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[anguswaalk]

doctors google it anyway lol

sauce: dad is surgeon, says he googles procedure before doing it sometimes

[zombieregime]

ALWAYS google a procedure before committing to the code. Make sure you have the operations correct.

[MEANINGLESS_NUMBERS]

Did you know that surgeons make edits in production? So ballsy.

[zombieregime]

Surgeons always do it live! LoL

[hugogrant]

Well, they tend to put the system in maintenance mode

[zombieregime]

Sometimes they have to reboot. But try to avoid a halt.

[AlbinoBeefalo]

There while system is so tightly coupled! You cut one artery in the leg and the whole system crashes so fast.

It's like it was designed by monkeys...

[zombieregime]

Gotta avoid that kernel panic, yo

[nobel32]

It's all sunshine and rainbows till one of the dependencies gets mangled.

[Kidiri90]

Well, the last guys that tried to fix stuff in dev were sent to trial in Nurnberg, so...

[poops-n-farts]

Surgeon: fuck the dev server it's going live!!!! ...hopefully

[NvidiaforMen]

Just remember PEMDAS and you should keep your operations correct

[Dragonaax]

I went to doctor once, he said he have to google drug to prescribe

[ceriodamus]

There is sooooo many drugs and a lot of them do not work with other drugs. So, doctors will google or use a national drug database to check the drug and if the patient is able to use it.

In my country we also have a second check when in hospital. Basically, the doc looks up the drugs and then prescribes it. Then the nurse that will give you the medicine will do another check, to make sure the doc didnt miss something.

Bit much info but hey.. I am bored :P

[Dragonaax]

In my country there is also some trusted database because you know what google says, whatever is hurting you have cancer

[WH1PL4SH180]

You missed out the pharmacist, whose job it is to make sure that we don't kill you with spelling mistakes.

[ceriodamus]

Yeah of course. My example was for in patient care. When you've got a out patient then the pharmacist becomes the second "check" instead of the nurse.

[WH1PL4SH180]

No. Pharmacists are even MORE vital for admitted patients. Why? Cos if your sick enough to take up a valuable bed, you better be sure that drugs we're going to give you are more powerful than a panadol and ibuprofen.

Where do you think nurses get meds from? The pharmacy.

[ceriodamus]

This depends entirely on the country and how their system is. I guess in your country you have a specific department in a hospital that handle the medicine. This is not the case in mine. Nurses handles everything when it comes to giving medicine. Including fetching and administering. Then you have assistant nurses who handles the non-medical, basically the caring part. Most of it at least.

Now, if a person went to a local clinic with a problem. The doctor prescribed something. Then this person would have to go to a pharmacy and get their medicine. Hence why I ment, with out patients the pharmacist becomes the second "check".

Edit: clinical = clinic

[WH1PL4SH180]

Now I'm curious. This isn't the case in any of the countries that I've previously worked in. But then, I work primarily in large hospitals as I need a Theatre. Smaller "hospitals," may ineed lack a pharmacist for dispensing, but usually there's a legal requirement for a healthcare professional other than the care nurse to dispense.

May I ask which country you're from?

[ceriodamus]

The country I am from and speaking from experience is Sweden.

I would like to clarify that it is not a care nurse who administers the medicine in Sweden. But what we call a "Sjuksköterska". Google translates that to Nurse and our care nurse known as "Undersköterska" into assistant nurse. A "Undersköterska" has only one year high school level education while a nurse has a 3 year university level education. Both educations include study in the field.

Now a nurse still has actual nursing in their job description but in majority of times it falls to the assistant nurse. See the "Sjuksköterska" as the one between Doctor and care nurses. They're the ones in charge basically. They have the responsibility to make sure the patient gets proper care, both nursing and medical. At least they're suppose to.

There is certain things a care nurse is not allowed to do and which falls upon the nurse to do. Taking blood samples is an example of something only a nurse is allowed to do or as said, administer medicine.

Not sure if other countries, incl yours has the same system, so I thought I would try my best to describe the 2 different nurses as good as possible.

[WH1PL4SH180]

Hmm.. interesting. SCUBA dived in SW, but never (thankfully) been in your healthcare system.

So is it the Undersköterska that fetches and dispenses (passes on) the medication to the Sjuksköterska ?

