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Comment by viraptor | Hacker News Reader

It's not just medical residents. Doctors do refresh their knowledge from videos online. And they totally google for information. But I don't think it's what many people imagine when reading it.

> How can doctors tell which videos are valid and which contain bogus information?

They're doctors. They had years of training and know the basics of what they're booking up. It's closer to experienced developers looking up specific usage for some tool which they're familiar with otherwise, rather than learning from scratch.

Sure, there's going to be some extreme bad cases, but those are bad doctors in general, the source of info is not relevant.

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Alternately:

> Developers are turning to Stack Overflow to fill in gaps in their training

There's a lot of garbage channels on YouTube, but there's no shortage of knowledgeable people too.

Nobody knows everything, and it turns out there are people on the internet who know things we don't.

I've seen some terrible code in codebases that I just know has come from Stack Overflow (often I can trace back and find it). Some of it's for security related code, so it's fairly critical to get it right.

Doctors aren't magically smarter than developers.

There's no magic to it - There's a lot more gatekeeping, training, board certification, etc. It's not perfect, but it's a darn sight better than the complete lack of professional standards that we developers are held to (myself included - I'm shipping code today that I wish I weren't, that I believe is unsafe at any speed, but thankfully I don't believe it'll be getting above .1MPH)

You can hire a developer off the street who just happened to be the CEO's nephew. You can't do that with doctors.

Would you prefer we had to get a license like a barber?

There's a growing shortage of developers. What would that look like with more barriers to entry?

It would look pretty good for the developers.

Putting gates around something as basic as medicine has only resulted in the price going up.

You can hire the CEO's nephew for any role. Doesn't mean you are getting anything done. That nephew can buy a medical degree abroad or locally at Harvard.

In this case, I welcome putting gates around medical hiring practices. Lives are at stake.

Twitter/FB going down, realistically, is not going to kill anyone.

Risk management is very real with people's very lives. The price going up is expected because of the filtering needed, but it shouldn't go up as fast as it does in America.

> In this case, I welcome putting gates around medical hiring practices. Lives are at stake.

Note that lives are also lost (and much suffering is caused) by the extremely restricted and expensive medical environment. I actually expect that we'd be better off (utilons wise) if we relaxed some of the restrictions.

100% agreed on the suffering caused. Separating the rising cost and the restrictions can be done.

Socialized, single payer, gov mandated caps, etc etc. There are lots of options. Each come with their own poisons, but far more effective in terms of overall coverage than what we have available in America without material change to the restrictions.

The gates begin before the hiring level at the college level.

>Putting gates around something as basic as medicine has only resulted in the price going up.

Citation required. This is pure bullshit. Those gates aren't there just because someone said 'hey there should be a gate there.' Those gates are there to solve problems, and while they also create their own problems, that doesn't change the fact that the underlying problems are still there.

Limiting the supply of doctors by limiting enrolment is an example of a gate the increases prices.

Those gates were put in place to solve a problem but in time gets abused.

>Limiting the supply of doctors by limiting enrolment is an example of a gate the increases prices.

It also has an effects on quality of instruction. Limiting the number of students tends to increase the quality of instruction, something I believe is extremely important in medicine.

I'm not saying that there are abuses. But you made the claim that the only effect it has is to raise prices, and that is completely wrong.

Doctors are “magically” smarter than developers. They have to clear a huge amount of training before they get to call themselves “doctors.” It’s like if someone had to reach L7 at Google before they could call themselves “developers.”

Don't know about doctors, but for statistics, optimization, and ML, a lot of stack/quora answers are just flat out wrong.

Even experienced person could easily fall trap to this.

I learned this lesson the hard way. But now I resort back to books and obscure sources for my stats training. It's slow and painful, specially when you're alone and there's nobody to answer questions about this weird aggregation function you're learning.

I so don't like when DDG presents me with SO links and previews at the top, instead of Github issues and official library docs. 95% is garbage.

Or perhaps less insidiously, a lot of answers are out of date. I remember that when I did AI game programming, I wanted to build a behavior tree, so in a recent project I Google for that. I get tons of great resources for behavior trees, libraries, examples, etc.

Except there's a lot more on the cutting edge I should be considering. Maybe GOAP is the right fit. Maybe HTN. Maybe something else. Sometimes these searches turn up results that are too specific to the old way of doing things and don't lead me to the latest and greatest.

The latest and greatest?

If that matters put in whatever subject and a year like 2019.

Be warned the latest is rarely the greatest.

True, but this isn't really case for optimization problems and results about theorems or lemmas.

I think one of YouTube’s strengths compared to SO is that you can find a few useful creators with good information on a topic and learn a lot from them.

On SO it’s the luck of the draw on each individual question.

SO also allows you to browse all answers (and questions) from a specific contributor.

Alternatively, patients are turning to youtube to fill in the gaps in their doctors' training.

I've not met a professional that doesn't make internet searches for information when necessary.

I'm a professional physicist, and I search for specialty-specific information multiple times per day, every day.

Are there websites like StackOverflow where you find pharmaceutical receipes for acetylcysteine?

I think the parent is a physicist, not a pharmacologist, but I'm curious about what exists in both physics and pharmacology so I hope people chime in on both.

Physicist here. ENSDF (Evaluated Nuclear Structure Data File) is a fantastic resource for anything related to nuclear physics.

Person doing simulations in plasma physics / astro physics here. I google tons of stuff every day. And I have a hard copy of https://www.nrl.navy.mil/ppd/content/nrl-plasma-formulary on my desk. And the PDF on just about any of my devices. Once every few years I ask the Navy for 20 copies and hand them out to grad students and colleagues.

