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my foot is hanging off - do you think mushroom paste will fix it

2

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  • Closed Accounts Posts: 11,001 ✭✭✭✭opinion guy


    roro1neil0 wrote: »
    I really don't know what to make of this thread. Seems to be only two trains of thought, "we are health professionals, everyone else is stupid and shouldn't be able to talk about individual health problems". Just the stench of elitism and smugness is nauseating. Especially as no one on this thread is an actual doctor except for one and that person is the furthest you can be from emergency medicine you can get without retiring.

    Is it not blazingly OBVIOUS to you that many of the problems people are asking about are potentially serious and require proper evaluation including physical examination, blood tests xrays etc ? In most cases on here for medical professionals to reply would be dangerous and probably negligent, whilst for boards to allow medical or non-medical randomers pitch diagnoses and treatment suggestions is both dangerous and potentially leaving boards open to legal claims.

    Would you think its ok for your GP to insist patients don't come to his office and he will advise them over the internet ? No I suspect not - and he actually should know a thing or two. Why then do you think its ok for internet randomers of uncertain knowledge to do so ?


  • Registered Users Posts: 339 ✭✭roro1neil0


    calfmuscle wrote: »
    That's ridiculous, just look at all the advice and support the threads in long term illness provide. However the advice that people usually look for in here is when the condition is acute an there is no diagnosis as of yet.
    What point are you making? LTI works, it's nothing to do with 'advice and support' from health care practioneers.
    Steve jobs is probably the most famous example.

    I said show me evidence not an anecdote, you do know the difference? Steve jobs went with alternative medicine strategies over conventional, it's questionable what difference internet advice made to his decisions. More important, patient autonomy allows for this.
    This is a health science's forum, therefore the lay person may pay more head to the advice given than from some guy down the gym. As has been pointed out that is dangerous as even though it is a health sciences forum there is no way of confirming the posters credentials.

    Just remove that stipulation. The only 'professionals' that need to be careful are doctors and the site administrators, afaik, users of this site will have no recourse against psychologists who offered advice.
    Further to that, there is nothing we can do about people accepting advice from non medically trained people. However it should not be encouraged as anyone here that works in healthcare, especially anyone that carries out patients assessments (physio's, doctors, psychologists) will know that the number of patients who come in convinced they have XYZ because biddy down the road had something similar is massive! Patient education is a huge part of treatment/management.

    What you are saying is that patients need to be educated but they can't seek education on the web? Why not? I don't really care if a psychologists job is made more difficult because their 'patient' googled their symptoms.
    If a poster comes on here complaining of low back pain and pins and needles around the groin and I give them a strengthening program with out assessing if they have signs of caudia equina impingement the person is at risk of being left incontinent for life. This is just one example of thousands of reasons its a bad idea!

    I don't think this point is actually really that relevant. firstly, you're assuming people will be giving medical advice in the absence of performing an examination. Obviously anyone with any medical knowledge wouldn't do that. but let's say for example, someone does come on this forum with sudden, acute lower back pain, paresthesia, pain / loss of sensation in l5/s1 and flaccid paralysis in their legs, I would agree, a strength programme wouldn't be practical advice, nor would it be advice someone with CES would accept. What's more likely is someone would say

    "sounds serious, go straight to doctor".

    What is more relevant and realistic example is someone comes on this forum with chronic back pain that didn't respond to GP visit (painkillers and anti-inflammatory) physio (what ever physios do for back pain) or chiropractic (what ever that is). I don't see why that user can't post that story here and take, with caveat emptor in place, any advice with a pinch of salt and have a discussion.


