Doctors are the #1 Cause of Death in the United States

il prescelto said:
cosign on all of this, I agree 100%. I think schools are to blame as well, Med School is basically just a ton of memorization...that isn't exactly helpful.
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Unless you are online filling out your ERAS right now I don't even know how you could make such a statement. And if that were the case you will be miserable in residency. But since I'm sure you're not I'll just go ahead and tell you that you are flat out wrong. Is there a lot of memorization involved? Absolutely. You need to memorize garbage about the Kreb's Cycle and Monophosphate Shunts, and all this other crap that you will never use in clinical medicine. But the vast majority of what goes on is application of principles. 99.9% of what I do on a daily basis is clinical application. Do I need to memorize the induction doses of lidocaine, propofol, fentanyl, etomidate, ketamine, succinylcholine, and rocuronium? Of course. But how do those doses change in a trauma patient, a patient with end stage renal disease, a patient with a recent MI? Those aren't facts that I can memorize. I need to know how each drug works and what it will do to every organ system in the body and tailor my anesthetic approach to each individual patient.
 
TypeRPinoY said:
rashi said:
Well, most of the medications people take are for things can be reversed or managed with diet and exercise. Studies prove that. Wolff's Law tells use that weight bearing exercises can reverse osteoporosis, so why aren't more orthos referring out to physical therapists? Why don't endocrinologists educate patients on proper diet if a pt has Diabetes?(because they aren't trained in diet and exercise) So why not refer out to to a dietician who is trained? Hyper/Hypotension, PH, circulatory issues, ect. studies show that low intensity exercise helps pts with these issues and improve quality of life.
I'm not criticizing you or any other MD. The fact is that MDs are highly trained in what they know. Unfortunately, they treat the disease instead of the underlying cause. Why does a pt have Cardiovascular issues if it doesn't originate from a congenital issue? Why are people obese? Why do people have metabolism issues? Why is there such an influx of autoimmune diseases? The "why" is a question that isn't answered. I read a lot of old work from old physicians such as William Osler (one of the founders of Johns Hopkins and I have his book on my desk along with Gray's Anatomy), Weston A. Price, ect. equate pathology with poor diet.
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im curious as to what you do for a living. obviously something in healthcare but definitely not a physician. you have a lot of misconceptions about what specialists do and how the american health care system works.
 
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You know what...I was starting to think Rashi was a D.O. (cool) or a N.D. (which is unacceptable IMO). 

No shots...just...curious... 
laugh.gif
 
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il prescelto said:
cosign on all of this, I agree 100%. I think schools are to blame as well, Med School is basically just a ton of memorization...that isn't exactly helpful.
Click to expand...

Alot of people talking as if they know something about which they truly know next to nothing.
As TypeR gave examples there is a lot of memorization in the first two years of med school HOWEVER the Licensing exam USMLE 1,2,3 test the application of that knowledge that you say we just memorize. I know people that have memorized the material and studied way more than I ever did and and spit out the facts but when it comes to application of that material to the questions on the USMLEs they do poorly and a lot of that is because they dont know apply the material as well. Many are smart enough to learn the application.

Medicine for the most part is not cookbook. There isnt a straightforward do this then do that. Every person has their own medical conditions and respond to therapies differently. Sure you can start out with a protocol or a set standard of treatment but the physician's job is to know how to act when things dont go as planned. Sure most people have very similar anatomy but what happens when you get into someones belly to do a simple cholecystectomy but when you get in there they have a variant or much more complex anatomy than originally thought.
 
TypeRPinoY said:
Unless you are online filling out your ERAS right now I don't even know how you could make such a statement. And if that were the case you will be miserable in residency. But since I'm sure you're not I'll just go ahead and tell you that you are flat out wrong. Is there a lot of memorization involved? Absolutely. You need to memorize garbage about the Kreb's Cycle and Monophosphate Shunts, and all this other crap that you will never use in clinical medicine. But the vast majority of what goes on is application of principles. 99.9% of what I do on a daily basis is clinical application. Do I need to memorize the induction doses of lidocaine, propofol, fentanyl, etomidate, ketamine, succinylcholine, and rocuronium? Of course. But how do those doses change in a trauma patient, a patient with end stage renal disease, a patient with a recent MI? Those aren't facts that I can memorize. I need to know how each drug works and what it will do to every organ system in the body and tailor my anesthetic approach to each individual patient.
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I know plenty of med students and many have told me, and I'm quoting, that it's "tons of memorization", so unless I only happen to know atypical med students I doubt I'm way off track with that statement.
Before telling me I'm wrong maybe you should consider the fact that "knowing how each drug works and what it will do to every organ system in the body" can probably (correct me if I'm wrong) be learned from a book...a.k.a memorized. After having learned that, you can conclude whatever you need to conclude based on the situation, I agree. I never said med school is only memorization, and I also don't mean memorization just in the sense of "remember the definition of this word". My point is that med students aren't taught to think outside of their field of study, to be innovative/creative, to question what they learn, etc.

