If you can read this, either the style sheet didn't load or you have an older browser that doesn't support style sheets. Try clearing your browser cache and refreshing the page.

(Slate)   Going to the doctor when you aren't sick or dying does more harm than good   (slate.com) divider line 93
    More: Obvious, injury, prostate cancer screenings, chronic kidney disease, average wage, Rand Corporation, doctor's visit, medical  
•       •       •

6905 clicks; posted to Main » on 20 Aug 2013 at 9:07 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



93 Comments   (+0 »)
   
View Voting Results: Smartest and Funniest
 
2013-08-20 08:12:55 PM
Unfortunately too many people who "feel fine" don't understand that if they have diabetes or hypertension they are "sick"  with chronic illness and this article will give them even more false impression that the doctor can give them some medicine and they never have to come in again like setting and forgetting a Ronco rotisserie oven
 
2013-08-20 09:09:27 PM
Wash your hands, cook your food, wear a condom, and get vaccines.
 
2013-08-20 09:11:13 PM
Duh.
 
2013-08-20 09:14:01 PM

Snarcoleptic_Hoosier: Wash your hands, cook your food, wear a condom, and get vaccines.


I ain't cookin my food.
 
2013-08-20 09:14:51 PM
Apart from anything else a healthy person in a doctor's waiting room will pick up every variety of sniffles, coughs, inexplicable rashes and galloping knob rot that could possibly exist on Satan's Petri dish.
 
2013-08-20 09:16:19 PM

Snarcoleptic_Hoosier: Wash your hands, cook your food, wear a condom, and get vaccines.


Add to that exercise regularly, eat a balanced diet, don't smoke, don't drink to excess, and watch your stress levels.

Do all that, and you'll probably live a long healthy life.

(I say probably because freak accidents could happen to anybody, but take good care of yourself and you're far more likely to enjoy your time on this planet)
 
2013-08-20 09:17:02 PM

Spiralmonkey: Apart from anything else a healthy person in a doctor's waiting room will pick up every variety of sniffles, coughs, inexplicable rashes and galloping knob rot that could possibly exist on Satan's Petri dish.


You might want to switch doctors.
 
2013-08-20 09:19:06 PM

Silverstaff: Add to that exercise regularly, eat a balanced diet, don't smoke, don't drink to excess, and watch your stress levels.

Do all that, and you'll probably live a long healthy life.

(I say probably because freak accidents could happen to anybody, but take good care of yourself and you're far more likely to enjoy your time on this planet)


Genetics also count for quite a bit. Some people are more prone to cancer, non-pathogenic diseases, or pathogenic infection than others. In many cases, there's relatively little doctors can do to combat these deficiencies before they crop up.
 
2013-08-20 09:21:10 PM

NuttierThanEver: Unfortunately too many people who "feel fine" don't understand that if they have diabetes or hypertension they are "sick"  with chronic illness and this article will give them even more false impression that the doctor can give them some medicine and they never have to come in again like setting and forgetting a Ronco rotisserie oven


Plus it makes you evil as fark.

i487.photobucket.com
 
2013-08-20 09:24:08 PM
This is my life -EVERY.SINGLE.DAY-people who've managed to live into their 70's without medical intervention come in for a checkup then 10 vials of blood and an EKG later, they are on 5 different meds and getting set up with a rash of specialists. I just want to tell them to run and don't look back.
 
2013-08-20 09:25:16 PM
Too many unnecessary doctor visits can be traced to the huge number of people on Medicaid.  No co-pays, why not take a periodic jaunt to the doctor, maybe to score another "pain killer' prescription.
 
2013-08-20 09:26:35 PM

NuttierThanEver: Unfortunately too many people who "feel fine" don't understand that if they have diabetes or hypertension they are "sick"  with chronic illness and this article will give them even more false impression that the doctor can give them some medicine and they never have to come in again like setting and forgetting a Ronco rotisserie oven


Plus, the purpose of those "pointless" annual blood tests, urinalysis, etc., is to provide a baseline against which to compare subsequent tests. A better way to warn people against them is to say if the annual test comes back "abnormal" to say "let's not go to the biopsy just yet. Let's do another test in six months and see how that one comes out." There could be a myriad of reasons why your blood work is "abnormal" on any given day. But you do need to have a series of numbers so that the doctor can look at it and say "see, these numbers have been MOSTLY the same for the last 15 years and now suddenly they're not; something could be wrong;" as opposed to two or three random numbers that are all different.
 
2013-08-20 09:26:58 PM
The article isn't about how bad it is for you to visit a doctor on semi-regular visits for checkups...The article is about how much it is costing the overall health-care system in raw dollahs.  The author's cost/benny analysis, the over-doctoring is not worth the "relatively minimal" (quotes are mine) lives saved by these visits, vs. the dollahs spent.
 
2013-08-20 09:28:25 PM

Gyrfalcon: NuttierThanEver: Unfortunately too many people who "feel fine" don't understand that if they have diabetes or hypertension they are "sick"  with chronic illness and this article will give them even more false impression that the doctor can give them some medicine and they never have to come in again like setting and forgetting a Ronco rotisserie oven

Plus, the purpose of those "pointless" annual blood tests, urinalysis, etc., is to provide a baseline against which to compare subsequent tests. A better way to warn people against them is to say if the annual test comes back "abnormal" to say "let's not go to the biopsy just yet. Let's do another test in six months and see how that one comes out." There could be a myriad of reasons why your blood work is "abnormal" on any given day. But you do need to have a series of numbers so that the doctor can look at it and say "see, these numbers have been MOSTLY the same for the last 15 years and now suddenly they're not; something could be wrong;" as opposed to two or three random numbers that are all different.