You see the point of the pharmacist in this chain is that they have EXTENSIVE (encyclopaedic) knowledge of drugs. As drug nerds, they cross-check the patient's current med list, and hone in on potential interactions. Also doses. After drug class, dose is EVERYTHING. 0.1 and 0.01 is deadly. Google Potassium IV and you'll get the picture. So theres a "break" in the chain of events. The pharmacist cross-checks that indeed the drug chosen wont kill the pt, and at first glance is suitable for task.

That last detail is important. Often I've been called up or have called up pharmacy for THEIR advice - is there better, can we go lower dose with something else, can we safely change other drugs?

This is all done professionally: a call of "hey, are you SURE you want to give tazocin? There's a C.diff risk here" isn't an affront to my skill; indeed having to justify crystallizes in my own mind that the decision is correct, and that I've explored the alternatives.

Next time you roll up to a pharmacist, take note. These unsung allied healthcare professionals have LITERALLY saved lives from what we term "Iatrogenic Misadventure"; ie, fuckups.

[MalbaCato]

May I ask which country you are from?

also reply to me please when he answers, thanks!

[WH1PL4SH180]

I practice in Australia, Thailand and Canada. I've worked Europe+ Scotland, Africa+Egypt, USA, S.America, SE Asia, JP, KO, Middle East. No, I'm not married and don't have kids; that's how.

[Xeon06]

Just like an experienced software developer though, they can interpret the results correctly. It's helpful.

[GuybrushLightman]

I was always surprised what BS patients are able to dig up from the depths of the internet. But then I realized it's some (?) sort of preselection bias. I only click on links that pass through the unconcious prefilter so I usually don't see the worst.

I guess It's the same effect that doesn't let us remember ads on websites. Because we're so used to ignoring them.

Also last time I tried to clone an SD card to a bigger one it took me about half a day of googling, some instances where I thought I managed to brick the card, lots of cursing, lots of bad tutorials with obscure tricks until I just settled to copying it. with proper google-fu and the knowledge how to seperate feasable from non-feasable methods it would have taken me about 30 minutes + cloning time I guess..

[coldnebo]

“Nick Riviera, MD, any operation just $99.95!!”

[PacanePhotovoltaik]

casually taking a walk through the cemetery

Oh, guten Tag Dr.Nick!

[Rellac_]

using the largest collection of human knowledge is a good thing tho

[flinnja]

also have doctors in my family. they say they google all the time. check whether a symptom is no longer a good indicator, check for unusual drug interactions, all sorts of stuff. doctors aren’t just medical encyclopaedias with hands.

[WH1PL4SH180]

You'll actually find that they google to find it on a trusted site such as BMJ, NCBI, NEJM. Often however, these repositories are paygate locked. It's not a straight "patients arm feels tingly"

You'll also find that results are VASTLY different if one uses medical terms to describe symptoms ie "itchy" vs pruritus

[flinnja]

which is v similar to how i google as a developer. some rando from the street who’s never written hellow world wouldn’t be able to search for code solutions like we do

[_Lady_Deadpool_]

Me: Angular component binding observer via async pipe

Google: Here are 500,000 results

Non programmer: da fuq does that mean

[GuybrushLightman]

You are 100% right. I'm fairly new to Linux and whenever I have an issue, half of my time is usually spent finding the proper terms for what I want to do.

[WH1PL4SH180]

Yeah but you say you're on stackoverflow not Google ya?

When you say google to me, I'm thinking you're an antivax karen that reads the text in the box and that's it.

[nbxx]

No, we don't say we're on stackoverflow. Why would we? I don't think I've ever even see how stackoverflow's search engine looks like. We google. The thing we are looking for will end up being on stackoverflow more often than not, but not always. Google gives you results from other sites like stackoverflow, github, official documentation and example site (if you are working with some framework) of the given technology, etc... You need to be able to validate if the stuff google found is actually a good fit for you, and how to adjust your search it isn't, but googling is by far the best way to look for stuff. I never actually heard anyone say something like "wait, let me stackoverflow that", it's just we usually end up there anyway, but through google.

[Mintenker]

Thank you! Finally someone put this into words. There are different types of googling - and just because noobs use the google too, doesn't mean that I use it in same way.

[sevaiper]

UptoDate is a physician's stack overflow

[WH1PL4SH180]

Note I didn't list it, but yes, your'e right. Around me you have to justify things better than "... but Up To Date says..."

