If you are a dentist, "more dentistry" is likely to resonate with them as a solution, especially if that means they charge for doing the work. No different than if you ask a software developer if you should hire them to automate some process. A true pro may say "nah it's not worth it for you" but that's rare...
It's fashionable to dunk on folks who "do their own research" but I admire that more than those who are proud of unquestionably taking direction from vested parties.
The reality is that modern medicine is absolutely amazing, but there are also many interventions backed by shoddy science or no science at all. Sometimes, "doing your own research" exposes such lapses. Sometimes, it sends you off the deep end and you end up chasing ghosts. To allow the former, you need to tolerate some of the latter.
And yeah, sometimes the shoddy science involves interventions so basic and so common that you'd think they're sorted out. Consider that Europe and the US take wildly divergent views on topics such as wisdom teeth, colonoscopies, or the value of flu vaccines.
"Science literacy" doesn't shield you from being wrong. Maybe it helps, but there's no shortage of Nobel laureates who believe in conspiracy theories or promote dubious medical treatments. Talking about "science literacy" is usually just how geeks convince themselves that their beliefs can't be wrong.
Every generation the advice on which way to put your kid to sleep flip flops.
It would be shamefully foolish to disregard all the incredible advances and technologies that modern medicine offers. It would be equally shamefully foolish to think it’s not still deeply flawed.
We'll make life changing decisions based on the opinion/advice of 1 individual, while shopping around on a home project or car repair that's +/- $5k.
It seems again like a combination of shortage of medical workers and the indirect nature of medical payment. If I knew up front that walking in and getting 3 medical opinions would cost me X, and I didn't need any pre-approval from insurance, or risk denials.. I'd just go do it more. But the system is so opaque that I don't know I can get those answers readily, or believe the numbers are real and won't result in random bills later.
Further, the next step after figuring out the cost of getting options would then e getting a quote for the actual resulting medical care recommends is opaque due to differing payment %s & co-pays by procedure, etc.
I had a really bad sprain about two years ago to the point where my partner had to help me on and off the toilet. Eventually I took off work, went to urgent care, and paid $200 for them to basically say "well it's not broken, we could do an MRI otherwise we don't know what you want us to do". Booking an appointment with a GP would have taken around a month. They won't be able to do anything long term but will recommend a physical therapist. All said and done it's probably a $5-10k ordeal and weeks until I could actually see any progress, plus work time missed. Big surprise, I didn't actually end up going to see a doctor. Recovery sucked and some movements still aren't quite right.
There’s nothing more quintessentially American than “not knowing how much you are going to pay for something until you owe it.” You go for a hospital visit and nobody has even a remote, order-of-magnitude idea of what you are going to pay. But you have to sign a doc right away that says “you agree to pay whatever number we eventually come up with!” And then you slowly get dozens of bills from individual doctors and hospital workers over the next 4 months. It’s absurd.
Indeed. In my country we have a public healthcare system. I also have private insurance, which I use sometimes because you can get consultations and tests much faster; but I wouldn't do anything invasive with the private insurance before getting an opinion from a public doctor first. The incentives aren't well aligned in private healthcare. For me, the combo (trust diganoses from the public system more, but use private when convenient) seems to work well.
Public healthcare doesn't cover dentists, though, and to be honest, from other people's experience, I don't trust them much. I haven't visited one in over 20 years, and so far I haven't experienced pain or any other annoying symptoms other than some slight gum bleeding once per year or so which seems to resolve by itself by brushing and flossing more thoroughly than normal for a few days. I know it's risky and this may come to bite me later. Fingers crossed.
I can't really common about the US, but here in the UK the quality of healthcare is shocking bad. Although we may have the opposite problem, where instead of doing unnecessary procedures to increase costs, the NHS generally tries to avoid doing anything unless you're dying.
I had some pain in my abdomen a few years back and had persistently elevated liver enzymes. My doctor told continuously told me not worry about it and would say the pain was probably because I was sitting funny and other nonsense. In their opinion I was too young to have liver problems so there was no point in doing any further tests.
Fed up, I decided to do my own research and pay for my own tests. From this I found out that I have a fairly rare generic condition which makes me highly predisposed to liver disease and NAFLD. Certainly not the end of the world, but it pissed me off a bit because the disease could have progressed had I taken their advice and simply ignored it.
Around this time I also had a family friend who was the same age as me. She went to the doctors repeatedly over the course of a year describing several symptoms she was experiencing just to be dismissed. Turns out she actually had cervical cancer, but they never ran any tests and kept telling her it was probably nothing to worry about. By the time she found out she had cancer it was stage four and she died a few weeks later. She was 28 and had two kids.
Like you I believe in listening to experts. Most experts know what they're talking about and generally give good advice, but it's important to keep in mind the conditions experts operate in. Here in the UK the NHS has neither the time or money to give you high quality healthcare. It doesn't really matter if you see the best doctor in the world, if they can't spent the time and money running the tests you need you're not going to get a good diagnosis.
I have seen this in my personal life time and again. I have seen it in my professional life time and again.
The only way though the mine field is to take personal ownership over your Healthcare, you need to learn more about what ailes you than the doctors know. You need to be confident in this knowledge enough to challenge them and walk out to receive better care at any moment. This is why people say that healthcare us such a trap in the US particularly. If you are injured and incapacitated you can't advocate for yourself, and if you don't have the support infrastructure in place in your personal life we are just one medical event away from financial and physical ruin.
> The only way though the mine field is to take personal ownership over your Healthcare
Shortly after graduating from university, when I no longer had access to student health, I started hunting for a regular family physician. The guy I found... my first "let's get to know each other/annual physical" kind of appointment he said "Look, I don't know if you noticed but there are a lot of people out in the waiting room. My staff here is great, but things happen. Maybe they call you with test results and you miss the voicemail. Maybe the lab forgets to send the results. Maybe the fax from the lab gets stuck to another piece of paper. We're all human here, and I try really hard to treat each one of my patients as a real human and not just a list of symptoms on a page. If I'm going to be your doctor, there's only one thing I ask: be your own advocate. If you're expecting to hear back from us and you don't, or if you feel like we've missed something, or you have questions, or... anything really, please don't hesitate to follow up. I promise I'm going to do my best to look after your health, but you care about it more than anyone else in the world. Does that work for you?"
He was, by far, the best damned doctor I've ever had. And then, apparently, one day he had a serious family emergency back home and vanished, never to return :(.
He know the realities of the system and is doing his best to get his patients good care.
It's like my first day of high school. I had a history teacher. The entire first class of history in high school was devoted to knowing yourself. He told us in basic terms how our bodies worked, that we shouldn't try to dp homework after a big meal, how we should use our resources, how we should be respectful, how learning the laws and history of our country could personally impact or protect us from injustice.
He treated us like equal human beings he truly wanted to help, not just work he had to do that day.
