o ceallaigh's picture

Sympathy for the Physician

HMO | medicine | New Millennium Devil's Dictionary | O Ceallaigh: Science Belief and Society | physician

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realitycheck's picture

Not all Physicians are bad

Ok, maybe we kind of bashed Physicians today, but it was truthful. I know that they have a hard job and that people falsely sue them, make accusations and so on. I know they get ripped off.
We have to remember that not all doctors are bad. It's important to research thoroughly to find a good one though. But in my opinion, based on my experiences, it seems like few doctors truly care about their jobs anymore. Maybe it's because of all the crap they go through, I don't know.

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o ceallaigh's picture

The last time I visited a physician ...

... it felt like I was treating him, because he regaled me with all the things he could no longer do thanks to the HMO-inspired curtailments on his income. I'm old enough to remember the "physician-patient relationship" and mourn its passing. Because the kinds of things that you and ModelMom have been experiencing are, to my mind, an obvious consequence of this level of social disrespect.

Hell, we're turning our physicians into teachers ... :p

ModelMom's picture

Good reading....re: physicians...

and I appreciate all that you have to say. I do agree with Reality though. And although I have had generally good experiences with physicians in the past, this experience with my son was far from acceptable. Also, my cousin's husband is a neurosurgeon and the things that he hears other doctors say re: patients, money etc. make me cringe. My best friend from college is a nurse at a major hospital here and yet she chose to give birth in her own home with a midwife, only hinting to me that she has seen too much that has turned her off to the medical profession while working in it. It's a sad state of affairs.

I also feel that often times medical doctors, especially older ones, tend to not take younger patients seriously. The few times I have asked my doc re: health concerns she always gives me a quizzical look and I end up feeling like a hypochondriac. My husband has a goatee and tattoos....when he went in to see a gastroenterologist, and an ear nose & throat spec. to determine mysterious bleeding from his throat they gave him the run around....the gastro. even so much as told him he was late to lunch and would have to resched the appointment while my husband was there! WTF? Pardon my French, but please! Young, goatee & tatoo, does not a punk make, yet these docs made my husband feel as such. I am sure there are many quality doctors out there, it's just a shame that I am not the only one having a hard time finding them!

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o ceallaigh's picture

The "older" (read "my age" :( ) docs ...

... were the ones raised in the "science über Alles" era ... the ones that devalued the "patient" relationship. The ones that Norman Cousins wrote about in "Anatomy of an Illness ...". I caddied for some of these people. It wasn't fun, dealing with their prejudices and self-important attitudes, bred of a "we know best, and don't let those stupid patients tell you different" attitude.

Used to be, this was self-regulating, in the manner Holmes Sr. describes. But it became harder and harder to find one person who could master all the data and therefore become the focus of personal care - especially when any mistake could land the dude in the poorhouse if not in jail. So the profession has become depersonalized. Which I think leads to more, not fewer, mistakes. And a closed-ranks, under-siege mentality.

In your case (if you haven't already) I'd be strongly tempted to speak earnestly with the physician you do trust about your episode. You will at least learn what he is, and is not, willing/able to do about it.

realitycheck's picture

Ok, I have a point to make

Going along with the "teaching physicians" thing:
You know how I worte about that doctor and the BM's, on model moms blog, well when I talked to the friend of the family doc he told me that a big problem is that science is ever changing. He explained that doctors have to continually take classes to learn new things and refresh old things. He also stated that the doctor was probably advising me using outdated information. So does this make the guy a "bad doctor"...um...I don't know. I would like to say he isn't but the advice could have killed my baby and left me deaf in one ear. In my opinion, that constitutes as poor doctoring skills. BUT, is it really possible for a doctor to keep up with all this information? I know they work demanding schedules sometimes. I don;t even see when they would be attending all these classes.

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o ceallaigh's picture

I saw a blog on here a couple of days ago ...

