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That may have been the most alarming doctor visit I ever had

… but not for any dire reasons you might imagine.

Good news: The doctor says there’s absolutely nothing wrong with me.

Bad news: I’ve gradually, reluctantly, and (as of yesterday) angrily concluded there’s something seriously wrong with the doctor.

Surprise: the test results looked good. But in answer to, “Then why am I having these symptoms?” her response was, in rote, rapid-fire delivery: “Maybe you just need to get more sleep, and an average woman should drink two liters of water a day, and be sure to eat three healthy meals every day with healthy snacks in between. And keep up the good work. I’ll see you in a year.”

The hell you will, woman.

—–

On the surface, her departing summary of Ladies Magazine Wisdom 101 sounds like an evasive way of telling me, “It’s all in your head, Cupcake.”

If that’s what she meant, I’d have rather she come right out and say it.

It’s worse than that, though. Because in the five or six minutes she’d been talking at me, she’d made such a series of ignorant errors that I was wondering what on earth was going on. She didn’t know what was in my records, despite having my file in hand. She didn’t remember my answers to questions she’d asked me just last week. She clearly didn’t recall the symptoms I’d come in for. She had forgotten to order a relevant blood test. Then at the end of the appointment, she shook my hand and said, “See you in a year” — twice within about 30 seconds, seemingly without realizing she’d already done so.

Alzheimers? This is a woman about 40 years old.

—–

When I first visited, 20 months ago, I was thrilled with her. She was new in town and before she arrived our small-town doctor pickins had been slim. But I gradually became disillusioned. She didn’t like to be questioned. Her advice seemed rote, memorized, conventional, shallow. If I resisted a recommendation, she’d respond either with snappishness or by pulling out a tragic anecdote about some person (with problems not resembling mine) who didn’t follow his doctor’s recommendations … and died!

Before yesterday, I had already become wary. But she was still the best our town had to offer.

After yesterday, I shudder to think I ever put myself into the hands of someone so negligent and unthinking.

At least I now have test results to take to some other doc. But that doc will have to be out of town, probably in the (heaven forbid) actual Big City far away where I never want to go as long as I live.

And the plain fact is that I hate doctors. And for good reason. I’ve spent most of my adult life successfully avoiding them. But during my younger years when I followed the conventional recommendations, and now that I’ve been forced into their presence again, I’ve had way more bad experiences than good ones.

I know there are competent, caring physicians out there. But I have never seen such a consistent combination of incompetence and arrogance in any profession.

I know I have to try another doc — perhaps a naturopath as a friend suggested, a doctor trained to consider the whole person and not just look at conventional numbers and spout conventional wisdom.

But after being cheerily told to eat healthy snacks by a doctor who had clearly forgotten the potentially ominous symptoms I’d described to her — and who didn’t care about those symptoms solely because the numbers on a piece of paper were all that mattered — well, I’m done for the moment.

I’ll have to work myself up to finding another doctor. But as a profession, they are so bad and so damned superior in their bloody ignorance that right now I’d rather go to some guy who’d rattle bones over my head or search for the source of my problem in chicken entrails than subject myself to another “medical expert.”

Or I’d rather happily believe “It’s all in your head, Cupcake” if by so deluding myself I could escape ever having to deal with these creatures again.

46 Comments

  1. free.and.true
    free.and.true June 14, 2018 5:52 am

    Yikes. Damn. Sorry you’ve had to deal with this whack-job, Claire.

    If it’s any consolation, I don’t think your experience is all that uncommon nowadays. I’ve had little to do with doctors in recent years… partly because I’ve noticed some similar tendencies.

    The last one I saw, several years ago, asked how many prescriptions I was taking (although I’d already noted so on my intake form). When I answered “none,” she looked at me suspiciously.

    I assured her it was true. She retorted in disbelief, “So you’re HEALTHY, then?”

    I just stared. Um, woman, how many regular prescriptions do MOST 40-something women take?

    But it scared the bejeezus out of me to consider the ramifications of what she was revealing. No one is healthy, everyone’s on multiple hard (but legal) drugs, and it’s all good (for the medical-industrial complex)?

    Haven’t been back since. I hope you find a much more helpful and caring professional to work with you on your situation, whatever it involves.

  2. Bear
    Bear June 14, 2018 6:07 am

    My father was in the hospital for pneumonia. What I took to be a glad-handing administrator walked into the room and introduced himself as a doctor doing rounds.

