Advice to new Doctors starting practice

1 anandjeyahar 07 August 2016 08:27AM

Hi all,

Please read the Disclaimers at the end of the post first, if you're easily offended.

 

Generalists(general medicine):

  1. Get extremely unbeatable at 20 Questions(rationality link). It'll help you make your initial diagnoses(ones based on questions about symptoms) faster and more accurate.
  2. Understand probability, bayes theorem and how to apply it** This will help you interpret the test results, you ordered based on the 20 questions.
  3.  Understand base rate fallacy, and how to avoid  being over confident.
  4. Understand the upsides and downsides of the drugs you prescribe. Know the probabilities of fatal and adverse side-effects and update them with evidence(Bayes' theorem mentioned above) as you try out different brands and combinations.
  5. Know the costs and benefits of any treatment and help the patient make a good decision based on the cost-benefit analysis of treatment combined with the probabilities of outcome.
  6. Ask and Keep a history of medical records and allergies of the patient and till their grand parents.*
  7. Be willing and able to judge, when a patient is better off with a specialist. Try to keep in touch with Doctors nearby and hopeful all types of specialists.
  8. Explain the treatment options and pros and cons in easy language to the patients. It'll reduce misunderstandings and eventually dis-satisfaction with the treatment.
  9. Resist the urge to treat patients as NPCs. Involve them in the treatment process.
  10. Meditate
  11. Find a hobby, that you can keep improving on till the end of life.
  12. Be aware of the conflict of interest between the patient and the pharmaceutical companies.
  13. Have enough research skills to form opinions on base rates/probabilities in different diseases and treatment methods as needed.
  14. If you're in a big hospital setup, make sure you've the best hospital administration. 
  15. Medical expertise is only relevant once you see the patient. Your ability to judge the evidence requires getting access to it; this means you need to be able to correctly send requests, get the data back, and keep all this attached to the correct patient.Scheduling, filing and communication. Lacking these, medical expertise is meaningless. 

Specialists:

Basically the same skill sets as above. One difference is in the skill level and you should customize that as needed.

  1. For ex: You would need to be able to explain the treatment options and the probabilistic nature of the outcomes to your patients.
  2. As for research, keep a track of progress in your area in treatment methods and different outcomes on the "quality of life" for the patients after the treatment.
  3. Better applied Bayesian skills. In the sense of figuring out independent variables and their probabilities affecting the outcome.

 

Some controversial ideas(Better use your common-sense before trying out):

  1.  Experiment a little with your bio-chemistry and see how they affect your thought-processes.  To be safe, stick to biologically produced ones. For ex: injecting self with a small adrenalin dose and monitoring bodily response can help keep your thinking clear in emergency situations.
  2. Know your self biology better. For ex: male vs female differences mean the adrenalin response is different and peaks later in females.  If you think that's wrong, please go back and check your course work. Also watch this 2 hour video and come back with objections after reading the studies he quotes.
  3. Keep regularly(whatever frequency your practice and nature of work demands) checking your(for ex; hormone levels) blood states, so that you  can start regulating your self for optimal decision-making skills.
  4. If you're a woman, you'll customize practice on some of the skill sets above differently. For ex: Mastery over emotions might need more practice, while empathizing/connecting with the patient might be easier.

Disclaimers:

  1. Most of what follows is based on my experiences(either as a patient myself or a concerned relative) with Indian Doctors. Some of it may be trivial, to others, but most of it is skills a doc will need and ignored in school.
  2.  I've split it in two (specialists and generalists) but there's a fair amount of overlap.
  3. These are fairly high standards, but worth shooting for and I've kept the focus on smart rather than hard work.
  4. I've stayed from a few topics like: bedside manners/social skills, specific medical treatments and conditions(obviously, I'm not a Doctor after all) and a few others, you can add/delete(also specify/pick levels) as you see fit.
  5. Pick the skill-levels as demanded by your client population and adjust.
  6. I'm assuming generalists, don't have to deal with emergency cases, but in some parts, that's not likely then pick common emergency areas and follow specialist advice.
  7. I wrote this based on my experiences and with humans in mind, but veterinary Doctors may find some useful too.

