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medical training vs skin in the game its tricky

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Oct 21, 2021

Once another doctor frowned when I described how an earlier doctor had treated me. Then he looked at the CDC website and was like "oh nvm the CDC updated its recommendation, you're fine." Did he even look at WHY it was updated? Did he AGREE with it? Ir-fucking-relevant.

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Scott Alexander Defense Force

@Roflsaurus16

Oct 21, 2021

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@eigenrobot

What Aella describes is true, but as a practicing doctor it’s also true that we don’t have the time or energy to do deep dives into the latest research on every single medical condition we may encounter. I tend to do it more if the official guidelines seem “off” to me…

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and

But it's not even the latest research! Lots of this stuff I find is *years* old. And if you did research into estrogen + aural migraines just once then you wouldn't have to repeat it for every additional patient who asks.

9:12 PM · Oct 21, 2021

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and

The combination of symptoms and treatments quickly becomes a combinatorial explosion, though. Which is why it’s good to have an ongoing relationship with a clinician.

Scott Alexander Defense Force

Replying to

and

Hm, were you seeing neurologists for your migraines? I'm a pediatrician so migraines are not my specialty, but I do have some vague understanding of "female hormones" being associated with migraines for many women. So sounds like you're right in this case!?

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and

This is what practice guidelines from big medical societies are for. Also, was this a neurologist, specifically one that focuses on headaches, or your primary care doc? This is somewhat surprising if they're a neurologist, somewhat shocking if headache doc