Pretty much everyone has their wisdom teeth removed nowadays. I was talking to my dentist a while ago (he's at UCSF as a PROFESSOR, if you want to make sure my sources are "valid") and he said lots of dentists these days just take people's wisdom teeth out for no good reason. Wisdom teeth are supposed to be taken out if they're impacted (obviously), or if the patient can't clean them well, but apparently many dentists will remove your wisdom teeth even if they are fine without knowing if you'd be able to clean them or not. Why? Because that's what they were taught.

That's just one example, I can come up with plenty more, if you want.
 
and UTVOL and I have already said that those people that just memorize will do horribly when they come to practice. in fact, i have several attendings who don't care if i memorize dosages at all since i can easily look it up. the application is infinitely more important at the end of the day.

why would med students need to be taught to think outside their field of study? are electricians taught to do refrigeration and air conditioning?
 
UTVOL23 said:
Alot of people talking as if they know something about which they truly know next to nothing.
As TypeR gave examples there is a lot of memorization in the first two years of med school HOWEVER the Licensing exam USMLE 1,2,3 test the application of that knowledge that you say we just memorize. I know people that have memorized the material and studied way more than I ever did and and spit out the facts but when it comes to application of that material to the questions on the USMLEs they do poorly and a lot of that is because they dont know apply the material as well. Many are smart enough to learn the application.
Medicine for the most part is not cookbook. There isnt a straightforward do this then do that. Every person has their own medical conditions and respond to therapies differently. Sure you can start out with a protocol or a set standard of treatment but the physician's job is to know how to act when things dont go as planned. Sure most people have very similar anatomy but what happens when you get into someones belly to do a simple cholecystectomy but when you get in there they have a variant or much more complex anatomy than originally thought.
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I meant memorization in a broader sense than you are intending it, and I also never said med school is JUST memorization.
Even cooking isn't "cookbook". What if the oven runs too hot? What if you run out of eggs? What if you spill milk where it wasn't supposed to go? You probably figure something out. You're still following a recipe though.
What I would like to see med students/doctors do is try to improve upon the recipe the follow, and based on what I know, all the doctors I've had in my lifetime, and the people in med school I talk to, almost nobody does that.
 
il prescelto said:
cosign on all of this, I agree 100%. I think schools are to blame as well, Med School is basically just a ton of memorization...that isn't exactly helpful.
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you didn't say what now? im quoting you bro. unless you misspoke, you clearly said that the majority of what is learned in med school is via memorization. that is absolutely false
 
TypeRPinoY said:
and UTVOL and I have already said that those people that just memorize will do horribly when they come to practice. in fact, i have several attendings who don't care if i memorize dosages at all since i can easily look it up. the application is infinitely more important at the end of the day.
why would med students need to be taught to think outside their field of study? are electricians taught to do refrigeration and air conditioning?
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Because one would expect and electrician to know about electronics but they don't. Most of what they know how to do is supplying power to buildings. But off the top of your head and maybe having not dealt with one first hand, you would expect and electrician to at least know how to fix a fridge a/c or some electronic device ( because they run off electricity) but they do not. Would it help them be better in their field if they knew some things cross field? Yes, but it is not required.

Hell, all things are powered by electricity. Even the human body. Problem is the plethora of different fields that actually overlap in reality, but in theory or on paper, people haven't caught up with them yet.

