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> And to disregard their previous experience with high-functioning alcoholics who deny everything when they mess up. I’d bet there’s a lot more hidden day-drink

by tivert 2y ago

> And to disregard their previous experience with high-functioning alcoholics who deny everything when they mess up. I’d bet there’s a lot more hidden day-drinkers out there than patients like this. I'd rather them disregard their bias than disregard their patients. If someone insists they don't drink when challenged with the BAC data (especially with corroboration like in this case), do a test to determine if they're lying or not. Don't just assume they're lying. But doctors often are arrogant and unwilling to admit error, even to other doctors. The best you can sometimes do in those situations is to get bossy and try to take control of the situation (e.g. I know you're assuming I'm a lying alcoholic, but I don't drink, so explain to me how I could be intoxicated without drinking...what tests would you need to prove that...), but not everyone has the confidence to do that or to do it only when it's needed.

DoreenMichele 2y ago
When I was extremely sick, I was super frustrated with the 15 Minute Appointment. It was more infuriating than the things that inspired me to bitterly joke "They majored in medicine and minored in hubris and contempt." Some of my big breakthroughs came in ER visits where they are a little more focused on problem solving and less on getting you out the door in time to keep to schedule. It doesn't live up to the fiction of House but sometimes if I had good rapport with an ER doctor, they took a few minutes to think about how best to keep me out of their ER in the future. This sometimes got me what a relative called "real drugs instead of tea and sympathy." We have a broken system. I don't know how to fix it but some of the criticisms of specific people in the broken system implicitly assume "These people are the problem!" And that doesn't really fit my firsthand experience.
- nerdponx 2y ago
  > little more focused on problem solving I actually had a great ER experience along these lines. I felt bad being there after it became clear that I was going to be fine while there was a lady wailing in pain about 10 feet away, but at least I left with a lot of things to discuss with my regular doctor and I at least knew when I should/shouldn't worry in future situations.
shermantanktop 2y ago
In my second paragraph I pointed out that this probably isn’t bias, this is Occam’s Razor. If the razor cuts against you, it’s your problem as a patient to fight back. Is that fair? No. Does a medical professional have an obligation to take a patient seriously? Yes. But I bet busy physicians have an hard time avoiding being biased by direct experience with unreliable patients: drug seekers, people with mental health issues, people who want the drug they saw on Fox News ads, etc.

by tivert 2y ago

DoreenMichele 2y ago

When I was extremely sick, I was super frustrated with the 15 Minute Appointment. It was more infuriating than the things that inspired me to bitterly joke "They majored in medicine and minored in hubris and contempt." Some of my big breakthroughs came in ER visits where they are a little more focused on problem solving and less on getting you out the door in time to keep to schedule. It doesn't live up to the fiction of House but sometimes if I had good rapport with an ER doctor, they took a few minutes to think about how best to keep me out of their ER in the future. This sometimes got me what a relative called "real drugs instead of tea and sympathy." We have a broken system. I don't know how to fix it but some of the criticisms of specific people in the broken system implicitly assume "These people are the problem!" And that doesn't really fit my firsthand experience.

nerdponx 2y ago
> little more focused on problem solving I actually had a great ER experience along these lines. I felt bad being there after it became clear that I was going to be fine while there was a lady wailing in pain about 10 feet away, but at least I left with a lot of things to discuss with my regular doctor and I at least knew when I should/shouldn't worry in future situations.

shermantanktop 2y ago

In my second paragraph I pointed out that this probably isn’t bias, this is Occam’s Razor. If the razor cuts against you, it’s your problem as a patient to fight back. Is that fair? No. Does a medical professional have an obligation to take a patient seriously? Yes. But I bet busy physicians have an hard time avoiding being biased by direct experience with unreliable patients: drug seekers, people with mental health issues, people who want the drug they saw on Fox News ads, etc.