I’m always trying to find experts to whom I can defer because I really want to not be the ultimate authority on things since I know how little I know, but the longer I try to find such experts the more I realize that nobody really knows much of anything and you can’t really defer to anyone.

I have worked in mental health care and I do believe that the direction that aspect of healthcare is going towards is recovery focused models of care. Hopefully, my fears of totalitarian authority are not going to come into medicine and the direction will be one of empowering people to make their own decisions about health. In my last job, in inpatient psychological therapies, a central idea was aiding the person to become their own therapist.

I agree completely.

I finished college and had still not acquired a very good, practical understanding of how a body worked. Over the last 50 years since I have put together what I think is a solid understanding through reading magazines like Scientific American or the New York Times science section, and picking up consistent information here and there in books, conversations with well informed people, etc.

Careful use of the Internet is also a good source of info, with the understanding that there is a lot of garbage out there.

For instance, Wikipedia affirms your evil spirit treatment by trepanation, but also says:

Evidence also suggests that trepanation was primitive emergency surgery after head wounds[4] to remove shattered bits of bone from a fractured skull and clean out the blood that often pools under the skull after a blow to the head. Hunting accidents, falls, wild animals, and weapons such as clubs or spears could have caused such injuries. Trepanations appear to have been most common in areas where weapons that could produce skull fractures were used.[5] — Wikipedia

Is trepanation an effective treatment for evil obstructionist conservative politicians? Let's find out! I have a wood chisel and a hammer; line them up and send them in. We could also try icepick frontal lobotomies, while we are at it.

Let me say a word about the poverty of a lack of expertise. I do my own water plumbing, because if there's a leak it's easy to spot. I don't do gas plumbing because it isn't, and the consequences of a gas leak can be more serious - also it's illegal. Hurrah for experts who can make dangerous stuff safe, fix computers, and sometimes mend bodies. I fix my own sprained ankles, but i go to the man to fix broken bones. Second opinions and second estimates are the ignoramus's friend. But with due caution, trust is the only way to navigate the complexities of life. There are the rare Dr shipman cases, but but given a basic goodwill, I would back a qualified practitioner over an enthusiastic ignoramus like myself most days of the week. It's a matter of playing the odds.

expert — synthesis

The words, "expert" and "experience" share the same word root which is "experiri" whose meaning is "TRY". By that token, anyone who tries even for the very first time is an experienced expert :lol:

Jokes aside, experts must have 1) knowledge at the level of principles governing the objects and phenomena that make up their domain and 2) hands-on experience, a good track record insofar as handling real-life situations that involve their area of expertise.

In short, an expert is a knowledgeable and experienced person. The problem is that our youth is spent absorbing knowledge and our dotage is spent gaining experience and so, quite naturally, we're all dead by the time the word "expert" is applicable to us.

Looking for an expert? Ask for directions to the nearest (to save time) mortuary.

In the end, it should be YOU who is making the decisions because nobody cares about your health like you. If you are going to defer to an expert, then you are going to treated by a physician doing the best they can, but that's not nearly good enough.

Don't leave something as important as your health to the experts because you never know when they are going to take the drill out of their black bag and... — synthesis

And yet doctors and other medical professionals routinely expect their patients to blindly trust them and obey them. They hate an informed patient.

They hate an informed patient. — baker

I rather think that is exactly not what they hate, but instead something else, the fool who thinks he knows.

remember, doctor means "teacher" in Latin — synthesis

And the fool goes to the teacher not to listen and be taught, but to teach!

And yet doctors and other medical professionals routinely expect their patients to blindly trust them and obey them. They hate an informed patient. — baker

In most cases this is true. The key is in understanding why this is the case.

Let's eliminate the ego-factor that many high achieving individuals seem to possess. This accounts for much of the, "I am better than you because I went to school X years, so on and so forth," attitude.

I will speak only for the U.S. as this is where I have always practiced. Doctors of all stripes are really good people. I have known very few who are incompetent or uncaring. That's the good news. The bad news is that doctors (as everybody should understand at this juncture), have been massively dis-empowered by the corporate-government cabal that runs the U.S. health care system.

