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Proposal: Health

I've been keeping an eye on this for months now, wondering to see if it would take a strong direction. I don't see it yet.

Mainly I'd like to know if medical questions are going to be allowed here, for example, "I've had this rash on my feet for 6 weeks. I was treated with miconazole cream, but it' getting worse. What's the next step?"

Are these kinds of questions going to be off topic?

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Personalized medical advice is problematic in many ways, and I don't see how it would make a good SE site. SE sites work best if the questions and answers are useful to future visitors, a personalized diagnosis doesn't fit that idea. They are also impossible to do well, I'm not a medical professional, but from what I understand a remote diagnosis without examining a patient, with no access to previous medical history and a likely very incomplete description of the issue from the patient is irresponsible in many cases.

We can't prevent people from treating answers on the site as medical advice, the only way to do that would be to not create the site in the first place. But questions asking for personal medical advice simply are not good questions for an SE site, that is a sufficient reason to disallow them.

I fully expect that the site will have to establish a Skeptics-style citation requirement for all answers. Health topics tend to attract a lot of problematic answers on the internet, and this proposed SE site likely won't be an exception. Such a rule can help a lot with removing low-quality answers and increase quality at the expense of being rather hostile to new answerers.

  • As with my comment to the other answer, I say again: there will be a huge amount of overlap between a "personalized diagnosis", and a general diagnosis of a condition that could well be useful to future visitors. I say we should err on the side of NOT closing questions, unless they are unambiguously personalized and cannot be reworded adequately. – Jez Jan 19 '15 at 0:50
  • @Mad Scientist I completely agree with the citation requirement, that would be critical to success. The site would ideally display a concise, simplified FAQ about what constitutes good evidence: for example that PubMed = peer-reviewed journal articles, Medscape and UpToDate = peer-reviewed compilations, and MedLine = NIH. (Vs. sites more likely to be biased or incomplete, like company or ad-supported websites.) And that small studies, case studies, and anecdotes are usually much weaker than large studies that look at many people. Etc – DoctorWhom Jan 29 '15 at 11:02
  • @Jez see more below - I agree with you that there is overlap with general information, and much is very valuable, but there's a fine line about personalized advice, and not everything is generalizabile. It will need to be carefully monitored or we risk perpetuating misinformation. "Do no harm." Health is a complex science, and it often takes more than intelligence/common sense to discern good from bad advice - or know whether advice applies to one's unique situation. If we can't have people prove their qualifications, citations will help raise the standards. But we must be careful. – DoctorWhom Jan 29 '15 at 11:12
  • @DoctorWhom Yeah, but I can see people getting really over-zealous on closing question because it's "too personalized", which would really suck. It already happens on places like StackOverflow and Programmers.SE; people regularly comment that perfectly good questions (with useful answers which helped them) get closed because of this obsession with closing stuff that "might theoretically get subjective answers" or something, and I'd like to try and avoid that on this site. – Jez Jan 29 '15 at 11:46
  • Definitely continued discussions on where to draw that line will be important. I am more cautious now than I used to be, now after having seen countless misinterpretations of medical information. There are usually many factors that have to be taken into account, and often people leave details out that are important. – DoctorWhom Jan 29 '15 at 12:02
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Yes, seeking personalized courses of treatment for a specific health issue would have to be off topic.

I foresee this one being abused a lot — people incorrectly closing any question even vaguely related to health issues and treatments — but in this case, it is pretty clear cut.

The phrase "for… anyone with health-related questions" refers to people interested in learning about health. But a Health site is not a replacement for the personalized medical advice you would receive from your doctor when seeking specific medical treatments tailored to your situation and condition.

