You hear that a lot from doctor bashers. And you know what? Doctors do listen. But they choose to ignore a lot of what you say. Why? Because they have to. And that is in YOUR best interest.
In response to a reader who flames up the profession, I decide to tell you America, the ones who believe doctors don't listen why it is you feel so unloved. It's not because we don't care. It's because we know that 90% of what you tell us is not important to the diagnostic algorithms we run in our minds. We are trained to weed out extraneous information. And that upsets you dearly. Read on and you will understand...
If I had to take every concern of a patient "seriously" i would have no time to take care of serious concerns. Part of my job as a physician is to weed out important information from garbage. 90% of the information presented to me on a daily basis is garbage. That means 90% of what you tell me is garbage. You don't want to hear it but it's true. My ability to weed out extraneous from good information comes with my years and years of experience, my intense residency training experience and my basic skills as a physician.
You don't want to hear this, but it's true.
90% of what you tell me is not helpful. 100% of what you tell me is serious from your point of view. Do you see the problem here? My job IS to ignore a lot of the concerns you have because if I didn't, you would be seriously harmed, injured, mauled and broke from 1 million dollar technological work ups for every possible complaint you ever had. When I get an achy back, I don't rush off and get an MRI. When I feel a palpitation, I don't rush off and get an EKG. You see, a lot of what I do IS ignoring what you say in the clinical context I am given. I have to. Otherwise, you would experience constant serious bank breaking medical harm from constant technological interventions.
So yes, we physicians don't act on a lot of what patients say because that part is just as important, if not more important as the stuff we do act on. Now, you only remember when doctors ignore your complaints. However, you fail to realize that by us ignoring a lot of what you "complain" about, we save you. And you find it hard to understand that concept. We are not ignoring what you say. We hear you. We use our skills to determine that most of it is not relevent information. And we choose not to act on it. Rightfully so.
When you DON'T get that MRI for every head ache, you don't thank us for preventing your dye reaction.
When you DON'T get that stress test for every cardiac twinge, you don't thank us for preventing a false positive resulting in a heart cath and a pseudo aneurysm that requires surgery.
When you DON'T get antibiotics for 95% of all bronchitis, you don't thank the doc for not giving you a case of c difficile colitis resulting in your total colectomy and life long colostomy bag.
You only see the act of not acting on the information you say. You fail to understand the paths of acting on your information. The costs associated with acting on it in copays, complications, false negatives and bad data that will kill or harm you.
You only see an jerk doctor that doesn't listen to you.
I'm here to tell you point blank that if that's how you feel, you don't understand how we are trained to help you. And that reason is why I am a doctor and I know what information to act on and what to ignore. You simply choose to focus on YOUR wishes and YOUR complaints and choose to believe your doctor is ignoring them for all the wrong reasons or incapable of understanding your body.
Trust me. Everyone knows their body better than me. You are not alone or special in that regard. But you don't know how to evaluate your body like me. That's why you come to me in the first place. Your doctor is ignoring a lot of your complaints because we are trained to ignore irrelevent data in the clinical context. Even if you think it's the most important and most concerning complaint of your life.
That's why you WANT a doctor taking care of you. If you want somebody just to order tests on you, go to someone less capable of weeding out your good information from your garbage. There are lots of less qualified health providers that will do this for you. Prepare to accept the consequences of your wishes and actions. Prepare to pay for it. And remember the next time you get a complication from something that should have never been done. You will have wished your provider ignored you more often.
If all you want is someone to LISTEN to you, go talk to your husband or your priest or your neighbor. If you want someone take care of you, that means we ignore a lot of what you say, based on our expert opinion on how likely it is that your complaint is garbage information.
That's the truth of our profession. It's what we do for a living. It's what makes us great. It's what makes you hate us. It's what separates us from all other providers of care. Being able to separate your garbage from your gold mine is what makes doctor level training superb in all regards. It's why you should seek us out, no matter how how much you think we are ignoring you. We are in fact, saving you in so many ways.
If 90% of what we tell doctors is garbage perhaps it's important for the doctor to tell us that what we're saying is unimportant.
ReplyDeleteIt's insane to think that anyone would trust a doctor with their care or their children's care if the doctor acts like they don't give a damn.
