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A better question might be: Why is the private sector responsible for providing accurate health information? As this article shows, the incentives for people ru

• alistairSH 4y ago
  The closest I've found to the NHS sites are published by Mayo Clinic in the US... https://www.mayoclinic.org/diseases-conditions https://www.mayoclinic.org/diseases-conditions Still not perfect, but I've found it more useful than WebMD.
• stevenbedrick 4y ago
  Check out the National Library of Medicine’s MedlinePlus resource for an equivalent to the NHS’s consumer-oriented health info portal: https://medlineplus.gov/ https://medlineplus.gov/ It’s a fabulous and under-utilized resource!
• ravenstine 4y ago
  That's a nice page, and I'll definitely bookmark that one. But I don't see most of the public using something like that over WebMD. WebMD is complete trash (I even block it in my Kagi search preferences), but it succeeds over sites like the NHS one because of blog SEO. WebMD is really a glorified blog with posts about every condition you might get paranoid over. I don't know how precisely they achieve this, but they're doing something right in an SEO sense if The Google continues to put them near the top of results after all these years. Meanwhile, there are also sites like Merck Manuals, which is both a terrific resource and privately run, but I don't recall ever seeing it coming up for a search query like "what is that bump on the side of my neck." https://www.merckmanuals.com/ https://www.merckmanuals.com/ The resources are out there. Whether The Google thinks the average person should read them is a different story. I don't believe The Google is going to ever filter out WebMD, so there must be a middle ground where sites like the ones you and I mentioned find a way to make themselves more WebMD-like without sacrificing their more academically-minded content they already have.
  • lupire 4y ago
    Google's problem is that it ranks pages, not sites. It will much prefer a crappy site with a crappy page that is highly specific to your search query, instead of showing you a good site related to the idea you are looking for. It puts far too much faith in its language parser, which doesn't comprehend.
    • deleted 4y ago
      [deleted]
    • mitchdoogle 4y ago
      Sites definitely matter. All indications are that domains have a ranking as well as individual pages
  • Spooky23 4y ago
    I disagree with the WebMD hate. It’s not the best site out there, but it isn’t delivering misinformation or otherwise problematic data. That type of site is difficult in general. People seeking medical advice via online means are always going to struggle.
  • brokenodo 4y ago
    I’m honestly blown away by the Merck Manuals! How can this resource be so comprehensive and clear yet seemingly never come up in topical searches? It seems like the most comparable medical version to Cornell’s Legal Information Institute. https://www.law.cornell.edu/ https://www.law.cornell.edu/
  • tmoravec 4y ago
    So there's a private option that's terrible (WebMD) and a private option that's terrific (Merck Manuals). And it's the terrible one that ranks well at Google. Sounds like a Google problem and apparently only a Google problem.
    • Cthulhu_ 4y ago
      It's a bit of a conundrum; on the one side, the NHS and (in a different area) MDN are better, more authoritative, etc sources, so Google should promote those. On the other, this would mean that Google can no longer cite neutrality or hide behind "the algorithm", as has been their legal defense against a ton of lawsuits where the suers said one websites should go higher or lower in the rankings.
• coldcode 4y ago
  I also prefer information from the NHS even though I live in the US. Here medical information online is all about making money from ads and who knows what else they sell. There is actually little money to make from providing relevant information, unlike a national heath care system (which despite its terrible current state politically in the UK, where it seems they want to move to the US model) has an incentive to provide good information.
  • lotsofpulp 4y ago
    The US government also provides healthcare info at cdc.gov, nih.gov, health.gov, or USA.gov/health.
    • KerrAvon 4y ago
      I don't know about the NHS, but we can't trust the information vended by the CDC -- they have proven willfully incompetent over the past two years. I will give just one example: they initially told us masks were ineffective against COVID, which they knew at the time was inaccurate. They said it because they didn't want a run on PPE required by medical workers. Result: there was a shortage anyway and they damaged their reputation irreparably. Great job everyone.
      • lotsofpulp 4y ago
        If one negative example decreases an entity’s credit, would positive examples increase an entity’s credit? What about the proportion of positive to negative examples? How does that impact an entity’s credit?
        • LawTalkingGuy 4y ago
          Mistakes to correct statements, yes. Those balance out. The opposite of being right is being wrong, the proportion of these two is their score. Lies though, where we find out they knowingly said something they knew was wrong when they said it, don't balance out. The opposite of lying to someone to manipulate them is respecting them enough to let them make their own choices. They need to acknowledge that and start purely providing facts again - even at the cost of some political narratives, before they'll regain trust.
