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352 points keithly | 23 comments | | HN request time: 0.193s | source | bottom
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pandatigox ◴[] No.41845382[source]
Current final year dental student pitching in here. While dentists of the past may push for unnecessary annual radiographs, the curriculum in dental school has changed to favour evidence-based dentistry. Annual bitewings are only indicated if you're a high caries risk, and, as the article mentions, 2-3 years if you're low caries risk. So your younger/newer dentist will be following much better protocols (and hopefully not scamming you)!
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1. fma ◴[] No.41848039[source]
My younger dentist did 2 xrays for me in a row (6 months apart)

I don't remember exactly what was done last time and only knew when they pulled up the xrays and I saw the date of the last one. They hygienist sits you down and just does it as if it is normal. I googled and found what you mentioned.

I am low risk for cavities. Those exact words came out of his mouth. I was pissed off after the fact, because I'm paying out of pocket for this, and for fluoride treatment. I have in my records to not give me fluoride treatment but she called it "varnish" which caught me off guard.

I speculate the office got bought out by PE as dentists have changed over the last few years.

They also told my wife she needs a night guard. She's been wearing one for 12 years.

I slowly see why there are people who do not trust medical professionals.

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2. koolba ◴[] No.41848388[source]
> I slowly see why there are people who do not trust medical professionals.

The opinions I trust the most are the doctors that have previously told me that no treatment is necessary and the problem will resolve on its own.

The more often they’ve said that, the more I’d value the opinion, especially if it suggested something invasive.

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3. smrtinsert ◴[] No.41848495[source]
> I slowly see why there are people who do not trust medical professionals.

I think the slider isn't between trusting and not trusting medical professionals - it's between being a passive and active patient. We have to involve ourselves in our care. Educate yourself, get second opinions, connect with fellow patients and national experts. And ffs, do not listen to yt/x/tiktok people for anything.

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4. positr0n ◴[] No.41848704[source]
Yep, I'm never leaving my dentist because he tells me things like "this crown will probably need to be replaced some time in the next twenty years, but it's not worth spending the time and money to do it yet."

Bonus anecdote: My previous dentist, who I went to once, had an office full of hygienists that were young, blonde, skinny women without exception. Something tells me the interview process was not merit-based...

5. ambicapter ◴[] No.41848734[source]
You don't have to be an "active" patient and "self-advocate" if you trust your medical professional to make the decision that is in your best interest. Ergo, if you're advocating active medical involvement, you don't trust your medical professional either.
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6. exe34 ◴[] No.41848797{3}[source]
I can't trust my own mother, so I'll look up things myself before committing to one decision. as far as I can remember, as an adult, I've only been to the doctor's once without diagnosing myself, and I've never been wrong yet (the handful of times I've needed medical care anyway).
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7. cruffle_duffle ◴[] No.41849075[source]
> The opinions I trust the most are the doctors that have previously told me that no treatment is necessary and the problem will resolve on its own.

This applies double or even triple for vets. There is a lot of cash to extract from pet owners who would “do anything”, no matter how unnecessary or ineffective, for poochy.

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8. xyzzy_plugh ◴[] No.41849207{3}[source]
I don't think this is charitable. I've been lucky to have a view into the back office of a veterinary clinic and the fact of the matter is it's just difficult medicine to practice. Every vet I know works hard to save their clients money.

If pet owners are inclined to take the "do anything" route it can open a lot of doors. I don't see anything wrong with that.

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9. itishappy ◴[] No.41849246[source]
Why do you go?
10. PawgerZ ◴[] No.41849451{4}[source]
Was this a PE owned vet clinic? They're much more common today and the practices have slowly become more predatory.
11. consteval ◴[] No.41850182[source]
The trouble is some doctors (a lot, actually) take this too far. So they'll insist absolutely nothing is wrong, and you should just lose weight or manage your stress or whatever.

So sometimes people, typically women and typically larger people, live for years with painful conditions because doctors didn't bother to look deeply at all.

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12. consteval ◴[] No.41850206{4}[source]
I've known a few people who worked in vet clinics, and they've all told me horror stories of how pets are mistreated. I'm talking left to sit in their own feces and urine overnight, fixed when they weren't supposed to be, injured during surgeries and then not communicated to owners.
13. consteval ◴[] No.41850295{4}[source]
That's great but the trouble is that as you get older medical conditions become harder and harder to find out. They also become more dangerous.

I'm telling you this because my father was the same way you are. he avoided going to the doctor at all and diagnosed himself.

He also smoked for 60 years. Yeah. He had his first heart attack in his 30s. Very avoidable. His second in his 40s. Then another in his 50s. Finally died of lung cancer in his 70s. Honestly a miracle he made it that far.

You can tell if you're feeling okay. But a lot of diseases have no symptoms. The reality is you cannot run your own blood tests. If you're young, maybe it's fine. But as you get older it no longer flies. What happens is you will become very sick, realize it's due to something like high blood pressure or diabetes, and you're WAY too far gone to fix it. The earlier you get on top of bad markers, the better. You don't want to live 30+ years with something like high blood pressure or high cholesterol.

