Hacker News

viraptor said 7 months ago:

It's not just medical residents. Doctors do refresh their knowledge from videos online. And they totally google for information. But I don't think it's what many people imagine when reading it.

> How can doctors tell which videos are valid and which contain bogus information?

They're doctors. They had years of training and know the basics of what they're booking up. It's closer to experienced developers looking up specific usage for some tool which they're familiar with otherwise, rather than learning from scratch.

Sure, there's going to be some extreme bad cases, but those are bad doctors in general, the source of info is not relevant.

wlesieutre said 7 months ago:


> Developers are turning to Stack Overflow to fill in gaps in their training

There's a lot of garbage channels on YouTube, but there's no shortage of knowledgeable people too.

Nobody knows everything, and it turns out there are people on the internet who know things we don't.

ISL said 7 months ago:

I've not met a professional that doesn't make internet searches for information when necessary.

I'm a professional physicist, and I search for specialty-specific information multiple times per day, every day.

msla said 7 months ago:

When reading articles like this, here's a quick check: Replace "YouTube" with "bookstores" and see if you're still outraged. Anyone can write a book, and the bar to getting a book published has absolutely nothing to do with the book's accuracy. If "Chariots Of The Gods?" can get published, you know publishers aren't doing sanity testing or any other kind of checks for the reliability of the content. And yet doctors buy books from bookstores, and use them to learn things. How do doctors know they're not getting nonsense? Because they know what real information looks like.

This is the biggest reason for teaching the basics of a broad variety of subjects: If you know what real information looks like, and how the real field basically fits together, you're less likely to be taken in by absolute nonsense. OTOH, if you get bad information to start, you're going to evaluate all subsequent information on that standard, and reject good information because it doesn't jibe with the bad stuff you've already internalized.

bbrodriguez said 7 months ago:

I recently had an elevated D-Dimer level in my blood lab which indicates a clot of some sort. I remember sitting in the doctor’s office while my primary care doctor was reading the lab results. He literally started Googling “primary causes of D-Dimer elevation” and clicked on the link to a WebMD documentation on D-Dimer levels. That’s when I realized that’s their StackOverflow. Combined with their existing training, I assume WebMD helps them make better judgement calls (definitely compared to a lay person self-diagnosing themselves). He then said, “well, none of the top causes really apply to your situation: you didn’t have a surgery recently and it’s impossible for you to get pregnant as a guy”.

I was consequently referred to a hematologist.

hinkley said 7 months ago:

I watch Youtubers build things, or just playing my favorite video game and while I learn a lot from them, sometimes I learn more from the times that I disagree with them.

I was watching a video for a game I play, about a dogmatic approach to solving a particular problem and realized it had been min-maxed into the ground by bad math. By de-optimizing it a couple percent I could get 2 and a half beneficial outcomes instead of just the one. Given how time consuming the process is, it was madness to sink so much effort into solving only one problem. Of course having spotted something someone else missed, I've been staying up too late trying to validate my theory. Unfortunately my change barely made it any faster, and my first attempt to break it down into two phases didn't work out and ended up costing me more time than I had saved.

Point is, I got all new nuances and areas to explore based on watching a video that I felt was provably wrong.

colonelpopcorn said 7 months ago:

There's also the compulsion that highly trained professionals have to correct false information out of a sense of pride or ego. It helps to combat misinformation when you have a fair number of "ummm, ACKSHULY"'s in your profession.

dang said 7 months ago:

Ok, we've promoted residents to doctors in the title above.

russdill said 7 months ago:

Many medical schools now use Problem Based Learning (PBL) approach. Fewer textbooks are assigned and there are fewer lectures. Students are taught to track down the resources they need, books, journals, internet resources, etc.


akira2501 said 7 months ago:

> rather than learning from scratch.

The idea of a medical equivalent to a "script kiddie" is a somewhat amusing mental image, though.

bredren said 7 months ago:

I'd be worried about a doctor that didn't use all online resources available to learn about the areas they practice in.

Around 2010, I started noticing medical professionals had less information about what I had come in with than what I could find in my own research.

Not every time, but part of the time I've felt like I did not get valuable information gleaned from obvious experience.

