7 ms·

Wow. I am a physician and this is perfect. 1. You just need to read about the Dunning-Kruger effect. Enough said. https://en.wikipedia.org/wiki/Dunning%E2%80%9

by Shinkei 10y ago

Wow. I am a physician and this is perfect. 1. You just need to read about the Dunning-Kruger effect. Enough said. https://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect https://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect 2. Each physician has their own motivations for this one... some liability, some internal moral code, but some just understand that science is about being objective. That being said, prevailing wisdom is that medicine is as much an art as it is a science. 3. Yes, but be careful. Try to establish a relationship with your provider before pulling out the graphs and spreadsheets.

aangjie 10y ago
After a recent argument with my wife's doctor, I decided to write a rationality style guide for new doctors. Feedback from practicing Doctors is hard to find. Please comment. Here's the link http://lesswrong.com/lw/ntq/advice_to_new_doctors_starting_practice/ http://lesswrong.com/lw/ntq/advice_to_new_doctors_starting_p... .
- Shinkei 10y ago
  It looks great! I will read it over the next few days.
arpa 10y ago
If you read about the Dunning-Kruger effect, it is essential to also read its' criticism, very aptly summarized here: http://www.talyarkoni.org/blog/2010/07/07/what-the-dunning-kruger-effect-is-and-isnt/ http://www.talyarkoni.org/blog/2010/07/07/what-the-dunning-k... (posted here numerous times; the truth is, well, we all suck at heuristic self-assessment, regardless of our skill, sorry). It's always easy to write off other people as "incompetent", blame Dunning-Kruger, and just ignore what they say and think they know. A lot of physicians tend to do that, and, frankly speaking, it just comes off as arrogance and does not help confidence at all.
icantdrive55 10y ago
Let's not forget good insurance, and large amounts of money. I hate to be that guy, but I have been to too many unneeded office visits over my years, or have been told flat out Dr. Whatever charges $350/hr. Hour? It's always just a short visit. As, I've gotten older, I don't want to spend to much time with them. The shorter the office visit the better. Yea, and I know, your physician lives are so terrible. You had to pay $400,000 for school. You had to get through that residency in which you where hazed, by other Doctors. You have to listen to people whine, and complain--in many cases because they are sick, and in pain. (Get ready for the "I don't treat pain" Doctor", and the FDA is on their side. I don't feel like debating this one either. Too tired.) Yea, you guessed right, I'm no fan of the American Doctor. I don't like the system? Or, I just don't like American Doctors, with that ego. An ego that seems undeserved after getting into med school, in so, so many cases. On another note, I'm shocked at how seemingly little advances medicine has made in the last 30 years. Advances that help the patients. Not theoretical advances that look nice on paper. I smile, and kiss their ass, but there's no love, nor even much respect anymore. Signed, Alotofpatients (I'm not comming back to this post. I will add this, I used to think older doctors were better. I think I was really wrong. In my life, I have met one doctor who appeared to get better with age. He had some unusual medical issues throughout his life that appeared to make him care?)
- cmdrfred 10y ago
  I take home about 32k a year. I also have asthma. I will have it until I die. With the insurance my company offers my medicine is 150 dollars a month on top of the $175 a month fee. To get the prescription I need to pay another $75 dollars every 6 months to the doctor (At the end, They dident even bother with the pretense of busting out the stethoscope anymore I'd come in sit down and they would write the script) I buy the same medicine from India for $30 without a prescription online. It's a scam pure and simple. The choice for me was either drop the insurance and buy a house or rent and pay for insurance that covers little and costs a lot.
  - Maskawanian 10y ago
    Out of curiosity, which vendor do you use?
    - cmdrfred 10y ago
      So they pop in and out of existence from time to time but they are all basically front business from what I can tell. support-rx.com is the 'support' site that you get sent to after you order (I've ordered from 5 or so 'front businesses' and always get sent there), but to actually order anything I go to canadapharmacy24h.com currently. Shipping is costly so I buy in bulk, it takes about 2 weeks to get to my door. When I was working as a cook these companies saved my life, this is what capitalism is all about.
  - no1youknowz 10y ago
    I too have asthma. When I was in the US, I needed a certain type of inhaler. It cost $150. I kid you not, I was furious! I had to pay knowing full well, the same inhaler cost £5 in the UK. Talk about a serious markup! Now back in the UK. Before I go back. I will visit my doctor about 5 times and stock up on them. Bring as many as I can in the UK so that I never run out again!
    - cmdrfred 10y ago
      People claim that they "Spend so much on R and D that they need to be able to charge these prices". My drug albuterol was in use 100 years ago.
kranner 10y ago
Why #3?
- Shinkei 10y ago
  Because--for better or worse--this raises red flags I think. I could see a lot of people getting defensive.
  - kranner 10y ago
    I'm sorry but I don't understand. What red flags? If I come into the hospital with detailed data on what pills I took and how symptoms varied from day to day (without offering my own interpretation as to causes), compared to coming in with no history, how is the former a cause for suspicion? As a haemophilia patient who carries a decade+ log of infusions (Factor VIII in my case) I have never been met with any kind of suspicion or defiance by doctors. In fact this has persuaded doctors in unfamiliar hospitals (when I have a bleeding episode while travelling) to give me only as much Factor VIII as I have needed historically, and not a much larger amount based on my body weight. (Large amounts of Factor VIII seem to be a trigger for inhibitor formation so I am interested in taking as little as needed.) Factor VIII assays on the other hand seem to present a different result every time I get them done (varying from <1% to 25%). I can assure you that any data geek who bothers to note this stuff down is very, very concerned about keeping accurate logs.
    - Shinkei 10y ago
      Ah, I think I misunderstood your situation. Yes, your specific case I think warrants that kind of specific, careful monitoring. I was speaking more generally about people who don't have significant past medical history who arrive with superfluous data.

by Shinkei 10y ago

aangjie 10y ago

After a recent argument with my wife's doctor, I decided to write a rationality style guide for new doctors. Feedback from practicing Doctors is hard to find. Please comment. Here's the link http://lesswrong.com/lw/ntq/advice_to_new_doctors_starting_practice/ http://lesswrong.com/lw/ntq/advice_to_new_doctors_starting_p... .

