It might help if there could be some kind of pathway that would allow learning from misdiagnoses. As it is, you go and see a GP (or whoever) with your concern, they say 'oh no, I shouldn't think it's that, you just need to stop worrying', and you then never see the same person again. So when the concern later turns out to be entirely correct, they don't find out about it and never get the chance to reflect on their decision-making process.
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UK: Daily Mail: Half of women fear the NHS treats their health as a 'second-class issue'
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It might help if there could be some kind of pathway that would allow learning from misdiagnoses. As it is, you go and see a GP (or whoever) with your concern, they say 'oh no, I shouldn't think it's that, you just need to stop worrying', and you then never see the same person again. So when the concern later turns out to be entirely correct, they don't find out about it and never get the chance to reflect on their decision-making process.
Having recently seen my mother in law on a hospital ward full of very elderly people, I think the elderly of both sexes probably win the prize for being treated terrriibly by medical staff.
I even had to have a row with a discharge nurse who was accusing her of bed blocking. I could see she was really ill. The nurse was outraged that I dared question her judgment. Turned out my mother in law had sepsis.
I even had to have a row with a discharge nurse who was accusing her of bed blocking. I could see she was really ill. The nurse was outraged that I dared question her judgment. Turned out my mother in law had sepsis.
MrMagoo
Senior Member (Voting Rights)
Unfortunately gynaecology services have their own issues in any case. And when you’re a woman with ME their service is one that’s difficult to avoid. I just think there are a lot of Drs who display less emotional intelligence than a call centre customer services rep.
Jonathan Edwards
Senior Member (Voting Rights)
I would turn that on its head. Empathising without knowing the facts is the road to disaster. Anyone can empathise if they feel like it. Empathy worth having is empathy backed up by knowledge. Lots of doctors make a living out of pretending they take people seriously. Not so many know exactly when people do need taking seriously. And I suspect in the end the patients see through and prefer the empathy of being taken seriously on the basis of knowledge.
Hmm the old starting gun on game theory where people are pointed to focus on compete with each other rather than wondering why it’s all so cruddy or where the money is going that might not be productive to any patient
the idea that the nhs serves all is the biggest myth in the books, and as that influences access to private too in this country it’s beyond divisive and means power that utterly seals everyone’s fate by luck of draw
I think Jonathan’s point about really we have a service where huge amounts is going on determinedly not treating people is why we have this culture - because it attracts and rewards such ideology over those who want to cure things and make people better. Ironically even if that latter reduces costs/contributes more financially because people are less ill for less long. We’ve produced a back to front service apart from a few areas that are seen as higher profile it sometimes seems.
and the irony is everyone accessing is seen with suspicion
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Yes but also don’t give those who don’t truly have that skill (aping it by pretending to be nice isn’t the same as insight) the power in any role that really needs to rely on tgat. There are enough who have empathy who can supervise and fir some reason despite this being the skill least replicable after AI revolution it’s under valued - I think because those without it want to maintain their status quo.
what I’m always curious about gif those missing that module (empathy) is how much sympathy and indulgence they give themselves compared to norms however. It’s fascinating watching someone without this module try and do empathy - they look for things they themselves ‘suffered’ at best (hence why we’ve probably gif the awful ‘a bit tired after doing lots’ bs from you know who’s ) then use sympathy to think they relate ie it has to be about their suffering. They literally have no imagination and nothing to access for others. Which is why I find it extra ordinary guven how important understanding the symptoms of a new condition is to unravelling it’s cause and cure why medicine chases hounding out empathy and doesn’t require it as a skill when recruiting in
Absolutely
bad knowledge has a huge amount of budget time and resource being bedded in simply because people don’t want to admit being wrong even when it’s a case of learning something new vs at the time
the amount of money on justifying misdiagnoses and burying them instead of putting things right makes medicine not a science but a politics
Major attitude issue isn’t there
as if anyone wants to go near an nhs ward if they have any choice at all
rvallee
Senior Member (Voting Rights)
Historically, institutions locked in a state of systemic failure don't get changed, they get replaced or sidestepped. The enormous size of the wellness and alternative medicine industry is the sidestepping. It's useless sidestepping but it's the only way people can 'vote' with their money, as otherwise electoral votes have no impact, health care does not change where it matters regardless of whoever is in power.
