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[quote=Anonymous][quote=Anonymous]There's a doc I've encountered twice, one for myself and once when a family member was hospitalized. On one of those occasions, he was pleasant, professional, and efficient. On another--maybe he was having a bad day, I don't know--he was impatient and then became extremely unprofessional --got into an argument with the patient about something the doc was objectively incorrect about and the patient was correct--EMR was consistent as well with the patient's info, then when patient disagreed the doc bizarrely said he was going to prove he was right by calling the patient's designated proxy, which escalated the argument; in the end the doctor fired the patient in the hospital and another attending took his place but it was the patient, not the doctor, who was labeled as "difficult." Unfortunately, this label followed the patient, who ended up changing his insurance to get away from the network where this occurred.

How about we agree--doctors have hard jobs (not, actually, all of them, but enough of them). Patients have hard jobs--while they are sick or hurt they ALSO have the "job" of managing life, insurance, and the universe (today, after several months of repeated days off trying to sort out helping someone get a procedure which implicates several medical conditions, involving 3 different provider networks, and trying to get a handle on getting insurance authorization, I ended up pretty much where we were 5 months ago. I've learned some facts that I couldn't have known before, but it still means tackling the entire business again, and is going to involve repeat visits to various specialists since so much time has passed trying to make this happen).

Increasingly I get the sense that doctors and patients are adversaries.

To some degree I think the "trust" thing has a lot of unfortunate carryover from traditions that disappeared with the horse and buggy. Back then, the doctor was the person who knew who had syphilis, who got pregnant outside of wedlock, who was a secret alcoholic, who had confessed things that weren't even medical in nature because a doctor was like a priest. (Of course, in today's political climate, we might be headed back there.)

This is very much less the case. The argument has been made for decades by some that healthcare should be based on market principles and consumers (not "patients") should be shopping around for the best deal in terms of cost and quality. Not only has the internet spawned customer service ratings, but corporate healthcare has also jumped on that as well (a family member had 144 medical appointments in 2022, including tests and therapies, every damn one of them meant a robocall from their customer survey people). For a large number of people, medical care is routine--minor illnesses and injuries and screenings. The concept of a sacred trust does not come into play except in terms of HIPAA rules and ordinary professional standards. For another segment of people, medical care is a very large part of their lives. Because scope of practice is increasingly limited, they see many more different doctors and are much less likely to have a single physician to shepherd them through all this. Marcus Welby (showing my age) would pop into the hospital to see his patient even though he was not their attending physician. That's not a thing for most people.

When it gets to be adversarial most of the time it is individual battle zones--the patient who fires doctors, the doctors who fire patients, the doctors fearing lawsuits (which very rarely end up favoring patients anyway, don't help patients with terrible outcomes that could not be helped, and only rarely are the vehicle to get rid of incompetent or unethical doctors). NONE of this is healthy for any of us.

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Meanwhile the C suite in healthcare (insurance companies and hospitals) are laughing all the way to the bank. [/quote]

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