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Why Did My Patient Leave Me?

cancer.nautil.us

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Re: Why Did My Patient Leave Me?

#121

Post by kbutler »

maxxxxx wrote: post #91

This is an interesting read. It seems doctors really believe they have a conversation with their patient whereas most patients feel that the doctor just rushes in and gives his standard recommendation without deeper thought and generally doesn't listen to them. Do doctors go to other doctors when they have a problem? Do they get more respect by other doctors? If they went to a doctor and got the same treatment as the…

This is definitely more at the specialist, chronic care level. Like anything else, if you have a weekly contact with them, you are much more significant than a once or twice a year visit.

Re: Why Did My Patient Leave Me?

#122

Post by david-gpu »

agumonkey wrote: post #45
XorNot wrote: post #39

Earlier quoted context omitted.

People looking for alternatives for cancer care tend to look for things which literally do nothing (high profile example: Steve Jobs), or get fixated on experimental drugs which have a high likelihood of being ineffective or much more immediately fatal.

Fair point. I just think a bit like DeVita: delay death (in a moral manner, not at any cost); then treat with recent combinations/molecules. The regulations forbid combinational trials first and delay learning (according to him). There are potent tumor inhibitors like CBD that aren't accepted by most of the medical field, thus patients too (high trust in the doctors). They can alleviate symptoms and slow down metasta…

I am very sorry to hear you are going through that. Best wishes from this stranger.

Re: Why Did My Patient Leave Me?

#123

Post by ganonm »

maxxxxx wrote: post #94
tim333 wrote: post #14

Earlier quoted context omitted.

Not sure the patient is always right but the docs are often wrong. Collaboration probably works best. The docs have more medical knowledge but the patient may know more about their particular condition. I recently went to a dentist with a broken tooth and he wanted to do a root canal not because their was any evidence it was infected but because he thought it might be and why not from his point of view. From mine I'd…

There may also be quotas to fulfill​ for certain procedures. I often get that impression from dentists when they push for something that doesn't really make sense.

Quotas for procedures is a very interesting topic. Doctors (in the UK at least) carrying out appendectomies consider a negative appendectomy rate (NAR) of around 20% to be optimum. The NAR being the proportion of appendectomies where it turns out the appendix wasn't the cause of the symptoms.

The reason this is considered optimum is that a doctor hitting 0% NAR (which you might naively assume is best) is most likely being overly conservative and missing some genuine cases of appendicitis, which as we all know can be life threatening if left untreated.

Re: Why Did My Patient Leave Me?

#125

Post by losteverything »

I'd say in a bar to this author dr

1. Kittens die

2. You have a unique position to help people.

1. If you have ever cared for 4-7 week kittens then you know sometimes they just die. Don't be surprised when they do. They simply do. One moment they seem healthy and the next-they are gone.

Your patients will not come back. They just won't. Don't be surprised when they don't come back. It happens. You will not know why. It's part of life like kittens dying.

2. You help people. You give them their life back. You are One of the few people who can make someone better. You improve. You prolong happiness. You give hope. It's often invisible to you. Yet it is real. It's real when your patients can travel, cook, walk, earn a living, hug grandchildren, breathe another breath.

I can't do that. Most people can't do that. But you do. Every day.

So who gives a ### that you don't know why the kitten left your practice. It never changed all the good you did and all the good you can and will do.

So... Forget the kitten.

Re: Why Did My Patient Leave Me?

#126

Post by csydas »

theoneone wrote: post #61
csydas wrote: post #35

Earlier quoted context omitted.

> Also, randomly billing me for stuff weeks or months after an appointment with cryptic explanations thoroughly pisses me off -- even it if is only $15.00 (going to get a new podiatrist over that one...). This part gets me a lot as well, and having experienced other pay-for healthcare systems, it's extremely frustrating remembering just how much I would pay in the US even when I had fair insurance through my employer…

So 3000$ for a biopsy: ticket to Greece and back to USA : let's say 1000€. Biopsy procedure if it's ultrasound guided around 300€. Lab fee for examining the biopsy:around 200€ max, maybe less. Hotel room for 2-4 days in Thessaloniki 120€-150€ in a decent hotel. Total:1500€ or even less. All these can be done by highly and well educate medical doctors, treatment in private clinics is very good(since you are paying in…

I would strongly agree, especially since it's already happening in the US for those who can afford the travel time, which is probably the biggest damning factor for most people. My last job was a good job, but it was University work so it paid pittance. Likewise, with such terrible sick leave/vacation policies, it's very hard for such a strategy to really work for many Americans. Even those at my company that had been there for 10+ years only got 16 days vacation a year - my job abroad has 28 days a year standard, with the requirement that one bout of it must be at least 2 weeks in duration. It's way easier to plan a vacation around a medical procedure when you have a month to plan around it.

Even when you make a steady livable income, it's really crappy to have to go to the doctor in the US.

Re: Why Did My Patient Leave Me?

#127

Post by XorNot »

ThomPete wrote: post #76
XorNot wrote: post #36

Earlier quoted context omitted.

Ah yes, because the "market" for healthcare operates so well ...

It's really sad that it's impossible to discuss healthcare without people jumping into their pigeonholes. Healthcare isn't perfect anywhere in the world whether private or public. And even the US healthcare system isn't really market driven.

That's my point. Any suggestion which starts with "this is unsustainable because the market isn't driving incentives right..." has completely missed what's going on in healthcare first and foremost: it's your life, and it's worth everything to save it.

Opening with "let's have a market" isn't opening with a cogent position, since rational actor economic theory is completely unable to deal with this (sure, there might be others, but no one making this assertion wants to talk about them).

Re: Why Did My Patient Leave Me?

#128

Post by GavinMcG »

giardini wrote: post #103
jacquesm wrote: post #26

Earlier quoted context omitted.

Good point. I'm not too worried about France, they seem to have their priorities straight there, other countries are less stable. Especially in former Eastern European countries there are disasters happening right now, and many Western countries will have to come to terms with the cost of health care and attempting to take commerce out of it. NL had a very good system which got replaced by something much less efficie…

I'm not so sure about "have their priorities straight there". Using the state to manage healthcare brings up strange priorities: "Should we cover kidney transplants or should our soldiers have real bullets in their guns this year?", "Should we build the new transit line or increase coverage to include penile transplants?", etc. I don't want people voting based on their appendix, their bad knee surgery, or a skin rash…

You say it's inevitable. Surely, then, you have some evidence of this trend actively weakening countries?

It's easy to sketch convincing strawmen. But if you could actually point to somewhere that is choosing between kidney transplants and bullets, I'd eat my hat.

Re: Why Did My Patient Leave Me?

#129

Post by JimXugle »

In my case it was because we weren't making progress towards turning a long list of symptoms into a diagnosis, compounded with some rather ill-informed and slightly offensive remarks about LGBT people and HIV/Aids.

Re: Why Did My Patient Leave Me?

#130

Post by madengr »

giardini wrote: post #81

In my case, - reluctance to diagnose and treat the ailment instead of the symptoms and - simply refusing to hear what the patient says. I had an oozing rash break out behind my knees. The dermatologist said "That'll go away easily if you put some OTC corticosteroid cream on it." Wrong! The rash flared up within hours and nearly ate the flesh off the back of my knees. I happen to know that this indicates a fungal infe…

Dermatologists have a cream for everything. Once in a while I have a horrible itch breakout on the top of my feat; so bad I'll scratch it bloody. In this case, the one pound tub he prescribed does work. Works well for chiggers too.
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