1. 34
  1. 52

    I’m always relieved when I see a doctor look things up instead of just relying on what they remember from 20 years past.

    1. 24

      Doctors also don’t typically use Google/Wikipedia. They use a service called UpToDate*, which is commercial and has its articles written by verified MDs and researchers, but with Google-like search and Wikipedia-like organization. There’s an interesting profile/obituary of the company’s founder here:

      https://www.statnews.com/2020/04/25/remembering-uptodate-creator-burton-bud-rose/

      *: I know because my wife is an MD.

      1. 9

        I assume this varies by region, but some surveys suggest that a lot of doctors (especially junior doctors) end up using Wikipedia or other free resources in practice. E.g. a 2013 study of European doctors found that:

        In line with previous research [6], general-purpose search engines (eg, Google), medical research databases (eg, PubMed), and Wikipedia were popular resources, while specialized search engines were unpopular. […] Even though point-of-care databases (eg, UpToDate) provide reliable, evidence-based clinical information, the reported use among physicians was shown to be limited. A possible explanation could be that most physicians are not willing to pay high subscription fees to access medical information.

        1. 3

          Yea, perhaps my word choice on “typically” is doing too much work there, or, assuming too much. I revise my statement to say, “Doctors have the option not to use Google/Wikipedia, but still be able to look up quality information with simple search queries.”

          I’m sure you are right that, as the study suggests, many doctors don’t use a service like UpToDate. It is definitely a cost (although, a trivial cost, compared to other healthcare costs, and ridiculously easy to justify on ROI basis for a practice or hospital). Many of my wife’s friends who did career changes out of medicine even keep their UpToDate subscription (on a personal basis), simply to be able to guide their own (or their family’s) care a little when they are seen by other doctors. IMO, UpToDate is a great service and every MD should have access.

          Also, I should mention that my wife is quite young, as far as doctors go, and there is a generational divide here. Many doctors who came of age before the information era were forced to “search their brain” for all the answers, so I imagine many of those doctors haven’t adapted to the internet age merely out of habit.

        2. 9

          If you have it. I do a lot of Google still. No institutional site license here and I’m not wild about the per cost.

          (source: also an MD)

          1. 3

            I use it to the tune of 100+ CME points a year so to me it’s worth the $52/mo. I know colleagues who split a subscription too.

          2. 4

            I’ve observed my GP doctor type stuff into Google and click on a few links. Usually whatever page they land on looks like an official source of some kind, rather than an SEO optimised opinion piece (so, they probably don’t click on the first result).

            I’m generally fine with that - I trust my Dr to have enough background understanding to gauge whether an article is factual or not.

        3. 17
          • “Imagine if Doctors yelled at their staff as much as Chefs do”
          • “Imagine if Programmers spent time outside as much as Gardeners do”
          • “Imagine if Car mechanics washed their hands as much as Doctors do”

          – Every vocation has their own modes of behaviour and comparing them is just futile.

          1. 3

            Did you read the article?

            1. 5

              Yes, it’s a good article, thanks for sharing! Sorry, should’ve been clear I’m showing the disdain for the phrase, not the content of the article.

              1. 2

                All good! Shoulda thrown a :p into my reply

                1. 3

                  There should be a feature on lobsters that the background of every post is the photo of the person at the moment of writing the comment :)

            2. 3

              Running a tyrannical kitchen is antiproductive. The food service industry as a whole has terrible practices related to a segregation of status and poor economics; the kind of anger that famous chefs are famous for is just part of a cycle of abuse.

              Also, some doctors do yell at their staff, and the result is that people with self-respect and options leave to go work elsewhere.

            3. 13

              My old doctor misdiagnosed me for over a year with a skin condition I was suffering from. She never looked anything up, just kept insisting it was something else.

              Went to a dermatologist finally (without a referral) and it was cleared up within a week.

              1. 3

                That’s annoying. I’ve heard similar stories before.

                Did you ask for a referral from this Dr? I can’t think of a reason they would deny you one.

                I’ve asked for, and received referrals even when I didn’t really need a specialist.

                1. 4

                  Nah didn’t even bother. She’s not my doctor anymore.

              2. 7

                I fell an urge to bring up a discussion here about the use of the word ‘Google’ as a verb meaning ‘To trigger a search for data using a computer’. Doctors are horribly reliant on a lot of really weird proprietary medical software made by private companies with nepotistic government contracts and an attitude towards transparency that mirrors that of the NSA. I don’t think your doctor is typing your symptoms into a google search bar. When clicked the headline to read the article I was expecting something about proton mail and elastic search. As a programmer I use google, but I rely on stackoverflow.

                I am not suggesting this is a major problem with the article, just something I thought was worth considering in this context. Also, are people really saying that data searching is bad? Why are we not just ignoring those people?