    Didn’t know who my father was, what he was in for, how long he’d been there. He had no records to consult.

    He would not speak to my father, but addressed all questions to me (father was present, lucid, and attempting to answer himself). His final question was, “Do you think your father is ready to be discharged?”

    -blink-

    “Well, since I’m a telecommunications and computer technician, I thought I’d leave that call to a medical professional.”

    “Well. I can see you have anger management issues. I’ll just leave.”

  3. rochester_veteran
    rochester_veteran June 14, 2018 6:31 am

    The situation with your doctor absolutely sucks, Claire! So sorry that you have to go to the big city to find another doctor.

    What free.and.true wrote about your experience not being uncommon is so true. When my wife was in the ICU, an internist came into the room to brief us that her situation had improved and that they were going to transfer her out of the ICU to a regular hospital room and that she would probably be discharged soon, when in actuality, she was dying and would take her last breathes later that day. He was briefing us on the previous person who was in her room in the ICU and didn’t realize that they had been moved. He came back almost immediately when he realized his mistake and apologized profusely and my daughter, older son and I realized that and accepted his apology, but that was a pretty serious error on his part.

  4. Claire
    Claire June 14, 2018 6:38 am

    I wish I could be shocked that your three horror stories dropped into comments right off the bat. But I doubt anybody would be the tiniest bit surprised these days.

    I know anybody can make a mistake. But the sheer negligence is getting worse, while the arrogance hasn’t diminished by a whisker.

    I’m sorry you all went through that — especially you on your wife’s last day, RV.

  5. Stryder
    Stryder June 14, 2018 6:42 am

    You can always ask your friend Furrydoc what she thinks. I mostly trust vets over MDs anyhow.

  6. Sara Wilson
    Sara Wilson June 14, 2018 6:42 am

    I, too, have been navigating the “healthcare” system with utmost frustration. I have a 20+ yr old hip implant which I suspected with good reason was wearing out. After getting a referral at an orthopedic clinic for an X-ray, I was told they wouldn’t X-Ray my hip until I told them what kind of implant I have. Suddenly, I get a call that I have an appointment with an orthopedic surgeon. And sure enough, the implant is GONE, worn out. He scheduled surgery ASAP and sent me home with a cane, but first we have to determine if I’m healthy enough for surgery. So more weeks later I see a “primary care” physician who sent me to a heart specialist for COPD and AV blockage. More weeks later I see a heart specialist who said ” you don’t have those conditions, who told you that?”

    Five weeks now after “revision” surgery, I’m driving, walking without pain, and have nearly discarded my cane. I am convinced my guardian angel kicked in somewhere along the line because my surgeon was likable and excellent.

    I’m a fan of Naturepathic doctors but for my problem this wasn’t an option. Good luck to you, dear Claire, and please know I’ve been a fan of yours for years. You are included in my will.

  7. William Conrad
    William Conrad June 14, 2018 6:42 am

    Clair, first thing to remind yourself, it’s not in your head. While I don’t know you personally you seem to be of reasonably stable mind. From what you said I think it is wise to “go to the big city” and get the help you need.
    One thought I had was to consider that something in that structure you call home may be the cause. There are many building products that “off gas” toxins which, to many people, don’t cause issues however, over the years we have seen the “Chinese drywall” problem, FEMA trailer issues, etc. that has made many people sick.
    I remember when you started your renovation the posts about how bad the mold and rot you uncovered. There could be something still lurking in a wall or floor. Whatever you do, don’t give up and suffer.

  8. Pat
    Pat June 14, 2018 6:51 am

    And this – all first four stories above – is what the medical profession has come to!

    I had the same experience as a patient a few months ago (and a follow-up visit last month) plus, as a retired nurse, I’ve watched it evolve over many years.

    Though I still respect the what-ought-to-be in medicine, I weep for the what-it-has-become– and can never imagine how it will get back to “Do No Harm.” There are a Few Good Docs around, but finding them is impossible, largely because they are so few and so scattered.

    Further, hospitals have latched onto the worst of traditional medicine and incorporated those treatments and those doctors into their government-pharmaceuticals-insurance cartel so the poor patients have no other choices for their care. And losr their money to boot.

