Anonymous wrote:Not the OPs question, but it baffles me that people go into a doctors office for a first visit with the mind frame that the doctor is going to try to harm them. Do you also meet with your child’s teacher with the mind frame “this woman is going to try to make my child hate school unless I beat her into submission during our first meeting”.

As I typed that I realized that yes, some people actually do do this I think. What an exhausting way to live.

A friend of mine had a heart attack and my first thought was that I hope no one hurts her.
I have been in many situations where myself, or my children were harmed by top-notch medical care.
For those of you who think I need help I absolutely do. I went to cognitive behavior therapy to learn how to walk into a doctors office. I have a chronic life-threatening condition and have found care that I trust.
Medical trauma is real

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PS: There's a difference between "asking questions" in a polite and respectful way, and asking them in a way that comes with insults, rude challenges, and an insistence to do excessive work for free when it isn't medically indicated.

Challenging a doctor is okay. They are not gods, and we are the ones who will die if they are wrong.

Of course it’s ok, as in it’s legal and it’s within your right. As you say, it’s your body, and you can challenge the doctor every step of the way as they try to help your body. But that’s exhausting for your doctor to be antagonized at literally every turn and while you might think, “who cares?”, your doctor is going to dismiss you from the practice or, as PP said, start ordering a zillion tests and say “take your pick, do any of these that you’d like” even though that’s against their better medical judgment. If you don’t trust their medical judgment, why not just move on to someone else??

There can be a back and forth. A conversation. That does not mean you don’t trust your doctor, rather you want to be sure you agree with what she is recommending.

DP. No, absolutely. When you have a civil conversation that is a reasonable back and forth about recommendations, the basis for recommendations, pros and cons, like a pair of adults? That's fine. If it's going to be a long conversation, or likely so, it should be something both agree to set aside time for, then sure.

We can have those conversations online in some forums, with some people. They are great conversations, and they make for the best kind of informed health care, including when people disagree with professional medical recommendations.

But it shouldn't be 4chan in that doctor-patient relationship, or DCUM Political Forum, or the YouTube comments under a video of Taylor Swift at the Super Bowl. We all know the difference between civil discussion and an edgelord coming in from the side quoting Ayn Rand with a side of "you're not my supervisor!"

Nobody knows how any of us really are when we are in a private conversation like that. I can tell you all day long how I am as a doctor (or how I see myself being, granted), or even how I am as a patient -- and you can sneer and call me any names you like. Or we could speak civilly about it, or whatever. The crux of it, though, is that people need good healthcare, and with emergent crises aside, good care never comes when people are working in opposition to each other. If they are, it's the professional's job to end that, not prolong it. If it's not helping, it isn't helping, and it's unethical to take money for it regardless.

Anonymous wrote:Don’t pretend all doctors keep up with the literature/current guidelines. Many of them do what they were taught in medical school or follow their gut, regardless of the evidence base.

The hours and hours of CMEs I have to complete every year to keep my license current disagree with you. But yes sometimes guidelines are population based instead of individual patient based. Sometimes my gut tells me this particular patient needs a pap more than once every 3-5 years despite the new recommendations saying yearly paps aren’t necessary for most women.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PS: There's a difference between "asking questions" in a polite and respectful way, and asking them in a way that comes with insults, rude challenges, and an insistence to do excessive work for free when it isn't medically indicated.

Challenging a doctor is okay. They are not gods, and we are the ones who will die if they are wrong.

Of course it’s ok, as in it’s legal and it’s within your right. As you say, it’s your body, and you can challenge the doctor every step of the way as they try to help your body. But that’s exhausting for your doctor to be antagonized at literally every turn and while you might think, “who cares?”, your doctor is going to dismiss you from the practice or, as PP said, start ordering a zillion tests and say “take your pick, do any of these that you’d like” even though that’s against their better medical judgment. If you don’t trust their medical judgment, why not just move on to someone else??

There can be a back and forth. A conversation. That does not mean you don’t trust your doctor, rather you want to be sure you agree with what she is recommending.

