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Generally agree, but can also see the other side. What you are talking about are people who are using sources like PubMed or even WebMD, etc. These at least help patients as reasonable questions even if they don't fully understand what they read. Then a discussion can take place.

I think what they are talking about are people using terrible sources (garlic curing HIV example). Then demanding that they are right.

So really, what we see here on both sides as the root cause are people who are not interested in a discussion and simply assert they are right. Dangerous if a patient does it, also dangerous if a doctor does it.

The other thing you don't see is how stupid the p05 patient is. Its not someone reading primary sources or coming in well informed. Its someone coming in saying Dr Oz says that eating blueberries cures cancer.

> Run as fast as you can away from doctors and other healthcare providers who think like this

For every 1 person who actually has discovered something useful or accurately self-diagnosed with some very well-done research, there are surely 10,000 complete idiots who have swallowed hook, line and sinker the first nutball result they read, which they now believe 100% and if you don't agree you're an ignorant, indeed murderous enemy.

It's completely understandable to me why doctors take this stance.

Yep, while it can be frustrating to be in the small percentage of people who are able to evaluate the validity of research, it's totally understandable why doctors are dismissive given how much rubbish is flowing around that people come up with.

Often it just requires a bit of pushing if it's a simple diagnostic test. "Can we just do this blood test to completely rule out [x]?". I remember about a decade ago my father was getting this extremely bad dermatitis on his elbows for years, and mum had researched and found coeliac (celiac) disease could cause that as a symptom. The GP was prescribing steroid creams, and they really had to push him to do a blood test to check for those antibodies. He thought it was dumb but gave in just to shut them up! Came back positive, next step was an endoscopy, which showed massive inflammation in the small intestine. Dad cut gluten out of his diet and over the next year the dermatitis and intestinal inflammation disappeared.

Assuming you’re a software engineer: how would you feel about a customer who comes to your workplace and aggressively tells you you really should be using The Blockchain to solve everything, because he read that on Twitter and you’re obviously in Big Tech’s pocket for not using it already.

What a callous way to put it! Patients suffering from diseases & conditions aren't trying to swab some magic block-dust on problems. They have symptoms & are desperate for help. Their ability to invest time in & explore possible conditions doesn't match up to a medical degree, but it's still considerable, and in spite of there being a lot of fluff & misconstruable & useless information, there's a ton of real, valuable, & good information too.

It does have to suck to have a lot of badly informed people parroting silly ideas they casually picked up online. But to so callously write off everyone, to so easily disregard any opinion & information other than your own, with what limited time you've got to examine a patient? Detestable, just absolutely revileable: this person has deeply failed their oath.

I also don't think your scenario is fair. The customer isn't just showing up & ordering you around. As a doctor, the patient is the product. The product is speaking for itself, asking for help. It's also paying you fairly well for your time & services. And as I said above, there's a good chance the product is well informed about itself. To write this off as a case of idiots making pointless requests- I can not disagree hard enough about what a callous, disregardful view this is. There are plenty of times when yes, the patient has fed themselves garbage, the patient is way off base, but let them not be so easily out of hand dismissed, let not the workplace maintain such a sense of absolute smug over the idiot rubes of the world.

>aren't trying to swab some magic block-dust on problems

That's exactly what patients are doing. Entire industries are built around this. People don't want to be told the hard answers to their problems, they want to do whatever they want and then take one tiny pill that causes weight loss, resistance to heart and respiratory disease, and increased libido.

>I also don't think your scenario is fair. The customer isn't just showing up & ordering you around

Read the stories. Watch the news. This is exactly what is going on. There is not a good chance that the patient knows what they're talking about - the overwhelming majority saw a quack on Facebook or Oprah saying something clearly wrong and stopped looking further because they want that one easy answer.

discarding & scorning all the public because there is some noteable contemporary upswell of problematic rank populist idiocracy about is not an elitism i can get behind.

if indeed a patient is requesting modern quackery, then yes, reject that. but simply turning up your nose at "Google Medical School" & dismissing all patient concerns blanketly is not ok.

If the engineer responds by harboring a grudge against all encryption, and silently failing to employ secure industry standards, then neither he nor his other customers win. Medical professionals treat individuals, not political groups.

Sure, but what about OP's point?

What if an engineer responded by harboring a grudge against all blockchain?

I mean, it would be unfortunate if that engineer decided not to donate to Scihub. But that exhausts my list of bad things that could happen due to such a grudge.

If it is so complex why would a lay person googling things suddenly be the better way to diagnose?

This is a great question! In my experience, the differences come down to:

- The doctor is going off a very short explanation you gave in a 30-minute appointment. If you have a serious medical problem, you can dump days, weeks, or months into finding information that matches your experience down to the fine details, which can very much matter - especially if you have an unusual case of something.

