I was stereotyped, and it just about killed me. In 2002, I went to the ER with _crushing_ chest pain. While the doctor was giving me an EKG he laughingly said, _"How many 33 year old women do you know who have had heart attacks?"_ (I didn't know how to respond to this horribly crass comment.) He ruled out a heart attack and sent me home without making any attempt to find the source of my chest pain. But, he did give me Dilaudid for the pain! Still in intense pain, I went back to the ER the next day and said, "I'm not leaving here until you find out what's wrong with me." So, they did a chest CT scan with contrast. The next thing I know, a team of doctors and nurses came rushing into my room telling me I had Mediastinitis, an infection around my heart. They started asking me if I "worked for the postal service" or if I had "handled any white powdery substances." Because this was 2002, the height of the anthrax mailings, *they literally thought I had anthrax poisoning!* I was immediately transported to the main hospital in an ambulance. I had to stay in the ICU for several days on high doses of antibiotics (which turned my skin purple for some reason). The ICU doctor informed me that Mediastinitis had a 70% mortality rate! Thankfully, I made a full recovery and it didn't leave me with any heart damage. However, no one was ever able to tell me _how_ I developed Mediastinitis. To this day, I cannot believe the way that ER doctor treated me. I don't know if it was because of my age or gender, or if he was just a bad doctor. But I do know that if I hadn't been _my own advocate_ and insisted on an answer, I could have died.
That's one of the big biases he left out; the tendency to underestimate women's pain. From what I understand it's had some studies done into it and I've seen/heard a ridiculous number of stories from women along very similar lines to yours. I'm sorry you had to go through that and glad you came out ok. Were there any repercussions for the original doctor who saw you?
Thank you for sharing your story. What a clear example of the kind of thing I'm referring to, sorry it happened to you. I won't defend the doctor's tone if he was rude but in terms of the clinical decision, statistically speaking I will have sent home at least some 33 year olds that will have re-presented with something more serious than I thought. Unfortunately that uncertainty is hard to entirely eliminate. I'm glad you recovered OK.
When I was a child I ate peanut butter out of a jar after it had broken on the solid floor. It had shards of glass in it and my mouth was bleeding. When my parents took me to the hospital they gave me some bread to eat and that was it. The idea being the bread would soak up any shards and sort it out. No scans or anything else. Mental
They make mistakes when their patients have eaten apples before visiting. This weakens the powers of the doctors to the point of them being unable to cast their spells properly.
WRONG. If you have eaten an apple within the last hour or two, you won't even be able to enter the hospital. It's like two north poles repelling each other, all the doctors within the building will repulse you from the entrance with such force you'll have to wait around until the apple is digested. This is simple Newtonian medicine.
It is a quite powerful effect. I have witnessed it in reverse some time ago. So there was this mate coming to the hospital, who I assumed had eaten a lot of bullets. I could tell because they came actually straight back out of his stomach again. With in seconds the doctor's just couldn't let the hands of him.
My late wife was stereotyped in hospital admissions as 'another woman who complains of pain to get oxycontin'. After months of increasing hip pain that put her in a wheelchair, and defied several specialist diagnoses, our GP sent her to hospital with supporting notes asking that she be admitted for surgical investigation. The admissions doctor refused to take notice and after lots of manipulation of her hip to check how real her pain was, said, 'OK, you I'll write a script for stronger pain killers and you can go home!. My wife refused to accept that, quoting the GP's request for investigation. My wife could be like a Mack Truck in her determination and in this moment was immovable. So the doctor called down an on-call orthopaedic surgeon. He checked out the hip, said there is something seriously wrong here, and she was admitted and listed for surgery. The issue turned out to be a malignant growth on the ball of her hip that required a hip replacement. Further tests showed untreatable secondaries in other bones and my wife only lived a further eight months. There were lots of moments that I wanted to go chasing up that admissions doctor and confront her with the reality my my wife's situation and the doctor's obvious stereotyping.
I primarily watch your videos for the comedy but them being also lowkey educational makes me feel less like a piece of crap for wasting time so, keep em coming chief.
@3:05 - The fact the viagra advert also mentions 'see our Ads in Golf Digest' is quite a clear indictment of who they're targeting with their marketing budget!
I find the younger doctors are being trained to listen more. As a nurse with 37 years in critical care I have taught docs how to read ekgs on patients having an MI. The other thing I learned long ago is to really listen. To my patients,to the other staff,to nursing assistants and housekeepers as well as doctors. It’s much easier to make accurate care plans when you have all the data.
I had a consultation with A Rudolf Steiner trained Doctor. Mostly discussion with lots of his questions (with a good outcome.) A physiotherapist asked me to talk about what I thought was causing my hip pain, and we formulated some changes in my gait - with a good outcome. I was supernating my foot. Listening to your patient will reveal more than a clinical diagnoses of the complaint.
David Renwick It’s a different world for doctors than it was in the 80’s. They now have “hospitalists “. These are docs employed by a specific hospital working similar to the nurses. A certain number of days per week either 7a-7p or 7p-7a. They are the internal med admission docs. They have a chance at a life outside of their careers. Most,not all,are fresh out of residency and a bit green. And believe me,they sink or swim at this point too. Part of me thinks it’s a great thing for a profession who too many die young,or work well into their senior years. My opinion is patients need protection. Every patient needs a Pitbull on their side. Someone who is knowledgeable as well as has the patients well being at heart. That used to be nurses. Now we spend almost more time at a computer or in meetings than actually caring for patients. But sorry,David,it’s time for me to crawl off my soapbox. I am so pleased your personal journey was a positive one with a good outcome!
Atheist groups have been making them for decades. One has even made a card game out of them. Check out "Rationality Rules" with Steven Woodford. The game looks like a fun way to teach them to people (or learn them, if you're yet to).
This is why I still love doctors despite having walked around with a broken neck due to doctors ignoring my pain. The issue was the hospital that I was going to itself, a hospital that out-right encouraged doctors and nurses to avoid tests (to the point of causing my mother to go home with a BP of under 70/30 after surgery). This hospital is always under-staffed and every nurse I've spoken to that use to work there says they under-pay while charging double what the public hospital does. It's the system, sometimes it breaks good doctors into not caring about their patients and sometimes it breaks good doctors into caring a little too much (overdiagnosis).
I was stereotyped, when I already had a diagnosis, and I'm still baffled by it to this day. It was completely unrelated to my actual illness, and was entirely based on my requesting a prescription for contraception. I had been on hormonal birth control for a few years, to manage hormonal acne and irregular bleeding (I've had PCOS, endometriosis, hormone imbalance etc ruled out, I've just got the bad luck, no cause 'abnormal uterine bleeding' diagnosis). I realised I forgot to get a new script for the pill (I also have ADHD lol), and my usual GP was booked out for a little while so I decided to just go to some local walk-in clinic, so that I wouldn't have to wait. It's just the pill, how hard could it be? Well. Despite my history, despite my pharmacy having records of my taking the pill, and despite the fact that I was in a long term, monogamous relationship, the doctor refused my prescription unless I took an STI test. No, this is not the standard practice for prescribing contraception here. I went through with the test because I needed the prescription sooner rather than later. Surprise surprise, I had no STIs. I wonder if living in a highly religious town had anything to do with it. I don't know, but it was frustrating and humiliating. There's no reason for me to have lied, relationship status, STI status, and number of sexual partners doesn't impact whether or not I can be prescribed. Nobody is taking the pill recreationally. If it were to do with actual health concerns he'd have questioned me about what I reported in regards to blood clots or whether I smoke, but nope, because I wanted contraception (and not even for the purpose of preventing pregnancy), I must be lying about my monogamous safer sex. I've had an easier time getting diazepam from a new doctor than I did getting the pill that day. I've got an IUD now, so hopefully I won't have to deal with that situation again (at least for a few years).
Yep, most offending!!! I think that women would not even need to explain why they want the bill other than saying: "to prevent unwanted pregnancy". Because so often these conversations are ending up in explaining your whole value system around your sexual behavior. And of course doctor will want to warn you against unprotected sex with multiple partners. But it is extremely offending that it is the first conclusion that the doctor makes when you go asking prescription for bill: "Young female, surely is having sex all around the place like a proper slut. I close my ears for her explanations. Probably lying anyway." That attitude is super offending!!! Next time, just move along to other doctor if possible. You do not need to have STI tests to get the bill. Just walk away from the doctors office.
I have unexplained hearing loss. When my ENT investigated, I was tested for a very rare condition called neurofibromatosis. This causes tumours and initially presents with hearing loss. It kills you by age 65 usually. I don't have neurofibromatosis, but it was a good idea to screen for it. I present with similar symptoms and if missed, I could have been very seriously unwell and untreated.
Stereotyping is crucial. It contributes to pre-test probability and gives weight to the tests in light of their sensitivity/specificity. Also... I don't think the Duck carried out a CURB-65? ;)Fantastic content! You don't see mumble rap and yellow nail syndrome quoted in the same video enough, if you ask me..
Episode 5: The One Where I Start To Lose My Mind. Are you Team Jook or Team Jelly? [Edit: This was my original, pretty lame, pinned comment but Lisa Bowers's is far better]
You showed a picture of a drop-point knife, so I wondered if "jook" was the name for such a blade. Googling, Wiki has some intriguing options: Jook may refer to: Congee, East Asian rice porridge, pronounced [tsʊ́k] in Cantonese and romanized jook [d͡ʒʊ́k] in some Cantonese diasporic communities. Juke joint, informal social establishment Take 'em to a speak-easy, they'll be fine ;)
This video saved me from accepting chemo, when I was diagnosed with brain mets. turned out I had an infection on the brain that was causing all the flairs on an MRI. Thank you
Another form of confirmation bias is using leading questions while interviewing patients. For example - Do you have a butterfly rash on your face that gets worse with sunlight (because the doctor is thinking about lupus) instead of asking open-ended questions like do you experience rashes?
You did forget one: "Who's the doctor, here?" bias. This is when a patient tells a doctor what they have, then explain why they think that, but the doctor's ego has already kicked in and he/she has decided that the patient is wrong just because "they're the patient and *I'm* the doctor!" In the last 15 years, I haven't been diagnosed correctly on the first try even once, despite my telling the doctor what I had (and being correct) every time except one (the doctor was also wrong, in that case). The most egregious example was when I got a sinus infection just after I started using a CPAP and, at a nurse's advice, an OTC steroidal nasal treatment to decrease inflammation in my nasal passages. I'd never been able to breathe through my nose, it was pretty much always inflamed, and this was a problem when using a CPAP, and the nasal spray helped. I got a sinus infection, but I knew that most of those aren't bacterial and don't need antibiotics, so I treat them with nasal irrigation or nothing, and they go away. This one didn't. It spread. Once the infection started spreading, I went to see a doctor at urgent care. I told her I had a sinus infection and it was probably bacterial because I used a CPAP, steroidal nasal spray, and it was spreading. She told me I was wrong and sent me home. I returned a few days later because the infection had spread more and was becoming very painful. By chance I got the same doctor. She gave me a steroid shot, still not believing my diagnosis. The infection spread into my upper jaw, where it attacked the nerves there. It was horrendously painful. I went to urgent care again, and a different doctor prescribed me pain medication (freaking opioids!) but not antibiotics. I went straight to the ER, but they heard "sinus infection" and tuned out everything else. "I have a sinus infection that spread to my jaw and it's eating the nerve--" "You have a sinus infection?" "Yes, but it's spread to my jaw..." "Okay, sinus infection." They then put me at the bottom of the triage list. I left after a few hours when it became clear that I was never getting treatment. Finally, I went to a different ER where, after several hours, they did a CT scan, then FINALLY prescribed antibiotics. Because of the pain and swelling, I couldn't use my CPAP and got basically no sleep during this ordeal. After 10 days, I began hallucinating, but it still took another 4 before I got antibiotics, which worked immediately. Parts of my jaw were numb for six months from the nerve damage , but ever since then, I've been able to breathe through my nose without any issue. I also know exactly where all the sinuses on the left side of my face are, because their locations are burned into my memory by days of constant pain.