You're doctor did the same, blessings on him.
Everyone in the UK should get to experience a private consultation just once. The difference between the rushed 10mins you get with the NHS and the considered 30mins you get private is amazing. You leave feeling like you’ve been taken care of and all your questions have been answered. It’s only when you see this you can see just how bad the quality of care in the NHS is at the moment. We need to stop equating the NHS with the people that work for it and start calling it out for how god awful it is. We’ve made it a dirty that can’t be criticised properly when it sorely needs to be.
However, I do want to provide an anecdote to illustrate that private healthcare is not perfect. I had some persistent pain in my foot. Realized I wouldn't get anywhere with the NHS so I went private. The person I saw had an excellent manner. They suggested some fairly gnarly surgery. Said I should think about it and in the meantime they gave me an anti-inflammatory injection. My problem cleared up in about two weeks. What was wrong: I have really really wide feet (seriously; they are wider than the widest setting on the foot measuring device they use at shoe shops.) I didn't know this. I was wearing Chuck Taylors, which are very narrow, and they were pinching my feet. I didn't wear my Chucks over the two weeks and I figured out what was wrong in that time. What I learned: everyone has a toolbox they want to reach into. In this case I was seen by a surgeon so they of course turned to surgery as solution. Always be your own advocate, to the best of your ability, in healthcare. (I thought the surgeon might have said something about the width of my feet given they spent so much time looking at feet.)
There might be an age component to it: the risk of it not healing correctly increases with age.
This is true for fairly simple cases. But when something is complex or very serious you want a true multidisciplinary team that sees the most cases per annum - that is the NHS.
A private consultant in a nice office with a very nice efficient secretary is great for their particular expertise but outside of that poor. This is based on more experience personally and with family than I would wish anyone to have.
I was diagnosed after a blood test (in the US) but they just put me on a statin (high cholesterol medication) that fixed only what the blood test showed and did not treat the problem. Now I’m having to, with 10 fewer years than when learned it, drastically adjust my life and diet to ensure I won’t develop additional complications.
Why are we so hilariously bad at treating chronic problems?
Btw through generic genealogy, I’ve managed to pinpoint which branch of my family that this comes from and they’re all from Yorkshire. Given how rare it is, there is a nonzero chance we are cousins of some sort if you have semi-recent ancestral origins there.
They time their appointments ever 2 minutes so you’re expected to arrive early. Once you start, they wiz you around to about a dozen tests including getting hooked up to electrodes while running on a treadmill. After less than an hour you see a doctor who goes through everything for about 15 very detailed and thoughtful minutes.
The entire thing is FREE! Completely publicly funded.
I don’t know much about healthcare but this type of thing always struck me as a missing apparatus of healthcare in the US. Although apparently Favoloro (who invented some kind of bypass surgery) founded the Institute after being inspired by the Cleveland Clinic.
Would love to hear other people’s thoughts on this because I tell that story all the time!
USA healthcare system burns me out.
I don't know how effective it is, and how much of it is theater.
They may not know either.
Most of our research is studying how well treatments work on "patients that came in with _____ symptoms and we found test X Y and Z was outside of the normal range".
Does that mean you should use the same treatments when you have X Y and Z out of range but without symptoms? We often don't know.
Interesting. I was considering commenting that your experience sounds a lot like the VIP (using the term loosely here, it's much more accessible than "multi-millionaire") care available at the Mayo Clinic. You can accomplish in a day or two what would typically take months to years in many areas of the US, including mine.
But at the same time it is very important to brush you teeth twice a day and floss weekly. You should also avoid sugary food as much as possible.
Dentistry is much like Realtors, they like to take credit for very little actual work.
"If I'm not here to confirm people are brushing regularly everyone would lose all their teeth"
"I'm so glad I could sell your house for 500k. Without me you may have never sold it"
Here's an article about the study: https://nutritionfacts.org/blog/raisins-and-dental-health/
Sugar.
For me daily makes a big difference. If I leave it until weekly my gums will start to suffer for it.
I use the little floss picks, as they're much easier to manage for me than floss, and - here's something - they're reusable. Rinse them off like you would your toothbrush and you can keep those suckers going for a long time. You can also get them made from bio-plastic, so that they'll degrade once they go to landfill.
The double string ones are really good, as they catch a lot of gunk in the gap between them.
where would be the conspiracy in your experience anyway?
> But that experience shook me and forever changed my trust in the dental industry.
don't trust any industry. industry is always about making money and keeping a comfortable status quo. sometimes this is achieved through conspiracies.
Did you mean an oral surgeon?
Thankfully it's just enough to the side to not be visible so I am getting away without one. (Though I think it's also problematic long term, because remaining teeth would shift.)
Never again to trust a dentist, no matter if it's a private clinic in developed country with supposedly great healthcare. Always talk, discuss and research and ask around enough to make own judgement...
My dentist also told me that tooth extraction is a last-ditch effort. But that come sooner than you would like; after one rounds of antibiotics, if the pain come back but there are no apparent mechanical defect in the tooth yet the roots are blurry on the x-rays, the probability that a root canal treatment would be successful is quite small and extraction followed by an implant is your best bet.
It’s hard to shop around for dentists but when you find a good one it’s life changing.
antidepressants (1 in 5 middle aged women)
opiates (mostly an epidemic for men)
amphetamines for ADHD (adderal, ritalin)
autism (this increase may actually be the most legit)
gender dysphoria (5% of young adults now)
DSM-5 has made it easier to diagnose someone with these things, boosting recurring revenues for the psychiatry and pharma industry.
And then look at the Tax Preparation industry, which always lobbies to keep things complex and perpetuate the individual income tax. If there was ever something that marched Graeber’s Bullshit Jobs essay, it’s that.
Take gender dysphoria for instance. It used to be called Gender Identity Disorder in DSM-4. Then it was renamed, and the approach of listing “Disorders” became replaced with “Traits” to lessen the stigma of a “disorder” while at the same time identifying traits that present in many otherwise normal individuals. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.1...
It is now becoming normalized to the point that 1 in 20 young adults identifies as nonbinary. Where it doesn’t add up is that this dysphoria was a serious disorder whose side effects included attempting suicide at a rate of 30-50%, depending on which study you looked at! Now, are you going to tell me that 2% of all young adults are attempting suicide in USA? Somehow I doubt that. It is too high. Hence it is overreported and overdiagnosed. The “social contagion” theory from 2018 is a part of an alternative answer but it goes deeper than that. It has to do with society making both parents work harder than ever to make ends meet and abandoning its children to be raised by school administrators. It has to do with capitalist industries like the music industry pushing gangst rap / drill music to young kids, instagram / tiktok pushing sexualization and much more very early on.
ADHD seems to be the new “hysteria” — for children instead of women. Hysteria was a catch-all “disorder” that was massively overdiagnosed, and by the way is how the medical industry invented the vibrator. Turns out the problem was upstream. Go figure! https://www.bbc.com/future/article/20181107-the-history-of-t...
