the reply is ALWAYS going to be "See a doctor" May 12, 2005 1:11 PM   Subscribe

Why do people keep asking medical questions on AskMe when the reply is ALWAYS going to be "See a doctor?" Should we have a message like they have on doctors phone lines that says, "If you think you have a medical problem, don't ask us, GO SEE A DOCTOR." in the AxMe posting page?

As a broader question, is community decision making and the internet replacing common sense?
posted by SpecialK to Etiquette/Policy at 1:11 PM (70 comments total)

We've discussed this before.

Common sense and the internet coincided last in 1981. Then came Usenet.
posted by Saucy Intruder at 1:19 PM on May 12, 2005


I think the reason people ask these questions (at least some of the time) is that they want some kind of reassurance or some idea of what they can expect. If I was worried about some ailment I had and had to wait several days before I could see a doctor then I might well ask on AskMe too.
posted by dodgygeezer at 1:20 PM on May 12, 2005


I don't think this is a good idea. There are a lot of medical questions that would clearly be appropriate for AskMe, like asking for stories about experiences with certain drugs or diseases. And even the "do I have a medical problem?" ones aren't necessarily a bad thing if, say, someone else in the community had the same problem and it's something obscure that a doctor might not think to look for. Community decision making can be a kind of common sense.
posted by transona5 at 1:22 PM on May 12, 2005


Why do people keep asking medical questions on AskMe

1 part ego + 1 part foolishness. The only useful medical questions are those asked after doctors have been consulted. Until then, you're wasting your own time. Maybe the AskMe posting page should have links to WebMD and those kinds of sites. Hey, there's an idea - links to all kinds of resources that should be checked before posting, like wikipedia, imdb, allmusic and so on.

is community decision making and the internet replacing common sense?

Yes. With hilarious results.
posted by loquax at 1:23 PM on May 12, 2005


We should have a message. Even if there was a qualified doctor registered here, and they were to answer a question, I think they would still end with "..but please see your own doctor in person, this is the internet after all etc..." Add to this that a bit of searching google will also tell them to see a doctor, reassurance could end up being more dangerous than no advice at all and half this stuff is trivial anyway, and we have a case for some sort of medical emergency advice smackdown.

General advice about conditions, drugs, coping with diagnosed illnesses = yes

Help I have sticky stuff in my belly button = hmm.
posted by fire&wings at 1:25 PM on May 12, 2005


I find most of these posts are from people who aren't sure something is bad, and want to know if there are any particularly dread diseases that symptom X could be a sign of. A lot of people that read this board can't see a doctor at the drop of a hat, either because they have no health coverage, or because they live in an underserviced area, where getting an appointment is not an instant sort of thing. They want a bit more information while they wait and/or decide if something is really necessary.

Of course they could get better information than they can get here by seeing an actual doctor, they already know that. What they want is better information than they already have, which is somewhere in the middle, so that they can decide if they need to see a doctor.
posted by jacquilynne at 1:29 PM on May 12, 2005


For a lot of people, seeing a doctor is an expensive option. Sometimes prohibitively so.

I don't think AskMe is the answer to this problem, but it might explain why some people resort to it. It's not so much a matter of lack of common sense as it is one of unfortunate necessity.
posted by mr_roboto at 1:32 PM on May 12, 2005


Yeah, last time I tried to get a doctor's appointment, I had to wait 2 weeks. If I called up and tried to express the emergency of my killer body order, or white stuff in my belly button. I don't think that I would have been bumped up in the line any sooner. I think that people are looking for an answer like "Yeah, my neice had something like that, and she's not dead" while they get the time/money/guts to see a doctor.
posted by 23skidoo at 1:37 PM on May 12, 2005


As a broader question, is community decision making and the internet replacing common sense?

I don't know. Let's take a poll.
posted by Armitage Shanks at 1:37 PM on May 12, 2005

A new study analyzing data from the Centers for Disease Control and Prevention shows that a significant number of working Americans in every state do not have health care coverage, with more than 20 million working adults not having coverage. In eight states, at least one in five working adults is uninsured. In 39 other states, at least one working adult in every 10 does not have health care coverage. The report further reveals that in all 50 states and the District of Columbia, between one-fourth and one-half of all uninsured adults were unable to see a doctor when needed in the past year because of cost.
posted by matteo at 1:38 PM on May 12, 2005


I think that people are looking for an answer like "Yeah, my neice had something like that, and she's not dead"

The problem lies in when someone says that and has not the slightest idea what they're talking about. AskMe posters, helpful as they try to be, are likely not trained in the art of eliciting useful descriptions of relevant symptoms, and cannot possible asses the patient first hand. *Any* advice is going to be at best useless and at worst harmful. If you can't afford to go see a doctor, that's really too bad, but asking random strangers about your perceived symptoms is not an alternative and has at least an equal chance of contributing to the problem as it does of helping.

