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Comment by davycro | Hacker News Reader

Medicine moves fast and it’s impossible to stay up to date on everything. In general I do not incorporate the latest discoveries into my daily practice unless the evidence is absurdly overwhelming, which rarely happens. Usually new therapies have marginal evidence to support them. I prefer to wait until multiple studies support a treatment before it becomes my standard of care, and by that time it’s likely going to be summarized in a Cochrane Review.

Should a patient come in with a preference for a treatment they read about on PubMed (which has never occurred in my practice) then I would likely accommodate their preference unless I thought it would put them at serious harm. A patient knowing more than I do about a particular disease happens more than you’d expect, especially if they have a rare chronic disorder. This does not diminish my ego or confidence in my knowledge base.

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You are a very unusual doctor. I wish there were more like you.

Doesn't seem unusual to me. I could have written the same thing myself. Most of my doctor colleagues would be similar. Maybe you live in a different part of the world where doctors jump on every latest trend/study, but I'm not sure where that would be. Most of us like to let the water settle first.

Not jumping on the latest fad is very common, and something I expect of a doctor. However, I wish more doctors I've met fit in with the latter part of the grand parent comment, though.

A friend of my family met 15 different doctors for a period lasting years because of agonizing headaches, they all sent her home thinking it was nothing unusual. She died of a brain tumor the size of a tennis ball. We often think about what would've happened if one of those 15 doctors would've shown some humility.

To be clear, I work in tech, we have more than our fair share of big egos too. I don't think this is anything particular about doctors.

15 doctors and none ordered a scan of her brain? Well I'd say that's very unusual and the exception rather than the rule. In my experience doctors are more likely to request imaging purely to demonstrate to the patient that there's nothing visible, even if imaging isn't indicated.

Some more context; she didn't ask for 15 different opinions, she lived in the country side and her nearest hospital used relay doctors. So, it was more a case of being sent home and told to return if it didn't get any better, and when she did return, her previous doctor was long gone and had been replaced. All the next doctor had was whatever the previous doctor left them to work with in her charts. I'm not a doctor, so I don't know how much that would be in a case of a piercing headache.

It is not the first paragraph that makes the OP unusual, but the second.

That also doesn't seem unusual to me. I'd say most doctors recognise their limitations.

Not to their patients in my personal experience.

I understand that 99% of patients are clueless and that most providing information are likely misinformed by whatever they read on google, but every so often you meet a patient that actually knows more than you about their problems. The experience for this rare patient is almost always very poor.

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