So we may be telling you crap in your opinion but not all patients go into the doctors not knowing what they are talking about.
Perhaps thinking you know it all and that we can't possibly know anything more than you is what leads doctors to make mistakes. If my daughter's pediatrician had thought like you, that what I was telling him was worthless garbage, he never would have caught her disorder and Lord knows she would have had brain damage.
Thank God he listened to my garbage and he's a truly great doctor for doing so. That's a good doctor. One that recognizes that maybe, just maybe, they don't know everything and maybe a patient can offer a little insight.
And there's comment #1 from somebody who doesn't get it.
ReplyDeleteHe didn't say that he "didn't give a damn". He's suggesting that he uses his professional judgement to pick out relevant facts and pursues testing in accordance with that.
Hi
ReplyDeleteI think the essential point that you are missing is that it is important to explain to patients that minor, self-limiting symptoms are just that. You shouldn't ignore them. At least summarise what patients have said so that they know you have heard them. Even better explain their self-limiting nature.
Doctor: So what brings you here today Mr. Smith?
ReplyDeleteMr. Smith: Well doc, back in 1952.........blah blah blah
I think most people think they need to give the doctor every little detail to be "cured" of every little complaint.
It would drive me nuts to have to listen to details that are not pertinent to anything.
I really love my doctor.. more importantly I trust her. She listens to me, tells me what she's focusing on and if there is something that doesn't worry her, why. I don't know what really matters and what doesn't so I tell her everything I can think of but the more I work with her, the more I know what doesn't matter because she has been teaching me with just a few words.
ReplyDeleteI've been with her now for four years, two pregnancies, a cancer scare and a thyroidectomy.
Oh Doctor Doctor our savior - thank you for clarifying why being an 'asshole' (your words) is in the patients best interest..... I have a great suspicion that you are recently graduated (<7 years out of residency) and you have yet to learn your lesson from a few patients who come back with their 'garbage' complaints which bite you in the butt..... please post again at about the 10 year mark when your holier than thou impatience wears off.... your demeanor is what gives us physicians a bad name.
ReplyDeleteCGFerris, MD PhD
Patients can give you details, insignificant or unrelated to the current disease, they get more attention to the symptons less harmfull, and sometimes they ignore the most relevant stuff, (because it doesnt hurt).
ReplyDeleteCollecting all the information is vital, but in the process of garthering, we find information particular less important.
one thing is not paying attention to a patient, and another thing is thinking that everything is really important.
Certain patients can give you a great % of acurrate information, some others dont, in most of cases is as happy says, it depends on the level of education of each patient.
I can give you endless examples of this, you need to be a doctor to understand most of it.
a patient goes like this:
Patient: my chest hurts, i look red colored, i am breathing faster, i feel palpitations, all my body hurts, i can walk ( patient on a wheelchair)
Doctor: do you have fever?
Patient: No, my body hurts, bla bla bla (here goes again)
After 5 min with thermomether
40ºC
Doctor: Looking for any posible cause of bacterial infection trought questionig and examination ¿does your troat, ear, &%/&&/ hurt?
Doctor: ¿does it hurt when you pee?
yes
Doctor: are you peeing less than before like drops?
yes
Doctor: do you make an effort in order to to pee?
yes
Three critical questions for the patient not relevant, she picked the less relevant symptoms, all of them related to the fever, a fever she didnt know she had, she goes to the er in a wheelchair, cause her muscles hurt because of the fever, she actually said she couldnt walk, which is not real. when the fever goes off all those symptons dissapeared.
It was a simple urine infection, i would be bad if some doctor will think about a paralisis or something, this is what happy is talking about. did i give a damn what she say? NO
Patients and relatives feel anxiuous, patients feel bad, p atients and relatives dont know what they have
Patients got an emotional view of their disease, thats why sometimes they talk much crap about their doctors, dont misunderstood the work of a professional, because you dont know, feel free to ask questions, to change of doctor, but in the long run is like happy said "90% of what patient says is garbage" and this a good example of it.
Recently I saw a new patient in the office. Chief complaint: "Every time I eat out, I have a bowel movement." She considered this a problem serious enough to make an appointment and show up. (Funded by the Bank of Medicaid). It is a good thing that docs know how to sort through the garbage because there sure is a lot of it.
