Starting to distrust doctors and find most to be smug

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My main issue with doctors is not the arrogance, though that does exist. My issue is that many of them are quick to prescribe drugs, despite that many health issues could be combated with dietary changes. I would like for doctors to focus more on diet and less on drugs.

A question for the medical types on this board - I have heard that medical school includes a laughably small amount of instruction on diet. Is this true?

Yes, it’s true. American medicine is big business, and just like any other business the #1 priority has to be profits. No one here can dispute that. So why would they prioritize healthy lifestyle changes?

I love how you guys who have no idea how medicine works or how doctors actually make a living (spoiler: it’s not from prescriptions) are so confident in your wrong ideas.

This, and the reason they don’t “prioritize lifestyle changes” is that 99.99% of their patients WON’T DO IT, or will do it for a short time, then fall back into their old comfortable patterns of behavior and choices.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Well most people go to the doctor when they are already feeling bad and therefore most work apart from pediatrics is not prevention it’s addressing already existing problems. Everyone knows by now that you should not smoke or drink, you should exercise, maintain a normal BMI, cut out transfats, and eat a diet rich in fruits, vegetables, whole grain and lean protein and sparing in refined sugar. And yet, most people do not do all those things so primary care doctors spend most of their time treating the consequences: hypertension, diabetes, high cholesterol, and consequences of smoking. I’m not sure why you think doctors, especially primary care doctors, have no interest in prevention. It’s literally their greatest hope that people would listen to them and take better care of their health. Instead doctors wind up working very downstream when problems have already developed and then people complain that things are so entrenched they have to take drugs—that they often can’t afford or don’t take.

Even if the doctor is working downstream when the issues have aLready developed, those issues can often still be reversed thru dietary changes. But doctors don’t prescribe that. They prescribe drugs instead.

BECAUSE ALMOST EVERY PATIENT THEY SEE WON’T DO IT. You can’t actually be this dim.

[Anonymous]

Anonymous wrote:My doctor is cool. But his nurse always freaks out I didn’t get vaccinated (she’s super liberal). I told her I believe it’s no big deal since the cdc has no comment on millions of unvaccinated crossing the border and congress exempted itself plus nobody is getting the boosters. She told me to shut up. I laughed.

Oh, you’re dumb. You must be lost. Parler is that way.

[Anonymous]

The health care system is so broken. Nothing about how anyone acts in it can be understood if you don’t start from there.

[Anonymous]

For every 1-2 good doctors in our area there are about 1,000 crappy doctors. When you have this many people needing medical care in one area it's pretty easy to hire anyone even crappy doctors that can be seeing 6-8 people an hour and billing for them.

Unless people start leaving reviews and not accepting crappy help this cycle will continue. The best thing anyone can do is report terrible doctors and leave online reviews.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My main issue with doctors is not the arrogance, though that does exist. My issue is that many of them are quick to prescribe drugs, despite that many health issues could be combated with dietary changes. I would like for doctors to focus more on diet and less on drugs.

A question for the medical types on this board - I have heard that medical school includes a laughably small amount of instruction on diet. Is this true?

Yes, it’s true. American medicine is big business, and just like any other business the #1 priority has to be profits. No one here can dispute that. So why would they prioritize healthy lifestyle changes?

I love how you guys who have no idea how medicine works or how doctors actually make a living (spoiler: it’s not from prescriptions) are so confident in your wrong ideas.

This, and the reason they don’t “prioritize lifestyle changes” is that 99.99% of their patients WON’T DO IT, or will do it for a short time, then fall back into their old comfortable patterns of behavior and choices.

I love how blithely you think telling a patient to do what you say is actually helpful. With all the information we have about things like semaglutide and how it quiets ever-present hunger signals in the body for people who would otherwise feel hungry all the time, to just give one example, and yet you arrogantly cling to the idea that a doctor telling someone “eat less and exercise more” is reasonable and counts as actionable medical advice. Ridiculous.

[Anonymous]

Doctors, unless they are cutting you open in a literal sense and testing what they find in there, are all part of an educated guessing game. They learn as much as they can in the hope of getting it right but they don't always get it right or they miss stuff or overlook things they shouldn't. Its because they are human and fallible. This is how the world works.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm an RN and prefer NPs for my PCP. Dh and DS also see NPs. I really do think part of the MD burnout is because of how PCP is set up. Med school is long and expensive and in the grand scheme of the MD world, they don't make much. The system is set up to see as many patients as they can a day in order to make money. And dealing with the general public burns you out as it is.

