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Why Did My Patient Leave Me?

cancer.nautil.us

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Re: Why Did My Patient Leave Me?

#211

Post by jacquesm »

sxg wrote: post #206
jacquesm wrote: post #146

Earlier quoted context omitted.

> I'm not totally convinced your story with the cup of water was an ego related issue. Ok. > The workflow of doctors in the hospital is complicated, and different doctors and nurses have different privileges for different patients, which can make things appear to be ego related. In your scenario, you're a post-operative patient. Your primary doctor is likely the surgeon that performed surgery on you. I'm thinking the…

Obviously I don't know all the details of your story, but I'm still a little skeptical. Yes, there are likely doctors out there that do believe they're too good to get water for patients, but I haven't worked with any like that yet. I have rounded with doctors who have delegated simple tasks like getting water to someone else, but it's always been to either save time or avoid giving water to someone who isn't allowed…

> which is often used for feeding solids and liquids.

No, it was there during the operation, not for feeding.

> Again, I don't know all the details, but I'd imagine what happened is that your consulting doctor saw you had an NG or OG tube and wasn't sure why.

No, this was definitely not the case.

> All of this leads to miscommunication, misunderstandings, and massive/frequent problems like your experience.

This may sound funny to you, but ego or miscommunication doesn't matter to me, the end result is what matters. If you can't communicate or have an inflated ego I'd rather not have you as my doctor because either one of those is an ingredient in a recipe for an accident.

Re: Why Did My Patient Leave Me?

#212

Post by bayouborne »

In my field when a customer has an environment with a problem, he or she files a ticket describing the problem to the best of their ability. Some of these customers are quite expert in accurately framing the issue, what they've done thus far, and they frequently provide addt'l information answering what would have been my next questions. Other customers are inexpert in stating the problem. Regardless of the customer's level of understanding of the issue, once we take a case (yes, we call them that) we understand it is our responsibility to resolve the issue.

Doctors today are literally too busy to care. They never 'Hold the Paper' to the issue. It isn't enough for a patient to manage to have the proper insurance and reach out to a primary care physician; it's now incumbent on you to continually identify the specialist areas which may be germane to your issue and make the appointments and interpret the resulting data. You, are the integral component to saving your own life, as no doctor or other medical professional is there now to provide continuity, or put any of what's happening to you into context.

I honestly think there is an opportunity for yet another layer to be inserted into American medicine - that of the patient's advocate, who is smart enough the carry the day, and who simply gives a shit.

Re: Why Did My Patient Leave Me?

#213

Post by madengr »

comicjk wrote: post #205
giardini wrote: post #203

Earlier quoted context omitted.

I asked two friends about my itching woes. Both are gardeners so have dealt with maddening itches. Their response: "I ask my doctor and he gives me a prednisone pill. The itching disappears; 3 days later I'm OK." In the case of the fungus, prednisone would have been a mistake, but I nonetheless sometimes feel I am a target for a form of alternative medicine. Why didn't _I_ get a prednisone pill instead of a tub of co…

Prednisone pills are substantially more dangerous than cortisone cream, no? The one time I've taken prednisone, I had pretty severe mood swings, which is just one of a dozen notable side effects.

Yes, prednisone is the 5-4-3-2-1 dose to wean you off. Had it recently for bad lung burning from bronchitis, and can work slipped discs in back.

Re: Why Did My Patient Leave Me?

#214

Post by madengr »

giardini wrote: post #203
madengr wrote: post #130

Earlier quoted context omitted.

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.

I asked two friends about my itching woes. Both are gardeners so have dealt with maddening itches. Their response: "I ask my doctor and he gives me a prednisone pill. The itching disappears; 3 days later I'm OK." In the case of the fungus, prednisone would have been a mistake, but I nonetheless sometimes feel I am a target for a form of alternative medicine. Why didn't _I_ get a prednisone pill instead of a tub of co…

FWIW by the time the chigger "bite" itches, it's probably long gone. Not actually a bite, but they inject a solvent around a hair follicle and slurp up the dissolved skin. The solvent causes the maddening itch.

Google "Hells itch"; it's worse than chiggers. Had it twice. First time I needed a steroid injection. Second time 20 years later I knew what it was and heavily dosed myself with Benadryl for 2 days.

Re: Why Did My Patient Leave Me?

#215

Post by maxxxxx »

magnetic wrote: post #201
maxxxxx wrote: post #188

Earlier quoted context omitted.

Probably correct. My girlfriend just had a few surgeries. I was shocked how little time these specialists gave their patients. I bet most of them spent less than an hour thinking about the whole case. There are exceptions but we had several surgeons who stopped by a few minutes before the surgery and didn't remember anything about the case or confused cases. Then they took 3 minutes to get up to speed. They also ofte…

I was following you until... > I can't imagine how bad software development would be if we acted like the medical system. ...which made me laugh. Until I realized you weren't sarcastic (I think).

I wasn't kidding. The management aspect of the medical system is terrible. The quality standards of individual procedures is high but the overall management is terrible. Nobody talks to each other, everybody just does their little part without anybody having a bigger picture. My girlfriend now has had several failed surgeries. Whenever we go to a different surgeon they never ask the previous guy what he has done. I once suggested he should call and ask. The surgeon seemed really insulted. And as I said before when something fails there is no retrospective. They disappear and send a 50000 dollar invoice.