Other times, I've found treatments I can handle on my own, saving copays and deductibles. For example, the procedure for draining blood from a fingernail after slamming it in a car door.

More recently, I had ankle sprain that seemed to recur, and a medical visit for $65 came back with "go to PT."

Which was going to be $125 per session. So I watched youtube videos and got therabands and have been doing the exercises for "free." And it is working.

There is unquestionable space for medical professionals, their treatments and the gates they create between people and prescribed medicines.

However, just as YC has turned expensive legal processes into simplified documents "anyone" can use online, some medical diagnosis / treatments have been similarly decomodified.

harry8 said 7 months ago:

Doctors are turning to medical journals to fill in gaps in their knowledge.

Doctors are referring to textbooks to fill in gaps in their knowledge.

Any doctor who isn't doing that possibly is in the wrong profession. Indeed most of what is learned in a medical degree is so the doctor can assess these sources and embrace or reject them.

Doctors attend lectures at conferences. Always have. Now cheap video distribution exists. So now sometimes virtually attending the lecture on youtube that they otherwise would have not been able to see.

Surgical techniques are often better demonstrated than described, so videoing them makes some sense. Watching videos of techniques that have the potential to be better than what you are using is a very good thing. Assessing and rejecting them if it turns out the technique isn't better is obviously what any competent human being would do.

Quality control? Hell medical journals barely have that. Ask a statistician about medical journal quality control - it's only driving policy accross all of health care...

You have to assess sources, evidence, outcomes etc. for literally anything that is new or you suspect might need revisiting. Any doctor who can't do that effectively should not be using that particular source or possibly should not be a doctor at all.

The practioners of every single complex job have "gaps in their knowledge" - nobody knows everyting. Most if not all people faced with having to perform tasks where they don't have perfect knowledge are using resources to study. Online video is just one, very effective in certain cases, way of increasing knowledge.

CNBC may not be a way of increasing knowledge based on this article and I assess a youtube video demonstrating the reading of this article is something I might reject as being useful.

sxg said 7 months ago:

I'm a current medical resident, and I have absolutely used YouTube to fill in the gaps. Just a few days ago during lunch, I watched a 3 minute video on how to remove a PICC line before taking one out of a patient. I have taken PICC lines out before, but I just wanted a quick refresher before doing another one. I've also used YouTube to improve my physical exam skills. In the real world, you just don't get enough abnormal findings in certain areas to learn quickly. For example, although ACL tears are common, I haven't seen more than a few due to the context I work in. I use YouTube to see more examples of these kinds of abnormal findings.

While I was in medical school, the vast majority of my education came from online resources, YouTube, question banks, or ancillary books that were not part of the official curriculum. If you go to any medical student in the US today, they'll be familiar with the four key resources: UWorld (massive bank of USMLE board questions), First Aid (reference text book containing key information for board exams), Pathoma (video series teaching histology and pathology created by a University of Chicago pathologist), and SketchyMedical (another video series of visual mnemonics to help you memorize microbiology and pharmacology facts). There are also community driven projects such as Zanki and Brosencephalon, which are Anki decks with 25,000+ cards containing info needed for board exams. Another popular YouTube channel is Armando Hasudungan, who illustrates medical concepts aimed towards med students.

The med school I went to and many others are moving away from the traditional lecture-based model. Lectures at my school were offered, but they were optional and attendance was usually <25% of our class as the quality was notoriously poor. My med school classmates and I found learning much, much more effective with this hands off approach. This does call in to question the value and role of a medical school today. Now that I'm a resident working with other residents who went to med schools all across the US, I'm realizing that most of us just forced our way through the official curriculum and did most of our "real" learning using the same resources I mentioned above.

fedups said 7 months ago:

Sometimes I google home maintenance videos for information on a project, and I need to spend a lot of time looking for a certain level of quality of the source since I'm a complete amateur. I'll often want to confirm by looking for multiple videos and making sure the sources converge on some basic points since I have so little background.

But since I'm much more knowledgeable about certain programming or mathematical techniques, I can do much quicker searches to refresh my memory since my BS filter is going to go off pretty quickly, and I can verify the truth of a source based on a more extensive background.