  9. Ruth
    Ruth June 14, 2018 6:57 am

    My primary care doctor is awesome. She LISTENS to me, and remembers my stuff (how I don’t know, considering how many patients she sees). She’s also willing to admit that she has little actual idea on some things that require a specialists knowledge, and unfortunately that’s where the problems tend to come in. My experience with the specialists……yah, been there. Doctor shopping sucks.

  10. Mark Call
    Mark Call June 14, 2018 7:03 am

    Most MDs know next to nothing about nutrition. In a world where GMOs, aspartame, glyophosphates, and a whole lotta lesser poisons dominate what most people have been told is food, it’s hard to get bodily systems, from digestion to immune response, restored to proper function again.

    “You are what you eat,” is still decent advice.

    Also, ask a potential “doctor” about the flu shot. Personally, I wouldn’t take non-specialty health advice from anyone who favors mainlining heavy metals, and can’t understand simple statistical evidence.

  11. David M. Gross
    David M. Gross June 14, 2018 7:43 am

    I feel sorry for physicians today. It’s just as difficult to jump the hoops to get into the profession as ever, but the status of it has dropped. More of the doctor’s time is spent with therapeutically-worthless paperwork and battling health insurance companies (you know how much fun that is when you do it; imagine that’s something you have to do all the time). Malpractice insurance and student loan debt siphons off whatever profits the health insurance companies let you keep. And your patients are always second-guessing you with some Google diagnosis.

    Some years back I found a doctor I was very happy with. Young in the profession and just starting up her own practice. Seemed smart and interested and inquisitive and eager to listen and to help… and then when I tried to make an appointment for my next physical her office told me she’d decided to quit doctorin’ and do something else with her life. Imagine devoting your life and studies to practicing medicine and then just saying “oh, f**k this noise” once you see what it’s become all about.

    So I’m not surprised when I see the quality of physicians dropping, or notice that they’re overly-distracted, less-attentive, and more sleep-deprived.

    (And no I don’t blame Obamacare for this… the problem started well before that — http://www.businessinsider.com/your-private-health-insurance-is-really-a-government-program-2013-10 — Obamacare just gets the blame for not making it a whit better in spite of all its upheaval.)

  12. rochester_veteran
    rochester_veteran June 14, 2018 7:55 am

    Imagine devoting your life and studies to practicing medicine and then just saying “oh, f**k this noise” once you see what it’s become all about.

    My cousin did something similar. He was a family practice doctor and gave up his practice and went to work for a medical insurance company. No more malpractice insurance to pay for and a lot less hours to put into work.

  13. Comrade X
    Comrade X June 14, 2018 8:12 am

    I really liked the good news part!

    Doctors have over the years become employees of the insurance companies and our solution to that has been to make them employees of the government, it’s bad so why don’t we make it worst, why don’t we?

    I’m lucky, I have a good doctor mainly because we look at things as a team and I am the one making the decisions using his knowledge.

    From my understanding you are located in a very small town area, there are bigger cities and then there are great big cities, hopefully you can find a not so big city that has a good sawbones in which you can develop an acceptable relationship.

    Living where you do has it’s +’s and it’s -‘s, IMHO the +’s still out weigh the -‘s by a wide margin.

    Again I’s really do like the good news part a bunch.

  14. Cube64
    Cube64 June 14, 2018 8:52 am

    Sorry about your doctor. As with most things, there’s a bell curve of quality doctors.

    My wife probably hates them even worse than you do. It is especially frustrating when you have something that is difficult to diagnose and they “pooh-pooh” your symptoms. She worked in hospitals for thirty years and saw first-hand some of the incompetent egomaniacs and coverups. Fortunately for her, her medical knowledge gives her a leg up on evaluating doctors and she’s happy with the primary physician that she has now. But it’s not easy finding a good compatible doctor especially if you don’t like going to the big city where there’s a larger pool to choose from. Nurses often have some good suggestions about who the best doctors are, but then you have to know a nurse to talk with. And even then, a good doctor for some people won’t necessarily be the best one for you.

    When we first moved here and didn’t know anyone, she called the University Medical Center and found out which doctors were accepting new patients, and then looked them up on healthgrades.com and read their biography on the University website, and made the best selection she could. It’s a bit of a crap shoot no matter what you do, but at least it’s a little bit better than choosing one randomly.

