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People come here to ask about queries related to their health. If doctor is so easily available nobody has to go online.

But I see most of the time, giving medical advise is being refrained from and OP is asked to see a doctor.

So why can't the community start giving medical advices as well?

  • 2
    Great question, deserving of a thorough answer. Please do read it. I'll try to make a TL;DR version at some point. – DoctorWhom Aug 13 '17 at 4:42
  • I've edited the tag to include faq-proposed because I think this is a great answer we should link to our FAQ. – Narusan Aug 19 '17 at 10:28
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SE is not going to start giving individual medical advice, for many reasons.

I absolutely do understand why people want answers to what is going on with their health. That is part of why I chose my career, to understand my health and help other people understand their health. And that's why I'm on SE.

I also understand why people don't understand why they can't just ask for advice; most underestimate everything that it takes for someone to give accurate, complete advice, and others don't understand that people have tried to blame the answerer for harm that has come from even well-intentioned advice.

There are Q&A sites that allow any questions and any answers, advice or otherwise.
There are Q&A sites where the people answering questions are physicians with validated credentials, and you have to provide a lot of your background to even ask a question.

HealthSE is neither of those site types, for multiple reasons.

Consider that on StackOverflow, if someone gave wrong advice, it could mess up a program and you'd have to troubleshoot. There are tons of programmers and it would be downvoted by other knowledgeable programmers. Time wasted but minimal harm done.

But if someone gave you wrong health advice you could get sick, overlook something that was actually important, even die. Actual harm. And there aren't enough medical professionals here to recognize all wrong advice and downvote it.

Note that I am going to use the term "wrong advice" rather than bad. I'll define wrong as: inaccurate/incorrect information and/or inadequate/incomplete information

So consider these questions:

  • Would you want to risk getting wrong advice? Advice that could harm you if you followed it?
  • Are you educated enough in health to be able to KNOW if the advice you received is wrong, whether you should follow it or not?

The internet is full of misinformation. Not out of intent to mislead (most of the time), just not evidence-based or well-educated.

That's the first point I need to make:

1. Adding a person's clinical background to a question CONVERTS a general health topic question into a request for personal medical advice.

You may think additional clinical context makes it easier to answer a question. But when you start to take clinical context into account, that's how individualized diagnosis and treatment works. It's individual advice then.

If this isn't clear why, keep reading to understand better.

Second:

2. People underestimate just how much education and experience it takes to be able to GIVE accurate, complete medical advice.

Human physiology and pathophysiology are ridiculously complicated. To be a practicing doctor it takes 4 years of college, 4 years of med school, and at least 3-7 years of residency (in the USA and is similar around the world). That means 11-15 years of intense education after high school. Plus it's said that healthcare professionals learn the most during the first few years out of training!

Okay, so what about non-physician health professionals? Minimum post-high school education for a PA? 8+ years. Pharmacist? 8+ years. Nursing? 3-4+ years. EMT? 1-3 years. Physical therapist? 8+ years. Dietician? 6+ years. Okay, then what about specialists in scientific fields? Bachelor's degree, 4+ years. Master's, 6+ years. PhD, 8+ years...

Yes, there are not enough doctors and other health professionals; this massive shortage is a failing of our education and health systems. It should be a priority when our governments decide how to allocate funding, but it isn't, so welcome to the consequences.

But the solution isn't to seek advice from those who are not trained to give it!

Which brings me to my third point:

3. People don't understand what it takes to give accurate, complete advice - what makes it so hard?

  1. Yes, first there's the massive amount of information - human physio/pathophys is exceedingly complex and must be understood to formulate a comprehensive understanding of how it all works together, since the body isn't just a collage of individual pieces.

  2. Because it's more than just pieces, there are lots of things that could impact your health, interacting and complicating the picture:

    • Current/past medical and surgical history
    • Medications, supplements, smoking/drinking
    • Family history and predisposing factors
    • Environmental factors, occupational hazards And more
  3. Because it's more than just pieces, there are a lot of factors that have to be drawn together to make a complete picture.