The fear mongering in this article requires you to assume that doctors are much more like amateur carpenters clicking on links at random rather than highly trained practitioners with years of education in their field.

soared said 7 months ago:

I have a friend in medical school who I asked about googling/etc, and he sent me a good article. Related and way less alarmist (quote from my link, not the article)

> Enter the online world of medical references that your doctor uses instead of Google: UpToDate, DynaMed, Current, and many more. These are medically sound, evidence-based databases that tell doctors most things they need to know to be able to treat just about any patient according to the most up to date guidelines.


arkades said 7 months ago:

Jfc no one is learning surgery from a video. A resident looks up an article or a textbook chapter, watches a video, then assists - and when they’re assisting, they’re better prepared because all of the above. Then they watch a video to refresh. If the video is nonsense, they’ll know right quick. They’ll assist many times before they take lead, and will take lead with a supervisor many times before ever going solo.

The headline makes it sound like someone is watching a YT video and then walking into the OR to perform an operation.

strstr said 7 months ago:

There's a pretty cool "journal" called JOMI [0], which is basically peer-reviewed videos of doctors performing common procedures. I actually watched one of the videos there to assuage my fear of a fairly routine arthroscopic procdure.

I suspect this is the type of thing most doctors are interested in seeing people rely upon, rather than youtube. It's been vetted for quality. There are obviously downsides (getting procedures to appear on this is more complicated than just uploading a video to youtube), but it seems much harder to question the quality.

[0] https://jomi.com/

swiley said 7 months ago:

I used to really dislike youtube because I thought there was nothing but people goofing off and ripped TV shows on it.

Honestly people are doing serious research on it, and besides that you can get lectures or even just friendly monologues/QAs from experts on almost any subject. It was MIT's math videos that convinced me to start watching it, after that I found some of my favorite proffessor's lectures there too along with a lot of graduate level stuff from other universities. Then there where all the videos from amateur and professional scientists and musicians and so on. The basics of my personal understanding of music theory came from a nearly century old book I found in a used book store but it's grown a lot thanks to youtube.

I hate that it's controlled by a single company, and that they keep tearing down the chemistry channels but while it's still no substitute for reading papers when you get into really niche subjects (ex: molecular dynamics and computational chemistry) the educational side of youtube is surprisingly underrated.

m0zg said 7 months ago:

The good ol' "Google the Stack Overflow" method. Except when advice is bogus people die. I frankly held doctors (and especially the very generously paid US doctors) in much higher regard until I got older and had a chance to seriously interact with a few. As far as I can tell unless the situation is blindingly clear (in which case Googling the symptoms works about as well as a doctor), they're basically guessing, often badly. To give just one example: I was once suggested a shoulder surgery (with a 6+ mo recovery period) based on an extremely blurry MRI of my shoulder where I'm pretty sure the doctor couldn't really see anything. Because why the hell not take another $20K in revenue for his practice, right? Ironically the shoulder pain went away in about 4 months after I switched my sleeping position.

I now basically avoid doctors other than for the yearly checkup or if there's something serious that Google can't fix (broken leg, or a prescription).

caycep said 7 months ago:

there isn't a "textbook" for a lot of these. AS a resident, we basically used a combo of pubmed, uptodateonline.com, and a lot of it was the time spent w/ older docs and gleaming bits and pieces of info from whichever patient happened to roll in or were scheduled that day. Haphazardly stochastic way of learning, but there it is....

nycbenf said 7 months ago:

I recently finished cardiac rehab but when I was on the waiting list to start my PCP told me "Just google cardiac rehab, find some videos and do them." The videos I found were from the NHS. They were very different from what cardiac rehab in the US was like, but they got me up and moving.

wilgertvelinga said 7 months ago:

A more curated and probably high quality alternative for surgeons and others in the operating room: https://incision.care

zby said 7 months ago:

OK - a lot of answers here are about "doctors using online resources to fill up their knowledge gaps is totally normal" - which is a fine point. But the article is about a particular online resource not known for an a priori high standard. The more interesting question is "How can doctors tell which videos are valid and which contain bogus information?" - and it is actually a quote literally taken from the article. The situation is not very good:

""" For instance, one recent study found more than 68,000 videos associated with a common procedure known as a distal radius fracture immobilization. The researchers evaluated the content for their technical skill demonstrated and educational skill, and created a score. Only 16 of the videos even met basic criteria, including whether they were performed by a health-care professional or institution. Among those, the scores were mixed. In several cases, the credentials of the person performing the procedure could not be identified at all.