ReplyDeleteRecently I saw a new patient in the office. Chief complaint: "Every time I eat out, I have a bowel movement." She considered this a problem serious enough to make an appointment and show up. (Funded by the Bank of Medicaid). It is a good thing that docs know how to sort through the garbage because there sure is a lot of it.
ReplyDeleteAdding MD, PhD to an anonymous post is a bit "assholish" in itself.
ReplyDeleteWould you prefer patients leave out some details? Maybe they are inconsequential, but better you hear an inconsequential detail than miss a consequential one.
ReplyDeleteI'm more concerned with doctors who don't think than doctors who don't listen. By all means, ignore any irrelevant thing I say as long as your critical thinking skills are really engaged.
ReplyDeleteIs there some way to signal to your doctor that you'd like the "that's nothing to worry about" feedback, rather than just having the doctor quietly ignore your comment because it's nothing to worry about? I gather that some people will find that offensive or upsetting, but I'd honestly like to know.
ReplyDeleteFor example, my three year old son has a large, flat mole in his hair. I was really worried about it because of its size, asked his pediatrician, and had it pretty-much blown off as not a big concern. I eventually took him to a dermatologist, who examined him, and explained that skin cancer was incredibly unlikely in someone that young, and made it clear that his mole wasn't anything to worry about. (He did give me some stuff to watch for, FWIW.)
I really appreciated the explanation. Assuming the doctor can give me an explanation that I can make sense of, it's much better for me to hear why it's not a concern. Even if I'm not going to get why it's not a concern, some acknowledgement that he's heard and thought about it would be nice, though I have no idea if that's practical.
Well said, Albatross.
ReplyDeleteHappy is right. I let my patients talk for about 10 minutes. Everyone, including most of those above, feel they are entitled to tell me everything they are worried about.
ReplyDeleteI really only need the answers to a few specific questions. So I let them talk. Then as we run out of time, I ask my 5 important questions. I could have cut them off after 30 seconds, but then they would feel like we didn't have a good conversation.
I generally learn nothing in the first 10 minutes and everything in the last 5 questions I ask. I decide whether or not to perform the heart cath (and hopefully NOT cause the psuedoaneurysm). It took me most of my 10 years of education/training to figure out the right thing to do.
As Happy has pointed out, my patient's medical education from Dr. Oz does not quite match my training.
Every once in a while I get a patient who says: "So what do you need to know?"
Fantastic. Now I can help you.
--- just a plain old MD
Hey Happy,
ReplyDeleteWhen I take a crap it smells really bad, I mean REALLY REALLY bad, is that anything to be worried about??
Frank,
ReplyDeleteIt's OK to like the cat, but let the cat have the cat food.
Sorting out BS, is not limited to the Medical Profession; as a teacher, I know how to sort out the 90%+ garbage, mainly from those doctors who think their kids should get A's just because of their parents' pedigrees.
ReplyDeleteFunny how we're all the same.
ReplyDeleteHee, hee, Dr. Drac, i love you even more...
ReplyDeleteI wonder if you would feel so strongly about your views if you weren't posting anonymously? I've commented on this post on my blog, Parenting Solved
ReplyDeleteAt its heart, the best medical care results from respectful communication from both doctors and their patients. A good doctor is one who can extract the 10% and explain in a respectful manner why the other information is less important.
ReplyDeletePoor medical care comes from arrogant physicians who intimidate their patients by suggesting that 90% of what they report is garbage, and simply create a bad name for the other professionals out there who remain respectful despite the contraints that are put on them.
Trisha Torrey
Every Patient's Advocate
www.EveryPatientsAdvocate.com
Trisha you are wrong, i dont think the point is to intimidate.
ReplyDeletePatients arent doctors, for them all the info is relevant, telling them most of it is not relevant sometimes, GET YOU IN TROUBLE.
if they ask, ill tell them about the irrelevant stuff, but i would try to focus informating just about the relevant stuff. if not i could be talking for 3 hours with just a patient to clearify EVERY DOUBT they have unrelated about their ilness, thats not practical.