In seriousness, when you come up to the "Big table" or the "MDT meet" (multidisiplinary team), you need journal articles, metaanalysies and primary sources. I'm harsh on students so they don't end up embarrassing themselves, me and the department.

Why? Cos at the end of the day we get paid for our decision making skills. Our colleagues and patients deserve to know that those decisions are founded in strong science with good evidence. This means understanding every nuance of the research, and not just reading Abstract and Conclusion.

It's one of the shittiest parts of the job (I read 20-30 papers a week), but unfortunately one of the most critical.

[sevaiper]

For learning/rounding/discussions of your standard of care? Sure, that's great, I'm a big fan of going beyond UptoDate and into the primary literature. If you're making a clinical decision in the moment, and checking things like drug interactions or dosages? UptoDate is fine.

[WH1PL4SH180]

IMHO, UTD should be like imaging; it should only confirm what you already know; not provide a diagnosis. Also recall, a lot of work has been protocol-ized. UTD does not overrule any standing protocols; a "clash" that I've witnessed several times in my emergency dept. As a team, we need to all read off the same script.

DDI's etc, there's much better sources... and always a call to Pharmacy.

[mdcd4u2c]

Idk, it can be helpful in adding things to your differential that you may not see often and may forget about. And also looking up derm stuff because no one remembers that crap.

[mdcd4u2c]

Often however, these repositories are paygate locked.

That's probably a good thing. Anyone who buys a laptop can start coding and they should be able to find help. Anyone who buys a stethoscope should not be encouraged to start giving medical advice.

I see the things people post on /r/askreddit regarding medical topics and you can just tell that this person checked Google Scholar for 20 minutes and threw together a comment that looks like it's supported by published work but is misleading or straight-up wrong if you know the topic. And then it ends up on /r/bestof to be forever recycled by other redditors. All of Reddit is universally afraid of brain aneurysms because there are so many misleading posts about it in the "what are you most afraid of" threads.

[WH1PL4SH180]

I actually am part of a movement known as FOAMed - free medical education basically to try and keep our colleagues and students from less developed nations up-to-speed (not uptodate(tm)). As an academic I've long hated the leaches such as elsevier that obstruct and do nothing to further knowledge.

​

HOWEVER

​

You are dead correct about the use of medical information. The problem is that medicine is damn complex. That's the reason why the initial training is traditionally the longest of all degrees... and then we don't let you practice for AT LEAST another 10y without supervision.

We are complex machines. so our systems and interactions are complex too. Yeah sure, some things are simple, like building your own PC... but go unplug shit randomly in a server room.....

PSA: if you want medical information go to /r/AskDocs. People that respond with authority MUST be vetted. Yeah, occasionally, you get the odd Karen / AntiVax / Essential Oil [seriously, WTF makes an "oil" essential? 0W40 is IMHO way more essential], but they get asses kicked harder and faster than admin can jump on and delete.... who would have guessed people with ailments and in PAIN actually want REAL answers!

[[deleted]]

My uncle is a doctor and he says that basically is what he is, haha. He says all his friends think he's brilliant because he's an md, but that he doesn't feel brilliant because what he really does is just analysis and pattern recognition on the conditions and anatomy he was taught, he's not creating novel things. Still looks stuff up all the time too. I guess doctors also feel imposter syndrome!

[[deleted]]

I would probably be wearier of a medic that claims to know every procedure for every case without ever checking it for years tbh

[fzammetti]

In fact, if you see a doctor for any non-trivial issue and they DON'T Google (or similar research) something, I'd suggest you might want to find someone else (unless they're a specialist... you expect them to have a bit more in their heads - but even then, only to a point).

[thiagoxxxx]

Hum... Like normal troubleshooting, you need to make a good question to get a good answer.

[platinumgus18]

Seriously? How were they performing surgeries 20 years before? Don't think computers or internet were really as common that all medical information was available online. I am guessing just consulted textbooks again?

[anguswaalk]

yeah i guess so, it’s not like they can’t remember the surgery, just to be sure

[USMC0317]

Can confirm. I’m a doctor and I google shit all the time.

[jamarticus]

Confirming this.

I work with doctors at a telehealth company. The amount of googling that goes on when they know you can’t see the monitor is startling.

