8 ms·

I would imagine the expectation comes from them being very well compensated, and supposedly very well educated and trained experts that people entrust their cur

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.
- monkeyfun 2y ago
  I replied to your other post in this chain, but felt like adding: Does a bad mechanic leave you in physical pain and have the potential to leave you suffering worse than before you arrived? Can you avoid the problem of a bad doctor by just getting a new body? Remember that the origin of this discussion is in many doctors not believing a woman despite reasonable evidence to the contrary. Nobody would be outraged if they still were broadly and even justifiably wary but put in ANY effort at all to attempt to at least humor the possibility she wasn't an alcoholic, especially after passing psych screening tests, however primitive. And sure, she could have gone to doctors other than ER doctors, but that is why I mentioned my own experiences that it isn't very different with (at least some) specialists. Going a bit back to the mechanic analogy, it's hard for people who are busy and suffering to make extremely well thought out and slow decisions in that state, especially if there's sometimes enough improvement they can seemingly be recovered.
  - s1artibartfast 2y ago
    I think the thing that gets me about this example is everyone comes into it with perfect hindsight, and then projects their own biases about lack of effort and care. If it was so obvious, then the woman should have been able to diagnose herself, or any of her family and acquaintances. It's not that clinicians didn't try to help, as some people claim. They gave her CT scans and psychiatric assessments try to figure it out, some of which she refused. It is easy to say that the doctor simply should have trusted her statements, and use them as a basis for further research, which may have identified the cause more quickly. However, people don't have an answer for how this would play out the other 999 times out of 1000 when the patient is lying or in psychiatric crisis. Armchair doctors say it would have been obvious if they trusted her and kept her overnight for observation. This ignores the fact that this is not what emergency departments are typically set up to do, if they did, they may have seen her blood alcohol decrease, consistent with her lying. For all we know, she left the emergency room each time with the recommendation to seek help from a specialist, but people fill in whatever narrative they want. Regarding your questions, I do think both doctors and mechanics have a responsibility to try not to make things worse than if they had done nothing at all. I don't think the doctor is here made her condition worse. If I have a broken car, it's my responsibility to fix or replace it, not the mechanics. If I don't like the service a mechanic offers, my choices are find a new one, do it myself, or go without. I think people would be better served if they thought about doctors in the same manner.

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.

monkeyfun 2y ago
I replied to your other post in this chain, but felt like adding: Does a bad mechanic leave you in physical pain and have the potential to leave you suffering worse than before you arrived? Can you avoid the problem of a bad doctor by just getting a new body? Remember that the origin of this discussion is in many doctors not believing a woman despite reasonable evidence to the contrary. Nobody would be outraged if they still were broadly and even justifiably wary but put in ANY effort at all to attempt to at least humor the possibility she wasn't an alcoholic, especially after passing psych screening tests, however primitive. And sure, she could have gone to doctors other than ER doctors, but that is why I mentioned my own experiences that it isn't very different with (at least some) specialists. Going a bit back to the mechanic analogy, it's hard for people who are busy and suffering to make extremely well thought out and slow decisions in that state, especially if there's sometimes enough improvement they can seemingly be recovered.
- s1artibartfast 2y ago
  I think the thing that gets me about this example is everyone comes into it with perfect hindsight, and then projects their own biases about lack of effort and care. If it was so obvious, then the woman should have been able to diagnose herself, or any of her family and acquaintances. It's not that clinicians didn't try to help, as some people claim. They gave her CT scans and psychiatric assessments try to figure it out, some of which she refused. It is easy to say that the doctor simply should have trusted her statements, and use them as a basis for further research, which may have identified the cause more quickly. However, people don't have an answer for how this would play out the other 999 times out of 1000 when the patient is lying or in psychiatric crisis. Armchair doctors say it would have been obvious if they trusted her and kept her overnight for observation. This ignores the fact that this is not what emergency departments are typically set up to do, if they did, they may have seen her blood alcohol decrease, consistent with her lying. For all we know, she left the emergency room each time with the recommendation to seek help from a specialist, but people fill in whatever narrative they want. Regarding your questions, I do think both doctors and mechanics have a responsibility to try not to make things worse than if they had done nothing at all. I don't think the doctor is here made her condition worse. If I have a broken car, it's my responsibility to fix or replace it, not the mechanics. If I don't like the service a mechanic offers, my choices are find a new one, do it myself, or go without. I think people would be better served if they thought about doctors in the same manner.