  15. coloradohermit
    coloradohermit June 14, 2018 8:58 am

    I agree with the comment above that you should probably check with furrydoc to look over your test results. She might see something that dementia doc missed.

    A thought that came to mind, not knowing your symptoms or what was included in your tests, is that you could be deficient in vitamin D. The pacificnorthwet isn’t noted for an over abundance of sunshine.

    I hate that you’re having this frustration!

  16. Adam
    Adam June 14, 2018 9:10 am

    Claire, I’m sorry you have run into the same problems with the “healthcare” system so many others have when they just don’t feel right, have nagging symptoms that can’t be explained and won’t go away.

    Many doctors have no clue how to help their patients with these mystery symptoms and have fallen back to Voltaire’s maxim, “The art of medicine consists in amusing the patient while nature cures the disease.”

    A couple of people I know have had success following the advice of a man named Anthony William. He’s not a doctor, and, this sounds “woo-woo”. He’s a medical medium. He is given information that these symptoms are caused by one or more of these four categories: toxic heavy metals, viruses, radiation, and DDT. He claims people can heal themselves from these things through eating fruits and vegetables, herbs and spices, and some supplements. There’s too much to get into in a comment.

    You can learn more at his blog, http://www.medicalmedium.com/medical-medium-blog, and his SoundCloud site with recordings of his radio programs, https://soundcloud.com/medicalmedium , and he currently has three books out that should be available from your public library.

    This isn’t a quick fix, and it’s also not too overbearing, but it will take several months to see full results.

    I wish you the best, Claire.

  17. ellendra
    ellendra June 14, 2018 9:27 am

    I know you’ve been vague about your symptoms on purpose, but, if you’d like another set of eyes researching for you, feel free to PM me. I’d be happy to do whatever I can to help.

  18. larryarnold
    larryarnold June 14, 2018 9:54 am

    Wish you weren’t so far away.

    Something about this area seems to attract good folks, including medics. Part of it is our hospital, which is known as a very friendly place to work. It’s big enough to be full-service, but not so big it’s impersonal. We’ve been going to the same group practice for 30 years, and are very satisfied.

    IMHO you shouldn’t blame insurance companies.

    The first problem is that most insurance plans are selected by employers, not the people who have to use them. The second is the heavy government regulation of the insurance companies.

    Follow an insurance executive around, and you’ll find that 90% of the decisions they make, and 99% of the decisions that are bad for customers, are made to comply with a federal or state law or rule or regulation.

    OTOH, insurance companies have certainly played their side of that game.

    The fun part is that folks my age have to get used to trusting doctors that aren’t old enough to be our children. 😉

  19. Claire
    Claire June 14, 2018 10:00 am

    Man, this gets more depressing as it goes along.

    Stryder and coloradohermit — I have in the past and will again ask Furrydoc. I know she’s given up on the locals and now goes to the not-quite big city.

    William Conrad — That’s a very logical assumption. I did get a good air purifier, but to my surprise it never detected pollutants in the air of my house.

    Sara Wilson — I’m glad your frustrating and complicated story finally had a good outcome. And on the will … I don’t know what to say; no one’s ever done that before. Thank you. But now may you live a long and healthy life.

  20. Claire
    Claire June 14, 2018 10:06 am

    As to insurance and government regulation (which I agree have very nearly become one-and-the-same), I know they’ve become a plague of modern medicine. To that extent I do feel for the doctors who’d like to do more for their patients but who find themselves trapped.

    The doc I went to actually moved here from the Big City because she wanted to practice more old-fashioned medicine. I don’t know what’s happened to that plan. But clearly much of her problem is truly “just her.” She’s a rote thinker. What’s written on paper is more important to her than what her patient says. All conventional medical thinking is “true.” Etc. No flexibility. Pity.

    I feel for everyone who’s had serious or chronic problems who’s had to deal with the seemingly typical tribulations described here.

  21. Claire
    Claire June 14, 2018 10:20 am

    Ellendra — Thank you for the offer to help. Yes, I have been vague on purpose, but I know you’re a specialist with herbs. So I may take you up on that. I’m going to try one more doc first.

  22. Claire
    Claire June 14, 2018 10:23 am

    “Fortunately for her, her medical knowledge gives her a leg up on evaluating doctors and she’s happy with the primary physician that she has now. But it’s not easy finding a good compatible doctor especially if you don’t like going to the big city where there’s a larger pool to choose from.”

