Where have all the doctors gone?

[Anonymous]

Anonymous wrote:My wife had her annual mammogram, high risk with family hx. Doc made her wait one year and 1 day to make sure it was covered etc etc...the statement from ins came back and still denied even though every year before that it was covered. No idea why BUT the point is that what happens to that money? The doc won't get it from ins and can't come get it from me so the entire appt is a waste. The admin staff that made the appt, verified ins, the nurse, the supplies, the doc who read the report and the list goes on should not be paid for what they did?? I don't know! The system is the broken, the consumer is like perfect but this had consequences. The docs are handcuffed by insurance thanks to politicians who get donations. This leads to docs leaving the networks and telling the patients we refuse to work for fee.

Uhh yeah they can bill you. Whether you pay it or not is a different issue.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

None of that sounds miserable to me. It sounds human. It sounds like humans who are struggling and are asking doctors to help them feel better.

Yes, people are trying to self advocate because care has become so abbreviated and disjointed

But without any nuanced understanding of the tests they insist on! Did you know that if chances are really low that you have a disorder (and you don’t meet criteria for testing for it), but you test for it anyways , and get a positive result, if that test is 99% accurate, it means that there is only a 1 in 10 chance your positive result is real? #mathdoesntlie

This article detailing how often doctors miss life threatening pulmonary embolisms is terrifying:
https://www.sciencedirect.com/science/article/pii/S2772632022000113

And what do you think the morbidity and mortality would be if every patient who might, on a very off chance, have a PE is given a pulmonary angiogram which is the gold standard for diagnosis?

Or even “just” a chest CT?

I’m not talking about cost, even. Or availability of practitioners and machines to run all these tests on every single patient with some shortness of breath. I’m talking about harm to patients that results from doing the test.

What harm? Ignoring the problems is the true harm.

Ok,
I’ll play. A pulmonary angiogram is an invasive procedure which can lead to disability or death.
A chest CT has so much radiation that the risk of it CAUSING cancer has to be weighed against any possible benefit of using it.

I've had multiple CT's lately trying to figure out what's going on. The newer machines don't have that much radiation and it's better to know and get treated than suffer. Be thankful you don't need it or have serious struggles with your health.

Maybe if doctors put more effort into helping than blowing me off, I wouldn't need them.

[Anonymous]

Anonymous wrote:Quality healthcare still exists but you have to know how to navigate the healthcare system.

Former physician here who went to top schools and training programs. I no longer see patients but rather do different work that is more interesting to me.

So how does that help us regular folks who don’t know how to navigate the system the same way a doctor does? For us, quality healthcare is out of reach.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

None of that sounds miserable to me. It sounds human. It sounds like humans who are struggling and are asking doctors to help them feel better.

Yes, people are trying to self advocate because care has become so abbreviated and disjointed

But without any nuanced understanding of the tests they insist on! Did you know that if chances are really low that you have a disorder (and you don’t meet criteria for testing for it), but you test for it anyways , and get a positive result, if that test is 99% accurate, it means that there is only a 1 in 10 chance your positive result is real? #mathdoesntlie

This article detailing how often doctors miss life threatening pulmonary embolisms is terrifying:
https://www.sciencedirect.com/science/article/pii/S2772632022000113

And what do you think the morbidity and mortality would be if every patient who might, on a very off chance, have a PE is given a pulmonary angiogram which is the gold standard for diagnosis?

Or even “just” a chest CT?

I’m not talking about cost, even. Or availability of practitioners and machines to run all these tests on every single patient with some shortness of breath. I’m talking about harm to patients that results from doing the test.

What harm? Ignoring the problems is the true harm.

Ok,
I’ll play. A pulmonary angiogram is an invasive procedure which can lead to disability or death.
A chest CT has so much radiation that the risk of it CAUSING cancer has to be weighed against any possible benefit of using it.

I've had multiple CT's lately trying to figure out what's going on. The newer machines don't have that much radiation and it's better to know and get treated than suffer. Be thankful you don't need it or have serious struggles with your health.

Maybe if doctors put more effort into helping than blowing me off, I wouldn't need them.