* -- I understand this is difficult in Indian circumstances, but I've seen it being done manually(simply leaves of prescriptions organized alphabetically, link to dr.rathinavel) , so it's possible and worth the effort unless, you practice in area of highly migratory population.(for example rural vs urban areas).

**-- If you're trying to compete on availability for consultation, you'll need to be able to do this after being woken in the middle of the night.

 

I'm hoping to convert it into a rationalist skills for Doctors Wiki page, so please provide feedback, especially if you're practicing Doctors. If you don't want to post publicly email me(in profile) or comment on wordpress.

Meetup : Bangalore meetup + pi-day wrap party

1 anandjeyahar 09 March 2015 11:57PM

Discussion article for the meetup : Bangalore meetup + pi-day wrap party

WHEN: 14 March 2015 11:00:32AM (+0530)

WHERE: Bangalore

Discussion article for the meetup : Bangalore meetup + pi-day wrap party

Meetup : Bangalore LWers meetup

1 anandjeyahar 25 January 2015 05:25AM

Discussion article for the meetup : Bangalore LWers meetup

WHEN: 07 February 2015 11:00:00AM (+0530)

WHERE: Bangalore, Karnataka, India

And here's the meetup link and details for the month of february. Incidentally(we stick to 2nd saturday of the month), it coincides with valentine's day. See the meetup link for agenda/plan, location and time details. http://www.meetup.com/Bangalore-LessWrongers-Meetup/events/220047394/

Discussion article for the meetup : Bangalore LWers meetup

Meetup : Bangalore Meetup

1 anandjeyahar 26 December 2014 05:15PM

Discussion article for the meetup : Bangalore Meetup

WHEN: 10 January 2015 11:02:00AM (+0530)

WHERE: Central Mall, MG road, bangalore

1st meetup of then new year for less wrongers in bangalore. Let's use the meetup.com page for co-ordinating. http://www.meetup.com/Bangalore-LessWrongers-Meetup/events/219133638/. And here's a mailing list. https://groups.google.com/forum/#!forum/bangalore-lesswrongers

Discussion article for the meetup : Bangalore Meetup

Meetup : Bangalore Meetup

2 anandjeyahar 10 October 2014 12:47AM

Discussion article for the meetup : Bangalore Meetup

WHEN: 22 November 2014 04:10:51PM (+0530)

WHERE: cafe coffee day, old airport road ,Bengaluru

I've registered and created a meetup.com account and a group there. For the first meetup am thinking of Nov.14. (Friday evening). If you would prefer a different date, please post on the meetup group. http://www.meetup.com/Bangalore-LessWrongers-Meetup/events/212529792/

Discussion article for the meetup : Bangalore Meetup

Meetup : Bangalore meetup

1 anandjeyahar 02 June 2014 11:11AM

Discussion article for the meetup : Bangalore meetup

WHEN: 21 June 2014 05:30:27PM (+0530)

WHERE: Leela palace, kodihalli, Bangalore

Hi, I am looking for more study partners (aka Bayesian co-conspirators wink) in my attempts at improving my rationality. I am set in Bangalore, India and not sure how many of you are in Bangalore. So how about we meet up in Bangalore sometime in last weekend of June(25th or 26th ) and find out? . As for location, Well there's enough coffee shops around bangalore. I'm thinking of around Leela palace, old airport road, or perhaps leela palace (barista if my memory is right) coffee shop itself.. We can decide about what to do, and how often to meet on that meeting.

Update: Ok people, Sorry got involved in work and forgot to update contact info. It is still on today 21st Jun 5.30 at leela palace. The coffee shop is called Lavazza. Here's a google maps link.https://www.google.com/maps/place/The+Leela+Palace+Bangalore/@12.9607933,77.6482773,15z/data=!3m1!4b1!4m2!3m1!1s0x3bae14067cca9bdd:0x111bbe37cc24e71a.

If you can't find the shop or the group or the place gimme a call on 89513655147

Discussion article for the meetup : Bangalore meetup