Nps who go into a PCP do it because they want to. And while the schooling is hard, its not as expensive and time consuming as MD

Yeah and just wait until they miss something important or you get really sick or they screw up your medications. I’m an MD and spend about 1/3 of my time correcting and undoing the mistakes of NPs and PAs who practice without supervision. It’s crazy that this is even allowed. I’ve worked with absolutely wonderful NPs and RNs as part of a team, inpatient. But allowing them to practice independently unsupervised on the theory that 85% of medicine is “routine” is insane. 15% of the time it’s not. And even in that 85%, only the best ones know when they don’t know and are wise enough to say so. So much invested in proving that medical school and residency are somehow superfluous to the practice of being a doctor.

I am a RN and I agree with you. I think NPs can be wonderful and a great resource (at least inpatient where I work). But unfortunately so many new nurse grads want to go straight to NP school without a solid bedside background and not to be mean, many should not be anywhere near patients even as RNs. I think the issue is that now there are tons of NP-diploma mills vs. actually solid schools. It completely undermines the whole profession.
To address the OP-I think a big issue is that PCPs are extremely overwhelmed. They have to see an obscene amount of patients daily. The general population is getting sicker and older which means the average patient has multiple comorbidities. There is no time for rapport. Plus charting demands on EMR--less time with each patient.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My main issue with doctors is not the arrogance, though that does exist. My issue is that many of them are quick to prescribe drugs, despite that many health issues could be combated with dietary changes. I would like for doctors to focus more on diet and less on drugs.

A question for the medical types on this board - I have heard that medical school includes a laughably small amount of instruction on diet. Is this true?

Yes, it’s true. American medicine is big business, and just like any other business the #1 priority has to be profits. No one here can dispute that. So why would they prioritize healthy lifestyle changes?

I love how you guys who have no idea how medicine works or how doctors actually make a living (spoiler: it’s not from prescriptions) are so confident in your wrong ideas.

This, and the reason they don’t “prioritize lifestyle changes” is that 99.99% of their patients WON’T DO IT, or will do it for a short time, then fall back into their old comfortable patterns of behavior and choices.

I love how blithely you think telling a patient to do what you say is actually helpful. With all the information we have about things like semaglutide and how it quiets ever-present hunger signals in the body for people who would otherwise feel hungry all the time, to just give one example, and yet you arrogantly cling to the idea that a doctor telling someone “eat less and exercise more” is reasonable and counts as actionable medical advice. Ridiculous.

Okay, argue with the laws of thermodynamics. I’m sure you’ll win.

[Anonymous]

Thank you. A good sensible nurse is a treasure and you sound old school. Love my OG nurses.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My main issue with doctors is not the arrogance, though that does exist. My issue is that many of them are quick to prescribe drugs, despite that many health issues could be combated with dietary changes. I would like for doctors to focus more on diet and less on drugs.

A question for the medical types on this board - I have heard that medical school includes a laughably small amount of instruction on diet. Is this true?

Yes, it’s true. American medicine is big business, and just like any other business the #1 priority has to be profits. No one here can dispute that. So why would they prioritize healthy lifestyle changes?

I love how you guys who have no idea how medicine works or how doctors actually make a living (spoiler: it’s not from prescriptions) are so confident in your wrong ideas.

This, and the reason they don’t “prioritize lifestyle changes” is that 99.99% of their patients WON’T DO IT, or will do it for a short time, then fall back into their old comfortable patterns of behavior and choices.

I love how blithely you think telling a patient to do what you say is actually helpful. With all the information we have about things like semaglutide and how it quiets ever-present hunger signals in the body for people who would otherwise feel hungry all the time, to just give one example, and yet you arrogantly cling to the idea that a doctor telling someone “eat less and exercise more” is reasonable and counts as actionable medical advice. Ridiculous.

Okay, argue with the laws of thermodynamics. I’m sure you’ll win.

Man, you are so proudly ignorant. No wonder people don’t trust you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:NP or PA is fine if you have an uncomplicated, easily diagnosable problem like strep throat that requires amoxicillin. Anything even slightly out of routine and they just aren't intelligent enough to deal with it. I've been misdiagnosed or received improper treatment from PAs/NPs many times, as have my family members.

Most of the time they will just throw a z-pack at a likely virus even after testing negative for strep just bc they get thrills from the feeling of doing something…I mean if they actually told you you have a virus they’d have to suffer the same haters as responsible physicians do.

I am an NP. I was a bedside nurse for a long time before I was an NP. I know what I don’t know. I have worked in Primary Care and specialities. In my experience, MDs give antibiotics much quicker than I do, esp in primary care. The time it takes to talk to a patient for symptom management for an upper respiratory infection and explain why he/she doesn’t need an antibiotic takes much longer than getting a Z-pack- which is what patients are used to. Some of that, I think, is just time saving for busy MDs.

Most of my NP colleagues are the same.

I don’t think intelligence has anything to do with it. Lots of super smart nurses out there. Education and training are different.

Interesting. It is not typical for NPs and PAs in general.