As a doctor I would caution you that doctors are human beings too and when faced with a person who is figuratively (or literally) attacking them, they will do always what they can and should, but you certainly won't get anyone to go the EXTRA mile for you. Unfortunately, you might need someone to go the extra mile and you won't get it this way with this attitude. When patients are nice and we have a good trusting rapport, we will go above and beyond to try and help them when something isn't clear cut (eg talk with specialists again, do more in depth research, ponder the problem...). You are a phenotype that is driving physicians to hate medicine some days.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

None of that sounds miserable to me. It sounds human. It sounds like humans who are struggling and are asking doctors to help them feel better.

Yes, people are trying to self advocate because care has become so abbreviated and disjointed

But without any nuanced understanding of the tests they insist on! Did you know that if chances are really low that you have a disorder (and you don’t meet criteria for testing for it), but you test for it anyways , and get a positive result, if that test is 99% accurate, it means that there is only a 1 in 10 chance your positive result is real? #mathdoesntlie

This article detailing how often doctors miss life threatening pulmonary embolisms is terrifying:
https://www.sciencedirect.com/science/article/pii/S2772632022000113

And what do you think the morbidity and mortality would be if every patient who might, on a very off chance, have a PE is given a pulmonary angiogram which is the gold standard for diagnosis?

Or even “just” a chest CT?

I’m not talking about cost, even. Or availability of practitioners and machines to run all these tests on every single patient with some shortness of breath. I’m talking about harm to patients that results from doing the test.

What harm? Ignoring the problems is the true harm.

Ok,
I’ll play. A pulmonary angiogram is an invasive procedure which can lead to disability or death.
A chest CT has so much radiation that the risk of it CAUSING cancer has to be weighed against any possible benefit of using it.

I've had multiple CT's lately trying to figure out what's going on. The newer machines don't have that much radiation and it's better to know and get treated than suffer. Be thankful you don't need it or have serious struggles with your health.

Maybe if doctors put more effort into helping than blowing me off, I wouldn't need them.

As a doctor I would caution you that doctors are human beings too and when faced with a person who is figuratively (or literally) attacking them, they will do always what they can and should, but you certainly won't get anyone to go the EXTRA mile for you. Unfortunately, you might need someone to go the extra mile and you won't get it this way with this attitude. When patients are nice and we have a good trusting rapport, we will go above and beyond to try and help them when something isn't clear cut (eg talk with specialists again, do more in depth research, ponder the problem...). You are a phenotype that is driving physicians to hate medicine some days.

I totally agree with you. The anger and frustration and not taking responsibility for anything is becoming too much and its a driving factor in me trying to leave ASAP. I am not even compensated for the work. I looked it up and since 2010 my field has seen 6% bump in average salary!!!! So the politicians, insurance companies and patients expect the same from 2010 in 2024 without anyone stepping up to fix the system?? Thank Obama care and the make you feel warm inside dems that are just trying to get your votes for this mess.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

None of that sounds miserable to me. It sounds human. It sounds like humans who are struggling and are asking doctors to help them feel better.

Yes, people are trying to self advocate because care has become so abbreviated and disjointed

But without any nuanced understanding of the tests they insist on! Did you know that if chances are really low that you have a disorder (and you don’t meet criteria for testing for it), but you test for it anyways , and get a positive result, if that test is 99% accurate, it means that there is only a 1 in 10 chance your positive result is real? #mathdoesntlie

This article detailing how often doctors miss life threatening pulmonary embolisms is terrifying:
https://www.sciencedirect.com/science/article/pii/S2772632022000113

And what do you think the morbidity and mortality would be if every patient who might, on a very off chance, have a PE is given a pulmonary angiogram which is the gold standard for diagnosis?

Or even “just” a chest CT?

I’m not talking about cost, even. Or availability of practitioners and machines to run all these tests on every single patient with some shortness of breath. I’m talking about harm to patients that results from doing the test.

What harm? Ignoring the problems is the true harm.

Ok,
I’ll play. A pulmonary angiogram is an invasive procedure which can lead to disability or death.
A chest CT has so much radiation that the risk of it CAUSING cancer has to be weighed against any possible benefit of using it.

