What your doctor doesn't know could kill you... (1 Viewer)

[Max Leung]

Very interesting article in the Boston Globe: What your doctor doesn't know could kill you.
Byline:

A computer program that provides vast amounts of information for diagnosing and treating patients could revolutionize the practice of medicine. So why won't physicians use it?

The MDs that responded to this article on Slashdot.org were fascinating, to say the least. A few of them rejected the software system out of hand...IMHO arrogantly assuming they can always diagnose a problem without the aid of a computer. Only one of them embraced the idea.
I don't care how badly it hurts a doctor's ego...if every possible avenue was not explored, then the doctor failed in his service to the patient!
Remember, this system AUGMENTS the doctor's intuitive ability. It is no different than having a complete medical reference library in the patient examination room, and is not intended as a replacement of a doctor or nurse!

 

[Ben Motley]

Don't get me started. After about five years of back pain, and a doctor that only ever told me to "do your exercises", I finally got off my ass and got a second opinion. My new doctor didn't even have to take x-rays (or check a computer for that matter) to tell I had one leg shorter than the other. Only by a quarter inch, but that quarter inch threw me off kilter over the years, and now my spine looks like I have scoliosis. A few heal supports in my left shoe, and a few weeks later I was good as new.
Five frickin' years. Some doctors suck! It amazes me their attitude when you question their say. It's like since you're not a doctor, you could have no clue as to what's wrong with you. I'm also convinced they think we're all hypochondriachs who can be waved away with placebos; either that, or they're more dedicated to getting insurence kickbacks for not encouraging real treatment which costs money than to keeping us healthy.
Like I said; don't get me started. Suffice to say, I'm all for computer technology in healthcare - not only for diagnoses, but for record keeping and communication of files to other doctors and offices. It's ludicrous if the popular consensus among doctors that this is a bad thing.

 

[Darren H]

After six years of almost criminal misdiagnoses by several doctors, I finally took my wife to Rochester, MN, where two specialists at the Mayo Clinic examined her, diagnosed her problem instantly ("It's an obvious case," one said!), then treated her with a simple out-patient surgery the next day. Her recovery has been swift and complete. I've lost my blind faith in the medical profession and welcome any technological advancements that will prevent others from going through what we've experienced.

 

[Clinton McClure]

A friend was misdiagnosed and treated for 2 years for Chrome's (sp) disease. After her condition began to rapidly deteriorate, she went to a second doctor who informed her she did not have Chrome's, instead she had endometriosis (sp). The medicine her first doctor had been prescribing was literally killing her. Her new doctor immediately switched her medication and she is 500% better now.

 

[ChrisMatson]

Amazing.

I'll limit my comments to just say that there are some physicians who, with all good intentions in mind, get stuck on one diagnosis. I think it comes down to what they have seen in the past. A generation from now, this will be less of an issue as computer-assisted diagnoses become accepted practice.

There is some burden on the patient to seek multiple opinions, especially any time when there is a diagnosis of a chronic condition or if surgery is indicated.

---
Clinton, I think you are referring to Crohn's disease. I am glad that your friend is doing better. Endometriosis can be difficult to diagnose and is often associated with irritable bowel syndrome.

 

[Brian Perry]

I tend to give doctors the benefit of the doubt when things go wrong, although I admit it is different when the person affected is a loved one. (My first child was born a week ago and has some breathing problems, so I'm trusting the doctors and nurses to come through for us.) I think doctors are like any other professionals in the sense that some are better and more experienced than others and that just because one can't figure out a problem doesn't make him a criminal. But like I said, each case is different and I understand the anger and frustration when you think mistakes have been made.

 

[Denward]

As the spouse of a physician, let me concur with those of you who are skeptical of doctors. I've met a lot of doctors over the years who are way too stupid to be doctors, but there's no good way to really police them. Doctors are human. There are good ones and bad ones. Even the good ones are fallible, and even when they don't do anything wrong, bad things can happen. No doctor should ever (but I'm sure many do) discourage you from getting a second opinion. Any doctor who thinks they know it all is BIG TROUBLE. My wife's friends refer to it as the "C-C Gap" (i.e. the Confidence-Competence Gap).

Let me also say that I have not read the article that started this thread. IMO, a database is absolutely no substitute for experience and training. You have to know enough to even know what to look for so doing something similar to a Google search on symptoms is not good medical care. Going to places like the Mayo Clinic can be a really good thing not because the doctors there are inherently better or smarter but because people go there with all sorts of unexplainable phenomena so those doctors see more and can recognize more.

Doctors operate under unreasonable pressure and expectations to be perfect. They can already get sued for poor outcomes, even if there's no fault. If a database becomes the "standard of care" and it suggests 5 different diagnoses and the doctor knows that 2 of them have a miniscule probability, he will probably feel legally obligated to test/treat for all 5 because he might get sued otherwise. This is not good medical care. This is CYA medical care which imposes tremendous costs on society in terms of dollars spent on health care and the number of patients that can see a doctor. There's been some news coverage recently about regions losing medical coverage because doctors can't afford their malpractice insurance anymore. I believe Las Vegas had no trauma center for a few weeks because of this.

 

[Clinton McClure]

Yes, Chris, it was Crohn's. I had no idea how to spell it. Thanks.

 

[Max Leung]

If a database becomes the "standard of care" and it suggests 5 different diagnoses and the doctor knows that 2 of them have a miniscule probability, he will probably feel legally obligated to test/treat for all 5 because he might get sued otherwise.

Again, you'll need to read the article...your concern is covered in there.
How is your concern different than a colleague (nurse or other doctor) who verbally suggests the 5 different diagnoses, where 2 of them are highly unlikely? Or a medical reference library that says the same thing? Are you suggesting the doctor should use ignorance as protection against being sued? If doctors actually feel this way, no wonder people don't trust them!