Comment by chronic7382 | Hacker News Reader

Comment by chronic7382 | Hacker News Reader

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> I'm the spouse/partner of a recently-trained doctor, and I'm a programmer and startup founder with 2 decades of experience. With all respect, you have no friggen clue what you're talking about.

Then you should know very well that the entire MD education pipeline optimizes for rote memorization and regurgitation of facts (from undergrad pre-med all the way through post-residency fellowships). Any patient with even the slightest deviation from what the physician searched on WebMD is given generic advice similar to how fortune tellers recite generic phrases. If you have a non-standard question or health problem, go to 3 doctors (or even specialists) and you'll get 3 different answers.

I work closely with clinicians at Tier 1 urban medical institutions daily, both at the in-patient and outpatient settings. Most doctors are dumb as a rock.

Note: Physicians with a MD/PhD are much better at critical thinking and make more of an effort to solve your problem.

I can second this! I studied medicine for two years in a SE Asian country. My late dad was a doctor. Both of my host family parents are doctors in the US. My gf is a doctor.

The main reason I left med school and decided to study math and comp sci. is because of the need of rote memorization necessary in medical training. This is especially worse in the US because the system here requires 4 yrs (undergrad) + 4 yrs (med school) + 3 yrs (residency) = 11 years of training to become a doctor. In contrast, it takes 5 yrs (med school) + 2-3 yrs (residency) of training to become a doctor in my home country.

The journey to become a doctor in the US is unnecessarily lengthy and it makes doctors feel more entitled (because they have spent a lot of time and money as investment) to charge exorbitant fees despite what most of them are doing is simply prescribing antibiotics; analgesic; insulin; and garden-variety stuff (or read up "Up-to-date" [https://www.uptodate.com/home] to refresh on what they learned or what the current consensus treatment is).

Most of them do the same thing day-in-day-out. Sure, there may be some specialists that are top notch, but they are like the minority and even their work is mostly about being able to keep steady hand and cool head during emergency situations.

This lines up extremely well with my personal experiences over the years.

It makes total sense if you think about it: medicine is an infinitely complex field, and at the end of the day even though doctors have (in the past) undertaken significant training, they are still human beings, subject to the same limitations and errors as the rest of us.

New discoveries and nuanced understandings are made in medicine constantly, the idea that it is safe to assume that any individual doctor is going to know and understand all discoveries seems to me like extremely wishful thinking.

What you don't perceive is why medical education has to be that way in the current state of affairs. Yes, has to.

You may be brilliant at other things, but your analysis of this particular problem is no better than the doctors you describe.

> What you don't perceive is why medical education has to be that way in the current state of affairs. Yes, has to.

No, medical education does not have to be this way. It is purely gatekeeping.

It's similar to how "You need a PhD" to land top AI/ML jobs. That's gatekeeping as well, though it is slowly changing.

Not many doctors or AI researchers will openly state this gatekeeping because they benefit, at the expense of those not in their field.

Nope, not gatekeeping. I know I won't convince you, but just think about that:

Most parts of the country are approximately medical deserts. So once you're educated, you are dispatched to said desert. Your hospital has standard pathways where nursing teams operate. Problem is, everything that escapes the standard pathway comes your way with no one to help you.

"Yeah, but there's UpToDate, MEDLINE, etc.". Well, no. NO! You simply don't have the time. Your job is to operate as a well-oiled machine to handle all the impromptu shit 70+ hours/week. That's why you did all this rote memorization.

A doctor is not an engineer. He is trained for a hostile environment where you have no time to think or search. As long as automation can't help (and it currently can't), docs are bound to memorization training.

By definition, most patient issues don’t deviate from the normal. Optimizing for the most common case makes sense.

And there's no Dunning-Kruger effect at play here, at all. You're entirely equipped to evaluate highly-trained technical specialists in a field not your own.

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