Be in price fixing by the government in Medicare/Medicaid or the incredible control that health insurance companies have over every aspect of modern practice, almost all doctors are no more than glorified employees (if not actual employees) of a system that has long prioritized efficiency and profits over patients.

The way they have done this is through all the same processes that have metastasized the U.S. economy since the seventies, i.e., changing the laws, rules, regulations, financialization (student loans and insurance schemes), and outright fraud (e.g., price fixing with BIG Pharma).

Doctors are caught between a rock and a hard place and most have absolutely no choice but to act in the interests of those who control them. This is why I have told my patients to never assume their doctor is acting in their best interests, and their best defense is to educate themselves.

Doctors do not want you to be informed because the system pays them for seeing as many patients as is possible, so an informed patient requires time...to further educate, to lay out options, to discuss options, to develop a plan, etc. It's THAT simple. The government and the corporations decided that you will remain ignorant and without choices because your doctor is not being paid to educate you, instead, they are being paid to make money for corporate interests (while at the same time keeping the government bureaucracy sufficiently bloated).

Of course, it's not that black and white and there are highly skilled and very compassionate doctors out there who do everything they can to circumvent the system, but the pressure to see patients "as efficiently as is possible" is ENORMOUS and has been for a long time now.

All systems work by creating dependency. There is no better example of this process than is modern health care in the U.S.. You have little choice other than educating yourself and then acting intelligently by taking good care of your body and then, if the needs arises, confronting the health care system armed with knowledge that will help you get the best care possible.

Very Socrates of you..ha

There is an old saying in medicine that goes....

"If you listen carefully enough, the patient will tell you EXACTLY what is wrong with them."

Never discount the value of your knowledge when you go to the see your doctor. Tell him/her everything you can remember about your issue. You have no idea how much this helps!

I rather think that is exactly not what they hate, but instead something else, the fool who thinks he knows. — tim wood

And the patient is, of course, by default "the fool who thinks he knows".

The problem is that our youth is spent absorbing knowledge and our dotage is spent gaining experience and so, quite naturally, we're all dead by the time the word "expert" is applicable to us. — TheMadFool

No, the problem is that people are too damn lazy.

Have these schools poisoned your minds to the extent where you simply believe there is no purpose to educating yourselves?

If this is the case, then you folks have zero chance.

Don't leave something as important as your health to the experts because you never know when they are going to take the drill out of their black bag and... — synthesis

I have said to my friends and family many times, "I don't see how anyone survives the American medical system without a nurse in the family." My wife is a nurse. My sister-in-law and many of my neighbors are nurses, with one doctor in the bunch. One neighbor, a maternity nurse, was at the birth of all three of my children. So, my solution to the problem, only partly in jest - marry a nurse.

Also, never leave anyone you care about in a hospital alone. See them every day. Make sure you understand what is going on and who is responsible. They probably won't be able to do that. Even without whatever problem they came there with, hospitals are disorienting and discouraging for patients. Someone needs to be paying attention to the patient's well being above all else. That's probably you.

Very Socrates of you..ha — schopenhauer1

Good observation! I honestly never noticed that parallel.

Never discount the value of your knowledge when you go to the see your doctor. Tell him/her everything you can remember about your issue. You have no idea how much this helps! — synthesis

I always come to doctors (and most any kind of expert) with all the information I can and what analysis I’ve done of it myself and where I got stuck trying to figure it all out myself (which is why I’m now seeking expert help)... and more often than not come away with an off-the-shelf non-solution that doesn’t account for most of the details of my particular case.

people are too damn lazy. — synthesis

You might be confusing efficiency with laziness. If a person can do more than another person in the same time, you might mistake the more efficient one as a lazy bum.

I always come to doctors (and most any kind of expert) with all the information I can and what analysis I’ve done of it myself and where I got stuck trying to figure it all out myself (which is why I’m now seeking expert help)... and more often than not come away with an off-the-shelf non-solution that doesn’t account for most of the details of my particular case. — Pfhorrest

This is exactly how broken the health care system is (as are all institutions). Keep in mind that there still are some good doctors out there. You just have to search for them (word of mouth) if you are able to access providers outside of your insurance.