Must not wait to do the biopsy...might get sued...better add a CT scan and MRI too. Jaysus....I think it's time for a career change.
 
2013-08-20 09:28:25 PM
The author has no readily-identifiable medical education or experience.

www.nextscientist.com
 
2013-08-20 09:28:50 PM

Snarcoleptic_Hoosier: Wash your hands, cook your food, wear a condom, and get vaccines.


I prefer to wear my food, cook vaccines, get a hand, and wash my condoms. (That way you can reuse them! It's the ecologically friendly choice.)
 
2013-08-20 09:29:34 PM
DNRFA but......there are a bunch of chronic and ultimately debilitating and deadly conditions that can be discovered and treated earlier during annual physicals.  Not to mention cancer which needs very early treatment for successful cure.  Sure, a physician can do a bunch of physicals without finding much of anything so the cost/benefit ratio is a question.  Women typically are much better about getting annual physicals.  Men often wait until they are damn near dead before darkening the door of a doctor's office.  Last time I checked, women live longer than men.  I think men might do a little better on longevity and health status while living if they had a routine doctor visit once in awhile.  That goes for health professionals too.  Health professionals often display an impressive level of denial about their personal health status.
 
2013-08-20 09:31:11 PM

Gyrfalcon: NuttierThanEver: Unfortunately too many people who "feel fine" don't understand that if they have diabetes or hypertension they are "sick"  with chronic illness and this article will give them even more false impression that the doctor can give them some medicine and they never have to come in again like setting and forgetting a Ronco rotisserie oven

Plus, the purpose of those "pointless" annual blood tests, urinalysis, etc., is to provide a baseline against which to compare subsequent tests. A better way to warn people against them is to say if the annual test comes back "abnormal" to say "let's not go to the biopsy just yet. Let's do another test in six months and see how that one comes out." There could be a myriad of reasons why your blood work is "abnormal" on any given day. But you do need to have a series of numbers so that the doctor can look at it and say "see, these numbers have been MOSTLY the same for the last 15 years and now suddenly they're not; something could be wrong;" as opposed to two or three random numbers that are all different.


Amen.  I found out through one of these "pointless" checkups that I was Type-II (no symptoms) and was promptly put on medication. I changed my diet and got more exercise, lost some weight, and a year later (two visits later,) my #'s were within the normal range, and I was off meds.  Had I followed the article author's advice, I would have been been oblivious of the fact that I was drifting into diabetic territory, and would instead wind up in the ER 5 or 10 years later with something that would cost the system in toto much, much more than those handful of office visits.
 
2013-08-20 09:31:31 PM
Mammogram?  I think she's getting a mammogram right there in the picture.  Jeez lady put on a jacket!
 
2013-08-20 09:32:27 PM

Snarcoleptic_Hoosier: Wash your hands, cook your food, wear a condom, and get vaccines.


In other words: Lord loves a workin' man; don't trust whitey; see a doctor and get rid of it.
 
2013-08-20 09:32:28 PM
The article isn't about how bad it is for you to visit a doctor on semi-regular visits for checkups...The article is about how much it is costing the overall health-care system in raw dollahs. The author's cost/benny analysis, the over-doctoring is not worth the "relatively minimal" (quotes are mine) lives saved by these visits, vs. the dollahs spent.

Well, it does also touch on the effects of false-positive test results on patients' health (via post-test exploration) and mental anxiety. False positives are a real problem given that doctors don't know the underlying statistics well enough to comprehend what they mean, let alone to explain it to their patients. The article itself even gets it wrong when it implies that a false positive rate will necessarily increase your risk of getting a false positive the more times you see a doctor. Technically, the probability doesn't change. What it does mean is that a test with a 10% false positive rate doesn't indicate that a positive = a 90% chance of a true positive.
 
2013-08-20 09:33:40 PM
Wait, so going to my doctor once a month for a hernia exam isn't normal?

/but I was looking forward to my monthly prostate exams
 
2013-08-20 09:34:09 PM
Today, approximately 177,000 Americans will visit a doctor, even though they have absolutely no symptoms.

And how many with symptoms but no insurance won't?


doglover: Snarcoleptic_Hoosier: Wash your hands, cook your food, wear a condom, and get vaccines.

I ain't cookin my food.


Fine. Have your manservant do it.
 
2013-08-20 09:37:02 PM

FourDirections: In other words: Lord loves a workin' man; don't trust whitey; see a doctor and get rid of it.


I quit giving blood when I cut myself shaving and nothing came out but air.
 
2013-08-20 09:38:41 PM
www.slate.com

That broad's tits looked healthy.
 
2013-08-20 09:40:46 PM

El Supe: Too many unnecessary doctor visits can be traced to the huge number of people on Medicaid.  No co-pays, why not take a periodic jaunt to the doctor, maybe to score another "pain killer' prescription.


Can someone else address this guy? I'm tired and he's stupid.
 
2013-08-20 09:43:22 PM
Slate is predictably doing its part to lay the groundwork for restricting care.
 
2013-08-20 09:45:23 PM
Okay, I have to go for the  low hanging fruit cheap shot.

Since this is in Slate, I assume this is some liberal rationalizing why Obamacare Death Panels are going to remove annuals from recommended care. Except for women's wellness visits which are of course, be free.
 