Re: Why Did My Patient Leave Me?

#216

Post by arkades »

peferron wrote: post #197
arkades wrote: post #166

Earlier quoted context omitted.

That's not a hierarchy thing. Docs are the chokepoint in the process. Overseers track very carefully how much time you spend, how productive you are, etc. and surround you with lower-wage employees to do every last thing except those responsibilities that you, by law, have sole power to do. My buddies are in latter years of residency and no one works that's despite running around like their hair is on fire. I assure…

Why are there so few doctors in the USA that they need a whole system around them to ensure they spend < 5 min in front of each patient?

After you graduate medical school you are required to undergo post-graduate education to receive your license. This post-graduate education system hasn't had an expansion of slots in over 20 years (the Balanced Budget Act of '96 put a frozen cap on the number of funded positions.) A number of positions are unfunded, and hospitals are trying to actively eliminate those (rather than grow the pool of physicians to meet demand.) The actual amount paid out for these slots has been repeatedly cut into as well, as part of various political wranglings.

New med schools are opening every day, but they're an irrelevancy when the chokepoint is actually getting narrower.

Additionally, docs are just the most expensive staff members. It's bad business to have someone who costs $10/hr doing work someone else can do for $5/hr. Hospital CFOs don't care if it makes patients feel like shit, and doctors feel like shit; they don't want to pay out the marginal $/hr.

Re: Why Did My Patient Leave Me?

#217

Post by ziikutv »

77pt77 wrote: post #111
ziikutv wrote: post #97

It ain't perfect in Canada either. I remember losing my hairs and getting patches of super smooth bald spots. Super embarrassing for a kid in a bad neighbourhood and bad school. Went to the doctor she looked at my charts and said I was super low on iron so low that I might even die if it continues to lower. I was given iron pills. Two months after I went to the doctor again and said my hair patches are not fixed. She…

> Then upon investigation it was noted that the staff gave her wrong chart; of a pregnant woman who had a similar "feminized" version of my name. This has happened many times to me. It's quite scary once you realize it. Thankfully no one ever told me I was pregnant. > We filed a complaint but she then resorted to personal attacks in her report Care to go into more detail? I'm really interested in knowing how these de…

> This has happened many times to me. It's quite scary once you realize it. Thankfully no one ever told me I was pregnant.

I was furious and told them to write my name, age, and gender on top of the leaflet in bold red letters and watched them do it. All subsequent visits started off with me making sure that it was the right chart. Some good doctors ask you name, age before opening the chart. Not this one..

> Care to go into more detail? I'm really interested in knowing how these details.

My mother is a registered nurse. Heck, she was part of the government that trained a school of just nurses. Needless to say, she comes from a time and with experience that would lead her to run around the nurses of today. The digression was to just point out that.. my mom knows her shit.

After injecting her, she said "OH NO" really loud and then quickly left the room after tossing the bulb in the hazard bin.

As she was gone, my mom tried to look for what it was hoping there wasn't anything else in there other than the bulb in question.

She came back and saw my mom looking and accused her of attempting to harm herself and tampering. She never physically touched anything in the room, just was leaning from her seat so she can see the contents of the bin.. What the fuck man!

> This is just called making sure your business is recurrent.

Yeah, this is why I wished Homeopathy and all those kind of things were actually realistically helpful. I think the problem is that Doctors are no different than road workers that periodically patch the cracks on the highway. Doctors need to prevent shit instead of patching shit.

Edit: Spelling error and remove colloquial tinfoil paragraph xD

Re: Why Did My Patient Leave Me?

#218

Post by ziikutv »

dleslie wrote: post #104
ziikutv wrote: post #97

It ain't perfect in Canada either. I remember losing my hairs and getting patches of super smooth bald spots. Super embarrassing for a kid in a bad neighbourhood and bad school. Went to the doctor she looked at my charts and said I was super low on iron so low that I might even die if it continues to lower. I was given iron pills. Two months after I went to the doctor again and said my hair patches are not fixed. She…

Bureaucratic mishaps and mediocre care providers are bound to occur in any sufficiently complex system.

I agree and the skeptic in me wonders if we can ever replace the "humans" in these roles with computers that crunch a bunch of numbers. However, just like computers, many doctors base their decision on statistics.

Re: Why Did My Patient Leave Me?

#219

Post by cmahler7 »

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…

no disrespect to doctors but you really don't have to be that smart to become one. It's more about being willing to take out 300k in loans and stay in school until you are 30+ years old.

Re: Why Did My Patient Leave Me?

#220

Post by henrikschroder »

dabbledash wrote: post #99

I think it's great for doctors to solicit feedback from departing patients to see if there is anything they could be doing better. But on a related note: I'm not sure about the value of using patient satisfaction surveys to evaluate physician performance generally. Patients will love doctors who tell them what they want to hear, over-prescribe antibiotics, over-prescribe powerful pain killers, go along with non-vacci…

I saw a study of patient satisfaction across the entire healthcare field which showed that overall patient satisfaction was the highest for massage therapists, and the lowest for oncologists.

The former deliver no bad news ever, and treat to make you feel good and relaxed, the latter deliver nothing but bad news, but they probably save your life.

So what happens is that people mistake their subjective feelings for the objective quality of care, and discount the value of being alive immensely.

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