Not so, of course, for post-examination advice related to drugs or specific conditions that have been diagnosed by a professional.
posted by loquax at 1:45 PM on May 12, 2005


What's the problem here? Bill Frist can diagnose someone from a video. Why can't random strangers diagnose your problems over the internet?

Anyway, anyone who suspects that they might have a medical problem would do well to consult this book.
posted by casu marzu at 1:45 PM on May 12, 2005


Even if there was a qualified doctor registered here, and they were to answer a question,

There are.

I think they would still end with "..but please see your own doctor in person, this is the internet after all etc..."

They do.
posted by raedyn at 1:46 PM on May 12, 2005


This is normal human behaviour, folks. If people aren't asking AskMe (and even if they are) they're asking friends, family and co-workers. Certainly it's not a replacement for proper medical advice, but unqualified people have these conversations all.the.time. It's not a phenomenon unique to AskMe.
posted by raedyn at 1:48 PM on May 12, 2005


*Any* advice is going to be at best useless and at worst harmful.

Sure, but "My neice had something like that once, and she's not dead" isn't advice. It's just an anecdote. If the person was giving specific things that the person should do, or drugs the person should take, that would be bad, I agree; the opinions of untrained strangers are a poor substitute for the diagnosis of a trained professional.

But that doesn't mean that all health advice from non-doctors is bad. I mean, in this thread it was pretty much on the money: wear earplugs, minimize the number of times you experience excessively loud noise.
posted by 23skidoo at 2:16 PM on May 12, 2005


I don't think we need to prohibit people from asking medical questions, but I think we should discourage people from getting all snippy when everyone tells them to go see a doctor.

But the answer isn't always going to be "go see a doctor." People are amazingly ill informed about their own bodies, and even the well-informed don't know much about medicine. There are likely cases where someone does get valuable information from AskMe, and there may be other cases where someone gets the message and goes to a doctor.
posted by anapestic at 2:17 PM on May 12, 2005


"is community decision making and the internet replacing common sense?"

When was there ever any common sense?
posted by mischief at 2:52 PM on May 12, 2005


I think the real danger is on someone taking the advice they are given on AskMe as real medical advice, instead of mostly anecdotal information. It is easy to assume that people are smart enough not to do this, but it is also very easy to take advice from anywhere as gospel when it aligns with what you thought in the first place. The venue doesn't really matter, you need to value free advice based on what it costs you, generally.

I am still apalled that Americans have such limited access to medical care. It boggles my mind that such an "advanced" country does not have the ability to look after its citizens.
posted by dg at 3:21 PM on May 12, 2005


Americans do not in general have limited access to medical care. Nobody has to wait two weeks to see a doctor. You might have to wait two weeks to see a specific doctor, but that's because there's only one of him. If you are not so picky, you can see a doctor or a nurse practicioner pretty much on demand at a walk-in clinic. And yeah, an NP can write prescriptions, and yeah, the clinic visit will be covered by most insurance.
posted by kindall at 3:37 PM on May 12, 2005


It occurs to me that some medical questioners on AskMe wish to know if the symptoms they're having are worrisome enough to see a doctor. As if it were me, telling my work buddies or my neighbor about this headache or skin rash I have that just won't go away. And what I really want to know is, "Am I being a whiny crybaby or do you think I should go to the doc?" Then the wonderful community that makes up AskMe answers, each commenter with his or her anecdote or hard fact that helps the questioner make up his or her mind whether or not to seek medical intervention, or do they have something that will respond to home treatment. No need to be so hard about it, surely most of you have engaged in this sort of banter face to face before, right? (On preview, what raedyn said!)
posted by Lynsey at 3:47 PM on May 12, 2005


kindall, "having medical coverage," is not a blissful cure all. The Doctors on my company's plan are supposedly only allowed to see us for 15 minutes at a time, so he usually just gives me a cursory exam and then prescribes painkillers or whatever. The one doctor on our plan in my part of Queens works out of a clinic across from the projects and seems to have drawn the conclusion that all his patients are drug-seeking miscreants and treats us accordingly. And our dental coverage is basically a discount plan, that renders preventative care so costly that I've gone to the dentist only when pain has become unbearable, and still wound up paying through the nose. But at least our Rx coverage is decent, even though you have to jump through hoops if any prescription is for a "controlled substance." And I spent much of my twenties with zero coverage ven though I was working full time hours. When I complained, my hours were suddenly cut, and this was a company with a warm and fuzzy public reputation (until the owner went to prison for tax evasion, but that's a whole other story).

