General doctors aren't trained for problem solving, they're trained for memorization. The doctors that are good at problem solving aren't general doctors.
That's a sweeping generalization unsupported by facts.
In reality you'll find the vast majority of GPs are highly intelligent and quite good at problem solving.
In fact, I'd go so far as to say their training is so intensive and expansive that laypeople who make such comments are profoundly lacking in awareness on the topic.
Physicians are still human, so like anything there's of course bad ones, specialists included. There's also healthcare systems with various degrees of dysfunction and incentives that don't necessarily align with the patient.
None of that means GPs are somehow less competent at solving problems; not only is it an insult but it's ridiculous on the face of it.
Even if they are good at problem solving, a series of 10-minute appointments spaced out in 2-3 month intervals while they deal with a case load of hundreds of other patients will not let them do it. That's the environment that most GPs work under in the modern U.S. health care system.
Pay for concierge medicine and a private physician and you get great health care. That's not what ordinary health insurance pays for.
>You followed up a sweeping generalization with a sweeping generalization and a touch of bias.
As opposed to what, proving that GPs are highly trained, not inherently inferior to other types of physicians, and regularly conduct complex problem solving?
Heck, while I'm at it I may as well attempt to prove the sky is blue.
>I imagine the issue with problem solving more lays in the system doctors are stuck in and the complete lack of time they have to spend on patients.
Maybe they are, but for most of my interactions with GP's in recent years, and several with specialists, for anything much beyond the very basics, I've had to educate them, and it didn't require much knowledge to exceeds theirs on specific conditions.
In one case, a specialist made arguments that were trivially logically fallacious and went directly against the evidence from treatment outcomes.
In other cases, sheer stupidity of pattern matching with rational thinking seemingly totally turned off. E.g. hearing I'd had a sinus infection for a long time, and insisting that this meant it was chronic and chronic meant the solution was steroids rather than antibiotic, despite a previous course having done nothing, and despite the fact that an antibiotic course had removed most of the symptoms both indicating the opposite - in the end, after bypassing my GP at the time and explaining and begging an advance nurse practitioner, I got two more courses of antibiotic and the infection finally fully went.
I'm sure all of them could have done better, and that a lot of it is down to dysfunction, such as too little time allotted to actually look at things properly, but some of the interactions (the logical fallacy in particular) have also clearly been down to sheer ignorance.
I also expect they'd eventually get there, but doing your own reading and guiding things in the right direction can often short-circuit a lot of bullshit that might even deliver good outcomes in a cost effective way on a population level (e.g. I'm sure the guidance on chronic sinus issues is right the vast majority of time - most bacterial sinus infections either clear by themselves or are stopped early enough not to "pattern match" as chronic), but might cause you lots of misery in the meantime...
Your personal experience is anecdotal and thus not as reliable as statistical facts. This alone is not a good metric.
However your anecdotal experience is not only inline with my own experience. It is actually inline with the facts as well.
When the person your responding to said that what you wasn’t backed up by facts I’m going to tell you straight up that, that statement was utter bullshit. Everything you’re saying here is true and generally true and something many many patients experience.
>When the person your responding to said that what you wasn’t backed up by facts I’m going to tell you straight up that, that statement was utter bullshit.
The person you just replied to here isn't the same person I replied to.
> In reality you'll find the vast majority of GPs are highly intelligent and quite good at problem solving.
Is this statement supported by facts? If anything this statement is just your internal sentiment. If you claim it’s not supported by facts the proper thing you should do is offer facts to counter his statement. Don’t claim his statement isn’t supported by facts than make a counter claim without facts yourself.
Read that fact. 800,000 deaths from misdiagnosis a year is pretty pathetic. And this is just deaths. I can guarantee you the amount of mistakes unreported that don’t result in deaths dwarfs that number.
Boeing the air plane manufacurwe who was responsible for the crashing Boeing 737 mcas units have BETTER outcomes than this. In the year that those planes crashed you have a 135x better survival rate of getting on a 737 max then you are getting an important diagnosis from a doctor and not dying from a misdiagnosis. Yet doctors are universally respected and Boeing as a corporation was universally reviled that year.
I will say this GPs are in general not very competent. They are about as competent and trust worthy as a car mechanic. There are good ones, bad ones, and also ones that bullshit and lie. Don’t expect anything more than that, and this is supported by facts.
Yeah, the main fact here is called medical school.[0]
>Read that fact. 800,000 deaths from misdiagnosis a year is pretty pathetic. And this is just deaths.
Okay, and if that somehow flows from GPs (but not specialists!) being uniquely poor at problem solving relative to all other types of physicians—irrespective of wider issues inherent in the U.S. healthcare system—then I stand corrected.
>135x better survival rate of getting on a 737 max
The human body isn't a 737.
>I will say this GPs are in general not very competent. They are about as competent and trust worthy as a car mechanic.
How is going to medical school a measurement of problem solving ability? You need to cite a metric involving ACTUAL problem solving. For example, a misdiagnosis is a FAILURE at solving a problem.