Today, one in five middle aged women is given SSRIs and ADHD kids are medicated with amphetamines! And many people are conditioned to carry water for the industry, and shut down any questioning of it. Until meta-studies come out to debunk the industry’s claims: https://www.nature.com/articles/s41380-022-01661-0
What I would say is, we should try to fix our capitalist society where both parents work for corporations and stick their kids in public schools where they have to sit still for long periods, and which are modeled on the outdated corporation / factory model. Look at other countries, eg Finland has much better aligned schools and the prevalence of ADHD is far lower.
Same thing with society in general. Middle-aged women are depressed for a reason. With the rise in divorce rates they are often divorced, feeling unattractive and alone. Our society has a lot sad lonely people, our people live in cities, order amazon and food in, and hardly know even their neighbors:
https://en.m.wikipedia.org/wiki/Bowling_Alone
Record levels of sadness in teens — look at TikTok and sexualization of women and body images, before prescribing antidepressants.
How does that work?
Between that and the water-carrying for anti-trans bigots, this has no place here.
Just because people are being systematically squelched for questioning gangsta rap or giving amphetamines to kids doesn’t mean they are “bigots”. They may care more about individuals than the people who view the kids as just a cog in a machine, and the administrators who cover their butt and barely know anything about the kid.
I believe that water-carrying is being done in the other direction far more — the capitalist industries that make a profit.
Check out the following issues and ask yourself whether all they have in common is “conspiracy nuts”, or whether on the other side they have a highly organized cooperation to push a change through, and to deplatform and delegitimize anyone — even previously respected experts or people whose job it is to deal with these issues - who dares to make too much noise or criticize whatever agenda is pushed:
Weapons industry / military industrial complex — the latest being the war in Ukraine, but previously in Iraq etc.
Plastic - recycling (later revealed to be a scam)
Depression - I saw lots of pushback right here on HN when questioning SSRIs and imbalance theory, but since the 2022 meta-study that died down
Vaccines - we are all aware of how pervasive the push for censorship was, just look at the latest revelations out of FB, Twitter
(CBDCs and National IDs - coming soon)
Gangsta Rap - anyone speaking against it or its misogyny is attacked
Trans activism - anyone voicing any concern for overdiagnosis, or the economic system that separates kids from both their parents, or even continues to use the psychiatric perspective of a disorder or dysphoria out of a concern for children, is shamed as “on the wrong side of history”.
BLM - Anyone discussing any other killings other than by cops of unarmed Black men was systematically attacked
MeToo - Men told to be quiet, listen and not be part of the conversation. Once again rape is very important topic, but the concept got “overdiagnosed” and stretched to the point where someone like Matt Damon making a nuanced distinction becomes persona non grata
To be clear, a man disagreeing with the following tweet is not the same as normalizing rape, but look how quick one side (the water-carrying one, in my opinion) is to paint the other as an “antisemitic/racist/white supremacist/misogynist/putin-supporting/bigot” for merely speaking up and voicing different opinion: https://twitter.com/driverminnie/status/941905518284566528?s...
There are groups who pounce on anyone attributing disparities in economic outcomes to any other factors than the one-dimensional explanation of systemic sexism, racism, etc. It is like when some Zionists explain criticism of Israel purely in terms of systemic antisemitism, or some anti-Zionists navel-gaze at Israel call it the world’s worst violator of human rights and hurl epithets at anyone who mildly disgrees. When you have an agenda you tend to do lots of adhominems. It shuts down the conversation and prevents real discussion exploring other factors. Because institutions have an agenda and they co-opt people into enforcing it. Whether it’s regular Han Chinese in China supporting the locking up of Uyghurs for the “greater good”. Or Sunni/Shiite proxy wars in Yemen. Their “solutions” are invariably worse than the problem, which in any case is upstream and probably due to the very institution and government working together to create it.
The well-meaning activists who carry water for these industries and agendas do not engage in good faith. They are so convinced they are morally superior that they simply insinuate you’re a bad person and then respond in passive-aggressive one-liners!
I said the systemic causes of problems are upstream. I named several of them: A, B, C that exacerbates X, Y, Z. That doesn’t mean A causes Z.
Gangsta Rap may be responsible for a totally different phenomenon than gender dysphoria: namely, the increase in violence, misogyny etc. in some Black communities. With the rise of Black music moguls it became essentially self-blaxploitation:
https://m.youtube.com/watch?v=Pr6gb1w72xA
And also influenced a lot of bad memes among many Black youth:
https://en.m.wikipedia.org/wiki/Acting_white
https://en.m.wikipedia.org/wiki/Sagging_(fashion)
This in turn hurt their economic chances as a class, to get high-paying jobs.
This shares elements with other similar examples, which are nevertheless distinct. For example, TikTok and Instagram harming the psyche of young teen girls, with one in three attempting suicide:
https://www.chconline.org/resourcelibrary/teen-girls-report-...
That’s insane! This was NOT the case in previous generations. But notice how few people in mainstream media talk about the upstream causes, and how they mostly discuss medicating this newfound problem away.
Similarly with diabetes, very few people talk about the prevalence of sugar in so many plants we eat (fructose in fruits for instance) or the government actually supporting high fructose corn syrup and genetically modified crops with sugar… or factory farms and so on…
https://weather.com/news/news/2018-10-03-fruit-so-sweet-zoo-...
Once you see it, you can’t unsee it:
Whereas something like, say, gender dysphoria has positively exploded in diagnoses. It’s a worrying disorder, which (eg unlike autism) studies show leads 30-50% to attempt suicide. So any increase in its prevalence to 5% of the emerging US population is worrying. If this was, say, a coronavirus with that kind of risk to life, we’d all be worried.
I want to be clear - I am not saying that the symptoms aren’t real and that “this is all in their head”, or that we need “conversion therapy” or something. I an saying the major systemic problems are upstream and by changing THE SYSTEM we will reduce the incidence instead of only focusing on medical interventions downstream as bandaids.
As an analogy — if we addressed antibiotic overuse on factory farms and sugar and high fructose corn syrup and pink slime, fast foods etc. we could address the epidemics of obesity and diabetes, including in children. But instead we focus on inventing new ways to medicate them!
And when the coronavirus comes around, instead of recognizing that these very same factors (obesity and diabtetes) are highly correlated with morbidity and mortality with that virus, we once again look for vaccines against the virus and once it subsides we continue to IGNORE all the systemic upstream factors in the underlying chronic epidemics in USA.
Autism could very well be yet another one, maybe it is like autoimmune diseases that are related to microplastics, maybe they affect hormones like aestrogen and testosterone. We need to LOOK UPSTREAM.
In no country is it true that 5% of young adults have been diagnosed with gender dysphoria.