We examined US nurse practitioner (NP) and physician assistant (PA) outpatient antibiotic prescribing. Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). Antibiotic stewardship interventions should target NPs and PAs.

Outpatient Antibiotic Prescribing Among United States Nurse Practitioners and Physician Assistants
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047413/

This was national data over decades from sites across the country, sampling 1.3 million visits out of about 1.13 billion.

All ambulatory visits from 1998 to 2011 in the United States were divided into 2 groups: visits that involved a NP or PA, and visits that involved physicians only. Both the frequency of NP/PA visit involvement and trends in antibiotic prescribing for all conditions over this time period were assessed to determine whether significant differences exist in the proportion of visits that result in an antibiotic prescription. ...
Between 1998 and 2011, there were an average of 1.13 billion (95% confidence interval [CI], 1.04–1.21 billion) ambulatory visits per year in the United States based on estimates from 1,301,474 sampled visits in the NAMCS/NHAMCS.

The referenced article is from 2016 with data from up to 2011. 10+ year old data. I am not saying that there are not NPs that are not following evidence based medicine. There are. There are also MDs doing the same, despite the longer education and training.

Yes, sampling from all the visits in the entire country, so over 1 million visits in the sample.

But if you find that too dated, what published days would you accept? Or is it just a conclusion you would reject, regardless of any data?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My main issue with doctors is not the arrogance, though that does exist. My issue is that many of them are quick to prescribe drugs, despite that many health issues could be combated with dietary changes. I would like for doctors to focus more on diet and less on drugs.

A question for the medical types on this board - I have heard that medical school includes a laughably small amount of instruction on diet. Is this true?

Yes, it’s true. American medicine is big business, and just like any other business the #1 priority has to be profits. No one here can dispute that. So why would they prioritize healthy lifestyle changes?

I love how you guys who have no idea how medicine works or how doctors actually make a living (spoiler: it’s not from prescriptions) are so confident in your wrong ideas.

This, and the reason they don’t “prioritize lifestyle changes” is that 99.99% of their patients WON’T DO IT, or will do it for a short time, then fall back into their old comfortable patterns of behavior and choices.

I love how blithely you think telling a patient to do what you say is actually helpful. With all the information we have about things like semaglutide and how it quiets ever-present hunger signals in the body for people who would otherwise feel hungry all the time, to just give one example, and yet you arrogantly cling to the idea that a doctor telling someone “eat less and exercise more” is reasonable and counts as actionable medical advice. Ridiculous.

Okay, argue with the laws of thermodynamics. I’m sure you’ll win.

Man, you are so proudly ignorant. No wonder people don’t trust you.

Keep pushing this rock uphill. You obviously love it and aren’t interested in disengaging, learning anything, or entering into a positive or productive relationship with any doctor, and get some kind of gratification by being antagonistic. Enjoy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I never cease to be amazed by the doctor hatred on this board. You’d rather entrust your health to someone who never went to medical school or trained in a residency. Just astonishing.

+1. I think Dr Google has encouraged patients to diagnose themselves. When the doctor (who went to medical school) doesn’t agree, he deemed incompetent. Another concern of mine: Med Express is not a PCP. It is imperative to find a doctor that YOU trust. If you only have annual appointments, this process will take awhile.

Having a medical degree does not make you a good listener, make you immune to the pharmaceutical sales people who descend in you office or make you a naturally curious person who keeps up on current research. Yes we need doctors . We also need a healthy amount of skepticism .

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My main issue with doctors is not the arrogance, though that does exist. My issue is that many of them are quick to prescribe drugs, despite that many health issues could be combated with dietary changes. I would like for doctors to focus more on diet and less on drugs.

A question for the medical types on this board - I have heard that medical school includes a laughably small amount of instruction on diet. Is this true?

Yes, it’s true. American medicine is big business, and just like any other business the #1 priority has to be profits. No one here can dispute that. So why would they prioritize healthy lifestyle changes?

I love how you guys who have no idea how medicine works or how doctors actually make a living (spoiler: it’s not from prescriptions) are so confident in your wrong ideas.

This, and the reason they don’t “prioritize lifestyle changes” is that 99.99% of their patients WON’T DO IT, or will do it for a short time, then fall back into their old comfortable patterns of behavior and choices.

I love how blithely you think telling a patient to do what you say is actually helpful. With all the information we have about things like semaglutide and how it quiets ever-present hunger signals in the body for people who would otherwise feel hungry all the time, to just give one example, and yet you arrogantly cling to the idea that a doctor telling someone “eat less and exercise more” is reasonable and counts as actionable medical advice. Ridiculous.

Okay, argue with the laws of thermodynamics. I’m sure you’ll win.

NP here. No one is arguing that low calorie diets don't result in weight loss. They’re saying that a low calorie diet without appetite suppression (never feeling sated) is unsustainable in the long run.