    Good for her for the research. It’s discouraging, though, when even medical professionals like your wife, Pat, and Furrydoc observe the same dismissals, incompetence, and rampant ego us ordinary mortals find ourselves crashing into.

    I’ll also check healthgrades.com and get all the recommendations I can.

  23. Mike
    Mike June 14, 2018 10:49 am

    Hey Claire, I’m sorry about the quack… er… doctor that you had to deal with. A couple of years ago, I had to go after a doctor with the licensing body because he was an idiot, so I know how you feel.

  24. Adam
    Adam June 14, 2018 11:08 am

    If you’re looking for another medical doctor, then you might consider checking his or her status and record with the state’s medical board. “Doctors can be disciplined for criminal convictions, medical negligence, wrongly prescribing controlled substances and other wrongdoing.”

    The public interest journalism site, ProPublica, has compiled a listing for every state on its page, How To Investigate Doctors. http://projects.propublica.org/graphics/investigating-doctors

  25. fred
    fred June 14, 2018 12:42 pm

    The medical replies have it pretty much covered.So sorry the Dr doesnt jive with your expectations,its hard to get a Dr you can be on the same page with.Ive had 2 primary care Drs in 40 years,how lucky is that???!!! Now my Doc is late 60’s,Im very concerned when he leaves.

    OK,medical advice,find a few nurses and ask them.Your best hope,they know the Dr’s and will readily share their experiences on who the best Dr’s are.If they are friends they will also tell you who the idiots are (which is even more important).

    I think this comment below covers my experience too,Vets as a whole sure have good bedside manners in my experiences.Really,Ive only met one jerk of a Vet,Dr’s,well thats a common occurrence.Too many really do think they are Gods and we the people are ignorant fools.Or think that since they read it in a textbook or much worse a medical journal its the same as the 10 Commandments…. and are incapable of independent thought.

    ======================
    Stryder June 14, 2018 6:42 am
    You can always ask your friend Furrydoc what she thinks. I mostly trust vets over MDs anyhow.

  26. UnReconstructed
    UnReconstructed June 14, 2018 1:37 pm

    Another story. Several years ago….actually many years ago, my wife developed a small lump in her groin where abdomen meets upper thigh (they call it the ‘crease’). She went to visit her primary, who did several tests, announced that its probably an infection, since it was really a swollen lymph node, and that is very common, and generally is nothing to really worry about. But she had a hunch, and suggested a biopsy.

    It turned out to be Non-Hodgkins Lymphoma. An incurable slow growing cancer of the antibody portion of the immune subsystem. We have been living with this ever since. Somehow medical science keeps pulling rabbits out of a hat, and she is doing very well.

    Point is….this was a primary physician who didn’t quite believe the rest results. It might have been an ‘unnecessary test’, but it wasn’t. I think primaries might get a bit jaded by all the poison ivy, warts, deep cuts etc etc, and might not notice something else lurking nearby. They caught the cancer early. It hadn’t metastisized….

    You have a hunch, follow it up. If another doc sez to get enough sleep…..well fine, you have done your ‘due diligence’.

    Fred is right. If you know any nurses, they have great info…..

    Warm thoughts and goodness to you !

  27. Bob
    Bob June 14, 2018 1:41 pm

    Claire,

    Welcome to by-the-numbers medical care. It gets worse as you get older.
    I blame Affirmative Action, Diversity and Inclusiveness. Can anyone name any organization/profession that’s actually tightened-up their requirements in the last 30 years? Most (not all) medical doctors today would not even qualify to be nurses 30 years ago. My advise: Find an older doc. – over 50 – that’s not in a hurry, and get the earliest A.M. appointment available. Also, most small-town docs aren’t out there for the lifestyle.

  28. Grant
    Grant June 14, 2018 3:31 pm

    My daughter was delivered at a small clinic in the Portland area operated by the dean of the Naturopathic Medical school there in Portland, 30+ years ago. She and my son were both unvaccinated, and we never took them to a pediatrician. They had some visits to our chiropractor, but never had any serious illnesses. We had read Dr. Robert Mendelsohn’s book, HOW TO RAISE A HEALTHY CHILD IN SPITE OF YOUR DOCTOR and his guidelines served us well. His other two books, CONFESSIONS OF A MEDICAL HERETIC, and MALE PRACTICE, MALPRACTICE are also very useful. If this doctor is in her 40’s she doesn’t have much of a life expectancy anyway, because MD’s die at an average age of 59. Iatrogenic deaths are the leading cause of death in the US, and American babies have the highest rates of infant mortality of any developed country. As far as tests are concerned, a pregnancy test will tell if you have cancer, and they are only a dollar. If you have specific concerns, there are online tests available for many issues.