Good medical care comes from critical thinking, analization, hardcore training, studying and a respectfull comunication with patient, having a good relationship with a patient is the ideal and sometimes the hardest to get, but i think that a doctor with a friendly attitude is overstimated, while knowledge is underapreciated. if i got ill i would choose knowledge with not doubt.
"What would you prefer - a doctor who holds your hand while you die or one who ignores you while you get better? I suppose it would particularly suck to have a doctor who ignores you while you die."
HOUSE QUOTE
Alexy and HH,
ReplyDeleteYou'll note I said "respectful from both the doctor and the patient."
Doctors have been taught to be doctors. You've been taught how to choose the salient points and how to act on them. You've been trained to identify what info you need and what info to act on.
Nobody has ever taught a patient to be a patient! No one has ever EVER taken the time to help a patient vet the salient points, how to pick out exactly which info you need to help you do your job well.
I wholeheartedly agree that simply acting on what a patient expects you to act on is not the best approach. No question.
But explain to me how patients are supposed to know which 10% is what you need to know if you, the doctor on the front line don't teach them?
You'll find throughout my writing that I consistently and emphatically try to teach patients to be partners -- which means being respectful of their doctor's time in addition to being concise. But I am only one person and people only find me when they are frustrated.
It's YOU DOCTORS and your associates who are on the front lines and have the oppty to actually teach patients how to help you. For now, they don't even know where to begin. Add to that the fact that they may be in pain, scared, frustrated, upset.... Just how are they supposed to know which 10% you need?
This is no high horse, HH. This is a recognition that the education needs to begin somewhere, and an arrogant rant doesn't move education forward.
Trisha Torrey
Every Patient's Advocate
http://www.EveryPatientsAdvocate.com
Trisha: This is a recognition that the education needs to begin somewhere
ReplyDeletei have this remarkable example, of a patient with low mental deficiency, that gave me a highly concise explanation of what he had, I was stunned, but the patient itself was well educated i guess the basic education is GIVEN AT HOME you wont get it on a ER, doctors even work as teachers, but we can solve all the problems of the society.
Trisha: "But explain to me how patients are supposed to know which 10% is what you need to know if you, the doctor on the front line don't teach them?"
its natural for patients to say the stuff that annoys them more, about their disease, ignoring the sign and symptons, that doesnt bother at all (example patient who had headache and he was 3 days not seeing in his right eye, after 15 min talkin i asked if he didnt see, he told me yes, why he didnt tell me before i asked, he said he didnt said it because it didnt hurt).
I dont have problems with this kind of situations, I dont expect my patient know that 10% important stuff, THATS MY JOB, it would be irrational and preposterous to expect that, but it doesnt change the fact that most of it is irrelevant, people get too emotional about happy saying 90% of the info is irrelevant.
Our complain is not for that, its for the disrespecfull attitude towards, confusing not acting on vs not listening, sometimes the patients arent the ones who DONT LISTEN, you can tell them as much as you want, educate them as much as you want, if they got the stubborn idea they are right and the doctor is wrong about not acting, if the doctor avoid their demands, then the doctor is a jerk that dont listen with no doubt.
being a jerk for not listening is not giving antibiotics in a patient with bronquitis that later developed Chronic Obstructive Pulmonary Disease, because the patient THINKS he needed the antibiotics in order to get better.
Being a jerk for not listening is not doing what the patient think you should do, thats a mentality patient should change.
I dont even live in USA, i live in place VERY DIFFERENT, yet your doctors and I have the same complaint.
Well, to be completely honest this is why I've been bleeding rectally for over a year and have been too scared to see a doctor. If what you think I'd have to say is all pap, I get too nervous to tell you anything at all! I knew most doctors really don't want to hear what you think is the reason, so I just get to gabby and waste everyone's time. Oh well. I care enough about making you like your job to not waste your time.
ReplyDeleteTrish maybe you need to practice what your preach.
ReplyDeletere: ".....respectful communication from both doctors......"
You see I have read your blog. Often when a doc points our how incorrect you are on a subject (which is far from infrequent), you will eventually delete the docs reply and sometimes rewrite the thread. This is neither respectful or professional. If you truly have hopes of beoming a healthcare journalist you need to act another way.
LOL! Anonymous -- are you kidding? I have never deleted any reply from a doctor, nor have I "doctored" the reply.... On the contrary, if I have a beef with what is being said, I simply say so.