  • Registered Users Posts: 339 ✭✭roro1neil0


    Is it not blazingly OBVIOUS to you that many of the problems people are asking about are potentially serious and require proper evaluation including physical examination, blood tests xrays etc ?
    I haven't looked at each case forensically but who said boards.ie discussion would be a substitute for people taking a convention medicine route? Nobody did. Surely wouldn't it be more likely that if they presented a case that required 'serious and proper evaluation' the resultant cacophony of "sounds serious, go to the doctor" would encourage them to do so. Rather than locking the thread, warning the user and giving a "visit your gp" one liner?
    In most cases on here for medical professionals to reply would be dangerous and probably negligent,

    who said medical professionals would or should? Surely if they had any sense they wouldn't risk negligence by offering medical advice to a patient they hadn't examined. Do you think if boards.ie changed it's policy, consultants from around the country would be expanding their practices onto this forum?
    Would you think its ok for your GP to insist patients don't come to his office and he will advise them over the internet ? No I suspect not - and he actually should know a thing or two. Why then do you think its ok for internet randomers of uncertain knowledge to do so ?

    stop making infantile, straw man arguments.


  • Registered Users Posts: 746 ✭✭✭calfmuscle


    roro1neil0 wrote: »
    What point are you making? LTI works, it's nothing to do with 'advice and support' from health care practioneers.
    Regardless of weather the advice is from health professionals or not the forum is aloud and it works well. Also if you read through the threads there are lots of posters who are not afflicted but have an interest in the area being discussed.

    roro1neil0 wrote: »
    I said show me evidence not an anecdote, you do know the difference? Steve jobs went with alternative medicine strategies over conventional, it's questionable what difference internet advice made to his decisions. More important, patient autonomy allows for this.

    You are complaining about elitism and smugness yet you come out with that sentence :rolleyes:. Not giving out medical advice is in the terms and conditions of posting on this sight if you wish to challenge that, the responsibility is on you to support your case with evidence.

    roro1neil0 wrote: »
    Just remove that stipulation. The only 'professionals' that need to be careful are doctors and the site administrators, afaik, users of this site will have no recourse against psychologists who offered advice.

    I'm not sure weather health professional could be legally penalised for giving advice or not, but ethically its just below standard.
    roro1neil0 wrote: »
    What you are saying is that patients need to be educated but they can't seek education on the web? Why not? I don't really care if a psychologists job is made more difficult because their 'patient' googled their symptoms.

    There are plenty of good resources on the web where people can gain information on various conditions such as ncbi etc. But taking an online diagnosis from a stranger on the internet is dangerous. I cant really believe your arguing this!

    roro1neil0 wrote: »
    I don't think this point is actually really that relevant. firstly, you're assuming people will be giving medical advice in the absence of performing an examination. Obviously anyone with any medical knowledge wouldn't do that. but let's say for example, someone does come on this forum with sudden, acute lower back pain, paresthesia, pain / loss of sensation in l5/s1 and flaccid paralysis in their legs, I would agree, a strength programme wouldn't be practical advice, nor would it be advice someone with CES would accept. What's more likely is someone would say

    "sounds serious, go straight to doctor".

    What is more relevant and realistic example is someone comes on this forum with chronic back pain that didn't respond to GP visit (painkillers and anti-inflammatory) physio (what ever physios do for back pain) or chiropractic (what ever that is). I don't see why that user can't post that story here and take, with caveat emptor in place, any advice with a pinch of salt and have a discussion.

    And you are assuming they wont! Plus do you know how many people like to think they have knowledge and just give out advice when they are not qualified!! Anybody can sign up and pretend to be a doctor/ot/clinical nurse specialist and give out advice. Its ridiculous!

    As for a chronic pain patient who has had little success with various treatment they can and do post regularly in the long term illness threads. :confused:


  • Registered Users Posts: 339 ✭✭roro1neil0


    calfmuscle wrote: »
    Regardless of weather the advice is from health professionals or not the forum is aloud and it works well. Also if you read through the threads there are lots of posters who are not afflicted but have an interest in the area being discussed.

    So you can discuss medical conditions in the LTI but not here? What's the difference? Ppl with LTI will often develop new or different illnesses/progressions that need to be seen by experts yet they are allowed to discuss this openly in that forum? Why can the equivalent not be discussed here?
    You are complaining about elitism and smugness yet you come out with that sentence :rolleyes:. Not giving out medical advice is in the terms and conditions of posting on this sight if you wish to challenge that, the responsibility is on you to support your case with evidence.