  29. Ron Johnson
    Ron Johnson June 14, 2018 6:49 pm

    My wife was diagnosed with a damaged disk in her back. Said she needed surgery. Years later a physical therapist fixed it with one treatment, no surgery. There was nothing wrong with her back, it was the atrophied muscles from favoring her non-existent damaged disk.

    I was once pronounced “cured” of high cholesterol when it dropped from 214 to 212.

    I had a sore tailbone. Dr. gave me free Vioxx. I didn’t take it. It was recalled two days later for causing heart attacks.

    My wife had a kidney stone. Passed it while sitting alone in an emergency room exam room. Bill was $6400.

    My wife had a blurry eye. The young opthamologist said she probably had the beginnings of multiple sclerosis. Made no sense to me because that diagnosis didn’t match the symptoms I found in numerous places on the internet. Was sent to specialists for Xrays, then MRI’s, neurologist consultations, etc. Nobody listened to her description of her job. A year later, she was examined again by the opthamologist and he saw she was cured. Oh yeah, he said, probably just a strain from pulling too hard on pallets.

    My wife had a questionable mammogram. Sent for another, more expensive test. Still questionable. Sent for a definitive test…negative. Should have just done the last test first, eh? Would have been thousands of dollars less expensive.

    I have a small mole on my shoulder. Probably nothing, but I should have it checked out. I wonder why I’m procrastinating…

    On the other hand….
    I was involved in a lawnmower accident many years ago. Had to have a skin graft. Had a high deductible insurance. The surgeon waived his fee, and the hospital let me pay in weekly installments.
    Sometimes you stumble on a good one.

  30. Gran
    Gran June 14, 2018 8:33 pm

    Fibromyalgia and Chronic Fatigue Syndrome are tough to diagnose. My blood work looks “great”, numbers look “great”, yet I have alarming symptoms. After being tested for just about every major disease known to mankind, the doctor told me I “probably” have one if not both of the above mentioned conditions. You can’t see them in normal medical tests, but I know something has drastically changed inside my body over the last year. I am thankful for my MD who actually listens to me and believes me when I am describing my symptoms. Good vibes and prayers for you Claire!

  31. Mike
    Mike June 14, 2018 9:50 pm

    And they say guns are dangerous. Guns pale to a mere shimmer compared to the medical professionals.

  32. Technomad
    Technomad June 14, 2018 11:42 pm

    I’ve never been too keen on the medicos since I noticed how often they wouldn’t listen to what I said! I tell them about the things that are bothering me, and they say “Yeah-yeah-yeah, what-EVER. Now, about your weight…” I admit I have a weight problem; that’s partly a sedentary lifestyle and partly just the way I’ve always been wired, but when I’m complaining about things like my circadian rhythms being totally out-of-whack and that OTC sleep aids do me no good (I had allergies when I was younger and got habituated to antihistamine long since, and the OTC sleep aids have less antihistamine than the ones I was once prescribed) and they just want to chatter about my weight, I get irritated.

    OTOH, when I had skin cancer on my lower left eyelid they did a splendid job; I almost don’t even have a scar from when they did surgery to remove it.

  33. Joel
    Joel June 15, 2018 6:02 am

    Seriously. All these stories confirm why I generally start thinking “doctor” when there’s a bone sticking out or blood is actually squirting. They seem competent to handle those things. Anything requiring judgment or diagnosis of subtle symptoms seems to be a matter of luck.

  34. Chris
    Chris June 15, 2018 9:02 am

    A long time ago I was a graduate student teaching freshman physics. Freshman physics is usually a “flunk out” course for wannabe physicists, engineers and doctors. It weeds out the unqualified. Of the three, the worst were the pre-meds. They just had to get top grades because “med school.” Yet, for the most part, they memorized. They were good at that. The weren’t so good at thinking, though. For qualified engineers and physicists, if I taught A=>B and B=>C, they could easily figure out A=>C. Not so the pre-meds. If I tested on an A=>C problem they would complain I hadn’t shown them how to do that, and I was costing them grades and careers!

