<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>curun1r</author><text>I don’t think they’re getting stupider. They’re what they’ve always been…a source of conventional wisdom. When conventional wisdom said bloodletting was good for health, they bled their patients. When mercury was considered a medicine, they administered it. When hacking off limbs was considered the best way to fight infections, their toolkit included bone saws. When electroshock therapy was considered a treatment for mental illness, they shocked the hell out of their patients. I’m sure that one day we’ll look at chemotherapy and radiation as barbaric practices representative of our ignorance of how easy it is to deal with cancer.&lt;p&gt;Scientists&amp;#x2F;researchers advance the state of our medical knowledge and doctors, over subsequent generations, absorb what they find and practices slowly change. But there’s always a lag. What we need to get past is the notion that doctors are some font of truth when it comes to medical information. They are, largely, a snapshot of what was conventionally believed at the time they graduated med school. We don’t have a system that effectively updates their knowledge or keeps them in the loop for cutting-edge research. They do learn a set of first principles that can help them reason about novel situations better than a lay person, but only if the right answer is one that follows from those principles as opposed to being counterintuitive.&lt;p&gt;It’s the nature of being a practitioner rather than a researcher.</text><parent_chain><item><author>2devnull</author><text>“the vast majority of doctors would have any knowledge on today, most would consider it ridiculous despite thousands of papers on this topic with growing evidence”&lt;p&gt;Are doctors, as a group, becoming stupider? I’m not trying to troll by asking that question. I legitimately feel, as a patient of a large HMO, that the doctors I interact with aren’t very bright, making frequent mistakes about stuff they could google as quickly as they give out wrong information, but instead confidently insist upon something they’re misremembering or have never learned correctly in the first place. It feels like the profession has been optimizing for the wrong things: quick recall of a breadth of information rather than a scientific orientation towards the work. Perhaps I’m just seeing downstream effects of the reform of health economics in the last decade. Perhaps it’s elite overproduction. In any case reading the featured article, I’m just not at all optimistic about current medical practices experiencing any sort of kuhnian paradigm shift. They can’t even get the basics right, and seem prone to extreme group think bordering on religiosity.</text></item><item><author>PaulKeeble</author><text>Covid has been found in the brains and organs of Long Covid sufferers at autopsy while not being found in their blood in PCR testing. Bhupesh Prusty recently found in an autopsy of 4 ME&amp;#x2F;CFS sufferers they had HHV-6 in their brain and spine and 3 of the 4 also had EBV too where 28 controls did not. The DOD just last year also linked Multiple Sclerosis to EBV. There is growing evidence that many viruses stick with us in cells, are not found in the blood and can lead to severe chronic illnesses later in life.&lt;p&gt;A lot of microbiome research is leading to particular bacteria in or missing from the gut being correlated with various diseases like diabetes and obesity and almost all chronic diseases have a corresponding microbiome adjustment. We don&amp;#x27;t know yet know if there is a cause here or its just correlated but its a potential diagnostic that shows long before more serious symptoms and could potentially be used diagnostically one day. Or it might be these shifts are causal and we need to find a way to restore gut function that works well and reliably.&lt;p&gt;The fundamental idea is becoming mainstream in research with significant labs working on this for Long Covid, ME&amp;#x2F;CFS as well as EDS across the globe. Its not a fringe idea in research looking at long neglected diseases and the more they look the more they find evidence for it. Its not something the vast majority of doctors would have any knowledge on today, most would consider it ridiculous despite thousands of papers on this topic with growing evidence for the fundamental idea of ongoing infections causing increasing problems.</text></item></parent_chain></comment><story><title>Endemic pathogens are causing psychiatric illnesses and shortening lives</title><url>https://return.life/2022/05/endemic-pathogens/</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>dec0dedab0de</author><text>&lt;i&gt;Are doctors, as a group, becoming stupider?&lt;/i&gt;&lt;p&gt;I think patients are getting smarter, and conditions for doctors are worse causing some intelligent people to choose different fields.  That said, I recently went through a major illness and interacted with many medical professionals. My first hand experience&amp;#x2F;anecdata is that doctors are just like every other professional. Some are good, some are mediocre. Some are so consumed by hubris they believe the public is always wrong, and 
Some are willing to talk things through and keep an open mind about everything, even if it is ridiculous.&lt;p&gt;The best thing we could do for healthcare is to remove the idea that &amp;quot;doctor knows best.&amp;quot;  While it is important for doctors to feel confident, and to teach the public to avoid snakeoil, it just places unreal expectations on these people.  If patients took more accountability for their own health, then we could loosen some of the malpractice laws, and doctors insurance premiums would go down, and that would in turn cause rates to go down. But that was a bit of a tangent from my point that doctors are just people, maybe with an average intelligence that is slightly above the population at large, but still just people.</text><parent_chain><item><author>2devnull</author><text>“the vast majority of doctors would have any knowledge on today, most would consider it ridiculous despite thousands of papers on this topic with growing evidence”&lt;p&gt;Are doctors, as a group, becoming stupider? I’m not trying to troll by asking that question. I legitimately feel, as a patient of a large HMO, that the doctors I interact with aren’t very bright, making frequent mistakes about stuff they could google as quickly as they give out wrong information, but instead confidently insist upon something they’re misremembering or have never learned correctly in the first place. It feels like the profession has been optimizing for the wrong things: quick recall of a breadth of information rather than a scientific orientation towards the work. Perhaps I’m just seeing downstream effects of the reform of health economics in the last decade. Perhaps it’s elite overproduction. In any case reading the featured article, I’m just not at all optimistic about current medical practices experiencing any sort of kuhnian paradigm shift. They can’t even get the basics right, and seem prone to extreme group think bordering on religiosity.</text></item><item><author>PaulKeeble</author><text>Covid has been found in the brains and organs of Long Covid sufferers at autopsy while not being found in their blood in PCR testing. Bhupesh Prusty recently found in an autopsy of 4 ME&amp;#x2F;CFS sufferers they had HHV-6 in their brain and spine and 3 of the 4 also had EBV too where 28 controls did not. The DOD just last year also linked Multiple Sclerosis to EBV. There is growing evidence that many viruses stick with us in cells, are not found in the blood and can lead to severe chronic illnesses later in life.&lt;p&gt;A lot of microbiome research is leading to particular bacteria in or missing from the gut being correlated with various diseases like diabetes and obesity and almost all chronic diseases have a corresponding microbiome adjustment. We don&amp;#x27;t know yet know if there is a cause here or its just correlated but its a potential diagnostic that shows long before more serious symptoms and could potentially be used diagnostically one day. Or it might be these shifts are causal and we need to find a way to restore gut function that works well and reliably.&lt;p&gt;The fundamental idea is becoming mainstream in research with significant labs working on this for Long Covid, ME&amp;#x2F;CFS as well as EDS across the globe. Its not a fringe idea in research looking at long neglected diseases and the more they look the more they find evidence for it. Its not something the vast majority of doctors would have any knowledge on today, most would consider it ridiculous despite thousands of papers on this topic with growing evidence for the fundamental idea of ongoing infections causing increasing problems.</text></item></parent_chain></comment><story><title>Endemic pathogens are causing psychiatric illnesses and shortening lives</title><url>https://return.life/2022/05/endemic-pathogens/</url></story>