    Ah here now. I can't really overlook every single thing (whether/weather, site/sight, allowed/aloud).
    I'm not sure weather health professional could be legally penalised for giving advice or not, but ethically its just below standard.

    A dr would risk losing their licence
    There are plenty of good resources on the web where people can gain information on various conditions such as ncbi etc. But taking an online diagnosis from a stranger on the internet is dangerous. I cant really believe your arguing this!

    who said anything about giving out diagnoses. i am talking about discussion, not people pretending to be doctors.
    And you are assuming they wont! Plus do you know how many people like to think they have knowledge and just give out advice when they are not qualified!! Anybody can sign up and pretend to be a doctor/ot/clinical nurse specialist and give out advice. Its ridiculous!

    more scaremongering
    As for a chronic pain patient who has had little success with various treatment they can and do post regularly in the long term illness threads. :confused:

    fair enough so


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  • Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    Is it Firday yet?


  • Registered Users Posts: 5,143 ✭✭✭locum-motion


    Just to clarify, for a couple of posters who don't seem to realise this:

    Discussion of disease states or health issues is allowed here (and also on the LTI forum, but that's a different story; discussion about what's allowed there belongs there, not here). What is not permitted is seeking or giving advice on a person's own medical condition.

    So, to continue the tongue-in-cheek analogy that Opinion Guy used in the OP:

    "My foot is hanging off. If you too have suffered from hanging-off feet, will you please share your experiences with me?" is allowed.

    "My foot is hanging off - do you think mushroom paste will fix it?" is not allowed.


  • Registered Users Posts: 339 ✭✭roro1neil0



    So, to continue the tongue-in-cheek analogy that Opinion Guy used in the OP:

    "My foot is hanging off. If you too have suffered from hanging-off feet, will you please share your experiences with me?" is allowed.

    "My foot is hanging off - do you think mushroom paste will fix it?" is not allowed.

    seems a bit kinda stupid. you are basically implying for people to pretend they're not asking for personal advice by phrasing their questions. Reminds me of recreational drug users saying "my friend did E last night ..." when they mean me or people talking about torrents using reference to their cousin. all seems a bit silly and childish to me and wouldn't really effect my opinion on this matter from an ethical point of view.


  • Registered Users Posts: 746 ✭✭✭calfmuscle


    roro1neil0 wrote: »
    So you can discuss medical conditions in the LTI but not here? What's the difference? Ppl with LTI will often develop new or different illnesses/progressions that need to be seen by experts yet they are allowed to discuss this openly in that forum? Why can the equivalent not be discussed here?



    Ah here now. I can't really overlook every single thing (whether/weather, site/sight, allowed/aloud).



    A dr would risk losing their licence



    who said anything about giving out diagnoses. i am talking about discussion, not people pretending to be doctors.



    more scaremongering


    fair enough so

    I think what you are asking for is already available in long term illness, the difference that you seem to miss though is that in long term illness the posters have been assessed and have a diagnosis. They are under the care of health professional already.
    The posts that are closed in here are normally people who have not yet been to a care provider and are looking to use the forum as a substitute. Hence the danger associated with giving medical advice online.

    As for a doctor loosing their licence so can each of the health professions. Physiotherapists are regularly struck off.


    As for my spelling, use some clinical reasoning - well informed, highly educated, but makes elementary spelling mistakes and uses poor grammar = dyslexia ;)


  • Registered Users Posts: 339 ✭✭roro1neil0


    calfmuscle wrote: »
    I think what you are asking for is already available in long term illness, the difference that you seem to miss though is that in long term illness the posters have been assessed and have a diagnosis. They are under the care of health professional already.
    The posts that are closed in here are normally people who have not yet been to a care provider and are looking to use the forum as a substitute. Hence the danger associated with giving medical advice online.

    Ok.
    As for a doctor loosing their licence so can each of the health professions. Physiotherapists are regularly struck off.

    Why? Are physios particularly unprofessional?
    As for my spelling, use some clinical reasoning - well informed, highly educated, but makes elementary spelling mistakes and uses poor grammar = dyslexia ;)

    well lucky enough you've got a job using your hands


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  • Registered Users Posts: 746 ✭✭✭calfmuscle


    roro1neil0 wrote: »
    Ok.