Just the same (and keeping in mind what the situation is) keep educating yourself. It's your best defense (other than doing everything possible to stay healthy) that may alert you to a provider who really isn't paying enough attention.

Hopefully, my fears of totalitarian authority are not going to come into medicine and the direction will be one of empowering people to make their own decisions about health. — Jack Cummins

The government-corporate coalition that controls health care pretty much everywhere is about as authoritarian as it gets. In the U.S., un-affordable medical/hospital bills are the number one cause of personal bankruptcy and has been for many years.

This health care system could care less about individuals. It's all about group statistics.

Based on my experience of working in England, it is hard to balance the emphasis on quality of patient care and statistics. I think that it fluctuates, but both are seen as important. At the moment, we have government funded healthcare, and I just hope it continues. Certainly, managers have an emphasis on high quality care, but this is also bound up with a concern to meet standards and targets in order for funding. But, generally, staff members in mental health care usually strive to give quality care in the settings which I have worked in.

Based on my experience of working in England, it is hard to balance the emphasis on quality of patient care and statistics. I think that it fluctuates, but both are seen as important. — Jack Cummins

Statistics are how large organisations decide if goals have been reached (and they are never about individuals). They always allow for the failures because they are only interested in how the majority fare, i.e., if the most people get mediocre care, than its a "win" for them (despite the fact that the minority received nothing that addressed their issues). Only individual providers are capable of dispensing human compassion.

At the moment, we have government funded healthcare, and I just hope it continues. — Jack Cummins

That's like hoping that the guy who rapes your sister is (at least) good looking. The answer is to get rid of the government and the corporations and give health care back to individuals and very small companies.

Mixing large groups and health care turned out to be the complete disaster as was predicted decades ago. It did not take an Einsteinian mental acuity to have predicted this outcome..

I think that if England lost the NHS it would be the biggest misfortune for England. If people had to pay for healthcare, most would probably simply go without it because they wouldn't have the money. I think it is already getting to the point where people are trying to do their own dental extraction. We would probably be in the situation of people becoming seriously unwell and not getting treatment, and I am talking about physical illness, not just mental illness. The rich would thrive and the poor would not.

In mental health care, many facilities, especially rehab services have been privatised but funding packages are usually available.The reason why the services were privatised was because what they were offering was social care mainly.

I don't know which area you worked in but I saw high standards of care in mental health care, because I know that most patients felt that way. I think that statistics is less a focus rather than quality care inspections, and patients views are central in England. The problem which I saw was that so much demand was put on staff members, especially in acute psychiatric care . Also, there is so much anxiety about inspections amongst managers and the staff who look after patients directly. I am thinking that I would like to go in a slightly different direction lon the future , like working with the homeless or in addiction services.

However, I do believe that there is a certain authoritarian aspect to the medical model of psychiatry, when patients are medicated against their wishes. However, it is complicated because the consequences of untreated mental health can be serious for the individual and for risks posed to others. I do see recovery focused care as a positive move, and I do favour holistic ways of helping people. However, I do think that some of the thinking in mental health care is a bit rigid and after being out of the system for a while, and writing on this site, I would find it hard to fit in again. Going back, I used to sometimes say things and other staff looked at me in a puzzled way. Certainly, most of the nursing staff I worked with didn't embrace philosophy, and I am not really sure about the psychiatrists. One funny comment I received from a patient when I was working in an acute psychiatric admissions ward was, 'You're madder than any patient on this ward.'

I live in a small town. 400 thousand denizens or so. There are not enough doctors here. The doctors stay in the megapolis 130 miles away.

Consequently if you get a family practitioner, you stick with him or her, because there is no way you can shop around. A lot of people rely on walk-in-clinics to get family medical help.

My doctor is good. He listens to me, and he does consider my input. However, he gets angry and he gets verbally hurtful. He does not trust that I say my symptoms right, or accurately, he's convinced that I exaggerate.

I state my problems as precisely as possible. My doctor listens, and I don't know what goes on in his mind. He gives me proper treatment, with a hurtful tone of voice and with hurtful remarks.

dr. Synthesis, what should I do? "Take two aspirins and I'll not see you in the morning."