Maybe you don't smoke (good for you), but that doesn't save you. Neither does living an active lifestyle. You can get high blood pressure, high cholesterol, diabetes, heart failure, etc regardless of your lifestyle. There're people who die MUCH younger than my father did while being much healthier.

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14. cruffle_duffle ◴[] No.41850488{4}[source]
That’s a good point. I’m unsure how to frame my observation in a way that makes vets look like they are intentionally doing something wrong. I guess what I’m saying is when I work with a vet it’s hard to know if the vet is going overboard with diagnostics and tests because me, the owner, want to “do everything I can” for my pet.

It’s a tricky subject to phrase correctly and way to early in the morning to come up with a good example.

15. lainga ◴[] No.41850507{3}[source]
I encourage you to explore, as a thought experiment, what profit opportunities can arise from the intersection of mass medicalisation and body positivity.
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16. consteval ◴[] No.41850706{4}[source]
I encourage you to be more straight forward with what it is you are implying.

These doctors were, and are, actually reducing profit by not treating illnesses and instead prescribing things such as diet, exercise, and stress reduction.

And yes, doctors do that. All of them. If you're obese, the first thing out of their mouth is weight management. And yes, this is typically a good thing. But it does mean that lots of genuine issues are missed because any problem is attributed to weight. When in actuality they actually do have a tumor in their colon and no, they aren't just eating bad. And then they die when it was easily preventable.

To believe we live in a body positive world is to be deeply delusional. At the absolute most extreme, you have people asking not to be ridiculed for their weight. There are almost 0 people who legitimately think being fat is good for health. I would say 0, but then I remember some people think the Earth is flat.

All that is to say: yes, we know being fat is bad. Yes, even fat people know being fat is bad. Yes, doctors often prescribe not medicine to treat obesity. And yes, this often leads to missing genuine issues. And no, before anyone asks, I'm not a fatty, I'm actually quite thin. Not that I think it matters, but people are vain so it might matter to you.

If this comment feels very ungenerous to you, that's because you have forced me to make many assumptions about what you're trying to say. You can avoid that by not speaking as though you're an oracle in a medieval fantasy movie.

And, before I hear some nonsense about how you have no biases and you just want to conduct a thought experiment - uh, no. You are implying something, and we both know it. You do have an opinion on this topic. It's best to just let it out or say nothing at all. Otherwise, I might assume your opinion is dumb.

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17. exe34 ◴[] No.41850731{5}[source]
oh it's not an issue for me, I've been suicidal since I was 12, but don't have the guts to off myself. a few years ago I gave up entirely and decided to wait it out the long way, but the sooner something takes me out, the better. but thank you for the concern :-)
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18. consteval ◴[] No.41850766{6}[source]
This actually didn't do away with my concern. I'm much more concerned now.

If it helps, keep in mind most medical issues don't kill you. They just lower your quality of life, sometimes a lot. So, if you've decided to stick it out, you might as well try to live the best life you can. Nobody wants to be chronically fatigued, or have bathroom troubles, or lose their hair, or whatever.

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19. coryrc ◴[] No.41850789{5}[source]
When you hear hoofbeats, think horses, not zebras. The body is extremely complicated and cannot be reproduced for testing. Testing and treatment has a cost not just in money.

If 99% of the time it's just a symptom of being obese, is it really a good idea to put 99 people through unnecessary procedures because 1 other person has a fixable problem? What if said testing procedure has a 1/1000 chance of perforating the colon and causing a serious problem for those 99 people without a tumor?

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20. exe34 ◴[] No.41850892{7}[source]
you don't need to worry, once I gave up on mental health, I've never been better. nothing really bothers me anymore.
21. DowagerDave ◴[] No.41850979[source]
so we take fluoride out of the water, where the poorest people can get it regularly and then we're supposed to believe if I pay for 2 applications a year were all good?
22. DowagerDave ◴[] No.41851024{4}[source]
I just can't reconcile this with my experience. The most charitable I can be is that these vets care deeply about the animals but treat cost as no obstacle or don't even recognize the cost.

>> If pet owners are inclined to take the "do anything" route it can open a lot of doors. I don't see anything wrong with that.

How about just like people-medicine: diagnostic tests when there is no likely treatment should not be proposed. Or charging 20-50x the generic cost for the same drugs humans use? The fact that some people will "do anything" when there's nothing that can be done is prone to abuse.

23. consteval ◴[] No.41851037{6}[source]
You're correct but what I'm referring to is subconscious bias.

Meaning that, because they are fat, they will be treated differently than they would have been if they were thin. Meaning their symptoms won't be listened to, they won't be taken as seriously, they will be assumed to know very little about health, etc. In through one ear, out the other.

This subconscious bias is the same reason why simply having a non-white sounding name on your resume greatly reduces your chance of being hired. It's not like anyone is actively racist, but in their mind there exists connections already made and those influence their decisions, without their knowledge.

In actuality, if you have, say, anal bleeding, pain, bloating, and dark stools you should get a colonoscopy.

Women and larger people face much more of this subconscious bias. Many women aren't taken seriously at all.