The infantilization of the public in the name of “safety” is offensive and ridiculous. In many countries, you can get the vast majority of medicines at the pharmacy without a prescription. Amazingly, people still pay doctors and don’t just take random medications without consulting medical professionals.
It’s only “necessary” to limit access to medical tools in countries that have perverted the incentive structure of healthcare to the point where, out of desperation, people will try nearly anything to deal with health issues that they desperately need care for but cannot afford.
In countries where healthcare costs are not punitive and are in alignment with the economy, people opt for sane solutions and quality advice because they want to get well and don’t want to harm themselves accidentally.
If developing nations with arguably inferior education systems can responsibly live with open access to medical treatment resources like diagnostic imaging and pharmaceuticals, maybe we should be asking ourselves what is it, exactly, that is perverting the incentives so badly that having ungated access to these lifesaving resources would be dangerous?
Well, the conditional in this if statement doesn't hold.
Yes, pharmaceuticals are open access in much of the developing world, but it has not happened responsibly. For example, Carbapenem-resistant bacteria are 20 times as common in India as they are in the U.S [1]
I really don't like this characterization of medical resource stewardship as "infantilization" because it implies some sort of elitism amongst doctors, when it's exactly the opposite. It's a system of checks and balances that limits the power afforded to any one person, no matter how smart they think they are. In a US hospital setting, doctors do not have 100% control over antibiotics. An antibiotic stewardship pharmacist or infectious disease specialist will deny and/or cancel antibiotics left and right, even if the prescribing doctor is chief of their department or the CMO.
[1] https://www.fic.nih.gov/News/GlobalHealthMatters/may-june-20...
The TLDR is that most people when interacting with anything other than their GP family doctor, are probably interacting with someone "fresh out of school."
It comes from dealing with the public.
> In many countries, you can get the vast majority of medicines at the pharmacy without a prescription. Amazingly, people still pay doctors and don’t just take random medications without consulting medical professionals.
I see people on this site of allegedly smart people recommending taking random medications ALL THE TIME. Not only without consulting medical professionals, but _in spite of medical professional's advice_, because they think they _know better_.
Let's roll out the unbelievably dumb idea of selling self-diagnosis AI on radiology scans in the countries you’re referring to and ask them how it works out. If you want the freedom to shoot from the hip on your healthcare, you've got the freedom to move to Tijuana. We're not going to subject our medical professionals to deal with an onslaught of confidently wrong individuals who are armed with their $40 AI results from an overhyped startup. Those startups can make their case to the providers directly and have their tools vetted.
So again, if you want to ignore the safeguards that we've built for good reason - take your business to Tijuana.
It was a serious 30 something woman who collected something like 50 pesos (around $3), listened to me for about 30 seconds, and told me to make sure I slept and ate well (I think she specifically said chicken soup). I asked about antibiotics or medicine and she indicated it wasn't necessary.
So I rested quite seriously and ate as well as I could and got better about a week later.
During the time that I was in Playas de Tijuana I would normally go to nicer pharmacies though, and they didn't ask for a prescription for my asthma or other medicine which was something like 800% less expensive over there. They did always wear nice lab coats and take their job very seriously if I asked for advice. Although I rarely did that.
I do remember one time asking about my back acne problems at a place in the mall and the lady immediately gave me an antibiotic for maybe $15 which didn't cure it but made it about 75% better for a few months.
Another time at the grocery store I asked about acne medicine and the lady was about to sell me something like Tretinoin cream for a price probably 1/4 of US price. She didn't have anything like oral Accutane of course. It was just a Calimax Plus.
There are of course quite serious and more expensive actual doctors in Tijuana but I never ended up visiting any of them. I was on a budget and luckily did not have any really critical medical needs. But if I had, I am sure it would have cost dramatically less than across the border.
EDIT: not to say the concession-stand office lady wasn't an actual doctor. I don't know, she may have had training, and certainly had a lot of experience.
They go to the doctor because the healthcare system here works, for the most part, and they value and respect the expert counsel in matters of their health.
I'm curious what you think the problem is, concretely, with a tool like this in the hands of the public which you clearly have such disdain for. Let's assume I buy this thing (the horror). I have to actually get access to my scans, which despite being legally required to provide most providers will be loathe to actually do. So I get my scans, I get this AI tool, I ask it some questions. It's definitely going to get some answers right, and it's very likely going to get some answers wrong. I'd be shocked if it's much less accurate than a resident, and if they're commercializing it there's a decent chance it's more accurate than the average experienced attending.
What is your doomsday scenario now that I have some correct data and some incorrect data? What am I going to do with that information that is so "unbelievably dumb" that I need the AMA to play daddy and prevent me from hurting myself? I can't get medication based on my newfound dangerous knowledge. I can't schedule a surgery or an IR procedure. I can't go into an ER and say "give me a cast here's a report showing I need one."
Unfortunately we have a lot of people that despite an abundance of ignorance are arrogant enough to think that they know better than most, but still are incapable of applying basic logic and critical thinking in their reasoning. (which if you think about it is sensible, since wisdom is largely a matter of comprehension of the depth of ones ignorance)
These people are a huge PITA to work with and every tool they wield inflicts pain on those trying to help them.