Perhaps people are trivializing the actual affliction and are “appropriating” the identity the way it has been done with blackface or wearing drag for the fun of it etc. I actually hope so since the opposite would imply a lot of psychological torment. But regardless, we must once again look at society and upstream issues.
For example, if a girl preferred traditionally male activities, today that is 1 of 2 criteria she needs to be considered as having gender dysphoria, while in the past she’d be called a Tomboy before. That was a normal acceptable category for explaining her tendencies. It didn’t come with an assumption that she is “REALLY” a boy inside and should make a decision on whether to take advantage of the latest technology to physically transition her gender before she hits puberty. And to be fair, the amount of people undergoing hormone blockers or surgeries is still low compared to the number of young kids who identify as trans. But if the capitalist psych and pharma industries have their way, they’ll push it to increase.
Most tomboys eventually changed as they got older, it was a phase, and it was contextualized differently by society. Also they had a mom at home, raising them, etc. Today both parents are away. School administrators cover their butt and say the parents can’t be notified and even if they do, they have no say. A lot of the industry increasingly is pushing ONE interpretation on all cases. An interpretstion that didn’t exist even 10 years ago. This is an experiment in novel interpretations and it’s not working well so far in terms of mental health outcomes.
Many times throughout history we had such interpretations (eg Hysteria for women, or chemical castration for gays) it turned out that the problem was societal.
Sorry, I don't have the energy to respond to the other stuff, but I really think you're mixing together the criteria for adults with the criteria for children.
Also, there are many antidepressants... I don't think there is a solid ground for why they describe a specific one for certain patients.
Check these too:
https://webcache.googleusercontent.com/search?q=cache:https%...
https://webcache.googleusercontent.com/search?q=cache:https%...
https://www.nature.com/articles/193377a0
What makes it difficult for some experts, is that they perhaps dont know there can be 1000-2000 mitochondria per liver cell, and Mn Super Oxide Dismutase increases with manganese intake and beta alanine, which is required for MnSOD.
Point being are symptoms of depression caused by not enough manganese and beta alanine, when looking at how its missing from so much food and water.
When looking at aging, at end of life, feeling the cold is also a symptom of not enough manganese as the iron based reactive oxygen species generates the most heat in the body, ergo increase MnSod, more of the iron based ROS in the mitochondria can take place, like unblocking a drain.
Even the WHO have just rolled back on its manganese in drinking water guidelines.[1]
High fat diets also increase the faecal excretion of manganese, and alcohol contributes to manganese deficiency.
The risk with it, is with kids getting too much as it triggers puberty early as it increases luteinising hormone, and in adults, this would suggest an increase in sexual activity, which from a law enforcement point of view, is undesirable, but also probably explains why Weed makes people horny besides it phytoestrogens, namely because leaves, including tobacco will have the most amount of manganese in.
So it would seem there is a lot of meta data pointing to not enough manganese. Water regulations also require manganese to be removed from the potable water in the UK, so there will only be a few micrograms of the stuff in water.
Obviously pre-internet and personal mobile surveillance phones, trying to find and identify a chemical change to control the population would have been order of the day, but when seeing the rise in depression, have we reached a point where its becoming obvious there isnt enough manganese in our diet?
I could put lots of links up, but cant be bothered at this stage.
Did you or someone you know try to take a manganese supplement and see the effects?
I think that term has lost all meaning. A more appropriate term for someone who no longer blindly trusts expert consensus without question is an inquisitive skeptic who takes in expert opinions and applies reason, judgement, analysis and data to determine a course of action.
It’s becoming more and more recognized that expert consensus has become highly politicized and that the problem with blindly following the science is that science often follows the money.
The problem for the most part in all industries is we have moved from a system of experts to a system of credentials. Now one would say that in order to get a credential in something one must be an "expert" but this is far far from the truth, there are all kinds of competing incentives to ensure an ever increasing supply of "credentialed" professionals that have nothing to do with validation of their expertise in a given field or subject.
It does not matter if it something like an electrician, or brain surgeon, from teaching, to physics, and everything in between including medicine, we favor credentials now not expertise
Largely the consumer public simply looks to see if this person as the correct credential. license, etc for the given job... Consumers often lack the resources, information, or decisions tree in most instances to look for any indicators of actual knowledge in the field beyond that credential
This is true. I have no clue how to check the expertise of my dentist, apart from using my own mental bullshit detector (of limited use here) and reading reviews by others (also of questionable use, because who reviews their dentist? And where?).
The analogous problem exists for certain kinds of expensive products with the property that they usually work well, but sometimes become flaky. Think a washing machine. Who posts a review about their washing machine four years post-date that it's still going strong? And absence of base rate information makes absolute numbers of bad reviews mostly meaningless.
that is a different problem, consumerism killed that. There used to be several media companies that focused on long term durability of "durable goods" like washing machines and such
But today most people buy new appliances not when they fail but when they need to upgrade to the latest technology, or because new government regulations makes them unfeasible to use / service, or because the Calendar function on their smart fridge does not work with google cloud anymore (true story), etc...
From my experience, the biggest issue is that a lot of the appliances and other gadgets we have these days are very complex. You have to be an electrical engineers, software engineer and a mechanical engineer, or a big service company that employs all three, to be able to fix anything.
Additionally it's sometimes really difficult to find service manuals for a lot of these things. If your doodat is flashing error code E-71-X1-C and the user manual you have just says "call for service", what are you going to do about it? You typically need pretty serious google-fu magic to find enough information to start figuring out what's wrong.
When my dryer broke several years ago I think I found the proper service manual for it on a site that looked exactly like a SEO spam site and seriously sketchy. Downloading the PDF I was praying my anti-virus application was up-to-date.
Call for service.
It’s at least better than the populist solution of anti-experts chosen on the basis of charisma or “truthiness.”
Your first part is more challenging because what you find is the people with true expertise in their field are often far to busy and/or have no interest in validating other experts so the people doing the validation at best are on the lowest end of the spectrum of "experts" which naturally causes the spectrum to expand.
Further you will find in many many many fields the method of obtain a credential is has no connection to another expert vouching for you, it is matter of simply passing some kind of standardized test, and completing a required amount of training
For example one that has been in the recent news is Airline Pilots where you have to have a fix number of flight hours to be a commercial pilots, many pilots get those hours by fly pipe or other utility line check operations which is done a clear day, fixed altitude, fixed path and with limited deviation. So the value of those hours would be far less than the same person flying in varied conditions, in varied locations, etc.
Ask anybody who’s experienced a “chronic” illness about the “experts” and they’ll tell you a tale or two. The experts are great until they have a case that is unusual. The don’t have the time or knowledge to treat you properly. You get passed from “expert” to “expert” each time having your hopes dashed. You start feeling like a conspiracy nut chatting with other patients online sharing what’s anecdotally helped. After running into this issue more than once I’ve lost all blind trust in medical experts. I’ll verify what they tell me as best I can and get second opinions if necessary. In one case I was passed up the chain of experts until I finally found the right one myself after a year, and it still blows my mind that this wasn’t the first referral. The system is at the same time incredible and awful.
I wouldn't assume that - just because the money isn't coming from your pocket directly, it's inevitable there are doctors that milk the system. But you'd think bureaucrats whose job it is to assess the legitimacy of requests to the NHS (or equivalent institution in your own country) for payment might be harder to swindle than your typical patient.
Truth is that modern medicine still knows much less than is often assumed, let alone individual doctors. There's an absurd amount of potential for LLMs here.
> There's an absurd amount of potential for LLMs here.
The problem is not that doctors are stupid, the problem is that a lot of ailments are just not easily diagnosed. Even if the doctor has one (or more) suspicions what the red rash on your skin is, there just aren't any tests for many conditions. Many diseases are only diagnosed by symptoms and the underlying cause is unknown.
And even if you get a diagnosis, there is often nothing you can do.
LLMs are not going to magically come up with cures.
https://coinbrain.com/coins/bnb-0xb131f5e8ec273af4652eecdd87...
This will change everything
There aren't any tests that the doctor has on hand, because the doctor is a unit in the medical system designed to provision affordable care instead of a scientist attempting to cure you. It would be too expensive to test you, especially for something that will probably go away on its own.
Everyone who talks to the patient, who touches them, and who is consulted by the doctor, gets to charge. Yup, that means if another doctor happens to walk by, and confirms what he just told me, he gets to charge me again (double).
Feels like theatre every time I go to the doctor, so I just tell the secretary "I'm talking to you and Doc, no one else", and just quietly stare at anyone else who pops in.
Usually insurance covers this stuff, but I was uninsured when I discovered it .
This is accurate. Years ago I had a kidney stone and the GP asked for an IVU (Intravenous urography) image to make sure about the size. The report prepared by the radiologist had the statement "operation is required".
When I got back to my GP just laughed sarcastically and told me that it was nothing to be worried of. He also said "the radiologist just wanted to return the favor, in case the GP wanted to operate". He was sick of this scheme too, but there was nothing he could do.
I was so pissed by this I created a way to find experts. People that actually studied the issue, have actual publish papers on the topic. What I found was no one cared. No one wanted "experts" - they want a specialist that is in their network and close.
Example of searching for mohs surgury. https://www.opendoctor.io/research/?research_papers=mohs&zip...
I struggled with back pain and told to go to a neurologist and informed my GP where I would and wouldn't go. The doc I was referred to was a no-go since I know him personally and he's a lying piece of shit in his personal life, I'm not trusting him with my back! Docs could NOT understand. "But he's so nice." Screw that.
Time and again, family and friends settle. I understand the insurance component, but even then, can you not find better?
And thank you for your work. It's very cool.
In US healthcare you have to be your own advocate and be willing to push. The system breaks down if you don't have a routine and obvious illness.
Now dentists...when we had money we went to a family friend. He still totally f'd us and did unnecessary work. It's only now that I have a cash only country dentist that I trust my dentist again. Crazy part is the cash only dentist ends up being cheaper than my previous copay/premiums insurance dentists.
My wife and I have both had to see various specialists. Some had very long wait times, many didn't, and of those that did, we were (fortunately) able to call around to different clinics to find one that wasn't too bad.
The exceptions are part of that data set
Really...
A few minutes research suggests it's not that expensive. (As little as ~2000/year).
However, that is beside the point. Believe me, I hate explaining simple, simple things--but the person I was responding to is probably comfortably middle or upper-middle class and could afford a miserable 2000/year on a doctor. He doesn't have to become "rich enough", and almost 100 percent of the people in this thread don't have to either.
2 k is a lot for even those at the 50th percentile and extremely significant for those below it.
Min wage earners make about 30k, so that 2k is 6.6% of thier income....
I mean, the wait times sometimes are, but they vary by province. More conservative provinces have worse wait times. That is not surprising given that the provincial conservative government are all actively attempting to sabotage public healthcare so we can move to an American style system. A system where we will all pay more, and still see similar wait times anyway.
MAID is not actively proposed as a way to save resources.
This feels like a pretty glaring generalization. If we look at the actual data, the story becomes a little more nuanced [1]. "Conservative" provinces have wait times that are a couple of days to a couple of weeks higher than national average (assuming we call BC, AB, SK and MB "conservative" [2]), but then again almost all of the maritimes provinces (which are considered strongly liberal-leaning) have abysmally bad wait times relative to the average (10-20 weeks worse).
Overall, the average is ~half a year anyways, which is pretty rough regardless.
[1] - https://www.fraserinstitute.org/file/waiting-your-turn-2021-... [2] - https://en.wikipedia.org/wiki/2021_Canadian_federal_election, "Results by province and territory
And nice lies dude. They all have over double the national average!
Don’t use Fraser institute for sources. They are a far right “think” tank. If they posted it, it’s a lie or misrepresentation.
I'm not aware of the reverse (admittedly, that would require more than just $$).
The reason to go to Mexico is price. The reason to go to the U.S. is quality.
How about for Canada vs the U.S.?
If you're a Canadian citizen, Canadian healthcare is cheaper, but generally has much longer wait times.
U.S. healthcare is much more expensive, but much more quickly available, and specialty care (e.g., rare disease treatment) is much better.
She will be able to see a psychiatrist "when one is available in the fall."
https://web.archive.org/web/20230809170345/https://www.thegl...
Getting a routine gynecological appointment for my wife any time in the next six months is impossible. I gave up on trying to get an appointment with an allergist for myself, even after getting a referral. What you describe is common in the US too, even for those with means. I cannot imagine what it is like for somebody who doesn't have money and insurance.
I wanted to get a sleep study done to get to the bottom of my occasional insomnia. My PCP at the time put in the pulmonologist referral (because this hospital network required a referral to get a sleep study done, which is insane in its own right, but that's neither here nor there).
This was in January. His next available appointment? March! For a friggin sleep study! And I have a HDHP + HSA and was going to pay full boat!
(He also prescribed me with an antipsychotic that can double as a sleep aid at low dosages, which I didn't take because five minutes of research into it made it obvious that taking that for extended periods of time is bad news bears. I stopped seeing him after that.)
(For those looking for answers like I was, I eventually stumbled upon Cognitive Behavioral Therapy for Insomnia, or CBT-I. It's essentially a rigid sliding window-style sleep schedule plus challenge therapy to make you rethink how you approach sleep. I've been doing this for six months now and it has been transformational. Best part? No meds!)
[1] Or shit, even a PCP that accepts new patients.
Really, you just engaged in deception and promulgation of propaganda intended to push people toward neofascist ideology.
Shame on you.
