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From Men's Journal:
Every time you walk into a physician's office, you run the risk of overtreatment: Tests you don't need, medications that are ineffective (or dangerous), procedures that cause more problems than they solve. In many cases the best thing for your health is to do nothing.
Make no mistake: A good doctor is, or should be, your most trusted resource if you're sick. If you're not sick and he wants to treat you anyway, that doesn't necessarily make him a bad doctor. But it does make him a player in a system that operates according to the unspoken and often unexamined assumption that more treatment is better for the patient. It's unquestionably better for the financial health of the stakeholders in the system: the doctors, the pharmaceutical industry, the health-insurance companies, and the hospitals. If you don't know how the game is played, the odds go up that you'll wind up the loser.
What do you people think, will people change if they know this?
(Score: 5, Informative) by VLM on Wednesday September 24 2014, @05:04PM
My mother in law went thru something like this for weeks recently WRT gallstones, they won't just treat the gallstones, she had to spend about two weeks making sure she isn't pregnant (she's in her 80s) or cancer or appendix or ulcer or STDs or heart problems or neck nerve pinches or ... Finally they took out the stones and all is well (she's not yellow any more, healthy, gettin around again, energy coming back, etc.) Its getting to the point where no diagnoses will be ever made, just an immense list of things that can be ruled out via tests, and after all the tests when only one thing is left, then and only then will they go for it. She's OK now, but holy cow they did everything head to toe on the poor woman. Anecdotally she says she'll never voluntarily set foot in that hospital again, and I can't blame her. Of course with consolidation there's only two chains in the area, so hope she doesn't get pissed at the other chain. Which works exactly the same way. Whoops.
It reminds me of my son being diagnosed with wheat (gluten) allergy. Well, surely it would be better for the doc if he had stomach cancer because we can treat that, but an allergy can't be treated so we'll never test for that until everything more profitable is tested for and ruled out. Oh drat, the MRI doesn't show stomach cancer? Well, we can treat leukemia, so lets try testing for that. Drat, the boy doesn't have that either. The doc actually looked defeated and unhappy when he finally ran a blood allergen test after months and then reported he just cant eat wheat stuff. Unfortunately for the doc, there's no money to be made off that, you see. Years later, with no wheat in his diet leading to no constant "digestive malfunctions", he's perfectly healthy now and has almost caught up with growth for his age, but what a mess when he was little.
The standard SN automobile analogy is modern medicine in 2014 is like taking your car to the mechanic, and no matter whats wrong with it, the mechanic just starts replacing the most expensive thing first, and working his way down the list until accidentally your problem is fixed. Come in with "funny scratch sounds when braking" "I don't care what you think, you're getting a new engine first, then we will replace the heater core, don't tell me how to be a mechanic".
(Score: 0) by Anonymous Coward on Wednesday September 24 2014, @08:34PM
Sounds like your physicians are practicing defensive medicine. I guess courts have been all to happy to award jackpot lawsuits in your area. You reap what you sow.
(Score: 3, Interesting) by VLM on Wednesday September 24 2014, @09:12PM
You are correct in the former, AC, donno about the latter, sounds believable.
The problem with defensive medicine is you can replace a very expensively educated doctor with a very small shell script.
Then again since 1950 or so, you could replace a very expensive pharmacist with a vending machine, and we're still stuck with them. Like, WTF? It would be like if travel agents still existed, or local bookstores. Its just weird. I remember being a smart as hell young kid (as opposed to my currently being a smart old-ish man) and thinking, yeah, that pharmacist gig sounds like it would be an awesome lifestyle, but those guys are all going to be replaced by a vending machine powered by one of those new fangled microprocessors like that brand new 8080, so forget pharmacy school. And here I am in 2015, if I had become a human vending machine I'd probably own a private island by now, but no, I'm slinging boring Scala code for internal apps and maintaining Perl data processors. Bummer.
(Score: 0) by Anonymous Coward on Thursday September 25 2014, @01:31AM
I realize you were just making a simple point, but I must argue that "very expensively educated" is not equivalent to an actual good, effective doctor. In fact possibly it's an inverse correlation where it's all prestige on the degree and no actual practical experience (heaven forbid we let our students touch actual patients, any incident could destroy our reputation!). Speaking from experience as a cheaply educated 3rd world doc who scored much much higher on the USMLE than US candidates did...