So, sometimes people are inclined to seek advice elsewhere before diving into the who health care maze.
posted by jonmc at 3:51 PM on May 12, 2005


Kindall - Have you been to a Veterans' Administration medical facility lately? A two week wait is prompt. Two months is not unknown, and a doctor in the "wrong" specialty will not substitute for the one needed.
At the moment, the VA in Portland Oregon has no neurosurgeon on staff.
Those who have some insurance might have a chilling co-pay for an office visit and might not have prescription coverage.
People out on their own for the first time, perhaps far from home, may just need someone to talk to. What raedyn and Lynsey said...
posted by Cranberry at 4:08 PM on May 12, 2005


I wasn't coming down against posting medical questions on AskMeFi, merely refuting the idea that access to medical coverage in the U.S. is somehow "limited." I've never had any trouble getting what I needed in a reasonably timely fashion. The "insurance is tied to the job" thing is a whole 'nother issue.
posted by kindall at 4:11 PM on May 12, 2005


The responsable thing is always to advise someone to be examined in person, so I don't much like health advice questions either. It's human nature to ask, though, so I don't think that's going to change. What I DO like are questions like, "My friend has just been diagnosed with XYZ, has anyone else been through it?".
posted by puddinghead at 4:16 PM on May 12, 2005


Maybe the AskMe posting page should have links to WebMD and those kinds of sites. Hey, there's an idea - links to all kinds of resources that should be checked before posting, like wikipedia, imdb, allmusic and so on.

I think this is a great idea. You could make the suggestions dependent on the category. Travel and transportation? You might try Flyertalk? Media and arts? You might try IMDB.
posted by grouse at 4:22 PM on May 12, 2005


I've never had any trouble getting what I needed in a reasonably timely fashion.

And therefore access to medical coverage in the U.S. is unlimited... because your experience is representative of everyone's!
posted by languagehat at 4:22 PM on May 12, 2005


Even if you have good access to a doctor, which I do, and even if he's a good doctor, which he is, it's still helpful to ask around for anecdotal experiences. Sometimes other people can clue you in to something you might not have thought of, or inform you about what questions you should ask your doctor, or give you the insight of their long experience diagnosing and treating an ailment which you may just have encountered for the first time. Many treatments affect different people differently. With some things like birth control pills or anti-depressants, it can help a lot to gather multiple personal accounts of side effects, etc.

Anybody who thinks that simply walking up to one doctor always autoamtically solves any problem has never had any health problems, IMHO. And anyone who's so bothered by the fact that folks want to discuss health issues with one another needs to take a frikkin' pill.

THERE IS NOTHING WRONG WITH DISCUSSING HEALTH ISSUES WITH OTHERS AND GATHERING THEIR EXPERIENCES AND INFORMATION.
posted by scarabic at 4:40 PM on May 12, 2005


Some things are so simple that the average person will feel comfortable just answering, but most will prompt a "it could be ... and go see a doctor" type of answer. Most people asking these questions know that seeing a doctor is the right thing, but we can't all go running off to the doctor for every ache, pain and malady. Well some people do; they are called hypochondriacs. With all of the medical information available online and armed with some sharp answers from AskMe one can go a long way toward determining whether some symptom is something to worry about or ignore. For many people it will probably increase their chances of visiting a doctor. My tendency is to skip the doctor, but if I know something might be potentially serious I will make the effort to see the doctor. If someone on AskMe gives me that info than good for AskMe. I happen to have some docs in the family so I usually ask them rather than AskMe, but if I didn't have that resource I would probably have asked a few things there. Used intelligently, and Metafilter has a pretty intelligent user base, AskMe can be a valuable resource for medical, legal and other specialist information.
posted by caddis at 4:42 PM on May 12, 2005


anyone who's so bothered by the fact that folks want to discuss health issues with one another needs to take a frikkin' pill

But only after discussing it with a physician.
posted by grouse at 4:42 PM on May 12, 2005


What scarabic said, up to a point. Medicine isn't a priesthood where one isn't permitted to know the holy secrets -- if you think you have a serious problem you're insane not to seek experienced opinions. All doctors and health plans are not created equal and the more informed your search is the better.