I've had multiple CT's lately trying to figure out what's going on. The newer machines don't have that much radiation and it's better to know and get treated than suffer. Be thankful you don't need it or have serious struggles with your health.

Maybe if doctors put more effort into helping than blowing me off, I wouldn't need them.

As a doctor I would caution you that doctors are human beings too and when faced with a person who is figuratively (or literally) attacking them, they will do always what they can and should, but you certainly won't get anyone to go the EXTRA mile for you. Unfortunately, you might need someone to go the extra mile and you won't get it this way with this attitude. When patients are nice and we have a good trusting rapport, we will go above and beyond to try and help them when something isn't clear cut (eg talk with specialists again, do more in depth research, ponder the problem...). You are a phenotype that is driving physicians to hate medicine some days.

Except most doctors will not even go an inch and try. They do a five minute appointment to get you out with no help.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

None of that sounds miserable to me. It sounds human. It sounds like humans who are struggling and are asking doctors to help them feel better.

Yes, people are trying to self advocate because care has become so abbreviated and disjointed

But without any nuanced understanding of the tests they insist on! Did you know that if chances are really low that you have a disorder (and you don’t meet criteria for testing for it), but you test for it anyways , and get a positive result, if that test is 99% accurate, it means that there is only a 1 in 10 chance your positive result is real? #mathdoesntlie

This article detailing how often doctors miss life threatening pulmonary embolisms is terrifying:
https://www.sciencedirect.com/science/article/pii/S2772632022000113

And what do you think the morbidity and mortality would be if every patient who might, on a very off chance, have a PE is given a pulmonary angiogram which is the gold standard for diagnosis?

Or even “just” a chest CT?

I’m not talking about cost, even. Or availability of practitioners and machines to run all these tests on every single patient with some shortness of breath. I’m talking about harm to patients that results from doing the test.

What harm? Ignoring the problems is the true harm.

Ok,
I’ll play. A pulmonary angiogram is an invasive procedure which can lead to disability or death.
A chest CT has so much radiation that the risk of it CAUSING cancer has to be weighed against any possible benefit of using it.

I've had multiple CT's lately trying to figure out what's going on. The newer machines don't have that much radiation and it's better to know and get treated than suffer. Be thankful you don't need it or have serious struggles with your health.

Maybe if doctors put more effort into helping than blowing me off, I wouldn't need them.

Sounds like you should stop demanding CT scans. If one didn’t find anything, multiple won’t either.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

None of that sounds miserable to me. It sounds human. It sounds like humans who are struggling and are asking doctors to help them feel better.

Yes, people are trying to self advocate because care has become so abbreviated and disjointed

But without any nuanced understanding of the tests they insist on! Did you know that if chances are really low that you have a disorder (and you don’t meet criteria for testing for it), but you test for it anyways , and get a positive result, if that test is 99% accurate, it means that there is only a 1 in 10 chance your positive result is real? #mathdoesntlie

This article detailing how often doctors miss life threatening pulmonary embolisms is terrifying:
https://www.sciencedirect.com/science/article/pii/S2772632022000113

And what do you think the morbidity and mortality would be if every patient who might, on a very off chance, have a PE is given a pulmonary angiogram which is the gold standard for diagnosis?

Or even “just” a chest CT?

I’m not talking about cost, even. Or availability of practitioners and machines to run all these tests on every single patient with some shortness of breath. I’m talking about harm to patients that results from doing the test.

What harm? Ignoring the problems is the true harm.

Ok,
I’ll play. A pulmonary angiogram is an invasive procedure which can lead to disability or death.
A chest CT has so much radiation that the risk of it CAUSING cancer has to be weighed against any possible benefit of using it.

I've had multiple CT's lately trying to figure out what's going on. The newer machines don't have that much radiation and it's better to know and get treated than suffer. Be thankful you don't need it or have serious struggles with your health.

Maybe if doctors put more effort into helping than blowing me off, I wouldn't need them.