Even more concerning, studies are finding that the YouTube algorithm is highly ranking videos where the technique isn’t optimal. A group of researchers found that for a surgical technique called a laparoscopic cholecystectomy, about half the videos showed unsafe maneuvers. """

Online epistemology is more and more important and while our culture is trying to catch up it is still behind. There is lots and lots of important phenomena (for example https://www.gwern.net/Littlewood).

By the way patients are also using online resources and encounter similar problems: https://medium.com/@zby/rational-patient-community-6d3617dff...

bashwizard said 7 months ago:

I had an anaphylactic shock a few years ago and started googling the symptoms (no, I didn't have cancer after all) and ended up realizing very quickly that I should probably go to the ER and get some antihistamine, so I did. The day after I booked a meeting with a doctor and while sitting there talking about my symptoms and reasons for getting the anaphylactic shock the doctor was on google and even the same web site I was looking at the day before.

So I told him "I already know that because you're basically just reciting the very same web site I was looking at yesterday before going to the ER but I felt that I should see an actually doctor about it. So do you have any clue what could have caused the shock or should I just pay close attention to what I eat, drink etc just like it says on that web site and hope for the best that I find the food that I'm allergic to?"

He had no clue. Thank god for free healthcare (oh well, tax paid universal healthcare) in Sweden.

mc32 said 7 months ago:

I just hope the “courseware” isn’t random videos with unsubstantiated claims.

That is to say I’d hope what they are watching is current and medically accepted information.

The article does claim that most of the ones accessed by profs are produced by professionals in their field —apparently in an effort to market their skills and help other professionals...

But one would hope there is some vetting going on.

Vysero said 7 months ago:

YouTube got me through engineering school. This is just how people learn now. Books have their place but in reality I think YouTube and videos in general are a much more versatile learning tool for students or anyone for that matter. Personally, I am glad doctors are taking advantage of this new and incredibly valuable resource.

bartread said 7 months ago:

I don't really see why this is surprising or horrifying: I turn to YouTube all the time to fill gaps in my knowledge, or watch talks/lectures (I've been enjoying Strangeloop recently, along with assorted DIY content).

As for quality control, this is what our critical faculties are for. I have no data but suspect good critical thinking skills correlate well with being a good doctor, so I don't worry about these people picking up information from YouTube.

Bringing this back to programming, others have mentioned StackOverflow. StackOverflow has descended into a cesspool of crowdsourced ignorance but nevertheless it's still possible for competent developers to find useful information there.

On the flipside, if StackOverflow disappeared tomorrow, all the bad programmers finger-vomiting garbage "information" across every question would continue to be bad programmers.

jonwachob91 said 7 months ago:

10+ years ago if you weren't familiar with the procedure you were performing, you'd just read a medical journal article about that procedure ( one that had been vetted by a peer-review process ).

10 years from now, will we see high level research from CERN being published to YT before it goes to Nature (or some other journal)?

zelon88 said 7 months ago:

The problem that I see is not so much that the quality of videos on YouTube is lacking, it is that the quality of officially sanctioned videos is lacking. Or that the availability of officially sanctioned videos of high enough quality are not readily available to the masses.

> ..."The researchers evaluated the content for their technical skill demonstrated and educational skill, and created a score. Only 16 of the videos even met basic criteria, including whether they were performed by a health-care professional or institution."

As I understand it; professionals compared the techniques used to the techniques as they are taught in classrooms and textbooks and found that the techniques used in the video would not have resulted in a passing grade in a classroom environment.

Assuming that is true then the root cause isn't low quality YT videos. That is a symptom of the problem that the learning materials provided in classroom environments are not providing enough educational value to students in the first place.

I'm not in the medical field, but I've watched the struggle and politics of people fighting through medical school. It is grueling. If it's anything like tech then maybe 65% of it will apply in the real world and 15% you won't ever need to use in the first place. It's also going to be loaded with advanced technical jargon and put an incredible cognitive stress on students to teach otherwise simple, menial tasks while stressing statistics and verbatim policy while completely losing the spirit of those statistics and policies.