2013-08-20 09:46:59 PM

bearded clamorer: [www.slate.com image 568x379]

That broad's tits looked healthy.


And, the doctor looks like he could croak right there.

www.shadowlocked.com

Sure, I'll take advice from a doctor who looks sick as fark.
 
2013-08-20 09:49:55 PM
Others add-on some useful, or at least arguably useful, preventive health procedures like mammograms, cholesterol checks, and prostate-specific antigen tests.

Slate... did you just use "arguably useful" and "mammograms" in the same sentence? How f*cking stupid are you? I know you do not mean to say this in such a way, but this is awful stupid phrasing.
 
2013-08-20 09:50:08 PM

Bacontastesgood: FourDirections: In other words: Lord loves a workin' man; don't trust whitey; see a doctor and get rid of it.

I quit giving blood when I cut myself shaving and nothing came out but air.


They're supposed to stop before you're deflated!
 
2013-08-20 09:51:39 PM

megarian: Can someone else address this guy? I'm tired and he's stupid.


I prefer not to waste my time.  Just imagine his fingers being curb stomped so he never types again.
 
2013-08-20 10:03:48 PM
My medical advice: just type your symptoms into a search engine and do whatever Google says.

/might be the worst example of irresponsible "journalism" I've ever seen
 
2013-08-20 10:09:16 PM
Just type your symptoms into WebMD or MayoClinic.com and that's what you have.  Then schedule your doctor appointment and tell the doctor what you've found.  They love that.

/medical underwriter for 12 years
 
2013-08-20 10:10:18 PM

voodoomedic: My medical advice: just type your symptoms into a search engine and do whatever Google says.

/might be the worst example of irresponsible "journalism" I've ever seen


Take a picture, post it on 4chan and list your symptoms and be ready to follow their advice.


Have a sharpie handy.
 
2013-08-20 10:11:56 PM
I don't know, what's your analysis?


It's when they test your pee.
 
2013-08-20 10:12:01 PM

cchris_39: Slate is predictably doing its part to lay the groundwork for restricting care.


Care already IS restricted, you derpaholic.
 
2013-08-20 10:17:26 PM

cameroncrazy1984: cchris_39: Slate is predictably doing its part to lay the groundwork for restricting care.

Care already IS restricted, you derpaholic.


For the most part its not restricted.  You might end up paying it off for the rest of your life.  Or fall into financial ruin.  Or just say farkit and kiss that useless credit goodbye.  But yea you can get care.   Then you are farked, financialy.

People just need to buy more money though, all this debate is just stupid.  Hell ask their parents for a raise if they have to.
 
2013-08-20 10:20:36 PM

Silverstaff: Snarcoleptic_Hoosier: Wash your hands, cook your food, wear a condom, and get vaccines.

Add to that exercise regularly, eat a balanced diet, don't smoke, don't drink to excess, and watch your stress levels.


You won't live forever, but it'll sure feel like it.
 
2013-08-20 10:20:59 PM

JenFromTheWood: This is my life -EVERY.SINGLE.DAY-people who've managed to live into their 70's without medical intervention come in for a checkup then 10 vials of blood and an EKG later, they are on 5 different meds and getting set up with a rash of specialists. I just want to tell them to run and don't look back.


Sorry, but harm can be done without it being obvious.

A simple example--my wife is from a country without routine dental cleanings.  Her first dentist visit was here--which resulted in a deep cleaning and over the years has cost her thousands and denied her the ability to eat some things she likes.  At that the damage was caught early enough that she's still got all her teeth.

Gyrfalcon: Plus, the purpose of those "pointless" annual blood tests, urinalysis, etc., is to provide a baseline against which to compare subsequent tests. A better way to warn people against them is to say if the annual test comes back "abnormal" to say "let's not go to the biopsy just yet. Let's do another test in six months and see how that one comes out." There could be a myriad of reasons why your blood work is "abnormal" on any given day. But you do need to have a series of numbers so that the doctor can look at it and say "see, these numbers have been MOSTLY the same for the last 15 years and now suddenly they're not; something could be wrong;" as opposed to two or three random numbers that are all different.


Yeah, although the doctors get pretty CYA over even obviously bad results.  I had a thyroid test come back with a zero.  Never mind that I show no symptoms that would come from that and my thyroid levels were normal a year earlier.  The next doc to see it ordered a couple of other thyroid tests that came back normal (which couldn't have happened unless my thyroid had just magically switched off a few days earlier) but they were still determined that I get a retest of the obviously bogus number.  Sorry, you're not getting a needle in me for bad data!
 
2013-08-20 10:26:40 PM
so anyways ... enough about that story.
 
2013-08-20 10:27:45 PM

bearded clamorer: [www.slate.com image 568x379]

That broad's tits looked healthy.


Chicks don't like being called broads.
 
2013-08-20 10:35:54 PM

seancakes: bearded clamorer: [www.slate.com image 568x379]

That broad's tits looked healthy.

Chicks don't like being called broads.


Dames don't like being called chicks.
 
2013-08-20 10:39:03 PM
Does this article have anything to do with the impending doctor shortage?
 
2013-08-20 10:40:52 PM
Meh, fortunately or unfortunately, I'm the type that avoids going to the doctor unless it's something pretty severe.  I've always been that way, good or bad.  I don't see any way I could afford anything more.  Are people really paying for all these visits or is there insurance out there that's so good as to make doctor's visits affordable enough to make them a regular occurrence?
 