When UFT ( Unified Field Theory) science takes over, all these professions will become relics of the past.
 
il prescelto said:
I meant memorization in a broader sense than you are intending it, and I also never said med school is JUST memorization.
Even cooking isn't "cookbook". What if the oven runs too hot? What if you run out of eggs? What if you spill milk where it wasn't supposed to go? You probably figure something out. You're still following a recipe though.
What I would like to see med students/doctors do is try to improve upon the recipe the follow, and based on what I know, all the doctors I've had in my lifetime, and the people in med school I talk to, almost nobody does that.
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the reason most doctors don't strive to improve upon the recipe is because a lot of us are not into research and development. do you know how tedious it is to get new drugs or surgical techniques or other therapies approved? it's not easy at all. and any deviation from the standard of care is grounds for litigation and potential loss of license
 
il prescelto said:
I meant memorization in a broader sense than you are intending it, and I also never said med school is JUST memorization.
Even cooking isn't "cookbook". What if the oven runs too hot? What if you run out of eggs? What if you spill milk where it wasn't supposed to go? You probably figure something out. You're still following a recipe though.
What I would like to see med students/doctors do is try to improve upon the recipe the follow, and based on what I know, all the doctors I've had in my lifetime, and the people in med school I talk to, almost nobody does that.
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Of course there is a lot of memorization but most of which is just the foundation to build upon but not reallly used in clinical practice.

Drs are always trying to improve upon the recipe as new studies are always coming out to modify how a disease is treated or an alteration in the surgical management hence why studies are always coming out with true new data but some physicians are more research driven than others and the time it takes is extensive esp with all the regulations in place. THis isnt the old days where is a clinician wanted to experiment he would just do it and see what happened now that would result in the loss of his job and license.
 
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Wr said:
TypeRPinoY said:
and UTVOL and I have already said that those people that just memorize will do horribly when they come to practice. in fact, i have several attendings who don't care if i memorize dosages at all since i can easily look it up. the application is infinitely more important at the end of the day.
why would med students need to be taught to think outside their field of study? are electricians taught to do refrigeration and air conditioning?
Click to expand...
Because one would expect and electrician to know about electronics but they don't. Most of what they know how to do is supplying power to buildings. But off the top of your head and maybe having not dealt with one first hand, you would expect and electrician to at least know how to fix a fridge a/c or some electronic device ( because they run off electricity) but they do not. Would it help them be better in their field if they knew some things cross field? Yes, but it is not required.

Hell, all things are powered by electricity. Even the human body. Problem is the plethora of different fields that actually overlap in reality, but in theory or on paper, people haven't caught up with them yet.

When UFT ( Unified Field Theory) science takes over, all these professions will become relics of the past.
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I legitimately wonder when this will take root.

Hell, we're still discovering particles. 
 
TypeRPinoY said:
you didn't say what now? im quoting you bro. unless you misspoke, you clearly said that the majority of what is learned in med school is via memorization. that is absolutely false
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I definitely didn't say it's all memorization. I said it's "basically a ton", by which I meant that at its core its memorization but it requires other skills as well. Now, if you wan to convince me that it's not actually mainly memorization, you'll have to give me a better example than the one you gave me, which is CLEARLY something that you can pretty easily memorize and then apply to different situations using other memorized material and some common sense. Oh, and all the articles written regarding memorization in med school or articles by doctors criticizing the way med school relies so much on memorization aren't exactly helping either.

As for why med students should at least be familiar with things outside of their field, it's because you can't understand or hope to cure the human body if you're looking at it from only one perspective. Correct me if I'm wrong, but there's a lot of research coming out that indicates that ADHD might be caused by (in addition to, of course, genetics) certain environmental factors. For years, ADHD was simply treated with medications, and that approach has proved to be a failure. Approaching the problem with a broader perspective might have avoided that failure.
I'm not too familiar with electricians (although a quick google search shows that many electricians also deal with fridges...), but it doesn't take a genius to figure out that, with so many interdisciplinary fields being created recently, there must be a good reason for doing so. It takes a psychologist to explain why a subject in an experiment being run by the Economics department isn't behaving in a "rational" manner.
 
bro we're saying the same thing. you just said doctors need to memorize facts and then apply them to different situations. but you are placing more emphasis on the importance of the memorization portion and i am placing more emphasis on the application part. obviously you should memorize those things in order to be able to apply them but the buck doesn't stop with knowing said fact.
 
