"...doctor because of course they know best" is a really strange thing to say. I don't mean to invoke paternalism here -- but between a patient with Google and a doctor with years of medical training, residency and practice, they more than likely do know best. At least, better than the patient. They won't always be right, and you can ask for a second opinion, but they do know better. If they didn't, you could practice your own medicine.
The doctor certainly knows better than the patient, all else being equal. However, the patient has much more time, motivation, and contextual information about their situation. This leads to situations (some of the time) where a patient who has done a lot of research can outperform a doctor who spent 10 minutes doing an exam and making an educated guess based on demographic factors.
I would love to see a study to back that up. I just don't think that in aggregate at the population level misdiagnoses would go down if people did it themselves. This study of online tools wasn't glowing [1].
"In comparison, other studies have found that Internet search engines for urgent symptoms led to content that suggested emergency medical treatment only 64 percent of the time." [1] It also found tooling less effective the less immediate the need for care was. "Overall, the software algorithms that the researchers studied listed the correct diagnosis first in 34 percent of cases." [1]
Certainly not at the aggregate level. But if you have a chronic condition, and your doctor's advice isn't working, I think it's reasonable to do your own research even though in general the doctor knows best.
In some ways I do practice my own medicine and doctors are just QA. I know when I need antibiotics, or I have a strong hunch, I just need them to confirm and write the script (They do this over apps now). My GP wasn't much help with a problem I was having, so I had to track down a specialist who would listen, eventually I was found to be RIGHT, and again just needed the doctor to write the script.
Not saying they don't know more than me about the body, naming its parts and what they do, but I know best when something isn't right and the amount of doctors you have to go through to get them to admit "OK, you feel bad, something is wrong, let's have a look" and actually do something other than go through the motions is astounding.
Edit: Leaving this but kind of wish I hadn't left this comment. I had a point to make, and maybe its in here, but this just comes off stupid. Sorry.
> I know when I need antibiotics, or I have a strong hunch, I just need them to confirm and write the script (They do this over apps now).
Frequently people do not know when or if they need antibiotics. People often end up taking antibiotics for viral infections (which do nothing). The CDC points out that taking antibiotics for viral infections can do more harm than good [1] and this leads to antibiotic resistance [2]. It's pretty unlikely a doctor would prescribe you antibiotics for a viral infection, certainly at the population level. This is why they're in the loop.
There's a lot that goes into prescribing antibiotics. For instance, do you have a bacterial, viral, or amoebal infection? Is it gram-positive or gram-negative? Broad-spectrum antibiotic or targeted? Is it worth the potential risks to your gut health? [3] How about side-effects and contra-indications? What if you have something else entirely?
You are overlooking the role of intelligence in the success rates of anything you try to do yourself. Fixing your car, running a business, investing and researching your own disease are all tasks that some people are far more likely to succeed at than others.
Unfortunately, I have learned from experience that it is a great mistake to trust that the doctors know best, regardless how experiences and how expensive they might be.
Regarding treatments, yes, most medical doctors are competent and it is likely that they know better than you.
On the other hand, regarding diagnosis, errors are frequent, for 2 reasons:
1. Most medical doctors are too narrowly specialized and they are experts in their narrow fields but ignorant about other medical domains. Unless you have an obvious problem it is quite likely for you to go to a medical doctor of a wrong specialty and receive a misdiagnosis instead of being redirected to an appropriate specialist.
2. Each human has a complex medical history, which is normally unknown to the doctor who attempts to diagnose you. The doctor might have some past data provided by you or by other doctors who treated you in the past, but that is not enough to know well your characteristics. Because of that, the doctor will try to attribute your symptoms to the most frequent causes encountered at other patients, even if there are reasons in your history that make those causes completely improbable.
I have experienced this several times, when I have received a misdiagnosis and I could not believe it because I know my body and I know how it feels, even if the doctors were right that the symptoms were frequently caused at other people by what they thought to be the correct diagnosis.