Oh absolutely and I encourage that. The patient should always understand , to the best of their ability at least, why I am ordering or not ordering a test for example. But having a conversation to make sure my patient understands my reasoning is different than “I read 84 articles about 19 different possible differential diagnoses for my stomach pain and I am going to aggressively quiz you on the difference between an ultrasound and an MRI for each of these diagnoses and ONLY when I am fully satisfied will I agree to get the ultrasound. But then I’m going to call you at 10pm to discuss it in detail as soon as it pops up in my patient portal”. I can’t do that. You need a private doctor.

Anonymous wrote:Don’t pretend all doctors keep up with the literature/current guidelines. Many of them do what they were taught in medical school or follow their gut, regardless of the evidence base.

Exactly who said they all did?

They all do have a medical license, if they are practicing medicine, and that license is something they put on the line regarding their judgment and actions if they accept to take on a case. They can't accept if they can't work with you.

If the doctor is an a## who won't work with you, then you don't want them. Obviously.
If they are someone who is worth working with, they still put that license on the line and have to make the call that they can take on what you bring to them.
- If they feel they can't (outside scope of expertise, time constraints, other factors), then you don't want them. Obviously.
- If they feel they can and are willing to take on the responsibility, then you work together, not in opposition.

None of the doctors who have been complained about in this thread seem to be of the latter type, the kind you actually want. I don't see the relevance of complaining about not being able to work with doctors you actually don't want to work with anyway. it's irrelevant to this thread, and in life in general.

Don’t pretend all doctors keep up with the literature/current guidelines. Many of them do what they were taught in medical school or follow their gut, regardless of the evidence base.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PS: There's a difference between "asking questions" in a polite and respectful way, and asking them in a way that comes with insults, rude challenges, and an insistence to do excessive work for free when it isn't medically indicated.

Challenging a doctor is okay. They are not gods, and we are the ones who will die if they are wrong.

Of course it’s ok, as in it’s legal and it’s within your right. As you say, it’s your body, and you can challenge the doctor every step of the way as they try to help your body. But that’s exhausting for your doctor to be antagonized at literally every turn and while you might think, “who cares?”, your doctor is going to dismiss you from the practice or, as PP said, start ordering a zillion tests and say “take your pick, do any of these that you’d like” even though that’s against their better medical judgment. If you don’t trust their medical judgment, why not just move on to someone else??

There can be a back and forth. A conversation. That does not mean you don’t trust your doctor, rather you want to be sure you agree with what she is recommending.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors really only fire patients for what they believe is a liability to their malpractice insurance. But I could see how questions could be seen as threatening by some doctors.

It's broader than that. My husband's gastroenterology practice, for instance, fires patients who have their screening colonoscopies done by another practice. That's one of the most profitable things they do, so they don't want patients that go elsewhere for those.

Wow, so much for the doctor patient relationship. I guess he sees them as future billing opportunities. Kind of gross.

It’s a business, isn’t it? If the doctor patient relationship was so special and sacred why would you even be going to a different doctor for your colonoscopy? Oh, because it was more convenient or less expensive? But what about the special doctor patient relationship you have with your gastro???

DP.

This is the problem. Some people (not all, and not even many, I think) want to insist that the doctor-patient relationship is not one with any special connotation or status. It's just like any other business, right? But then they *also* want it to be a special relationship that comes with extra obligations -- but only on the doctor. The doctor has to do additional work outside office hours for free, spend uncompensated time (not ten minutes, but over an hour) doing special research on topics or perspectives outside the standard scope of care for their practice, not react to being criticized or challenged as not being good at your job to their face, remain calm in the face of emotional, angry, and/or aggressive patients, and put their license at risk to delicately step around special idiosyncratic concerns about vaccines or masks or my child being special or I know my own body which means I also know all of he field of medicine and so on and so on.

You can't hold both perspectives at once. Either it is, or it isn't. When you insist on the one, you reject the other.

As for me and the people I trained with, we took on this job and its training with the expectation that it was not just a business and there *were* special obligations. But if a given person is going to salt the earth insisting it isn't, then, well, it isn't. Not for that person, as it's obviously not the relationship they are willing to engage in. But then there are not special obligations on me, and if I am *also* not helping them, I will gently but firmly disengage and wish them well.

That's not thin skin. It's not unprofessional. It is eminently practical and respectful of the stated wishes of the patient.

