3 ms·

Maybe I’m out of luck, but can honestly say it’s been very difficult to find the kind of doctor you describe.

phobosanomaly 6y ago
I think the most tragic thing of all is that many doctors find it difficult to be the kind of doctor you would not be disappointed by. People on both sides of the exam table are not thrilled with the current system. I've watched grown, experienced doctors break down and cry over what they have seen, the expectations and pressures placed on them, the type of things they've had to tell people, mistakes they've made, etc. It's not pretty. They're not building apps for a living while working from home, they're trying to fix ill people within the constraints of human behavior and mother nature, and that is a rough job. Many get paid a lot, many don't, but for people who went into it with the desire to help people you can't just buy off the dying kids and the lifelong smokers who killed themselves one cigarette at a time for 40-years, and the diabetic feet, and sexual assaults, and the dead bodies harvested of organs looking up at you after the surgeons have left the room, the frequent flyers, the smell of bloody feces, the smell of infection, everything else that can possible go wrong with a human being. Not to mention the over a decade of school, and hundreds and hundreds of hours of documenting for insurance, and covering your ass for each time you get dragged into court to testify over what at any other job would be a benign clerical error.
- sebmellen 6y ago
  Agreed, these things are all terrible, but the arrogance with which a fair percentage of doctors carry themselves and dismiss the intuitions of their patients is shocking.
  - phobosanomaly 6y ago
    I do think that things are trending in the right direction with regards to physician arrogance. Here's a paper from the International Journal of Surgery that talks about this issue: "Today however there is a new alliance between the doctor and patient, based on co-operation rather than confrontation, in which the doctor must “understand the patient as a unique human being”. Thus patient-centered care has replaced a one-sided, doctor-dominated relationship in which the exercise of power distorts the decision-making process for both parties." https://doi.org/10.1016/j.ijsu.2006.01.005 https://doi.org/10.1016/j.ijsu.2006.01.005 (Although if it was written by surgeons, might take it with a grain of salt.) Definitely an arrogant physician is something that will hopefully fade into obscurity as patients become more educated, and medicine becomes more corporate 'customer-centered' and less solo practice. With regards to patient intuition, that's actually a field of active research. When do you trust patient intuition, and when do you not? "Intuition, like analytical reasoning, is fallible. However, we suggest conditions under which clinicians and patients should take patient intuition seriously. We invite empirical investigation of these conditions, which relate to the credibility (or accuracy) of the intuition and its meaning and significance to the patient. More generally, research is needed on non-conscious and automatic processes of decision-making and on how patient intuition can complement rather than oppose reasoned thinking in jointly shaping patient and clinician judgments, decision-making and action. Such research may help to integrate the processes of intuition and reasoning used by patients and clinicians in decision-making, with a goal of improving the patient-clinician relationship and health outcomes." Buetow SA, Mintoft B. When should patient intuition be taken seriously?. J Gen Intern Med. 2011;26(4):433-436. doi:10.1007/s11606-010-1576-6

I think the most tragic thing of all is that many doctors find it difficult to be the kind of doctor you would not be disappointed by. People on both sides of the exam table are not thrilled with the current system. I've watched grown, experienced doctors break down and cry over what they have seen, the expectations and pressures placed on them, the type of things they've had to tell people, mistakes they've made, etc. It's not pretty. They're not building apps for a living while working from home, they're trying to fix ill people within the constraints of human behavior and mother nature, and that is a rough job. Many get paid a lot, many don't, but for people who went into it with the desire to help people you can't just buy off the dying kids and the lifelong smokers who killed themselves one cigarette at a time for 40-years, and the diabetic feet, and sexual assaults, and the dead bodies harvested of organs looking up at you after the surgeons have left the room, the frequent flyers, the smell of bloody feces, the smell of infection, everything else that can possible go wrong with a human being. Not to mention the over a decade of school, and hundreds and hundreds of hours of documenting for insurance, and covering your ass for each time you get dragged into court to testify over what at any other job would be a benign clerical error.

sebmellen 6y ago
Agreed, these things are all terrible, but the arrogance with which a fair percentage of doctors carry themselves and dismiss the intuitions of their patients is shocking.
- phobosanomaly 6y ago
  I do think that things are trending in the right direction with regards to physician arrogance. Here's a paper from the International Journal of Surgery that talks about this issue: "Today however there is a new alliance between the doctor and patient, based on co-operation rather than confrontation, in which the doctor must “understand the patient as a unique human being”. Thus patient-centered care has replaced a one-sided, doctor-dominated relationship in which the exercise of power distorts the decision-making process for both parties." https://doi.org/10.1016/j.ijsu.2006.01.005 https://doi.org/10.1016/j.ijsu.2006.01.005 (Although if it was written by surgeons, might take it with a grain of salt.) Definitely an arrogant physician is something that will hopefully fade into obscurity as patients become more educated, and medicine becomes more corporate 'customer-centered' and less solo practice. With regards to patient intuition, that's actually a field of active research. When do you trust patient intuition, and when do you not? "Intuition, like analytical reasoning, is fallible. However, we suggest conditions under which clinicians and patients should take patient intuition seriously. We invite empirical investigation of these conditions, which relate to the credibility (or accuracy) of the intuition and its meaning and significance to the patient. More generally, research is needed on non-conscious and automatic processes of decision-making and on how patient intuition can complement rather than oppose reasoned thinking in jointly shaping patient and clinician judgments, decision-making and action. Such research may help to integrate the processes of intuition and reasoning used by patients and clinicians in decision-making, with a goal of improving the patient-clinician relationship and health outcomes." Buetow SA, Mintoft B. When should patient intuition be taken seriously?. J Gen Intern Med. 2011;26(4):433-436. doi:10.1007/s11606-010-1576-6