2013-08-20 10:42:40 PM

Lerxst2k: Does this article have anything to do with the impending doctor shortage?


If only we could do something about that... like remove the limit on new medical schools or something...

We got it backwards.  We limit the doctor schools and let law schools churn lawyers out like cheddar.
 
2013-08-20 10:45:10 PM

MrHappyRotter: Are people really paying for all these visits or is there insurance out there that's so good as to make doctor's visits affordable enough to make them a regular occurrence?


Doesn't most insurance cover a yearly physical? I'm pretty sure mine does with zero co-pay... it's at least no more than 10%.
 
2013-08-20 10:46:37 PM

orclover: voodoomedic: My medical advice: just type your symptoms into a search engine and do whatever Google says.

/might be the worst example of irresponsible "journalism" I've ever seen

Take a picture, post it on 4chan and list your symptoms and be ready to follow their advice.


Have a sharpie handy.


And a mirror. A penis is hard to free-hand on one's own forehead.
 
2013-08-20 10:47:39 PM

FrancoFile: seancakes: bearded clamorer: [www.slate.com image 568x379]

That broad's tits looked healthy.

Chicks don't like being called broads.

Dames don't like being called chicks.


An MILFs don't like being called dames.
 
2013-08-20 10:49:23 PM
OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!
 
2013-08-20 10:52:02 PM

MrHappyRotter: Meh, fortunately or unfortunately, I'm the type that avoids going to the doctor unless it's something pretty severe.  I've always been that way, good or bad.  I don't see any way I could afford anything more.  Are people really paying for all these visits or is there insurance out there that's so good as to make doctor's visits affordable enough to make them a regular occurrence?


Basically this. Even with insurance, my last trip to the doctor still cost me ~ $140, and I got literally nothing out of it. I'm only going back if I feel like I'm dying.
 
2013-08-20 11:10:05 PM

Mistymtnhop: OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!


If you've had symptoms for more than 10 days, you'll get antibiotics (might get an inhaler out of the deal too depending on what exactly's going on; those are always handy to have around for pick-up football games).  You should probably go to the doctor and pick up a Z-pak.

/almost a doctor
 
2013-08-20 11:13:13 PM

mr0x: bearded clamorer: [www.slate.com image 568x379]

That broad's tits looked healthy.

And, the doctor looks like he could croak right there.

[www.shadowlocked.com image 200x200]

Sure, I'll take advice from a doctor who looks sick as fark.


I once had a doctor who looked like that tell me I had to lose weight.
 
2013-08-20 11:14:54 PM

RentalMetard: Mistymtnhop: OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!

If you've had symptoms for more than 10 days, you'll get antibiotics (might get an inhaler out of the deal too depending on what exactly's going on; those are always handy to have around for pick-up football games).  You should probably go to the doctor and pick up a Z-pak.

/almost a doctor


Gee that's funny. When I was pregnant with my daughter, I reported that I had symptoms for over a month that prevented me from sleeping more than 2 hours a night due to severe coughing fits, that I was falling asleep standing up, and that the mucous was now coming out pink. The response was, "Try to get some rest during the day." A week later I was rushed to the hospital with a placental abruption, I delivered at 29 weeks and almost died from the blood loss.

/don't trust doctors
 
2013-08-20 11:17:15 PM

Gyrfalcon: Bacontastesgood: FourDirections: In other words: Lord loves a workin' man; don't trust whitey; see a doctor and get rid of it.

I quit giving blood when I cut myself shaving and nothing came out but air.

They're supposed to stop before you're deflated!


Personally, I like the re-inflation part...

1.bp.blogspot.com
 
2013-08-20 11:20:09 PM

kg2095: mr0x: bearded clamorer: [www.slate.com image 568x379]

That broad's tits looked healthy.

And, the doctor looks like he could croak right there.

[www.shadowlocked.com image 200x200]

Sure, I'll take advice from a doctor who looks sick as fark.

I once had a doctor who looked like that tell me I had to lose weight.


In my late 20's I regularly saw a dermatologist for a condition I had at the time. He had all these posters up about "wear your sunscreen" and "stay in the shade" and "is this mark on my skin bad?" He was always warning about how one can get skin cancer, the horrors of it, all that. And then after one visit I walk outside and there he is, under a tree, smoking a farking cigarette.
 
2013-08-20 11:20:29 PM

Mistymtnhop: OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!


Thats the worst -- i hate it when supervisors insist on a doctors note if you call in sick.

If im sick with the flu or a cold then spending 5 hours in an uncomfortable room so a doctor can tell me to get some rest and drink lots of fluids seems pretty dumb. Then the supervisors will say - if you arent sick enough to go to the doctor then your not sick enough to miss work. And thats retarded because you are drooling snot left and right and your fever is making you feel like every room is ice cold and you are slopping germs on everything you touch and being completely unproductive.

Dont go into the doctor because you have the sniffles. Just dont.
 
2013-08-20 11:21:41 PM
I recommend yearly cancer screening starting sometime in the thirties.  You don't have to have the doc do anything else, just look for cancers in all the likely places to ensure you don't have them.  Its worth the cost, and you aren't likely to get misdiagnosed.

/also, check you balls once a month for lumps.  If you are a woman, check your breasts.
//No really, do it right now.  Fark's readership is big enough that statistically, one of you has a good chance of having cancer.
 
