Medical Advice

[awal3207]

Reading the forums I can not help but notice the amount of medical advice that is been given. I am not a doctor yet but am currently a final year medical student and to say the least some of the information being offered is not what I would consider near best practice. Often people seem to making diagnosis/recommendations when lacking basic necessities of clinical practice or with any ethical right to do so.

When making any diagnosis or recommending any treatment at a minimum 3 basic tenants should apply

1. A decent patient history regarding the current as well as any complicating medical issues
2. A physical examination i.e looking at the injury and assessing the problem
3. Referenced information regarding the source of their recommendations for treatment. Do these people giving advice simply search Dr Google or do they read medical textbooks/journals etc.

(Investigations e.g. biopsy/Xrays etc are required if indicated)

People are often unhappy with the diagnosis/treatment plans of their family docotrs and this is often justified. I will be the first to admit that the doctor is not always correct. However when seeking a second opinion why not seek it from an alternative qualified health professional. It does not always have to be a doctor. Often the best people to consult are people such as physiotherapist, community nurses or your local pharmacist.


Andrew

 

[elapid]

What are you specifically referring to? There are many doctors, physiologists and coaches on this forum. There are also many riders with years of experience, some professionals, that know bikes and fitting people on to bikes. And then there are people posting their questions on a forum - firstly you have to expect certain answers if you do post on a forum and secondly, just like the information provided by any person, whether they be a doctor or not, they need to process the answers with the knowledge that these answers are being provided by total anonymous posters. They, you and me, have no idea of the profession and experience of the poster. That's a forum - take it or leave it. For my money, with the available information provided by the poster, some of the replies have often been quite good.

 

[awal3207]

I am not suggesting that all medical advice on this forum is bad. No doubt much of it is very useful to those concerned (Pacemaker thread for example). All i am doing is suggesting that if a second opinion is what your after get it from someone who you can trust. In addition, if people are going to post medical advice can they please identify themselves and any related experience in the area of concern and perhaps a reference if giving medical advice on treatment options. I do acknowledge that a number of people/threads do this very well.

In regards to specific threads to outline this point there are a number. You yourself post a thread in reply to question relating to 'saddle sores.' It is clear from your answer and the 'preferred' treatment you recommended that you have very little idea of the issues involved. For starters, how do you know that the patient did not already have an abscess (he was on a 14 day course of antibiotics)? Also on this same thread a 'Dr Wattini' mention veneral disease. What?

Secondly on a post regarding a severve meniscal tear I quote the following

'since you are a cyclist, i doubt you will have any problems later on in life/sport.....since your CL (cruciate ligament) is in good shape, you might not have any problems, otherwise at worst, swelling of the knee after extensive walks.."

THis is essentially a lie as the meniscus is what prevents people from getting osteoarthiritis and knee replacements. Without any real information by the poster for someone to make this comment is ludicrous.


Anyway, I do love the forum(s) and the tips it has supplied me with have been invaluable. That is tips on cycling, not medical and surgical health issues

 

[egtalbot]

I have to agree with elapid here. There are for sure some spectacularly bad answers. And I suppose the real fear is that a lot of people are idiots and will take bad advice uncritically.

Nevertheless, it's valuable to have insights and suggestions from a variety of sources. If I get a piece of advice on the forum that is accompanied by the reasoning behind it, certainly I'm better off than before I had it. I can go to my physician and bounce it off him and if he doesn't like it I can ask for similar reasoning to justify that position. Seems like a win-win.

I believe the medical profession as a group is improving in its willingness to accept input, but there are still plenty of doctors who either think they know more than they do or are unable to take the approach that unlike most people who exercise only so they can stay healthy, their athlete patients aim to stay healthy so they can exercise/compete. I know there are a variety of resources out there beyond a traditional G.P., but not everyone does.

For me, the positives of having more information outweigh the negatives of the possibility of poor unsuspecting souls doing something wrong based on what someone said on a forum. That said, if you are concerned, I think it would be valuable for you to post responses in specific threads when you see something you disagree with. That is simply the nature of a forum.