... that was bemoaning the fact that the "definitive" information of yesterday is the "bogosity" of today. This "updating" phenomenon is part of the same dynamic. And it's one that doesn't ever make it into the mainstream media. I'll just have to blog on this topic ... :)

realitycheck's picture

There ya go!

MsV's picture

--

I enjoyed reading your post very much. It was well written,informative.

When I went to the emergency room the doctor was breezy and such. But it's understandable considering that he probably saw a lot of patients, had dealt with unbearable patients and such.

I think of it as being a waitress in a place that gets lots of traffic.You have the nice customers, the ones that you get to know, the idiot customers, the unbearabler ones. You keep working that long enough, you keep getting crappy customers who expect you to do everything for them and you're bound to be bitter and jaded.Or maybe not.

IntricateGirl's picture

Don't get me wrong. I have

Don't get me wrong. I have also written about bad doctors. The doctor who delivered my first baby made a mistake that put my health in jeopardy. But it was a mistake. And it was one of two major ones that she has made in a long career. Furthermore, she was NOT the only one responsible, and if you want to get right down to it, I feel the hospital is much more to blame than the doctor. So when I became pregnant with my second one, I went back to her. I was a little more firm and insistant about my wishes, and she was open and attentive to what I needed. As a result, my second birth was amazing.

The doctor who treated my son was completely worthless, and it had nothing to do with being in an HMO or 250K in debt. He just didn't know what he was doing. Neither did his associates. The clinic I have now is the complete opposite. When my daughter placed mattress foam in her nose, one doctor did everything she could to get it out, and spent 2 hours going throughout the clinic and hospital. At points she would stop and think about what we could try that might work. She used her training to try and discover a solution. It didn't work, but the trying counted for a LOT. I know I've raved about her here before. Another doctor there is very fast. His appointments rarely last very long, but they are in depth, and his treatments always work. He has an incredible amount of knowledge, and he always explains things completely.

So please don't think that I am bashing all doctors. As in any profession, there are people who were born to do the job, and there are people who should switch careers.

o ceallaigh's picture

Intricate ...

there are people who were born to do the job, and there are people who should switch careers.

True. very true. But when the demand for physicians exceeds the supply, as it currently does especially in non-"plush urban" areas, you will get the ones that should move on. And the "managed care" systems will ensure that your opportunity to choose your way around them will be limited. After all, the less competent are likely to be cheaper, because people won't pay a premium to retain them.

Obviously, the dynamic is more complex than what I wrote in the blog. Hell, that topic could be a book. Several books. Probably already is. All I can really hope for in such a forum is to encourage people to see with slightly greater clarity why certain things are as they are.

IntricateGirl's picture

We are in exactly the area

We are in exactly the area you describe, yet the doctors here are top notch. I have wondered before how we manage to keep them here, but I think I already know the answer. The people here have ties several generations back, and if the doctors don't provide proper care, they face making the entire community upset. They are not just treating a person, they are caring for a member of a community. In some cases, they may have delivered that person into the world. Even if they didn't, their grandparents know each other, and their parents know each other, etc. So they may not be paid as much as if they worked in Beverly Hills, but they don't live in fear that they will face malpractice suits. Because it works the other way too. They care for the community, but more importantly, the community cares for them.

In bigger cities, you are right. Nobody knows Dr. So-and-so from way back, and they pick a number out of a phone book. They have no loyalties, and if Dr. So-and-so does not treat them perfectly, then they feel no qualms about moving on. And Dr. So-and-so does not feel tied to him either. He knows that his waiting room is full, there is 10-15 minutes per person, and the very first person will go late. So he will be stuck there late, which causes his wife to get upset and leads to trouble in the marriage. Eventually, the good doctor stops caring, because he gets the same paltry amount no matter what. And now, nobody is happy. And when nobody is happy, mistakes are made and the results of those mistakes are blown out of proportion. And those aren't even the BAD doctors. Those are the beaten down ones.

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