ReplyDeleteIn fact, more often, I will acknowledge what I have learned from someone with another point of view -- respectfully. I may not always agree, but the dialog is always important.
I've said this to you before, Anonymous, and I'll say it again... whether or not you are the same Anonymous....
When you are willing to identify yourself and be confident enough in what you have to say to actually use a name that identifies you, then I'll respect what you have to say, too.
Trisha
So Trish the Carla McClain/Norma Greer thread just rewrote itself and the replies deleted themselves? OK anything you say. Look it is your blog do whatever you want. However, nobody will take you seriously or treat you like a medical journalist if you continue to rewrite threads and delete replies you don't agree with.
ReplyDeletePS: As you deleted my name and email on your blog (like most other docs) I think it is rather pointless to attempt to have a honest discussion with you.
I think ignoring patients could possibly come back to haunt you. My doctor ignored me for 10 years and I finally diagnosed myself AFTER I was forced to quit my career of 25 years. I guess he attended the same school you attended. Unfortunately for him, a malpractice suit is being brought against him. It was the simplest disease to detect, but he chose to ignore my symptoms, my monthly and bi-monthly trips for more pain medication, etc... He chose to treat the symptoms instead of getting to the cause of the symptoms.
ReplyDeleteNo shit sherlock... We all weed out stuff, everybody does. Not a revelation. Marty and Cooper do when you come home every day. All they choose to hear is "Blah, blah, blah, blah, dinner, blah, blah, blah, go for walk, blah, blah, blah...." -just kidding.
ReplyDelete-Second career nursing student
With all due respect, that is bullshit. I have had serious back problems with my siadic nerve and in my neck. i told the doctor exactlly what I was experiencing and told him these problems run in my family. He told me it sounds like a strained muscle. Bullshit. I know the symptoms asshole my Mom had it so did my Aunt and one of my uncles. It took multiple visits for the doctor to do a damned thing. When he could have told me the problem the first time I went in. They down play everything because they get paid to. The same shit happened with my hernia, sounds like a strained muscle. Take some motrin and come back in two weeks. Doctors aren't worth a crap. I've put up with pain for years, because of their misdiagnoesis.
ReplyDeletehow many of your patients have died because of your ignoring them?
ReplyDeleteMy hip pain and difficulty walking was ignored by a doctor. He actually laughed at me. It turned out to be vitamin D deficiency. My friend's abdominal pains were dismissed by doctors for a year. Turned out she had Crohn's Disease. Sorry, but as a health professional I have to agree that too many doctors don't listen. What's that old saying? Something like; 'listen to your patients and they will give you the diagnosis'.
ReplyDeleteIsn't it obvious ? you can tell straight off the bat by the wording of this article (or whatever it is), words like 'superb' and 'great', that this person thinks they are something and we (the stupid laypeople) are (just that) stupid ....
ReplyDeleteIt doesn't matter in the end God will judge the motives of every mans heart and all will be made "NAKED" for all to see (yes I said NAKED). Some doctors are humble, honest, and useless for most things - some are proud arrogant, and quite good (doing things to our bodies in the natural) ... some are proud arrogant and think they are really good but are actually terrible.
ReplyDeleteI don't hate doctors. I've had a doctor take special time to take care of me when I wa sin a place of being o nthe verge of complete breakdown. He held my hands and was really reassuring, calm, and caring. Even though he made the mistake of sneding me on to the butcher at the psychiatric emergency department who laughed, mocked and accused me of all sorts of things with the most smug arrogant look I think a human being would be capable of. Another doctor I went to screamed at me and threw me out of his office because I refused to take medication that made me sick (said to never come back) even though he had previously been prescribing me medication that had been working wonders for 5 months or so (he got wind that I had a mental health diagnosis you see and freaked out). Another doctor continually ignored almost every single thing I went to him for and it ended up costing me hundreds to be continually given the lazy half asleep eyes and the same prescription almost every single time - losec losec losec ... so ya tummies burning take some more losec ... but i'm telling you it has gotten worse since taking the losec ... explanation of why I must be lying because, losec losec losec lol it was PATHETIC !
9/10 G.Ps i've seen have been TERRIBLE !
