6 ms·

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

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 infection so I stopped the steroids and applied an OTC antifungal regularly. Slowly it began to heal. A week later I had a minor bout with detergent dermatitis around my jeans pockets (happens every winter if I use a strong detergent). Next time the dermatologist sees the residue of my scarred legs behind the knees and the "jeans-pocket" rash, I tell her that her steroid recommendation was absolutely a wrong call, what happened and how I treated the problem. Rather than take a culture from the back of my legs (and later possibly prescribing an antifungal), she then prescribes not a tube, but a 1-pound _tub_ of corticosteroid cream and tells me to put it on all rashes (behind knees and on "pocket" rashes) for six weeks! So I figure either she's deaf, has a serious learning disorder or flatter myself that she is trying to kill me. In any case I won't see that dermatologist again. On the upside: I have an unopened pound jar of steroid skin cream in my refrigerator.

madengr 10y ago
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.
- giardini 10y ago
  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 corticosteroid lard? As for chiggers: in college I got a serious case of chiggers from a romantic blanket evening in the Texas desert. We two were apparently the only mammals within miles as every chigger available mobilized to fulfill its Darwinian destiny. Next morning I awoke up with a maddening itch everywhere (and I do mean _everywhere_) that lasted until the chiggers died (~3 days IIRC). Best treatment was to take as hot a shower as possible [The only thing better than sex is steaming hot water on chigger bites - it's like the Scratch of God]. Rest 30 minutes and repeat. I've heard a hair dryer works too. Thanks to your recommendation I'll keep the tub of steroid cream around just in case.
  - comicjk 10y ago
    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.
    - madengr 10y ago
      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.
      - reboog711 10y ago
        Prednisone is common to reduce inflammation in patients with Crohn's disease or Ulcerative Colitis. I think my dad also takes it in much lower doses for asthma. But, it has horrible affects both long and short term.
    - tasty_freeze 10y ago
      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.
      - goldenkey 10y ago
        Prednisone won't cause that. Its a very safe anti inflammatory.
        maxerickson 10y ago
        Not really. http://www.mayoclinic.org/steroids/art-20045692?pg=2 http://www.mayoclinic.org/steroids/art-20045692?pg=2
cmahler7 10y ago
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.
- siculars 10y ago
  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 well versed in.
  - sndean 10y ago
    > These are just some of the areas doctors need to be well versed in. I agree that, on average, doctors are smart. But my newly-minted MD fiancee would be the first to tell you that they're not the "just about the smartest" and that she can basic algebra, no more. And, for example, they only have to pass introductory physics. My undergraduate university had a special lower-level physics course specifically made for pre-med students.
  - orbifold 10y ago
    While I don't think doctors are not smart, the amount of physics, math and statistics they actually learn is laughable and does not really go beyond what they already learned in a good high school. Just like in any profession over time they develop deep expertise in very specific problem areas, but that is not much different than in any other profession.
  - deleted 10y ago
    [deleted]
  - MegaButts 10y ago
    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).
Jach 10y ago
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...)

madengr 10y ago

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.

giardini 10y ago
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 corticosteroid lard? As for chiggers: in college I got a serious case of chiggers from a romantic blanket evening in the Texas desert. We two were apparently the only mammals within miles as every chigger available mobilized to fulfill its Darwinian destiny. Next morning I awoke up with a maddening itch everywhere (and I do mean _everywhere_) that lasted until the chiggers died (~3 days IIRC). Best treatment was to take as hot a shower as possible [The only thing better than sex is steaming hot water on chigger bites - it's like the Scratch of God]. Rest 30 minutes and repeat. I've heard a hair dryer works too. Thanks to your recommendation I'll keep the tub of steroid cream around just in case.
- comicjk 10y ago
  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.
  - madengr 10y ago
    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.
    - reboog711 10y ago
      Prednisone is common to reduce inflammation in patients with Crohn's disease or Ulcerative Colitis. I think my dad also takes it in much lower doses for asthma. But, it has horrible affects both long and short term.
  - tasty_freeze 10y ago
    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.
    - goldenkey 10y ago
      Prednisone won't cause that. Its a very safe anti inflammatory.
      - maxerickson 10y ago
        Not really. http://www.mayoclinic.org/steroids/art-20045692?pg=2 http://www.mayoclinic.org/steroids/art-20045692?pg=2

cmahler7 10y ago

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.

siculars 10y ago
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 well versed in.
- sndean 10y ago
  > These are just some of the areas doctors need to be well versed in. I agree that, on average, doctors are smart. But my newly-minted MD fiancee would be the first to tell you that they're not the "just about the smartest" and that she can basic algebra, no more. And, for example, they only have to pass introductory physics. My undergraduate university had a special lower-level physics course specifically made for pre-med students.
- orbifold 10y ago
  While I don't think doctors are not smart, the amount of physics, math and statistics they actually learn is laughable and does not really go beyond what they already learned in a good high school. Just like in any profession over time they develop deep expertise in very specific problem areas, but that is not much different than in any other profession.
- deleted 10y ago
  [deleted]
- MegaButts 10y ago
  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).

Jach 10y ago

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...)