Posted by: notdeaddinosaur | February 27, 2015

Crowd Sourced Suckers

“What do you think of this?” writes a friend:

…[A]n untraditional approach to medical diagnosis that is helping solve the country’s most difficult medical mysteries and creating real miracles.

This is the description of something called CrowdMed, the latest version of getting doctors to provide services for free. Thus my short answer about what I think of it: not much.

To be fair, and because I had a few minutes of free time, I went and checked it out. Patients submit questions about their medical condition(s), accompanied by varying levels of supporting detail, and “medical detectives” offer their opinions about possible diagnoses and/or other courses of action.

Are all these “detectives” doctors? Um, no:

Our Medical Detectives include medical students, retired physicians, nurses, physician assistants, chiropractors, scientists, naturopaths, and regular people who enjoy solving medical mysteries. We believe in the wisdom of crowds, not just individual experts, as you never know who will provide the insight that leads to a correct diagnosis or cure. We recruit Medical Detectives from a broad range of medical and non-medical backgrounds to assure cognitive diversity.

Right. Because regular people, presumably with access to Wikipedia and perhaps Up To Date, in large enough numbers, are just as good as doctors; maybe better. Really? “You never know who will provide the insight that leads to a correct diagnosis”?? Even a broken clock is right twice a day.

Ah, but this site actually pays. Well, offers financial compensation. How?:

Point rewards and cash compensation offered by patients are awarded to those Medical Detectives who contributed and/or assigned points to the best diagnostic or solution suggestion as determined by the patient or their physician, divided up according to each Medical Detective’s overall point winnings on that case. Patients may also direct up to 80% of their reward points and cash to named Medical Detectives who they found to be most helpful. Note that CrowdMed collects 20% of cash compensation offers as commission.

Huh?

Well, where does the money come from?

Where it always does, ultimately: from patients. Anywhere from $99 to $499 depending on how long you want to let the Crowd have at it, whether you want to limit input to just the top tier “detectives,” or have a moderator involved.

There are other sites that try to rope doctors into answering patient questions, like this one. Most of the questions fall into one of these categories:

  1. Just google it.
  2. What the hell are you talking about?
  3. What on earth are you doing at a computer/get your ass to a doctor!

To its credit, CrowdMed tries to offer as complete a clinical picture as they can. But in perusing their cases, I always find myself wondering what the patient is leaving out, even inadvertently. Nothing online can take the place of actually sitting a room with a patient face to face.

So why do doctors go online and answer questions from strangers for free?

At first, you just want to help. Just a few simple words to ease someone’s mind. But then you find yourself carefully crafting those answers, and before you know it, an hour is gone. Points! Ratings! Levels! Increase your score! The competitive urge starts kicking in. Solve the case and level up!

But not for long. It’s as much of a time sink as cats on YouTube, and not nearly as adorable.

“Medical Mystery” is a literary term, not a clinical one. Doctors discuss complex cases, or zebra diagnoses, or “patients with significant psychiatric overlay.” The truly elusive diagnosis is rare. Most of these cases are indictments of a broken medical system in which doctors are not given sufficient resources (mainly time) to both gather the necessary information AND mentally process it, ie time to think. It’s the hectic, workaday world of modern American practice that sends patients shuttling around to specialist after specialist, often repeating expensive tests for no rational reason. It’s almost a wonder that so many complex diagnoses are correctly made .

CrowdMed is just another way for non-physicians to siphon money away from sick people and the doctors who are trying to take care of them. No miracles to see here. Move along.

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Responses

  1. Hmm I find the premise of these medical detectives disturbing because their advice could cause more harm or even death. Over here in Australia because of the vastness of the continent there are people who live in very very isolated and remote areas. (Some cattle properties are larger in physical size than some European Countries) These people are linked to doctors (proper medical doctors) via the internet using programs like Skype where there is vision and the treating doctor can see the person and make a triage judgement on sending the Royal Flying Doctor Service to either pick them up and bring them to the remote area clinic or hospital. I worry that these “medical detectives” will undermine this as many living remotely are reluctant to leave their properties. I hope it doesn’t become too popular over here.

  2. All I can say is, “Ugh!”

  3. Reminds me of this Jimmy Kimmel monologue, which actually is better than the video he put together at the end: http://aboveaverage.com/2015/02/27/jimmy-kimmel-got-a-bunch-of-actual-doctors-to-tell-off-anti-vaccinators/

  4. Oh. My. Goodness.

  5. I just became aware of your site, and I must tell you I love your approach; I love your manner. You aren’t a dinosaur; you’re insightful and knowledgeable — a resident expert if you will! stevenvonloren.com

  6. If the patient suffers as a result of the CrowdMed diagnosis can the medical detectives be sued for malpractice?


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