9/10 of the doctors in the A&E that I kept turning up to with tummy complaints (and yes I admit anxiety) didn't investigate furthur and the one who did found severe constipation and prescribed a bottle of fleet which really helped ! ... all it took wasa quick xray to identify the problem I was having with fatigue and stuff (xray also showed up an enlarged stomache which the subsequent docters ignored - never did get to the bottom of that one lol).
And no it was not enlarged because I eat too much lol
ReplyDeleteO.K, if you think you're onto something here than explain why your presciriptions for improvement are many times wrong and cause further complications! The patient knows what they need---LISTEN TO THEM ASSHOLE!!!!!!!
ReplyDeleteI WILL NEVER NEVER NEVER VISIT ANOTHER DOCTOR AGAIN!!!!! I CAN BUY ALL THE PRESCRIPTIONS I NEED AT A PET STORE OR ON THE INTERNET!
ReplyDeleteI hope that the blogger on this site is a PhD in Sociology who is simply playing with the Internet public in the interest of some odd bit of research. A qualified MD would not likely talk this way without having become so jaded with his/her practice as to dump years of frustration on a willing or curious readership. Doctors do need to weed out information, but they can't begin to do so without the information given them. And, the chances are that better than 10% of that information is useful. The ego exhibited above is rather striking and the kind of language used--not at all exemplary of the medical practitioner.
ReplyDeleteExactly why I no longer have a primary physcian. When I am sick I go to the emergency room so I don't have to be confronted by somone who "claims to know me" with all his subjective ideas. The last primaryI had only wanted to layer drug after drug to eleveate a symptom from the last drug. Reducing liability.Definately did not have my interest at heart. Sorry drama queen.
ReplyDeletePinky51
Fascinating. In my practice I think it's more like 90/10 (important, peripheral). But, hey, I'm a specialist in endocrinology/diabetology so everything actually is important. Even the 10% - how can I tailor treatment to someone's life without knowing about their lives. And, yes, that includes their dogs and their cousins half-way across the country. Good luck, buddy.
ReplyDeleteMy mother had symptoms of gallbladder disease for 3 years. Over and over she went to the doctor and they dismissed her, telling her it was IBS. Finally when she was 6 months preganant with my brother, she had a severe attack and while at the ER, they examined her and determined that she needed to have her gallbladder out. At this point it was full of stones and gangrene. My unborn brother almost died because of the complications from surgery. For the last year, I have had all of the same symptoms she had (luckily I'm not preganant as well). I have seen both my primary physician and my gastroenterolgist, and have been to the ER several times with severe pain, chronic nausea, diarrhea, etc. All of these physicians have been informed of my mother's history and yet none of them show any interest in my chronic symptoms. They tell me it is IBS, and they tell me to take pain medicine and come back in 4 weeks. I believe that many physicians have forgotten how to treat their patients, and they would just like to fatten their wallets by blowing off patients and telling them to come back and see them every month. Just because I have the same symptoms over and over does not mean I am crazy or I don't know anything. When these doctors who don't listen become sick, I would like to know how they feel when no one tries to diagnose and take care of them. Of course, they probably think they are so intelligent that they can figure it out for themselves.
ReplyDeleteI think you an I have different definitions of 'not listening.' When you say someone is 'not listening,' it sounds like you mean that someone is not doing what the other person wants them to do. When I say that someone is 'not listening,' I mean that they didn't even let me finish a single sentence. It's unfortunate that the people who typically become doctors are the usually the most stereotypically 'intelligent' people; because they're usually also the world's most clueless people about interpersonal communication. How unfairly elitist of you to think that no one could ever surpass your perception. And how naive of you to think that everyone is in America.
ReplyDeletePlease stop looking at the damn computer screen, finishing my sentences with what you think I'm going to say and taking that as what I actually said, and talking to me like I'm beneath you. If you don't have the time to spare for me, then tell me where I should go and I will happily go there instead.
And please, it's best for all of us if you put that pride of yours to rest.
And this is why "pay for performance" is coming to a doctor near you. These quacks will be out of business!
ReplyDeleteThis is the hubris that is the sine qua non of poor medical care. I have silent reflux, do you have any idea how many doctors misdiagnosed this for over two years?