Went from nothing/reluctance to popular for some segments of the population
100% the same thing on this side of the pond, US healthcare isn’t special here.
To be fair, doctors are usually overworked and on a human level I understand that the system is a bit broken, but it's still infuriating when it's your health that is suffering.
It gave me a new perspective on that kind of work. From my/our point of view, I was the most important person in the room and my problems really really matter.
From the doctor or dentists POV, I'm one a long long list of people they're seeing that day. It's a health care production line, and even if they have the inclination to be equally caring about everyone - which is a rare quality, because a good medical professionals are only in it for the money - they just don't have the time.
This is not an excuse unprofessional behaviour. But it made me realise that self-advocacy works because you're asking - maybe demanding - more than the production line gives you by default.
Also, medicine is incredibly complicated. And the research is often very low quality.
And that's not taking into account Big Pharma trying to tout its products, whether or not they're suitable or effective.
The most depressing thing recently has been the professional response to Covid. In the UK countless doctors have aggressively given up masking, even in settings with immunocompromised patients.
It's really made it obvious that some doctors are just in it for the money, a good few are phoning it in, surprisingly many have quite irrational beliefs, and the caring expert professionals are much rarer than they should be.
It’s just “extraordinary”.
People have weird habits, weird diets, are exposed to weird chemicals in small amounts over extended periods of time, etc. There are all kinds of genetic factors where something can be really minor for most people and debilitating for others. There are all kinds or problems or diseases that people can have, and there can be weird combinations that interact or provide an overall confusing array of symptoms. And it's all mixed up with the patient's brain, which may be exacerbating or compensating in all kinds of ways (psychologically or through behaviors that the patient develops).
It may be because they see a wider range of illnesses and this empathy/awareness might not work well with the patients are of varying ethnicity and race but they’re pretty good if you look past the exterior - shabby offices, gruff manner.
That's with 3 different people and a handful of different doctors. They are actually pretty eager to look inside your stomach out here heheh. I'm really sorry to hear that happened to your friend though! I hope they're doing better now!
Private healthcare is basically broken out the gate, public healthcare can be much better but it still does need to be funded.
Much of Europe went wild assuming that we would always have 5 to 7 workers per person retired to care for, and I won’t be surprised if we get down to 1 to 2 in the next 50 years.
That’s a type of system collapse people aren’t prepared for.
Clearly both systems have benefits and drawbacks.
The main complaint about the UK system that people quote is "it takes a while to see a doctor" but that's true about most people here in the US as well. If you have not top-line insurance or live in a slightly rural area or a million other things.
Not sure if this practice is just shit or if all of them are. They then have the audacity to strike too. I've had absolutely zero sympathy for them since the months long ordeal of being in pain and taking pills that made me feel worse rather than better. Fucking disgraceful is what it has become.
Humans don't have a full understanding of everything, and in fact it's quite the opposite, in that we don't understand almost everything. Almost all paths are untrodden. It's fine to look where others haven't and come up with your own theories and ideas, as long as you retain a healthy skepticism and back things up with data as much as you can.
Science and exploration should not use fear of social reprisal as a guide.
Until COVID came around and unearthed the absolute hoards of dO yOuR oWn ReSeArCh imbeciles. Now the sensible practice of getting a second opinion and exploring other options/doctors has been mixed up with the kooks: extreme politics and actual conspiracy theories, to the point where it’s hard to take any of it seriously.
When someone now says they don’t trust doctors, you have to dig deeper to understand if it’s someone genuinely seeking out other options, or if it’s one of Those People who’ve gone off the deep end.
For example, Western health authorities used to be absolutely certain that viruses could not be airborne (outside of very specific medical procedures), even though they did not have any good reason or evidence to back that up: it was just an old idea that happened to fit in with their priors, so generations of experts kept parroting it until horror unfolded.
God didn’t do it
Gravity is the curvature of spacetime
Things are not attracted to the planet through static electricity
Covid is real
Vaccines work
Rich mother fuckers do NOT have our best interests at heart
Intelligent aliens have not visited earth
People are called conspiracy nuts for being conspiracy nuts. Not for “taking less trodden paths”. Getting real tired of the HNs new “wahh wahh, we’re such major victims for believing stupid shit and being called out on it!” And just trying to paint it as “less trodden paths”.
It’s impossible to take anything in your post seriously because it’s entirely conspiracy theorist copy pasta.
“I’m the victim here for daring to believe the earth is flat and we’re being lied to by the governments, who’s engaged in a massive conspiracy that’s millions of people large, and costs more than the planets gdp to keep alive so as to convince people that’s gods not real”
You’re being called a conspiracy nut because you are one. The only victims are the people in shouting dictance of the bullshit spewing from your mouth.
Similarly, I will certainly and absolutely NOT stop calling out conspiracy theorist propaganda just because conspiracy nuts don’t like it.
If you don’t like being called out for posting conspiracy propaganda, don’t post it, and don’t defend it.
So go away!
You went ham on someone sharing a comment about their son's dentists. Maybe touch grass and stop being so angry, eh? The only conspiracy 'nut' here is you, who is inserting themselves by going "look at me, look at me" at someone sharing their experience.
>I will certainly and absolutely NOT stop calling out
I feel sorry for everyone in your family who has to suffer this.
It is never used in the spirit of promoting insightful discussion.
Instead it is used to shut down a line of inquiry in its tracks. It’s like calling someone an anti-semite.
It is used as a soft form of censorship, to disqualify the mere idea of engaging in the specifics of an argument.
If someone dismisses a comment by implying it is a conspiracy instead of offering a substantive rebuttal of why the comment is mistaken, it reduces the quality of the entire community.
I think we can do better, but more people need to call out this bad behavior.
I reserve the right to dismiss low-quality posts with a low-quality answer. And yes, that's a judgement call. There is no way around that.
People get called conspiracy nuts when they make big claims with no real evidence. That is the opposite of 'science and exploration'. The difference is always evidence. Go on a conspiracy site and ask for hard evidence of anything and they will get very upset.
On the other hand, from the administrator's perspective:
"Your team of four people treat about one patient a week, why am I paying your salaries again?"
In our universe, I probably won't receive that much medical care in my lifetime.
(But I know I was lucky - my oncologist could order a river to reverse itself and it probably would.)
I don't really know how it works in the US but here in Brazil it's actually pretty easy to order laboratory tests and imaging studies. There's taxpayer funded public health care but it can't handle the demands of the entire population so people would rather pay for the ultrasound or CT scan than wait two years for the government to provide it. An ultrasound costs about $30, an MRI costs about $150 and the price of a CT scan is somewhere between those two.
Don't even get me started on diseases where we have medication that sort of works with tons of side effect where no significant progress has been made for decades. If you're alergic to the said medication or your side effects make it a no go, tough luck!
But this is true for every thing in the planet. Data modelling, computer programming, building, everything. Name something that the unusual is not more complicated and difficult to do.