 

[runninboy]

I have to agree with elapid here. There are for sure some spectacularly bad answers. And I suppose the real fear is that a lot of people are idiots and will take bad advice uncritically.

Nevertheless, it's valuable to have insights and suggestions from a variety of sources. If I get a piece of advice on the forum that is accompanied by the reasoning behind it, certainly I'm better off than before I had it. I can go to my physician and bounce it off him and if he doesn't like it I can ask for similar reasoning to justify that position. Seems like a win-win.


For me, the positives of having more information outweigh the negatives of the possibility of poor unsuspecting souls doing something wrong based on what someone said on a forum. That said, if you are concerned, I think it would be valuable for you to post responses in specific threads when you see something you disagree with. That is simply the nature of a forum.

I agree. I would never accept what someone says on a forum in LIEU of a doctors advice, However I find forums an invaluable source of information to ask my doctor regarding an injury. Because you are mentally juggling so many issues, insurance, financial. etc etc it is nice to have a resource where someone has a different perspective and opinion . I recently had knee surgery, they gave me crutches which they showed me how to use. But someone suggested a walker would cause less complications, I asked the doctor and he thought it was a good option but he hadn't suggested it because most people my age do not have access to a walker.

 

[elapid]

In regards to specific threads to outline this point there are a number. You yourself post a thread in reply to question relating to 'saddle sores.' It is clear from your answer and the 'preferred' treatment you recommended that you have very little idea of the issues involved. For starters, how do you know that the patient did not already have an abscess (he was on a 14 day course of antibiotics)?

I suggest you read that thread again. The lesion had decreased to 0.5 cm in diameter and was not infected after 7 days of antibiotics. This was based on the description provided by the poster.

Today marks the seventh day of the course of the Levaquin. At this point the sore is reduced to 1/2 cm in diameter and hardly noticeable.

My answer to this poster's question was standard wound care options. As a surgeon, I know how to care for wounds. This saddle sore was obviously responding to treatment and contracting normally. My advice was sound and appropriate. As you obviously have so many more ideas of the issues involved, you being a medical student and me being a board-certified surgeon, please enlighten me as to what I don't know about saddle sores, wounds and wound healing.

See, this is both the problem and the beauty of forums. You don't know me and I don't know you. But if someone is asking advice, then most offer their opinions based on their experience with all sincerity. There are some a-holes that are just trying to get their jollies off about how funny they are, but for the most part our advice is well meant. As others and myself have stated, you should also be realistic about the replies you receive when you ask a question on a public forum: discard those you don't think are appropriate, and consider those you think make some sense.

 

[usedtobefast]

i am not a doctor here or on tv, but do have many, many years of cycling and training knowledge. the experts that just posted before i did are one reason i follow this forum. sometimes you get maybe questionable statements, but the
posters will ferret out the wheat from the chaff.

 

[David Suro]

Contact the Editors

I am a physician who was formerly a member of the staff of the Health and Fitness Forum.

The way the forum is operated is as follows:

A reader writes a question and the question is forwarded to all of the members of the Health and Fitness Forum.

Members of the forum respond to the editor regarding whichever questions they feel they can answer most competently.

Each member of the Forum has the opportunity to read the responses from the other members of the forum prior to their being published on the site.

The editors read all of the conversations between the members of the Forum and publish whichever response or responses they see as being the best.


The editors of the forum are very nice and decent people who truly have the best interest of the readers in mind. They do a great job of sifting through the answers from the various members of the Forum. I can assure you, there are some spirited debates between the members of the forum that, at times, become quite heated.

It is true that a diagnosis or plan of treatment cannot be made without a complete history, examination, and research. For that reason, any suggestion from a member of the Forum must be regarded as just that, a suggestion. It is important for the readers of the forum to realise that the most valuable suggestions always are accompanied by advice to seek the hands-on care of a doctor, physical therapist, orthopedic specialist, chiropractor, professional bicycle fitter, or any other licensed health care practitioner.