    Why? Are physios particularly unprofessional?

    You would have to ask them that


    roro1neil0 wrote: »
    well lucky enough you've got a job using your hands
    True that, I dont need to spell much pulling pint! :pac:


  • Registered Users Posts: 5,143 ✭✭✭locum-motion


    roro1neil0 wrote: »
    ... you are basically implying for people to pretend they're not asking for personal advice by phrasing their questions...

    Absolutely not. There's a world of difference between the two questions I asked, and I am in no way suggesting that people should try to disguise their requests for advice, although I am aware that some might try it. As for sorting out which ones are genuine questions and which ones are disguised advice requests... well, that's why we have Mods!


  • Closed Accounts Posts: 8,073 ✭✭✭sam34


    just as an FYI re the LTI forum, posters there who ask for advice about new symptoms are also advised to see their gp- eg recently someone with MS posted about new symptoms and wondered if it was "just" optic neuritis - they were promptly told to see their GP. the lti forum is for discussing experiences of an established diagnosis and treatment thereof, not for making a diagnosis or advising on a treatment plan. it's quite tightly modded to ensure the line isn't crossed.


  • Closed Accounts Posts: 8,073 ✭✭✭sam34


    roro1neil0 wrote: »
    Especially as no one on this thread is an actual doctor except for one and that person is the furthest you can be from emergency medicine you can get without retiring.

    incorrect.

    at least two doctors have posted on this thread, and I know a third has read it as they have thanked posts. and one of those doctors is in fact a specialist in emergency medicine.

    secondly, I'm not sure if the second part of your sentence refers to me, a psychiatrist, I'm guessing that it does... if you think psychiatrists do not encounter emergencies, both psychiatric and medical, you are seriously mistaken, but that's another discussion.


  • Closed Accounts Posts: 8,073 ✭✭✭sam34


    ^edit to above actually at least 3 doctors have posted here.


  • Registered Users Posts: 5,143 ✭✭✭locum-motion


    Regarding the issue of the front page of this forum being clogged up with closed threads:

    Rather than closing the threads, would it be an idea to have a great big superthread, to which threads asking for advice could be moved. The mods could just move all the dodgy threads into it and re-lock it each time. Call it 'The Advice Seekers' Graveyard', or something.


  • Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    Regarding the issue of the front page of this forum being clogged up with closed threads:

    Rather than closing the threads, would it be an idea to have a great big superthread, to which threads asking for advice could be moved. The mods could just move all the dodgy threads into it and re-lock it each time. Call it 'The Advice Seekers' Graveyard', or something.

    The only problem with this L-M is that when a thread is moved into another forum/thread, the title of the thread still remains where it was (albwit as a dead link) preceded by a "Moved" tag, so this would still clog up the front page. The only solution to the forum being crowded by medical advice threads would seem to be deleting them, which comes with its own issues.


  • Closed Accounts Posts: 8,073 ✭✭✭sam34


    the issue with deleting them is that we'd have to leave them up a day or so to prevent the op thinking it just hadn't appeared and posting it again.

    I used to think that having locked threads with the standard reply still on the front page would act as another sign to posters that we don't give medical advice here, but as I look at the current front page I see how misguided I was!


  • Moderators, Science, Health & Environment Moderators Posts: 2,881 Mod ✭✭✭✭Kurtosis


    sam34 wrote: »
    the issue with deleting them is that we'd have to leave them up a day or so to prevent the op thinking it just hadn't appeared and posting it again.

    I used to think that having locked threads with the standard reply still on the front page would act as another sign to posters that we don't give medical advice here, but as I look at the current front page I see how misguided I was!

    I was going to make the same point Sam about the locked threads still being visible with on thread warnings acting as a deterrent to further medical advice threads but based on the evidence of the current make up of the first page I thought better of ot!


