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330 points wglb | 1 comments | | HN request time: 0s | source
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bonoboTP ◴[] No.41841883[source]
Real-life medical practice is basically going through the motions, then intuitively guessing the issue, prescribing something common since most cases are so banal and next patient please.

Engineer-minded people can discover lots and lots of such "obvious" issues in healthcare and of course the answer isn't that nobody would've guessed it, it just doesn't matter. Healthcare (outside of very specific diagnosable illnesses) is 90%+ medicine theater. People expect some pills, they want a few words with someone in a white coat, and their problem goes away usually by itself. Chronic persistent issues without obvious cause befuddle docs and they often don't find anything even after lots of tests.

Our better health and longevity today is more due to better work conditions, better food, better sanitation and food preservation, basic vaccines, basic disinfectants, basics like penicillin, smoking less etc. And the low hanging fruit to improve further is lifestyle: eating/drinking fewer calories (especially less sugary stuff), exercising/sleeping more and having better social connections. None of it is particularly arcane or in need of precise measurement.

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rscho ◴[] No.41842686[source]
> Engineer-minded people can discover lots and lots of such "obvious" issues in healthcare

It is a defining characteristic of "engineer-minded people" to think they understand better than others. Amusingly, they won't pretend to repair their car engine better than a mechanic, but they will strongly believe they understand all the bad tricks and failings of doctors. They almost never understand that current medicine is mostly experience and not hard science. Future medicine is science. 2024 medicine is not, and cannot be.

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1. bonoboTP ◴[] No.41846090[source]
I wouldn't put the blame on them though. There's a lot of obfuscation and posing as science.

But at the moment it's intractable to do it at scale at a meticulous, evidence-based way. It's a bit of a Santa Claus moment to realize this. People want to believe someone has a proper grip on things. Medicine has done wonders in narrow, specific things like various surgeries - I'm mostly talking about everyday GP stuff where some average 65 year old has generic issues like blood pressure. It doesn't mean that nothing can be done, and I'll in fact say that a smart person with some biology/chemistry background and internet access can often figure out what they actually need,better than a median doctor with limited time and little deep thought effort to spend on the case.

Cultural change is very hard, especially since doctors enjoy a very high status which they earned through long years of very hard work. So the attitude similar to the opposition to Semmelweis persists.