2013-08-20 11:35:33 PM

Gyrfalcon: NuttierThanEver: Unfortunately too many people who "feel fine" don't understand that if they have diabetes or hypertension they are "sick"  with chronic illness and this article will give them even more false impression that the doctor can give them some medicine and they never have to come in again like setting and forgetting a Ronco rotisserie oven

Plus, the purpose of those "pointless" annual blood tests, urinalysis, etc., is to provide a baseline against which to compare subsequent tests. A better way to warn people against them is to say if the annual test comes back "abnormal" to say "let's not go to the biopsy just yet. Let's do another test in six months and see how that one comes out." There could be a myriad of reasons why your blood work is "abnormal" on any given day. But you do need to have a series of numbers so that the doctor can look at it and say "see, these numbers have been MOSTLY the same for the last 15 years and now suddenly they're not; something could be wrong;" as opposed to two or three random numbers that are all different.


This.  I got a "pointless" ECG a month ago.  I have no heart issues, I'm perfectly healthy (despite a most likely unrelated problem) but I also haven't had one since I was in the hospital with sepsis 11 years ago in high school.  The thing was all kinds of messed up and I had to do a series of tests that showed all the abnormalities were just normal variants (the damn thing said I was having a heart attack.  I was not having a heart attack).  It will however, serve as a baseline so I don't have to do all those other tests all over again next time a doctor notices the same thing. It's the same reason people do levels of markers that are not at all specific (like PSA or CA-125).  They don't mean much alone (again, not specific) but if you get a huge jump you pay attention.  They also can monitor the course of the disease.  I guess it's one thing to run to the doc for every minor thing, but annual check-ups are a little different.
 
2013-08-20 11:36:41 PM

suzy_qu3: /don't trust doctors


This!

/also don't trust Slate
 
2013-08-20 11:40:23 PM
I went to the doctor for an "Adult Physical" and he told me I had diabetes...sort of. Then his solution to my insomnia was an anti-depressant. And then he put his finger up my butt.

The Trazadone actually helped me sleep.
 
2013-08-20 11:43:33 PM

Great Justice: I recommend yearly cancer screening starting sometime in the thirties.  You don't have to have the doc do anything else, just look for cancers in all the likely places to ensure you don't have them.  Its worth the cost, and you aren't likely to get misdiagnosed.


/also, check you balls once a month for lumps.  If you are a woman, check your breasts.
//No really, do it right now.  Fark's readership is big enough that statistically, one of you has a good chance of having cancer.


Eh...

TFA: A 2009 study showed that, for many cancer screening tests, a patient who undergoes 14 screenings has more than a 50 percent chance of a false positive.

Unless there's something in your personal or family history that suggests a substantially higher risk of cancer, I can't imagine any earthly reason a thirty-something should be doing annual checks for cancer.

The advice on self-checks, though -- yeah, no argument there.
 
2013-08-20 11:48:59 PM

juvandy: The article isn't about how bad it is for you to visit a doctor on semi-regular visits for checkups...The article is about how much it is costing the overall health-care system in raw dollahs. The author's cost/benny analysis, the over-doctoring is not worth the "relatively minimal" (quotes are mine) lives saved by these visits, vs. the dollahs spent.

Well, it does also touch on the effects of false-positive test results on patients' health (via post-test exploration) and mental anxiety. False positives are a real problem given that doctors don't know the underlying statistics well enough to comprehend what they mean, let alone to explain it to their patients. The article itself even gets it wrong when it implies that a false positive rate will necessarily increase your risk of getting a false positive the more times you see a doctor. Technically, the probability doesn't change. What it does mean is that a test with a 10% false positive rate doesn't indicate that a positive = a 90% chance of a true positive.


Actually, we are taught the important concepts of statistics (false pos, false neg, specificity, sensativity, pos predict value, neg predictive value, and so on) from the start of medical school.  Along with being taught the actual stats for various diseases, and weighing the benefits to risks for just about everything down to an algorithm.  On top of how to break this down to patients.  These things are pretty heavily tested on our licensing exams.
 
2013-08-20 11:56:55 PM

orclover: cameroncrazy1984: cchris_39: Slate is predictably doing its part to lay the groundwork for restricting care.

Care already IS restricted, you derpaholic.

For the most part its not restricted.  You might end up paying it off for the rest of your life.  Or fall into financial ruin.  Or just say farkit and kiss that useless credit goodbye.  But yea you can get care.   Then you are farked, financialy.

People just need to buy more money though, all this debate is just stupid.  Hell ask their parents for a raise if they have to.


Not legally restricted, but yes it is restricted.  You take 4 days to treat pneumonia when the next guy took 3 (regardless of the patient profile and individual situation)? You get a call from Humana saying they're dropping as an approved physician. It's not just patients that have to watch their asses.  Or if you try to order a test without justification? You will be getting a call.  And, Medicare will show up to your office and examine 5 years of records and find every way to not reimburse you.  The fact that we're taught how to avoid these things just as much as we're taught actual medicine is telling.
 
2013-08-20 11:59:01 PM
Well, great.  I didn't feel like getting that pelvic exam anyway, then when I'm dying of lady bits cancer, I can at least look at this Slate article and know I did everything I should have done to prevent it!