Wow that sucks that happened to you. On the other hand there EXIST doctors that listen. I have an amazing GP so when I told her "hey I know my symptoms look like tonsilitis but I actually think it's mononucleosis could you test me for that?" she listened and the results came back positive for mono. It was caught very very early and I still had to stay home for 6 weeks due to being extremely tired. I can't even imagine how much it sucks when they tell people it's tonsilitis for weeks before finally checking mono
yeah i finally got diagnosed after like 3 years of seeking care. initially i had a friend tell me that i have what she had, told me what it was and that weed would help. multiple doctors didn’t listen, denied symptoms, at one point got told to do a therapy that didn’t work (my annoyance is mostly because being cold is a symptom trigger, and the therapy they recommended was all about lowering body temperature. the doctor doing it didn’t listen when i explained that), and one neurologist was incredibly rude. finally i got recommended to a specialist who diagnosed me with what i thought it was all along, and told multiple doctors about, which was what my friend told me.
Nothing so bad as what happened to you, but the doctors I saw were useless as well. I don't want to go into it, but years of pointless suffering and I basically had to figure out everything myself.. Have I just been unlucky? Are some types of doctors worse than others? Is it a class thing? I think partially it's just that doctors are that bad, but they aren't worse than any other profession, but their decisions are more vulnerable to bias and their mistakes have greater consequences..
@@selainx The medical education system, which was devised in the early 20th century by a man who thought black people were too stupid to be doctors, is built on training doctors that they are always right and always know more than the patient. It's also built in a way that only the healthiest people can be doctors at all, and puts them through sleep deprivation while they're working by making them work day- or multi-day-long shifts while on call. This makes it impossible for anyone who can't tolerate such literal torture to become a doctor, despite the fact that people with their own chronic illnesses are the ones most likely to understand such things. It also leads to as _staggeringly_ high rate of addiction among hospital doctors, who have access and think they have enough knowledge to use stimulants and painkillers to get through their shifts without becoming dependent. They're usually wrong. In my experience, the best "doctors" are nurse-practitioners, who didn't go through the hazing process and got their experience "in the trenches," while not being too full of themselves to, you know, _listen_ and _look stuff up._ What do you call someone who got straight D's in med school? "Doctor."
I definitely had a tough time of sorts when my appendix burst when I was 10 years old. I went to the second largest hospital in my city (Royal Jubilee in Victoria at the time) because it was closer (and my mom took me there because I was 10). The doctors didn't do a CT scan, but they pressed on my side where it was hurting - because having my appendix burst was really, really painful. I was clearly in pain. But I assume that because I was a kid and otherwise healthy with no other issues, they brushed it off as a stomach ache of some kind. They gave me a couple aspirin and Tylenol pills to take and said that if I wasn't better by tomorrow morning, I should go to the main hospital for the city. Oh, and through all of this, I was vomiting and having diarrhea constantly. Forward to next morning and I was still in pain. We went to the main hospital (Victoria General Hospital). Except my pain had progressed far enough now that I couldn't walk properly. My mom had to carry me through the parking lot. We waited in the ER lobby for 3 hours... And I spent most of my time in the washroom vomiting and on the toilet. Finally I get admitted in properly, they take me to a CT scan about 30 minutes after admission and then an hour later after that, the next thing I know, they had me in the operating theatre and said my appendix burst. They had to perform surgery to get all the contaminants out of my abdomen and seal up the wound. After I came to, they said I was lucky. They said I'd have died if we let it go on for 18 - 24 hours longer. Something about a serious infection, and the whole 9 yards. I spent 2 weeks in the hospital after and they made sure I left with no signs of infection or other odd gunk coming out of either end of me. My mom went and gave the Admin at the Royal Jubilee and earful because I almost died and they assumed I was otherwise healthy, but just having a stomach ache.
"No, Dr. [Smith] has been my doctor for 20 years, and you shouldn't try to take credit for other people's work." Oh, well *_I'm glad Dr. Smith diagnosed you 20 years ago!_*
Great video! Mistakes are normal in every profession, and it's important to to talk about them. I want to add something to stereotypes: Other commentators have pointed out their experiences as female patients, and there are several studies that show that bias in several settings (especially for afroamerican women). I myself am a female med student with quite bad rheumatoid arthritis, and for years, my pretty painful symptoms were explained away as being psychosomatic (mind you, they were very untypical for a psychosomatic disorder). The fatigue and the pain made medschool pretty hard for the first years, and I felt so bad for being weak and having pain. In hindsight, I don't know how I managed being in so much pain for such a long time - I just didn't want to be hysterical or a difficult patient. I'm not mad at anyone for not diagnosing me right away. I understand that this can take months to years. But the thing that hurt me was everyone telling me it was psychological. No-one ever offered me any therapy to treat the suspected psychosomatic disorder, I was just told to take pain medication. I really don't think anyone believed me when I said I was in bad pain. And that's so experience of so many other young women I know. If somebody just had said "We'll observe the symptoms, but we don't know exactly what to look for right now", that would have made handling the pain a lot easier. Another important aspect is the "emotional" bias - I just observed a lot of doctors, especially young ones, that seemed overwhelmed with all the pain they are seeing. And some of them react by getting unsympathetic, and stop taking the pain of their patients seriously. I don't know if you can call it compassion fatigue, since I always felt that it affected people who weren't able to handle compassion very well in the first place. If you know how to set your boundaries, compassion can be a great resource. But it takes some experience and self reflection to handle all those emotions, and unfortunately, doctors are being left quite alone with that. It's kind of taboo to talk about how your feelings influence your work as a doctor. Also, many are feeling attacked if you try to bring up that bad stereotypes exist and some make stupid decisions based on them - not because of spite, but because they are human beings, who maybe didn't learn to self reflect so well. I hope that will change in the future.
I've had RA for 40+ years and I simply cannot express my admiration enough for you. Almost no one understands the pain but the most debilitating thing has been the chronic fatigue. Well done, you! for making it through med school.
A quick note about drug advertising in New Zealand - we may have drug advertising to consumers (which does suck) but it's slightly less awful than in the US because of Pharmac. Pharmac is a state-owned drug buyer, and almost all of the drugs that people get prescribed have been bought by Pharmac - this means we tend to get generic medicines over brand names, and we have a single buyer who aggressively pursues the cheapest version of any given medicine. It's the only drugs people can buy themselves over the counter that they tend to get ripped off on here.
I went to the ER once thinking I was having a stroke at 25 Turns out I was just really high from too much coffee and weed and really tired from working a 12 hour shift But the doctors at the ER took me very seriously despite obviously smelling like weed and probably just being paranoid from being too high They gave me all the tests to see if I had any signs of a stroke, including putting me in a scanning machine to be absolutely sure I was okay. I bet they got some great scans of what too much THC and caffeine do to the brain lmao
My mother suffered from pneumonia due to a genuinely silly misdiagnosis. There was an outbreak of swine flu in my country - so when my mum presented with yet another chest infection (she had a series of them) instead of antibiotics she was given an antiviral. I pointed out this was extremely dangerous to her when she returned from the GP's practice. I pointed out how infectious influenza is and that no one she knew had it, and that even if she had a virus that didn't preclude her from having another bacterial infection. She got worse really quickly and sprinted through pleurisy etc frightening fast. By the time she saw a doctor a short time later she was really ill with pneumonia. I asked her to make a complaint and she refused.
I had the same stomach issue form the age of three... And I got a diagnosis at sixteen. Through these years they put me on stronger and stronger acid reducing medications, starting off with a pill that dissolved in my mouth, then one that I had to swallow, then two of them. Then a stronger one, then two of them. Then another stronger one. I had plenty of endoscopies. I had to eat a radioactive omelette to get an x-ray of the way my intestines moved the food along. We did a scan where I swallow contrast liquid standing up, laying down and being tilted whilst swallowing. We did a 24 hour scan where I had a tube in my nose that looked to see if there was any "backwards" movement in my stomach. Then, finally, I got a diagnosis. Regurgitation syndrome. A completely psychosomatic disorder that was set of by childhood trauma as my brain, to deal with stress, made me throw up which in turn gave attention and the household would calm down for a couple of days. So, were all of the tests and medications necessary? Yes. Why? My diagnosis is less common than the ones that can be life threatening issues. Because had it been stomach ulcers, that can go bad real fast. Had it been my stomach working backwards, I could've quickly become deficient in nutrients and gone severely underweight (I was overweight all my life till the age of fifteen... so I dont know why they thought that but ok). My point is, the doctors I was being looked at by wanted to exclude any possibility of a life threatening disorder. As well, healthcare in Sweden is completely free so tests were not run for financial benefit, but purely to see if I would die from this.
Wow cool story, thanks for sharing. The brain is so complex and fascinating. Has having a diagnosis improved your symptoms? How is a psychosomatic disorder treated? Btw I was just wondering if any of your testing showed dysmotility? A lack of peristalsis? No pressure to answer any of my questions and have a lovely day!
@@lindsaybrown2137 no lack of peristalis, a slight dismotility if I eat "more than on portion". When I had the tube down my nose, I ate a meal of like pasta salad and then some nuts afterwards which made my stomach stretch and then contract which forced all the food to come back up. Not all in one go, but some at a time. So there is a slight dismotility. But because my symptoms are worse during stress and no dismotility was found in any of the other tests, they did rule that out. And having a diagnosis has not lessened the symptoms. Still, almost three years after diagnosis, if work has been really stressful that day or if something happens at home, dinner will come right back up. And treatment for a psychosomatic disorder like this is really just about treating the surrounding causes. It's a learnt behaviour form age three, all I can do is avoid triggering situations such as concerts, clubs, or any situation where things will be loud, tight and there is a risk of violence. I also just have to do my best in dealing with stress. That means exercise and sleep as well as not take on too many shifts. We have tried anxiety meds but I just become drowsy on those.
Thanks for sharing, how fascinating. A friend of mine with the exact same diagnosis (in fact one of my ex-juniors at work) was written up as a case report in a gastroenterology journal, by one of her bosses who also saw her as a patient!
Not sure I would have said they were all worth it. Tests for a potentially lethal condition sure, but since you had been suffering since 3 it would seem unlikely to be life threatening. At what point should someone bring up a psychosomatic disorder as the cause? I don't know, just asking - but it might have saved a lot of time and testing that might have been used on the next patient.
