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I think a corollary to this is that no one will CARE as much about your health than you, even your doctor. It is perhaps scary to realize it fully, but no one is as invested in getting to the root cause of your issues, and no one has as. much intimate information about how it feels/manifests itself etc. than you. I think taken together this surely spells out that you ought to have a much more active role in your care than you may otherwise think to do, especially in situations where those factors may be more pronounced.

I speak from experience. I was born with serious congenital issues which are non-evident from looking at me or a simple examination. Switching doctors, for instance, is quite the ordeal, and it is always a few sessions before I get someone to be "leveled" up to where I need them to.

My parents have a remarkable story related to me being born that ties into this as well. Apparently my mother suffered from severe pain later acknowledged to be polyhydramnios. They went to several doctors, did many ultrasounds, etc. From the first to the forth doctor, she got anything from needing to stress, to rest, to this is normal, etc. But luckily one hinted just slightly that he thought there MIGHT be something, and suggested she go see this other specialist who was at the tail end of his career. Apparently a minute or two into the ultrasound, he apparently mentioned it with utter certainty: It could be one of two things, either anencephaly or esophageal atresia; I'd either be stillborn or would need surgery shortly after birth. Guess there's not much suspense for the reader for which one of these it turned out to be, but I always remember that story -- and my parents relentless pursuit to find someone until they were convinced they had it "right" -- whenever folks bring up searching for medical advice.

The trope that doctors are very smart isn't one Ive ever understood.

A funny story was my shop teacher (Electrician class in high school) told us after he was sued by a customer who's doctor son attempted to rectify a "mistake" the electrician made. I forget the details but the doctor wound up blowing out or damaging something in his botched attempt to play electrician. Doctors father sues electrician for doing a faulty job when it was clearly his idiot "doctor" son who blew it all up. The mans argument in all this was summed up by his plea to the judge to understand why he thought the electrician was wrong: "Your honor, my son is a doctor." The judge laughed and dismissed the case.

That seems more like a demonstration of arrogance and lack of wisdom than lack of intelligence.

I find that doctors are somewhat like a frustrating computer form, making patients jump through the procedural hoops to finally get to anything of value. There’s no way around it, patients can tell them what’s been tried before, their family history, what else is going on, but they will always defer to the simplest most common condition without fail, and ignore any association. That’s because that’s what they’re trained to do and it will work in many situations. However, when someone has something that is not a simple condition they fail to piece together the multiple conditions and other circumstances which tell them that a nose bleed may be more serious than dry air.

There’s also the complication of overdiagnosis. I’ve had a doctor not refer me to others because he believed that if I am referred to certain doctors and tested, they will find something wrong with me, but that condition may have not been serious and caused many problems, but the treatment could be worse. I don’t think this “ignorance is bliss” philosophy is unique to my doctor.

But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me.

I agree, but this has happened less and less as I have gotten older. I'm not sure if there is newer training, or they just give me the benefit of the doubt because I'm a decade older than them. Either way, I have found that older doctors are more likely to talk down to me, even when they clearly do not know what they're talking about.

This is an overgeneralization, but I’ve experienced this most often with affluent baby boomers, across all disciplines. I don’t think it’s purely an age gap issue, as I generally don’t get that sense from generations older than baby boomers. It could have less to do with your age and more to do with baby boomers aging out of the workforce.

The most arrogant and least approachable managers, teachers, doctors, etc I’ve encountered always seem to be from that generation.

Maybe I’m just a “spoiled millennial”… this kind of generational generalization is almost definitely unproductive, but I can’t help myself from thinking it has some validity.

But on the flip side of this, you don't know your internal workings better than they do.

Just because you live in your body doesn't mean you know how it works. I drive a Civic, it doesn't make me a mechanic.

Diagnosis is tricky. Especially in a system as complicated and interconnected as the human body. People often have a bad tendency to misattribute effects to recent events.