- There may be new information since your doctor was trained. Medicine has advanced a lot, and while doctors do their best to keep up, there’s more new research than any one person can digest.

- You will always believe yourself, never dismiss your experiences as “exaggerated” or “drug seeking”, and never blame your conditions on obviously unrelated causes.

That last one is especially relevant to people who aren’t cis white dudes. I’ve witnessed, with my own eyes, a woman talk to a doctor about chronic nasal congestion, and his response was to tell her to lose weight. Doctors habitually not believing the experiences of their patients has done incredible harm over the years.

Arcsech says >" I’ve witnessed, with my own eyes, a woman talk to a doctor about chronic nasal congestion, and his response was to tell her to lose weight. Doctors habitually not believing the experiences of their patients has done incredible harm over the years."<

I've seen a similar situation but felt the doctor was stating what was important. He did accept her experiences but... Her congestion was not remotely as important as her weight, her weight was going to speed her death, and she'd best lose weight soon.

IOW he was saying "regardless of how you solve your congestion, you simply must lose weight now or you will die soon from a heart attack or stroke."

Are you suggesting that losing weight wouldn't help this woman's nasal condition? What basis do you have for that?

Well, she went to a different doctor later who helped her diagnose & treat her allergies. Which made exercising easier too, turns out. Who’d have thought? (Her. One of the reasons she’d sought treatment is that the difficulty breathing through the nose was making it unpleasant to exercise.)

Why are you questioning that? You should first question "Are you suggesting such a stupid doctor exists? What basis do you have for that, show proof."

Are you saying the doctor did not believe she had chronic nasal congestion?

I dunno. He didn’t elaborate. We left pretty quickly after that and she found a doctor who helped her figure out and treat her multiple allergies.

> If it is so complex why would a lay person googling things suddenly be the better way to diagnose?

It's not about "be the better way".

It's about being able to to entertain & consider multiple theories, versus just being an asshole who won't even regard any convictions except your own.

Google Medical School doesn't have to be right every time. It doesn't have to be the more consistent option to be not "the better way", but simply worth entertaining. It doesn't have to be right 10% of the time. Some suffering patients will find & learn & discover things that do seem to fit their own problems. Being an asshole doctor who disregards, who writes off alternate theories: that's the wrong fucking way, and fuck those doctors, run the fuck away, get them fired, get them blacklisted, & warn other people. That's the wrong way.

There's no one more invested in a patients health than the patient. The resources of time & analysis they'll put in to trying to figure out what could be an issue is far far higher than what the medical system can provide for all but the very very richest of people. The resources out there to figure stuff out are real. Is it a better way? No. The patient doesn't have years and years of medical school. But that doesn't make their way wrong. That doesn't make them caring about themselves wrong, doesn't make their quest for truth & healing wrong. Any doctor that would turn their nose up at a patient, would refuse to hear a patient out, that refuses to acknowledge how wonderful & accessible medical information is in the world, and how helpful that can be: they are strictly worse. Worse diagnosticians, and worse people.

It wouldn't be better necessarily. Generally you want to get the opinions of multiple doctors and do your own research and use your own judgement in evaluating the advice you're getting. The point is that in the face of such enormous complexity the difference between a layperson with a rudimentary understanding of biology and your average doctor is not much. The difference is more pronounced when you're talking about people who are in the very top of their field but those people tend to be quite open minded and curious in my experience. They have such depth of knowledge that they are aware of how little they know.

It's also important to distinguish between technique and knowledge. The difference between a layperson and their surgeon is enormous, a layperson and their doctor, not so much in the grand scheme of things.

My wife has a few chronic illnesses so I've encountered more doctors than the average person. There are two primary types that account for all but one or 2 out of around 30 that we have seen in order to attempt to get my wife effective help.

1. The type that's too incompetent to diagnose anything more complicated than a cold or a broken bone. Usually they are general practitioners, sometimes they are specialists.

2. The type that might have been a productive person but they are too arrogant and/or lazy to diagnose anything but the most common things that pop up in their specialization. If its starting to look like its going to take any amount of effort at all to diagnose they'll throw their hands up and literally claim they don't know and its probably just something you'll have to live with.

