4 ms·

No, its not an edge case. If you have a rapport with a doctor/care provider, you would want to stay with them. I have a genetic disease and an endocrinologist w

No, its not an edge case. If you have a rapport with a doctor/care provider, you would want to stay with them. I have a genetic disease and an endocrinologist who helps me manage it. I wouldn't want to leave that doctor, who has seen me multiple times, has my charts, understands what Im working with, and so much more.

nervousvarun 9y ago
But isn't that OP's point? By nature of your specific disease/condition you are a bit of an outlier no? Obviously the ideal would be you have a system that accommodates "my kid has a fever/fell out of a tree and broke their arm" majority of medical issues who could be helped by basically anyone trained in basic medicine while also accommodating people who need a rapport with a highly trained/expensive specialist. That's how I took the comment...apologies in advance if this comes off as insensitive to your condition, definitely not my intention.
pc86 9y ago
People want to believe that their medical condition(s) are a special, one-in-a-billion mix requiring years or decades of rapport-building and conversations. That's not the case for the vast majority of people, even with very complicated medical histories and diagnoses. "Has seen me in the past" and "has my charts" are not indicative of medical efficacy. There are doctors I have rapport with, absolutely. I still have lunch occasionally with the physician who was my family doctor as a child and still sees my parents. But that doesn't mean his medical treatment is going to be any better than a doctor seeing me for the second or third time.
- firstplacelast 9y ago
  Wait...except the decrease in care when transferring a patient to a new doctor is the EXACT reason health care professionals say we can't put a cap on working hours and introduce more doctors to help with the work-load. They always says it hurts the patient's care. I think there is some truth to both sides, but we'll probably never know. Too many people are making out like bandits in the current health care system.
- L_Rahman 9y ago
  there is clinically proven evidence that seeing the same provider in the same setting improves outcomes: https://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care https://www.newyorker.com/magazine/2017/01/23/the-heroism-of...
  - dv_dt 9y ago
    Given the tiny slices of time doctors seem to have for each patient, it would seem that having time and history to have actually spent time with patients and their medical background would seem to be a common sense advantage. It's good to see that borne out in evidence.
  - pc86 9y ago
    There's also clinical evidence in favor of placebo usage, that doesn't mean that placebos increase medical efficacy, it means sometimes people just need to feel good about what's happening. And people - myself included - would probably prefer seeing the same physician long term.
optimuspaul 9y ago
I'm sorry but that does sound like the definition of an edge case to me. You have a rare situation that requires a unique solution.
- superhuzza 9y ago
  I bet that health outcomes are improved with longer term patient-physician relationships - Imagine having a new family doctor every year vs. a doctor who has known you for the last 15 years. edit: This (quite extensive and longitudinal) study would suggest that it's true. Check out the sources on the paper for other studies with similar findings: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226774/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226774/
  - tonyedgecombe 9y ago
    I'd like to see some evidence on that because I can imagine staying with one doctor might result in some conditions not being diagnosed.
    - jen20 9y ago
      Indeed - I am familiar with people who were misdiagnosed by a GP (in England) for over a decade before a visit to a different doctor yielded the correct diagnosis and treatment.
    - superhuzza 9y ago
      Updated my post - The introduction provides a decent overview of other studies (and and their limitations) suggesting the same results.
- BadCookie 9y ago
  Each rare disease is rare, but it is not very rare to have a rare disease. There are just thousands of rare diseases. For example, it is estimated that 6-8% of the EU population has a rare disease: https://en.wikipedia.org/wiki/Rare_disease#Prevalence https://en.wikipedia.org/wiki/Rare_disease#Prevalence
neltnerb 9y ago
I've had great luck with just using whatever specialist is in network by default, and just calling or emailing my old doctor for a second opinion if something weird happens. I assume not all doctors are so communicative, but I think many are happy to help as long as it doesn't take much time.

nervousvarun 9y ago

But isn't that OP's point? By nature of your specific disease/condition you are a bit of an outlier no? Obviously the ideal would be you have a system that accommodates "my kid has a fever/fell out of a tree and broke their arm" majority of medical issues who could be helped by basically anyone trained in basic medicine while also accommodating people who need a rapport with a highly trained/expensive specialist. That's how I took the comment...apologies in advance if this comes off as insensitive to your condition, definitely not my intention.

pc86 9y ago

People want to believe that their medical condition(s) are a special, one-in-a-billion mix requiring years or decades of rapport-building and conversations. That's not the case for the vast majority of people, even with very complicated medical histories and diagnoses. "Has seen me in the past" and "has my charts" are not indicative of medical efficacy. There are doctors I have rapport with, absolutely. I still have lunch occasionally with the physician who was my family doctor as a child and still sees my parents. But that doesn't mean his medical treatment is going to be any better than a doctor seeing me for the second or third time.

firstplacelast 9y ago
Wait...except the decrease in care when transferring a patient to a new doctor is the EXACT reason health care professionals say we can't put a cap on working hours and introduce more doctors to help with the work-load. They always says it hurts the patient's care. I think there is some truth to both sides, but we'll probably never know. Too many people are making out like bandits in the current health care system.
L_Rahman 9y ago
there is clinically proven evidence that seeing the same provider in the same setting improves outcomes: https://www.newyorker.com/magazine/2017/01/23/the-heroism-of-incremental-care https://www.newyorker.com/magazine/2017/01/23/the-heroism-of...
- dv_dt 9y ago
  Given the tiny slices of time doctors seem to have for each patient, it would seem that having time and history to have actually spent time with patients and their medical background would seem to be a common sense advantage. It's good to see that borne out in evidence.
- pc86 9y ago
  There's also clinical evidence in favor of placebo usage, that doesn't mean that placebos increase medical efficacy, it means sometimes people just need to feel good about what's happening. And people - myself included - would probably prefer seeing the same physician long term.

optimuspaul 9y ago

I'm sorry but that does sound like the definition of an edge case to me. You have a rare situation that requires a unique solution.

superhuzza 9y ago
I bet that health outcomes are improved with longer term patient-physician relationships - Imagine having a new family doctor every year vs. a doctor who has known you for the last 15 years. edit: This (quite extensive and longitudinal) study would suggest that it's true. Check out the sources on the paper for other studies with similar findings: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226774/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4226774/
- tonyedgecombe 9y ago
  I'd like to see some evidence on that because I can imagine staying with one doctor might result in some conditions not being diagnosed.
  - jen20 9y ago
    Indeed - I am familiar with people who were misdiagnosed by a GP (in England) for over a decade before a visit to a different doctor yielded the correct diagnosis and treatment.
  - superhuzza 9y ago
    Updated my post - The introduction provides a decent overview of other studies (and and their limitations) suggesting the same results.
BadCookie 9y ago
Each rare disease is rare, but it is not very rare to have a rare disease. There are just thousands of rare diseases. For example, it is estimated that 6-8% of the EU population has a rare disease: https://en.wikipedia.org/wiki/Rare_disease#Prevalence https://en.wikipedia.org/wiki/Rare_disease#Prevalence

neltnerb 9y ago

I've had great luck with just using whatever specialist is in network by default, and just calling or emailing my old doctor for a second opinion if something weird happens. I assume not all doctors are so communicative, but I think many are happy to help as long as it doesn't take much time.