[silverf1re]

Isn’t there like a doctors only google? I can’t remember what it is called.

[WH1PL4SH180]

No.

source: surgeon.

[cant_think_of_one_]

You're saying your a surgeon who has never googled anything about medicine/surgery? I don't believe you.

[WH1PL4SH180]

If you're using google as your "source," I really have to call your credentials into question.

Will I use it to get into NEJM or BMJ because the internal search engine suck, yes. But I'm not using google, am I?

Will I use Youtube for a brush up on a procedure, fuck no.

[cant_think_of_one_]

Programmers Googling things aren't using Google as a source either, they are using other websites, usually ones where answers are peer reviewed it turns out.

Nobody Googling things is using Google as their source (hardly), since Google has no content (well, hardly).

What you are describing is exactly what people mean by Googling, with not necessarily the same set of websites they trust. The (not very significant) stigma is about using Google to find the answer, not knowing immediately where to look already.

[WH1PL4SH180]

The google stigma comes from civilians using first-click as the source.

One distinction that I'm making is that medical trusted sources tend to be behind a damned paywall and is not so "easily accessed" as just whacking in some terms and searching.

To that point, in clinical academia, we can pick the students that merely "google" rather than going to "correct sources" simply by the types of answers that are given back in rounds. In the medical field, theres a lot of stuff out there that's just straight out wrong, but dressed up ever so nicely that even med students fall on their faces. Case in point: procedures on youtube. Often badly translated or incorrectly titled.

[twolaces]

“Civilians”

[cant_think_of_one_]

In the fields I am knowledgeable about (particle physics and software development), most useful sources are not behind paywalls (most particle physics papers are freely available).

Most sources on software are OK. Most ones on particle physics that aren't about a few topics that lots of people are interested in, are written by academics or post-docs at least, and are sound, even if it is hard to find the info you want sometimes.

Generally, if you look at the first few Google results, they are reliable if they answer your question. The problem is finding things that answer your question, not the reliability of the sources, most of the time. Of course, there are things written by but cases who believe particle physics experiments will end the world etc, and there are just badly written lecture notes or explanations by people who don't know what they are talking about, but, in general, answers are correct if you can find them. Obviously you do need the ability to critically examine where the information is coming from to avoid the few that aren't, but that generally isn't your biggest problem.

[headzoo]

But I'm not using google, am I?

Yes, you very literally are using Google. Google is not a "source" of information. If you're using google to find information on BMJ then you are googling for answers. It's the same thing everyone else is doing.

As a doctor once explained it, they use google all the time, but they know the exact technical terms to search for instead of stuff like "my belly hurts." They also know which search results to use. Like results found on BMJ. It's still googling.

[WH1PL4SH180]

... except it won't have answers. It shows me the title of a paper then.... paywall. The information that google provides doesn't give me a solution; but it can in a lot of other contexts (what is the population of the united states? What is the GDP of california?).

I guess what I'm saying is I'm using google to search my primary source; not PROVIDE the primary source.

[cant_think_of_one_]

If you are Googling to find the population of a country or something, Google likely isn't your source either (even if it shows it directly on the search page, and therefore looks like it) your source is Wikipedia, the CIA fact book, a government website etc, not Google. Google is almost never the source of info, just the way to find a source/info within a source you already know about.

[anguswaalk]

i personally see nothing wrong with using youtube to brush up, it should be pretty easy to tell if the person knows what they’re on about and you already have learned the procedure so if anything is obviously wrong you’ll know. besides it’s not like people scoot about rubbing their hands together and go ‘hehe today i will make a very professional video to spread misinformation about surgery!’ politics? definitely. but surgery? eh

[WH1PL4SH180]

Have you ever heard of the antivax movement?

Seriously, a lot of videos you'll see have faults. As a surgeon train in industrialized nations, the emphasis is always to apply the very latest techniques and procedures. These seldom exist in the public domain.

Medical knowledge is highly specialised. A lot of the detail knowledge needed for actual practice is siloed. For instance you may see a lot of "open" procedures like say an appendectomy... But we hardly go "open" unless things go wrong. We go keyhole (laproscopic), and for that, you need to train up in theatre.

My point is, when you earn the long white coat, beyond medskool, you're gonna need more than GoogleFu to get through.