Shinkei 10y ago
It looks great! I will read it over the next few days.

arpa 10y ago

If you read about the Dunning-Kruger effect, it is essential to also read its' criticism, very aptly summarized here: http://www.talyarkoni.org/blog/2010/07/07/what-the-dunning-kruger-effect-is-and-isnt/ http://www.talyarkoni.org/blog/2010/07/07/what-the-dunning-k... (posted here numerous times; the truth is, well, we all suck at heuristic self-assessment, regardless of our skill, sorry). It's always easy to write off other people as "incompetent", blame Dunning-Kruger, and just ignore what they say and think they know. A lot of physicians tend to do that, and, frankly speaking, it just comes off as arrogance and does not help confidence at all.

icantdrive55 10y ago

Let's not forget good insurance, and large amounts of money. I hate to be that guy, but I have been to too many unneeded office visits over my years, or have been told flat out Dr. Whatever charges $350/hr. Hour? It's always just a short visit. As, I've gotten older, I don't want to spend to much time with them. The shorter the office visit the better. Yea, and I know, your physician lives are so terrible. You had to pay $400,000 for school. You had to get through that residency in which you where hazed, by other Doctors. You have to listen to people whine, and complain--in many cases because they are sick, and in pain. (Get ready for the "I don't treat pain" Doctor", and the FDA is on their side. I don't feel like debating this one either. Too tired.) Yea, you guessed right, I'm no fan of the American Doctor. I don't like the system? Or, I just don't like American Doctors, with that ego. An ego that seems undeserved after getting into med school, in so, so many cases. On another note, I'm shocked at how seemingly little advances medicine has made in the last 30 years. Advances that help the patients. Not theoretical advances that look nice on paper. I smile, and kiss their ass, but there's no love, nor even much respect anymore. Signed, Alotofpatients (I'm not comming back to this post. I will add this, I used to think older doctors were better. I think I was really wrong. In my life, I have met one doctor who appeared to get better with age. He had some unusual medical issues throughout his life that appeared to make him care?)

cmdrfred 10y ago
I take home about 32k a year. I also have asthma. I will have it until I die. With the insurance my company offers my medicine is 150 dollars a month on top of the $175 a month fee. To get the prescription I need to pay another $75 dollars every 6 months to the doctor (At the end, They dident even bother with the pretense of busting out the stethoscope anymore I'd come in sit down and they would write the script) I buy the same medicine from India for $30 without a prescription online. It's a scam pure and simple. The choice for me was either drop the insurance and buy a house or rent and pay for insurance that covers little and costs a lot.
- Maskawanian 10y ago
  Out of curiosity, which vendor do you use?
  - cmdrfred 10y ago
    So they pop in and out of existence from time to time but they are all basically front business from what I can tell. support-rx.com is the 'support' site that you get sent to after you order (I've ordered from 5 or so 'front businesses' and always get sent there), but to actually order anything I go to canadapharmacy24h.com currently. Shipping is costly so I buy in bulk, it takes about 2 weeks to get to my door. When I was working as a cook these companies saved my life, this is what capitalism is all about.
- no1youknowz 10y ago
  I too have asthma. When I was in the US, I needed a certain type of inhaler. It cost $150. I kid you not, I was furious! I had to pay knowing full well, the same inhaler cost £5 in the UK. Talk about a serious markup! Now back in the UK. Before I go back. I will visit my doctor about 5 times and stock up on them. Bring as many as I can in the UK so that I never run out again!
  - cmdrfred 10y ago
    People claim that they "Spend so much on R and D that they need to be able to charge these prices". My drug albuterol was in use 100 years ago.

kranner 10y ago

Why #3?

Shinkei 10y ago
Because--for better or worse--this raises red flags I think. I could see a lot of people getting defensive.
- kranner 10y ago
  I'm sorry but I don't understand. What red flags? If I come into the hospital with detailed data on what pills I took and how symptoms varied from day to day (without offering my own interpretation as to causes), compared to coming in with no history, how is the former a cause for suspicion? As a haemophilia patient who carries a decade+ log of infusions (Factor VIII in my case) I have never been met with any kind of suspicion or defiance by doctors. In fact this has persuaded doctors in unfamiliar hospitals (when I have a bleeding episode while travelling) to give me only as much Factor VIII as I have needed historically, and not a much larger amount based on my body weight. (Large amounts of Factor VIII seem to be a trigger for inhibitor formation so I am interested in taking as little as needed.) Factor VIII assays on the other hand seem to present a different result every time I get them done (varying from <1% to 25%). I can assure you that any data geek who bothers to note this stuff down is very, very concerned about keeping accurate logs.
  - Shinkei 10y ago
    Ah, I think I misunderstood your situation. Yes, your specific case I think warrants that kind of specific, careful monitoring. I was speaking more generally about people who don't have significant past medical history who arrive with superfluous data.