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Why Did My Patient Leave Me?

cancer.nautil.us

231–240 of 257 posts

Re: Why Did My Patient Leave Me?

#231

Earlier quoted context omitted.

maybe it goes without saying, but you also avoided the infection risks which come with surgery.

Yeah, and the risk of spontaneous anesthesia death (it's rare, but some people simply don't ever wake up). There's always plenty of reasons not to get surgery, and the only reason to get it is if the outcome for the injury is better, which it wasn't in this case! The default should be to not get surgery unless it has a clearly better expected outcome, whereas the orthopedist seemed to default to surgery for any injur…

> The default should be to not get surgery unless it has a clearly better expected outcome, whereas the orthopedist seemed to default to surgery for any injury

i'm not a doctor, but that makes sense to me.

i sometimes hear that medicine has entered the "post antibiotic" era. i can't help but wonder: are surgeons about to take a big financial hit because of that?

Re: Why Did My Patient Leave Me?

#232

Earlier quoted context omitted.

Right, without you there would be zero humor on this site.

Rosa Parks wasn't the only person who was a victim of institutionalized racism, but she is uniquely remembered for her form of protest

Comparing your cowboy-commentary on an internet forum to Rosa Park's dangerous form of protest where her very life was on the line is completely disingenuous and makes you sound completely ignorant.

Re: Why Did My Patient Leave Me?

#233

As someone who deals with chronic joint pain, getting opiod pain relief right now is a fiasco. It is funny: prescribe pain relief, then act like I'm an addict? Give me a break. Who is selling the opiod epidemic story ad nauseum?

I have had severe chronic pain for many years as well. I use opioids but for a very short duration. It is a huge pain to get off them when you take them for a while. Max dosage of medical marijuana (cbd and indica not sativa) and synthetic opioids like tramadol not used daily works best for me. Current political climate is a no no to all opiates which is why it's so hard to get them now and it is awful for those with lots of pain, but doctors really did prescribe them too much.

Re: Why Did My Patient Leave Me?

#234

Earlier quoted context omitted.

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.

Mate, you couldn't be more wrong. Doctors, on the whole, are just about the smartest folks out there. Are there bad, less intelligent doctors? Sure. If you think it's as simple as "taking out 300k and staying in school until you are 30+" you're delusional and frankly don't know what you're talking about. Math, statistics, physics, chemistry, biology and on and on. These are just some of the areas doctors need to be w…

I almost married a neurologist, who was woefully incapable of helping me deal with my migraines. In my anecdotal experience, doctors really aren't that smart. They are taught rote memorization instead of critical thinking, and according to my ex, 90% of their job is using something similar to WebMD. And many of the people I grew up with that weren't particularly bright ended up going to med school and becoming doctors. And my ex was definitely terrible at math and physics, although she was competent with biology.

There is a notable exception for surgeons though, every one of whom I've met is a badass. Again, this is based on anecdotal experience and I'm sure there are exceptions (or maybe I've just had poor sampling, but the sample size is dozens of people). But I do know that most doctors are not taught how to think, but much more how to follow processes that are incredibly similar to basic computer scripts (if X then Y).

Re: Why Did My Patient Leave Me?

#235
Not that the author of the linked piece will see this thread, but my experience has been that those patients who leave for personal reasons, as opposed to logistical reasons, e.g., changed insurance, moved away, etc. are usually not missed. My office staff will say, "We sent Ms. So-and-so's records over to Dr. Xyz" I'll say, "Gee, that's too bad." Almost invariably the reply comes back, "No, he can have her. She's impossible." (Of course, they're nice to me, but the office staff gets a more realistic picture.) So it tends to be that people who appreciate my style and personality hang around.

Re: Why Did My Patient Leave Me?

#236

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.

I work with a guy who was given prednisone to treat some problem or other. It wasn't some high dose, and he didn't take it for long, but he was unlucky. The capillaries feeding the network around his hip sockets essentially all died, and he started having a lot of pain walking, then started using a cane (he was in his late 40s). A couple years later he had a double hip replacement.

Re: Why Did My Patient Leave Me?

#237

Earlier quoted context omitted.

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.

Mate, you couldn't be more wrong. Doctors, on the whole, are just about the smartest folks out there. Are there bad, less intelligent doctors? Sure. If you think it's as simple as "taking out 300k and staying in school until you are 30+" you're delusional and frankly don't know what you're talking about. Math, statistics, physics, chemistry, biology and on and on. These are just some of the areas doctors need to be w…

Honestly I'd disagree with you (though I agree that the loan and schooling comment was definitely simplified). Not that they're dumb, but medical schools select more for hard workers who know how to memorize large quantities of information than anyone who's particularly bright among college graduates.

Most medical students and doctors have a fairly poor understanding of math and statistics, a level of understanding of chemistry that's not particularly difficult, and a level of understanding of physics that doesn't go beyond a freshman level.

Have you actually looked at MCAT study materials? Anyone who's majored in biology would know the material. What determines how well you do is the quality of your study habits.

That said, hard work is usually what wins in the end in most fields, even those that do tend to attract the brightest.

Re: Why Did My Patient Leave Me?

#238

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…

I suspect they won't change their ways unless they're sued over it. It would definitely be something I'd consider if I was prescribed something that hurt me further. (Of course not much you can do if it's a known and disclosed possible side effect...)

Re: Why Did My Patient Leave Me?

#239
post #189

Earlier quoted context omitted.

"cost still is bigger than the money you can afford to put into it." - so spending even more would be super sustainable, so long as it enriches the wealthy shareholders? "you can never spend enough money on it" - i say again, 'enough' is defined differently, a 'socialist enough' is enough to please the people; where a 'capitalist enough' is the smallest number that can sustain profit. these 'enough's are radically di…

Spending even more is whats unsustainable you can't keep spending more and more money in a single payer system as it will either affect other areas or you will have to tax the citizens even more. There is a limit to that. If you get more and more treatments available and what people consider being part of healthcare and you are running a cost center then your system gets more and more expensive. No enough here is mea…

"Spending even more is whats unsustainable" - nationalized healthcare spends less for the same or better outcome, if your problem is price, then your problem is private healthcare.

'cost center' Vs 'profit center' '[denying treatment] because it can't pay if everyone used it' - This is just false, moneys going into a countries nationalized health system is high return (due to taxes), its also cheaper (due to group union prices). So long as its a healthy part of a healthy GDP (12%) it should have capacity for everyone in the country. compared to the US system which costs over 40% of your GDP and still does not have capacity for all your citizens.

'which drugs it will prioritize' - true, but this is done mostly on evidence of usefulness, not price.

I largely agree with your last statement, but whatever problems a socialist system has, they pale in comparison to the misery caused by Laissez-faire in our health system.

Re: Why Did My Patient Leave Me?

#240
post #111

Earlier quoted context omitted.

> 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…

> Doctors need to prevent shit instead of patching shit.

Ideally yes. But we as individuals already have the capacity to do this:

- Eat well

- Exercise

- Don't smoke

- Don't drink

- Wear sunscreen

etc.

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