And instead of fighting it, medicine has recently decided to embrace it, which has lead to the absurd outcome of making medicine worse while actually increasing the size and influence of the alternative industry. Which I guess is no longer alternative, since you hear the same pseudoscience from MDs and their institutions. So what is it an alternative to, other than science and the scientific method? Which equally applies to the biopsychosocial and most evidence-based medicine, which ignores the scientific method.
Intro classes to politics are the best source for this issue: we still face the exact same political problems today that people did 2500 years ago. Because ultimately only technology matters in effecting change, and technology has not impacted the process of politics itself. Just the same, everything in health care that isn't biomedical has not been impacted by technology, so it hasn't changed. Medicine doesn't know anything more about illness, about the subjective experience of being ill, than Hippocrates did, because technology is of no help here.
The only solution humanity has found to similar problems is with markets subject to supply and demand. When something works, people buy it. When it doesn't work, people generally don't, as long as there are proper regulations. The size of the alternative medicine industry is an outlier here because it doesn't take away demand from the official system. Because health is not a commodity, it's a basic necessity where people can't actually make choices, those choices are always made for us, regardless of how much fluff is being said about informed consent and other meaningless tropes.
So we can't change that system. Nothing will change it without replacing it or offering an effective alternative. Which is what AI medicine will do. It will disrupt everything by offering a completely alternative, and far more effective, supply and demand dynamic. I know I say this a lot and many will be justifiably skeptical, but there is literally no other viable solution, and this one is coming soon.
Most political problems in history follow the same rough pattern: politics tries expensive and ineffective ways, then technology disrupts the whole thing and makes the issue non-political, solving the politics aspect that locks in systemic failure. It's economics. Health care is a scarce resource. Out there is supply for about 10% of the demand. That forces choices. Impossible choices that result in preventable death and suffering.
The disbelief and general nastiness in health care is almost entirely caused by this. There just isn't enough for everyone, so we get the equivalent of a mob of 1000 hungry people waiting for a food truck with only enough food for 100 and no backup, no plan B. None of the nastiness we see would exist outside of this scarcity. The bad MDs would simply have empty patient lists, would probably not even make it through the certification process.
There's just no solution to this without technology, the only thing that really matters, because it takes politics and human judgment out of the equation. It removes the top-down control that locks systems in a failure mode. And there is literally no other possible technology that can disrupt health care than AI, just as much for the clinical side as for research.
A huge number of people have tried changing this for decades. It hasn't worked at all. The systems haven't budged one tiny bit. Even when they admit to their failure, they simply refuse to change anything. They flat out refuse. Those systems are getting worse, and so is their workload. We're just beginning to see the impact of aging populations, the worst of it is ahead of us. Things will get a lot worse, a lot more biopsychosocial, before they get better. That's the only guarantee about systems where secretive human judgment is the only decision-making process: it can always get worse, it will likely get worse.
Unfortunately, empathy seems to be one of those things you cannot teach. It might be something people can learn from direct experience over their life (indeed, that might be the main way people develop it). But I don't think it can be taught in the same way as arithmetic, for example.
I would say it can’t be taught by rote or examined by plain written question without being played
But I think it can be taught just not all can develop it. However truth is that that type can be identified quite easily during an admissions process and during all the windows in the medical career wheedling pricess that currently actually tend to wheedle out ill people and those with things that would actually be useful (by hours not being adjusted snd set arbitrarily or networks if people or claims you need 25thingz on your ucas form even tho many might have lied or just taken them up for the year to apply) . It’s all doable, but needs different experts to the ones currently in post of course.
ps I don’t mean empathy misunderstood as sympathy or niceness but actual curiosity snd able to walk in and imagine a described circumstance
I can’t think of a creativity more vital for medicine - it’s sort of no wonder certain specialisms have stagnated as they have
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