• SilasX 4y ago
  Interesting! But the first link you gave is just a list of conditions, which requires that I already know what my problem is. Is there a page that goes from symptoms to likely causes and what to do, like WebMD?
  • jjar 4y ago
    You can search at the top for symptoms: https://imgur.com/a/y5RUk5x https://imgur.com/a/y5RUk5x I'd say if I were to suggest improvements the symptom search could definitely be better and more prominently placed. In the UK I personally (and I'd imagine most people) get to the NHS website directly from Google, which is better at finding more relevant pages.
    • SilasX 4y ago
      That doesn’t really help. It just vomits a list of articles that mention coughs. The “killer” (rescuer?) feature of WebMD is being able to start from a symptom and narrow down through clarifying questions. You implied the NHS does this better, when it doesn’t attempt that feature at all. I’m not sure this is the prime “UX done well for symptoms->cause” example you cited it as. Though I agree UK government sites follow much better UX patterns!
• duxup 4y ago
  Is that NHS page what people go to webMD for? I feel like that's something else entirely.
  • gpm 4y ago
    It's my first time seeing it, but it seems like yes. I have a relatively new mole that I thought looked a bit funny, so I awhile ago now I looked up what malignant ones look like, thankfully it doesn't seem to be. This page is definitely clearer and more concise than what I found at the time: https://www.nhs.uk/conditions/moles/ https://www.nhs.uk/conditions/moles/
• switch007 4y ago
  One issue with the NHS is that I get the impression the information they publish that strongly respects their goals and desires perhaps to the detriment of patients sometimes. I’ve certainly noticed in the past big differences in advice. The NHS will downplay and not suggest investigations whereas another (non UK) site does the opposite. The NHS advice surely is carefully crafted not to cause unnecessary (from their point of view) GP visits, tests etc.
  • mclouts91 4y ago
    NHS is focused on the appropriate allocation of resources to the problem. It strikes an excellent balance of doing the right work when necessary and based on probabilities. If you have evidence that the process recommended by the nhs is failing patients in statistically significant numbers I would agree with you on them not doing enough tests but frankly, I think NHS would perform very well if it was adequately resourced (it’s currently starved of necessary funding). The NHS follows a strict set of guidelines for the identification and treatment of illnesses. They do not act like medical businesses such as hospitals whose goal is to do as much testing as they can justify to get more money from insurers.
    • lupire 4y ago
      That's nice, but when I'm sick, I want to get well, and I might be willing to pay for it with my money, time, or labor. I don't want to die just because it's more cost efficient for the government to save two others.
      • DanBC 4y ago
        That's not the argument being made. If you're not sick you should not be subjected to too much testing, because the risk is that you are diagnosed with a thing that will not harm you. And once you're diagnosed with it the tendency is to treat you for it. Treatment is not a neutral option, it carries risk. Over-testing, over-diagnosis, and over-treatment all contribute to patient harm.
        • 4y ago
• _fat_santa 4y ago
  I think the issue isn't data, its the "packaging". Going through the NHS website, it's useful if you already know what you have. I'll use myself as an example because I had an ingrown hair on my neck a few weeks back, went on google and I didn't search for "Ingrown Hair" because at that stage, I didn't know that it was an ingrown hair. I searched for "bumps on your neck" which led me to conclude that it was an ingrown hair (followed by a doc telling me the same thing). One idea I've had for a long time is the US Gov't (and all major governments) should have a large data gathering/distribution operation. This data would be things like medical research, and other data that would be in "the public interest" (basically all the data we have now, just in one place), everything from meeting notes, congressional bills, etc. With a wealth of data from a single source, companies like WebMD could stop focusing on how to get the data, and shift their focus to how to "package" the data. A list of conditions with symptoms is nice, but lets repackage that into a "medical graph" that lets you explore related conditions through symptoms. Companies could then compete on the "packaging". You could go to FreeMD and get the same data as you could on WebMD, but WebMD has a much better search engine for X thing so they are worth the $4.99/month cost. It would be expensive, and probably be a decade long multi billion dollar operation. But imagine the revolution in government services if there was a single source of truth for data. There are arguments against this, mainly do you want a government to have that much power. But I think it could be done with some strict limits and checks. Data in this API would only be public government data, so IRS data and other private information is not on there.