As a doctor I would caution you that doctors are human beings too and when faced with a person who is figuratively (or literally) attacking them, they will do always what they can and should, but you certainly won't get anyone to go the EXTRA mile for you. Unfortunately, you might need someone to go the extra mile and you won't get it this way with this attitude. When patients are nice and we have a good trusting rapport, we will go above and beyond to try and help them when something isn't clear cut (eg talk with specialists again, do more in depth research, ponder the problem...). You are a phenotype that is driving physicians to hate medicine some days.

Except most doctors will not even go an inch and try. They do a five minute appointment to get you out with no help.

I’m definitely in and out as fast as possible with patients like you that’s for sure

[Anonymous]

Part of it is, patients are more and more expecting- demanding!- that doctors put them back to perfect health, well into their 40s, 50s, and beyond. I’m sorry you have chronic low back pain. I’m sorry the only possible solution at this point is a surgery that may or may not help. I’m sorry about XYZ problems. But- you’re 50 years old and your body is never going to be 22 again. Stop expecting miracles. People get old , things don’t work as well, a million expensive MRIs and visits with every specialist on earth aren’t going to change that.

[Anonymous]

Anonymous wrote:Part of it is, patients are more and more expecting- demanding!- that doctors put them back to perfect health, well into their 40s, 50s, and beyond. I’m sorry you have chronic low back pain. I’m sorry the only possible solution at this point is a surgery that may or may not help. I’m sorry about XYZ problems. But- you’re 50 years old and your body is never going to be 22 again. Stop expecting miracles. People get old , things don’t work as well, a million expensive MRIs and visits with every specialist on earth aren’t going to change that.

We have amazing technology for some conditions, but for others we might as well still be in the dark ages.

[Anonymous]

Anonymous wrote:Part of it is, patients are more and more expecting- demanding!- that doctors put them back to perfect health, well into their 40s, 50s, and beyond. I’m sorry you have chronic low back pain. I’m sorry the only possible solution at this point is a surgery that may or may not help. I’m sorry about XYZ problems. But- you’re 50 years old and your body is never going to be 22 again. Stop expecting miracles. People get old , things don’t work as well, a million expensive MRIs and visits with every specialist on earth aren’t going to change that.

If only some of our health issues were just back pain.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

None of that sounds miserable to me. It sounds human. It sounds like humans who are struggling and are asking doctors to help them feel better.

Yes, people are trying to self advocate because care has become so abbreviated and disjointed

But without any nuanced understanding of the tests they insist on! Did you know that if chances are really low that you have a disorder (and you don’t meet criteria for testing for it), but you test for it anyways , and get a positive result, if that test is 99% accurate, it means that there is only a 1 in 10 chance your positive result is real? #mathdoesntlie

This article detailing how often doctors miss life threatening pulmonary embolisms is terrifying:
https://www.sciencedirect.com/science/article/pii/S2772632022000113

And what do you think the morbidity and mortality would be if every patient who might, on a very off chance, have a PE is given a pulmonary angiogram which is the gold standard for diagnosis?

Or even “just” a chest CT?

I’m not talking about cost, even. Or availability of practitioners and machines to run all these tests on every single patient with some shortness of breath. I’m talking about harm to patients that results from doing the test.

What harm? Ignoring the problems is the true harm.

Ok,
I’ll play. A pulmonary angiogram is an invasive procedure which can lead to disability or death.
A chest CT has so much radiation that the risk of it CAUSING cancer has to be weighed against any possible benefit of using it.

I've had multiple CT's lately trying to figure out what's going on. The newer machines don't have that much radiation and it's better to know and get treated than suffer. Be thankful you don't need it or have serious struggles with your health.

Maybe if doctors put more effort into helping than blowing me off, I wouldn't need them.

As a doctor I would caution you that doctors are human beings too and when faced with a person who is figuratively (or literally) attacking them, they will do always what they can and should, but you certainly won't get anyone to go the EXTRA mile for you. Unfortunately, you might need someone to go the extra mile and you won't get it this way with this attitude. When patients are nice and we have a good trusting rapport, we will go above and beyond to try and help them when something isn't clear cut (eg talk with specialists again, do more in depth research, ponder the problem...). You are a phenotype that is driving physicians to hate medicine some days.

Except most doctors will not even go an inch and try. They do a five minute appointment to get you out with no help.