  • Registered Users Posts: 5,143 ✭✭✭locum-motion


    penguin88 wrote: »
    The only problem with this L-M is that when a thread is moved into another forum/thread, the title of the thread still remains where it was (albwit as a dead link) preceded by a "Moved" tag, so this would still clog up the front page. The only solution to the forum being crowded by medical advice threads would seem to be deleting them, which comes with its own issues.

    True, didn't think of that.
    Still, the dead link would say "Moved to the Advice Seekers' Graveyard", wouldn't it? Might act as a deterrent a bit, no?


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  • Registered Users Posts: 339 ✭✭roro1neil0


    tbh it really isn't much of an inconvenience having locked threads, there rarely is anything worth talking about other than politics, payments and bitching about the hse.


  • Registered Users Posts: 1,722 ✭✭✭anotherlostie


    I think calling it the advice seeker's graveyard might actually worry a few people...


  • Registered Users Posts: 5,143 ✭✭✭locum-motion


    I think calling it the advice seeker's graveyard might actually worry a few people...

    That was the point!


  • Registered Users Posts: 1,722 ✭✭✭anotherlostie


    That was the point!

    Perhaps this might help - I doubt it's on the curriculum for health professionals yet, but I personally believe it's important to have some when dealing with people who are worried about their health, even those online where they are actively told not to ask about it :)

    http://www.businessballs.com/empathy.htm


  • Registered Users Posts: 5,143 ✭✭✭locum-motion


    Perhaps this might help - I doubt it's on the curriculum for health professionals yet, but I personally believe it's important to have some when dealing with people who are worried about their health, even those online where they are actively told not to ask about it :)

    http://www.businessballs.com/empathy.htm

    Low blow, and not in keeping with the humourous nature of this particular thread.


  • Registered Users Posts: 4,611 ✭✭✭maninasia


    Humorous, the only humorous part is the title!


  • Registered Users Posts: 2,320 ✭✭✭MrCreosote


    Perhaps this might help - I doubt it's on the curriculum for health professionals yet, but I personally believe it's important to have some when dealing with people who are worried about their health, even those online where they are actively told not to ask about it :)

    http://www.businessballs.com/empathy.htm

    Maybe you could point out some unempathic posts in the locked threads- because I've never seen one. They are usually gently reminded to check the charter and see their doctor. "Empathy" doesn't extend to recommending people get bullsh*t advice on an anonymous message board.


  • Closed Accounts Posts: 372 ✭✭UL_heart_throb


    perhaps all new threads should be pre-moderated and or people with less than 25 posts (or another number)cannot start a new thread.


  • Closed Accounts Posts: 5,451 ✭✭✭Delancey


    perhaps all new threads should be pre-moderated and or people with less than 25 posts (or another number)cannot start a new thread.

    Good point - going from memory alone I think a disproportionate number of advice threads are started by people with nil previous posts anywhere on boards.ie , in otherwords they join specifically to ask for medical advice.
    Perhaps low post counters could be compelled to go through pre-moderation ?
    Even if technically possible pre-moderation can tend to increase Moderator workload and on the 1 forum that did operate it I know the mods were not sorry to see it done away with.


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  • Users Awaiting Email Confirmation Posts: 5,620 ✭✭✭El_Dangeroso


    calfmuscle wrote: »
    Apply for a medical card. . . . . . . . .

    I'm actually shocked at the amount of people I know who are entitled to a medical card but are too lazy to get off their arse and organise one. Like putting off really concerning symptoms lazy, the mind boggles..
    roro1neil0 wrote: »
    If you asked this down your local gym someone would say you probably have Athlete's foot and should go to the chemist and get some cream or powder.
    If you asked your mother the same thing you'd get the same answer. In both instances, there is no presumption of unlicensed medical advice. Why is it different on this forum?

    Because people tend not to sue their mom or the bloke down the gym. Random companies are very suable. :)

    But on a broader note, how do other internet sites get around the liability issues? Some sites have 'ask the doctor' threads that people post their medical histories and get direct advice on thread.

    Not fringe sites either, webMD has a snazzy new symptom checker:

    http://symptoms.webmd.com/#./introView

    Now that's a lawsuit waiting to happen.


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