Doctors tend to “fire” patients for multiple no shows, or non adherence. Not necessarily garden variety non adherence like “I stopped taking the Flovent because I felt better, now I’m wondering why I’m coughing again?” Or “I never scheduled the X-ray because I got busy and my back was feeling a little better anyways”. I’m talking like, refusing a diagnostic work up or refusing to try medication X before moving on to medication Y despite medication X being a safer choice for the patient. That’s fine if you don’t want to start with medication X but I can’t in good conscience prescribe you medication Y without at least trying something safer first. So if your only goal is to get prescribed medication Y, as opposed to work with me to try to get to the bottom of your symptoms, then yeah, you should go elsewhere to someone who will just prescribe medication Y without further work up. And since some patients “do their research” before coming to see me , I get a lot of patients like this, that have a treatment plan in mind and don’t want to hear anything else about it. Fine, but you can’t just buy a prescription from me with your copay, my license is on the line here.

Anonymous wrote:Not the OPs question, but it baffles me that people go into a doctors office for a first visit with the mind frame that the doctor is going to try to harm them. Do you also meet with your child’s teacher with the mind frame “this woman is going to try to make my child hate school unless I beat her into submission during our first meeting”.

As I typed that I realized that yes, some people actually do do this I think. What an exhausting way to live.

Exactly. But they are on the side of right and are “informed” and only seek guidance they may or may not follow. Sounds like a great way to waste a massive amount of energy instead of actually living like a normal person.

Not the OPs question, but it baffles me that people go into a doctors office for a first visit with the mind frame that the doctor is going to try to harm them. Do you also meet with your child’s teacher with the mind frame “this woman is going to try to make my child hate school unless I beat her into submission during our first meeting”.

As I typed that I realized that yes, some people actually do do this I think. What an exhausting way to live.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:PS: There's a difference between "asking questions" in a polite and respectful way, and asking them in a way that comes with insults, rude challenges, and an insistence to do excessive work for free when it isn't medically indicated.

Challenging a doctor is okay. They are not gods, and we are the ones who will die if they are wrong.

Nobody said it wasn’t okay. What isn’t okay is setting this up like some kind of duel at high noon before you’ve even walked through the door.

Exactly.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors really only fire patients for what they believe is a liability to their malpractice insurance. But I could see how questions could be seen as threatening by some doctors.

It's broader than that. My husband's gastroenterology practice, for instance, fires patients who have their screening colonoscopies done by another practice. That's one of the most profitable things they do, so they don't want patients that go elsewhere for those.

Wow, so much for the doctor patient relationship. I guess he sees them as future billing opportunities. Kind of gross.

It’s a business, isn’t it? If the doctor patient relationship was so special and sacred why would you even be going to a different doctor for your colonoscopy? Oh, because it was more convenient or less expensive? But what about the special doctor patient relationship you have with your gastro???

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Doctors really only fire patients for what they believe is a liability to their malpractice insurance. But I could see how questions could be seen as threatening by some doctors.

It's broader than that. My husband's gastroenterology practice, for instance, fires patients who have their screening colonoscopies done by another practice. That's one of the most profitable things they do, so they don't want patients that go elsewhere for those.

Wow, so much for the doctor patient relationship. I guess he sees them as future billing opportunities. Kind of gross.

Or, doesn’t want to accept as gospel another doctors procedure results. Kind of like how if you show up to an ortho appt with x ray results on a CD, they often repeat them anyways to get their own. Liability issue.

Anonymous wrote:

Anonymous wrote:PS: There's a difference between "asking questions" in a polite and respectful way, and asking them in a way that comes with insults, rude challenges, and an insistence to do excessive work for free when it isn't medically indicated.

Challenging a doctor is okay. They are not gods, and we are the ones who will die if they are wrong.

Of course it’s ok, as in it’s legal and it’s within your right. As you say, it’s your body, and you can challenge the doctor every step of the way as they try to help your body. But that’s exhausting for your doctor to be antagonized at literally every turn and while you might think, “who cares?”, your doctor is going to dismiss you from the practice or, as PP said, start ordering a zillion tests and say “take your pick, do any of these that you’d like” even though that’s against their better medical judgment. If you don’t trust their medical judgment, why not just move on to someone else??