ReplyDeleteIt's the "job" of any thinking person to weed out 90% of the garbage from their information intake. Doctors are no exception.
I find the author of the monologue to be immoral and unprofessional- not to mention rather unlettered.
Doctors ignored my mother - dead at 37 from cancer. Doctors ignored my father - said it was gallbladder issues - dead at 63 from cancer. Doctor said I wasn't in labor because I could say my ABC's - daughter born that night anyway. She just had to stay in the NICU for 3 days due to complications - i.e. labor 36+ hours etc. Doctors ignored my daughter's coughing, "lungs sound fine to me", "here's another bottle of Tanafed" until, by some miracle a different doctor filled in one day "Why hasn't anyone taken a chest x-ray?"....collapsed right lung thought to be an inhaled toy, but was actually, found during bronchoscopy, mucous from bronchial asthma - 2 years of going to the doctor and them weeding out the 90% while I stayed up all night every night with my child being unable to breath...10 years with no day in which I wasn't having my period - only to be told by my doctor..."Nice that you're good and regular, see you next year." Then when he finally agreed to surgery, he said "I am sure I won't find anything." only to have him come out of the operating room apologizing to my husband that I had stage 4 endometriosis, the worst he had ever seen and he had to take everything. Then, while working as a medic/EMT in the Army, I had to listen to a doctor telling a woman during her 2nd pregnancy that all her complaints were in her head - there was nothing wrong. Only to have to assist with later in the week with an exam in which the dead baby's feet were exposed...yeah, I guess that little 10% you guys listen to really pays off for you, but for all of the people that suffer and die simply because you think that your education somehow negates a person's experience in their own body - really hasn't worked out too well for anyone I know. I think if you are bleeding profusely or have broken a bone, a doctor can help - but otherwise, you don't listen, you don't care and all I can hope for you is that some day, you will come to understand that people do not deserve to die because you want a new boat or because you are jaded by the hypochondriacs so much that you lump all people into the category of "Shut up, there is nothing wrong with you. Now pay me!"
ReplyDeleteDocs and patients: This is A WARNING!
ReplyDeleteIt is CARBON MONOXIDE POISONING SEASON. According to the CDC, CO poisoning is misDx'd as cold/flu in tens of thousands of patients each year.
If you develop flu-like symptoms right around the time your fuel burning heater kicks in, GO TO THE ER within 4 hours, demand a blood test for carboxyhemoglobin levels (the finger-pulse oximetry won't detect it)and demand oxygen.
If HH or any of his ilk try to dismiss you, ask him if he would rather risk a little O2 and 2 hours for a simple blood test, or a malpractice suit for failure to diagnose. At worst, you are wrong, and HH can vent more vitriol on his blog.
But if you are right, you will have saved not only your own life, but also the lives of HH's subsequent CO poisoning patients. This will be true of ANY MD (RN, OD, LPA, etc.) you encounter. Yup, patients can whinge and be ignorant, but so can docs, as HH so humbly reminds us in his enlightening and surely sardonic blog.
I would be especially interested to hear from HH why he considers himself "happy"; he certainly doesn't sound "happy", does he? He sounds manic. So perhaps HH would care to educate the class, in a spirit of public service, of course, as to the rampant levels of substance abuse amongst MDs and other hospital staff?
I completely agree with many commenter's opposing this article and confirming with my own experiences that doctors do not seem to care that much. You have to be constantly on the lookout for yourself and push the doctors to do something. If you just let it happen on it's own, no one is going to care to inform you, diagnose, treat or follow up with you in good time.
ReplyDeleteThis is exactly why so many problems are not diagnosed at the early stage of preventative care and thus are relegated to the emergency care when the problem has deteriorated beyond simple "repair". And this is also many people feel that US system of care is poor at preventative measures.
Doctors also like to carelessly prescribe very powerful medicines in very large doses in complete disregard to the negative side effects that accompany the drugs without any responsibility.
Just recently in my own experience, I was asked by the doctor to take a first ever Vicodin tablet, on empty stomach, with very little pain at that moment. 30 minutes later, I fainted and had to be delivered to the emergency room across the street from his office. Did the that doctor come out to see me? No. Did he call/leave me message on how to alter my medications (what take instead or etc)? No.
