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Should doctors never trust their patients? What's the threshold for where doctors should begin to believe their patients' claims, as opposed to simply assuming

Should doctors never trust their patients? What's the threshold for where doctors should begin to believe their patients' claims, as opposed to simply assuming they're merely some drug addict seeking another hit or someone lazy seeking time off work? I'm someone who's specifically had GI doctors ignore what I say so intensely as for this conversation to have seriously taken place: Me: "The [medication] might have worked, I feel slightly better, but it was way too strong. I had nearly all the major side effects that the instructions said to contact you if I get them. Is there any smaller dose, or could I try out something else?" GI Specialist: "Ok, so would you like me to increase the dose? I can prescribe [double]." Edit: meant to conclude that I think it's not just excessive distrust, and that it'd be absurd and cruel to just always distrust patients completely -- that doctors definitely seem to ignore patients heavily, especially if they're in any way abnormal.

s1artibartfast 2y ago
Doctors are human. how did the rest of conversation go? did you explain that they misunderstood what you said? Also, Did you consider just taking half the dose?
- hooverd 2y ago
  They can't be human too and make oopsie whoopsies with no repercussions while demanding unlimited deference from society.
  - s1artibartfast 2y ago
    What is this "unlimited deference" you speak of? I dont think doctors should be elevated to some super-human status. They are human. Many of them do a tricky and socially useful job, but there is nothing magic about it or them.
- monkeyfun 2y ago
  The rest of the conversation was mostly uneventful, I did explain it but got told that it was the smallest dosage available. As for the doctor personally he mostly just acted like it was a misunderstanding and not actively not paying attention to what I was clearly saying, but I'd have to say that's a pretty incredible lack of listening/language comprehension for a native english speaker with a college degree. I sure didn't trust that doctor ever again to be paying attention or properly respond to my symptoms if he could hear the exact opposite of what I said. And as for dose, it was a medication measured in micrograms -- I'd have to be able to carefully measure microgram amounts and put them back into new capsules, it wasn't very realistic. I wound up finding alternatives on my own. As an aside, I actually have FAR worse stories of GI doctors being incompetent and careless, that one just seemed the most relevant to the topic there. One other funny one seriously went like: GI Specialist Dr., "No, you can't really be feeling pain there, the intestines don't have any nerves" Me, "So why did you say I needed to be sedated for my colonoscopy because it would be too painful otherwise?" Dr, [angry response about if I want to just argue or let him do his job] If you can't tell, I soon switched doctors after. But overall that sort of encounter, or things like even violating their own medical association's recommendations such as with prescribing PPIs and Antibiotics simultaneously to a patient already at higher risk of c. Difficile or more than one doctor not being aware of which painkillers are NSAIDs (Yes, really! One GI and one Urologist) has really reduced my trust in specialists, at least in Texas. They so, so, so often seem to just ignore or disbelieve patients.
  - s1artibartfast 2y ago
    I think people have pretty unrealistic of expectations for doctors, and am really curious where it comes from. They are all humans with variability, and some aren't even particularly smart or even good. I get being frustrated to work with a bad doctor, but the outrage seems deeper, like people are frustrated that they even exist.
    - willy_k 2y ago
      I would imagine the expectation comes from them being very well compensated, and supposedly very well educated and trained experts that people entrust their current and future wellbeing to, and who try very hard (often successfully) to minimize their own accountability. One would expect a nurse to know less about which medication is likely to produce the best outcome in a given patient than a doctor, but the opposite is often the case due to some mix of the average doctor’s ego, and their investment and presence around patients over prolonged periods. Many doctors appear frustrated that patients exist, they’d rather just look at a list of symptoms and write a prescription without acknowledging the individual.
      - s1artibartfast 2y ago
        >I would imagine the expectation comes from them being very well compensated, and supposedly very well educated and trained experts that people entrust their current and future wellbeing to, and who try very hard (often successfully) to minimize their own accountability. I just think this is delusional. Pay, and education, and accountability do very little to make them superhuman. similarly, just because people dont have good alternatives to doctors, doesnt make doctors good at their job or their expectations rational. That is wish casting, and not how the world works. I think it is more realistic to think of them like a mechanic who you are asking for advice. They might shrug or give their best guess, but they aren't promising anything. At the end of the day, it is your car and your problem, not their problem. They might try to help, but they dont owe you anything. I guess I dont think patients are entitled to results or anything else from doctors, besides trying not to leave them worse off and maybe a mild positive intent.

