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    Saturday, February 04, 2006

    How Do I Distrust Thee II: On a more personal level, here are some commonly used phrases that scream out to a doctor "I DON'T TRUST YOU.":

    My [husband, wife, daughter, son] thinks I should see a specialist.

    My [husband, wife, daughter, son, neighbor, friend, grocery clerk] says I should be on medication x, not medication y.

    If Dr. Specialist A isn't on my plan, then I'll see your friend, er, Dr. Specialist B.

    Do you mind if I tape our conversation?

    Well, you're the doctor.
     

    posted by Sydney on 2/04/2006 01:35:00 PM 9 comments

    9 Comments:

    This comment has been removed by a blog administrator.

    By Blogger Jake, at 2:34 PM  

    There is so much medical information on the web so I am not surprised by the patients' reactions.

    My PSA took a jump from 1.84 to 3.49 in two years so my doctor scheduled me for a biopsy. In the meantime, I read about 150 research papers on all the treatments for prostate cancer. I can give you survival rates, side effects rates for every treatment available.

    From the biopsy my urologist told me I had prostate cancer in a very early stage. (Three cheers for PSA tests). He then gave me an excellent review of the disease and the treatments. His disclosure of the survival rates and side effects of surgery (he recommends) agreed with the research. Although his numbers for radiation were out-of-date because of the arrival of IMRT.

    However, during his 1 1/2 hour lecture, I did not learn anything new. Is this knowledge good or bad for the doctor or the patient?

    By Blogger Jake, at 2:46 PM  

    *shrug* My doctors know I take everything they say with a grain of salt. I have a family practitioner who I really love--he is the sweetest guy, and he is a great doctor.

    But.

    I took him at his word on taking beta blockers, took them against my instincts, and ended up having a heart attack.

    My dealings with the cardiologists are a whole 'nother topic.

    Lesson: No matter how much you love and trust your doctor, do your due diligence. If you don't, you're a dope.

    By Anonymous Lynn, at 3:20 PM  

    Why should we trust doctors? And, why are doctors so hot on the issue? I assume that doctors are just like everyone else, they'll screw you if they don't have to pay a price. That's why it's smart to be informed, know good lawyers, and ALWAYS tape record.

    By Anonymous Anonymous, at 3:41 PM  

    From the family doc/PCP perspective in the UK, my all time favourite one for polite distrust, usually voiced with a total lack of insight and only at the end of a twenty minute consultation that you thought was going very well is:

    "Well, thank you very much doc, but don't you think I ought to see someone?"

    I used to have this fantasy that I was "someone".....

    John

    By Blogger Dr John Crippen, at 12:01 PM  

    Hi Lynn

    I just cannot hold back from commenting on:


    "I took him at his word on taking beta blockers, took them against my instincts, and ended up having a heart attack."

    Medpundit may feel that he cannot comment. I will. You talk about doing "due diligence"....heavens, your statement, without further and better particulars, has to get the award for the non sequitur of the year.

    You might equally have said, I had a cup of coffee and had a heart attack; coffee is more likely to CAUSE heart attacks than beta blockers.

    If you are going to dis the doc, you need more facts/info than that.
    John

    By Blogger Dr John Crippen, at 12:06 PM  

    Trust is a critical issue. But it is important to look at the real causes and consider practical solutions:

    Trust: Traditional or Electronic, A Doctor-Patient Relationship Starts There

    By Anonymous The Medical Blog Network, at 12:08 AM  

    I respect my current doctors, but I also believe that they are human. They work, they come home to their families. They don't have time to follow all the latest research on every condition. They are also worried about malpractice and that colors their judgement.

    There is nobody in the world that is interested in my health more than I am (with the only possible exception being my mother). So why shouldn't I find out everything possible about stuff that interests me?
    For example, I have POF. This is rare and most genecologists even good ones know very little about it - the fact that it took them 5 years to diagnose me in spite of constant complaints of irregularities and 2- and 3- months delays when there is a simple and 100% accurate blood test available proves it. Many doctors treat it as normal menopause but there are important differences. Also, many doctors don't understand, that WHI wasn't about women with POF, that benefits/risks of HRT for 63-year olds are different than for women in their 20s, 30s or 40s, that "smallest possible dose for shortest time" guidelines don't apply to women with POF for whom most experts recommend full replacement until normal age of menopause.
    I cannot expect my doctors who have lots of patients to read everything possible about POF simply because of me. So it is my responsibility to learn everything I can about it from, for example, NIH web site and other articles in medical journals written by doctors who study POF.

    There are other things as well, like defensive tests, etc. Doctors admit to doing lots of unnecessary tests because of malpractice, so I have two choices: be a good girl and do everything they recommend even if it is unlikely to help me but can harm me or learn everything I can about the stuff they order and make my own decisions.

    By Anonymous Anonymous, at 10:58 AM  

    We certainly aren't going to trust every Dr. we come across in our lives. On the other hand we will encounter ones who don't trust us either.

    I have 3 Drs. that I see regularly and the issue of trust is different with each. I have an orthopedic surgeon who I second guess every thing he tells me. I am so confused when I leave his office, that I think he is about 1 month away from admission to the dementia ward.

    His advise is sometimes ridiculous. Following total knee replacement, after he had stopped my pain meds at 2 weeks post surgery, I asked him "Doc, what am I supposed to take for this pain, as it is keeping me from even progressing with my PT?" His answer "Stop on your way home and buy a fifth of Jack Daniels." On this same visit he also told me he didn't want me sitting in a straight chair with my legs hanging down nor did he want them up in a recliner! "Um, OK, But where are they supposed to go"? His answer: "Lay in bed and elevate your legs so your knee is higher than your heart, but, don't you dare put any pillows under your leg!" "Thanks Doc., see ya next time.

    I have a family Dr. that I trust completely. He and I have had a good relationship for many years. Then there is the GI specialist who gets all my trust and I his. We have an 8 year Dr./pt. relationship. If I need him I know that he is 1 call away, and when I call him, he knows I need an EGD tomorrow or on his next day to do procedures.

    Trust has to be earned on both sides.

    By Anonymous Anonymous, at 8:48 PM  

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