    I now think that is exactly what the medical establishment wants. They do not want doctors to think! They want them to memorize symptoms and treatments. They want to categorize patients, and prescribe the “protocol.” It’s the same with the insurance, too. Cookie cutter patients need cookie cutter treatment, or it’s experimental and they won’t pay! Unfortunately, patients are individuals. At least, most are 😉

  35. Claire
    Claire June 15, 2018 10:38 am

    “For qualified engineers and physicists, if I taught A=>B and B=>C, they could easily figure out A=>C. Not so the pre-meds. If I tested on an A=>C problem they would complain I hadn’t shown them how to do that”

    Scary. But that does make a lot of sense, given what so many of us have experienced. Med students almost have to be good memorizers, but given the complexities and unknowns of the human body, it’s a must for them to be good synthesizers, too. Except perhaps surgeons, for whom it’s so much about technique. And patients do seem to talk more highly about surgeons than almost any other docs.

    I remember something similar being said about Bill Clinton by one of his fellow Oxford students. S/he said that Clinton had an almost supernatural ability to absorb information, but that when they sat in seminars where they were expected to reflect on the meanings and consequences of things they’d learned, he was lost. He couldn’t even comprehend the concept that you could take event A and understand how it affected event B or was influenced by concept c. (I always thought that explained a lot about his presidency; but things have gotten so much worse now it’s hardly even worth thinking about.)

  36. fred
    fred June 15, 2018 11:08 am

    And patients do seem to talk more highly about surgeons than almost any other docs.
    ——————————-
    The absolute biggest idiots in the medical profession IMO are surgeons.Total aholes.The nicest? Cardiologists by far. IMO,FWIW.

  37. Claire
    Claire June 15, 2018 11:13 am

    I didn’t know that about cardiologists.

    And I know that surgeons are notoriously not people persons and some (e.g. neurosurgeons) get reputations for being monsters of arrogance. But as far as satisfaction with the results of their work, I do hear more people who are happy with their surgeons.

    This is just my limited observation, though. And although part of it does come from living around Mayo Clinic staffers for years, I admit I try to keep my observation of docs as limited as possible.

  38. fred
    fred June 15, 2018 12:10 pm

    Surgeons are like lawyers.never ever want to even be in the same building as one,but when you DO need one,you want a good one when youre up against the wall.

    Best surgeon I ever met was a neurologist who did my back.In and out in 20 minutes flat.

    Recommended by a couple medical secretaries (Yup,secretaries know docs for sure) because when I told em who workmans comp sent me to,they about fell off their chairs and said NO,he’s a HACK,you want Dr NJ,they were so right.

    I wound up working with him in later,socially awkward and literally couldnt work a desk phone that has 6 buttons for picking the phone line.No joke.

    Total Idiot…Idiot Savant that is.Fantastic surgeon and just a hell of nice guy.A heart bigger than Texas.Also knew ONE nice cardiac surgeon,go figure.All the rest…not my cuppa tea.

    Hey back to Vets,my dog had a great surgeon for her cancer.Whats up with Vets anyhow,are they all awesome for the most part? 🙂

  39. Tom
    Tom June 15, 2018 6:43 pm

    Vets are awesome, for the most part, I believe, because their patients don’t talk! Think about hearing, for example how “precious little whoever” did something so awesome over and over. Or “that “couldn’t possibly be the problem – The plumbers wife felt the same way, and she had whatever, so must I- now prescribe me!
    One interesting fact: the state epidemiologist (at least a couple years ago, I didn’t check today) was/is a veterinarian. Why? A vet knows to look at populations and their symptoms – regular MDs focus on individuals.

  40. Comarde X
    Comarde X June 16, 2018 6:01 pm

    “But as far as satisfaction with the results of their work, I do hear more people who are happy with their surgeons.”

    The unhappy ones ain’t talkin!

  41. fred
    fred June 16, 2018 6:13 pm

    Comarde X…LOL!!!!!

  42. Pat
    Pat June 17, 2018 2:40 am

    It’s also true that surgeons can show a more immediate and satisfactory result; they can remove the problem or repair it, and the patient is relieved. The GP or internist often has to wait for his results; non-surgical problems take longer to heal, with or without medication, and may even take longer to diagnose before treatment (and healing) can begin.