So a healthcare provider needs to understand the full picture to be able to understand what's happening in a certain circumstance. That's why they ask you the above. That's why they measure your vital signs. That's why they examine you. That's why they do tests. It's to build a comprehensive picture and then identify what is going on.

And it takes years of education and practice to develop the knowledge and discernment to take this complete picture and work through the differential diagnosis process to land on an answer; then have the knowledge and wisdom to offer the right treatment.

I hope this makes sense. But to further illuminate, I'll give 2 examples using fatigue, a common complaint.

  1. You feel fatigue and ask "I'm fatigued all the time. What's wrong with me? What can I do about it?"

A well-intentioned person without medical training, who wants to help you answer the question, could think "Lack of exercise and dehydration are 2 causes of fatigue." Which is correct, but incomplete. So they answer "Poor sleep and dehydration are causes of fatigue. So get 30 mins of vigorous exercise a day and drink lots of water and you'll feel better!"

Sounds good right? And it would work well for some people, sure. But I'll give you one circumstance where if you did that, you'd get very sick or die.

You didn't tell her that you have Congestive Heart Failure after a Heart Attack and Chronic Kidney Disease stage 3; that you are on Beta Blockers and have a 2g sodium restriction, 1.5L fluid restriction, etc. So you drink 3L a day which fluid overloads you; meanwhile you exercise vigorously and become hypoxic from that; then with your history of cardiovascular ischemia the hypoxia exacerbates your ischemia and with increased metabolic demand while on the treadmill you have another heart attack.

Maybe you didn't include that in your question because you didn't know you had CHF due to a silent MI. Maybe you didn't include it because you thought it was unimportant to the issue. You aren't a medical professional either.

But she didn't know what she was missing, either. Maybe her answer was so good that you thought she was a medical professional.

Did she intentionally harm you? No! But did you cause yourself harm inadvertently? Yes. Did her answer lead to harm? Yes. Why?

  • Advice was given without having a complete picture to work from. You didn't know what info to give; she didn't know what info to ask.
  • Included only 2 of the possible causes of fatigue She didn't know the other causes; you didn't either and acted upon the answer.

This harm was avoidable by not individualizing the question or the answer.

  1. You feel fatigue and ask "I'm fatigued all the time." And you give a lot of current symptoms and clinical history.

A medical professional here answers based on what you give, and gives you advice, which you follow.

But the picture was incomplete.

  • You didn't know what's important to include, and thus you neglected to mention some key symptoms that would have pointed the diagnosis in a different direction.
  • The person couldn't examine you and pick up on alarming features

The advice turns out to be wrong due to misdiagnosis from incomplete information. You could end up being harmed by following this advice, even if it was from a medical professional.

Medical professionals generally understand that under most circumstances, it's not a good idea to give individual medical advice online due to incomplete info and lack of physical exam, and don't do so here. But people without training don't understand this, and may give advice, which may or may not be dangerous.

We don't have a way of having ANSWERERS prove their credentials. We don't have a way for POSTERS to provide a sufficiently-complete history/meds/review of symptoms (or a video camera for exam). So the clinical picture is going to be incomplete for most situations. And thus insufficient for accurate, complete advice.

Then, since most posters don't know enough to discern whether all advice is accurate/complete or not, harm can happen. Sometimes when harm happens, the well-intentioned answerer gets blamed.

Therefore it is better to just avoid medical advice, and instead provide evidence-based answers to questions that do not pertain to an individual case. Then readers can use that information to guide their own understanding, and seek medical assistance where needed.

And if someone does need individual advice, beyond just understanding a concept, then they need to see a medical professional, or at minimum check out the site with credentialed physicians. Health is not really worth risking wrong advice.