It would be foolish for a layperson to think they can train themselves to be a doctor using google and diagnose a wide range of medical conditions in a large group of random patients better than a doctor. Its not foolish at all to think that given you have all the time in the world since its your life, that you might be able to do some productive things and try to figure out what could theoretically be wrong with you so you can make a more educated guess about which specific specialist might be able to diagnose your condition or rule out one that you suspected you might have. 99% of doctors are going to make a basic effort and then pretend its just some unknown chronic thing you probably shouldn't worry about, even if you feel like you are dying on a daily basis. Or diagnose you for one of the common things that doesn't fit your symptoms, give you medicine that will either not help at all or actually exacerbate your condition, and then double down on the diagnosis. And its not just about finding the right type of specialist, you can go to two specialists within the same field and one can be completely worthless to you because they have no experience with your set of symptoms.

I've gotten too many blank stares from doctors when asking them basic things that they should know to buy into the notion we seem to promote in the US that all of them are geniuses.

FYI Not an anti-medicine, anti-vax conspiracy nut. I just went through a nightmarish ordeal for several years trying to get help for my wife. Her condition is a physical condition that's misdiagnosed 80% of the time as anxiety. Once you have anxiety listed on your medical record, good fucking luck getting any of these arrogant assholes to do their job. Once you do get a diagnosis, the results of treatment are pretty mixed, but mostly not amazing. Fortunately it doesn't significantly shorten a person's life, but it does make it difficult to live it.

I've seen mildly famous and wealthy youtubers (famous for being sick youtubers, in some cases having the same condition as my wife) get teams of doctors working together hand in hand to figure out some rare set of conditions and make a person's life better. Most doctors I've encountered will figuratively tell you to go fuck yourself if you even want them to talk to another specialist. The closest I came to that was spending several thousand dollars sending her to the Mayo clinic. They rush you through a series of tests and then send you home without doing much of anything at all, hoping that you have a good team of doctors that can pick up where they left off. If you don't (and you won't) its a massive waste of time and money.

Sadly accurate. I have a condition common enough that every doctor thinks they can treat it, but severe enough none of them will. Trips ahead to several states, possibly outside the US to address this. Local resources are too arrogant to want to look at even recent peer reviewed studies, or too busy to do so. A family member in medicine tells me what I describe is pervasive. Medicine, he says, is broken.

chevill says >"1. The type that's too incompetent to diagnose anything more complicated than a cold or a broken bone. Usually they are general practitioners, sometimes they are specialists."<

Dermatologists! Dermatologists!

My wife and I have gone to our healthcare providers' dermatologists about 6 time in total: each time they've sent us home with a diagnosis of "allergic reaction" and a prescription for a tub of cortisone (which we have, at this point, ceased to fill):

https://cdn.shopify.com/s/files/1/0996/0350/products/triamci...

The cortisone never works, but I have two tubs of cortisone cream in the refrigerator in case of nuclear war.

This is a shame. We once had a private dermatologist who was simply outstanding - he nailed every problem with his diagnoses. But he retired. It seems the colleagues he left behind are all candidates for the Golgafrinchan Ark Fleet Ship B.

My wife recently was given another "allergic reaction" diagnosis for a skin irritation and got another cortisone tub prescription. I looked at her skin and then, on a hunch, sat at her computer terminal awhile. Sure enough in a few minutes I felt stings on my neck and right arm. An examination with a magnifying glass revealed very tiny fire ants on my arm. I searched above her chair and found the source - a Chinese lantern was the ants' launch platform - they were falling onto her and then stinging her.

How a trained dermatologist cannot distinguish ant bites from an "allergic reaction" is beyond me. The ant bites have a red center and form blisters, which is nothing like a generalized allergic reaction.

A little bug spray and some ant baits took care of the ants. I don't know how to fix the dermatologists.

Thank you for sharing your experience. Medical science is probably the hardest endeavor we aspire to understand. We could use a lot more humility and diligence on all sides when approaching it.

Those 2 types sound a lot like software engineers.

They likely wouldn't be. At the same time, I wouldn't want my doctor to dismiss things just because I happened to suggest it.

Right. But assuming you're not clueless, you're going to discuss actual medicine and not Turmeric or crystals.

I only agree with the sentiment. The problem is that doctors aren't here to improve your life, they are here to treat symptoms and diseases when it's already too late.

If the solution to your particular disease involves a year of changing your lifestyle then no doctor on earth is going to help you. (it's not their job)

Just curious - what is your opinion of non-technical managers that, upon arriving back to work from a conference, order their teams to implement a buzzword bingo soup, without being able to articulate why their life-critical aerospace software suddenly needs to support SOAP over REST backed by HADOOP, all implemented in Golang monads.

I like to read up on something first so that I can have an intelligent conversation with the doctor.

Please consider the context here. This is specifically about people who refuse vaccines but demand their dying loved ones be treated with huge doses of vitamin C or antiparasitics with no proven effect against the disease.

Entirely this. There are plenty of bad doctors out there - it does not hurt to be educated.