Why would anyone think that it would not be true for the health field??
I think the problem is people think health is magical and everything is known. Because they choose not to educate themselves.
The problem is most doctors have absolutely no humility and will never admit to not knowing something. I don't see that behavior among engineers.
That is incredibly surprising.
Sometimes (when possible) you just reset yourself: stop all medications for some days, so that the collateral effects are gone and you're left with the original condition (aggravated, of course, because you left the one medication that was working with the 3 others that were just giving you wrong symptoms), and then another "expert" begins from the "start".
The practice of medicine is not science. The practice of medicine can be informed by science - to a degree that is almost entirely up to the practitioner. ; but it remains more art than science. The distinction is similar to that between an aviation maintenance and aerospace engineering.
Sometimes doctors are just out of their depth.
Which is which though? As I understand it, aviation maintenance is quite rigorous, systematic, and informed by and taking into account every mistake made in the past.
When you compare their behaviors to IT it all starts making sense.
Honestly of all the professions that could be enhanced by AI, medicine has the most to gain. An AI can remember a much larger data set than any human and look for correlations among many more dimensions.
They are so unreasonably effective for being, fundamentally, word predictors.
As do I.
a lot of the 'magic' around being human evaporates when you have to quantify the 'worth' of any particular organ
untangling this closed-source blob always reveals secrets: 2023 just had an update to anatomy! https://www.urmc.rochester.edu/news/story/newly-discovered-a...
Hopefully medical science will keep advancing rapidly here..
I’m hoping AI systems can help. A good medical AI should be able to stay abreast of all the research, know your personal medical history and suggest and evaluate any and all medical tests that are needed. Doctors will hate it, but I expect AIs will give much more accurate diagnoses than humans before long.
It's a really ideal use case for AI - not only figuring these things out but also doing things like clinical trial and research matching.
In neurology at least, I think a lot of the problem is that everyone is hyper-specialized. Luckily for us, my wife's insurance company convinced a generalist neurologist to come out of retirement and examine her, which put us on the path to effective treatment. But yes, that whole experience completely soured me on blind trust in the medical profession
Doctors tend to believe that female patients exaggerate pain in comparison to male patients, in accordance with stereotypes that portray men as "stoic" and women as "emotional". The bias is systemic, with female doctors often assuming the stereotype too[1].
You can trace this bias back through medical literature which (often subconsciously) reiterates these stereotypes[2]. It shows up in many statistics, such as the difference in wait times for analgesics: women reporting pain had to wait an average of 30% longer than men.[3]
But a key cause of the problem is worse than just assumption of stereotypes: it's that modern medicine still knows far more about men than it does women. For centuries, the primary medical research and literature was done by men, about men, for the treatment of men. Most of the clinical trials performed in the 20th century enrolled far fewer women than men, and often _none at all_.[4]
Of course, gender is not the only bias that shows up in medicine. Age, race, (dis)ability, body shape, and economic/social status are all useful factors to keep in mind when considering why certain people, even entire sectors of society, aren't getting the treatment they should.
- [1] https://www.dovepress.com/the-roles-of-gender-and-profession... - [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845507/ - [3] https://onlinelibrary.wiley.com/doi/full/10.1111/j.1553-2712... - [4] https://www.theguardian.com/lifeandstyle/2019/nov/13/the-fem...
But to be honest: There are also some motivated and honest doctors. If you find one of these, stick to them.
Also the very standard cases, they can mess up very badly.
"The system is at the same time incredible and awful."
The science behind the medicine is awesome, but the standard implementation is horrible and not up to at all, where we could be.
1. Don't mouthbreathe and don't overbreathe. See "Breath - The New Science of A Lost Art" by James Nestor for why and how.
2. Don't eat sugar, it's a chronic poison. See https://www.youtube.com/watch?v=dBnniua6-oM
3. Min. 1 hr of physical activity per day. Your body is not meant to sit all the time.
4. Avoid noise of the city life as much as you can. It leads to chronic stress and thus chronic diseases. Noise-cancelling earphones may help.
Why aren't you using connections on a daily basis to get reliable services?
Except my teeth were my second teeth, and they were half broken. I was walking around with half-blackened by the rot teeth, which caused all sorts of health problems on top of all the bullying and the first kiss kids tend to take came to me after I fixed the teeth.
And don't get me started with my chronic illness that I've been looking for diagnosis for the last 10+ years.
while a dentist should of course make sure to double check if its the permanent teeth and all that, I feel that your dad did not really fulfill his role as a proper parent here
I think what happened to that dentist is he changed his diagnostic because of an external factor, like realising that removing the teeth is less risky with regards to getting sued by you.
To be fair, in your story the "former head of the province’s dental association" apparently did know his craft, indicating that competence is rewarded in dentistry also...
There are a lot of doctors and dentists, and as in any field, mastership of a profession is rare. So you did the obvious and correct thing of finding someone more competent when you had doubts.
That would honestly have reinforced my trust in medicine more than do the opposite...
Seemed fine to me, but my father insisted to ask a friend of his who is a dentist. Turns out my wisdom teeth were completely fine and none needed pulling. My pain just stemmed from me grinding my teeth at night.
For which magnesium (try different types of Mg-salts) helps many! (never heard that from a dentist, again, possssibllyy because the solution is not sold in their shop)
Personally I’ve had this eczema where I found the correct cream by reading the research on it, and later found out this is also the official advice. Most doctors here just prescribe an old cream out of habit, that contains hormones and often creates worse side effects.
But bigger diagnosis mistake was a close family member diagnosed with a very bad gen defect that would cause liver failure within a few years. He wanted the kid to start taking unpleasant medicines to be sure. He told us to get bloodwork done, but in the end couldn’t find enough genes that had the mistakes. He wanted to do even more bloodwork, but I clearly told him he was going in uncharted territory, after doing the extra bloodwork he had to come back and agree he was mostly wrong.
He was a well intentioned doctor, but these academics doctors get obsessed with analysing and diagnosis without always understanding the costs for the patients. Although they try to.
One search on Reddit and many people just said to use petrolium gel. Bam fixed it up in two days! Costs me about $3 a year to control this now.
Most of the expensive moisturizers is going to be 80-90% petrolatum and a bunch of crap that's more likely to irritate than help (but smells nice!).
Don't get me started on "non-greasy" formulations... it's the greasiness that makes it work!
Pro-tip: put your moisturizer on just after washing. You want to trap in all that water!
I took him to my dentist who found a single tooth that may have a cavity but it's too early to be sure. A year later he's had one filling. And that one was not any of the teeth the other dentist wanted to drill. He flosses in public bathrooms.
They obviously was a cash grab and were going to just drill the fuck out of his mouth to maximize medicaid payments.