And let's say your conjecture of why they dismiss you is true. That it's because everyone else is an idiot and they're not accustomed to dealing with the brilliance that is you. Everyone thinks like that. Everyone thinks they're the bright shining star who knows medicine better than the doctor. You were not the first person and you won't be the last who walks in with reams of printed out papers on the very thing they're sure is the problem.

They have no way of knowing if you actually know what you're talking about unless they put in the work of figuring out what's up with you. So yes, you could be right, but you could also be wrong. And the work is the same either way.

> and the work is the same either way

I think I that’s the issue. Not all doctors are the same. I’ve been to many that just gave me a surface level amount of thought and sent me on my way. I’ve been to others that took time to really dig in and try to solve the problems. People resort to self research because (for whatever reason, some valid) too many doctors are the former.

Operating in a system where regression to the mean is so prevalent rewards doing the bare minimum with the added benefit of generally reducing your liability.

> Everyone thinks like that. Everyone thinks they're the bright shining star who knows medicine better than the doctor.

This seems more truthy than True.

It may be an exaggeration for effect, but in any walk-in clinic, you're going to get at least one of those a day.

"at least one of those a day" sounds like a vast minority rather than "everyone" though doesn't it?

That's why we call it an exaggeration for effect.

At the time you said it, didn't you believe it to be actually true? I mean, there is a fair amount of truth to it in my experience.

I think there was a fair enough number of people who act that way that I didn't think the exaggeration would require this level of explanation.

I am directly challenging the notion that you considered it an exaggeration at the time you wrote the comment. Considering you were criticizing the judgment of others in the comment, it seems a bit rich to play off examination of yours as somehow unfair or weird.

Cognition is often a group activity (comments on social media have effects upon the beliefs of others), and some of us actually take that very real phenomenon seriously.

Then you are simply wrong.

It's certainly plausible, but considering your epistemic track record I am skeptical.

Only if you are coming into the discussion in bad faith to try and score points on what you see as technicalities.

There can be no other way than bad faith? Not something you may not have thought of or perhaps never encountered before?

An old guy once told me how veterinarians were often better doctors than medical doctors because their patients couldn't confuse the diagnosis with bad input.

But, I've also met simply belligerent doctors before, that simply couldn't be wrong no matter what the evidence said...

There's human error on both sides to take into account.

Which is really my point here.

The person I responded to is laying the fault completely with doctors. But doctors see patients like him all the time. And they're often wrong.

The cases where they're not wrong is survivorship bias at work. It makes "patient knows better than doctor" feel more common than it is.

But if you are the kind of person very conscience of your health (or lack of it) and know very, very well what is going on. Your experience will be "most doctors ignore my (the patient) input".

So it's easy to see how skewed this can get based on perspective.

I have been told once by a doctor that he flatly refused to see me anymore if I didn't do exactly what he said, but he was just wrong.

I’m not sure if the work is the same either way (I feel ambivalent on this question). If you know that no diagnosis is possible you have to simply alleviate the symptoms as best is possible (I wish therapy was thought more of in this way, maybe it’s not all in your head but we can’t figure it out so let’s help you deal with it), if there is a possible silver bullet you need to keep chasing that even if that chasing increases the symptoms.

But thinking this over that’s a false dichotomy, even if your doctors have exhausted their theories it doesn’t mean that some other doctor might not have an idea or there’s some variation on one of the existing theories that might explain things.

Likewise, even if an exact diagnosis is found, few treatments are 100% effective in all cases, and most diagnosis have special cases which complicate things in sometimes baffling ways.

Realistically, people usually need to both address symptoms directly and seek underlying causes to some degree when dealing with illness. That exact degree depends on the exact situation but it’s typically not 0% in either case.

I would add something else, ultimately, especially with vague complicated symptoms which occur both in firmly physiological and firmly psychological disorders, the primary goal is typically to return function to ones life. Whether or not the mechanism to do so is real or not is of secondary importance especially if it doesn’t cause much harm relative to its benefit (which is not a simple matter to evaluate in cases like long term antibiotics for chronic pain, but I think is easier to evaluate for things like exercise (it might not cure the underlying cause, but it is likely to be indirectly helpful and unlikely to harmful so…))

True, but you know which noises are normal for your Civic much better than your new mechanic (or even your old one). If you know there's a new sound, your mechanic has to take that as truth and find the (a) problem. Works the same for a body.