"Thinking Fast and Slow" is an excellent read regarding these different types of thinking and biases. Also, have you read "This Is Going To Hurt"? It's the most hilarious book I've ever read.
A great item - thanks. Long ago (so long, cars were manual, had distributors and carburetors), I heard an item that compared the human body's issues with those of a car. The item proposed a car that had hormones, cycles, emotions, and cussed-mindedness, imagination, and with a susceptibility to microbial infection. Hearing this item caused me to adjust my hopes/expectations of my doctor. Also because of this I figured out just how patients will describe the same symptom in so many different ways, and how difficult that makes it to give the doctor a good understanding of the problem. Now I am elderly, I do wonder what merit there is in treating me? Nobody can same my life, because regardless of treatment, I am doomed to die - We all are. So I am placing more emphasis upon enjoying my days as mush as I can, as opposed to leading a medically optimal life. So really treatment for me is about enabling me to avoid unnecessary suffering.
When I was in college I was taking psychology courses on a number of things. One of them was the psychology of education. Throughout the course we talked about why older methods of educating have been largely debunked and learned a bunch of new ways to help people retain information better. I walked up to my professor and asked her. "Why is it that we know better ways to teach and yet this class is taught exactly as we are told not to teach?" And she replied. "Because the old way is how I was taught." It dumbfounded me. I couldn't understand the point of learning new things but never applying them. (Also I recognize I didn't capitalize some proper nouns up there, I too am lazy.)
Well she probably didn't learn them, just about them she was probably never trained in the new ways of teaching, knowing something exists doesn't meant you know how to apply it.
@@thepinkestpigglet7529 Also I doubt it is equally applicable to all areas. I would have thought psychology would require active mental processing of information, but getting people to learn something by rote is a bit different.
Another great video. Never realised how interested I was in medical things. With exception to House of course!! So many take away points from this video. Galaxy S10 over iPhone 10, Peng- shanks !! lol The "jook" procedure. I call that " Youf kulchur bias" Loving the skeleton too. Brilliant though, and well done on the diagnosis. I now feel compelled to go and binge watch House MD from start to finish!
You should do a review of John Olivers Bias in Medicine that would be awesome. He covers racial and sexual bias in medicine, I have loved your series so far.
I ran into a case like this that nearly cost my vision. I was having an undue amount of time off work for headaches (definitely atypical for me). Family doc, walk in doc, and emerg doc all tried various pain control and tests to make sure my brain wasn't falling out. After a while my family doc suggested an opto. Optometrist checked my vision *during a headache*, and didn't find anything abnormal. I was getting up to leave when she said "wait a minute, sit down again". I'm an early 30's male at this point and she had neglected to even bother looking for glaucoma since it was statistically very very rare. My pressures were in check but she hadn't looked. Back in the eye-looky-machine-majig (sounds better in latin) and she checked. Sure enough, my angles (the bit at the edge of the iris where it lets fluid go from the front to the back of the eye) were almost completely sealed off. I was rushed off to an ophthalmologist who agreed and I was quickly zapped with some lasers (very uncomfortable) to punch new 'breathing' holes in my irissses...iri? Bilateral iridotomy later and I haven't had a headache since. Left unchecked glaucoma can render a person very quickly permanently blind. Doc had a hunch, rule out eyeballs. Opto had a bias and didn't check one of the hazards because of low threat.
I have a question about the title thumbnail of you with your face scrunched up. Is that your, "I'm trying to simplify a difficult topic" face? Or is it your, "I just realized that I'm going to need a manual disimpaction" face? As always, another great job. You've made statistics interesting. Thanks.
It's more like 'damn I forgot to take a picture yet again, let's find the one still frame of the video where I'm not making a face like I'm fainting, having a stroke or smelling a fart'
I live in New Zealand and didn't even know it was legal to market directly to patients as I've never seen it. I thought it was only in USA as when I went there every 3rd advert on the TV was about some drug or another.
Terrific video. It's brilliant. But how widespread is this knowledge in the medical world? Also, in Los Angeles there are dialysis clinics owned by doctors. A friend was advised by one of these doctors that he needed to start dialysis immediately. He got a second opinion that completely disagreed with the first dialysis-clinic-owning doctor. What would be the result of sending a person with healthy kidneys to dialysis ? Would it cause that person to be put on the transplant list in 5 years or worse, or would it bump up the positive stats for the clinic? My father was repeatedly sent for tests at--you guessed it--the testing laboratory owned by the doctor. Both of these happened in the United States, so the likelihood of such corrupt practices occurring in a developed nation are probably very small.
I imagine most if not all of those apply equally to any diagnostic style role, I've definitely seen / done most of those working in IT. Love that Dunning-Kruger effect is an actual recognised thing, I've remarked about that effect to collagues in the past in relation to new IT staff (and did it myself earlier in my career!), where they learn enough to think "I know ALL about IT!" after a year or two, then given more time they come to realise quite how vast a subject it is and how little of it they actually know themselves.
0:10 But that dark chocolate one is true. Dark chocolate (of course in certain doses) can be very healthy, though it's naturally best to go as dark as possible to avoid as much added sugar as possible.
Doctor here in NZ won't even do tests and referrals aren't sent in unless you are literally dying or old. Its messed up. I have a bunch of issues that leave me mostly bed bound. None of which have ever been diognosed and getting a doctor to pay attention is like pulling a camel through the eye of a needle
"In 1865, Semmelweis supposedly suffered a nervous breakdown and was treacherously committed to an asylum by his colleague, where he died at age 47 after being beaten by the guards, from a gangrenous wound, due to an infection on his right hand which may have been caused by the beating (officially of pyaemia), only 14 days after he was committed. " Wikipedia. This story is wild.
Very interesting and informative as always. As a new FY2 it's great to hear these and bear them in mind on the job, especially when observing senior's decisions, let alone making my own.
Doctors aren't a monolithic entity that all behave exactly like the ones you know. Especially regular clinical practicioners or whatever you call them in English are usually quite lazy when it comes to non-life threatening complaints; if there's (harmless) medicine to prescribe. This is of course anecdotal but one can easily logically deduce why that might be. Speaking of anecdotes: So, I went to the clinician to get something for my (what turned out to be a) yeast infection. I moved in between, so I had two doctors prescribe me antibiotics. When the first two rounds didn't work (much), the last doctor prescribed me a "heavier" dose, which also didn't work. 6 months later I was still in as much discomfort as when I started. So, I googled what else could be done about it and one thing that kept coming up was diet. *Two weeks later, and gone was the itchy eczema.* Can't make money off of patients healing themselves now can you?
A type of stereotyping I've experienced, both personally and as a relative or in my previous job in assisted living, is aimed against people with mental health issues. Very real problems are disregarded as exaggerated or imagined because of a history of mental health problems. Even if there is no reasonable link between the two.
Yeah, my sister almost died from undiagnosed spontaneous pneumothorax, because she had a history of strong back pains (explaining the pain) and anxiety (explaining the shortness of breath), so the doctor gave her painkillers and muscle relaxants and sent her home. Luckily our family doctor was thorough enough to use a fuckin' sthetoscope and she found out exactly what was going on. Needless to say, she now gets chest X-rays everytime she comes in with a severe back pain...
Building the whole video around Timmy was a brilliant idea for making us viewers stay until the end but then we want to know exactly what Timmy's problem was, and whether he got cured and how he is doing now. That's the storytelling bias
I need a Baymax. Just so I can watch him stroke my dog and call him "Hairy Baby". 2:10 moving forward without adequate evidence leads to Thalidomide babies. SOooo I'd really like my doctor to not be on the leading edge and pushing boundaries, thanks. Marketing hype: My Dr. once insisted I take Levaquin for a bladder infection, despite the fact there was clear evidence it wasn't working. I went through three courses before finally saying, "Look, just give me the damn drug that worked last time." and hey presto, the infection was gone. Why did my dr. insist on levaquin? Because it was the new wonder drug and was being pushed at that time. Luckily I wasn't a runner then so no ruptured achilles. My friend ended up with one though. =(
What about bias bias? When you think about all the biases that could affect you, overthink it, get overwhelmed, go home, lock the door and cry in your bed until you pass out from exhaustion? Asking for a friend...
Thanks! Been waiting for this episode. Been an eye opener for me. Keep up the good work! BTW, I honestly thought the diagnosis of that chronic patient to be Munchausen syndrome. Was it really Yellow nail syndrome after all?
My dad was sick for his whole life but severally sick, bed ridden for 35 years ish. There was never really very good diagnosis. I don't blame doctors. Most medical conditions we still know little to nothing about. The amazing thing is how effective the minute things we do understand are.
I'm a medical student and phrases like : 《the urge to do something or the desire to avoid any potential harm, are both the natural and normal responses [...] learning when they aren't the right thing to do is one of the hardest skills in medecine,》 help me understand that this isn't something that will just come naturally but I need to work on it and try to improve it all the time. Just like the fact of avoiding the other biases. This is the kind of unspoken rules (not the biases, but the fact that avoiding them is a skill that we need to learn!) that open huge doors once they are clearly phrased just like you did in this video. Thank you for all the reminders and the wonderful examples
i’m glad that my doctors (some were psychiatrists some were medical, but it was in the same department) didn’t stereotype me when i was going through gender dysphoria issues at 12 because damn if i was a doctor and i saw an obviously autistic kid without a diagnosis of it and only a history of family bipolar i wouldn’t have done shit but hey i’m happier now, i mean like i’m depressed but less depressed now
As a resident on another service, I saw a patient in a room and thought I would impress the attending resident with my diagnostic acumen. I said, "I see you have an Achondroplastic Dwarf with Pickwickian Syndrome." His reply, "No, just some short fat funny looking guy."
WHAT THE HELL IS THAT FACIAL HAIR, like Jesus. Side note, love the vid, if it ducks like a quack is one of my favorite series on TH-cam. Keep up the good work
I hate to correct you, however, I'm sure you are the type of person who actually won't mind. It revolves around using the terminology "strong and weak antibiotics." As we both know when we empirically choose an antibiotic, the two greatest factors are spectrum of activity and ability for the drug to reach effective concentrations in the target tissue (e.g. amoxicillin/clavulanic acid for bite wounds). Using the term "strong" when referring to a particular antibiotic undervalues the thought process involved in choosing an appropriate antibiotic and, in the vein of this video, can lead to an "antibiotic selection bias." A problem I see in both the veterinary and human medical professions. Antibiotic resistance would be a great topic for you to cover as that problem is having a dramatic effect in patient outcome in both of our professions. I really enjoy your work, keep it up, it is most appreciated!
Biases shmiases, how about good old fashioned human laziness or trying to make up time because doctors are always running terminally late? Love the skeleton btw :)
How about a loud doctor bias/cut and paste bias/google bias? I had an ingrown toenail. I looked online. I'd used the 'cut a triangle in the nail' technique before. It worked pretty well, but I was wondering if there was something better. I ran into an article by a podiatrist saying that the cut a triangle method doesn't work at all. This seemed odd, because I'd gotten fairly decent pain relief even within a few minutes, so I looked to see if there were any other doctors. I ran into another article saying the same thing, and another... and actually, they all seemed to say EXACTLY the same thing. I looked and low and behold it was the same article by the same doctor. It was everywhere, and I couldn't find any other articles on the first couple pages of google results. My friend had an ingrown toenail. I suggested cutting a triangle in the tip of the nail to relieve the pressure. He said he'd read several places online that that didn't work. Again, it does seem to help, and the logic behind it seems to be pretty sound. It could be just a placebo effect, but with just one doctor's opinion online it's kind of hard to say.