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    My concern is that this will be the most frequent type of question we'll get. As a medical professional, that kind of question will be a real problem. Unqualified people give bad advice when these aren't promptly closed. What do you anticipate happening if these are 70% of your questions? – anongoodnurse Jan 15 '15 at 14:27
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    @medica Then 70% of the questions would have to moderated and closed. If they're not, the site wont be making the Internet a better place for this subject and the site would be closed. – Robert Cartaino Jan 15 '15 at 14:38
  • @medica Possibly the closest similar site is Pets.SE which has Nearly 300 pet health questions we have found that most questions that are written as personalized can be reworded to be wider. – James Jenkins Jan 15 '15 at 15:38
  • Robert, your response seems quite dismissive. Surely there will be a lot of overlap between personalized advice and general advice about a question. I think we should try to keep as many open as possible. And, shouldn't it really be the community determining this rather than you? How does aggressively closing questions cater to "anyone with health-related questions"? – Jez Jan 18 '15 at 2:00
  • @medica As for your concern, the "bad advice" is meant to get voted down by the community on StackExchange sites; that's the whole point. – Jez Jan 18 '15 at 2:07
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    @Jez - bad advice is often given in comments, which cannot be voted down. Comment wars ensue, which are unpleasant. Also, how does the average internet user, like yourself for example, know good advice from bad? They don't. They will accept the advice thet most appeals to them, not the best advice medically. – anongoodnurse Jan 18 '15 at 2:14
  • @RobertCartaino - I hope you see an indication in this thread of the direction that concerns me. – anongoodnurse Jan 18 '15 at 2:18
  • Don't troll, @medica. You could make this same argument for any of the StackExchange sites; "what if people follow bad advice in the comments?" Should we just shut them all down? Are you being purposely obtuse as to how StackExchange sites function or something? – Jez Jan 18 '15 at 17:25
  • @Jez - I am far from trolling. This is a sincere concern I have about this site and I'm glad to see the feedback I've gotten. nor am I being purposely obtuse. That is not my forte. – anongoodnurse Jan 18 '15 at 17:31
  • I am medical professional too, and I see 2 types of health/medical sites that should exist on StackExchange. Neither involve personal medical advice (I will explain why later). The 1st site should be general discussion of all health topics, in which anyone would participate. The 2nd site should be the medical version of StackOVERFLOW - specifically for students/ practitioners/ experts of medical professions to refine knowledge and understanding of pathophysiology, diagnoses, treatments, and current evidence-based topics. The medical professions NEED a StackExchange. – DoctorWhom Jan 29 '15 at 9:11
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    Personal medical advice is often (not always, but often) unsafe online because of the inability to obtain the full history/physical necessary to make appropriate recommendations. Also, there is no way on SE to validate whether someone is qualified to answer a question. Health is a complicated science, and incomplete education on a topic can be harmful or fatal. I myself used to be upset that doctors/nurses wouldn't answer health questions online, until I entered med school and realized how complex it is. I love offering general advice and information, but personalizing it can be dangerous. – DoctorWhom Jan 29 '15 at 9:26
  • Look at HealthTap as an example - anyone can ask ?s, but you have to register an account with your medical license information before answering ?s. You can feel secure that the person answering your question at least completed training and passed exams. – DoctorWhom Jan 29 '15 at 9:54
  • Btw it's not an issue of doubting anyone's intelligence or common sense. Discernment of good/bad advice in medicine is not always straightforward, and there is a LOT of misinformation out there. I had a different career before medicine, and I made some bad partially-educated health decisions from reading online forums. Learning correct health information has empowered me to make better decisions, and educating people about health is my favorite part of medicine. Which is why I would participate on both sites! But there is valid concern about people seeking/answering personalized advice. – DoctorWhom Jan 29 '15 at 10:36
  • @DoctorWhom On the other hand, I've read various accounts over time of how people got one recommendation from a doctor, or a really bad prognosis, and they went and did they own research and figured out a better course of treatment. Being too restrictive about who can answer would curtail the ability for these people to give their suggestions. You talk about bad advice being potentially fatal, but people don't have to follow the advice on this site. I'd agree with a big legal disclaimer along the top, but not on aggressively closing questions or restricting answers somehow. – Jez Jan 29 '15 at 11:50

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