  • swores 4y ago
    NHS already offers a (fairly rudimentary, last I checked) diagnostic tool in the form of NHS 111, which as well as being a phone number that people in the UK can call to talk to someone, is also a website (https://111.nhs.uk/ https://111.nhs.uk/) where you can give your symptom(s) and get a suggestion if possible causes. It may not yet be good enough in all cases, I'm not sure, but is that what you're asking for? I'm not quite sure as you dived into things like data licensing without being clear on your actual hoped end result. (Of course, the 111 site is designed as part of the wider NHS system, so when in doubt it's more likely to give advice to speak to a GP / call to speak to a nurse / visit a hospital, than to say "not sure, here are all the conditions it could be". But as it gets better I expect it to be able to do both.) Not to mention that the main NHS site also lets you search for symptoms in the main search bar, so you don't need to know the condition to use it to search for possible conditions. edit: as better pointed out by jjar here https://news.ycombinator.com/item?id=32650958 https://news.ycombinator.com/item?id=32650958
• snarf21 4y ago
  It is the misaligned incentives that come from advertising. Click-bait and outrage drive views and ad revenue. Look at the "news" segment these days.
• deleted 4y ago
  [deleted]
• dreamcompiler 4y ago
  To extend this a bit, the ultimate solution is a quasi-government nonprofit organization along the lines of ICANN (or maybe part of ICANN) that operates a crawler and a database of crawled sites, plus an API for that data. This would not be a search engine per se but a neutral backend that anybody could build a search engine on top of. Want to build a search engine and sell ads? Fine. Want to build a search engine specializing in health information subsidized by the drug companies? Fine. Want to build one as a neutral nonprofit and charge subscriptions? Fine. The same backend database works for them all. Even Google could build a frontend on top of it. Yes it would be expensive. The government would have to pay for all the backend infrastructure (whether the government buys it or rents it from Amazon, Google, Microsoft, etc.), and Cloudflare and robots.txt would have to allow "icanncrawler" to access sites without friction. But it would finally allow the creation of neutral search engines not beholden to advertisers. It's a piece of infrastructure the modern Internet sorely needs.
• briandear 4y ago
  If the “government” becomes the only source of truth, that source of truth is necessarily political. The oft-mentioned NHS — do they not have an incentive to lower health care expenditures? Would providing medical information to the public that prescribes a suggested course of action incentivize the course of action that is least expensive to the government but not necessarily the best treatment? Is there any potential for a conflict of interest there? Of course there is. If some condition is best treated with an expensive procedure, would the NHS be incentivized to recommend a cheaper, but less effective approach? Of course they would. The NHS routinely denies or delays life-changing surgeries over cost despite such denials not being in the best interests of the patient. (Try getting an NHS knee replacement.) There are treatments NHS won’t recommend because a person is too old. Not because they can’t handle the procedure but because the expense isn’t worth the amount of lifespan remaining in the patient. Medical information provided by governments is often centered around what’s best for “populations” and not necessarily the individual. Covid is a prime example: masking kids was bad for the kids but allegedly “good” for the population. Damaging to the individual for the alleged benefit of the so-called greater good. Despite all the kid masking “science” turning out to be garbage. Covid vax for kids is another example: the government right now in the US promotes vaccinating even toddlers despite their individual risk of serious illness being statistically zero. HIV is also something that the government really got it wrong in the 1980s. https://www.aier.org/article/fauci-was-duplicitous-on-the-aids-epidemic-too/ https://www.aier.org/article/fauci-was-duplicitous-on-the-ai... Covid information is another example: the government was wrong on multiple occasions throughout the pandemic. Yet when “official sources” are the only approved source of information, the public gets mislead. The marketplace of ideas is a real idea and it should be embraced. We need more private sector competition for information, not less. If WebMD is bad, the solution isn’t government, it’s a competitor.
  • lupire 4y ago
    > If WebMD is bad, the solution isn’t government, it’s a competitor. And how to decide who to trust? Still unsolved. The general public loves being lied to, as long as they like who is lying to them (same political party, religion, or just making impossible promises).
  • Aengeuad 4y ago
• smoe 4y ago
  I also highly recommend the NHS website. The information there a couple of years ago helped me losing a lot of weight and adapt a healthier overall lifestyle. The information is dry, concise and easy to understand for a layperson. I cannot judge how well it is aligned with recent science, but I trust the site much more than most others, because their incentives after all is public health (I'm sure some politics play a role as well), not selling you books and courses with unrealistic expectations.
• mbostleman 4y ago
  >>Why is the private sector responsible for providing accurate health information? As this article shows, the incentives for people running medical websites <in the private sector> and the people reading them are not aligned.>> I don't know that the cause of this particular misalignment is "private sector". But no doubt the current implementations by the private sector exhibit this misalignment. >>I'd say the UK NHS website <which is public sector> and symptoms/medications pages hit the nail on the head>> I assume this implies that the NHS website does not exhibit the previously noted misalignment. Why is that? Obviously this site's sole funding is not from advertising. I assume it's from taxes collected by the government. So what is incentivizing those that build this site and maintain its content to make it so good?
  • mbostleman 4y ago
    I'm wondering why my question got downvoted. I've had this happen before when asking questions. Could it be a matter of a couple of readers not assuming benign intent? As in, someone thinks I'm not actually asking a question but making a statement and they don't agree with the statement. Either way it's interesting. Perhaps the more likely to be read as benign version would be this: We all agree site A is bad because it's misaligned (which I think all agree is due to being driven by ads). Then we propose that site B is good - but there's no indication about WHY site B is good. We know why site A is bad, but why is site B good. And more specifically since we're describing the value in terms of alignment, what alignment is there in site B that drives the goodness?
• RosanaAnaDana 4y ago
  Just another aspect of neoliberalism. An undue faith in markets.
• winternett 4y ago
  It's a common conflict for info publishers, the only solution is really to get rid of advertising. WebMD relies too much on industry advertisers and on companies selling pharmaceuticals and it corrupts their ability to objectively provide health advice. Advertisers pressure publishers for prime placement, and for editorial influence when they have weight to them, and it corrupts the tone of what a site can publish by nature. The same is happening with many doctors that need to pay their overhead, many offices turn into "pill mills" because that is what keeps the lights on. We're at a very weird time in history, where people are more profitable as unhealthy individuals, so certain actors in health care peddle fear, confusion, and paranoia to sell medications as well as the valid issues and panaceas to them, and even minor and completely minute afflictions normally have commercials running non-stop on TV. WebMD is a tiny blip when you consider that people type their affliction into Google first. Perhaps for them, and as the online ad economy melts itself down, contracting with the government to provide official information on a non-ad funded site with a far less cluttered UI might be a better long-term profit model.
  • wongarsu 4y ago
    > We're at a very weird time in history, where people are more profitable as unhealthy individuals The thing is that to wider economy and society at large, people are vastly more profitable if they are healthy. This is one of the top reasons why countries spend so much on healthcare: healthy citizens are productive citizens. The entire problem is one of externalized costs and misaligned incentives.
• Melatonic 4y ago
  What would be better if basic stuff like this was part of our public education system. We need the equivalent of "shop" class but for basic medical needs. Wilderness First Aid would be a good start
• googlryas 4y ago
  A fairly straightforward answer is that the government's goals are not necessarily aligned with your own. You, presumably, care very much about your own personal health. You also care about other people's health, but you really, really care about your own health, and probably don't want to die earlier than you need to. The government, on the other hand, doesn't generally care about individuals, and is working on a statistical level. A good government wants the population overall to be in good health, and has a budget within which it must operate. It may make more sense for the government to ignore your rare disease if detection/treatment is expensive, and that money can be better used to save, say, 10 people with a more common disease. Now, if the government was just providing health information, and individuals were on the hook for payment, this disconnect wouldn't really exist. But if the government is also providing the healthcare services "for free" to individuals, then there is an incentive to downplay testing for rare or expensive to treat diseases due to the cost/benefit ratio.
  • nickff 4y ago
    The terse version of this is to say that the government would prefer you die cheaply rather than live at great expense.
    • quickthrower2 4y ago
      The government is pulling the lever on the train track thats saves 5 but kills another 1.
    • PragmaticPulp 4y ago
      That's not really what's happening at all. It's often cheaper to get an early diagnosis or catch a condition before it progresses too far. The government doesn't actually hide information about diagnosing or treating diseases, even rare or expensive ones. They do, however, take into account the relative risk of false positives and resulting unnecessary treatments, which often outweigh any benefit of proactive testing for rare diseases. It's counterintuitive, but if you have a 99% accurate test for something that means you're going to end up with 1 in 100 people getting false positives and undergoing potentially expensive (out of pocket) or dangerous diagnostics and treatments. When considering rare conditions that might only occur in 1 out of 100,000 patients each year, a 99% accurate test results in 1000 unnecessary false positives just to catch the 1 true positive. At scale, this can produce a lot of problems that can actually make life worse on average for the population rather than better.
• andrewljohnson 4y ago
  In the US, the CDC has been really bad at providing health information, and the FDA has been really bad at providing food safety info. They also don’t have incentive alignment (incentives are mostly to grow the bureaucracy and serve careers). I’d expect private enterprise to eventually converge on better info… eventually consumers will choose services that provide the best info amidst competition.
• davidgerard 4y ago
  NHS Conditions was what I came here to post. You'll notice your GP glances at precisely those pages when they're talking to you too.