TypeRPinoY said:
the reason most doctors don't strive to improve upon the recipe is because a lot of us are not into research and development. do you know how tedious it is to get new drugs or surgical techniques or other therapies approved? it's not easy at all. and any deviation from the standard of care is grounds for litigation and potential loss of license
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It doesn't have to be testing new drugs or techniques though. How about doctors talking to their patients about their personal life? I have had only 1 doctor that has ever asked me anything about my personal life besides "How are your grades? Are you happy? Do you play sports? etc.". It's well known that many physical problems have psychological causes. The physical human body isn't separate from the brain. If doctors were more aware of that, I think going to a doctor would be a lot more effective than it is now. Unfortunately, I don't think med schools are pushing students in that direction.
 
you know what...im actually gonna back track and say that you probably are right. med school might actually be mainly memorization. residency on the other hand is a whole different beast where solely memorization will get you nowhere and the application of those memorized minutiae are what make you a good doctor.
 
il prescelto said:
It doesn't have to be testing new drugs or techniques though. How about doctors talking to their patients about their personal life? I have had only 1 doctor that has ever asked me anything about my personal life besides "How are your grades? Are you happy? Do you play sports? etc.". It's well known that many physical problems have psychological causes. The physical human body isn't separate from the brain. If doctors were more aware of that, I think going to a doctor would be a lot more effective than it is now. Unfortunately, I don't think med schools are pushing students in that direction.
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that's a flaw of the health care system here, not med school. we spent countless hours studying humanities in med school. but when it comes down to it and you have 15 minutes in a primary care setting to diagnose a patients problems and come up with some form of therapy, asking how your day is going is probably at the bottom of the list. doctors simply do not have the time to do that
 
TypeRPinoY said:
that's a flaw of the health care system here, not med school. we spent countless hours studying humanities in med school. but when it comes down to it and you have 15 minutes in a primary care setting to diagnose a patients problems and come up with some form of therapy, asking how your day is going is probably at the bottom of the list. doctors simply do not have the time to do that
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Yeah that's a good point, that makes sense. I mean, I definitely think the health care system has its own problems (lots of them :lol:)
 
il prescelto said:
It doesn't have to be testing new drugs or techniques though. How about doctors talking to their patients about their personal life? I have had only 1 doctor that has ever asked me anything about my personal life besides "How are your grades? Are you happy? Do you play sports? etc.". It's well known that many physical problems have psychological causes. The physical human body isn't separate from the brain. If doctors were more aware of that, I think going to a doctor would be a lot more effective than it is now. Unfortunately, I don't think med schools are pushing students in that direction.
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I agree. For someone to bring up psychological issues, their gonna have to call in a psychologist. It's a whole nother type 'o doctor. This is the problem. You got a bunch of dumb smart people. They know a whole lot, about 1 subject. For anything else, they have to collaborate with some else who has a "major" ( majority of their degree of understanding) in that field. It's cool and works great if people link up and handle things properly. But there's always that human element.

Think of having an intellectual master as your doctor/ surgeon. Imagine if you had like a Da Vinci for lack of a better example in our era as your doctor. Someone who was smart in a variety of differing fields. All that information/ knowledge/ and experience comprised in one house of a person. No need to liaison with someone for this, contact this person for that and no more stepping into grey area, "that's not my department".
 
^but that is exactly why there are so many specialties in medicine now. da vinci was an absolute genius. to expect only geniuses to be physicians in ridiculous. you can and should only be expected to know so much within your specialty in medicine. i wouldn't want my relatives seeing a cardiologist that spends equal time dilly-dallying in colorectal surgery and physical medicine and rehab. how can someone be expected to keep up with everything in each of those fields. not to mention there are separate governing bodies for each specialty and it's absolutely impossible to have a jack of all trades in medicine.
 
TypeRPinoY said:
^but that is exactly why there are so many specialties in medicine now. da vinci was an absolute genius. to expect only geniuses to be physicians in ridiculous. you can and should only be expected to know so much within your specialty in medicine. i wouldn't want my relatives seeing a cardiologist that spends equal time dilly-dallying in colorectal surgery and physical medicine and rehab. how can someone be expected to keep up with everything in each of those fields. not to mention there are separate governing bodies for each specialty and it's absolutely impossible to have a jack of all trades in medicine.
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I was saying it in a If this were another kind of world type of way. No never mind to the plurality of bureaucracies we have these days.

When we have society like we have, it doesn't, nor is it in it's interest to raise it's members to be complete "wholes" of knowledge.

We are members of societies. Not societies in our own rights.
 
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