Pro tip for dealing with doctors, kids! If the doctor says "No" to a test, then say these magic words: "I would like you to make a note in my chart that I specifically requested these tests, and that you refused".
It's *AMAZING* how often they'll change their minds, if you ask them to document their logic!
The flip side of that is that if they *do* refuse, you should take it as STRONG Bayesian evidence that their perspective is correct, and should spend a lot of time doing research on the issue before you pull that again; you should also probably be prepared to eat some humble pie on your next doctor visit, when you recap what you've learned, and why you now agree with the doctor. Not guaranteed of course, just a likely outcome.
Ever get a response back? I wouldn't want someone to implement my suggestion without knowing how well it's likely to be received on the doc's end...
(I actually haven't had these problems myself, but I often tell my doctors "I recognize that you're the expert here, but I'm a physicist, and already did a literature review on this topic, and my initial reading was X; what's your take?"... so I have never *actually* had to use this line, because I've already set myself up as a particular kind of patient.
Fwiw i saw an article about automotive work that said the EXACT same thing, but from an informed inside perspective.
The gist was that diagnostic work = time consuming, ppl dont want to pay/wait. Its easier to guess since 95% of the time you save the customer time and money. 5% you waste their time and money and make them think youre a moron, but hey, thats 1/20
To do this with peoples lives is ridiculous, but i guess it works
This hits close to home for me because i once went to the ER for stomach pain. The ambulance ($3k bill) was like "probably the taco bell" and the triage team was... nonresponsive? To be fair it was 3am but i was screaming, begging for help, explaining that i was in the worst pain of my life and if they couldnt treat me immediately i at least needed painkillers. I was told to go outside and get some at a gas station- which i tried to do and failed
Anyway it was a burst appendix. I was literally 24 hours to death, in a hospital, and still could have died that day
The takeaway from all of this is that you CANNOT trust in the medical system on your own. You NEED an advocate, even as an adult. The system is overworked and being financially preyed upon by people outside of it.
Surprised nobody mentioned what is probably the central issue with overtesting, which is iatrogenesis, either mild (making people constantly worried and running to the doctor for tests for reassurance) or significant (unnecessary biopsies, etc)
I'll never forget the time I went to a gastroenterologist with inexplicable stomach pains and he was like yeah we don't know what it is, probably IBS (which means we don't know what it is, but your stomach hurts, I guess), though it could be IBD (stomach hurts and we DO know why and can help), but it's probably not IBD based on random things you've said or something. And I asked if there was a test he was like yes, but I don't think it's IBD, so it would be a waste. And then he said, I swear to God, that I didn't seem to be the type of person to waste the time and effort required to get a test done.
Genuinely, I think some doctors are just... Lazy? They know if you get tests done, they have more work to do.
But then I can't really explain why no doctors ever bothered to test my iron levels despite my complaining about fatigue for years. Men don't get iron deficiency is the consensus, I guess? Well, I paid out of pocket and found out I do.
People are taking their health back into their own hands with Function / Superpower / etc for good reason, at least I think.
No, insurers are billed at discounted markups. It is the uninsured who are billed at 10x markup. And in many places the insurance companies own the hospital or clinic, hire the doctor, and an MBA is running the facility. MBAs really like flow charts like that, and they read them the way it is presented. The sick person should read the chart from the bottom right corner "you are here" to realize why the system is designed not to diagnose them.
Capitalism is a great system, but it is magical thinking if you believe it is aligned to solving every problem, or your problem. Insurance is aligned backward. You are a paying customer when you do not need it. You are an expense when you do need it.
I've previously considered to just pay a doctor out of pocket for an hour of their time to make sure the billability question is out of the picture. I didn't pull the trigger though. Curious if someone has done that and how different the experience was.
Pro tip for dealing with doctors, kids! If the doctor says "No" to a test, then say these magic words: "I would like you to make a note in my chart that I specifically requested these tests, and that you refused".
It's *AMAZING* how often they'll change their minds, if you ask them to document their logic!
The flip side of that is that if they *do* refuse, you should take it as STRONG Bayesian evidence that their perspective is correct, and should spend a lot of time doing research on the issue before you pull that again; you should also probably be prepared to eat some humble pie on your next doctor visit, when you recap what you've learned, and why you now agree with the doctor. Not guaranteed of course, just a likely outcome.
@Theayhura, curious what your doctor-buddy says his response would be in that case.
I'll ask!
Ever get a response back? I wouldn't want someone to implement my suggestion without knowing how well it's likely to be received on the doc's end...
(I actually haven't had these problems myself, but I often tell my doctors "I recognize that you're the expert here, but I'm a physicist, and already did a literature review on this topic, and my initial reading was X; what's your take?"... so I have never *actually* had to use this line, because I've already set myself up as a particular kind of patient.
In short - yeah nobody knows but the vagus nerve is part of the reflex pathway. Two ways to reset it:
1. Try the hiccaway straw if you haven't yet.
2. Stick your face in a bowl of ice water.
Yeah. Its scary out there.
Fwiw i saw an article about automotive work that said the EXACT same thing, but from an informed inside perspective.
The gist was that diagnostic work = time consuming, ppl dont want to pay/wait. Its easier to guess since 95% of the time you save the customer time and money. 5% you waste their time and money and make them think youre a moron, but hey, thats 1/20
To do this with peoples lives is ridiculous, but i guess it works
This hits close to home for me because i once went to the ER for stomach pain. The ambulance ($3k bill) was like "probably the taco bell" and the triage team was... nonresponsive? To be fair it was 3am but i was screaming, begging for help, explaining that i was in the worst pain of my life and if they couldnt treat me immediately i at least needed painkillers. I was told to go outside and get some at a gas station- which i tried to do and failed
Anyway it was a burst appendix. I was literally 24 hours to death, in a hospital, and still could have died that day
The takeaway from all of this is that you CANNOT trust in the medical system on your own. You NEED an advocate, even as an adult. The system is overworked and being financially preyed upon by people outside of it.
Surprised nobody mentioned what is probably the central issue with overtesting, which is iatrogenesis, either mild (making people constantly worried and running to the doctor for tests for reassurance) or significant (unnecessary biopsies, etc)
Like it’s not that it’s wasteful to test everyone for everything, it is reasonably likely to cause net harm
I'll never forget the time I went to a gastroenterologist with inexplicable stomach pains and he was like yeah we don't know what it is, probably IBS (which means we don't know what it is, but your stomach hurts, I guess), though it could be IBD (stomach hurts and we DO know why and can help), but it's probably not IBD based on random things you've said or something. And I asked if there was a test he was like yes, but I don't think it's IBD, so it would be a waste. And then he said, I swear to God, that I didn't seem to be the type of person to waste the time and effort required to get a test done.
Genuinely, I think some doctors are just... Lazy? They know if you get tests done, they have more work to do.
But then I can't really explain why no doctors ever bothered to test my iron levels despite my complaining about fatigue for years. Men don't get iron deficiency is the consensus, I guess? Well, I paid out of pocket and found out I do.
People are taking their health back into their own hands with Function / Superpower / etc for good reason, at least I think.
No, insurers are billed at discounted markups. It is the uninsured who are billed at 10x markup. And in many places the insurance companies own the hospital or clinic, hire the doctor, and an MBA is running the facility. MBAs really like flow charts like that, and they read them the way it is presented. The sick person should read the chart from the bottom right corner "you are here" to realize why the system is designed not to diagnose them.
Capitalism is a great system, but it is magical thinking if you believe it is aligned to solving every problem, or your problem. Insurance is aligned backward. You are a paying customer when you do not need it. You are an expense when you do need it.
Benzos?
I wonder, given the muscle relaxant effects.
Not saying it's a good idea, but I'm curious if it would work.
(Sort of in the vein of Randall Munroe's 'how many feet of water would I need to have between me and nuclear waste to be safe?')
I've previously considered to just pay a doctor out of pocket for an hour of their time to make sure the billability question is out of the picture. I didn't pull the trigger though. Curious if someone has done that and how different the experience was.