I said, "up to a point" because it's worth adding that you should never treat anecdotal information as fact. Some stranger telling you "oh, don't worry I had that and it turned out to be nothing" could make you dead if you treat it as gospel. Ask around, shop around, see a doctor and if you have any doubt that you've been competently diagnosed and treated, see another. Where your peers can help you most is in doing research on your own. Good doctors usually like it if you've taken the trouble to learn a little something about your condition. (Bad doctors get pissed because they don't want to listen to you talk about things you don't understand.)
posted by George_Spiggott at 4:48 PM on May 12, 2005


Access to medical services is not really limited in the US, yet the cost is prohibitive to many, leading to situations where people only seek treatment in extreme situations. You can walk in to an emergency room with nearly any problem and you will be seen. You will also receive a very large bill.
posted by spaghetti at 4:58 PM on May 12, 2005


. . .needs to take a frikkin' pill.

I was wondering when the pill pushers would show up.
posted by mlis at 6:10 PM on May 12, 2005


I EAT DOCTORS
posted by I EAT TAPES at 7:07 PM on May 12, 2005


As someone who recently asked a medical question, I have to say everyone's explanations are correct: I have no healthcare, a visit to a sports doctor is expensive, and I wanted to figure out if I was being a baby or it was worrisome. I got great advice on how to finagle, what things to consider, and actually decided it was worth begging a relative with money to help out, so now I get to go see a doctor.

Therefore, a medical AskMe worked very very well. Yay Ask. Boo SpecialK.

And kindall, when something is limited by your ability to afford it, it's limited.
posted by dame at 7:23 PM on May 12, 2005


How do they taste?
posted by jonmc at 7:23 PM on May 12, 2005


Umm...has anyone got link(s) to Q's where there's been patently bad information given? I don't know that there's tooooo much outrageous stuff being disseminated - or at least, those topics where there's a wide range of views, there's likely no absolutely correct answer anyway.
I'd like to see questioners themselves show some links to what they've found beforehand when they post their question (not just for medical questions) -- that way a critique of the source(s) or a re-google can often times produce the salient information. I also like to see people answering put up links to support what they're saying (other than when it's their own experience/anecdotes) so that everyone reading has a source and judgment calls can be made.
But most people answering seem to give caveats (see Doctor blah blah) most of the time -- it's not like there's serial twats trying to give false answers on purpose (yes, yes...best intentions &c)-- if something's suspect, others come in and generally help sort it out. But everyone knows that it's the poster's own responsibility to themselves as to how many grains of salt to take with each answer. Medical-ish questions are ok -- it's perhaps the most well respected area of the site in a lot of ways and the discussions and linking support for each means everyone can get a little bit better educated (ingrained stupidity and misconeptions notwithstanding).
posted by peacay at 7:37 PM on May 12, 2005


And kindall, when something is limited by your ability to afford it, it's limited.
That is what I meant (and I was not meaning to insult Americans or America in any way). From a point of view where access to medical care is free (with very few exceptions) for everyone, the stories that I hear of people paying huge sums for basic health care make me glad to have Medicare and hope that those who wish to dismantle it stay the fuck away. It may be a long way from perfect, but it beats the crap out of what the situation seems to be in America, supposedly one of the most advanced nations in the world.

*gets off soapbox*
posted by dg at 7:49 PM on May 12, 2005


Yeah, so anyway...I've got this, uh, friend, who has this rash on his penis. It's spreading. Uh..or so he says. I'd ...uh...I mean he'd....like a diagnosis, and, if possible, the name of the drug I....fuck, he....should be taking. Thanks, guys!
posted by graventy at 8:17 PM on May 12, 2005


He needs psylocibin and this.
posted by peacay at 9:02 PM on May 12, 2005


Peacay, that's just wrong. Funny. But wrong.
posted by dame at 9:13 PM on May 12, 2005


"I have no health care." You mean you have no health insurance.

There is a difference. People without health insurance still have access to healthcare. (Just sick of people who depend solely on the media for their information about the state of health care in the US thinking a large number of us can't see a doctor.)
posted by Carbolic at 11:09 PM on May 12, 2005


I think lots of the health questions in AskMetafilter are of the sort I ring NHS direct with - NHS direct is a telephone service staffed by nurses, who listen and usually say one of
  • stop whingeing
  • it can be cleared up easy, go see a pharmacist and buy X
  • go see your doctor but it's not urgent
  • go get an urgent appointment with your doctor
  • go to casualty
If you've got nothing like that over in the states, so can't ask a qualified nurse, I don't see any problem with asking the usually sensible and erudite metafilter.
posted by handee at 4:03 AM on May 13, 2005


Oh be fair. Most of these questions are wondering if other MeFites have had similar experiences and can thus quickly reassure the questioner. You can't get that from a doctor, and what you can get from a doctor you need an appointment for, you know?