But to add insult to the injury the costs for the services rendered are not in pennies - instead they are extreme if not astronomical. And I have a PPO plan...
There is really no excuse for a doctor ignoring what a person tells them, or even for a doctor assuming before hearing everything that 90% of what comes out of person mouth is garbage. Because if you assume that first, you might think your listening, but you really aren't because you've already decided it's garbage before you hear it and consider it.
ReplyDeleteSure, people go to the doctor for things that aren't serious. Sure, one aspect of a good doctor would be the ability to listen, determine what is important and what is not, what needs further testing and what does not, weight the risks and the benefits as well as discuss the risks and benefits with the patient and get their take on it, and explain to a patient what your very good reason is for thinking that something requires no further testing and/or no treatment. But none of that is the same as ignoring what a patient tells you or what a patient is concerned about.
Any doctor who agrees with this post should not be a doctor. Find another professional and get over your damn god complex.
I have a horrible time with my new doctor. She wanted to put me on Yaz for PCOS-I told I researched that before coming in and I didn't want it due to all the risks and side effects, some so serous Yaz is now facing several class action lawsuits. She ignored me, put me on it anyway, and yep: I've had nothing but wild mood swings, constant diarrhea, insomnia, loss of hair, loss of sex drive, etc. I told her I just wanted Metformin for treatment, and she tried to give me another form of BC. I've always had bad reactions to BC, and let's face it-if I wanted simple BC I'd just go to the free clinic and get it there. I'm definitely going to have to change doctors, but that is a feat in itself.
ReplyDeleteYou GET PAID to listen to your patients "garbage." The patients, on the other hand, pay for the routine visits, medication, nights without sleep, and general pain and stress. Excuse us if we're scared and feel that you don't listen when we are undergoing great emotional and physical stress because of whatever condition you can't diagnose properly. To be clear: I don't feel that all doctors are uninvested in their patients, I do however, feel that doctors such as yourself are.
ReplyDeleteWhy should you care? Your patients are struggling, but thats their problem, correct?
Any good professional in a given profession knows how to treat their clients with care. At the end of the day it's a team effort.
It's not about whether or not you assess the given information, it's about HOW you go about it. Patients, as people, need to feel heard and because you are responsible for curing their ailments, they need to know that you care a little or they will blame your mistakes on that lack of care. Malpractice suits occur when a patient feels neglected and not taken care of. People make mistakes and mistakes are easily forgiven when they come from an individual who is doing their best.
Do your job, and shows a little empathy. It's possible that medicine isn't the right fit for you career-wise.
They obviously don't give out personalities with medical degrees do they and it's unfortunate as many people that try to be doctors are just book smart and they don't have the skills to listen, or do much else. I wouldn't doubt that there is some sort of slimy relationship between doc's and insurance companies that limits their hearing ability as well.
ReplyDeleteI love how some physicians are soo angry that PA's and NP's exist that they have to throw out jabs at them whenever possible. Do "other providers of healthcare" order hundreds of tests of patients unnecessarily? No... They too can decide what parts of a patient's complaint are important and act appropriately. "Being able to separate your garbage from your gold mine is what makes doctor level training superb in all regards." Yes, you're well educated and trained. A more secure person would have a lot more tact and a lot less arrogance. Truly believing that 90% of what patients tell you is garbage will get you a lot of unhappy and poorly cared for patients. Yes, a lot of what patients tell you is irrelevant and not worrisome. But that arrogant attitude is going to cause you to miss things that a less arrogant person would not. It would do you well to pay a little more attention to patients and have a slightly lower threshold for considering that what a patient is telling you may be important. Studies have shown that past 10 years post-residency, physicians' judgement actually declines with experience because they inaccurately believe they can immediately pick up on what is and isn't a problem.
ReplyDeleteThere is a way to filter out unimportant things a patient says without making them feel like they're not being listened to. Would you say that 90% of what patients say is garbage or 90% of their complaints are garbage? A lot of the details are junk because patients often misattribute the cause of the problem and want to tell you all about their theories. A good physician can convey that their giving the problem attention while ignoring the junk details, and not make the patient feel bad. A little bit of explanation about the condition can go a long way.
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