I am blessed. My Dr. Is so cheap, when I asked him my blood type, he said WE never did that test and the hospital does not have the information any longer. He told me to go give blood and ask for a copy of everything. It will save me around $7500.00 and I could save a life. I had forgotten that they test everything, especially covid19 (that they know about), when someone gives blood. He just told me that about August 2020, so the price of $7500. Is how much a simple blood scan costs now days. Brother James
In a recent survey of male tennis viewers, more than half assumed they could score a point against Serena Williams. Dunning-Kruger effect in full swing. Pun intended.
I was sent to the A&E by my GP. First thing the nurse said: "I have seen your face before." She explained my symptoms away, tried to kick me out from A&E, but relented when her colleque did not join her campain. She put me last on the list for people to see a doctor. What would you call that bias? Hahhaaa personal bias? 😊 Or "we only offer services once per year if you come twice...it is too often we see your face"-bias.
Great video, as always! Please make a video about heart rate variability. How accurate is the HRV calculation on the Apple Watch and what is the normal range? What does it say about the condition one’s heart and how can it be improved? Thanks.
I spent years of gp's and a&e doctors laughing me off, telling me nothing was wrong. It took the symptom of TN. By the time I went to neuro (a few weeks) the same pain/numbness had spread into a lot of my body.a few months after i was finally diagnosed with MS. I was diagnosed with rrms. Because you can't diagnosed secondary progressive without previous information. So I'm sat knowing it's likely secondary but unable to get that diagnosis. In the time prior I lost feeling in my legs, lost ability to move my legs which came back sort of during my trip to a&e the doctor was saying there was nothing wrong. While I was sat watching my reflexes and noticing my right reflexes are heightened. I'm not a doctor but I know that's not normal for me. (But that's one little issue not a big thing). I complained constantly to my GP I have severe leg pain, primarily during period, but also if I walk too much or just randomly. She gave me different things to try and treat a woman's problem. but later on another gp sent me for an ultrasound. Nothing obvious. Radiographer said oh you have cysts maybe that's your pain (it was the wrong side). I gave in. In 2015 I was in the hospital for suspected meningitis. I had a spinal tap. They clearly meningitis yey. Had the worst migraine I'd had in my life for weeks after the doctor in hospital comment "should get someone to look at that" thanks pal. When I was being diagnosed with ms 2017, my husband noticed it said "occular bands Jan 2015". Hang on... they found something and noone followed up. Assumption being it wasn't clinically notable because it was outwith symptoms of a relapse and my CT had been clear. But why not check via MRI? Could I have had a diagnosis almost 3years earlier? (It's doubtful but it's still going to float in my head). I can go on. But ultimately after over a decade I was finally diagnosed with ms. Wether or not my outcome would have been different. We'll never know.
I was about to say the video was brillant. Then I remember watching the first part and being sponsored by Brilliant, so I'll say the video was amazing. Btw, also doc here, and am doing my masters in this area, that's a really cool field
So back from my little vacation, I'm trying to get more exercise in with my diet so I decided to start walking from my school to my house (a little over 6500 steps a day)
Between the Darth Vader skeleton at the left, and the green hearth at the right, there is the electric schematic of a valve radio transmitter from the '60s. I thought it could have been a Marconi therapy device from the same period, tho. Thanks for all the clarifications on the various types of bias; I believe the human thought is all a big bias in the most disparate directions, and what save most of us is the pull of reality telling that we aren't, after all, so much different from all other peoples. Greetings, Anthony
sometimes i like pretend diagnosing my family (im only 14 vibe down and they go to the doctor,i just like putting into play what i learn from research kk) and it worked sometimes my mother told me her symptoms and i said i think she has vertigo she went to the hospital and she has vertigo, idk if its just an easy one but i was surprised. Then my sister came home with narks on her hip and she described the pain she had already told my mom and she was comign to take her. with the pain and everything i realized it was exam season and said it might be stress induced shingles, she went to the doc and i was right she got treatment and got better! reminder im nto the doctor this is just for fun and my mom thinks in being weird i think science is cool
I couldn't find part one, but this is a great video. I hope that in part one you mentioned what I call "psych bias," against patients with a psych diagnosis. You could show up at the ER with your intestines dragging on the floor and two missing limbs. But if you have a mental health diagnosis on file, you'll get treated to a lecture about wasting the doctor's time before being sent home with a benzo injection and a referral to a therapist. I hear about race and sex bias in medicine all the time, but somehow psychiatric bias is invisible. Why is that?
i had a sneaking suspicion this was pancreatitis from the labs showed (esp the amylase and elevated LFTs) but i'm a nurse not a doctor - just seen a lot of young atypical presentations of pancreatitis. nevertheless this is an amazing video, thank you for it - as a healthcare worker it is a really important wakeup call! ALSO PROFESSOR GARAGE
Hey! I was wondering, my blood type is B neg, i used to donate but have not done for a while. If i were to recieve a blood transfusion, is there much difference between my group and O neg? Your channel is great! Ive found all your videos really interesting. Sorry i sound really dumb, i can't write to save my life, so this is me awkwardly trying to show my appreciation. Theres no way to not sound like a sycophant.
Canada; In referance to all the drug commercials on TV...I am truly sick of seeing them. All they do is make some people believe in these products. Then they go running to their doctor, cause that is what the add tells them to do & ask for the drug. Oh also tell your doctor of all the drugs you are on....(like your doctor does not know). All this is doing is people are trying to change their doctors into drug pushers while these companies cover their behinds with all the ...drug side affects that they spout off at the end of the commercial. I am truly disgusted with all this. It should not be allowed!
All joking aside, Bruh, your content is fire. You're If It Ducks... series is so damn informative and funny. I bet it's really common for the doctor who explains it best to get the credit over the doctor who diagnosed it first. Also there's the whole 'God did it' thing stealing your thunder.
This reminds me of a diagnosis my daughter got just before she turned 30. She had a patch on her forearm that started as tiny little pin pricks (nerves in the skin fired off first), erupted as tiny little blisters in a circle about an inch in diameter. They grew bigger and merged into one large blister and hurt like the dickens. She went to the doctor and he looked at it and when "hmmm." She said, "Hmmm? No, you are supposed to say AHA!" He had to go to his computer to look up what he thought it might be, but wasn't sure. Turns out it was bollous pemphigoid. It is a rare skin condition and usually only shows up in the elderly. She is very young to have it show up. It is malfunction of the immune system and can be triggered by certain medication. She had at least 5 episodes - forearm, upper thigh and armpit over a 2 year period. There is no specific thing that sets it off, but we have read some suggestions from others sufferers. One was antibiotics and/or ibuprofen. She has avoided ibuprofen since the last flare up over 5 years ago, so that seems to be her trigger. She has had antibiotics since then, but never ibuprofen. I told she should feel special getting some rare about 50 years before she should. She just gave me the stink eye.
4:00 He’s lucky he got a bloodtest, When I was in the hospital as a slim 17 year old, but very healthy because I do a lot of fitness, I had the luck they ran a bloodtest due to someone dieing 1 year before who was misdiagnosed with the same thing I had. They thought he had a heartburn and send him home with some meds and he died 3 days later because of myo- and endo-cardites. This blew up big time in the news and likely because of this I got a bloodtest, after which I was rushed to the IC.... I guess having a Trop value of over 1300 had its perk too
Liusila squealing brakes? It's the brake pad wear indicator scrapping the rotor. But that's one of the bias listed here assuming it's what's the most common cause.
Regarding Vista, as a developer I really like it as it gives stability over Win7, and the gadget toolbar is really handy when you have dual monitor configuration. What annoys people is the UAC. However with Linux background and got used to more annoying protection mechanism like SELinux, I don't think it's too bad either.
![[ENGSUB] UNPRODUCTIVE DAY ใช้ชีวิต (เปื่อยๆ) ด้วยกัน 1 วัน! | OUROAD CLOSEFRiEND SS2 EP.9](http://i.ytimg.com/vi/pyYKZ3kra9w/mqdefault.jpg)
![Why Stupid People Think They're Smart [The Dunning-Kruger Effect]](/img/n.gif)
I was stereotyped, and it just about killed me. In 2002, I went to the ER with _crushing_ chest pain. While the doctor was giving me an EKG he laughingly said, _"How many 33 year old women do you know who have had heart attacks?"_ (I didn't know how to respond to this horribly crass comment.) He ruled out a heart attack and sent me home without making any attempt to find the source of my chest pain. But, he did give me Dilaudid for the pain!
Still in intense pain, I went back to the ER the next day and said, "I'm not leaving here until you find out what's wrong with me." So, they did a chest CT scan with contrast.
The next thing I know, a team of doctors and nurses came rushing into my room telling me I had Mediastinitis, an infection around my heart. They started asking me if I "worked for the postal service" or if I had "handled any white powdery substances." Because this was 2002, the height of the anthrax mailings, *they literally thought I had anthrax poisoning!*
I was immediately transported to the main hospital in an ambulance. I had to stay in the ICU for several days on high doses of antibiotics (which turned my skin purple for some reason). The ICU doctor informed me that Mediastinitis had a 70% mortality rate! Thankfully, I made a full recovery and it didn't leave me with any heart damage. However, no one was ever able to tell me _how_ I developed Mediastinitis.
To this day, I cannot believe the way that ER doctor treated me. I don't know if it was because of my age or gender, or if he was just a bad doctor. But I do know that if I hadn't been _my own advocate_ and insisted on an answer, I could have died.
That's one of the big biases he left out; the tendency to underestimate women's pain. From what I understand it's had some studies done into it and I've seen/heard a ridiculous number of stories from women along very similar lines to yours. I'm sorry you had to go through that and glad you came out ok. Were there any repercussions for the original doctor who saw you?
Thank you for sharing your story. What a clear example of the kind of thing I'm referring to, sorry it happened to you. I won't defend the doctor's tone if he was rude but in terms of the clinical decision, statistically speaking I will have sent home at least some 33 year olds that will have re-presented with something more serious than I thought. Unfortunately that uncertainty is hard to entirely eliminate. I'm glad you recovered OK.
When I was a child I ate peanut butter out of a jar after it had broken on the solid floor. It had shards of glass in it and my mouth was bleeding.
When my parents took me to the hospital they gave me some bread to eat and that was it.
The idea being the bread would soak up any shards and sort it out. No scans or anything else.
Mental
A doctor thought my cousin was too young to be having heart attack or angina; he was sent home with his chest pain. He was 26.
You should always be your own advocate when dealing with any profession.
They make mistakes when their patients have eaten apples before visiting. This weakens the powers of the doctors to the point of them being unable to cast their spells properly.