Instead you say “medical school” and cite the Harvard handbook as if everyone went to Harvard and that the medical book was a quantitative metric on problem solving success or failure. Come on man. Numbers. Not manuals.
> The human body isn't a 737
Are you joking? You know a 737 is responsible for ensuring the survival of human bodies hurdling through the air at hundreds of miles per hour at altitudes higher than Mount Everest? The fact that your risk of dying is lower going through that then getting a correct diagnosis from a doctor is quite pathetic.
This statement you made here is manipulative. You know what I mean by that comparison. Don’t try to spin it like I'm not talking about human lives.
> Ignorant.
Being a car mechanic is a respectable profession. They get the typical respect of any other occupation and nothing beyond that. I’m saying doctors deserve EXACTLY the same thing. The problem is doctors sometimes get more than that and that is not deserved at all. Respect is earned and the profession itself doesn’t earn enough of that respect.
Are you yourself a doctor? If so your response speaks volumes about the treatment your patients will get.
>This statement you made here is manipulative. You know what I mean by that comparison. Don’t try to spin it like I'm not talking about human lives.
Let me spell it out then: The mechanisms by which a human body and a 737 work are so vastly different that one may as well be alien to the other. It's quite an apples and oranges comparison.
Yeah, you can draw parallels in some areas but I'd say on the whole the analogy isn't exactly apt. That said, I'll indulge:
Imagine if every 737 was a few orders of magnitude more complex, and also so different to the point that no plane even looked or functioned the same. Then, imagine we didn't fully understand how they worked.
Point being: Medicine is fuzzy because the human body is fuzzy and imprecise. Everybody's a little different. Contrast to aviation, which is very much an exact science and engineering discipline at this point.
Medicine isn't engineering. Treating patients isn't the same as the design and manufacture of aircraft.
That of course doesn't excuse shitty healthcare systems that can clearly do better when stats indicate there's preventable adverse outcomes happening. I just don't think laying the blame at the feet of doctors somehow being too stupid to problem solve is helpful when there's a larger system that's preventing them from doing their best work for their patients. If anything that narrative is counterproductive.
>Are you yourself a doctor?
Nope, just a layperson who knows they're a layperson.
>Let me spell it out then: The mechanisms by which a human body and a 737 work are so vastly different that one may as well be alien to the other. It's quite an apples and oranges comparison.
Should've done this in the first place because no one understands what you're saying otherwise.
The problem internals are different but we are comparing the outcome and that is: human lives. You seem to think this is an invalid comparison. It's not.
>Medicine isn't engineering. Treating patients isn't the same as the design and manufacture of aircraft.
I never said that. The whole point was you made the claim doctors are good problem solvers because they went to medical school.
I said that claim is utter bullshit. They aren't that good and they misdiagnose shit all the time. The point still stands and you delivered evidence to validate that. You said Medicine is fuzzy and engineering exact. You said the problem was vastly more complex as well.
All of this proves the point. The problem is harder, the science is fuzzy. Doctors armed with medical science, which is definitively worse, operating on a problem that is definitively harder will be generally WORSE problem solvers then people in other occupations IF we hold everything else the same. So doctors as a group ARE not good problem solvers. That WAS the point. We are referring to doctors as a group and thus the ONLY point of comparison for problem solvers ARE other occupations.
That's just a given and it follows from your OWN logic.
>That of course doesn't excuse shitty healthcare systems that can clearly do better when stats indicate there's preventable adverse outcomes happening. I just don't think laying the blame at the feet of doctors somehow being too stupid to problem solve is helpful when there's a larger system that's preventing them from doing their best work for their patients. If anything that narrative is counterproductive.
Did I lay the blame on doctors? No. I just said they aren't good problem solvers. That's a fact. That's not blame.
But let's be clear, I agree it's counter productive to lay blame OR call doctors stupid and such a thing WAS not done by me. I was simply making the claim that THEY are NOT good problem solvers. You inserted extra negative sentiment into the "narrative" as an hallucination by your own imagination.
Look, point is you're wrong on every count. Doctors are not good at problem solving period. They're pretty bad at it. The comparison with aviation engineers is apt because those guys are GOOD problem solvers.
And again, it's not the doctors fault that they are incompetent. It's the hardness of the problem and the limitations of the science that make them like this.
After undergoing stomach surgery 8 years ago I started experiencing completely debilitating stomach aches. I had many appointments with my GP and a specialist leading to endoscopies, colonoscopies, CAT scans, and MRI scans all to no avail and they just kept prescribing more and more anti-acids and stronger painkillers.
It was after seven years of this that I paid for a private food allergy test to find that I am allergic to Soya protein. Once I stopped eating anything with Soya in it the symptoms almost completely vanished.
At my next GP appointment I asked why no-one had suggested it could be an allergic reaction only to be told that it is not one of the things they check for or even suggest. My faith in the medical community took a bit of a knock that day.
On a related note, I never knew just how many foods contain Soya flour that you wouldn't expect until I started checking.
The one I had as kid, well. He was old, stuck in old ways, but I still think he was decent at it.
But seeing the doctor is a bit more difficult these days, since the assistants are backstopping. They do some heavy lifting / screening.
