New at Reason

June 23, 2004

Hanah Metchis discusses the AMA's efforts to keep you from self-diagnosing.

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|6.23.04 @ 4:57AM|#

Isn't this similar to those hair-braiders in D.C. being forced to go to beautician school plus buy an expensive license?

|6.23.04 @ 5:37AM|#

Actually, I'd say the two cases are different.

There may be good reasons to regulate service industries like hair-brading, though there is plainly such a thing as mis-regulation (e.g., the hair-braiders being forced to go to beautician school, which is mostly irrelevant to what they do), overregulation (e.g., forcing the hair-braiders to undergo extensive training when a spot check like a driver's test would surely suffice) and industry capture of regulators (possibly licensed hair-braiders favor the license as a means of driving up prices, although I don't know if this is true).

There is no evident reason for denying people access to an essentially risk-less test that would provide them with information about themselves, which is what is at issue here.

|6.23.04 @ 6:49AM|#

"Yet the battle for consumer control of medical choices is raging on many grounds, from high-tech scans to contact lenses to contraception. With so much information readily available about the benefits and risks of medical procedures and devices,"

You left out prescription drugs.

When I get home from the doctor with a prescription, I never pop a pill without checking the net for a more complete picture of the drug I'm about to take. There is soooo much information out there.

|6.23.04 @ 7:31AM|#

dead elvis,
Then why aren't you alive today?
uh... wait a minute...

and alkali,
there are no reasons to regulate any service industries.

|6.23.04 @ 8:06AM|#

...there are no reasons to regulate any service industries.

That's theology, not argument. In any event, I don't care to debate that here: I was just pointing out that this situation is analytically distinct from the ordinary case for service industry regulation.

|6.23.04 @ 9:48AM|#

I just busted my gut. A rather impassioned post about the need for government regulation of hair braiders. My initial take is that government regulation of hair braiders is hare brained. Perhaps someone can point out the dangers of being handled by an inept hair braider. My worst case scenario is that you have a bad hair day and don't pay the charlatan. What am I missing? The nanny goat march continues unabated.

|6.24.04 @ 1:50AM|#

Having worked in the medical industry for a while, one thing I've found is that a doctor will generally try to treat you symptomatically, i.e., assess your condition based on symptoms and co-morbidities, then attempt to treat those symptoms with prescriptions before using diagnostics. They figure if they can alleviate all the symptoms you're complaining about, you'll go away. The health insurance company is constantly browbeating the health provider towards cost reduction, regardless of the patient's situation. Ultimately the health insurance company does not care whether you live or die. The CEO wants to repave his 1/4-mile driveway; the medical case reviewer wants to pay off his school loans.

As a patient, you must be proactive about your own health. Do not trust your doctor's expertise; s/he has a significant profit motive that precludes trusting him or her on such a vital subject. Make him show you through diagnostics that his assessment is correct. If you have a doubt, always get a second or a third opinion. If you are ever not satisfied with your physician, find another - they're a dime a dozen. They are supposed to provide a service for you, not the other way around.

You'd be surprised how straightforward the practice of medicine is. With research and careful experimentation, you *can* accurately and appropriately self-diagnose. Bringing an informed set of information to your physician will generally convince him to humor you at the least, and may even help prevent problems *before* the physician has a chance to write it off as "stress".

|6.24.04 @ 2:35AM|#

rst,
Flesh out your post there and you may be able to peddle it to Prevention Magazine.

|6.24.04 @ 2:38AM|#

I can think of many reasons -- some of them even good -- why people would eschew doctors. For one, far too many of the latter are imperious, dismissive, egotistical jerks.

|6.24.04 @ 8:49AM|#

Frankly, I'm embarrassed when I go to a new doctor and find that I know more about a particular prescription drug--or even more about a given condition--than the doctor apparently does.

I realize that the doctor is only one human and probably works tirelessly to fill their brain with data. I guess that is the problem in a nutshell--I could not presume to step into the doctor's shoes and treat patients, but I'm in a position to have more focused knowledge about a condition that I have a specific, immediate interest in.

|6.24.04 @ 9:18AM|#

Ralph writes:

I just busted my gut. A rather impassioned post about the need for government regulation of hair braiders.

I don't have any particular view on whether there is any need for government regulation of hair braiders. I just used that as an example of three ways in which government regulation of a service industry -- assuming arguendo that it was justified at all -- could go wrong. I could have used lawyers or plumbers instead.

My worst case scenario is that you have a bad hair day and don't pay the charlatan. What am I missing?

Sounds about right, although I don't really know anything about it.

|6.26.04 @ 10:41AM|#

the danger is the people that refuse to trust doctors, don't particularly know much about their (presumed) condition themselves, and go and set out their own course of treatment based on the information available to them. via the internet, via books, and via the diagnostics available without a prescription.

i'm on a decent number of medical/educational forums. i've run into pleanty of people who fit that description for any number of reasons.

and they can do real damage to themselves by their ignorance and confusion.
no, not all doctors are good.
yes, it pays to proactive and informed about your own condition and your own care. and a good doctor should respect that.
but good health care, ultimately, needs to be about the patient and the doctor working TOGETHER toward a common goal: the patient's health. both have an important part to play in the equation, and leaving on party out is to the detriment of all, most especially, of health.