WRONG. If you have eaten an apple within the last hour or two, you won't even be able to enter the hospital. It's like two north poles repelling each other, all the doctors within the building will repulse you from the entrance with such force you'll have to wait around until the apple is digested. This is simple Newtonian medicine.
Medlife Crisis ah of course, how did I miss that!
It is a quite powerful effect. I have witnessed it in reverse some time ago. So there was this mate coming to the hospital, who I assumed had eaten a lot of bullets. I could tell because they came actually straight back out of his stomach again.
With in seconds the doctor's just couldn't let the hands of him.
Can I still get a medical prescription for gin please? Asking for a friend.
I guess we better thank god for not making Newton a doctor, imagine if he'd invented gravity the wrong way around.
My late wife was stereotyped in hospital admissions as 'another woman who complains of pain to get oxycontin'. After months of increasing hip pain that put her in a wheelchair, and defied several specialist diagnoses, our GP sent her to hospital with supporting notes asking that she be admitted for surgical investigation. The admissions doctor refused to take notice and after lots of manipulation of her hip to check how real her pain was, said, 'OK, you I'll write a script for stronger pain killers and you can go home!.
My wife refused to accept that, quoting the GP's request for investigation. My wife could be like a Mack Truck in her determination and in this moment was immovable. So the doctor called down an on-call orthopaedic surgeon. He checked out the hip, said there is something seriously wrong here, and she was admitted and listed for surgery.
The issue turned out to be a malignant growth on the ball of her hip that required a hip replacement. Further tests showed untreatable secondaries in other bones and my wife only lived a further eight months.
There were lots of moments that I wanted to go chasing up that admissions doctor and confront her with the reality my my wife's situation and the doctor's obvious stereotyping.
10:50 Familiarity Bias - otherwise stated as "When the only tool you have is a hammer, every problem looks like a nail."
Also called the golden hammer anti-pattern
a yellow nail, to be exact.
Haha very good!
Also known as "degree in evolutionary psychology".
As we all know, Jeremy Clarkson has proven time and time again that everything can be fixed with a hammer.
Finally a Dr with a realistic anatomical model of the human skeleton.
Best girlfriend ever
@@TheMarcymark Does your ideal gf talk a lot of shit?
Nope it's missing the tongue bone
@@cristomathew9171 i thought the ability to talk was a feature that went by the wayside when this design put together.
@@cristomathew9171 I like my girls calcified
I primarily watch your videos for the comedy but them being also lowkey educational makes me feel less like a piece of crap for wasting time so, keep em coming chief.
@3:05 - The fact the viagra advert also mentions 'see our Ads in Golf Digest' is quite a clear indictment of who they're targeting with their marketing budget!
maybe they have a surprisingly tiny marketing budget
I find the younger doctors are being trained to listen more. As a nurse with 37 years in critical care I have taught docs how to read ekgs on patients having an MI. The other thing I learned long ago is to really listen. To my patients,to the other staff,to nursing assistants and housekeepers as well as doctors. It’s much easier to make accurate care plans when you have all the data.
The one benefit in the medical community ? Quite simply, an experienced nurse! Worth their weight in gold!
I had a consultation with A Rudolf Steiner trained Doctor. Mostly discussion with lots of his questions (with a good outcome.) A physiotherapist asked me to talk about what I thought was causing my hip pain, and we formulated some changes in my gait - with a good outcome. I was supernating my foot.
Listening to your patient will reveal more than a clinical diagnoses of the complaint.
David Renwick It’s a different world for doctors than it was in the 80’s. They now have “hospitalists “. These are docs employed by a specific hospital working similar to the nurses. A certain number of days per week either 7a-7p or 7p-7a. They are the internal med admission docs. They have a chance at a life outside of their careers. Most,not all,are fresh out of residency and a bit green. And believe me,they sink or swim at this point too. Part of me thinks it’s a great thing for a profession who too many die young,or work well into their senior years.
My opinion is patients need protection. Every patient needs a Pitbull on their side. Someone who is knowledgeable as well as has the patients well being at heart. That used to be nurses. Now we spend almost more time at a computer or in meetings than actually caring for patients. But sorry,David,it’s time for me to crawl off my soapbox. I am so pleased your personal journey was a positive one with a good outcome!
Thank you for that! My doc missed some essential symptom because I said it too colloquial and didn't know the term for it
A poster with all of these biases would make some good merch
Atheist groups have been making them for decades. One has even made a card game out of them. Check out "Rationality Rules" with Steven Woodford. The game looks like a fun way to teach them to people (or learn them, if you're yet to).
Also do take a look in the vid description for the 'Catalogue of Bias' - great website
Oh and PS Rationality Rules is awesome! :)
@@PinataOblongata Beautiful username, by the way.
www.visualcapitalist.com/wp-content/uploads/2017/09/cognitive-bias-infographic.html
Damn doc, that story at the end was bloody heart-wrenching. Or that could be an undiagnosed cardiovascular issue, who knows.
Your anatomical model has completely explained my migraines. It would appear my head and hips have been switched, no wonder my head hurts!
This is why I still love doctors despite having walked around with a broken neck due to doctors ignoring my pain. The issue was the hospital that I was going to itself, a hospital that out-right encouraged doctors and nurses to avoid tests (to the point of causing my mother to go home with a BP of under 70/30 after surgery). This hospital is always under-staffed and every nurse I've spoken to that use to work there says they under-pay while charging double what the public hospital does. It's the system, sometimes it breaks good doctors into not caring about their patients and sometimes it breaks good doctors into caring a little too much (overdiagnosis).
I was stereotyped, when I already had a diagnosis, and I'm still baffled by it to this day. It was completely unrelated to my actual illness, and was entirely based on my requesting a prescription for contraception.
I had been on hormonal birth control for a few years, to manage hormonal acne and irregular bleeding (I've had PCOS, endometriosis, hormone imbalance etc ruled out, I've just got the bad luck, no cause 'abnormal uterine bleeding' diagnosis). I realised I forgot to get a new script for the pill (I also have ADHD lol), and my usual GP was booked out for a little while so I decided to just go to some local walk-in clinic, so that I wouldn't have to wait. It's just the pill, how hard could it be? Well. Despite my history, despite my pharmacy having records of my taking the pill, and despite the fact that I was in a long term, monogamous relationship, the doctor refused my prescription unless I took an STI test. No, this is not the standard practice for prescribing contraception here. I went through with the test because I needed the prescription sooner rather than later. Surprise surprise, I had no STIs. I wonder if living in a highly religious town had anything to do with it. I don't know, but it was frustrating and humiliating. There's no reason for me to have lied, relationship status, STI status, and number of sexual partners doesn't impact whether or not I can be prescribed. Nobody is taking the pill recreationally. If it were to do with actual health concerns he'd have questioned me about what I reported in regards to blood clots or whether I smoke, but nope, because I wanted contraception (and not even for the purpose of preventing pregnancy), I must be lying about my monogamous safer sex.
I've had an easier time getting diazepam from a new doctor than I did getting the pill that day. I've got an IUD now, so hopefully I won't have to deal with that situation again (at least for a few years).
Yep, most offending!!! I think that women would not even need to explain why they want the bill other than saying: "to prevent unwanted pregnancy". Because so often these conversations are ending up in explaining your whole value system around your sexual behavior.
And of course doctor will want to warn you against unprotected sex with multiple partners. But it is extremely offending that it is the first conclusion that the doctor makes when you go asking prescription for bill: "Young female, surely is having sex all around the place like a proper slut. I close my ears for her explanations. Probably lying anyway." That attitude is super offending!!! Next time, just move along to other doctor if possible. You do not need to have STI tests to get the bill. Just walk away from the doctors office.
I have unexplained hearing loss. When my ENT investigated, I was tested for a very rare condition called neurofibromatosis. This causes tumours and initially presents with hearing loss. It kills you by age 65 usually.
I don't have neurofibromatosis, but it was a good idea to screen for it. I present with similar symptoms and if missed, I could have been very seriously unwell and untreated.
Stereotyping is crucial. It contributes to pre-test probability and gives weight to the tests in light of their sensitivity/specificity.
Also... I don't think the Duck carried out a CURB-65? ;)Fantastic content! You don't see mumble rap and yellow nail syndrome quoted in the same video enough, if you ask me..
Episode 5: The One Where I Start To Lose My Mind.
Are you Team Jook or Team Jelly?
[Edit: This was my original, pretty lame, pinned comment but Lisa Bowers's is far better]
I do love Jelly
I'm more of a jello type of person
Are you gonna make video about fasting?
Team jelly all the way!
You showed a picture of a drop-point knife, so I wondered if "jook" was the name for such a blade. Googling, Wiki has some intriguing options:
Jook may refer to:
Congee, East Asian rice porridge, pronounced [tsʊ́k] in Cantonese and romanized jook [d͡ʒʊ́k] in some Cantonese diasporic communities.
Juke joint, informal social establishment
Take 'em to a speak-easy, they'll be fine ;)
This video saved me from accepting chemo, when I was diagnosed with brain mets. turned out I had an infection on the brain that was causing all the flairs on an MRI. Thank you
Another form of confirmation bias is using leading questions while interviewing patients. For example - Do you have a butterfly rash on your face that gets worse with sunlight (because the doctor is thinking about lupus) instead of asking open-ended questions like do you experience rashes?
You did forget one: "Who's the doctor, here?" bias. This is when a patient tells a doctor what they have, then explain why they think that, but the doctor's ego has already kicked in and he/she has decided that the patient is wrong just because "they're the patient and *I'm* the doctor!"
In the last 15 years, I haven't been diagnosed correctly on the first try even once, despite my telling the doctor what I had (and being correct) every time except one (the doctor was also wrong, in that case).
The most egregious example was when I got a sinus infection just after I started using a CPAP and, at a nurse's advice, an OTC steroidal nasal treatment to decrease inflammation in my nasal passages. I'd never been able to breathe through my nose, it was pretty much always inflamed, and this was a problem when using a CPAP, and the nasal spray helped.
I got a sinus infection, but I knew that most of those aren't bacterial and don't need antibiotics, so I treat them with nasal irrigation or nothing, and they go away. This one didn't. It spread.
Once the infection started spreading, I went to see a doctor at urgent care. I told her I had a sinus infection and it was probably bacterial because I used a CPAP, steroidal nasal spray, and it was spreading. She told me I was wrong and sent me home.
I returned a few days later because the infection had spread more and was becoming very painful. By chance I got the same doctor. She gave me a steroid shot, still not believing my diagnosis.
The infection spread into my upper jaw, where it attacked the nerves there. It was horrendously painful. I went to urgent care again, and a different doctor prescribed me pain medication (freaking opioids!) but not antibiotics.
I went straight to the ER, but they heard "sinus infection" and tuned out everything else. "I have a sinus infection that spread to my jaw and it's eating the nerve--" "You have a sinus infection?" "Yes, but it's spread to my jaw..." "Okay, sinus infection." They then put me at the bottom of the triage list. I left after a few hours when it became clear that I was never getting treatment.
Finally, I went to a different ER where, after several hours, they did a CT scan, then FINALLY prescribed antibiotics.
Because of the pain and swelling, I couldn't use my CPAP and got basically no sleep during this ordeal. After 10 days, I began hallucinating, but it still took another 4 before I got antibiotics, which worked immediately. Parts of my jaw were numb for six months from the nerve damage , but ever since then, I've been able to breathe through my nose without any issue. I also know exactly where all the sinuses on the left side of my face are, because their locations are burned into my memory by days of constant pain.
Wow that sucks that happened to you. On the other hand there EXIST doctors that listen. I have an amazing GP so when I told her "hey I know my symptoms look like tonsilitis but I actually think it's mononucleosis could you test me for that?" she listened and the results came back positive for mono. It was caught very very early and I still had to stay home for 6 weeks due to being extremely tired. I can't even imagine how much it sucks when they tell people it's tonsilitis for weeks before finally checking mono
yeah i finally got diagnosed after like 3 years of seeking care. initially i had a friend tell me that i have what she had, told me what it was and that weed would help. multiple doctors didn’t listen, denied symptoms, at one point got told to do a therapy that didn’t work (my annoyance is mostly because being cold is a symptom trigger, and the therapy they recommended was all about lowering body temperature. the doctor doing it didn’t listen when i explained that), and one neurologist was incredibly rude. finally i got recommended to a specialist who diagnosed me with what i thought it was all along, and told multiple doctors about, which was what my friend told me.
Nothing so bad as what happened to you, but the doctors I saw were useless as well. I don't want to go into it, but years of pointless suffering and I basically had to figure out everything myself.. Have I just been unlucky? Are some types of doctors worse than others? Is it a class thing? I think partially it's just that doctors are that bad, but they aren't worse than any other profession, but their decisions are more vulnerable to bias and their mistakes have greater consequences..
@@selainx The medical education system, which was devised in the early 20th century by a man who thought black people were too stupid to be doctors, is built on training doctors that they are always right and always know more than the patient. It's also built in a way that only the healthiest people can be doctors at all, and puts them through sleep deprivation while they're working by making them work day- or multi-day-long shifts while on call. This makes it impossible for anyone who can't tolerate such literal torture to become a doctor, despite the fact that people with their own chronic illnesses are the ones most likely to understand such things. It also leads to as _staggeringly_ high rate of addiction among hospital doctors, who have access and think they have enough knowledge to use stimulants and painkillers to get through their shifts without becoming dependent. They're usually wrong.
In my experience, the best "doctors" are nurse-practitioners, who didn't go through the hazing process and got their experience "in the trenches," while not being too full of themselves to, you know, _listen_ and _look stuff up._
What do you call someone who got straight D's in med school?
"Doctor."
"Need I say more than Theranos."
_Mic dropped._ 🎤
I definitely had a tough time of sorts when my appendix burst when I was 10 years old. I went to the second largest hospital in my city (Royal Jubilee in Victoria at the time) because it was closer (and my mom took me there because I was 10). The doctors didn't do a CT scan, but they pressed on my side where it was hurting - because having my appendix burst was really, really painful. I was clearly in pain. But I assume that because I was a kid and otherwise healthy with no other issues, they brushed it off as a stomach ache of some kind. They gave me a couple aspirin and Tylenol pills to take and said that if I wasn't better by tomorrow morning, I should go to the main hospital for the city. Oh, and through all of this, I was vomiting and having diarrhea constantly.
Forward to next morning and I was still in pain. We went to the main hospital (Victoria General Hospital). Except my pain had progressed far enough now that I couldn't walk properly. My mom had to carry me through the parking lot. We waited in the ER lobby for 3 hours... And I spent most of my time in the washroom vomiting and on the toilet.
Finally I get admitted in properly, they take me to a CT scan about 30 minutes after admission and then an hour later after that, the next thing I know, they had me in the operating theatre and said my appendix burst. They had to perform surgery to get all the contaminants out of my abdomen and seal up the wound.
After I came to, they said I was lucky. They said I'd have died if we let it go on for 18 - 24 hours longer. Something about a serious infection, and the whole 9 yards. I spent 2 weeks in the hospital after and they made sure I left with no signs of infection or other odd gunk coming out of either end of me.
My mom went and gave the Admin at the Royal Jubilee and earful because I almost died and they assumed I was otherwise healthy, but just having a stomach ache.
They gave you Aspirin?? It's contraindicated for kids that young
"No, Dr. [Smith] has been my doctor for 20 years, and you shouldn't try to take credit for other people's work."
Oh, well *_I'm glad Dr. Smith diagnosed you 20 years ago!_*
Great video! Mistakes are normal in every profession, and it's important to to talk about them.
I want to add something to stereotypes: Other commentators have pointed out their experiences as female patients, and there are several studies that show that bias in several settings (especially for afroamerican women). I myself am a female med student with quite bad rheumatoid arthritis, and for years, my pretty painful symptoms were explained away as being psychosomatic (mind you, they were very untypical for a psychosomatic disorder). The fatigue and the pain made medschool pretty hard for the first years, and I felt so bad for being weak and having pain. In hindsight, I don't know how I managed being in so much pain for such a long time - I just didn't want to be hysterical or a difficult patient.
I'm not mad at anyone for not diagnosing me right away. I understand that this can take months to years. But the thing that hurt me was everyone telling me it was psychological. No-one ever offered me any therapy to treat the suspected psychosomatic disorder, I was just told to take pain medication. I really don't think anyone believed me when I said I was in bad pain. And that's so experience of so many other young women I know. If somebody just had said "We'll observe the symptoms, but we don't know exactly what to look for right now", that would have made handling the pain a lot easier.
Another important aspect is the "emotional" bias - I just observed a lot of doctors, especially young ones, that seemed overwhelmed with all the pain they are seeing. And some of them react by getting unsympathetic, and stop taking the pain of their patients seriously. I don't know if you can call it compassion fatigue, since I always felt that it affected people who weren't able to handle compassion very well in the first place. If you know how to set your boundaries, compassion can be a great resource. But it takes some experience and self reflection to handle all those emotions, and unfortunately, doctors are being left quite alone with that. It's kind of taboo to talk about how your feelings influence your work as a doctor. Also, many are feeling attacked if you try to bring up that bad stereotypes exist and some make stupid decisions based on them - not because of spite, but because they are human beings, who maybe didn't learn to self reflect so well. I hope that will change in the future.
I've had RA for 40+ years and I simply cannot express my admiration enough for you. Almost no one understands the pain but the most debilitating thing has been the chronic fatigue. Well done, you! for making it through med school.
A quick note about drug advertising in New Zealand - we may have drug advertising to consumers (which does suck) but it's slightly less awful than in the US because of Pharmac. Pharmac is a state-owned drug buyer, and almost all of the drugs that people get prescribed have been bought by Pharmac - this means we tend to get generic medicines over brand names, and we have a single buyer who aggressively pursues the cheapest version of any given medicine. It's the only drugs people can buy themselves over the counter that they tend to get ripped off on here.
I really loved when you talk about Novelty Bias. I really think that as society we are relying too much in innovation without pondering all the data
I went to the ER once thinking I was having a stroke at 25
Turns out I was just really high from too much coffee and weed and really tired from working a 12 hour shift
But the doctors at the ER took me very seriously despite obviously smelling like weed and probably just being paranoid from being too high
They gave me all the tests to see if I had any signs of a stroke, including putting me in a scanning machine to be absolutely sure I was okay.
I bet they got some great scans of what too much THC and caffeine do to the brain lmao
Perhaps they were just acting it out because they knew you were high?
@@Cheepchipsable Partially yeah, but they also had to make sure. Maybe it gave em some practice with their stroke testing lol
My mother suffered from pneumonia due to a genuinely silly misdiagnosis. There was an outbreak of swine flu in my country - so when my mum presented with yet another chest infection (she had a series of them) instead of antibiotics she was given an antiviral. I pointed out this was extremely dangerous to her when she returned from the GP's practice. I pointed out how infectious influenza is and that no one she knew had it, and that even if she had a virus that didn't preclude her from having another bacterial infection. She got worse really quickly and sprinted through pleurisy etc frightening fast. By the time she saw a doctor a short time later she was really ill with pneumonia. I asked her to make a complaint and she refused.
I had the same stomach issue form the age of three... And I got a diagnosis at sixteen.
Through these years they put me on stronger and stronger acid reducing medications, starting off with a pill that dissolved in my mouth, then one that I had to swallow, then two of them. Then a stronger one, then two of them. Then another stronger one. I had plenty of endoscopies. I had to eat a radioactive omelette to get an x-ray of the way my intestines moved the food along. We did a scan where I swallow contrast liquid standing up, laying down and being tilted whilst swallowing. We did a 24 hour scan where I had a tube in my nose that looked to see if there was any "backwards" movement in my stomach.
Then, finally, I got a diagnosis. Regurgitation syndrome. A completely psychosomatic disorder that was set of by childhood trauma as my brain, to deal with stress, made me throw up which in turn gave attention and the household would calm down for a couple of days.
So, were all of the tests and medications necessary? Yes. Why? My diagnosis is less common than the ones that can be life threatening issues. Because had it been stomach ulcers, that can go bad real fast. Had it been my stomach working backwards, I could've quickly become deficient in nutrients and gone severely underweight (I was overweight all my life till the age of fifteen... so I dont know why they thought that but ok).
My point is, the doctors I was being looked at by wanted to exclude any possibility of a life threatening disorder. As well, healthcare in Sweden is completely free so tests were not run for financial benefit, but purely to see if I would die from this.
Wow cool story, thanks for sharing. The brain is so complex and fascinating.
Has having a diagnosis improved your symptoms? How is a psychosomatic disorder treated?
Btw I was just wondering if any of your testing showed dysmotility? A lack of peristalsis?
No pressure to answer any of my questions and have a lovely day!
@@lindsaybrown2137 no lack of peristalis, a slight dismotility if I eat "more than on portion". When I had the tube down my nose, I ate a meal of like pasta salad and then some nuts afterwards which made my stomach stretch and then contract which forced all the food to come back up. Not all in one go, but some at a time. So there is a slight dismotility. But because my symptoms are worse during stress and no dismotility was found in any of the other tests, they did rule that out. And having a diagnosis has not lessened the symptoms. Still, almost three years after diagnosis, if work has been really stressful that day or if something happens at home, dinner will come right back up.
And treatment for a psychosomatic disorder like this is really just about treating the surrounding causes. It's a learnt behaviour form age three, all I can do is avoid triggering situations such as concerts, clubs, or any situation where things will be loud, tight and there is a risk of violence. I also just have to do my best in dealing with stress. That means exercise and sleep as well as not take on too many shifts.
We have tried anxiety meds but I just become drowsy on those.
@@veronicae2291 Bless you. Thank you for your thoughtful response. The body is so weird.. I wish you the best in this life ❤
Thanks for sharing, how fascinating. A friend of mine with the exact same diagnosis (in fact one of my ex-juniors at work) was written up as a case report in a gastroenterology journal, by one of her bosses who also saw her as a patient!
Not sure I would have said they were all worth it. Tests for a potentially lethal condition sure, but since you had been suffering since 3 it would seem unlikely to be life threatening.
At what point should someone bring up a psychosomatic disorder as the cause? I don't know, just asking - but it might have saved a lot of time and testing that might have been used on the next patient.
