<rss version="2.0" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:atom="http://www.w3.org/2005/Atom"><channel><title>Hacker News: rran</title><link>https://news.ycombinator.com/user?id=rran</link><description>Hacker News RSS</description><docs>https://hnrss.org/</docs><generator>hnrss v2.1.1</generator><lastBuildDate>Sun, 27 Sep 2026 07:03:07 +0000</lastBuildDate><atom:link href="https://hnrss.org/user?id=rran" rel="self" type="application/rss+xml"></atom:link><item><title><![CDATA[New comment by rran in "Back and shoulder surgery is often worse than useless"]]></title><description><![CDATA[
<p>Patients globally think that procedures are inherently good, it's not inherent to the US system.<p>I'm a doctor working in a government funded public healthcare system, where there is every incentive for the system to NOT do investigations and procedures where there is a poor evidence base. Yet we still waste $BILLIONs every year on them and the majority of this is driven by patient demand.<p>I frequently get patients where the evidence is for intervention A - that requires the patient to do N amount of work (for example physiotherapy, strengthening exercises) with slow, but real, results. After 15 years of medical practice I can honestly count on one hand how often a patient has genuinely taken an interest in this approach and committed to it. This sentiment is shared across colleagues. The vast majority of patients want a 'quick fix', even when there is no evidence that a quick fix exists.<p>So they push for intervention B, creating long waits for patients who would genuinely benefit from seeing the interventionist who offers B, resulting in worse outcomes for that cohort.<p>As the system is free at the point of access patients can simply 'doctor shop' and see as many doctors that are needed until they get one who agrees that intervention B is what is required.<p>I think it comes from an assumption that lay people have that the body is a machine and if a part of it is broken it can simply be 'fixed'. The truth is, is that the human body and biology are messy. We can't even define broken in a lot of cases, you can have two people with the same finding on a scan and one is in pain and the other is completely symptom free. People find this concept really hard to understand, but most of biology is happening on a microscopic level for which we don't have tests and scans, which again people find hard to accept, that we do not always have an answer. Human biology is not a solved science, not even close. There is also the whole complicated factor of human perception.<p>Two people can have the exact same experience but have completely different feelings and ideas about it. For one person, post-nasal drip maybe completely distressing and make their life miserable. Another person may have the exact same level of post-nasal drip but it does not bother them at all and they live their entire life with it without ever consulting a doctor. So what partly drives health demand is a patients tolerance and perception of their symptoms, which can change over time.</p>
]]></description><pubDate>Fri, 25 Sep 2026 10:05:48 +0000</pubDate><link>https://news.ycombinator.com/item?id=49842386</link><dc:creator>rran</dc:creator><comments>https://news.ycombinator.com/item?id=49842386</comments><guid isPermaLink="false">https://news.ycombinator.com/item?id=49842386</guid></item></channel></rss>