We do this in real life too, don't we? A mate of mine was agonising about a painful lump behind his testicle and I was able to tell him it was almost certainly an epidydimal cyst - something I'd had myself. He instantly felt better and managed to stop thinking he certainly had cancer. I think it's perfectly reasonable that people ask about their medical sympoms here. Sure, they should see a doctor too, but meanwhile, with a population as large as this, it's distinctly possible someone will be able to offer advance reassurance or useful advice.
posted by Decani at 5:21 AM on May 13, 2005


"...merely refuting the idea that access to medical coverage in the U.S. is somehow 'limited.'"

and

"Just sick of people who depend solely on the media for their information about the state of health care in the US thinking a large number of us can't see a doctor."

Well, I'm just sick of people who have some form of health insurance thinking that it's not true that a large number of people in the US can't see a doctor. Because it is true. Matteo's statistic is correct. From state to state, the percentage of uninsured ranges from 20% of the population to 10% of the population. The uninsured have exactly two options for health care: substandard low-income clinics that will see people that cannot pay up front, and emergency rooms which will by law are usesually required to see everyone regardless of whether or not they can pay in advance but will bill amounts much, much higher than regular office visits. An ER visit will always be in the hundreds of dollars and usually more because an ER doctor moreso than most can't take the chance of not being very thorough (and so will order a variety of expensive diagnostic tests). A low-income clinic visit will have a long waiting list for anything not extremely urgent (and then will likely say: "go to the ER").

Anything requiring hospitalization will likely be unavailable to the uninsured if they can't pay (if it is "elective" or basically non-emergency); and, if it the hospital will perform the procedure, the bill will run to the thousands of dollars. Anything serious will be multiple tens of thousands, up to hundreds of thousands. In fact, the amount billed to uninsured may be more than it would be to the insured because, a) insurance companies have the clout to refuse to pay or negotiate and b) billing to the uninsured for any large amount is unlikely to ever be paid in full anyway so they're anticipating only a portion of it, possibly to be recovered through court actions. This is "available" health care. Right.

Being uninsured is no longer confined to those supposedly lazy people who won't work—vast stretches of the service landscape, such as fast food workers and most others that work part-time at a job (but often cumulatively full-time between two jobs...tough luck), can't get health insurance.

So I just don't understand this "of, Americans really have no trouble getting health care" attitude. It's offensive to me, it's terribly privileged and hidebound. I mean, I'm no socialist. I'm a big market economics person. I have no ideological interest in condeming the American health care system or making negative claims about it.
posted by Ethereal Bligh at 5:40 AM on May 13, 2005


As to the point being raised in this MeTa post...I completely agree with scarabic. People ask each other medical question in real life all the time. It's stupid to say that they can't ask them here—or that it's stupid to ask them here. Loquax and others that claim the latter, I really hope you've never asked a family member or a non-medical person any medical questions like those people are posting to AskMe. If you have, you're a hypocrite.

Secondly, there's nothing magical about seeing a doctor. You've no guarantee that any particular doctor you see will really know what he/she is talking about. Doctors know much less than people think they do. The absurd expectations about what doctors are supposed to know, their infallibility, and the supposedly advanced state of medical science are why people are ignorantly incredibly upset when a doctor—gasp!—makes a mistake or fails to diagnose a problem or a disease. And then they sue. First, in diagnoses doctors are guessing. Second, they are playing the probabilities. If you have some rare problem, you're probably not much less likely to get a correct diagnosis from your mechanic cousin than you are from your family doctor. So the supposed disparity of utility between a doctor and anyone else is not as great as people think.

People don't say "Oh, don't ask questions about your transmission on AskMe, you should see a mechanic because any answers you get here are worthless or less than worthless". Why not? Because that's not true. Answers here are not worthless and medical answers here are not worthless. That doesn't mean they're good. But they may, in fact, be cost-effective if you don't have insurance and even when accounting for the fact that occasionally something dangerous will be missed or misdiagnosis by a folk diagnosis and you'll die. Because you're making that same calculation every time you don't seek a second opinion, every time you don't go to the best doctor money can afford. Whatever. Just because out there somewhere is the very best health care possible doesn't mean that it makes sense to get it. You probably can't afford it. And if you're really poor in the US, you may not be able to afford much more than advice from family and coworkers and askme. Maybe it shouldn't be that way, but that's reality and Loquax's black-and-white version of things is irrational.

What I think is sort of funny about this is that the other area people say, "there's no point in asking" is about law. But the two aren't that comparable. People on mefi are far more likely to give me reasonably accurate information about appendicitis symptoms and treatment than they are on ciminal law in my particular jurisdiction.