    Medicine is not an exact science, after all – which is something patients don’t always realize, and even doctors and other medical personnel are reluctant to admit. In addition, patients themselves make it difficult because 1) they don’t always tell or recognize what is important for the doctor to know, and 2) an illness can stew inside the body a long time before patients know they are sick, or sick enough to see a doctor.

    For all that I can find fault with the practice of medicine today, I still recognize there are inherent factors in the field of medicine that make it a difficult practice. No one is a mind reader or can see inside the body. And no one can predict categorically what is happening inside that body.

  43. Thomas L. Knapp
    Thomas L. Knapp June 17, 2018 5:38 am

    It seems to me that medicine has, to a large degree, gone the route of auto repair.

    When I was a kid, if your car was making a funny noise you took it to a mechanic who listened to the engine running, told you to gas it a little, maybe asked if he could drive it around the block so that he could physically feel what it was doing. These days he plugs a cable into a port, gets a code, looks up the code in the manual, and replaces whatever the code tells him to replace. Not all of them, not always, but it’s a lot more the latter than the former as far as I can tell.

    When I was a kid and went to the doctor, the first thing he did was look me over, listen to my heart, tell me to say AHHHHHHHHHH, and try to figure out what was wrong with me. These days my doctor does that stuff, if at all, after looking at a computer screen that tells her what medications I’m on, what my blood work revealed, and PROBABLY (I never see the screen) diagnoses any actual or potential problems from the data. Basically her job is to lecture me on smoking, ask if I’ve had my flu shot this year, and shuffle me along to a specialist for any actual problems.

    My mom is switching doctors after hers (a guy I went to high school with) seemed to be phoning it in. And he actually told her he didn’t feel like he was a doctor any more. His job, he told her, now boils down to “do I send this person home or do I send this person to a specialist?” and he wasn’t even the one really making that decision, the insurance company network was. He was just a friendly face in a lab coat to make the patient feel like someone was paying attention. In fact, in my mom’s insurance network, the primary care physicians are barred from the hospital. If the patient is admitted to the hospital, he or she gets a “hospitalist” randomly assigned and their regular doctor isn’t even supposed to “interfere” by checking up on them to make sure they’re getting what they need.

  44. Claire
    Claire June 17, 2018 9:23 am

    “It seems to me that medicine has, to a large degree, gone the route of auto repair.”

    A couple of years ago, I had to sell my Xterra for less than 1/3 of its value because three mechanics kept wanting to replace the same perfectly functioning part and couldn’t bother (or didn’t know how) to find that part that was actually malfunctioning.

    And yes, same thing from both doctor and mechanic. NO thinking. NO diagnostic skills. Just “diagnose by the numbers” — meaning no real diagnoses at all.

    We’re dooooooooomed.

    And that’s terrible, what you say about “hospitalists.”

  45. ~Qjay
    ~Qjay June 17, 2018 3:51 pm

    Consider looking for a Cash Only doctor. They are out there, they don’t take insurance, and they rely on doing a good job.
    There are still nutty ones, but there are fewer, because “no cure, no pay, no repeat business”.
    I know your funds are limited, but it might be the way to make sure you get a real look at your symptoms.

    Consider also talking to your doctor, outside of the exam room, even an email, and express your concern. Lay out exactly what you are concerned about in your visit, and tell her you didn’t come to see her because you wanted advice on eating better snacks, you wanted to know about your serious symptoms that are making your life difficult.
    I have this conversation every couple of years with my current doctor, and she stays excellent.
    Mostly. 🙂

  46. Claire
    Claire June 17, 2018 4:23 pm

    The nearest fee-for-service doctor I’ve found (or rather, a reader found for me) is hours away, unfortunately. IF I thought she could give me a solid diagnosis, it would be worth the $300 or so to go to her on the understanding that it would be a one-shot appointment.

    “Consider also talking to your doctor, outside of the exam room, even an email, and express your concern.”

    That’s a very civilized idea, thank you. If she were a fundamentally good doctor with whom I had some differences of expectation, I’d do exactly that. I’m definitely a believer in good communication. But after the sheer malfeasance I saw from her (not reviewing my records, not remembering my symptoms, and responding with silly and dismissive platitudes when I mentioned them), I’m not motivated to want to try to work anything out with her.

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