The Decay Chain article on Wikipedia is a go-to favorite of mine: https://en.wikipedia.org/wiki/Decay_chain

The graphics for the natural decay chains are eminently-usable and teachable.

Not a medicinal chemist, but I think the general procedure for that is to do a google (or better, Google Scholar) search for "$chemicalName synthesis".

Here you go:

One-step synthesis of N-acetylcysteine and glutathione derivatives using the Ugi reaction

https://www.sciencedirect.com/science/article/abs/pii/S00404...

I can't seem to find an openly available PDF, but you can search sci-hub to pirate that.

From reading the abstract and the graphics, it doesn't exactly look like something you cook up in the kitchen. For instance they run the reaction in trifluoroethanol, which is flammable, toxic, irritant and possibly causes reduced fertility from exposure.

Not sure if you have access to it, but reaxsys[1] is an amazing database for stuff like this. I've used it many times for looking for (un)safe reaction paths for particular drugs. It looks like the ``free'' version might let you get a lot of information from it.

Also, pubchem[2] might be of help as well. This is entirely free.

[1]https://www.reaxys.com/ [2]https://pubchem.ncbi.nlm.nih.gov/

That's usually done by literature search, which nowadays, can be done online. You draw a structure and it will look up literature that reported that as a product.

I haven't seen a website like stack overflow in the sense of posting questions like "How do I purify after this Beckmann rearrangement?"

When reading articles like this, here's a quick check: Replace "YouTube" with "bookstores" and see if you're still outraged. Anyone can write a book, and the bar to getting a book published has absolutely nothing to do with the book's accuracy. If "Chariots Of The Gods?" can get published, you know publishers aren't doing sanity testing or any other kind of checks for the reliability of the content. And yet doctors buy books from bookstores, and use them to learn things. How do doctors know they're not getting nonsense? Because they know what real information looks like.

This is the biggest reason for teaching the basics of a broad variety of subjects: If you know what real information looks like, and how the real field basically fits together, you're less likely to be taken in by absolute nonsense. OTOH, if you get bad information to start, you're going to evaluate all subsequent information on that standard, and reject good information because it doesn't jibe with the bad stuff you've already internalized.

Even worse, imagine it was medical journals that are mostly pay to publish, have clickbait titles, and have never been replicated or have poor p values,

I recently had an elevated D-Dimer level in my blood lab which indicates a clot of some sort. I remember sitting in the doctor’s office while my primary care doctor was reading the lab results. He literally started Googling “primary causes of D-Dimer elevation” and clicked on the link to a WebMD documentation on D-Dimer levels. That’s when I realized that’s their StackOverflow. Combined with their existing training, I assume WebMD helps them make better judgement calls (definitely compared to a lay person self-diagnosing themselves). He then said, “well, none of the top causes really apply to your situation: you didn’t have a surgery recently and it’s impossible for you to get pregnant as a guy”.

I was consequently referred to a hematologist.

Almost, but not quite right. Usually doctors and medical professionals use reference guides like Merk Drug Manual and Up To Date. They essentially fill in the gap somewhere between review articles (which can be a bit too specifically focused) and medical textbooks (which can be a bit overly broad in how they describe topics). These guides often provide the "typical" routine, but is then augmented by a physicians judgement.

I hope that your physician didn't use WebMD. There are significantly better resources that are heavily vetted whereas WebMD is for the lay person.

My wife is a resident.

She'll often does similar to verify she's not missing something obvious. In most cases, WebMD is simply agreeing with her pre-existing knowledge. Occasionally, it will present some other information - which she will research further to verify accuracy.

Some resources Doctors use: Medscape [1] which is owned by WebMD; Sources like MPR [2] for handy drug information and The Medical Letter [3] for in-depth medication reviews; UpToDate [4]; various journals depending on specialty, The New England Journal of Medicine being one of the most prestigious [5]; the Sanford Guide for infectious diseases [6].

[1] https://www.medscape.com/

[2] https://www.empr.com/

[3] https://secure.medicalletter.org/

[4] https://www.uptodate.com/home

[5] https://www.nejm.org/

[6] https://www.sanfordguide.com/

I watch Youtubers build things, or just playing my favorite video game and while I learn a lot from them, sometimes I learn more from the times that I disagree with them.

I was watching a video for a game I play, about a dogmatic approach to solving a particular problem and realized it had been min-maxed into the ground by bad math. By de-optimizing it a couple percent I could get 2 and a half beneficial outcomes instead of just the one. Given how time consuming the process is, it was madness to sink so much effort into solving only one problem. Of course having spotted something someone else missed, I've been staying up too late trying to validate my theory. Unfortunately my change barely made it any faster, and my first attempt to break it down into two phases didn't work out and ended up costing me more time than I had saved.

Point is, I got all new nuances and areas to explore based on watching a video that I felt was provably wrong.

Now I want to watch your video on this. What game?

There's also the compulsion that highly trained professionals have to correct false information out of a sense of pride or ego. It helps to combat misinformation when you have a fair number of "ummm, ACKSHULY"'s in your profession.

As always there is a relevant xkcd: https://xkcd.com/386/

Ok, we've promoted residents to doctors in the title above.

That's more of an "expansion" than a "promotion" (residents are a subset of doctors)

Many medical schools now use Problem Based Learning (PBL) approach. Fewer textbooks are assigned and there are fewer lectures. Students are taught to track down the resources they need, books, journals, internet resources, etc.

https://en.wikipedia.org/wiki/Problem-based_learning#Medical...

> rather than learning from scratch.

The idea of a medical equivalent to a "script kiddie" is a somewhat amusing mental image, though.

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