To the degree to which it's affordable and convenient to see a doctor (or calling his/her nursing staff, or calling your insurer's nurse hotline), it doesn't make much sense to ask the question here. So if it's really just being lazy, best just use the reliable and available resources you have. But for a large number of people, it very much isn't merely an issue of laziness. Besides which, very often I'm sure that people have already or are about to contact a doctor and they're asking on mefi anyway because they are curious, need reassurance, or whatever. That's valid, too.
posted by Ethereal Bligh at 5:43 AM on May 13, 2005


Ethereal Bligh speaks mighty sense. Heed these words.
posted by Decani at 5:51 AM on May 13, 2005


Ooh, say that again! I'm all tingly.
posted by Ethereal Bligh at 5:58 AM on May 13, 2005


Answers here are not worthless and medical answers here are not worthless.

of course not, EB, but the difference between "answers" and "medical answers" is, and you know it very well, that doctors are forbidden by law to give medical advice over the Internet. hence, what you're getting is anecdotical stuff that could very well be true or could be totally wrong. more like a support group than anything else -- chicken soup for the worried. imagine if people who know about computers were forbidden by US law to give advice over the Internet -- the technical advice here would suck ass. instead, almost every computer question gets excellent answers (I asked one, and users gave a perfect diagnosis of my iBook problem minutes after the problem arose). I agree that medical advice here doesn't suck as bad as some of us say. but it's very generic, non professional advice by definition. a user above points out the epidydimal cyst anecdote -- well, what if his colleague had cancer instead' you're telling somebody to calm down because you had a lump and it was a simple cyst. maybe the other guy will lose a ball instead, because it's malignant.
if I were an American who can't afford a good doctor I'd take a lame-ass low-income clinic doctor's advice over AskMeFi any day of the week. waiting list and all. problem is, as you say, EB, and you're so right, way too many people -- many of them employed -- don't have coverage.
posted by matteo at 6:01 AM on May 13, 2005


doctors are forbidden by law to give medical advice over the Internet

What law?
posted by grouse at 6:15 AM on May 13, 2005


if I were an American who can't afford a good doctor I'd take a lame-ass low-income clinic doctor's advice over AskMeFi any day of the week.

So, because you would do that means everyone should?

There are quite a few topics that are just anecdotal (i.e, every "what should I see in Somewhereville, what is it like to live here") that medical ones aren't any worse. Everyone on here knows that they should see their doctor for medical queries; do we even know of anyone who resisted seeing a doctor because their AskMe answer was so good?

The entire point of the question is more to have an idea of what they're going to get at the doctor; more along the lines of being a prepared patient, having consulted others to perhaps add light to their problem. If I find out on AskMe that my symptoms lead to condition X, and I do a little research on condition X and I find that I actually exhibit more symptoms than I realized, I'm helping my doctor out by knowing EXACTLY what is happening that is strange.
posted by dflemingdotorg at 6:56 AM on May 13, 2005


"...what you're getting is anecdotical stuff that could very well be true or could be totally wrong...

Yes, but I don't have the sense that this is as big of a problem as it sounds. As someone says above, even among people that have excellent health insurance it simply isn't the norm that people consult a doctor for every small ailment that they feel. If they did, then being dissuaded from doing so by a casual aquaintance or across the internet would have a substantial impact. But most people don't consult a doctor about, say, a small (mildly) painful lump on their skin until a long enough time has passed that they're pretty sure, regarldess of what most other people tell them, that they should see a doctor about it. So if someone tells them it's probably not a big deal (which someone probably will tell them), after awhile they'll see a doctor anyway. But maybe by then it would be too late. The alternative would be that they see a doctor early on, when they weren't sure they should. Okay. Are they goind to do that for everything that they're not sure is important or not? They won't. No one anywhere has so easily available and unlimited health care that every little thing that "shouldn't" be ignored isn't, in fact, ignored. So my point is that I don't think that, really, most people are basing their decisions to not see a doctor that strongly on what other people (who are not medical professionals) tell them. In fact, I suspect that talking about it with other people (as opposed to keeping it to one's self) makes people more likely to see a doctor than not (regardless of what other people tell them).

As to the second part, I also think you're vastly overstating the case. I was, in fact, arguing the opposite point in my post. That is, that talking to a pool of certain non-medical professionals is not that hugely worse, comparatively, than talking to a pool of mostly non-computer professionals. You're assuming there is a much larger gulf concerning everyday medical knowledge (that people are inclined to ask casually about) between doctors and non-doctors than there really is. I'm not that comfortable with Decani's self-confidence of his medical advice to his friend. In fact, I think his(her?) example is a bad one for making his (and my) argument. But here's a different way to think about it. Say that you once stubbed one of your toes very badly and it was swollen for a week or so and hurt quite badly. You went to the doctor and the doctor said that you may have broken it, at worst, but that even if you had there's not much worth doing about it except pallative and waiting for it to heal and taking an x-ray would likely just be a waste of money. Okay, now it's a couple years later, and you've done the same thing and are having the same symptoms with a different toe. Would you a) decide to wait a few weeks and see if it doesn't get better in the same time frame that the other one did till you went to the doctor; or, b) see a doctor right away? And if you choose "a", how can you justify that decision? What do you know? You're not a doctor. Would you be as critical of yourself, or someone else who made that decision as you would if they'd not previously had a broken toe and asked someone else who had (who wasn't a doctor)? Why is the first reasonable and the second not? Yeah, when you've personally experienced the symptoms you have more info to decide if they are similar than if you describe it to a doctor. But you still know much less than a doctor knows about such things.