Every time, second opinions confirmed that I was right, because even if those doctors had experience with thousands of other patients, I have an experience of half a century with my body and I understand it better than anyone can understand it after 5 minutes of examination.
Regarding cancer, my father broke his arm and he went to an orthopedist, who put a misdiagnosis of osteoporosis.
In fact he had bone cancer. Even if it was a cancer form that has good chances of treatment with some recent drugs, my father lost half of year due to the misdiagnosis and by then it was too late.
I have read a medical manual and my father had obvious symptoms of bone cancer, exactly as they were listed in the manual, word by word (continuous all-day pain, which was confused with arthrosis by the doctor, followed by a bone fracture as a result of small effort, which should not have been enough to fracture the bone, which was confused by the doctor as being caused by osteoporosis).
A competent doctor should have recognized that even if he had assigned the symptoms to what he thought as the most probable causes, there are also other possible causes, e.g. cancer, and he should have sent my father to supplementary investigations, e.g. scintigraphy, which would have discovered immediately the cancer and allowed adequate treatment.
Unfortunately, I was not prescient enough to have read the medical manual before the problem appeared, because I naively trusted that whenever medical problems will appear I will just pay professionals and they will solve the problems.
It did not happen so. My mother also had serious problems because of a misdiagnosis. In her case it was not cancer, but I have also discovered after reading the appropriate textbook that her symptoms were completely typical, but also unknown to the doctor (of a wrong specialty) which consulted her first.
Misdiagnosis is a problem -- and one that hopefully technology will help us address further -- but what I'm saying is that misdiagnosis would in aggregate be much higher if people did it themselves. Its a common joke that first-year medical residents will diagnose everyone with everything. Second opinions, to your point, help mitigate the issue, but we have to look at the population level.
I'm very sorry for what happened to your father, and your family. The fact is that you wouldn't have known to look for bone cancer in the specific situation after skimming the medical manual unless you had proper training and experience. In retrospect, the symptoms fit, but they fit the original diagnosis too. And the original diagnosis was far more likely. Diagnostics is as much art as it is science, every single human is different -- to the extent internal anatomy often looks absolutely nothing like textbooks and varies hugely from person to person. [1]
And yes, in aggregate, experience with thousands of bodies is far more valuable than experience with just your own.
We must find ways to be better at this, I just don't think DIY will get us there.
No, they don't. They practice first-aid. There's a big difference between slapping on a band-aid and a DIY hip replacement, or cancer diagnosis.
Maybe this is a uniquely American thing and with the self-sufficiency narrative being so at the fore. I don't fix my own car because I'm not a mechanic -- I share the symptoms with a professional. I don't tell my doctor what to prescribe or what's wrong with me because I'm not a doctor -- I share my symptoms with a professional.
As a concrete example, advertising prescription drugs direct to individuals in Canada is illegal. It's illegal in most countries. [1] As it should be!
Dietary supplements largely don't work, at all, and some of them are outright harmful. They basically do nothing, at best. So 75% of America probably, er, shouldn't. This is something a medical professional might tell you if you asked them. This visualization should help you understand the magnitude of just how little dietary supplements do -- it came up here on HN a while back as an example of a beautiful visualization [1].
Most multivitamins are totally worthless unless you're eating an incredibly poor diet. There's actually an association between multivitamin use and an increase in all-cause mortality [2] with a more pronounced effect in smokers [3].
So, I re-iterate, there's a reason these people went to school to become doctors.
Again, in context, what I said was that there's a big difference between first aid and supplementation and a diagnostics and treatment. Nobody is arguing people don't take supplements and that probably technically counts as medicine, however it's clear in context that's not the kind of medicine I was referring to. Also, people are by and large bad at it, and shouldn't.
Thanks for your insightful contribution to the thread. I also hope to hear from the original poster about the type of cancer, because the story is interesting.
The kind of cancer where the patient can be easily dismissed by the doctor because of course they know best.