  • 3
    We are trying to build up recommendations for next steps that are not individualized advice but guidance as to whom to ask or where to start when getting answers for individual problems. – DoctorWhom Aug 13 '17 at 4:25
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    +10000 If there were bounties on Meta, I'd spent all my reputation on this! – Narusan Aug 13 '17 at 6:02
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    Thx :) I've been wanting to write this for a while. I'm thinking we can create a set of explanations for the "why" that we can link to in our comments like "see your doctor, we can't give advice, here's more info [link]." I'll put a shortened version up sometime so that the text wall doesn't blind everyone. – DoctorWhom Aug 13 '17 at 7:08
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    This a fantastic answer :) Something we should definitely link to whenever a question is closed as a PMQ. – michaelpri Aug 16 '17 at 21:23
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    @michaelpri, DoctorWhom. Should we make this a Community Post and link it to the FAQ? – Narusan Aug 19 '17 at 10:25
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    Great answer! I think a link in the FAQ would be a good idea. – Carey Gregory Aug 26 '17 at 18:53
  • @CareyGregory Umm, just realised we don't even have a FAQ... We can include it in the How to Ask page though, see the other Meta thread. – Narusan Sep 4 '17 at 10:00
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    Literally one of the most informative posts I've read! It's unfortunate we can't help those who need it but based on what was said here, and yesterday by Narusan-in-coma and @LangLangC it makes sense why we should not. – Mike-DHSc Sep 16 '17 at 20:44
  • Regarding the example, shouldn't the person stop following the advices when they start feeling tired/hurt? – Ooker Oct 22 '17 at 4:16
  • Serious harm is often asymptomatic until it is advanced. – DoctorWhom Dec 15 '18 at 4:44
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    FYI- This is now the answer linked to in the close reason for personal medical advice questions. – Carey Gregory Dec 16 '18 at 21:42
3

As indicated in various parts of StackExchange the purpose of this site

to build a high quality repository of good questions and great answers.

And it's not necessarily to provide help to the person asking the question. That's why you get points for asking a good question and lose points when asking a question which is poor or indicates a lack of research.

So by their very nature, questions that ask for personal medical help are tightly focused and so are very poor questions as they lack generality. Almost all questions that are deemed off-topic on this account can be made general to a point that they become acceptable, but the person asking the question almost invariably fails to make the effort to do so. Sure, the community could do this for them, but this becomes old very quickly. And when the OP lacks the skills to do so, often they lack the skills to understand the answer when couched in medical terminology.

2

Here's yet another reason not to allow medical advice questions. Although this would only apply in the US state of Minnesota (so far), it could make physicians in that state liable for any advice they gave here. Are there other jurisdictions where this is true? I don't know, but it wouldn't surprise me if somewhere in the world it is.

MN Supreme Court Rules Physician-Patient Relationship is Not Necessary to Sue Docs for Malpractice

4/18/2019
In a case that could have wide-reaching implications for medical practice in Minnesota, the Minnesota Supreme Court issued a ruling on April 17 in the case of Warren v. Dinter holding that the existence of a physician-patient relationship is not a prerequisite for a medical malpractice action. Rather, a person may sue a physician for malpractice – even if that person was not a patient of the physician – if the harm suffered by the person was a “reasonably foreseeable consequence” of the physician’s actions.

https://www.mnmed.org/news-and-publications/News/MN-Supreme-Court-Rules-Physician-Patient-Relations

  • I'm guessing that a disclaimer would be sufficient to defend against this new standard, otherwise life is about to get quite interesting for the people who publish quack medical texts and diet books. – Bryan Krause May 7 at 16:03
-4

This site is not popular and won't ever be popular, since the totalitarian party line has already exiled or censored all the opposition. The only way to fix this is to break up the exchange for monopolistic conduct, which can be done in practice through proposing a new one via Area51 Stack Exchange.

See Break up Medical Sciences Stack Exchange for further reading.

The moment this happens, I'm switching to the new exchange and never coming back. Viva la exodus!

  • 3
    I bid you good luck to make the proposal happening. – Andrew T. Apr 22 at 18:37

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