I think an LLM could help with symptoms and then looking at the most probable cause, but either way I wouldn't take it too serious. And that is the general issue with ML: people take the output too serious, at face value. What matters is: what are the cited sources?
You still need 2 deviations above the average college student to get to med school. As a rough proxy for intelligence. The bottom threshold for doctors is certainly higher than lawyers
In general your comment was false. You're just lying and making things up. There are lower-tier medical schools in California, Massachusetts, and most every other state. The state, whether it's Kansas or somewhere else, is almost totally irrelevant to the quality of physicians produced.
No I'm not. I'm referring to a specific bad school(s) in kansas. I never made a comment about Kansas itself.
I never said the state is correlated with the quality of the doctor, or even if the quality of the school is associated with the quality of the doctor. You made that up. Which makes you the liar.
>If you're referring to a specific school then name the school instead of making lame low-effort comments about a state.
You're fucking right. I should've named the specific school. (And I didn't make a comment about the state I made a comment about school(s) in the state which is not about all schools in the state.)
That's would I should do. What you should do is: Don't accuse me of lying and then lie yourself. Read the comment more carefully. Don't assume shit.
No point in continue this. We both get it and this thread is going nowhere.
Huh? So your complaint is that you keep getting black doctors? That’s dumb, but whatever - why not just… get a white doctor? Or Asian or whatever you think is the smart one?
Black students (among other minorities) with unacceptable MCAT (as in, if another race had them they would be rejected) are accepted, at a rate 6-10x more likely to be admitted with similar scores. The motivation is that doctors should match the demographic they treat, and minority doctors are underrepresented, so should be accepted at higher rates: https://www.uclahealth.org/news/article/clinical-outcomes-pa...
The obvious outcome is that minorities students, being less prepared as measured by MCAT and somewhat setup for failure, have a much higher failure rate, with black students being 85% more likely to leave medical school than white: https://news.yale.edu/2023/07/31/black-md-phd-students-exper...
The system was, as is the stated goal by all, setup to pass minority students that would have previously been rejected, at every step of them becoming a doctor, to provide a net positive for minority populations, since it's accepted that you'll get the best outcome if your doctor is the same race as you.
Thank you, this is it exactly. And my biggest concern isn't the % of unprepared students who leave medical school. It's the % who stay and get passed through.
"You know what they call the most unqualified insert-identity-here person in the med school class of 2025 who squeezed by because it would look bad if they didn't?"
"Dr."
Which is why 99% AI-driven diagnosis can't come fast enough.
I feel like only the last paragraph was relevant here - I don’t particularly care why he wants a doctor of race X instead of Y. My question remains the same: why not just… get a doctor with the skin color you prefer? You’re not exactly assigned one for life at birth.
I think you're bringing up a different (very related) point than him, with both points having truth:
1. You're free to pick the race of your doctor. Matching your race is a data driven positive.
2. 30 years ago, the system made sure a minority doctor was (at least, but probably more so do to discrimination) as competent as a white doctor. These days, the system is intentionally and deliberately set up so to help pass less competent minority students, due to the positives of #1.
They’re not even trained for memorization. They’re trained for mitigation and I don’t really blame them for the crap pay they receive. Over the course of a 40-year career they basically make what a typical junior dev makes. It’s fast becoming a rich man’s hobby career.
It's about the same pay as a (professional) engineer. In the US, both engineers and doctors are very highly paid. In the UK and Japan they are paid about 50-100k if experienced, which is somewhere about 2-4x less than their US counterparts.
"According to the Government of Canada Job Bank, the median annual salary for a General Practitioner (GP) in Canada is $233,726 (CAD) as of January 23, 2024."
That's roughly $170,000 in the US. If you adjust for anything reasonable, such as GDP per capita or median income between the US & Canada, that $170k figure matches up very well with the median US general practitioner figure of around $180k-$250k (sources differ, all tend to fall within that range). The GPs in Canada may in fact be slightly better paid than in the US.
I wouldn't be surprised if AI was better than going to GP or many other specialists in majority of cases.
And the issue is not with the doctors themselves, but the complexity of human body.
Like many digestive issues can cause migraines or a ton of other problems. I am yet to see when someone is referred to gut health professional because of the migraine.
And a lot of similar cases when absolutely random system causes issues in seemingly unrelated system.
A lot of these problems are not life threatening thus just get ignored as they would take too much effort and cost to pinpoint.
AI on the other hand should be pretty good at figuring out those vague issues that you would never figured out otherwise.
> AI on the other hand should be pretty good at figuring out those vague issues that you would never figured out otherwise.
Not least because it almost certainly has orders of magnitude more data to work with than your average GP (who definitely doesn't have the time to keep up with reading all the papers and case studies you'd need to even approach a "full view".)
And speaking of migraines, even neurological causes can apparently be tricky: Around here, cluster headaches would go without proper diagnosis for about 10 years on average. In my case, it also took about 10 years and 3 very confused GPs before one would refer me to a neurologist who in turn would come up with the diagnosis in about 30 seconds.