s1artibartfast 2y ago

Doctors are human. how did the rest of conversation go? did you explain that they misunderstood what you said? Also, Did you consider just taking half the dose?

hooverd 2y ago
They can't be human too and make oopsie whoopsies with no repercussions while demanding unlimited deference from society.
- s1artibartfast 2y ago
  What is this "unlimited deference" you speak of? I dont think doctors should be elevated to some super-human status. They are human. Many of them do a tricky and socially useful job, but there is nothing magic about it or them.
monkeyfun 2y ago
The rest of the conversation was mostly uneventful, I did explain it but got told that it was the smallest dosage available. As for the doctor personally he mostly just acted like it was a misunderstanding and not actively not paying attention to what I was clearly saying, but I'd have to say that's a pretty incredible lack of listening/language comprehension for a native english speaker with a college degree. I sure didn't trust that doctor ever again to be paying attention or properly respond to my symptoms if he could hear the exact opposite of what I said. And as for dose, it was a medication measured in micrograms -- I'd have to be able to carefully measure microgram amounts and put them back into new capsules, it wasn't very realistic. I wound up finding alternatives on my own. As an aside, I actually have FAR worse stories of GI doctors being incompetent and careless, that one just seemed the most relevant to the topic there. One other funny one seriously went like: GI Specialist Dr., "No, you can't really be feeling pain there, the intestines don't have any nerves" Me, "So why did you say I needed to be sedated for my colonoscopy because it would be too painful otherwise?" Dr, [angry response about if I want to just argue or let him do his job] If you can't tell, I soon switched doctors after. But overall that sort of encounter, or things like even violating their own medical association's recommendations such as with prescribing PPIs and Antibiotics simultaneously to a patient already at higher risk of c. Difficile or more than one doctor not being aware of which painkillers are NSAIDs (Yes, really! One GI and one Urologist) has really reduced my trust in specialists, at least in Texas. They so, so, so often seem to just ignore or disbelieve patients.
- s1artibartfast 2y ago
  I think people have pretty unrealistic of expectations for doctors, and am really curious where it comes from. They are all humans with variability, and some aren't even particularly smart or even good. I get being frustrated to work with a bad doctor, but the outrage seems deeper, like people are frustrated that they even exist.
  - willy_k 2y ago
    I would imagine the expectation comes from them being very well compensated, and supposedly very well educated and trained experts that people entrust their current and future wellbeing to, and who try very hard (often successfully) to minimize their own accountability. One would expect a nurse to know less about which medication is likely to produce the best outcome in a given patient than a doctor, but the opposite is often the case due to some mix of the average doctor’s ego, and their investment and presence around patients over prolonged periods. Many doctors appear frustrated that patients exist, they’d rather just look at a list of symptoms and write a prescription without acknowledging the individual.
    - s1artibartfast 2y ago
      >I would imagine the expectation comes from them being very well compensated, and supposedly very well educated and trained experts that people entrust their current and future wellbeing to, and who try very hard (often successfully) to minimize their own accountability. I just think this is delusional. Pay, and education, and accountability do very little to make them superhuman. similarly, just because people dont have good alternatives to doctors, doesnt make doctors good at their job or their expectations rational. That is wish casting, and not how the world works. I think it is more realistic to think of them like a mechanic who you are asking for advice. They might shrug or give their best guess, but they aren't promising anything. At the end of the day, it is your car and your problem, not their problem. They might try to help, but they dont owe you anything. I guess I dont think patients are entitled to results or anything else from doctors, besides trying not to leave them worse off and maybe a mild positive intent.