So, mainly, I think that the decisions that each of us make all the time not to see a doctor about something are, taken together, much, much bigger a negative effect on our health than are the few times that we might ask someone else and they convince us not to see a doctor. Making a huge deal out of this possibility is simply not a very accurate (or rational) cost-benefit calculation. It's mostly motivated by a fear of the possibility that one time that you decide to not get something checked by a physician because of a wrong answer on AskMe that turns out to be, for example, deadly.
posted by Ethereal Bligh at 7:01 AM on May 13, 2005


"The entire point of the question is more to have an idea of what they're going to get at the doctor..."

I think also people are using other people's opinions as a measurement of their own. Ultimately, you yourself decide to go to a doctor if you feel like something is urgent. But since we know that we ourselves are ignorant, we measure our ignorance against other people's ignorance. We don't expect doing so to measure against what a doctor knows; instead, we do this to make sure that our own uninformed opinions aren't much more uninformed than we think they are. So, as such, I tend to think that it's rarely the case that someone would put a huge amount of stock in one other ignorant person's opinion. In this way, AskMe performs this service better than just asking two or three friends. AskMe will get more responses from more people that have firsthand experience. Contrast to Decani's friend who only got Decani's advice. People are going to do this sort of opinion-of-peers reality check—AskMe is a better place to do it than most. This is an argument in favor or AskMe medical questions, as opposed to one against them. Perhaps it's the case that the viewpoint against is one that misunderstands what it is that most people are doing when they ask such a question on AskMe. They're not looking for a qualified medical opinion, really; therefore pointing out that they're not going to get one isn't a counterargument.
posted by Ethereal Bligh at 7:11 AM on May 13, 2005


On my planet, doctors can and do give advice online... just saying.
posted by naomi at 7:17 AM on May 13, 2005


I never thought I would say this, but . . . What EB said. In spades.

Though I wold like to point out that you can be fully employed in a nonservice job and still not have insurance--because they dick you around and make you a contract employee to save money, because you work for a small business that can't afford the premiums, or because you can't afford the amount the company expects from you.
posted by dame at 7:25 AM on May 13, 2005


EB "Well, I'm just sick of people who have some form of health insurance thinking that it's not true that a large number of people in the US can't see a doctor."

I call bullshit. This is exactly what I was reacting to earlier. Can't see the doctor they want to see when they want to see them, sure. Cannot see a doctor period? You even go on later to say that there are the clinics and emergency rooms who basically cannot turn people away. Not exactly what I would want to have to rely on for health care either but it doesn't equate to "can't see a doctor".
posted by Carbolic at 9:05 AM on May 13, 2005


I would just like to note that MeFite/neurologist ikkyu2 has contributed a metric ton of medical advice, answers, information and good cheer on AskMe since joining last summer, and I, for one, commend him for it. He doesn't do diagnosis by Cold Fusion Markup. DocPops, too.
posted by planetkyoto at 9:06 AM on May 13, 2005


You even go on later to say that there are the clinics and emergency rooms who basically cannot turn people away.

You left out the part where she said that the free place is probably going to tell you to go to the place that isn't free. Money is the limiting factor with regards to healthcare for many people, not lack of doctors.
posted by 23skidoo at 9:20 AM on May 13, 2005


And just because those places "can't" turn you away, doesn't mean they aren't going to send you a bill for at least part of their services. For a lot of people, even a token payment is more than they can afford.
posted by deborah at 9:34 AM on May 13, 2005


People keep on asking medical questions in MeFi because it gets them results. Yes, it's no replacement for seeing a doctor, but that doesn't mean it's not a great way to get some valuable help. I offer this thread as an example. I have a history of fainting, and it turns out that it's almost certainly due to my low blood pressure. I'd consulted several doctors, one neurologist and a number of nurses, and they'd never suggested that.

