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With the change of scope for this site, I am wondering if we should be more strict on Personal Medical Advice questions.

What sparked my question was CBC showing Metamyelocytes at 2% (normal range is 0%) which was originally a Medical Advice question regarding the OPs daughter. The question was edited and now that 90% was redacted, the length and content of the question now makes it a very low quality question with no prior research.

Due to the way we have been trying to improve this site, we have become more strict on requesting prior research. We have even been discussing this in this meta and along with some others, I have been actively encouraging new questions to have information on prior research.

What should we do with this question and future questions of this type? Prior to my comment I left on the question regarding lack of prior research, I voted to close for personal medical advice as that was the original basis to the question and I still think it should be closed for this reason.

If there was indication that there was prior research with reputable sources etc. I would have been inclined to allow the question to stand in an edited form with personal advice elements removed.

The trouble is that most personal advice requests here are just that. There is no prior research and they are just after a quick answer which really and truthfully we cannot provide for safety sake.

What are others thoughts on this?

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    In the question here on doctor-patient communication, @Narusan said "Although there have been quite a few well-researched well-motivated questions regarding personal medical advice, we as a Community advocated to close them because we don’t want the type of answer those questions attract." I agree that personal medical advice questions should be closed unless there is ample prior research in the question to support a suitable question, in which case it is to be edited to make it fit the scope of this site – Chalmondley Nov 8 '18 at 8:21
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    I just closed it. See my comment on the question as to my reasoning. – Carey Gregory Nov 8 '18 at 15:55
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Such edits are clearly conflicting with OP‘s interest. I would have rejected such an edit if it came up anonymously in an edit queue.

I think the appropriate solution would be to ask the 90% redacted question yourself, or comment and explain to the OP how it can be salvaged.

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    I agree. It was a mistake to try and edit it into something it wasn't. – Carey Gregory Nov 9 '18 at 6:08
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I'm going to start my reply and add more later when I have more time.

I have been struggling to find a clear rule for whether a question that starts as personal advice could be salvageable or not.

I'll use a couple of recent questions to illustrate why one I rewrote/answered, and one I VTC'd without any intention to reopen:

With a question like "is the anorgasmia side effect of lithium permanent?" I see it as a common general complaint, and because there is high risk to an individual if they discontinue medications due to side effects that are likely treatable, I felt it was straightforward and worthwhile to rewrite and answer it. Of course, including "talk to your doctor" since there may be something additional going on.

However, with a question like "what can I eat for this raging hyperthyroidism?" I would not even want to try to generalize it, because something like Grave's ds can be a potentially sight-or-life-threatening situation if not properly and promptly treated by a medical professional. Giving any information that suggests it's self-treatable would be potentially harmful, so I voted to close right off the bat.

What I'm working on is an algorithmic approach to differentiating between these sort of situations. I hope to find some way to summarize it in a clear way!

Of course, this always depends on whether we have the time/energy/stamina to take the initiative to revise questions ourselves, or to hand-hold guide the OP to do so. I do not think we should expect each other to do so. But if one of us manages to generate a spark of energy about a topic of interest and wants to revise a question, then I think there should be a way to make it a little more straightforward...

  • With the sexual dysfunction question, I can see the logic on editing as there is indication of prior research as talked about by others including myself. Looking at the edit, the OP didn't mention the fact that the dysfunction is a side effect of depression so that is an addition via the edit, but otherwise the edit didn't change the crux of the original post. I asked a similar question in 2017 and therefore can agree it is a common general complaint and to me you.... – Chris Rogers Nov 12 '18 at 10:02
  • ....salvaged a question which could be safely salvaged. I agree with the hyperthyroidism question being closed and left closed as answers to this question can be life threatening. – Chris Rogers Nov 12 '18 at 10:05
  • The most important aspect here is that OP fully agreed explicitly on the edit. We seem to judge motivation (personal) too much instead of actual form and content – that can be achieved, despite motivation? – LаngLаngС Nov 12 '18 at 11:03
  • Which is why everyone so far seems to me to agree that if there is no prior research to support editing it gets closed as personal medical advice @LangLangC – Chris Rogers Nov 12 '18 at 13:39
  • To avoid talking past each other: I agree to put those "on hold" (via VtC) entirely. It just is my intention to clarify that while up to my answer here the rule of thumb of "close&forget" (please, do not edit ever) seems to have been the bottom line of it. To repeat: some can't, some shouldn't be edited, but some "can be" and I guess the more general goal for the future should be most should be edited into compliance if possible here. I may have misread that tendency, I may have put my thoughts on the too-inclusive end in word choice. – LаngLаngС Nov 12 '18 at 14:39
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Excellent question and I now think the answer is a resounding no. We should not try to edit requests for medical advice into something they're not.

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Q Should we edit Personal Medical Advice questions?

Is a general question and less about the concrete examples prompting this meta discussion. As such we should make the distinction between fixable questions and unsalvageable. It seems quite self evident that plainly unfixable questions are not the real topic here.