The whole going to the doctor because you have a cold thing has to stop.  Not every little sniffle needs an antibiotic.  This world is full of hypochondriacs.  I know 2 females in their 20's who swear they have debilitating diseases and NEED to go to the doctor (specialists, no less) multiple times per year.  One of them went to 3-4 different doctors, and was finally happy when one of them gave her a pill to take to ease whatever disease it is she thinks she has at the moment.  (Of course, she only stays on these pills long enough for the sympathy to wear off.)  Then there were the sleep studies that showed she was normal, and she didn't believe.  Cripes.

If I have to sit through one more conversation about this gal's rotten vagina, sleep issues, PMDD, or alleged lactose intolerance (while drinking milk and eating cheese), I'm going to scream.
 
2013-08-20 11:59:33 PM

jaylectricity: I went to the doctor for an "Adult Physical" and he told me I had diabetes...sort of. Then his solution to my insomnia was an anti-depressant. And then he put his finger up my butt.

The Trazadone actually helped me sleep.


To be fair, that drug is rarely used for depression anymore, if that makes you feel better.
 
2013-08-21 12:06:23 AM

RentalMetard: Mistymtnhop: OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!

If you've had symptoms for more than 10 days, you'll get antibiotics (might get an inhaler out of the deal too depending on what exactly's going on; those are always handy to have around for pick-up football games).  You should probably go to the doctor and pick up a Z-pak.

/almost a doctor


Ma?
 
2013-08-21 12:16:01 AM

Bumblefark: Great Justice: I recommend yearly cancer screening starting sometime in the thirties.  You don't have to have the doc do anything else, just look for cancers in all the likely places to ensure you don't have them.  Its worth the cost, and you aren't likely to get misdiagnosed.

/also, check you balls once a month for lumps.  If you are a woman, check your breasts.
//No really, do it right now.  Fark's readership is big enough that statistically, one of you has a good chance of having cancer.

Eh...

TFA: A 2009 study showed that, for many cancer screening tests, a patient who undergoes 14 screenings has more than a 50 percent chance of a false positive.

Unless there's something in your personal or family history that suggests a substantially higher risk of cancer, I can't imagine any earthly reason a thirty-something should be doing annual checks for cancer.

The advice on self-checks, though -- yeah, no argument there.


The problem with cancer is that there are just so many things that can cause it.  Sunlight exposure, diet, breathing smoke (recreational or industrial), radon, chemicals in your water table, and yes, the dreaded family history which means you will give yourself cancer!

That scary study does indeed indicate a high rate of false positives, but in the case of cancer a false positive is generally better than a missed actual.  For most of your health, you can just stay healthy, but you have so little control over your carcinogenic exposure; its all who you are and where you live.

Its one test a year, and it can save you so much pain, and give a little bit of peace of mind too.  Better safe than sorry.

/and in case you didn't catch it, "looking for cancer in the likely places" means a doctor sticks his finger up..well...you know...
 
2013-08-21 12:17:14 AM

SurfaceTension: kg2095: mr0x: bearded clamorer: [www.slate.com image 568x379]

That broad's tits looked healthy.

And, the doctor looks like he could croak right there.

[www.shadowlocked.com image 200x200]

Sure, I'll take advice from a doctor who looks sick as fark.

I once had a doctor who looked like that tell me I had to lose weight.

In my late 20's I regularly saw a dermatologist for a condition I had at the time. He had all these posters up about "wear your sunscreen" and "stay in the shade" and "is this mark on my skin bad?" He was always warning about how one can get skin cancer, the horrors of it, all that. And then after one visit I walk outside and there he is, under a tree, smoking a farking cigarette.


It's moments like that you realise you need to change doctors.
 
2013-08-21 12:17:29 AM
It's a dangerous place
latimesblogs.latimes.com
 
2013-08-21 12:34:53 AM

Snarcoleptic_Hoosier: Wash your hands, cook your food, wear a condom, and get vaccines.


You forgot don't drive drunk and don't smoke.
 
2013-08-21 12:37:44 AM
Please remember this simple fact:

Half of the world's doctors graduated at the bottom 50% of their class.

It's that simple.

Google can really be smarter than your GP.  Or not.

Good luck, citizen.

Bad doctors are far more dangerous to more people than any "bad cop thread,"  Let us rate doctors on Yelp or TripAdvisor and we would see real advances,  "Modern Medicine" is a load of horse puckey.  Even rate them among auto-parts stores for comparable service, and they would lose.  Badly.  Doctors suck.  Really.  "Oh, I graduated at the 37th percentile in my class!"  Personally, I would call that a fail.
 
2013-08-21 12:40:23 AM

kg2095: SurfaceTension: kg2095: mr0x: bearded clamorer: [www.slate.com image 568x379]

That broad's tits looked healthy.

And, the doctor looks like he could croak right there.

[www.shadowlocked.com image 200x200]

Sure, I'll take advice from a doctor who looks sick as fark.

I once had a doctor who looked like that tell me I had to lose weight.

In my late 20's I regularly saw a dermatologist for a condition I had at the time. He had all these posters up about "wear your sunscreen" and "stay in the shade" and "is this mark on my skin bad?" He was always warning about how one can get skin cancer, the horrors of it, all that. And then after one visit I walk outside and there he is, under a tree, smoking a farking cigarette.

It's moments like that you realise you need to change doctors.


I'm sure he's aware smoking is bad for you and wouldn't recommend it based on his own personal poor decisions.  Mine was pretty obese but this really didn't influence his advice to wear sunscreen, recommendations for what kind to pick up at the store, how to still get enough sun for Vitamin D,  and to check for moles.
 
2013-08-21 12:52:53 AM
not urgent, don't care
 
2013-08-21 12:55:36 AM

MylesHeartVodak: Half of the world's doctors graduated at the bottom 50% of their class


Yogi Berra, is that you? Sounds like you've spent some time researching and thinking about this, I'll certainly take your word for it.

That's just ridiculous logic.  You seem to be forgetting how competitive medicine is, and the fact that there's waaaay less spots compared to applicants, both in the first 4 years and in residency.  Plenty of people that are waitlisted or plain don't get in are perfectly capable of becoming great doctors - there's just not enough spots. There's also these things called basic sciences, comp, licensing (those things that residency programs actually care about) and board exams that not only have to be passed, but have to be passed with flying colors to secure a residency and/or have a chance of succeeding as a doctor.  Also, most US med schools are pass/fail and they hold you hand to make sure you pass to keep that attrition rate down.  So yeah...
 
2013-08-21 12:55:49 AM
Hey, not cool, man. Those visits help pay for hard working doctors' second and third boats, you know!
 
2013-08-21 12:59:46 AM

Five Tails of Fury: Hey, not cool, man. Those visits help pay for hard working doctors' second and third boats, you know!


Sounds like you know a lot of doctors (sarcasm). Really hard to do when you have 250K of debt not counting the cost of buying into a practice.  And the whole 12 total years of schooling past high school.  And the fact that you have absolutely no time and no life to enjoy those alleged 3 boats.
 
2013-08-21 01:06:12 AM

Mistymtnhop: OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!


Maybe so he can tell you to STAY THE FARK HOME and stop getting everyone else sick!

/tired of these "such a trooper" students and employees
//you're not a trooper, you're a jackass prolonging your own illness and passing it to everyone around you
 
2013-08-21 01:08:40 AM

Spiralmonkey: Apart from anything else a healthy person in a doctor's waiting room will pick up every variety of sniffles, coughs, inexplicable rashes and galloping knob rot that could possibly exist on Satan's Petri dish.


My adopted Mom, who worked as an ER Nurse for over 22 years said it best:

"A hospital is no place for sick people!"

The same pretty much holds for doctors' Office waiting rooms.
 
2013-08-21 01:23:02 AM

Great Justice: Bumblefark: Great Justice: I recommend yearly cancer screening starting sometime in the thirties.  You don't have to have the doc do anything else, just look for cancers in all the likely places to ensure you don't have them.  Its worth the cost, and you aren't likely to get misdiagnosed.

/also, check you balls once a month for lumps.  If you are a woman, check your breasts.
//No really, do it right now.  Fark's readership is big enough that statistically, one of you has a good chance of having cancer.

Eh...

TFA: A 2009 study showed that, for many cancer screening tests, a patient who undergoes 14 screenings has more than a 50 percent chance of a false positive.

Unless there's something in your personal or family history that suggests a substantially higher risk of cancer, I can't imagine any earthly reason a thirty-something should be doing annual checks for cancer.

The advice on self-checks, though -- yeah, no argument there.

The problem with cancer is that there are just so many things that can cause it.  Sunlight exposure, diet, breathing smoke (recreational or industrial), radon, chemicals in your water table, and yes, the dreaded family history which means you will give yourself cancer!

That scary study does indeed indicate a high rate of false positives, but in the case of cancer a false positive is generally better than a missed actual.  For most of your health, you can just stay healthy, but you have so little control over your carcinogenic exposure; its all who you are and where you live.

Its one test a year, and it can save you so much pain, and give a little bit of peace of mind too.  Better safe than sorry.

/and in case you didn't catch it, "looking for cancer in the likely places" means a doctor sticks his finger up..well...you know...


Yeah...I still dunno. I don't think you can just wave away false positives as a "better safe than sorry" thing. Those sorts of errors have very real implications for the patient -- not only in terms of financial and psychological costs, but also the risk of unnecessary and potentially harmful medical interventions while the false diagnosis is in effect.

Annual screenings beginning in your 30s makes it highly likely (depending on what you're being screened for) that you're going to get a false positive at some point within the next 20 - 30 years -- and to guard against what? The 0.1% chance that you're a 30-something with cancer?

I mean, to each their own, but that seems like a pretty crappy tradeoff.

/And, I don't think I'm being cavalier about the possibility of being that 0.1%, either. I'm a 30-something who got some (non-routine) tests this last week.
//Looks like I should be in the clear, at least presently, but -- yeah, unsettling stuff.
 
2013-08-21 01:48:40 AM

EmmaLou: One of them went to 3-4 different doctors, and was finally happy when one of them gave her a pill to take to ease whatever disease it is she thinks she has at the moment.


While there certainly are hypochondriacs there are also the difficult-to-diagnose things that often end up with patients seeing a series of docs.  I was on doc #6 when I got a partial answer that sure made my life better and it was a lets-try-this-just-in-case thing.  I don't fit their pigeonholes, they decide what I describe simply can't be right and I got a psych referral out of that--and it took the shrink almost no time at all to figure out I wasn't nuts.  Being good at identifying triggers doesn't mean it's psychosomatic, it simply means I know how to figure them out.

MylesHeartVodak: Bad doctors are far more dangerous to more people than any "bad cop thread," Let us rate doctors on Yelp or TripAdvisor and we would see real advances, "Modern Medicine" is a load of horse puckey. Even rate them among auto-parts stores for comparable service, and they would lose. Badly. Doctors suck. Really. "Oh, I graduated at the 37th percentile in my class!" Personally, I would call that a fail.