As long as people realize it's a supplement to actual medical advice, not to be used in lieu, it's fine.
posted by orange swan at 9:44 AM on May 13, 2005


I left out the parts about whether or not people can pay for the health care after they receive it because I was reacting to the statements saying that people could not see doctors. I never said there weren't people who have trouble paying for health care. There is a significant difference.

My apologies. This is really off the original topic.
posted by Carbolic at 9:49 AM on May 13, 2005


It's an old thread (I don't spend much time on AskMe) but I asked a medical question there at one point and the results were useful. This year, I finally started seeing a physical therapist for the problem described and asked him the same question. I got about the same answer.

As far as the medical coverage, a few years ago, when I was uninsured, I came down with a really bad bout of bronchitis (I could not lie down, because my lungs would creak, could barely sleep because I could not breathe, etc. Turned out I was carrying a 101 degree fever and my lungs were solid with fluid). I suffered through it, because the $100 going rate for a doctor or clinic visit was outside of my budget (and, as I was employed at all, the emercency room would have seen me, but they would not have waived billing). Finally, a friend of mine (online) pointed out "If you can't afford to see a doctor, how do you think you'll afford a stay at the hospital?" I called a local walk-in clinic and figured I'd take up a collection. When I explained to the doctor why I'd waited so long, she fudged the paperwork to charge me the smallest amount she could get away with and gave me sample boxes of the antibiotic I needed. The moral here - (1) yes, there really are people for whom a doctor's visit is a prohibitive expense, (2) I got good advice from someone I knew online, (3) if you're lucky and know how to work the system, it is possible to get health care if you're not covered - on an emergency, if not regular, basis.
posted by Karmakaze at 11:20 AM on May 13, 2005


I'd just like to remind the USians: it's a real shame that there are so many people in your country that have to jump though all these hoops and weigh their options so carefully before seeking out medical care. It doesn't have to be like that. In many other countries it's NOT like that. What a shame.
posted by raedyn at 11:27 AM on May 13, 2005


*attempts to heed too many words at once*
*faints*
posted by graventy at 11:47 AM on May 13, 2005


*attempts to heed too many words at once*
*faints*


What yer gonna wanna do fer that is rub a small radish on your wrists once a day and drink yer own pee for about a week, should clear that right up.
posted by Divine_Wino at 12:04 PM on May 13, 2005


You're a doctor, right?

*drinks pee*
posted by graventy at 6:05 PM on May 13, 2005


*follows graventy's lead*

Hmmm, tastes like weak beer.
posted by jonmc at 6:09 PM on May 13, 2005


I don't trust doctors simply on the basis that they have medical degrees. Many are in the business solely for the money and the golf trips. For general health questions, I would follow community advice long before I would trust what a given doctor told me. Broken bones and serious infections excepted.
posted by telstar at 11:57 PM on May 13, 2005


"I don't trust doctors simply on the basis that they have medical degrees. Many are in the business solely for the money and the golf trips. For general health questions, I would follow community advice long before I would trust what a given doctor told me. Broken bones and serious infections excepted."

I won't go that far and I don't mean to give the impression that i support such a view. I have a great deal of respect for doctors, their training, and their benevolence. But I do think that people greatly overestimate their supposed near-infallibility and underestimate what smart, informed people will know about common health conditions.

Not to waffle too much, but I also don't mean to deny your point too strongly, either: there's about a bazillion reasons why your doctor might not give you the best, of even good, advice. Greed is certainly one of them. All sorts of other pressures are others, including lack of time or being overworked. Or laziness. Or bureaucratic constraints. Chance.

As someone who's dealt with medical professionals all my life (because of my genetic condition), I have a lot of respect for doctors but strongly believe in the necessity of informed and activist patients. In the long run, the patient himself/herself has the greater burden of responsibility for the quality of their health care. In short: it's your body. No physician can ever know it like you do. They need your help to do their job. Not just in fully reporting your condition, but also in listening to (or first, demanding!) the explanations they give you for their reasoning and decisions, and being informed participants in those decisions. And, honestly, for this reason I think I prefer to see "activist" patients seeking out information wherever they can find it. Some doctors don't like that. They're not, in my opinion, the best doctors.
posted by Ethereal Bligh at 1:00 AM on May 14, 2005


This is normal human behaviour, folks.

Just wanted to see that again.
posted by mediareport at 5:55 PM on May 14, 2005


Excuse me, guys. My mate didn't only get my advice. He went to the doc too, but I was able to tell him about a possible explanation for his problem that wasn't what he feared it was. I let him know that sore lumps behind the testis are, in fact, unlikely to be cancer, since testicular cancer symptoms aren't like that.

He felt better.

Then he went to the doctor, and hey, waddya know? He had an epidydimal cyst.
posted by Decani at 8:33 PM on May 14, 2005


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