It's nice to read about all these fancy tests you can do in America but out here in the boondocks where there are only 3 CT and 1 MRI (and no PET) machines in the country, lab tests are extremely limited, etc, well, we tend to rely more on little things like patient clinical history and physical exam, basic tests and brainpower. And we seem to be doing quite ok, statistic wise... our limited health dollars go much, much further. At one point medicine becomes about all the toys and tests and the patient is forgotten. I always tell students TREAT THE PATIENT NOT THE LAB RESULTS.
(Score: 2) by strattitarius on Wednesday September 24 2014, @08:54PM
It reminds me of my son being diagnosed with wheat (gluten) allergy ... there's no money to be made off that, you see.
You nearly described my kids path to finding his peanut allergy, but instead of digestion issues it was overnight stays in ICU.
A lot of his symptoms where difficulty breathing, wheezing and all that. So after the second stint in the hospital a asthma specialist came by and diagnosed him with severe asthma. But that did not make sense (I was able to predict one of the hospital visits the night before... does that sound like asthma?). We got in an argument right there in the ICU room, with her final argument being that what she said was correct because she was an asthma specialist doctor. Regardless of all that, she was a bitch.
After an hour wait in her waiting room on the first visit, we just left... "Yeah, you'll get that $25 no show fee... bill me."
Fast forward a few months and I, the idiot father, give the kid some peanut butter and BAM... and soon as it hit his mouth he reacted like it was cayenne pepper. He seriously looked like a still image from when Neo blows up the agent at the end of the Matrix (the bumps/hives on his head). The next week he was at an allergist getting tested and sure enough... several allergies, the main one was peanuts.
More than likely a less knowledgeable, less confident, and less "well off" person would have submitted to the numerous in-office breathing treatments, medications, and probably spent thousands before realizing one day it was a peanut allergy. Not only that, the kid could have actually gotten the peanut down his throat and that's when they die from anaphylaxis.
Watch out for your own health (and you kids). Nobody gives a damn as much as you do.
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(Score: 2) by VLM on Wednesday September 24 2014, @09:25PM
"her final argument being that"
With all due respect sir she might have said exactly what you reported, but I'm fairly certain she was thinking the whole time "I can make a sh!t load of money off a lifetime of asthma diagnosis, but this gravy train is over when someone tells him not to eat peanuts anymore"
Did the allergist schedule followup appointments?
My son's gastroenterologist scheduled us for $450/hr follow up appointments after the diagnosis and some elaborate A/B testing (Oh look, he eats pure cooked hamburger meat for a day and like a miracle no problem, but every time we do a trial with whole wheat bread 3 hours after he explodes out both ends till he's dehydrated... golly wonder if he might be allergic to wheat? So for $450/hr, every six months for the next 80 years, its all "so hows that not eating gluten containing wheat and barley and stuff going?" "Oh its going great? In that case I'd suggest continuing to do that, that'll be $450 see ya in 6 months, sucka" We cancelled the future appointments with the nurse freaking out that child protective services is going to take him away if we don't pay the gasto-ent the proper protection money. Called their bluff and all is well and happy for the last decade, although the doc hasn't been getting his protection money. He has an iron stomach, in fact a bottomless teen boy iron stomach, my god can he eat, just don't feed him wheat / dairy / soy or his iron stomach turns into a volcano for about a day.
(he's also allergic to soy and casein, its a rather elaborate procedure with antibody blood tests followed by all manner of crazy (yet rather obvious) A/B testing, which you probably got to experience although with nuts, although I donno if they'd be crazy enough to A/B test him with peanut butter if its ICU time)
(Score: 2) by strattitarius on Wednesday September 24 2014, @09:46PM
"Protection money" - yeah they didn't threaten CPS but it was more a "think of the child - he could die from an attack" type of stuff. The whole thing changed me from a typical person that trusts doctors as "experts" to someone who realized that I was probably smarter than the doctors and had much more information than they did. I am not going to try my own surgery, but I will be active in diagnosis from now on.
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(Score: 2) by VLM on Wednesday September 24 2014, @10:00PM
"renew his prescriptions for his epi pen"
ah that makes sense especially if its dosage depends on body weight. That at least makes sense, even if they probably bill $450/hr like our specialist.