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I work as a doctor (in the UK) in a hand injury clinic and see tens of hand and finger injuries a day, including a lot of fingers slammed in doors.

Whilst you are correct that trephining a nail (making a hole) to relieve the subungal haematoma (blood under the nail) beneath isn't a very skilled procedure, that's not why we see these patients. Most of the time, it is a simple straightforward injury requiring simple treatment. But a significant amount of the time there is an underlying open fracture of the distal phalanx (bone at end of finger) which can lead to a severe, potentially finger-threatening infection. There are also often nail bed injuries which without repair will lead to nail deformities.

There are a lot of injuries I have seen with delayed presentation where patients felt they knew what to do and wanted to save themselves the time of visiting the hospital (as there is no additional financial cost to healthcare in the UK). Many of these delays have led to severe infection requiring hospitalisation and surgery which would not have been required if they had visited promptly, or presenting past the point where we can fix e.g. a mallet finger, displaced fracture, etc.

As in all fields, there is a danger in not knowing what you don't know.

I'm a medical student in the States. Everything you said is spot on. Most of the time the presentation is straight forward and treatment fairly unremarkable. It's when nuances are introduced where medicine becomes complicated quickly. There are a plethora of patient presentations that can mimic benign illnesses while being much more insidious.

This idea that one cannot use Youtube to learn about medicine is a little silly. I use Wikipedia daily to further my understanding of diseases. Hell, it's usually the first place I go when I have a question.

I think there are a few things here. First, a lot of people go to the doctor for things that don't require a doctor at all. Your smashed fingernail is a perfect example - why would you even go to the doctor for that unless you really think your finger is fractured? Same with basic illnesses - waiting rooms are packed with people who have a basic cold and haven't even given it a week to resolve itself. This is really where telemedicine/remote doctors/whatever you want to call it should fill in the gap.

On the other hand, your ankle sprain example is a good one to use for a reason why doctors can be really important for basic things like PT. A rather large percentage of people straight up will not follow a basic PT regimen (let alone a diet/exercise change) to resolve a problem unless 1) a doctor tells them to, and 2) they are instructed on exactly what to do at regular on-site sessions. Ortho offices are packed with people who just want an MRI and some injections rather than having to actually do some work over the course of a few months to get better.

For people who are self-motivated and take care of their own health, doctors are rarely actually needed until you get to the point of needing specific tests and prescriptions. But for the other ~80ish percent of people, doctors are pretty much the only route to getting better.

why would you even go to the doctor for that unless you really think your finger is fractured?

This is answered in the same sentence. Blood was pooling up under the fingernail and had to be drained.

That doesn't answer it at all. Why do you need to go to the doctor for something that basic? Do you also go to the doctor when you get a blister? A 30 second google search would tell you what to do if you didn't learn this as a child (is basic health stuff like this really not taught anymore?), and it doesn't require a doctor.

Straighten out a paper clip, heat it with lighter or stove burner, melt a hole in the fingernail. A lot of runners with no medical training have done this.

And you don't have to disinfect anything?

Heating it should disinfect it. Growing up, my mother would sometimes heat a needle to disinfect it before using it to pierce and drain something, like a boil.

She wanted to be a doctor at one time and delivered babies in her teens. She was quite knowledgeable about medical stuff.

Red hot metal disinfects itself!

Yeah so if I didn't know that, I would go to a doctor. It's exactly the kind of thing where a YouTube search could make the difference between needing a doctor or not.

This kind of somewhat flippant-sounding advice is really, really heavily dependent upon the general background knowledge of the individual.

Some people can run with it and be fine and some really can't.

You would be supprised what people can learn quickly to alieve their pain. I nearly passed out when it was explained to me by a family member who was a doctor, but within a few seconds the pain ironed my resolve. The relief was immediate, as was the tiny, if momentary, fountain of blood.

I wouldn't be surprised actually. I've done a lot of "home remedy" type stuff.

I know from first-hand experience that discussing it online is a space with a lot of pitfalls. It's difficult to gauge the level of background knowledge of your audience and challenging to provide enough warnings to make it safe and useful while not insulting anyone's intelligence when different people in the audience will have vastly different levels of background knowledge pertinent to the problem space.

I had no idea you could "melt" a fingernail

Don't even know where to start with this--with all due respect this reads as textbook dunning kruger You aren't a trained medial expert. You lack the years of training and experiance somebody in the field has. Just like any other profession, that training is there to help you filter out how to properly think about the problem-space you are in and filter out all the noise. There is no-doubt a lot of unstated things that those youtube videos dont talk about that an untrained random person like yourself simply doesn't know.

You lack the internal knowledge-base that somebody with training has and therefore you are much more likely to mis-diagnose yourself, fall into an edge case that somebody with training could have easily caught, or miss something very important because it wasn't stated in the video you watched.

I dunno man... when it comes to the medial field I personally let the experts do their work. Relying on the internet, which is especially full of superstition, noise and pure bullshit when it comes to medial information, seems like setting yourself up to get hurt. But maybe that is just me...

I agree with your point of view that only trained medical experts are qualified to treat a real medical health issue. However, the mentality of completely entrusting your own life and health to someone whom you don't know whether they have good enough work ethics and compassion or not is frankly quite a big risk.

In reality, other than medical scientific knowledge and methods, effective treatments also come from having compassion and caring deeply for your patients. Unfortunately, we have to admit that not all doctors today have that. I have seen the good and the bad ones, good doctors were really good and bad doctors were also really terrible, just like in any other professions I guess. Without those human attributes though, those bad doctors can't really help anyone as it is the main force driving them to help seek the right cures for the patients. Worse, they may contribute to misdiagnoses and malpractices that are the prevalent sources for medical related accidents and deaths.

As individuals, we should all educate ourselves so we are more equipped in working together with the doctors when issues arise, rather staying in the unknown and completely leave your own fate to the hand of luck.

> Around 2010, I started noticing medical professionals had less information about what I had come in with than what I could find in my own research.

This is my experience with every doctor in NZ. Unfortunately, we have a toll system where i still have to pay every 3 months for literally zero value except 30 seconds of signing off my drugs.

You pay for the experience. They have done it thousand of times, while this will be your first. I have this problem myself, that I can scan hundreds of papers and literature and get a decent picture of the current state - which makes me dangerously over-confident.

Yeah my mom cured her trigger finger via youtube and also helped my dads colleague solve his right before he was scheduled for incredibly invasive surgery

This is an important point in that, health care systems often are motivated to get you to do more unnecessary things that cost. This is particularly true at end of life stages. Not every provider is trying to do this, but some absolutely are.

I think I’ve seen her ads. Doctors hate her because of this one weird trick?