There's a big problem here.  The doc who does what his patients want would rate highly.  You don't really want the doc who hands out antibiotics for colds getting a high rating.  A patient can rate how they were treated, they can't really rate the medical advice too well.
 
2013-08-21 02:58:59 AM

Mistymtnhop: OMG, I'm going on week two fighting a nasty cough/cold. I sound horrible and all people say is "Go to the doctor! " Why! So he can tell me its a cold and there's nothing he can do? Stop telling me to go to Urgent Care! It's farking annoying!


Two weeks is long for a cold. You could have developed a sinus infection. These are often bacterial and can be treated with antibiotics. Even if it's viral, you can get some relief from your symptoms. You really should see a doctor.
 
2013-08-21 03:34:42 AM

jaylectricity: I went to the doctor for an "Adult Physical" and he told me I had diabetes...sort of. Then his solution to my insomnia was an anti-depressant. And then he put his finger up my butt.

The Trazadone actually helped me sleep.


You sure?  I'll put $20 down that the UFIA actually helped you sleep.
 
2013-08-21 03:39:35 AM

Bumblefark: Annual screenings beginning in your 30s makes it highly likely (depending on what you're being screened for) that you're going to get a false positive at some point within the next 20 - 30 years -- and to guard against what? The 0.1% chance that you're a 30-something with cancer?

I mean, to each their own, but that seems like a pretty crappy tradeoff.


Agreed. My doctor once convinced me to get an ultrasound to check out a cyst she found. Its conclusion, "Might be lady-parts cancer, check it again in 6 months." The followup ultrasound was clear, but they found a kidney stone. My doctor wanted to send me to a specialist just in case for that too. My response was, "Will it kill me before I get symptoms? No? Then NO."

I spent 2 months pay on out-of-pocket medical expenses that year,
and since I hate my job, that's like taking away 2 months of my life.
Net loss.
 
2013-08-21 03:50:17 AM
Oh, and my thyroid tests keep coming back "sub-clinical", "just barely within range" and "borderline, better keep an eye on it" even though I DO have symptoms, and a family history, and there's a simple pill to treat the problem! But no, better to poke around for things we might get to biopsy instead.
 
2013-08-21 04:53:41 AM
i.imgur.com

i.imgur.com

To American viewers: Read subby's link.  It is wise, and you should consider what it says.

To the rest of the world:Yeah, yeah... stop laughing.  No, seriously; stop laughing.  This is for THEM, remember?
 
2013-08-21 06:46:09 AM

pissnmoan: Last time I checked, women live longer than men.


Last time I checked, men are also more likely to die on the job at younger ages than women.
 
2013-08-21 06:49:46 AM
regular self-evaluation's rarely stupid in any context.
 
2013-08-21 08:34:03 AM
There have been people who have ended up dead because they thought they just had a virus or something else that they'd be over soon and didn't go to the doctor.  So how does one tell when they really do need to go to the doctor and when doing so wouldn't help anything?
 
2013-08-21 12:08:30 PM
Too frequently, I have a little kid (5-10 years old) being brought in by their mother, and there is basically nothing wrong with them. I explain that patiently to the mom ("Looks like it's just a bruise. He's moving his arm without pain and there's no limitation, and it was a small injury anyway. We certainly don't need to cast it or operate on it or anything else. It'll just get better if we let it be.")

And, no lie, the mom will say, "Oh, I know. He just wanted to come to the doctor to make sure it's OK."

I've gotten to the point where I look at the mother and politely but clearly ask who the grownup is in the family. Sometimes I give a couple of sentences about how, if you're participating in letting them think the world is a scary and dangerous place, then they're going to carry that with them forever - and it's not a good thing.

Sigh.
 
2013-08-21 12:15:49 PM
The idea of the "routine physical" is simple:

Let's say I'm a doc with a private practice. How do I know that I can pay my mortgage and car payment? I must have some form of ongoing, baseline income.
So I tell people to come in, once a year, just to make sure things are OK. Boom! Instant cash flow.

Over the years, we've found that - in big population studies - only certain tests are useful. These screening tests (e.g., mammography) are mandatory. Some even more so, if you probably have a genetic time bomb (e.g., breast cancer in your mom).
But most stuff is a waste of time and money. And health care costs skyrocket because of all the unnecessary crap we do to people.

Some of that unnecessary crap is due to patients' anxiety and, frankly, ignorance. Plenty of misinformed folks out there.
And a large part of it is due to lawyers, and their need to make a buck by suing for "malpractice." Their need to generate income regularly leads to the same unnecessary litigation that the yearly physical leads to.
 
2013-08-21 12:56:53 PM
Oh, so the insurance companies are tired of paying for well visits?  And they can kill two patients with one stone since people who don't do well visits won't find the fatal conditions that would kill them early until it's too late.  Every diabetic we kill before we have to start paying for their treatment saves us money!

Fark insurance companies as hard as possible, man. Bend them over and fark them in the sewer pipe with a rubber full of broken glass.
 
2013-08-21 09:40:07 PM

CWeinerWV: There's also these things called basic sciences


Somehow it never makes me feel better when an MD asks me what kind of scientist I am (because they see that under "occupation") and I tell them and they inevitably groan and say how hard they found that subject.
 
Displayed 93 of 93 comments

View Voting Results: Smartest and Funniest


This thread is closed to new comments.

Continue Farking
Submit a Link »






Report