"Thinking Fast and Slow" is an excellent read regarding these different types of thinking and biases.
Also, have you read "This Is Going To Hurt"? It's the most hilarious book I've ever read.
Smooth transition to adverts, brilliant!
Ah man I just LOVE comedy and on point informative content together. Thank you!!
A great item - thanks. Long ago (so long, cars were manual, had distributors and carburetors), I heard an item that compared the human body's issues with those of a car. The item proposed a car that had hormones, cycles, emotions, and cussed-mindedness, imagination, and with a susceptibility to microbial infection. Hearing this item caused me to adjust my hopes/expectations of my doctor. Also because of this I figured out just how patients will describe the same symptom in so many different ways, and how difficult that makes it to give the doctor a good understanding of the problem. Now I am elderly, I do wonder what merit there is in treating me? Nobody can same my life, because regardless of treatment, I am doomed to die - We all are. So I am placing more emphasis upon enjoying my days as mush as I can, as opposed to leading a medically optimal life. So really treatment for me is about enabling me to avoid unnecessary suffering.
this makes for great revision for research methods
When I was in college I was taking psychology courses on a number of things. One of them was the psychology of education. Throughout the course we talked about why older methods of educating have been largely debunked and learned a bunch of new ways to help people retain information better.
I walked up to my professor and asked her. "Why is it that we know better ways to teach and yet this class is taught exactly as we are told not to teach?"
And she replied. "Because the old way is how I was taught."
It dumbfounded me. I couldn't understand the point of learning new things but never applying them.
(Also I recognize I didn't capitalize some proper nouns up there, I too am lazy.)
Well she probably didn't learn them, just about them she was probably never trained in the new ways of teaching, knowing something exists doesn't meant you know how to apply it.
@@thepinkestpigglet7529 Also I doubt it is equally applicable to all areas. I would have thought psychology would require active mental processing of information, but getting people to learn something by rote is a bit different.
Another great video. Never realised how interested I was in medical things. With exception to House of course!!
So many take away points from this video. Galaxy S10 over iPhone 10, Peng- shanks !! lol The "jook" procedure. I call that " Youf kulchur bias" Loving the skeleton too.
Brilliant though, and well done on the diagnosis.
I now feel compelled to go and binge watch House MD from start to finish!
You should do a review of John Olivers Bias in Medicine that would be awesome. He covers racial and sexual bias in medicine, I have loved your series so far.
How long did you practice your accents in a mirror before making this video? That South African accent was spot on
Haha do you need a mirror to practice accents? 😂 I worked in Cape Town for a few months, one of my favourite countries🇿🇦🇿🇦🇿🇦
Medlife Crisis you need the mirror to get into character
@@campbelldavid7830 very true
The feeling that you're imitating an accent well is known as "lack of mirror bias"
10:54 3/10 Tsonga pronounced correctly, 10/10 Chopi knowledge, 10/10 Kwa-Zulu Natal pronounced correctly - All in all an A grade, well done!
I ran into a case like this that nearly cost my vision.
I was having an undue amount of time off work for headaches (definitely atypical for me). Family doc, walk in doc, and emerg doc all tried various pain control and tests to make sure my brain wasn't falling out. After a while my family doc suggested an opto. Optometrist checked my vision *during a headache*, and didn't find anything abnormal. I was getting up to leave when she said "wait a minute, sit down again". I'm an early 30's male at this point and she had neglected to even bother looking for glaucoma since it was statistically very very rare. My pressures were in check but she hadn't looked. Back in the eye-looky-machine-majig (sounds better in latin) and she checked. Sure enough, my angles (the bit at the edge of the iris where it lets fluid go from the front to the back of the eye) were almost completely sealed off. I was rushed off to an ophthalmologist who agreed and I was quickly zapped with some lasers (very uncomfortable) to punch new 'breathing' holes in my irissses...iri? Bilateral iridotomy later and I haven't had a headache since. Left unchecked glaucoma can render a person very quickly permanently blind.
Doc had a hunch, rule out eyeballs. Opto had a bias and didn't check one of the hazards because of low threat.
9:10 Aah, Pattern Recognition. One of the more difficult Iain M Banks novels to diagnose, but still rewarding.
I have a question about the title thumbnail of you with your face scrunched up. Is that your, "I'm trying to simplify a difficult topic" face? Or is it your, "I just realized that I'm going to need a manual disimpaction" face?
As always, another great job. You've made statistics interesting. Thanks.
It's more like 'damn I forgot to take a picture yet again, let's find the one still frame of the video where I'm not making a face like I'm fainting, having a stroke or smelling a fart'
I live in New Zealand and didn't even know it was legal to market directly to patients as I've never seen it. I thought it was only in USA as when I went there every 3rd advert on the TV was about some drug or another.
Thanks for the revision on biases just studied it for an psychology exam I'm probably gonna watch it a few more times
This is an amazing breakdown video about medical bias. Thank you for making this!
LOL, it pretty well applies to every profession.
Great video, both info and edit
Terrific video. It's brilliant. But how widespread is this knowledge in the medical world?
Also, in Los Angeles there are dialysis clinics owned by doctors. A friend was advised by one of these doctors that he needed to start dialysis immediately. He got a second opinion that completely disagreed with the first dialysis-clinic-owning doctor. What would be the result of sending a person with healthy kidneys to dialysis ? Would it cause that person to be put on the transplant list in 5 years or worse, or would it bump up the positive stats for the clinic?
My father was repeatedly sent for tests at--you guessed it--the testing laboratory owned by the doctor. Both of these happened in the United States, so the likelihood of such corrupt practices occurring in a developed nation are probably very small.
I imagine most if not all of those apply equally to any diagnostic style role, I've definitely seen / done most of those working in IT. Love that Dunning-Kruger effect is an actual recognised thing, I've remarked about that effect to collagues in the past in relation to new IT staff (and did it myself earlier in my career!), where they learn enough to think "I know ALL about IT!" after a year or two, then given more time they come to realise quite how vast a subject it is and how little of it they actually know themselves.
As a simple country joint replacement surgeon, I love your videos.
0:10 But that dark chocolate one is true. Dark chocolate (of course in certain doses) can be very healthy, though it's naturally best to go as dark as possible to avoid as much added sugar as possible.
Doctor here in NZ won't even do tests and referrals aren't sent in unless you are literally dying or old. Its messed up.
I have a bunch of issues that leave me mostly bed bound. None of which have ever been diognosed and getting a doctor to pay attention is like pulling a camel through the eye of a needle
I'm a simple hungarian. I see Ignaz Semmelweis mentioned, is press thumbs up. :)
"In 1865, Semmelweis supposedly suffered a nervous breakdown and was treacherously committed to an asylum by his colleague, where he died at age 47 after being beaten by the guards, from a gangrenous wound, due to an infection on his right hand which may have been caused by the beating (officially of pyaemia), only 14 days after he was committed. "
Wikipedia. This story is wild.
Very interesting and informative as always. As a new FY2 it's great to hear these and bear them in mind on the job, especially when observing senior's decisions, let alone making my own.
Doctors aren't a monolithic entity that all behave exactly like the ones you know.
Especially regular clinical practicioners or whatever you call them in English are usually quite lazy when it comes to non-life threatening complaints; if there's (harmless) medicine to prescribe.
This is of course anecdotal but one can easily logically deduce why that might be.
Speaking of anecdotes:
So, I went to the clinician to get something for my (what turned out to be a) yeast infection.
I moved in between, so I had two doctors prescribe me antibiotics. When the first two rounds didn't work (much), the last doctor prescribed me a "heavier" dose, which also didn't work.
6 months later I was still in as much discomfort as when I started.
So, I googled what else could be done about it and one thing that kept coming up was diet.
*Two weeks later, and gone was the itchy eczema.*
Can't make money off of patients healing themselves now can you?
Wow, that was a lot of information in a short time! I appreciate it :)
A type of stereotyping I've experienced, both personally and as a relative or in my previous job in assisted living, is aimed against people with mental health issues. Very real problems are disregarded as exaggerated or imagined because of a history of mental health problems. Even if there is no reasonable link between the two.
Yeah, my sister almost died from undiagnosed spontaneous pneumothorax, because she had a history of strong back pains (explaining the pain) and anxiety (explaining the shortness of breath), so the doctor gave her painkillers and muscle relaxants and sent her home.
Luckily our family doctor was thorough enough to use a fuckin' sthetoscope and she found out exactly what was going on.
Needless to say, she now gets chest X-rays everytime she comes in with a severe back pain...
This guy is the real deal!
Building the whole video around Timmy was a brilliant idea for making us viewers stay until the end but then we want to know exactly what Timmy's problem was, and whether he got cured and how he is doing now.
That's the storytelling bias
I need a Baymax. Just so I can watch him stroke my dog and call him "Hairy Baby".
2:10 moving forward without adequate evidence leads to Thalidomide babies. SOooo I'd really like my doctor to not be on the leading edge and pushing boundaries, thanks.
Marketing hype: My Dr. once insisted I take Levaquin for a bladder infection, despite the fact there was clear evidence it wasn't working. I went through three courses before finally saying, "Look, just give me the damn drug that worked last time." and hey presto, the infection was gone. Why did my dr. insist on levaquin? Because it was the new wonder drug and was being pushed at that time. Luckily I wasn't a runner then so no ruptured achilles. My friend ended up with one though. =(
What about bias bias?
When you think about all the biases that could affect you, overthink it, get overwhelmed, go home, lock the door and cry in your bed until you pass out from exhaustion?
Asking for a friend...
Thanks! Been waiting for this episode. Been an eye opener for me. Keep up the good work!
BTW, I honestly thought the diagnosis of that chronic patient to be Munchausen syndrome. Was it really Yellow nail syndrome after all?
Here I was about to go take a shower... That can definitely wait 20 minutes... I guess I'm biased.
No you just lazy.
Wooooaaa.... such lack of control. Saw the video, went out for a 2 hour bike ride, came back, shower, hot soup... and only then... enjoy the video. :P
My dad was sick for his whole life but severally sick, bed ridden for 35 years ish. There was never really very good diagnosis. I don't blame doctors. Most medical conditions we still know little to nothing about. The amazing thing is how effective the minute things we do understand are.
You're absolutely hilarious Rohin. Like your randomness always cracks me up.
I'm a medical student and phrases like : 《the urge to do something or the desire to avoid any potential harm, are both the natural and normal responses [...] learning when they aren't the right thing to do is one of the hardest skills in medecine,》 help me understand that this isn't something that will just come naturally but I need to work on it and try to improve it all the time. Just like the fact of avoiding the other biases. This is the kind of unspoken rules (not the biases, but the fact that avoiding them is a skill that we need to learn!) that open huge doors once they are clearly phrased just like you did in this video.
Thank you for all the reminders and the wonderful examples
Merci! Et bonne chance a medschool👍🏽
C'est très gentil de votre part! :D ^_^
i’m glad that my doctors (some were psychiatrists some were medical, but it was in the same department) didn’t stereotype me when i was going through gender dysphoria issues at 12 because damn if i was a doctor and i saw an obviously autistic kid without a diagnosis of it and only a history of family bipolar i wouldn’t have done shit but hey i’m happier now, i mean like i’m depressed but less depressed now
As a resident on another service, I saw a patient in a room and thought I would impress the attending resident with my diagnostic acumen. I said, "I see you have an Achondroplastic Dwarf with Pickwickian Syndrome." His reply, "No, just some short fat funny looking guy."