                1. 5

                  One or two AI revolutions ago, the big buzzword of the day was ‘expert systems’, which were mostly databases with fuzzy search terms that provided flow charts to help refine the search. A whole bunch of the tech demos involved large symptom databases that would recommend tests to narrow down a diagnosis. In the 1980s, they were demonstrating that a nurse capable of running the tests (and, importantly, interpreting what the person said when describing the amount of pain) with an expert system could easily outperform a doctor relying on the things he or she remembered from a medical degree. I’ve rarely seen these systems actually deployed in the wild. A huge amount of education time is spent getting people to memorise things that would be easy to search for, rather than learn skills that would actually help them develop useful skills.

                2. 4

                  I’ve found that having offline docs really helps to mitigate the sort of helplessness from frantically googling things, because the feedback loop can be sooo much quicker.

                  Highly recommend people install Dash/Zeal (and of course sources for libs you use when possible). It’s much easier to figure stuff out when you don’t have an HTTP request per page turn

                  1. 1

                    Is your internet particularly slow? I’ve never found the HTTP request of online docs to be particularly problematic, it takes far less time than reading the docs does, or typing the type name that I’m searching for, or whatever.

                    What I do find really useful is

                    • Duckduckgo’s !rust to search the rust standard library documentation from my browsers search bar (online, via http requests)
                    • Cargo’s cargo doc --open to build (and open in a browser) local documentation for my project and all it’s dependencies (except the standard library)

                    I really miss these when working with other languages, even for languages/dependencies with good documentation, I never know how to find it or navigate inside it as quickly. But that’s not because of latency from http requests, it’s because of familiarity and quality of search functions.

                    1. 2

                      I think a part of it is the interface of Zeal or Dash, I’d recommend you try it out! It’s the difference between a BMW and some Formula 1 car: both are pretty fast but one just outperforms consistently.

                      I used to read comics online back in school. Each page turn is a click. The next page would load in under a second, so real fast! But once I downloaded something offline and read from there, I was reading through stuff 3 or 4 times faster.

                      The data just being present is a huge advantage for these tools’ UIs, and you’re really able to move at the speed of thought

                      1. 1

                        was reading through stuff 3 or 4 times faster.

                        Ok, faster. But faster is not always better.

                    2. 1

                      +1 on offline docs

                      For me the low latency loop of local docs just helps me keep the flow of coding going. I love quickly searching docs and finding what I need, or using an IDE to open up the docs for me. I don’t feel helpless necessarily, just have the potential to lose my focus. And if my life is stressful at a given moment I tend to lose focus easily.

                    3. 4

                      The world of professional reference materials, for professions outside of programming, has always been an interesting one to me. In high school I took advanced chemistry classes and was exposed to the CRC Handbook, a hefty and well-organized book that’s intended to contain most of the information you would need day-to-day as a working chemist - formulae, physical properties, constants, etc. Similarly but more in biochemistry and pharma the Merck Index is a pretty famous resource with the general goal of allowing you to look up any chemical and find out its properties, including medical uses. Pharmacies usually have a copy (of course it’s software now) for the pharmacist to look up questions about interactions and etc.

                      Anyway, in medicine, the Merck Manual of Diagnosis and Therapy is a very old, many times revised reference that aims to fit your typical doctor use case - looking up symptoms to find a diagnosis and treatments. Nowadays there are several software-based options that are updated continuously, although the Merck Manual continues to be revised and reissued (and is available in software form including a mobile app).

                      The cool thing about these references of course is that they are not only comprehensive but also authoritative - the publishers put a lot of time and effort into following the state of research in order to provide the most current citations for all of their information. Google doesn’t offer this type of service, but in practice you can still often get to it by Google, since despite the best efforts of shady SEO googling medical symptoms still usually gets you results from either respected medical institutions or government agencies. These sites, like the Mayo Clinic online reference, do give you citations in the academic literature if you click through.

                      My point is that many of these references are 100 years old - respected professionals have been looking things up for a long time, because any meaningful profession encompasses more information than one person can remember. This seems even more true in fields like medicine and pharmacy where we would hope practitioners aren’t just trusting their memory!

                      1. 2

                        I don’t think that’s a problem. Just like Imagine if Doctors never use internet.

                        1. 4

                          That’s what the article is about.

                        2. 1

                          Imagine if becoming a programmer required a five-year degree, and then you’d look forward to being a junior for the next 5-15 years.

                          1. 2

                            We call those “automation free working environments”

                          2. 1

                            If doctors relied on Google as much as programmers do, I’d have a lot more respect for doctors. Come to think of it, whence cometh BloodOverflow?

                            1. 1

                              I have been going to OPD in a hospital and they literally have a cabin with bookshelves and I have seen them looking things up. I feel vey relieved.

                              1. 1

                                In oral medical fellowship exams, when a resident is asked a question they don’t know the answer to the correct response is “I’d look it up”.