Incidentally this problem is what is stopping me from going to a doctor right now. I'm having headaches recently which are not normal for me, but are still in the realm of "normal". I'm putting off a visit to the doctor because I'm afraid they'll say it's normal. It is not, for me.

Also, always search a second opinion. I wouldn't be born if my parents went for the "absolute truth" of the doctor they had at the time.

> I just ask in the very first appointment before I consider hiring that doctor to help me.

Ask what?

Maybe that is the question (doubt it). Think about it. Its brilliant. You say 'I always ask this one question to my doctors' then ramble off on some other tangent. See if they come back to that question. It means they are paying attention and are inquisitive.

I had to read 3 times to get it: They’re asking within 15 minutes of meeting the doctor about their symptoms and providing their personally identified cause and seeing what the doctor does. Whereas before they would go through the long drawn out process of following the doctors recommendations and getting no progress because the doctor misdiagnosed them.

> But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me.

It’s not that doctors think you unintelligent, but you are not a doctor. It doesn’t matter how many YouTube videos you’ve watched on a subject or how many hours you’ve spent reading about your current symptoms to convince yourself that your special intellect justifies doctors paying closer attention to your opinion, if you haven’t gone through the 7 years of education and passed the exams, then you are not a doctor and you will not be treated as one. Patients should be more accepting of this fact. It does not make sense in general to have doctors ask their patients to self-diagnose, even if their patients are intelligent, it doesn’t add value.

The problem is that every gambler will tell a statistician that actually their odds are abnormally high. And it’s true, if you pull 5 cards from a deck, the odds of getting exactly the cards you drew are incredibly small… no matter what you draw, so when you try to post rationalize events that have already occurred you even feel that statistics will back up your claim, but that’s not how it works, you can’t do that, just like patients being correct occasionally does not mean they should be treated as doctors because they don’t have the required education and experience.

The average doctor is an expert in memorising text books but has no ability to think.

I think it's too much to ask that every doctor (or any professional in any field, really) make an accurate individual judgement on who of their clients are able to do their own research or not. That's a luxury you might be able to afford if you're offering high-end (and thus expensive) services, but not when serving a large amount of customers.

The issue is we’re not “customers”, it’s a regulated profession so you don’t get to pick and choose ad infinitum, and it’s also not like you could bypass them and directly receive treatments you think you need.

If you’ve done your homework when coming to them, I don’t think it’s too much to expect to have them at least pay attention to what you bring to the table.

I think it is, actually - especially if 90% of people who "do their homework" actually end up with the wrong conclusions, and 50% of those are too stubborn to admit that they are wrong. It can be a massive waste of trained professionals' time.

“Doing their homework” means learning enough about a subject to be able to explain in details what they are seeing/feeling and understanding what the doctor has to say about it.

It’s the difference between “my poo is weird” and “here’s my temperature during the last three days and each feces according to the Bristol scale”. A doctor just telling you to shove your observations in indecent places isn’t sparing anyone’s time. They might be missing the mark or unreliable, but that’s not what the parent was talking about.

On patients that think they know what they need and won’t budge an inch, you’ll have them anyway. Recognizing and properly dealing with these cases is part of being a doctor. You won’t see many 6 yo kid naturally sold on getting intramuscular injections.

> But the complete failure to consider the possibility that I might also be intelligent, educated, and able to understand the applicable research just because my day job isn't in medicine immediately disqualifies a doctor for me.

To my eye, this reads quite a bit like the same sort of thing anti-vaccine and Flat Earther types think. Just because you think you're smart in some area, or even in general, doesn't mean you've got a natural aptitude for anything else. Maybe you're the exception to the rule, (probably not) but you can't blame other people for not taking your layperson confidence as gospel truth that you're smart and not at all being misled by your own or others hubris.