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Comment by rjkennedy98 | Hacker News Reader

The fact that this extremely dismissive comment can be upvoted makes me despair about ever fixing a broken healthcare system. Covid may have killed 250K in the US, but negative interactions with the medical system kill 150K year at the minimum each and every year. https://www.hopkinsmedicine.org/news/media/releases/study_su... This makes medical errors (which include negative effects of properly prescribed drugs) the 3rd leading cause of death in the US. More aggressive number such as Peter Gotzche's put that number even higher by including more nuanced side effects. He estimates that psychiatric drugs alone kill 500K people a year in the west. https://vimeo.com/178943789

Doctors as a general rule are very bad at listening to patients and our medical system simply does not track drug efficacy or side effects. You might be in a privilege situation to have never had to experience this, but there are millions of people who have.

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I live in a country with socialized medicine. People trust the healthcare system since we "pay" 0$ for access. (pay in quotes since obviously taxes are significantly higher)

And Drs. I know are great at listening! I'd honestly go as far as to say they listen too much at times; I don't tell a mechanic how to do his job, it's not my place to tell a Dr. how to fix me since I have literal 0 understanding of the human body.

Again, maybe its a socialized medicine vs privatized medicine problem, but it absolutely boggles my mind the level of distrust in what should be a respected profession.

My comments aren't meant to disparage, but point out that colloquial evidence is not a substitute for research and the scientific method. I will call baloney on people who spew it.

Having lived in both privatized and socialized medical systems I actually find that the privatized health care system was better at listening. It cost more money, but it was definitely better bar none.

I think doctors are as good as their tools (education) and the feed back they get. They can only listen to what patients say, however most people aren't able to explain in detail what is going on. As well, western medicine tries to focus on specific locations/ailments and can miss the holistic portion of sickness. This challenge is compounded by the fact that many illness have similar symptoms and human bodies are intensely complicated.

I don't trust a doctor 100% (many of my friends do) however I do put a fair bit of faith in their training. Anything serious requires more research on my own as doctors are fallible.

The thought you raise that you shouldn't challenge or ask questions of what a doctor is telling you is quite alarming and I would wager that kind of laziness leads to poor health outcomes. As I said, doctors are human and are fallible, the research (i.e. human health systems) is not complete, and they are working on deeply complex issues that have incredible amounts of interactions that are unknown and incredibly challenging.

That said - the doctor better be able to explain in a straightforward manner in order to gain trust. And any profession that you should just "inherently trust" allows openings for laziness, abuse and bad outcomes. Strongly disagree with you.

I should make clear my opinion - I do trust western medicine, vaccines, science et al. I do not however trust them 100% - mistakes are made, and this is my life. I can question them, and I should. Their role is to instill trust and not disregard peoples concerns out of hand.

For sure; and I'm not saying we should give people carte blanch. But those mistakes, errors, whatever we want to call them, are the exception, not the rule.

Do you distrust your co-workers if they make a single mistake?

My co-workers aren't responsible for the quality and length of my life. Their mistakes have an incredibly small impact compared to a mistake by a doctor (depending on the scope of problem).

Do you have factual references for the claim about errors in medical care being exceptional? From impartial sources?

I'm honestly skeptical of the claim based on my life experience. I've heard directly from people of numerous of terrible errors that destroyed their lives. e.g. bone implants that were poisonous, different implants that weren't sterilized properly, forced saving of patient life to charge/steal his assets instead of passing to family - direct from people I know well, that happened to them.

Then I've personally experienced a common pattern of doctors not being able to identify things that weren't common or obvious based on their flowchart style diagnosis. I've also experienced a lot of successful diagnosis of simpler obvious issues.

What if there aren't straightforward explanations to what needs to be done? Should I not trust my Dr because they can't bring complex medical concepts down to my level? Do clients of software development companies require that the developer explain things in "clear terms" for them? I thought we called that marketing wank.

Drs, nurses, and all other medical professionals are required to do training/recertification in my country. I "inherently trust" them because the system allows me to.

As for private vs. socialized, that will always be a point of contention. Some people want to be able to choose, but even being able to choose shows some amount of (and I hate this word) privileges. The vast majority of people simply do not have the financial means to "choose" a Dr in a privatized system; if they can even get access to one.

Why do we trust professionals so little?

I agree with the statement about privatized - and that wasn't what I was referring to. You had said that they public health care listened better, I wanted to refute that. I also recognize that in private health care your insurance and ability to pay impact the health care you receive. I don't think that is the best mechanism to provide good care for the entire population.

All I am saying is that if they can't explain things better than take this pill, than I wouldn't trust them. Like I said, I trust their education (which is the certifications) but I will certainly run questions up the flagpole if I have them. They shouldn't be given "god like" carte blanche status in terms of no questions.

That last question is a tough one - I would wager it is because everyone knows someone who has had some bad experiences, and there have been many a story about seriously effed up medical experiences. Most people can't do statistics and then get deeply concerned that the likelihood that they might have bad experience then spills over into lack of trust. That's my two second hot take.

Because of misaligned incentives.

My mechanic might know what to do, but his incentives can include things that are in opposition to mine, such making more money from an issue (real or not), doing less work, even getting more social attention and status for making their work more important.

By the way I'm an expert investment structured, and you might be interested in these neat things called CDOs I can hook you up with ..

The best doctor’s office experiences I’ve had were in a country with socialized health insurance (not socialized health care). I’m pretty convinced that private providers with public insurance is the optimum for providing a high standard of care.

There was also a supplemental private insurance market which covered a range of elective treatments. Best of both worlds!

I agree. Its hard to counter the feeling that HN is getting too big for its boots. In certain "culture war" threads the easy to digest opinions are beginning to dominate. Maybe I just payed less attention a few years ago but I never noticed this in the past. Will it spread past the culture war threads or will it not? Who can tell at this point.

How is being pro-science part of a culture war?

Being pro-science is very unpopular with the anti-science culture. It implies global warming is real, humans evolved from apes, and a whole host of other implications.

Considering the GGP of this comment is on the verge of dead and it includes two citations, with one being https://www.hopkinsmedicine.org/ which is a world class medical institution, I think the answer is obvious.

Hacker News is only pro science in some areas. Try looking at threads about organic farming or GMO seeds and you will discover a different side. That but one example, easy for me to see because my biases are different.

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