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I have luckily been very healthy in my life, but I have always believed that the relationship between a doctor and a patient is a collaboration with the aim bei

I have luckily been very healthy in my life, but I have always believed that the relationship between a doctor and a patient is a collaboration with the aim being to help the patient make the most appropriate decision for their needs. Too many doctors seem to be of the opinion they know best and the patient should just do as they say - even if they are correct technically it is not their life that is on the line. The patient is always right.

agumonkey 10y ago
Well, I've been plunged into this very issue. Even for cancer care, I found no trace of collaboration. It was bureaucratic, sometimes cold, out of sync (no news, contradictory news). No team work possible. Also if you ever try to mention alternate ideas, you get dismissed right away. And for fallacious reasons. Mostly statistical and experience driven, which looked like myopia to me. I'm actually collecting evidence to back my ideas right now. I understand they're humans, have limits, budgets. But the overall "this (comfy death) or nothing" is maddenning to me.
- XorNot 10y ago
  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.
  - agumonkey 10y ago
    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 metastasis (some academics have seen regression even). This gives time to plan for the rest. Instead you're sent home to die thinking it's hopeless. I guess it's better than dying at hospital, or being cut into pieces by resections... but it's far from acceptable IMO.
    - david-gpu 10y ago
      I am very sorry to hear you are going through that. Best wishes from this stranger.
      - agumonkey 10y ago
        Thanks for the support. We're a bit all in this together because the same issues occur to any patient and families. And it's neither me nor a very very close member. That said family ties are strong and deep reaching so I'll keep digging until the last minute. Egoless war mode.
andoon 10y ago
>The patient is always right. No he is not.
- danieltillett 10y ago
  Even when "wrong" the patient is right. It is their life and it is for them to decide what to do.
tim333 10y ago
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 rather wait and see if it was - it wasn't. That kind of stuff seems quite common.
- danieltillett 10y ago
  Collaboration would work best, but it is rarely used by medical doctors. It is amazingly hard to establish a collaborative relationship in medicine, despite it being the norm outside of medicine. As a general rule delaying treatment is almost always the best option. I am glad you avoided an unneeded root canal.
- maxxxxx 10y ago
  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.
  - ganonm 10y ago
    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.

agumonkey 10y ago

Well, I've been plunged into this very issue. Even for cancer care, I found no trace of collaboration. It was bureaucratic, sometimes cold, out of sync (no news, contradictory news). No team work possible. Also if you ever try to mention alternate ideas, you get dismissed right away. And for fallacious reasons. Mostly statistical and experience driven, which looked like myopia to me. I'm actually collecting evidence to back my ideas right now. I understand they're humans, have limits, budgets. But the overall "this (comfy death) or nothing" is maddenning to me.

XorNot 10y ago
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.
- agumonkey 10y ago
  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 metastasis (some academics have seen regression even). This gives time to plan for the rest. Instead you're sent home to die thinking it's hopeless. I guess it's better than dying at hospital, or being cut into pieces by resections... but it's far from acceptable IMO.
  - david-gpu 10y ago
    I am very sorry to hear you are going through that. Best wishes from this stranger.
    - agumonkey 10y ago
      Thanks for the support. We're a bit all in this together because the same issues occur to any patient and families. And it's neither me nor a very very close member. That said family ties are strong and deep reaching so I'll keep digging until the last minute. Egoless war mode.

andoon 10y ago

>The patient is always right. No he is not.

danieltillett 10y ago
Even when "wrong" the patient is right. It is their life and it is for them to decide what to do.

tim333 10y ago

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 rather wait and see if it was - it wasn't. That kind of stuff seems quite common.

danieltillett 10y ago
Collaboration would work best, but it is rarely used by medical doctors. It is amazingly hard to establish a collaborative relationship in medicine, despite it being the norm outside of medicine. As a general rule delaying treatment is almost always the best option. I am glad you avoided an unneeded root canal.
maxxxxx 10y ago
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.
- ganonm 10y ago
  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.