It seems quite clear that we should not just shoot down all questions that appear as personal advice/medical advice. They should be put on hold quickly and we should try to help OP to get the question into on-topic area.

As one of our residents put it:

I think this is another way we need to approach the floods of "diagnose me" "advise me" questions. If we only downvote, it doesn't help the dilution of good questions. This way we pull out the good in their question and increase the % of good questions. Also, sometimes the answers to downvoted questions are great and deserve a good question stem!!

Please, those who have downvoted, look at questions that have been revised and see if it deserves an upvote instead! If not, consider revising it.

And another professional had this say:

To edit or not to edit?

I happened to look at the front page and saw an interesting (to me) question which was appropriately closed as seeking personal medical advice. I edited the post to remove that aspect.

To which yet another pro added:

Any question can be potentially re-opened in this fashion, but this becomes very old very quickly.

While it was a "total rewrite" it really fixed the post. Consequently the post in question became: "Post Reopened by Graham Chiu, DoctorWhom, LangLangC, Chris Rogers, bertieb"

Of course this should be accompanied ideally by the OP further editing the question to comply with guidelines. But if OP cannot or simply will not edit then I see no reason for any of us not to edit the question. If anyone feels like she is up to it, I'd say "go ahead". I thought we only abstained from these edits as they were too strenuous on our time budgets. If that's the case, just do not edit. But if you see value in the de-personalised core of the question, you have the time, do edit. It then may need further edits by the OP. But we should not take pride in closing questions. We do that in desperation, I hope, at least.

Removing the personal/diagnosis/advice aspects is a first start to help users, we should try to do that. If that leaves the question in a poor state it is at least not as bad as before. The example was personal and lacking research. Now it's still lacking research and not personal. That is an improvement according to our standards.

We cannot fix them all, as they are so many. We cannot fix them all as some are really beyond fixing. This post is not about an encouragement to edit every post into admission. This answer merely suggests that we are a better site if we try to keep fixing posts. We even have a canned comment for that Question: medical advice question but potentially salvageable.

The home page is now full of "holds" and "closed" signs. Considering the transition that is a good sign. But it will not be a good sign in the future. It will remain a judgement call. But if you think you can fix it, then edit.

Very sadly I ended up being the top close voter on this site. That really makes not for a nice statistic. It is nothing to be proud about. Although I strictly distinguish between "put on-hold" and "close". Ideally in "on-hold" the OP continues to work with us to improve the Q.

This is just to emphasise that we should not shoot down everything "and forget about it". For the example, Carey's edit was a good start, not "a mistake". Well, in my opinion.

As canbe found on several meta-meta posts:

"Please note that once you post a question or answer to this site, those posts become part of the collective efforts of others who have also contributed to that content. Posts that are potentially useful to others should not be removed except under extraordinary circumstances."

And a reminder from our own How to ask page:

Personal medical advice questions are off-topic here on Medical Sciences.

We care! And that is why Medical Sciences cannot give individualized medical advice or diagnosis for multiple important reasons! Such questions will be revised or closed.

If we don't manage to do that for resource reasons then that's one thing. But we should not give up this goal. If we declare shooting down to be our principle then that is a mistake. "Be nice" would be fixing more questions and get them re-opened.

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    The post you cited by anongoodnurse was a complete rewrite. She basically wrote a brand new question with none of the original question remaining. I don't think we should be doing that. If some fairly minor changes will make it on-topic and there is some level of prior research, that's fine. But I don't think we should be rewriting questions. If it's an interesting topic then just write a new question. – Carey Gregory Nov 9 '18 at 20:20
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    On top of what @CareyGregory said here, where you said "Now it's lacking research and not personal. That is an improvement." because it is lacking research it still should be closed so what benefit will editing make? Surely an edit should only be done in order for a question to be saved from closure due to the fact it can be helpful to others? Questions without prior research helps neither the OP or anyone looking to answer the question as the OP may not have a good grounding for the answer or the answerer may be just repeating non-declared research which is not understood – Chalmondley Nov 9 '18 at 23:58
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    @Chalmondley I strictly distinguish between "put on-hold" and "close". Ideally in "on-hold" the OP works with us to improve the Q. this is just to emphasise that we should not shoot down everything. For the example, Carey's edit was a good start, not "a mistake". Well, IMO. – LаngLаngС Nov 10 '18 at 0:05
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    @LangLangC - When talking of question closures it is a case of semantics. On-hold questions are closed questions and are treated as closed in the SE system, hence you can call up a list of held questions by filtering for closed questions – Chris Rogers Nov 12 '18 at 10:18
  • @ChrisRogers Correct. And that is quite unfortunate terminology & practice. On-hold means really/for me: subpar Q, prevent premature answers now, time to improve, nudge the OP. Closed means OP didn't respond, no-one edited to improve, Q remains bad, no answers allowed, everyone lost interest, may be deleted if badly voted upon. – LаngLаngС Nov 12 '18 at 10:39

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