Doing your own research (1 Viewer)

[The Longtime Lurker]

At the end of the day, we need to acknowledge all doctors are not equal. There are good doctors and poor doctors. Finding the right one is important and can be a long difficult process.

This is at the heart of my earlier comment. I've had the misfortune of having a bad doctor. One that lost my trust and caused me to question their motivation for even being a doctor.

Since then I've found a much better doctor that is more than willing to discuss treatments, treatment alternatives, and accept patient input. It's refreshing. For the record in almost every instance i defer to their expertise, but will push for non pharmaceutical methods if possible or PT vs surgery.

Medicine isn't one size fits all and when i felt lumped into the same category as a patient not willing to work at their health like i am and told refusing pills in lieu of dietary intervention was wrong I "researched" a new doctor.

Eta. There was much more to this particular doctor than haggling over medication. Just an easy example of a conflict over treatment.

Although their communication was poor, it’s entirely possible your initial doctor wasn’t wrong.

Diet and exercise typically lower LDL (“bad” cholesterol) 10-20%, and compliance is usually poor. Guidelines account for this, and suggest immediate medication, plus lifestyle modification, if LDL is sky high. What is sky high? 190+, or lower, if coupled with other vascular risk factors.

There should have been more shared decision making in that process, and tolerance for your trial of lifestyle modification. That was your doctor’s failure.

You also should know, “optimal” LDL hasn’t been well defined, as every 40 point drop associated with roughly 20% cardiovascular risk reduction, all the way down to 45 mg/dL - I’m guessing yours isn’t that low. For this reason, some physicians think HMG reductase inhibitors (aka “statins”) should be nearly universally prescribed.

Can't recall excact numbers, but was in the 270-280 total cholesterol range. Tris were good, HDL good, LDL high, no apob or LPa testing.

I'm sure there's guidelines (have also seen the case for everyone on statins), but for me, a patient that is willing to stick to dietary and lifestyle modification, which he knew i was capable, willing, and medication averse unless all other options fail it felt generic and his dismissive attitude that i wouldn't just go along with his recommendation off-putting.

Now, was he wrong, i guess not. Was i wrong, no, the results then and still today speak to that. And again it wasn't a single issue, but this was the easiest example. He seemed to despise questions.

I guess the point i wanted to make was that patient input isn't necessarily obtuse and out of left field. Sometimes we know ourselves and what we're comfortable with.

 

[Alex P Keaton]

If you ask me, "merely daring" conveys a ton of bias and tilts the conversation.

Not a bias. It's a strong opinion. I'm not tilting the conversation. I have a strong viewpoint and I'm sharing my opinion. The fact that questioning an authority and not blindly swallowing whatever is offered is seen as a negative trigger by some is remarkable to me. And some others.

Joe: As a counter, I have to believe you know some people who use the phrase “I’ve done the research” as a reflexive comment to justify any contrarian view they might have. My cousins, for example, use that phrase to justify their views on vaccines, homeschooling, and now the consumption of raw milk, just to name a few.

I don’t really care what they do on any of these subjects. It doesn’t really affect me or (mostly) anyone else. But they also tell my aunt what to do, and she then blindly repeats “I’ve done the research.” Except she hasn’t. And really, neither have my cousins. How do I know? Because when I ask them simple questions like “hey cool, can you share any links with me about raw milk?” there is zero reply. And I hate — hate — pasteurized skim milk. So I’m the target audience on this simple topic.

Anyway, when I think of the phrase “I’ve done the research” this is what comes to mind. Of course it could also be used to mean what it literally says — like when I went into the 10k/running thread and asked all experienced folks in that thread what type of running shoes to buy. Who better to ask? That’s a form of research — except I didn’t ask Joe Rogan (who knows less than me about running shoes, medicine and probably most things). I asked dudes who are really awesome and experienced runners.

I get your broader point though too. We’ve reached this stage where experts are mad - not just mad, shocked and dismayed - that people don’t just blindly bow to their expertise. Even though our world has a lot of problems, many of which *seem* to be either caused by or exacerbated by the experts.

It’s going to be fascinating to watch this dynamic to play out. On many topics.

Oh, for sure. Totally uncool for people to lie and say they've done the research when they haven't really done any research.

I'm talking about the negativity cast toward people by some when they question the authority. And I get why the people in power and authority are clutching so hard to retain their power and authority. That makes total sense.

In fairness to Terminalxylem, I think the point of his OP is built around people using the phrase “I did my own research” when either a) they didn’t really, or b) they did crap research, or c) they got mis or disinformation during the research. And how frustrating and concerning that trend is. I’ll add a “d” — many people truly are too dumb to do their own research. Or to interpret it properly. (My litmus test for all of this is my cousin in WI who has an IQ of 95-100 but thinks she is a genius)

When I hear the phrase “I’ve done my research” it is rarely followed by any credible evidence of reliable research.

On the flip side, I’m all for questioning experts. And I get that my view on these two closely linked topics is inconsistent at best.

 

[Joe Bryant]

Admittedly, I usually cringe when people address their medical care in this manner. "Doing my own research" is on the short list of trigger phrases which bias me against a patient, along with "I know my own body" and "everybody's different", as these statements usually precede noncompliance with the suggested plan.

Are you honest with your patients and disclose to them you hold this bias against them?

That feels like a super important thing for the patient to know.

I try to keep an open mind in these situations. I’m honest with them, but no, I don’t typically find a need to disclose potential biases - it’s incumbent on me to recognize and avoid them.

Interesting. You were clear here to say it was a bias. Not a potential bias.

"Doing my own research" is on the short list of trigger phrases which bias me against a patient, along with "I know my own body" and "everybody's different", as these statements usually precede noncompliance with the suggested plan.

You going to keep hammering on his original post ad nauseum? Or you going to allow him to clarify or even change it to "potential bias" if that's what he truly meant?

You asked the question about it and he answered why he's honest and why it's not something that would need to be disclosed and yet you keep going back to "but you said..!!!!"

When he says something isn't happening and he literally said the thing that's happening, yes, I'll reference that. Hope that's ok.

"Hope that's ok".

That's some pretty overt snark from the Boss who asks everyone to "show grace" and be excellent.

I do hope that's ok. And I do want people to be excellent and show grace. He was literally saying something wasn't happening when he was doing it himself. Showing grace and being excellent does not mean never challenge.

When you wrote,

You going to keep hammering on his original post ad nauseum? Or you going to allow him to clarify or even change it to "potential bias" if that's what he truly meant?

You asked the question about it and he answered why he's honest and why it's not something that would need to be disclosed and yet you keep going back to "but you said..!!!!"

I don't think noting something happening in front of our eyes is "hammering something ad nauseum". Or pointing out he was doing something he said wasn't happening is "yet you keep going back to "but you said..!!!!" was unusual. That you seemed confused by that was odd.

 

[Joe Bryant]

On the flip side, I’m all for questioning experts. And I get that my view on these two closely linked topics is inconsistent at best.

Thanks GB.

 

[Peggy]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around. He's a primary source of information for sure, but, they're my decisions.

 

[waiver wire]

if this was anyone else, they probably would have a timeout by now

 

[tommyGunZ]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

I don't think I've ever disagreed with a Nipsey post in 25 years here but this is crazy to me. You're penalizing science for doing science. Of course dietary guidelines and recommendations change over time as we learn more, are better able to analyze data, and become more informed about the human body. That's literally how science is supposed to work.

I don't understand the logic in attempting to override scientific consensus and advice from your doctor who literally spent 7 years becoming an expert because of a Facebook post or a podcast from a comedian. In almost every scenario, you are better off taking the advice from your physician rather than contradicting her/his advice because you "did your own research".

Think of it as placing bets. You walk into a casino and a team of MIT mathematicians offer you blackjack advice. When is it ever smart to say, "nah, my ex-wife's uncle once hit on 19 and got a 2, so that's my strategy". Even if you hit and get a 2, it was a stupid bet.

 

[gianmarco]

Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic.

Thank you.

The idea it would be seen as a negative that people might dare to think for themselves instead of blindly following the directives of a massive for-profit industrial complex industry seems wild to me.

Ok, you've said this now over and over and over many times here.

There is a MASSIVE difference in what's driving the "massive for-profit industrial complex" and physicians.

Insurance companies, pharmaceuticals, hospital systems, and business administrators are the MASSIVE drivers of cost in healthcare. Not physicians. There's been a huge explosion on the business side and that's why it's spiraling out of control.

Meanwhile, physician salaries, which make up about 8% of healthcare costs, have remained virtually unchanged over the last couple decades, if not longer. In fact, when taking inflation into account, they've actually decreased. Reimbursement is going even further down as we speak. All while the business/administration tasks increase.

So, the "for-profit" area isn't being driven by physicians. Whether a physician decides to order a test or not, give a medicine or not, perform a surgery or not is not dictated by finances. A lot of physicians are salaried (I believe it's something like 70%). Even those that are productivity based, they earn more by having to work more. Physicians don't get more money by prescribing a certain medicine over another or ordering a certain test. Thus, when the face to face encounter that you're implying is being influenced by finances, that is almost entirely untrue. Are there certain instances or "bad apples"? Of course. But the VAST majority.....completely non-existent.

In fact, most of the time, it's patients coming in ASKING for certain medicines or tests or procedures and physicians having to explain why they aren't necessary. Many of those patients, which are likely the ones referred to in the OP, will then "shop around" until they find a physician willing to give in to what they want.

This implication that finances drive most medical decision making just isn't accurate.

Physicians are entirely complicit in the for-profit pharmaceutical business. I fully understand why they'd want to dissociate themselves from it. But there's a very good reason drug companies spend the $$$ they spend trying to influence physicians. Of course the guise is "education". And apparently no better way to educate than catering lunch for the office.

If you don't think finances drive most of the Medical Industrial Complex and the massive For-Profit corporations behind it, we'll have to disagree.

Do I think finances drive most of the "Medical Industrial Complex"? Absolutely, 100%

Do I think finances drive most physicians and their medical decision making? Absolutely not.


You aren't distinguishing between those 2 entities.

And if you disagree with the latter, then that's a very different issue.

 

[BlackCrowes]

Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic.

Thank you.

The idea it would be seen as a negative that people might dare to think for themselves instead of blindly following the directives of a massive for-profit industrial complex industry seems wild to me.

Ok, you've said this now over and over and over many times here.

There is a MASSIVE difference in what's driving the "massive for-profit industrial complex" and physicians.

Insurance companies, pharmaceuticals, hospital systems, and business administrators are the MASSIVE drivers of cost in healthcare. Not physicians. There's been a huge explosion on the business side and that's why it's spiraling out of control.

Meanwhile, physician salaries, which make up about 8% of healthcare costs, have remained virtually unchanged over the last couple decades, if not longer. In fact, when taking inflation into account, they've actually decreased. Reimbursement is going even further down as we speak. All while the business/administration tasks increase.

So, the "for-profit" area isn't being driven by physicians. Whether a physician decides to order a test or not, give a medicine or not, perform a surgery or not is not dictated by finances. A lot of physicians are salaried (I believe it's something like 70%). Even those that are productivity based, they earn more by having to work more. Physicians don't get more money by prescribing a certain medicine over another or ordering a certain test. Thus, when the face to face encounter that you're implying is being influenced by finances, that is almost entirely untrue. Are there certain instances or "bad apples"? Of course. But the VAST majority.....completely non-existent.

In fact, most of the time, it's patients coming in ASKING for certain medicines or tests or procedures and physicians having to explain why they aren't necessary. Many of those patients, which are likely the ones referred to in the OP, will then "shop around" until they find a physician willing to give in to what they want.

This implication that finances drive most medical decision making just isn't accurate.

Physicians are entirely complicit in the for-profit pharmaceutical business. I fully understand why they'd want to dissociate themselves from it. But there's a very good reason drug companies spend the $$$ they spend trying to influence physicians. Of course the guise is "education". And apparently no better way to educate than catering lunch for the office.

If you don't think finances drive most of the Medical Industrial Complex and the massive For-Profit corporations behind it, we'll have to disagree.

Yikes

 

[gianmarco]

if this was anyone else, they probably would have a timeout by now

Thank you.

 

[Joe Bryant]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around.

 

[Joe Bryant]

if this was anyone else, they probably would have a timeout by now

For exactly what reason? What would be the quote you'd reference?

 

[tommyGunZ]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around. He's a primary source of information for sure, but, they're my decisions.

Can you give an example of a situation where you feel your own research puts you in better position to diagnose and treat a serious medical condition than your physician?

 

[Nipsey]

When you're watching non-RedZone football this season, almost every commercial break will feature overweight people dancing or acting out some upbeat scene to a reworked song from 40 years ago with the lyrics changed. It’s all part of the race for maximum profit before the medication goes generic. While these medications will surely help many who take them, it’s also fair to ask: How safe are they really? How long were they tested? Who funded the studies? What happens if side effects appear years later? Heaven forbid you mention to your doctor that you’ve done a little research before your visit.

 

[Peggy]

I guess the point i wanted to make was that patent input isn't necessarily obtuse and out of left field. Sometimes we know ourselves and what we're comfortable wiwith.

Are you kidding me. How the patient fells and what his body is telling him are the most important piece of information a doctor has. It's like question #1.

 

[gianmarco]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around. He's a primary source of information for sure, but, they're my decisions.

Can you give an example of a situation where you feel your own research puts you in better position to diagnose and treat a serious medical condition than your physician?

Plus, physicians can't/don't force you to take medicines, have tests done, or have surgeries. That's what consent is for.

They advise, then you can do with it what you want. Don't want to take the medicine they prescribed? Then don't. Don't think the surgery is necessary? Don't have it. Don't think you need the CT scan? Don't go have it done.

And best part: Don't like your physician? Go find another one.

 

[Mister CIA]

My emoji game needs work.

 

[gianmarco]

Next time I'm flying somewhere, I'm going to make sure I read up on that aircraft with some Google research and let the pilot know my thoughts on how we should handle the flight.

 

[Alex P Keaton]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

I don't think I've ever disagreed with a Nipsey post in 25 years here but this is crazy to me. You're penalizing science for doing science. Of course dietary guidelines and recommendations change over time as we learn more, are better able to analyze data, and become more informed about the human body. That's literally how science is supposed to work.

I don't understand the logic in attempting to override scientific consensus and advice from your doctor who literally spent 7 years becoming an expert because of a Facebook post or a podcast from a comedian. In almost every scenario, you are better off taking the advice from your physician rather than contradicting her/his advice because you "did your own research".

Think of it as placing bets. You walk into a casino and a team of MIT mathematicians offer you blackjack advice. When is it ever smart to say, "nah, my ex-wife's uncle once hit on 19 and got a 2, so that's my strategy". Even if you hit and get a 2, it was a stupid bet.

That’s a weird post to quote if you want to pick a nit. Opioids and antibiotics are two areas where it’s no longer debatable whether or not the medical-industrial complex has behaved appropriately.

If you “followed the advice” on opioids you might very well be an addict today. Or dead.

Might want to pick a better example to target.

 

[Peggy]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around. He's a primary source of information for sure, but, they're my decisions.

Can you give an example of a situation where you feel your own research puts you in better position to diagnose and treat a serious medical condition than your physician?

Sure. Long story short.

My wife had issues with stomach pain, bloating, issues going #2, and eventually abnormal bleeding. Couple years in the experts found a lump and wanted to medicate, track it's growth, etc. etc. I knew my wife better and at her age told her it would be wise to get a hysterectomy. Doctor came out of the operating room with a photo of a mass (non-cancerous) the size of a softball that was completely smashing her ovaries. He said it was a really good thing we jumped straight to having everything removed.

 

[fatness]

Glad to hear you’ve had that experience. So have I — sometimes. Other times (like above)? Not as much.

What were you trying to convey with your counter example?

That I've had many interactions with doctors in the last several years and that, with varying amounts of effort on my part, communication was achieved without one party talking down to another. I'd estimate that there were 40 visits or so. You had listed 1 example of things going badly with a doctor for you and I felt like some more examples would be informative.

The last doctor who talked down to me and would not listen to me was a referral from my PCP, so I went back to the PCP and complained. He no longer gets referrals from that PCP.

 

[Terminalxylem]

Many many years ago I went to the ER with a high fever and wicked headache. Obviously they thought it was meningitis, some varaints of which can be deadly. The doc ordered a CT scan, but I had bare bones basic insurance that would only cover 80% of that cost. I explained that the CT scan would bankrupt me as I was fresh out of grad school with a temp job. The doctor listened to me, and agreed to a lumbar puncture (aka spinal tap) to check and see if I had bacteria in my cerebral spinal fluid. Thankfully it came back clean and there was no bacterial infection. I got a bunch of fluids in me and they sent me home without admitting me since my fever was now under control.

In this instance, the doctor went against his initial course of diagnosis due to the financial situation of the patient. I'm glad he listened to me, but I know he was not happy about it. He may have thought I'd refuse the cat scan (and i honestly might have refused) and this was the best of a bad situation.

I'd like to hear from the physicians about this story and whether they've ever been in a similar jam with a patient.

Although CT scans are typically done, this is an example of excess diagnostic testing. Assuming your neurologic exam was reassuring and you weren’t severely immunocompromised, spinal tap can be performed sans imagery.

To answer your question, standards of care are compromised all the time, typically due to patient preference.

 

[STEADYMOBBIN 22]

I support doing your own research. It can only make you more informed on a condition. Of course there is going to be bad information floating around, but the important thing is to not marry that information and change your views as more information comes to light. Walking into a doctors office and blindly following their assessment posses risks as well.

At the end of the day, we need to acknowledge all doctors are not equal. There are good doctors and poor doctors. Finding the right one is important and can be a long difficult process.

During my father's last few years he experienced several health related issues and was a big proponent of getting a second or third opinion. He was running into situations where three different doctors would provide three different diagnoses and treatment plans for the exact same symptoms with similar testing done. It's frustrating, because how does a patient know which way to go from there without doing their own research?

This is flat out completely, 1,000,000% wrong. It can also make you completely uninformed and mislead. This board is FULL of examples. I think you know that as you immediately attach a caveat right after the statement.

Is it your opinion that anything a doctor says is 100% factual and not to be questioned? I can't wrap my head around this ignorance is preferred agenda.

Of course not. Another straw man that shouldn't really need addressing, but here we are. Virtually NOTHING is 100%. There are almost ALWAYS exceptions. But the "arguments" are much easier to make if you ignore that reality.

What do you want to do argue semantics? It makes 99% of people more informed to research things. Does that make the statement better for you?

No, because that's not true either (unless you are equating misinformed and informed because they both have "informed" in the word). There are so many factors here that the initial statement is just wrong. What is absolutely true are these three things:

1. Disinformation is easier to get than real information. It's not close. The studies are out there showing the social side of this. I encourage you to read them.
2. The average person will NOT go through all the steps to be thoroughly researched on the topic they are "researching".
3. If the average person is off on their own to do "research" given #1 and #2, more often times than not, they will likely be steered astray because it is incredibly difficult for those outside the fields of study to wade through all the mis/disinformation to get at the nuggets of truth. Hell, there's no way I could do it on many topics if I didn't have access to subscriptions of various medical journals and research databases. I'd spend months trying to figure out truth from fiction.

Does that mean one doesn't go and read and study about it? Of course not. Does that mean you just blindly listen to your doctor and try not to educate yourself at all? Nope. Those are the extremes that are both incorrect. The answer is in the middle and if you're doing either extreme, you're doing it wrong. Period. We all know the 80/20 rule around the demo of the "do your own research" crew and what that has come to mean when we hear it. Perhaps those of us in medical fields are more sensitive to this than the average person. I'm not sure, but that generalization is a red flag as pointed out in the OP with which I completely agree.

So basically you agree with everything we say, you just REALLY despise DiSin4MATIONRawR.

OK.

 

[Alex P Keaton]

Next time I'm flying somewhere, I'm going to make sure I read up on that aircraft with some Google research and let the pilot know my thoughts on how we should handle the flight.

Close family friend is a pilot. I call him often to share “situations” that arose while flying for work. He patiently explains why my crazy hypotheses don’t match his lived experience as a pilot. Maybe 5% of the time he tells me that I’m half-right. But I’m pretty sure he’s just being polite that 5% of the time.

 

[Nipsey]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

I don't think I've ever disagreed with a Nipsey post in 25 years here but this is crazy to me. You're penalizing science for doing science. Of course dietary guidelines and recommendations change over time as we learn more, are better able to analyze data, and become more informed about the human body. That's literally how science is supposed to work.

I don't understand the logic in attempting to override scientific consensus and advice from your doctor who literally spent 7 years becoming an expert because of a Facebook post or a podcast from a comedian. In almost every scenario, you are better off taking the advice from your physician rather than contradicting her/his advice because you "did your own research".

Think of it as placing bets. You walk into a casino and a team of MIT mathematicians offer you blackjack advice. When is it ever smart to say, "nah, my ex-wife's uncle once hit on 19 and got a 2, so that's my strategy". Even if you hit and get a 2, it was a stupid bet.

I’m absolutely not saying people should ignore their doctors because they watched a podcast. And I understand that science and guidelines change as we learn more but it is not always just about new facts. Politics, industry (money), and incomplete research can all play a role in how recommendations are shaped. That is why I think it's is reasonable for people to be cautious and ask questions instead of accepting everything without thinking it through.

 

[Alex P Keaton]

Glad to hear you’ve had that experience. So have I — sometimes. Other times (like above)? Not as much.

What were you trying to convey with your counter example?

That I've had many interactions with doctors in the last several years and that, with varying amounts of effort on my part, communication was achieved without one party talking down to another. I'd estimate that there were 40 visits or so. You had listed 1 example of things going badly with a doctor for you and I felt like some more examples would be informative.

The last doctor who talked down to me and would not listen to me was a referral from my PCP, so I went back to the PCP and complained. He no longer gets referrals from that PCP.

Thanks. Appreciate the reply. I’ve also had great interactions with doctors. Not always. And that’s ok. People in my professional world probably don’t always have perfect interactions with me.

 

[Nipsey]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

No one has said doctors are omniscient. How did you reach that conclusion?

Regarding your examples, of course doctors are fallible, are medicine Is an imperfect, evolving science. But an argument can be made that each of your examples

You said that if a patient tells you they’ve done research it may bias you against them. That may not be claiming omniscience, but it does suggest that you see their perspective as not worth considering.

 

[tommyGunZ]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

I don't think I've ever disagreed with a Nipsey post in 25 years here but this is crazy to me. You're penalizing science for doing science. Of course dietary guidelines and recommendations change over time as we learn more, are better able to analyze data, and become more informed about the human body. That's literally how science is supposed to work.

I don't understand the logic in attempting to override scientific consensus and advice from your doctor who literally spent 7 years becoming an expert because of a Facebook post or a podcast from a comedian. In almost every scenario, you are better off taking the advice from your physician rather than contradicting her/his advice because you "did your own research".

Think of it as placing bets. You walk into a casino and a team of MIT mathematicians offer you blackjack advice. When is it ever smart to say, "nah, my ex-wife's uncle once hit on 19 and got a 2, so that's my strategy". Even if you hit and get a 2, it was a stupid bet.

I’m absolutely not saying people should ignore their doctors because they watched a podcast. And I understand that science and guidelines change as we learn more but it is not always just about new facts. Politics, industry (money), and incomplete research can all play a role in how recommendations are shaped. That is why I think it's is reasonable for people to be cautious and ask questions instead of accepting everything without thinking it through.

I think asking questions is essential to proper treatment and understanding.

“I do my own research” implies something far different.

 

[Terminalxylem]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

No one has said doctors are omniscient. How did you reach that conclusion?

Of course doctors are fallible, and medicine Is imperfect. But an argument can be made that each of your examples illustrate failures at multiple levels, including patients, with doctors playing a relatively small role. Also, if we’re holding physicians accountable for evolving science, how can we ever trust them?

 

[gianmarco]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

No one has said doctors are omniscient. How did you reach that conclusion?

Regarding your examples, of course doctors are fallible, are medicine Is an imperfect, evolving science. But an argument can be made that each of your examples

You said that if a patient tells you they’ve done research it may bias you against them. That may not be claiming omniscience, but it does suggest that you see their perspective as not worth considering.

Doctors may not be omniscient, but it is HIGHLY unlikely a patient is going to come in more knowledgeable about a medical subject no matter how much "research" they've done. Even if it's new research that is excellent quality, peer reviewed, and something the physician hasn't seen yet, it's unlikely to change practice by itself. That's just not how it works.

The whole point of the OP is that phrase USUALLY is very suspect and it is likely to indicate a patient that isn't going to accept standard care readily.

And, with those exceptions to that, if it is something worth discussing, most physicians are more than willing to consider new perspectives that might change practice. That's part of the job and continuing medical education that happens regularly.

 

[Terminalxylem]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

No one has said doctors are omniscient. How did you reach that conclusion?

Regarding your examples, of course doctors are fallible, are medicine Is an imperfect, evolving science. But an argument can be made that each of your examples

You said that if a patient tells you they’ve done research it may bias you against them. That may not be claiming omniscience, but it does suggest that you see their perspective as not worth considering.

Not at all. I welcome informed discussion. The problem starts when the information is suspect, which is common, unfortunately.

 

[Mister CIA]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

No one has said doctors are omniscient. How did you reach that conclusion?

Of course doctors are fallible, and medicine Is imperfect. But an argument can be made that each of your examples illustrate failures at multiple levels, including patients, with doctors playing a relatively small role. Also, if we’re holding physicians accountable for evolving science, how can we ever trust them?

That's a question worthy of lingering on.

 

[Nipsey]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

I don't think I've ever disagreed with a Nipsey post in 25 years here but this is crazy to me. You're penalizing science for doing science. Of course dietary guidelines and recommendations change over time as we learn more, are better able to analyze data, and become more informed about the human body. That's literally how science is supposed to work.

I don't understand the logic in attempting to override scientific consensus and advice from your doctor who literally spent 7 years becoming an expert because of a Facebook post or a podcast from a comedian. In almost every scenario, you are better off taking the advice from your physician rather than contradicting her/his advice because you "did your own research".

Think of it as placing bets. You walk into a casino and a team of MIT mathematicians offer you blackjack advice. When is it ever smart to say, "nah, my ex-wife's uncle once hit on 19 and got a 2, so that's my strategy". Even if you hit and get a 2, it was a stupid bet.

I’m absolutely not saying people should ignore their doctors because they watched a podcast. And I understand that science and guidelines change as we learn more but it is not always just about new facts. Politics, industry (money), and incomplete research can all play a role in how recommendations are shaped. That is why I think it's is reasonable for people to be cautious and ask questions instead of accepting everything without thinking it through.

I think asking questions is essential to proper treatment and understanding.

“I do my own research” implies something far different.

Feels like semantics to me.

 

[Peggy]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around. He's a primary source of information for sure, but, they're my decisions.

Can you give an example of a situation where you feel your own research puts you in better position to diagnose and treat a serious medical condition than your physician?

Plus, physicians can't/don't force you to take medicines, have tests done, or have surgeries. That's what consent is for.

They advise, then you can do with it what you want. Don't want to take the medicine they prescribed? Then don't. Don't think the surgery is necessary? Don't have it. Don't think you need the CT scan? Don't go have it done.

And best part: Don't like your physician? Go find another one.

So now we're in the quandary of making those decisions and the OP, and I think you're trying g to agree with him, thinks the only information you should consider in making those decisions is exactly what your DR told you. And it is a primary source of information. So would a second opion if you get one. But I still prefer to include my research, and more importantly my experiences as being the closest to the actual issue, and whatever other information is available to make those decisions.

Information is power and anyone making any decision ought to use any and all information available. You do that in business, you do that in relationships, you do that in every aspect in life. Suggesting your health is somehow different is absurd.

And the argument that some are suseptible to disinformation and AI is making people less smart is a different argument. But you still wouldn't tell them to listen solely to once source of information when making a business or relationship decision.

 

[Terminalxylem]

Admittedly, I usually cringe when people address their medical care in this manner. "Doing my own research" is on the short list of trigger phrases which bias me against a patient, along with "I know my own body" and "everybody's different", as these statements usually precede noncompliance with the suggested plan. I realize that's not ideal, and the link offers advice to communicate more effectively:

But you also understand why people ask questions, right?

I don't know you, of course, so I'm not saying you do this, but I know some people in the medical field who become indignant if the lowly patient dares to question even the smallest things as the medical person hands down the omniscient answers.

Medicine is business. A huge business. I do find it interesting how some people will blindly ignore the financial motivations that drive the business and somehow assume there's some sort of magical altruism to the business of healthcare, where the best interests of the customer are the only factor and the best interests of the company are ignored.

Where is the connection between doing my own research and medicine is a business?

They're connected as they relate to the person/customer/patient.

And they don't necessarily have the same motivation. Hopefully they do. But not necessarily.

And I fully understand some people have much more faith that zillion dollar for profit corporations will operate with magical altruism than I do.

The fact that merely daring to ask questions about a treatment or procedure can be seen as defiant or a negative by some is incredibly telling.

No one here is doing the bolded, and not really the point of this discussion imo.

Disagree. I think when a physician is bold enough to admit in public,

"Admittedly, I usually cringe when people address their medical care in this manner. "Doing my own research" is on the short list of trigger phrases which bias me against a patient, along with "I know my own body" and "everybody's different", as these statements usually precede noncompliance with the suggested plan. I realize that's not ideal, and the link offers advice to communicate more effectively:"

that's exactly the bolded of "merely daring to ask questions about a treatment or procedure can be seen as defiant or a negative"

Not sure what you mean about it not being the point of the discussion. It was literally in the original post.

We’ll have to agree to disagree then.

Admitting I find certain characteristics of the “I’m doing my own research” crowd off putting is hardly the same as stifling questions, or shared decision making.

 

[BlackCrowes]

Just in our lifetimes doctors have pushed dietary guidelines and foods that turned out not to be beneficial, and in some cases, like trans fats, were actively harmful. Antibiotics were handed out like candy and now we’re dealing with resistance. Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic. Sure, the person who refuses a vaccine because of something they read on Facebook is probably super frustrating. But a healthy dose of skepticism (even “research") doesn’t seem like the worst thing in the world. Sometimes it’s just a patient trying to stay informed in a system that doesn’t always earn blind trust.

I don't think I've ever disagreed with a Nipsey post in 25 years here but this is crazy to me. You're penalizing science for doing science. Of course dietary guidelines and recommendations change over time as we learn more, are better able to analyze data, and become more informed about the human body. That's literally how science is supposed to work.

I don't understand the logic in attempting to override scientific consensus and advice from your doctor who literally spent 7 years becoming an expert because of a Facebook post or a podcast from a comedian. In almost every scenario, you are better off taking the advice from your physician rather than contradicting her/his advice because you "did your own research".

Think of it as placing bets. You walk into a casino and a team of MIT mathematicians offer you blackjack advice. When is it ever smart to say, "nah, my ex-wife's uncle once hit on 19 and got a 2, so that's my strategy". Even if you hit and get a 2, it was a stupid bet.

I’m absolutely not saying people should ignore their doctors because they watched a podcast. And I understand that science and guidelines change as we learn more but it is not always just about new facts. Politics, industry (money), and incomplete research can all play a role in how recommendations are shaped. That is why I think it's is reasonable for people to be cautious and ask questions instead of accepting everything without thinking it through.

I think asking questions is essential to proper treatment and understanding.

“I do my own research” implies something far different.

Feels like semantics to me.

"i saw an article saying a study found this about people with X, so i clicked on the link in the article and it took me to the paper in the New England Journal of Medicine. It was interesting"

"My friend heard i had X, so he sent me a link to a youtube video where i guy in a labcoat said this about X"

semantics

 

[Terminalxylem]

Next time I'm flying somewhere, I'm going to make sure I read up on that aircraft with some Google research and let the pilot know my thoughts on how we should handle the flight.

I mean, pilots have crashed before - how can we trust them?

 

[Peggy]

Doctors may not be omniscient, but it is HIGHLY unlikely a patient is going to come in more knowledgeable about a medical subject no matter how much "research" they've done. Even if it's new research that is excellent quality, peer reviewed, and something the physician hasn't seen yet, it's unlikely to change practice by itself. That's just not how it works.

It's so unlikely that its happened twice on this page of this thread alone.

I'm never going to be performing surgery, but, I can frame a house better than an average carpenter. I worked with a professional engineer that didn't know how to turn on his computer or jump start his car. And I've met a lot of just so-so doctors in my lifetime, it's no different than any other profession. I think suggesting it is is what spurred the omniscient comments.

 

[gianmarco]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around. He's a primary source of information for sure, but, they're my decisions.

Can you give an example of a situation where you feel your own research puts you in better position to diagnose and treat a serious medical condition than your physician?

Plus, physicians can't/don't force you to take medicines, have tests done, or have surgeries. That's what consent is for.

They advise, then you can do with it what you want. Don't want to take the medicine they prescribed? Then don't. Don't think the surgery is necessary? Don't have it. Don't think you need the CT scan? Don't go have it done.

And best part: Don't like your physician? Go find another one.

So now we're in the quandary of making those decisions and the OP, and I think you're trying g to agree with him, thinks the only information you should consider in making those decisions is exactly what your DR told you. And it is a primary source of information. So would a second opion if you get one. But I still prefer to include my research, and more importantly my experiences as being the closest to the actual issue, and whatever other information is available to make those decisions.

Information is power and anyone making any decision ought to use any and all information available. You do that in business, you do that in relationships, you do that in every aspect in life. Suggesting your health is somehow different is absurd.

And the argument that some are suseptible to disinformation and AI is making people less smart is a different argument. But you still wouldn't tell them to listen solely to once source of information when making a business or relationship decision.

When you say "my research", what exactly is that?

Are you reading medical studies from journals written by doctors/clinical scientists? If so, are you able to determine good quality studies from not?

If so, do you think you're reading something your physician hasn't read yet? Do you feel your physician doesn't stay up to date? Why do you trust THOSE doctors but not the one you're seeing?

If it's not the above but from other sources, do you think there might be a reason your physician isn't reading "your research"? What makes this other research more helpful despite not being accepted into qualified, respected journals?

Do you feel "your research" is enough to override what your physician is recommending?


I'm genuinely curious about the above.

To answer your question, yes, I do think your physician, who has received vast training to take care of your health, should be your primary source of information. If you don't trust that physician, then get a second opinion or find another physician. But no, I don't think "your research" should play much of a factor except in very rare instances.

If I hire an engineer for a project, I'm not researching it myself and checking his work. I already made the pilot comment above. Etc.
I find it a bit much to think I could spend any amount of reading on those subjects above and think it would even remotely compare to their knowledge in that field that they specifically trained years for.

 

[Nipsey]

Next time I'm flying somewhere, I'm going to make sure I read up on that aircraft with some Google research and let the pilot know my thoughts on how we should handle the flight.

I mean, pilots have crashed before - how can we trust them?

What if pilots were trained by airlines that made more profit every time they flew riskier routes?

 

[Terminalxylem]

For the doctors in here, are there financial incentives to prescribe medication? Not necessarily a monetary transaction, but when say a drug rep comes in are there incentives offered for using their specific pharmaceutical company's medications (travel, gifts, outright payments, etc)?

Generally, no. But there are some instances when secondary gain clouds prescribing practices.

 

[Peggy]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around. He's a primary source of information for sure, but, they're my decisions.

Can you give an example of a situation where you feel your own research puts you in better position to diagnose and treat a serious medical condition than your physician?

Plus, physicians can't/don't force you to take medicines, have tests done, or have surgeries. That's what consent is for.

They advise, then you can do with it what you want. Don't want to take the medicine they prescribed? Then don't. Don't think the surgery is necessary? Don't have it. Don't think you need the CT scan? Don't go have it done.

And best part: Don't like your physician? Go find another one.

So now we're in the quandary of making those decisions and the OP, and I think you're trying g to agree with him, thinks the only information you should consider in making those decisions is exactly what your DR told you. And it is a primary source of information. So would a second opion if you get one. But I still prefer to include my research, and more importantly my experiences as being the closest to the actual issue, and whatever other information is available to make those decisions.

Information is power and anyone making any decision ought to use any and all information available. You do that in business, you do that in relationships, you do that in every aspect in life. Suggesting your health is somehow different is absurd.

And the argument that some are suseptible to disinformation and AI is making people less smart is a different argument. But you still wouldn't tell them to listen solely to once source of information when making a business or relationship decision.

When you say "my research", what exactly is that?

Are you reading medical studies from journals written by doctors/clinical scientists? If so, are you able to determine good quality studies from not?

If so, do you think you're reading something your physician hasn't read yet? Do you feel your physician doesn't stay up to date? Why do you trust THOSE doctors but not the one you're seeing?

If it's not the above but from other sources, do you think there might be a reason your physician isn't reading "your research"? What makes this other research more helpful despite not being accepted into qualified, respected journals?

Do you feel "your research" is enough to override what your physician is recommending?


I'm genuinely curious about the above.

To answer your question, yes, I do think your physician, who has received vast training to take care of your health, should be your primary source of information. If you don't trust that physician, then get a second opinion or find another physician. But no, I don't think "your research" should play much of a factor except in very rare instances.

If I hire an engineer for a project, I'm not researching it myself and checking his work. I already made the pilot comment above. Etc.
I find it a bit much to think I could spend any amount of reading on those subjects above and think it would even remotely compare to their knowledge in that field that they specifically trained years for.

Ive found the third most valuable piece of information is found by talking with others that have had the surgery or decided not to and their outcomes, successes and regrets. Everyone knows somebody who has had a hip replacement right? And pretty soon that leads to finding out which hip surgeon is the best and which ones to avoid. For example.

The second most important is what your doctors says.

But the very most important piece of information is what your body is telling you. Every surgery we've had we knew it was time. I just can't take the hip pain anymore, something has to be done! And despite exrays and exams saying otherwise there are surgeries likely in the future that we do not need now. Bone on bone with huge spurs, doctor can't believe that shoulder even works!

And any doctor worth his salt will start with #1 above.

 

[djmich]

I remember going to a gastroenterologist years ago when I was having extreme stomach / reflux problems. Did a bunch of basic research ahead of time. Nothing exotic — just lots of basics. Sat down with the doc and he was asking me questions, so I answered honestly and included some basic info that I had learned from “research.”

He looked at me like “silly child, I’m the doctor here.” And then proceeded to repeat back to me the same info, except with more jargon. My BIL is a doctor, and to this day he likes to make fun of me for this incident, which includes imitating what I probably sounded like to the doctor.

To be clear, I actually did need the doctor’s advice. But…..basically I learned nothing that visit. The next step? As suspected, an endoscopy. After that? Reflux meds.