So to fix the issue, researchers should be studying these YT videos to determine what makes them so informational and engaging.

With car or computer repair videos people familiar with the subject matter will skip the non-essential information, focusing cognitive resources on the parts they need to clarify most. Students can focus on their own deficiencies without having to waste energy on arbitrary and irrelevant information.

ratfaced-guy said 7 months ago:

Is there a Stack Exchange site for medical professionals? If not, why not?

Mathnerd314 said 7 months ago:

> Medical experts say this content hasn't been particularly well curated, in part because it's an expensive process.

There are lots of paid medical video sites, e.g. a quick search turns up https://www.madeformedical.com/ and https://cine-med.com/. Presumably these are better curated than YouTube and may even go through some type of peer-review process.

ssully said 7 months ago:

I have a feeling this is common in nearly every field these days.

While not equivalent to a medical procedure, I had some furnace issues last year. I was able to do a lot of repairs myself with a mix of reading forum posts and youtube videos. I ended up having to call a furnace tech for an issue that was outside my comfort area at the time, but I was still able to communicate my issue with him more intelligently because of the knowledge I learned from watching a few videos.

wnmurphy said 7 months ago:

When I see my doctor, there's an understanding between us. We both know that professionals like software engineers and doctors look up the answers constantly. I don't expect him to know everything, nor is that even possible. I do trust him to know how to find the right answer, and think structurally through a set of symptoms, and debug them.

GordonS said 7 months ago:

I've had GPs and consultants alike google all sorts of things (even opioid conversion charts)... I have to say, I don't like it! I know they can't know everything, but quite often it feels like it's something they should know, or at the very least have a trusted source/calculator bookmarked for.

dillonmckay said 7 months ago:

Here is a Harvard Business Review podcast that discusses how new doctors train for robotic surgery.


barkingcat said 7 months ago:

Who in this day and age and in a job that gives access to the internet doesn't use it for checking up on things for their job?

Developers do it on a near constant basis. Computer techs do it, secretaries use this, lawyers use it constantly...

martyvis said 7 months ago:

News at 11: Professionals (and everyone else) uses the internet to plug gaps in their knowledge. (We used to make do with books, journals,schools, guilds, coffee shops)

sharadov said 7 months ago:

I am pretty sure there are quacks in certain parts of the world who are seeing these videos and performing surgeries on people.

booleandilemma said 7 months ago:

Would you want a doctor that does not go to YouTube/Google for gaps in their training?

Are you assuming they’ll have no gaps?

vmchale said 7 months ago:

They only mentioned VR for surgeons in passing, but such a development would be interesting.

jeffreyrogers said 7 months ago:

I know a surgery resident who says it's common to google info during surgeries.

chris72205 said 7 months ago:

Perhaps they will call this curated content "YouTube Med"

chewz said 7 months ago:

Good move. Patients are doing this for some years now.

take_a_breath said 7 months ago:

Doctors are just like the rest of us!!

asimovfan said 7 months ago:

Yes. This is what internet is for.

codingslave said 7 months ago:

Doctors are the most overrated profession of all time. Before any kind of diagnosis, medical procedure, or conversation about anything specific, I do a ton of research. I read the latest publications, the drug interactions, the human biology, etc. When I go in there and question the doctor, they usually dont know the half of what I bring up. They prescribe the same thing to the same set of symptoms basically every time, without much capacity to take in the nuances of some condition. These people need to lose their status in American society and be brought down to skepticism, half of the doctors in hospitals became doctors for the status. Computers cannot replace these people fast enough, I trust very few. If anything, I think that the recent trend of data driven medicine will expose the medical industry for what it is, most of these drugs and procedures have no positive effect on the patients. In a ton of cases, the outcomes and long term ramifications of different treatments are never recorded and analyzed on a wide scale. Very few drugs we have do anything at all but cover up the symptoms.

faissaloo said 7 months ago:

What might it take to create medical hackspaces?

buboard said 7 months ago:

just don't let big pharma find out!

williesleg said 7 months ago:

I'm finding a lot of "do the needful" doctors these days like H1B programmers, they just do the needful in order to get you shuffled out of there.

mrtweetyhack said 7 months ago:

Reassuring news

wso said 7 months ago:

Please don't

said 7 months ago: