I was working on a long post, but the short version is: I’m with Q.

Yes. Agree with the docs. There will always be good and bad docs. Ethical and unethical docs. Hippocratic and greedy docs. Just like any profession, there will be a normal distribution of the human condition. Pharma, HMO, insurance, dei just may overlay another layer on top. God help us if the Gov wants to help.

quote:

Originally posted by konata88:
Yes. Agree with the docs. There will always be good and bad docs. Ethical and unethical docs. Hippocratic and greedy docs. Just like any profession, there will be a normal distribution of the human condition. Pharma, HMO, insurance, dei just may overlay another layer on top. God help us if the Gov wants to help.

You may be on to something. The wife and I are friends with the couple that own the farm next to ours. A few years ago we were visiting with them and she told us that her family doc had set up an appointment for her with a Cardiologist due to her having a long family history of heart disease and her high blood pressure. Apparently this guy was from some African nation, and fairly new to this hospital. She told us neither her or her husband could understand what he was saying to them. They actually asked if a nurse could come in and translate his English.

I remember back in the Obama days I was listening to Rush Limbaugh and he had a long segment on the consequences of the news that many of the huge Universities in the US were lowering their requirements for entrance to their medical schools for "disadvantaged" minorities. Gee, what could go wrong with that?

quote:

Originally posted by MelissaDallas:
Here’s my thought. Prior to high tech testing, MRI’s, CT’s, etc, doctors used to know how to diagnose. Now they know nothing without high tech confirmation. The dawn of advanced orthopedics was World War II. My grandad was a doctor, so we had a great network of his friends, who were also WWII medical vets. They knew what they were talking about with no stinking scan to confirm it.

Here’s my thought. Prior to high tech testing, MRI’s, CT’s, etc, there was an enormous amount of diseases and conditions that were impossible to know about, let alone diagnose. Now they can be accurately assessed and treated due high tech confirmation.

It may also be over-utilized by providers for loss prevention, treatment by mid-level providers rather than docs or for the reasons noted above.

Like most things this cuts both ways.

I agree with Q and sjtill.

Healthcare IS NOT what it used to be. It's much more complex today due to many factors.

It is difficult to have the relationship with your physician that you had 20 years ago or even 10 years ago in this era.

Life changes and medicine is changing with it.

RMD

quote:

The world of medicine has changed

...for the better, overall. Yes, there is more bureaucracy and red tape, insurance shitstorms, wokeness, etc, but medicine has drastically improved in the last 50 years. Breast cancer survival rates have drastically gone up, same with HIV/AIDs and many other conditions. Modern imaging technology has taken a lot of the guess work out of medicine. I certainly have far more confidence in my current stable of physicians (geriatrician, orthopedist, dentist) than the ones I had decades ago, and a lot has to do with the advancement in medicine and med technology.

This guy could diagnose all kinds of obscure stuff.

^^^^^^^^

Wait until 200 years later

quote:

Originally posted by oddball:

quote:

The world of medicine has changed

...for the better, overall. Yes, there is more bureaucracy and red tape, insurance shitstorms, wokeness, etc, but medicine has drastically improved in the last 50 years. Breast cancer survival rates have drastically gone up, same with HIV/AIDs and many other conditions. Modern imaging technology has taken a lot of the guess work out of medicine. I certainly have far more confidence in my current stable of physicians (geriatrician, orthopedist, dentist) than the ones I had decades ago, and a lot has to do with the advancement in medicine and med technology.

Not to disagree per se. But curious what the real trends are with respect to things like cure vs symptom management, competency levels, pharma efficacy, pharma side effects (severity, prevalence), patient vs financial orientation. What's the incidence rate of new diseases / orphan diseases? Idiopathic conditions? What's the cure (not treatment) rate of legacy diseases? What are the numbers today vs 50 years ago?

Normal distribution corollaries can be made to every profession. But curious what the medical normal distribution trend looks like. And maybe especially last 20 years vs the prior 50 years.

No doubt there have been great advancements in research and tools. How well are they being leveraged?

I realize much of this is probably unknown. Still, just curious.

Don’t need to wait 200 years. AI now is better at reading mammograms than human radiologists. Our PCP uses AI to listen to our conversation and writes up a progress note (which needs to be reviewed but still saves “paperwork” for the doc).
I use Grok AI to help diagnose family illnesses outside my specialty, because within my specialty it gives answers one would expect from a seasoned, well-trained professional.

I have heard that many of the younger docs rely too much on looking at their computer screen and don’t pay attention to the patient. That’s been a big problem; as has the inability of some older docs to get used to using the electronic medical record. For me, it was a dream come true to be able to use an integrated EMR.

Another dream come true: I use UpToDate, an online electronic medical reference that far surpasses any textbooks or journals we had to use in the past to try to find answers to help our patients.

So there’s no going back. Except in one good way: I now see some light at the end of the dark DEI tunnel, which threatened to turn medical school and residency training into indoctrination programs.

quote:

Originally posted by sjtill:
I now see some light at the end of the dark DEI tunnel, which threatened to turn medical school and residency training into indoctrination programs.

Good to hear. A sound for sore ears.

We are seeing an increase in autoimmune disorders that are not "diseases" in the traditional sense. We are also seeing an increase in allergies, which are really autoimmune disorders as well. The reasons for this are unclear. There are hard to diagnose because there is no infectious agent and thus no quick pharmaceutical fix.

It probably has a lot to do with processed food and drugs we take for other reasons.

It's interesting about the autoimmune trends, including lactose / gluten intolerance in addition to the more traditional plant and food allergies. Perhaps it's better communication but as a percentage of people I know, much higher incidence now than 30 years (non-existent?). And anectodical speculation that it hits first world countries with minimal incidence rates in rural regions.

quote:

It is difficult to have the relationship with your physician that you had 20 years ago

It's going to get worse. Physicians and PAs are apprehensive about AI and its influence on medicine. Patients are already coming in with symptoms/vague symptoms and informing the Provider with AI's diagnosis.

Providers are worried because it's going to increase the possibility of legal liability and litigation. They are going to be much more conservative in their treatment and less willing to discuss options.

Many are planning early retirement for just that reason.

“Malpractice lawyers” have been the bane of conscientious physicians for 50 years. My late father-in-law, an orthopedic surgeon, had to worry about the skyrocketing cost of malpractice insurance back when I was dating his daughter.

quote:

Originally posted by konata88:
It's interesting about the autoimmune trends, including lactose / gluten intolerance in addition to the more traditional plant and food allergies. Perhaps it's better communication but as a percentage of people I know, much higher incidence now than 30 years (non-existent?). And anectodical speculation that it hits first world countries with minimal incidence rates in rural regions.

Internet news feeds, etc. seem to be increasing reports about micro plastics from various sources, food containers for one, and the amount of microplastics in one’s body. Even saw an article about the new paper pill bottles versus the existing plastic used now. Remember when the plastic versus paper was hot? Now the trend is reversing.

Should we go back to dripping ether on a cotton mask and hoping you don't wake up...or die?