WHAT THE HELL IS THAT FACIAL HAIR, like Jesus. Side note, love the vid, if it ducks like a quack is one of my favorite series on TH-cam. Keep up the good work
We call that Echo Chamber Bias.
I hate to correct you, however, I'm sure you are the type of person who actually won't mind. It revolves around using the terminology "strong and weak antibiotics." As we both know when we empirically choose an antibiotic, the two greatest factors are spectrum of activity and ability for the drug to reach effective concentrations in the target tissue (e.g. amoxicillin/clavulanic acid for bite wounds). Using the term "strong" when referring to a particular antibiotic undervalues the thought process involved in choosing an appropriate antibiotic and, in the vein of this video, can lead to an "antibiotic selection bias." A problem I see in both the veterinary and human medical professions. Antibiotic resistance would be a great topic for you to cover as that problem is having a dramatic effect in patient outcome in both of our professions. I really enjoy your work, keep it up, it is most appreciated!
Biases shmiases, how about good old fashioned human laziness or trying to make up time because doctors are always running terminally late? Love the skeleton btw :)
How about a loud doctor bias/cut and paste bias/google bias? I had an ingrown toenail. I looked online. I'd used the 'cut a triangle in the nail' technique before. It worked pretty well, but I was wondering if there was something better. I ran into an article by a podiatrist saying that the cut a triangle method doesn't work at all. This seemed odd, because I'd gotten fairly decent pain relief even within a few minutes, so I looked to see if there were any other doctors. I ran into another article saying the same thing, and another... and actually, they all seemed to say EXACTLY the same thing. I looked and low and behold it was the same article by the same doctor. It was everywhere, and I couldn't find any other articles on the first couple pages of google results.
My friend had an ingrown toenail. I suggested cutting a triangle in the tip of the nail to relieve the pressure. He said he'd read several places online that that didn't work.
Again, it does seem to help, and the logic behind it seems to be pretty sound. It could be just a placebo effect, but with just one doctor's opinion online it's kind of hard to say.
Couldn't you go past the first two pages? Look for articles that weren't exactly the same?
I am blessed. My Dr. Is so cheap, when I asked him my blood type, he said WE never did that test and the hospital does not have the information any longer. He told me to go give blood and ask for a copy of everything. It will save me around $7500.00 and I could save a life. I had forgotten that they test everything, especially covid19 (that they know about), when someone gives blood. He just told me that about August 2020, so the price of $7500. Is how much a simple blood scan costs now days. Brother James
In a recent survey of male tennis viewers, more than half assumed they could score a point against Serena Williams. Dunning-Kruger effect in full swing.
Pun intended.
Was the pun "swing" or "Dennis" instead of "Dunning"?
Can't you just wait for her to lose a point to an unforced error?
Piñata Oblongata ahh, my mistake. Editing the comment now
@@Corporis Guess you didn't know as much about the effect as you thought you did, eh? lol ;)
Piñata Oblongata This comment ended up becoming more meta than expected. Also, as an anatomy nerd I adore your username
I was sent to the A&E by my GP. First thing the nurse said: "I have seen your face before." She explained my symptoms away, tried to kick me out from A&E, but relented when her colleque did not join her campain. She put me last on the list for people to see a doctor.
What would you call that bias? Hahhaaa personal bias? 😊
Or "we only offer services once per year if you come twice...it is too often we see your face"-bias.
Great video, as always!
Please make a video about heart rate variability. How accurate is the HRV calculation on the Apple Watch and what is the normal range? What does it say about the condition one’s heart and how can it be improved? Thanks.
I spent years of gp's and a&e doctors laughing me off, telling me nothing was wrong. It took the symptom of TN. By the time I went to neuro (a few weeks) the same pain/numbness had spread into a lot of my body.a few months after i was finally diagnosed with MS. I was diagnosed with rrms. Because you can't diagnosed secondary progressive without previous information. So I'm sat knowing it's likely secondary but unable to get that diagnosis.
In the time prior I lost feeling in my legs, lost ability to move my legs which came back sort of during my trip to a&e the doctor was saying there was nothing wrong. While I was sat watching my reflexes and noticing my right reflexes are heightened. I'm not a doctor but I know that's not normal for me. (But that's one little issue not a big thing).
I complained constantly to my GP I have severe leg pain, primarily during period, but also if I walk too much or just randomly. She gave me different things to try and treat a woman's problem. but later on another gp sent me for an ultrasound. Nothing obvious. Radiographer said oh you have cysts maybe that's your pain (it was the wrong side). I gave in.
In 2015 I was in the hospital for suspected meningitis. I had a spinal tap. They clearly meningitis yey. Had the worst migraine I'd had in my life for weeks after the doctor in hospital comment "should get someone to look at that" thanks pal.
When I was being diagnosed with ms 2017, my husband noticed it said "occular bands Jan 2015". Hang on... they found something and noone followed up. Assumption being it wasn't clinically notable because it was outwith symptoms of a relapse and my CT had been clear. But why not check via MRI? Could I have had a diagnosis almost 3years earlier? (It's doubtful but it's still going to float in my head).
I can go on. But ultimately after over a decade I was finally diagnosed with ms. Wether or not my outcome would have been different. We'll never know.
I was about to say the video was brillant. Then I remember watching the first part and being sponsored by Brilliant, so I'll say the video was amazing. Btw, also doc here, and am doing my masters in this area, that's a really cool field
Even the non human “AI” knowledge base suffers from bias
I don’t know what you have against doctors from kwazulu natal, but your South African Durban accent killed me.
So back from my little vacation, I'm trying to get more exercise in with my diet so I decided to start walking from my school to my house (a little over 6500 steps a day)
all of these unconcious biases are a lot to not think about
Between the Darth Vader skeleton at the left, and the green hearth at the right, there is the electric schematic of a valve radio transmitter from the '60s.
I thought it could have been a Marconi therapy device from the same period, tho.
Thanks for all the clarifications on the various types of bias; I believe the human thought is all a big bias in the most disparate directions, and what save most of us is the pull of reality telling that we aren't, after all, so much different from all other peoples.
Greetings,
Anthony
sometimes i like pretend diagnosing my family (im only 14 vibe down and they go to the doctor,i just like putting into play what i learn from research kk) and it worked sometimes my mother told me her symptoms and i said i think she has vertigo she went to the hospital and she has vertigo, idk if its just an easy one but i was surprised. Then my sister came home with narks on her hip and she described the pain she had already told my mom and she was comign to take her. with the pain and everything i realized it was exam season and said it might be stress induced shingles, she went to the doc and i was right she got treatment and got better! reminder im nto the doctor this is just for fun and my mom thinks in being weird i think science is cool
I couldn't find part one, but this is a great video. I hope that in part one you mentioned what I call "psych bias," against patients with a psych diagnosis. You could show up at the ER with your intestines dragging on the floor and two missing limbs. But if you have a mental health diagnosis on file, you'll get treated to a lecture about wasting the doctor's time before being sent home with a benzo injection and a referral to a therapist. I hear about race and sex bias in medicine all the time, but somehow psychiatric bias is invisible. Why is that?
Would fall under stereotyping.
Thanks!
i had a sneaking suspicion this was pancreatitis from the labs showed (esp the amylase and elevated LFTs) but i'm a nurse not a doctor - just seen a lot of young atypical presentations of pancreatitis. nevertheless this is an amazing video, thank you for it - as a healthcare worker it is a really important wakeup call!
ALSO
PROFESSOR GARAGE
Hey! I was wondering, my blood type is B neg, i used to donate but have not done for a while. If i were to recieve a blood transfusion, is there much difference between my group and O neg?
Your channel is great! Ive found all your videos really interesting. Sorry i sound really dumb, i can't write to save my life, so this is me awkwardly trying to show my appreciation. Theres no way to not sound like a sycophant.
Canada; In referance to all the drug commercials on TV...I am truly sick of seeing them. All they do is make some people believe in these products. Then they go running to their doctor, cause that is what the add tells them to do & ask for the drug. Oh also tell your doctor of all the drugs you are on....(like your doctor does not know). All this is doing is people are trying to change their doctors into drug pushers while these companies cover their behinds with all the ...drug side affects that they spout off at the end of the commercial. I am truly disgusted with all this. It should not be allowed!
All joking aside, Bruh, your content is fire. You're If It Ducks... series is so damn informative and funny. I bet it's really common for the doctor who explains it best to get the credit over the doctor who diagnosed it first. Also there's the whole 'God did it' thing stealing your thunder.
Are you gonna make video about fasting?
You could set up a patron and give the money to organisations like MSF (doctors without borders) or UNICEF or similar
You are a comedic genius. I can't stop cackling
This reminds me of a diagnosis my daughter got just before she turned 30. She had a patch on her forearm that started as tiny little pin pricks (nerves in the skin fired off first), erupted as tiny little blisters in a circle about an inch in diameter. They grew bigger and merged into one large blister and hurt like the dickens. She went to the doctor and he looked at it and when "hmmm." She said, "Hmmm? No, you are supposed to say AHA!" He had to go to his computer to look up what he thought it might be, but wasn't sure. Turns out it was bollous pemphigoid. It is a rare skin condition and usually only shows up in the elderly. She is very young to have it show up. It is malfunction of the immune system and can be triggered by certain medication. She had at least 5 episodes - forearm, upper thigh and armpit over a 2 year period. There is no specific thing that sets it off, but we have read some suggestions from others sufferers. One was antibiotics and/or ibuprofen. She has avoided ibuprofen since the last flare up over 5 years ago, so that seems to be her trigger. She has had antibiotics since then, but never ibuprofen. I told she should feel special getting some rare about 50 years before she should. She just gave me the stink eye.
Mumble rap catching a stray. I love it.
4:00
He’s lucky he got a bloodtest,
When I was in the hospital as a slim 17 year old, but very healthy because I do a lot of fitness, I had the luck they ran a bloodtest due to someone dieing 1 year before who was misdiagnosed with the same thing I had. They thought he had a heartburn and send him home with some meds and he died 3 days later because of myo- and endo-cardites. This blew up big time in the news and likely because of this I got a bloodtest, after which I was rushed to the IC.... I guess having a Trop value of over 1300 had its perk too
Thank you for the video, enjoyed it immensely. Only just noticed the skeleton 14 mins in :D
I just realized how biased I am when it comes to car repair.
Quickshot Gaming Alpha Romeo - just throw it away and buy a new one, mate!
Liusila squealing brakes? It's the brake pad wear indicator scrapping the rotor. But that's one of the bias listed here assuming it's what's the most common cause.
Everything tastes better with a good source* (*citation not required)
Regarding Vista, as a developer I really like it as it gives stability over Win7, and the gadget toolbar is really handy when you have dual monitor configuration.
What annoys people is the UAC. However with Linux background and got used to more annoying protection mechanism like SELinux, I don't think it's too bad either.