the doctor learning something new about medicine. Unless medicine is somehow the one magical profession where there is no gradient of competency - all practitioners are perfect.
1: This is the closest analogy I have come upon to explain to folks the difference between websites and search engines. 2: Typically NIH or Mayo Clinic
EDIT2: An under-rated site is the Merck Manual. Their corresponding page for the consumer edition is thus: https://www.merckmanuals.com/home/infections/tuberculosis-an... .
Not to cut down doctors, but finding a good doctor can often be very difficult. I completely understand the demand in trying to find quality medical advice that you can trust. It's a hard & very valuable problem to solve, so the more resources people throw at it the better.