[pilowsky]

thepossum, on 2022-November-30, 19:34, said:

My concern in Australia has been the fairly recent change in and growth in different types of practices, clinics etc

I hate to sound sceptical and suggest anything remotely unprofessional but I feel they are not all run with a medical ethic in mind. I could be wrong

Even a lack of decent business ethics too if I may be so bold.

It's an interesting point.
Of course every generation looks at the present through the lens of their past.
So I try to temper my occasional discomfort with current social norms by remembering my teenage contempt for the way that "the grown-ups" were stuffing everything up.

[thepossum]

pilowsky, on 2022-November-30, 20:59, said:

It's an interesting point.
Of course every generation looks at the present through the lens of their past.
So I try to temper my occasional discomfort with current social norms by remembering my teenage contempt for the way that "the grown-ups" were stuffing everything up.

Maybe I'm still in grief over the loss of a much loved family GP practice

EDIT To clarify I feel so much of the world has become totally impersonal (and worse). I faced it in my own industries and professions, and even withdrew from some, and I see it from the other side (client) too. With that level of individual relationship and ongoing care. Everyone are just commodities or units these days. Widgets. How many did we process today?

[kenberg]

barmar, on 2022-November-30, 17:23, said:

Most doctors know more about medicine than I do. Even when they're guessing, the guesses will be based on a medical education, which is more than I have. So why shouldn't I put faith in them? Who should I listen to instead?

Yes, I know some doctors have prescribed medicines because they're getting kickbacks from big pharma. But how am I supposed to know when this might be happening and view it skeptically?

I also put faith in car repair places, even though I've heard of scams there. Again, I can't easily tell better.

They say you should get a second opinion as a check on this. That's just too much work for me.

You mention car repair. Of course analogies are risky but it could illustrate my point.

In 1954 I bought a 1947 Plymouth. After a bit the engine was clearly having some trouble so I stopped at a repair place. They said it needed a complete overhaul. The cost would have been almost as much as I paid for the car ($175). What to do? I went to the library and read a bit (they had shop manuals, including the 47 Plymouth). I got out some tools, removed the cylinder head from the cylinder. and found that the gasket had blown. It was obvious. So I bought a new gasket for a buck or two, and put it all back together. Not hard but it was good that I had read up on it. The cylinder head is held to the block by, if I recall correctly, 12 bolts. When reassembling you don't just tighten these in any order, there is a specified sequence of bolt tightenings and you go through the sequence two or three times, each time getting them tighter. Ok, but after a while, the same problem developed. After reading and chatting with friends, I again took the cylinder head off, again the gasket was blown, but this time I took the head to a machine shop. They said the head had become a bit warped and they could fix it by shaving it down. The cost was low, they did it right then, I got a new gasket, put everything back together, that did it, no more troubles with blown gaskets.

Ok, maybe if I had left my car with the shop that said I needed a full overhaul they would have quickly noticed the blown gasket and then thought to check the cylinder head to see if it was warped. That's very optimistic. They saw a 15-year-old sucker standing in front of them and they said the car needs a full overhaul. They would have charged me a bundle and, most likely, they would not have thought of shaving the head. Too bad, kid. As one adult told me after ripping me off in a different situation "You're a juvenile, you got no standing".

Now I don't think the medical field is, at least for the most part, trying to rip us off. But whether it's my car or my body, it is best to ask a few questions before just doing as told.
Of course I do not think that I know more about medicine as a total subject than doctors do. But when it is a specific issue with specifically my body, I think it is both fair and wise to expect something resembling explanation and discussion rather than "I'm the doctor, do what I say". As I grow older, I have found it more and more important to do some reading on my own, to ask questions, and seek answers. This is by no means theoretical, I could lay out many instances where this has paid off very well.

[PassedOut]

kenberg, on 2022-December-03, 09:09, said:

Now I don't think the medical field is, at least for the most part, trying to rip us off. But whether it's my car or my body, it is best to ask a few questions before just doing as told.

Of course I do not think that I know more about medicine as a total subject than doctors do. But when it is a specific issue with specifically my body, I think it is both fair and wise to expect something resembling explanation and discussion rather than "I'm the doctor, do what I say". As I grow older, I have found it more and more important to do some reading on my own, to ask questions, and seek answers. This is by no means theoretical, I could lay out many instances where this has paid off very well.

Amen.

Mechanics and doctors should be able to diagnose and address a multitude of situations that arise. We have very particular situations to address and -- if the matter is important -- can benefit greatly by researching our own situations. I know that for a fact from my own experisnces.

I understand that doctors (and mechanics) are annoyed when morons spout misinformation about matters they know nothing about. So what! All of us who aren't morons have to deal with stuff like that too in our own professions.

[Winstonm]

PassedOut, on 2022-December-03, 11:00, said:

Amen.

Mechanics and doctors should be able to diagnose and address a multitude of situations that arise. We have very particular situations to address and -- if the matter is important -- can benefit greatly by researching our own situations. I know that for a fact from my own experisnces.

I understand that doctors (and mechanics) are annoyed when morons spout misinformation about matters they know nothing about. So what! All of us who aren't morons have to deal with stuff like that too in our own professions.

From the perspective of someone in the field, I urge everyone to actively engage in their health care decisions. As an example, I told my sister-in-law not to wait the 3 weeks for the biopsy results but go ahead and find a surgeon and schedule surgery for the day after her results would be known. She did and now has s 98% chance of non-recurrence.

As I explained to her, every day you wait is one day closer to possible metastasis so why wait.

[pilowsky]

Global estimates of excess deaths from COVID-19.
This is a commentary in Nature discussing the difficulties in estimating the death (not other problems) toll from the pandemic.

Quote

Msemburi and colleagues set out to estimate excess deaths from COVID-19 for every country in the world. The authors report that there were between 13.2 million and 16.6 million more deaths than expected in 2020 and 2021.