I think that if England lost the NHS it would be the biggest misfortune for England. — Jack Cummins

We have a similar system here in Canada. And all, or most Canadians think that if we lost the NHL, we'd be much poorer for it.

If England lost the NHS I think it would the complete end of the country. Significant proportions of the population would die literally. It would be on such a scale that it would make the deaths from Covid_19 seems a minute fraction. I think that is why England has imposed such extreme restrictions on people, because the NHS and the welfare state are central to life. So many people are dependent on it and would not be able to survive at all if it collapsed. It would be a catastrophe beyond all proportions if the NHS crumbled.

So we can all agree that present system, be it private insurance or a national health model, is clearly not working (as is the case for all Western institutions). Is the answer to do more of the same?

There are many issues here but the bottom-line is that each individual needs to be personally responsibility for their own heath (just like the solution to education is to make each parent responsible for their children's education) . The days of treating your body like an hated enemy is over. Society can not afford to repair everybody due to the fact that people have refused to take proper care of themselves.

Imagine if tomorrow your government decided that they would fix everybody's automobile regardless of the maintenance you preformed on it. How would that work? This is what's going on in health care.

Health care needs to be about health care, not sick care. The majority of the money invested in the system needs to be about education and promoting beneficial health practices. Of course, there's no money in maintaining good health which is why the corporations must go. They are only concerned with profits (as they should be). There is no niche for this type of organisation in health care.

On the way out the door (and right behind the corporate CEOs) should be the government bureaucrats as the only purpose they serve is to make things worse (more complicated and more expensive). The system needs to be given back to individuals and small non-profits

You will ask, "What happens to the people who become ill or are born with various issues that are no fault of their own?" I suppose each society will have to answer this question after taking off the rose colored glasses that have been allowing them to go into massive debt and/or counterfeit their currencies. The funny money is going to go away sooner than you think.

Much of the previous fifty years of completely irresponsible social policy has been financed fraudulently, something that the majority of folks should be aware of at this point. New leadership needs to tell the truth (adopt sustainable policies via using real money) and then societies can decide on what they are willing to spend on sick care.

These are complex issues but ones that need to be confronted before the corporations decide that serfdom is truly the new black.

(just like the solution to education is to make each parent responsible for their children's education) . — synthesis

R-i-g-h-t! Plato buries this in at least one of his dialogues. The idea is if you wish to train your horses, can everyone do it? Answer: no. The right choice is to find the man who knows how to train horses, and similarly with children. To the cobbler for shoes, and so forth. Because they are the ones who know how.

Do they always? Are there bad practitioners and bad medical delivery systems? No doubt. But that is not against expertise or system itself, but rather against deficiencies, shortcomings, and failures in either (and it being important to distinguish between them). The last thing I want in my community is parents determining the educational path of their children, though it seems reasonable to let those demonstrably able to attempt it with appropriate oversight.

Willy-nilly dismantling systems? That's not a knee-jerk reaction, rather it's a sign of pathology.

Cool.

SO how do those with disabilities fit your scheme?

I am not sure how health care is different in America but in England there I am more worried that we are on the verge of losing what we have rather than wanting it all to go. Personally, I am able to read up on health matters but that is because I have worked in health care. I usually only go to the doctor if feel that I need some specific medicine or some interventions which I cannot get without a prescription. However, when I interact with so many people, who are intelligent, they really don't seem to have much knowledge of health. It may be a problem of the education system, and it may be at this level that improvement can take place rather than by trying to dismantle the health care system itself.

The funny money is going to go away sooner than you think. — synthesis

If you simply mean that capitalism and the global banking system is unsustainable then yeah, no-shit Sherlock, but if you mean anything more specific it would be interesting to hear.

It truly amazes me how dependent (intelligent) people have become. You people act as if am asking for two kidneys and a liver instead of just suggesting that you take responsibility for your own health.

These systems are horrendous but you'd rather have them then take the chance on having a much better system that actually addresses core issues. The deal is to stay healthy, not wait until you body refuses to take any more abuse. This should not be this hard to understand.

And desiring to hang on to broken-down institutions? What's with that?

It's time to move on, folks. It's long past time to say good-bye to mommy and daddy (corporations and governments) and take control of your own lives. Don't you people want to be free again?