Your description of your AMA membership trajectory really tells the story. The AMA is bigger and more powerful than the AAP. You quit to join an org that represented your opinions better, at a time when you thought you had the option to ignore what the larger and more powerful orgs were doing. What you’re describing is a strategic mistake at every level of governance—organizations, political parties, the works. The answer is never to divest; it is to lean in on winning. These folks you want me to fix are your reps as well, so I hope you’re calling them; they take docs a lot more seriously than they take patients. And as a patient, I’d be a lot more willing to tolerate all your dithering with the EMR if I knew you were doing that. |
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Sure it is. So tell me what exactly I was supposed to do (while seeing patients) in the AMA that I didn't -- what more than voting, serving on committees, and advocacy? And what exactly are you "doing" to fix our country politically? Why is it even more of a dumpster fire now than it has ever been? This looks a LOT like someone who likes to give advice and criticism but produces jack squat. Am I wrong? |
I think it's hilarious that you think they will listen more to one doc than to a national voice of more than 65,000 members. You like to talk, don't you? Focus on being accurate instead. |
+2 |
It might be a starting point, but it's meaningless on its own. If you increase medical student admissions, where are you going to find the clinical slots for training?
Concierge medicine doctors are usually not training students. Private equity sees it as a drain on efficiency and a loss on profit. The Crisis of Clinical Education for Physicians in Training https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797035/
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This is the logical first step. If someone’s BP is higher than usual you monitor for a few weeks. You don’t jump into extensive testing or refer after one elevated reading. What was the end result? Did they find a reason for your hypertension? |
This correct. You don't make a diagnosis of hypertension on one value, but on multiple values taken on different days. Blood pressure is too labile. It also trends up as you get older, so although it may have been "high for you" at a younger age, it's not unexpected to be higher now. |
And this here is the problem. People want to be treated in the way they have descided was best (which is not the appropriate way to proceed), and if they’re not, then the doctor sucks. I mean how do you deal with that? |
You can try to explain it to them in person or online, and often get accused of being defensive or spending too much time doing that. But it does take time.
Sometimes people are open to looking at the actual protocols and recommendations. However, no amount of time is going to replace a thorough grounding in statistics, critical analysis, and how to do an accurate lit review. People who don't want to understand can always just say, or write, "word salad" or say you don't make sense. And from their point of view they may be justified, but the truth is that the time spent with someone with that perspective is entirely wasted. Entirely. Some people have a provider they trust, and they don't need details. You can move through that appointment both accurately and on time. Some people don't trust for very understandable or valid reasons, or they may have a good sense that they are outliers in dome way (rightly or wrongly). All of them deserve good care. Only some of them can get it in the current system. The system needs to change. One way of doing it is for physicians to take more control of their professional workspace, decide who they can work with (even if it takes more time), set aside the needed time, and charge what they need to make up for loss in economies of space, shared overhead, etc. But they can make sure they do it right. Another way is to use the economies of scale and shared overhead costs to the advantage of patients, but this requires larger group buy-in and the removal of financial investment and shareholder interests from the provision of medical care, which shouldn't be driven by making as much money as you can squeeze. That's more systemic, and it's much more difficult. It comes with other costs, too. But if someone is convinced that they are right and unable to consider in any significant ways that they have no idea what they don't know, then this system does not permit good care for them without going concierge, or -- possibly -- getting very very lucky, in a specific context which cannot be held over time, or for many people. |
^^"outliers in some way" |
Reading this thread has been very informative about the lack of bedside manner. While there have been some extremes, generally speaking, the most common complaints have been physicians being very late for appointments and not listening to the patients. Most providers, rather than acknowledge that these are valid complaints and offer empathy, instead tell patients to either 'deal with it' or 'get a concierge doc.'
It would have been more effective to have noted that it's often out of the doc's hands, but agree that these are valid complaints. Too many egos though seemed to get in the way for a reasonable approach. Of course, the worst have been the spouses of docs. I'm not sure why they believe they have special insight because of who they sleep with. |
You sound so angry—imagine how angry a patient is. Imagine you had multiple people in your immediate household attempting to navigate this garbage, broken system with disabling illnesses—and the healthiest one of them was you. Doctors and patients are not equally situated in this debacle. The badness that prevails in your work and the badness that prevails in patients’ lives are not the same experiences. So no, we won’t be having a showdown about how angry and helpless it makes you, a doc, feel that your industry is on fire, and what patients should do about that. Start a new thread if you’d like. |
Focus on returning the messages in your patient portal. |
it was the dismissive attitude about it. When it is unusual for that person, the doctor should at least wonder why. No, they didn't find a reason because they never looked into it. He was just the GI doc, anyway. By the time I got back to my PCP, it was nearer to my normal. I personally believe it was a short "long-term) temporary effect related to the COVID vaccine. |