That local dentist I guess saw a blank check when I walked in the door and tried to convince me I had 5 cavities that needed filling. I told him to finish just the cleaning and I’d check back in with my military dentist.
Military dentist later looked me over again and said I had one slowly developing potential cavity to keep an eye on. That’s it.
A lot of dentists are apparently unethical hack shops.
From my point of view (patient), I feels like dentists base their treatment recommendations on how much kickback they’re getting from medical corporations (Invisalign anyone?) and biased papers.
I wonder why dentistry is so far removed from the rest of the medical profession on this. Not that MDs are immune to the above but it feels to me like it’s not as bad as in dentistry.
Anyways beyond that, dentistry sits in a very interesting position where there isn't a whole lot that can be done (without major breakthrough). It's why so much is based on preventative measure. It's also why the field feels "antiquated" in a way, we're still using simple instruments to scrape the teeth (or inside the tooth when it comes to root canals), or yanking the entire tooth out. We haven't got much farther than cavemen using stones to clean plaque in that way, besides the pain mitigation.
It's the one field that is ripe for revolutionary improvements if it weren't for corporations constantly pushing their garbage studies.
It might work, but the conflict of interest is there and you’ll never know if there wasn’t a superior/cheaper/more suitable alternative.
Ditto Oral B toothbrushes. Or Pedigree Pal at vets.
He said he could see no indication of decay that would need treatment, and all the 'fillings' I had were more like sealants in the enamel, none of which reached the dentin, and any of them could have been avoided by a more wait and see approach.
I saw 5+ dentists on the public health system that all had the same cavalier approach, and it's hard to assume it wasn't to line their own pockets.
UK NHS diagnosis was to pull 4 front top teeth out. I asked a relative (a doctor working in a public hospital but not a dentist) who advised to absolutely don't do that without even seeing him in person (COVID lockdown BS).
A local private dentist agreed and wanted 5k to fix his teeth (remove cavities, put fillings under general anesthetics).
In the end we went to Russia and got it done for 1k.
That's public healthcare for you!
His teeth have been fine for years, not long until he loses them naturally.
Why?
This is the same thing with doctors for any difficult disease to treat. You will tons of different opinions based on the same facts that are available to them.
It makes you seriously wonder what kind of expertise is that in the end?
It fixed itself as well.
The whole point of consulting a professional is so they can provide you with the necessary information to make important decisions. It's up to them to explain things to you so that you understand well enough to make an informed decision.
Unsatisfactory, meandering answers means you aren't getting the information you need to decide and you should absolutely seek another professional until you find one you trust. In fact, when we don't know something, the professional thing to do is to admit it and refer you to another professional who does.
About a week later I fell against a large wooden block in the classroom and knocked the other top front tooth clean out.
I went for something over a year without top front teeth, but my adult teeth came in early, so it wasn't 2 or 3 years like it might have been.
This was a long time ago, and I still have both the adult teeth, although one of them died when I got hit in the face with a football in the third grade.
All to say that n=1 but it likely wouldn't have been the worst thing if the two teeth had come out.
I'm a grown-ass adult now, and I haven't had issues like this since my late teens.
Went full engineer and finally met the right people.
Medicine is a marvel, but it’s a opportunity cost. You meet with people who have 10 minutes to pattern match you, which works for probably close to all the cases they see, until it doesn’t, and it’s you.
It's completely reasonable to believe in modern medicine, but also to remember that humans are imperfect and have all sorts of biases and limitations when practicing modern medicine. Add on top of that how most health care systems make things much more difficult than they need to be, for both the doctor and the patient.
It’s stated at the bottom that the original article is from 1997. COVID doesn’t factor into it.
This can be applied to almost everything. Looking at average software developers around, I see people with 10 years of experience who have no idea how anything works, they just copy paste the same CRUD APIs for their whole career, never really learning anything, trying to understand, just coasting through corporate life. Half of people are worse than 'average' person, this applies to everything and it's especially evident with doctors. They'll just tell you to wait and see, take vitamins or straight out ignore you. They might not know any better, or just think they know everything, you never know because you're not an expert. As an example of this I highly recommend reading Wired's article on Lee Holloway.
Then I went to a different dentist (I had to cause I moved) and he had the wait and see approach. I didn't tell you yet that I had a chronic inflammation (abscess) under the molar. A year or so later, I finally went to the dental stomatologist and he suggested oxazepam. What an experience (both the drug and the removal of the inflammation). Then the healing process came. And I even had some stomach pains from all the ibuprofen (too long w/o stomach protector). Ever since that I always use a stomach protector with ibuprofen, just to be sure. No stomach protector, no ibuprofen.
We were very happy with this dentist. Since it became a bit too impractical we now are at yet another dentist who's in our neighborhood and literally next to our kid's school. Very practical, but we were happier with the previous dentist.
Now our 3 year old has damage on all 4 of his milk canines, having damaged tooth enamel. We don't know what or why, only difference I can tell with his older sister is he's been going on with breastfeeding longer, and he liked chewing on stuff more than her (his teeth and mouth also have a bit different form; more my wife's than mine). The rest seems fine. The dentist guilt tripped us into that I'd probably not been brushing his teeth well enough (because of COVID my wife was waiting with our daughter, she'd have given him a firm reply but I just listened and took it in), but I'm pretty sure we did this correct (perhaps too well?); twice a day since his first tooth showed up. So I'm considering going for a second opinion.
The beauty is my kids are freely insured for teeth until their 18th in The Netherlands, after that they're on their own. But until then, the government takes care of their costs. I know it ain't like that in certain other (even rich) countries.
Dentists are also business people, and there are strong monetary incentives for them to upsell.
That's not to defend the behavior, but I think we should acknowledge the problem is systemic and that a non profit healthcare approach would be more appropriate for the vast majority of situations.
My current dentist's niche is NOT performing anything that is unnecessary. A lot of people are taken aback when they say everything looks good. Makes for a great culture in his office.
I am sure you came across many staff engineers with +10 years of exp that will give weird ideas too and architecture decisions, tech choice etc.. it’s everywhere not just for dentists.
I went into engineer mode and while I acknowledged I didn’t have domain expertise, I asked questions and probed the whole situation. Very unsatisfactory, meandering answers.
This was a deeply distressing experience. For the first time ever I did the “call in a personal favour” thing and asked my dad to reach out a family friend, a former cosmetic dentist and former head of the province’s dental association for a second opinion.
He saw my son a few hours later and he was just livid about the diagnosis. That it was possible they’d have to come out but it’s impossible to know this for at least a few more weeks or more.
In a few months the teeth returned 100% to normal and firmed right up as the ligaments healed.
I’m not a conspiracy nut. I believe in listening to experts (but ultimately making an informed decision). I believe in modern medicine. But that experience shook me and forever changed my trust in the dental industry.
My feeling is that the nature of dentistry leaves a lot of room for subjectivity and COVID left a lot of dental chairs empty.