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(Slate)   Going to the doctor when you aren't sick or dying does more harm than good   (slate.com) divider line 29
    More: Obvious, injury, prostate cancer screenings, chronic kidney disease, average wage, Rand Corporation, doctor's visit, medical  
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6905 clicks; posted to Main » on 20 Aug 2013 at 9:07 PM (46 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



Voting Results (Smartest)
View Voting Results: Smartest and Funniest

2013-08-20 09:09:27 PM
4 votes:
Wash your hands, cook your food, wear a condom, and get vaccines.
2013-08-20 10:42:40 PM
3 votes:

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 08:12:55 PM
3 votes:
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
2013-08-21 12:55:49 AM
2 votes:
Hey, not cool, man. Those visits help pay for hard working doctors' second and third boats, you know!
2013-08-20 10:52:02 PM
2 votes:

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 10:49:23 PM
2 votes:
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 10:03:48 PM
2 votes:
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 09:43:22 PM
2 votes:
Slate is predictably doing its part to lay the groundwork for restricting care.
2013-08-20 09:34:09 PM
2 votes:
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 09:32:28 PM
2 votes:
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 09:31:11 PM
2 votes:

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 09:28:25 PM
2 votes:
The author has no readily-identifiable medical education or experience.

www.nextscientist.com
2013-08-20 09:24:08 PM
2 votes:
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 09:17:02 PM
2 votes:

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 09:14:51 PM
2 votes:
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.
2013-08-21 01:48:40 AM
1 votes:

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.
2013-08-20 11:56:55 PM
1 votes:

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 11:48:59 PM
1 votes:

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 11:35:33 PM
1 votes:

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 11:20:29 PM
1 votes:

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 11:14:54 PM
1 votes:

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 11:10:05 PM
1 votes:

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 10:40:52 PM
1 votes:
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 09:49:55 PM
1 votes:
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 09:29:34 PM
1 votes:
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 09:28:25 PM
1 votes:

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 09:26:58 PM
1 votes:
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 09:26:35 PM
1 votes:

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 09:19:06 PM
1 votes:

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.
 
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