Omar
@dromar.eth
History of medical decision making: 1900-1980 (post Flexner era): physician driven 1980 to 2020 (employer based insurance growth/managed care boom): Insurance/Institution driven decisions 2020 - present (post-COVID/GLP-1): Patient-driven clinical decisions
3 replies
0 recast
4 reactions
Omar
@dromar.eth
Factors leading to where we are today: - distrust of institutional medicine/credentials - ROI on insurance is trash (left ppl hanging too many times) - social media - AI democratizing knowledge - availability of DTC (byproduct of GLP-1 growth)
1 reply
0 recast
3 reactions
keccers
@keccers.eth
Do you think the majority of patients are capable enough to make correct choices? How justified is paternalism based on your patient exp?
2 replies
0 recast
2 reactions
Omar
@dromar.eth
Not really to be blunt. Quite a bit I would say. I feel the 1% that are capable of understanding medical decisions and their implications are used too often as the reason to shift the balance away from paternalism towards autonomy. Because even with LLMs, you can say things to justify anything. If someone is having a headache, giving the right symptoms on the list can skew it to have it say take ketamine. Even if it was just sinusitis
1 reply
0 recast
1 reaction
keccers
@keccers.eth
if I infer from trends, this may mean the people least capable of making independent healthcare decisions will be pushed towards it — presuming care for the poor is what gets automated while the rich get high touch ☹️
1 reply
0 recast
1 reaction
Omar
@dromar.eth
Yup thats already happening in some spaces with the type of care that one receives from the big chain telehealth companies. Have had patients on 5 different psych medications that interact with each other and no review of their past history on those was done.
1 reply
0 recast
1 reaction
keccers
@keccers.eth
no words
0 reply
0 recast
1 reaction