I’m definitely in and out as fast as possible with patients like you that’s for sure

Fund a new profession and stop wasting peoples time with your incompetence. Ironic you can post here during the work day but cannot take the time to help someone.

[Anonymous]

We need more medical schools with student loan forgiveness programs for drs that go into low paying areas and a transparent process of who wants to be a dr and isn't getting to get the training. there are many qualified people who do not get into med school yet somehow almost everyone i know who's dad was a dr gets into a med school

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Cut back to 24hr a week now that med school loans are paid off. Enjoying having a life again. I’d work 40 hours if patients weren’t so miserable and management didn’t try to cram my schedule way past full.

What makes the patients miserable? I mean, specifics in terms of behavior thet shouldn't be doing.

Just angry about wait times in the office (that I can’t control), having a lot of things that they “insist “ on being tested for despite it not being relevant for their symptoms - and some tests will yield a lot of false positives if you test everyone for them. It sounds wrong- like, “if I test positive, and the test is 99% accurate, then it’s a real positive!” but google the Bayes Theorum and you’ll see that’s actually wrong. But patients INSIST on testing for things. And it muddies the waters and makes my job harder and doesn’t make their symptoms go away because now they’re convinced they have, for example, chronic Lyme disease and they won’t consider that their fatigue is actually probably from sleep apnea or depression. Anyways I’m ranting.

None of that sounds miserable to me. It sounds human. It sounds like humans who are struggling and are asking doctors to help them feel better.

Yes, people are trying to self advocate because care has become so abbreviated and disjointed

But without any nuanced understanding of the tests they insist on! Did you know that if chances are really low that you have a disorder (and you don’t meet criteria for testing for it), but you test for it anyways , and get a positive result, if that test is 99% accurate, it means that there is only a 1 in 10 chance your positive result is real? #mathdoesntlie

This article detailing how often doctors miss life threatening pulmonary embolisms is terrifying:
https://www.sciencedirect.com/science/article/pii/S2772632022000113

And what do you think the morbidity and mortality would be if every patient who might, on a very off chance, have a PE is given a pulmonary angiogram which is the gold standard for diagnosis?

Or even “just” a chest CT?

I’m not talking about cost, even. Or availability of practitioners and machines to run all these tests on every single patient with some shortness of breath. I’m talking about harm to patients that results from doing the test.

What harm? Ignoring the problems is the true harm.

Ok,
I’ll play. A pulmonary angiogram is an invasive procedure which can lead to disability or death.
A chest CT has so much radiation that the risk of it CAUSING cancer has to be weighed against any possible benefit of using it.

I've had multiple CT's lately trying to figure out what's going on. The newer machines don't have that much radiation and it's better to know and get treated than suffer. Be thankful you don't need it or have serious struggles with your health.

Maybe if doctors put more effort into helping than blowing me off, I wouldn't need them.

As a doctor I would caution you that doctors are human beings too and when faced with a person who is figuratively (or literally) attacking them, they will do always what they can and should, but you certainly won't get anyone to go the EXTRA mile for you. Unfortunately, you might need someone to go the extra mile and you won't get it this way with this attitude. When patients are nice and we have a good trusting rapport, we will go above and beyond to try and help them when something isn't clear cut (eg talk with specialists again, do more in depth research, ponder the problem...). You are a phenotype that is driving physicians to hate medicine some days.

Except most doctors will not even go an inch and try. They do a five minute appointment to get you out with no help.

I’m definitely in and out as fast as possible with patients like you that’s for sure

Fund a new profession and stop wasting peoples time with your incompetence. Ironic you can post here during the work day but cannot take the time to help someone.

I’m retired! From medicine! Thank the lord! See the title of this thread.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:They quit because people kept showing up to appointments with stacks of self identified pub med articles demanding they be evaluated.

Some of us are desperate for help and most doctors do the bare minimum and we suffer unnecessarily.

I can tell you're one of the patients driving doctors out. So many patients mainly need to see a psychologist, but instead pester their PCPs and specialists.

Patients are less equipped to know what they need or to navigate the system. Surely you can appreciate that and show a little compassion?