I’m really grateful it was nothing worse. But that wasn’t because of the doctor. And he really didn’t do anything that I wouldn’t have done, despite him being an expert.

It was a weird experience. But I still trust doctors and still want to look to them as experts.

I started having gastro issues about 5yrs ago. Went to a gastro Dr. After a series of tests including endoscopy and colonoscopy he tells me I have IBS, which based on "doing my own research" and the haphazard way he was having me try different things I discovered that IBS is code for we don't know why your stomach is misbehaving. Fortunately, he provided me with full paperwork and I decided to do more of my own reasearch, particularly around the "mild diverticulitis" part on my paperwork...and over time by doing my own research I narrowed the issues down to this and I've found a regimen that greatly reduces my flares and limits them when they occur (some elements that were recommended by my doctor after I shared with him I thought diverticulitis was the key issue).

Thats one data point with doctors, based on my lifetime experience my assessment is:

Overall, doctors are seeing way too many patients to be able to be close to maximum effectiveness, especially when cases like the gastro one above requires assessment and tests over time. Its like each time you walk in, you, the patient, have to bring the doctor up to speed from the last visit.

The amount of time they spend with you also does not allow them to really be exhaustive in a visit, especially when trying to connect dots from prior visits.

Doctors are valuable, but they're human, they don't know everything, don't always bring up everything they know if they don't think its necessary (but may still be valuable) and importantly they cannot possibly spend as much time as you can assessing yourself, trial and error, and "doing your own research" as part of that. AI helps make that exponentially more effective. Its not perfect for sure, and yes it can even be bad in cases, results may vary based on user. But if you've got a brain, imo you're foolish not to do your own research.

 

[Terminalxylem]

The Oxycontin addictions and lawsuits against Purdue Pharma are a great example of the doctors not being able to get it right because they were fed junk data from Purdue. That's not that the "industry" got it wrong. It's that dis/misinformation was fed everyone. I would hope that we can all see that as an example of the "exception". Its true that this kind of stuff can happen (nothing is perfect), but it is not really evidence of what Term or myself are talking about. And its certainly not evidence of where "did my own research" would have helped in any way. Everyone was working off the same published data (which was altered).

This may have been true at some early to middle stage. But to pretend that right up until “the end” pill doctors didn’t know opioids were addictive is total ********. There was absolutely a point in time where it became patently obvious — and yet pill/ kept being prescribed (by what percentage of doctors? You tell me.) to patients.

Longtime Lurker is spot on — if the excuse is “we were fed faulty data” then how can we trust that ALL the data isn’t faulty?

What percentage of doctors prescribed opioids for secondary gain, realizing their addictive potential?

My guess? 1%, or less. My wife, a physician, thinks < 10%.

What percentage of people in your field of work are unscrupulous?

 

[Peggy]

If I hire an engineer for a project, I'm not researching it myself and checking his work.

You're a different type of person. I check everything. But that's probably the engineer in me.

And I've caught and saved a lot of mistakes. The latest being a wndow order mistake. No way I was going to replace all our windows myself, but, had I not checked the order when the windows arrived we would have had the wrong type in two windows. Good thing I didn't just leave it to the window experts.

 

[Terminalxylem]

Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic.

Thank you.

The idea it would be seen as a negative that people might dare to think for themselves instead of blindly following the directives of a massive for-profit industrial complex industry seems wild to me.

Ok, you've said this now over and over and over many times here.

There is a MASSIVE difference in what's driving the "massive for-profit industrial complex" and physicians.

Insurance companies, pharmaceuticals, hospital systems, and business administrators are the MASSIVE drivers of cost in healthcare. Not physicians. There's been a huge explosion on the business side and that's why it's spiraling out of control.

Meanwhile, physician salaries, which make up about 8% of healthcare costs, have remained virtually unchanged over the last couple decades, if not longer. In fact, when taking inflation into account, they've actually decreased. Reimbursement is going even further down as we speak. All while the business/administration tasks increase.

So, the "for-profit" area isn't being driven by physicians. Whether a physician decides to order a test or not, give a medicine or not, perform a surgery or not is not dictated by finances. A lot of physicians are salaried (I believe it's something like 70%). Even those that are productivity based, they earn more by having to work more. Physicians don't get more money by prescribing a certain medicine over another or ordering a certain test. Thus, when the face to face encounter that you're implying is being influenced by finances, that is almost entirely untrue. Are there certain instances or "bad apples"? Of course. But the VAST majority.....completely non-existent.

In fact, most of the time, it's patients coming in ASKING for certain medicines or tests or procedures and physicians having to explain why they aren't necessary. Many of those patients, which are likely the ones referred to in the OP, will then "shop around" until they find a physician willing to give in to what they want.

This implication that finances drive most medical decision making just isn't accurate.

This is a great post, especially the bolded.

 

[Max Power]

What do you mean by misinformed?

Odd question.
And answered above already: "stuff that directly conflicts with evidence-based standards of care."

So let's take covid shots for under 2 years old. Up until recently the US was one of the only countries recommending the covid shot for all babies. Most other developed nations were only recommending it for "at risk" children because that's where the evidence points to for who needs it.

A U.S. parent who didn't want to get their baby vaccinated for covid gets looked at sideways because they consume "misinformation"?

 

[gianmarco]

I'd prefer to keep thinking for myself. My doctor works for me, not the other way around. He's a primary source of information for sure, but, they're my decisions.

Can you give an example of a situation where you feel your own research puts you in better position to diagnose and treat a serious medical condition than your physician?

Plus, physicians can't/don't force you to take medicines, have tests done, or have surgeries. That's what consent is for.

They advise, then you can do with it what you want. Don't want to take the medicine they prescribed? Then don't. Don't think the surgery is necessary? Don't have it. Don't think you need the CT scan? Don't go have it done.

And best part: Don't like your physician? Go find another one.

So now we're in the quandary of making those decisions and the OP, and I think you're trying g to agree with him, thinks the only information you should consider in making those decisions is exactly what your DR told you. And it is a primary source of information. So would a second opion if you get one. But I still prefer to include my research, and more importantly my experiences as being the closest to the actual issue, and whatever other information is available to make those decisions.

Information is power and anyone making any decision ought to use any and all information available. You do that in business, you do that in relationships, you do that in every aspect in life. Suggesting your health is somehow different is absurd.

And the argument that some are suseptible to disinformation and AI is making people less smart is a different argument. But you still wouldn't tell them to listen solely to once source of information when making a business or relationship decision.

When you say "my research", what exactly is that?

