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Not only in Canada, it's like that in every country I've seen a doctor. As for the 'why'... You'd be surprised on how difficult is to get an answer like that f

• chimeracoder 10y ago
  > My suspicion [from personal observation] is that they simply don't know anymore: It's something they learnt in college, but after a few years of dealing with symptoms and prescribing treatments, they forget about the why. If your doctor actually doesn't know why it's necessary to take the full course of antibiotics (antibiotic resistance), please get a new doctor. Seriously. (And report the old one, since he/she should not be practicing). Of course, if the problem is simply that you can't get a layperson-intelligible answer from them, or get enough time with them for them to explain it to you, or if they're willing to explain it to you, but only if you ask... that's another story, and much more commonplace. The sad truth is, even for the most compassionate, attentive, dedicated doctor - the one who would always go the extra mile to provide you with the best care imaginable - over the years, it's become increasingly difficult (read: next-to-impossible) to dedicate that extra time to the patient unless they really press for it. Insurance reimbursements have been cut to the point where the only way most physicians can stay afloat is to make their practice a volume game[0]. As the patient, you're not actually the paying customer (the insurer is), and the insurer doesn't care if the doctor takes an extra five minutes to talk about bacterial resistance and evolution. They'll reimburse him/her the same amount either way[1]. The exception to this is high-end, self-paying practices (think 'concierge medicine'). Unsurprisingly, those tend to have the best service (of course, you pay heavily for this). [0] Or to go bankrupt, and sell to a hospital/practice group. Which is subject to the same pressure to generate volume, except the hospital cares a lot less about you, the patient, on an emotional level than a private practitioner does. [1] In fact, in the worst case, the provider is getting reimbursed exactly $0 for providing you this care, because you're on a capitated plan. Under captitation, the provider (usually a hospital) gets a fixed, annual amount per patient that they are responsible for, and that's all the payment they ever get. The idea there is that it discourages unnecessary care - which is true, but it also disincentivizes necessary care as well. And spending an extra 5 minutes to educate the patient in a way that may have an impact on broader public health, but is unlikely to affect their own actual care in any measurable way? They don't have time for that, and they're certainly not getting paid for it.
  • loopbit 10y ago
    As I said in other comment, the antibiotics one is a very simple case, but I've had plenty of other examples. As to report the doctor... To whom? Do you know how difficult it is to prove almost any kind of malpractice? I've had a doctor insist that I had a sprained wrist when it was a broken radius (as another doctor and a simple x-ray proved). Another said that the cramps I was having were from an unborn brother (ahem). My wife was told in the hospital that she wasn't having an allergic reaction to antibiotics because she had had them before (surprise, antihistamines helped and further tests detected she's allergic to penicilin). Of course, nothing gets written and doctors are very quick to cover each other. So how do you report these? As for the doctors not being able to dedicate extra time to patients, I totally agree and indeed mention it in my first message.
• fucking_tragedy 10y ago
  > As for the 'why'... You'd be surprised on how difficult is to get an answer like that from any doctor. My suspicion[0] is that they simply don't know anymore: It's something they learnt in college, but after a few years of dealing with symptoms and prescribing treatments, they forget about the why. The reason why is very simple Biology 101 level material. It's so fundamental that it makes your last statement incredibly comical. Forgetting this is like forgetting that your computer is powered by electricity.
  • loopbit 10y ago
    You are right, the antibiotics one is pretty simple, I ran with it because I didn't want to get into personal details. Let's put a simple one from my experience: No doctor has been able to tell me what the bilirubin is. They go on to tell possible causes, and what it means to have a high value and so on.. but after hours with them, no one could tell me what it is. The closer I could get was for one of them to tell me that its secreted by the liver (close, but no cigar). The first paragraph in wikipedia explains it perfectly. I know that my computer is powered by electricity. I know most of the ways to produce said electricity, but I've forgot the details of an hydroelectric plant even though I studied it in college; it's not part of my daily life. I also know that power lines use alternate current and computers use direct current, but I've forgot the details of the AC/DC converter. Even though I was able to design one from scratch in university. I also studied the internals of microprocessors up until the pentium, how they were designed and manufactured, but nowadays all I remember, vaguely, is the x86 assembler. Do you remember every single detail you studied in college? Do you know how to calculate the root of a number by hand? I don't. Not anymore.