Are you reading medical studies from journals written by doctors/clinical scientists? If so, are you able to determine good quality studies from not?

If so, do you think you're reading something your physician hasn't read yet? Do you feel your physician doesn't stay up to date? Why do you trust THOSE doctors but not the one you're seeing?

If it's not the above but from other sources, do you think there might be a reason your physician isn't reading "your research"? What makes this other research more helpful despite not being accepted into qualified, respected journals?

Do you feel "your research" is enough to override what your physician is recommending?


I'm genuinely curious about the above.

To answer your question, yes, I do think your physician, who has received vast training to take care of your health, should be your primary source of information. If you don't trust that physician, then get a second opinion or find another physician. But no, I don't think "your research" should play much of a factor except in very rare instances.

If I hire an engineer for a project, I'm not researching it myself and checking his work. I already made the pilot comment above. Etc.
I find it a bit much to think I could spend any amount of reading on those subjects above and think it would even remotely compare to their knowledge in that field that they specifically trained years for.

Ive found the third most valuable piece of information is found by talking with others that have had the surgery or decided not to and their outcomes, successes and regrets. Everyone knows somebody who has had a hip replacement right? And pretty soon that leads to finding out which hip surgeon is the best and which ones to avoid. For example.

The second most important is what your doctors says.

But the very most important piece of information is what your body is telling you. Every surgery we've had we knew it was time. I just can't take the hip pain anymore, something has to be done! And despite exrays and exams saying otherwise there are surgeries likely in the future that we do not need now. Bone on bone with huge spurs, doctor can't believe that shoulder even works!

And any doctor worth his salt will start with #1 above.

Ok, so, that's helpful....

1). Talking to others that have had the surgery. I think that's a GREAT way to find a doctor in your area for that specific surgery or maybe specialist or whatever. Then you can go see them and trust them and their expertise. I would 100% agree that everyone should do this, especially for specific conditions or considering surgery. I don't consider that "doing my research" in any way that was meant by the OP. And this will be location dependent.

2) At the same time, using anecdotal information from the people you talk to about whether or not to have it done, that I would NOT agree with. Even if you found 100 people and asked each about their experience, the surgeon has almost certainly done 10x-100xs more of the actual procedure. If it's not successful or recommended, they aren't going to continue to offer it as an option. No surgeon wants patients that aren't happy and do worse after surgery than before. That's just common sense. So, you might find 10 people that all say "man, don't get the hip surgery, it's been awful". But, if your surgeon is still recommending it, there is likely something specific about your case that may warrant that and is different from your anecdotes. And your surgeon's "n" is far greater than yours with intimately more knowledge about pros and cons.

So, that's an example of your own research I would definitely disagree with. I think having the discussion of "hey, I've talked to some people that had it done and they had this negative experience, can you elaborate on why that may be and why you are still recommending it" is definitely worthwhile so you can get a better understanding.

But if you're telling me that you talking to 10 people that tell you they had hip replacement and it went bad and your surgeon is recommending hip replacement and you are siding with the 10 people over your doctor, then I think that's not wise. At all.

3) What your body is telling you isn't "my research". That's part of the discussion you have with your doctor. If he's recommending no surgery and you think "I need this because of x symptoms or pain", then you have a shared discussion. And, if you still don't feel comfortable, then absolutely get a 2nd opinion. Or even a 3rd. That is also very reasonable, but that's not "doing my own research" as what was intended in the OP at all.


So, interestingly enough, most of what you wrote out is normal patient behavior and is very different from "I did my own research" that OP was referring to.

And I'm glad you actually clarified and explained it as you did. We are in far more agreement than not, I think.

 

[Terminalxylem]

Then came the over-prescription of opioids and we all know how that turned out. So the idea that doctors now have it all figured out, especially when it comes to medications being aggressively marketed for profit, feels unrealistic.

Thank you.

The idea it would be seen as a negative that people might dare to think for themselves instead of blindly following the directives of a massive for-profit industrial complex industry seems wild to me.

Ok, you've said this now over and over and over many times here.

There is a MASSIVE difference in what's driving the "massive for-profit industrial complex" and physicians.

Insurance companies, pharmaceuticals, hospital systems, and business administrators are the MASSIVE drivers of cost in healthcare. Not physicians. There's been a huge explosion on the business side and that's why it's spiraling out of control.

Meanwhile, physician salaries, which make up about 8% of healthcare costs, have remained virtually unchanged over the last couple decades, if not longer. In fact, when taking inflation into account, they've actually decreased. Reimbursement is going even further down as we speak. All while the business/administration tasks increase.

So, the "for-profit" area isn't being driven by physicians. Whether a physician decides to order a test or not, give a medicine or not, perform a surgery or not is not dictated by finances. A lot of physicians are salaried (I believe it's something like 70%). Even those that are productivity based, they earn more by having to work more. Physicians don't get more money by prescribing a certain medicine over another or ordering a certain test. Thus, when the face to face encounter that you're implying is being influenced by finances, that is almost entirely untrue. Are there certain instances or "bad apples"? Of course. But the VAST majority.....completely non-existent.

In fact, most of the time, it's patients coming in ASKING for certain medicines or tests or procedures and physicians having to explain why they aren't necessary. Many of those patients, which are likely the ones referred to in the OP, will then "shop around" until they find a physician willing to give in to what they want.

This implication that finances drive most medical decision making just isn't accurate.

Physicians are entirely complicit in the for-profit pharmaceutical business. I fully understand why they'd want to dissociate themselves from it. But there's a very good reason drug companies spend the $$$ they spend trying to influence physicians. Of course the guise is "education". And apparently no better way to educate than catering lunch for the office.

If you don't think finances drive most of the Medical Industrial Complex and the massive For-Profit corporations behind it, we'll have to disagree.

FTR, there are are many physicians who purposefully avoid Pharma reps, including their samples and "educational" meals, and place extra scrutiny on their research. We're aware of the potential for undue influence.

 

[Terminalxylem]

If you ask me, "merely daring" conveys a ton of bias and tilts the conversation.

Not a bias. It's a strong opinion. I'm not tilting the conversation. I have a strong viewpoint and I'm sharing my opinion. The fact that questioning an authority and not blindly swallowing whatever is offered is seen as a negative trigger by some is remarkable to me. And some others.

All in a span of two pages...

• lowly patient
• omniscient answers
• blindly ignore
• magical altruism
• incredibly telling
• merely daring
• blindly swallowing

And my favorite, "Are you honest with your patients."

Yeah, the rhetoric is pretty inflammatory.

Admittedly, I've become irritated by it, responding with snark of my own. That's not good, and undermines an otherwise interesting discussion imo.