Author Topic: Doctor's assumptions  (Read 2462 times)

Re: Doctor's assumptions
« Reply #25 on: November 19, 2018, 03:32:11 pm »
Not a GP, but a neurologist . . .

"Why are you continuing to take that medication if your symptoms have stopped?"

    Er, maybe because they come back when I start to reduce my medication?

Same neurologist refuse to have me tested for epilepsy, on the grounds that:
A) If I tested positive, I'd lose my driving licence
B) The fits I was having were going on too long for it to be epilepsy
C) I was taking such a low dose of anti-spasmodic medication (and having a good response) that it was unlikely for it to be epilepsy.
<i>Marmite slave</i>

Kim

  • Timelord
Re: Doctor's assumptions
« Reply #26 on: November 19, 2018, 03:35:02 pm »
"Why are you continuing to take that medication if your symptoms have stopped?"

    Er, maybe because they come back when I start to reduce my medication?

They seem to like doing this to asthmatics too.  Fortunately not something I've been on the receiving end of yet.
To ride the Windcheetah, first, you must embrace the cantilever...

ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: Doctor's assumptions
« Reply #27 on: November 19, 2018, 04:30:11 pm »
I had a pharmacist do that to me.  I pointed out that most people don't suddenly recover from T1 diabetes.
“Procrastination is the thief of time, collar him.” –Charles Dickens

Re: Doctor's assumptions
« Reply #28 on: November 19, 2018, 04:34:55 pm »
What's the problem with that? No different from my IT job.

I don't expect my doctor to have detailed knowledge of every possible condition.

Their years of training would help them dismiss the misinformation amongst a bunch of google results and pick out the relevant/useful information.

No, no different from mine either, but the difference is sort of that I can try it out, and if it fails, lob it in the bin and try something else. ;D

If he had to look it up, I would hope at least it to be an official NHS repository or knonw reputable source rather than just the raw internet.

What's wrong with the "Raw Internet" if you have the intelligence to parse the results? I would suggest much better than any single curated site. You would very quickly see if there was a consensus of opinion from sites you trust from the first results page, and be able to choose what seems to be the most relevant results. I'm sure you use <whatever search engine> in that manner on subjects on which you are informed.

ian

  • fatuously disingenuous
    • The Suburban Survival Guide
Re: Doctor's assumptions
« Reply #29 on: November 19, 2018, 09:07:03 pm »
Sadly, the requirements for re-validation aren't onerous (it's been a while since I was involved in a project that looked at this, but I don't think any specific requirements for professional development exist, doctors just have to show they've done something) and probably not fit for purpose in modern medicine. I think some more old-school doctors view even that as an undue burden. The structure where GPs are sub-contracting their services to the NHS is a bad one for enforcing standards, of course. Which makes finding a good doctor a bit of a crapshoot. If you've got good healthcare coverage in the US, for instance, you wouldn't put up with a crap doctor (Americans generally not being reticent about complaining). I think American doctors expect you to turn up with your own diagnosis and treatment plan (because you saw it on TV) and then having to spend their time dissuading you...

Please note the following is a reasoned supposition, I stand to be corrected by those with direct experience if I have got it entirely wrong.

I think part of the problem here is the assumptions that have to be made about the patients capability to comprehend and analyse the information provided by the medics and the patients research. A UK GP sees everyone, in the US the doctor will typically only see those who have sufficient insurance to see them. As the insurance is often work related there is a degree of segregation of the population based on their employment and subsequent cover. A US doctor may therefore only see Professionals who will have a level of education and competence that encourages self directed research, where the UK GP probably gets habitualised with patients who may find this difficult and so pitch to the lowest common denominator.

As an aside when I recently saw my consultant to get the results of my MRI I pulled a chair round so that I could see the screen with the scan and was promptly told to put it back and sit where I couldn't easily see the screen. I should have pulled him up about it but didn't.

Yes, I am sure this true, I had good a good insurance plan intended for, amongst others, medical professionals. I have no idea how much she got to 'regulate' who she saw however, she was attached to the university medical centre but that also covered one of the main hospitals. But anyway, she knew she was getting someone with a doctoral education. That said, it was a very different experience from seeing a GP in the UK (actually, the ones at our local practice are OK). Not that this should be taken as an advert for US healthcare.

That said, UK doctors don't often seem to pick up on cues from the patient, their level of knowledge, etc. and sometimes information is delivered in a medical-bot rote fashion that doesn't seem to vary whether you're five or 55, failed to pass a GCSE or have umpteen doctorates. It's not just me, I know a number of ex-GPs, and despite them explaining that yes, they were a doctor, their GP carries on. A couple of them have questions 'did I do that?' The thing is, the result is that yu don't feel part of your treatment, and to be honest, I think most people avoid their GP as 'one of those experiences.' OK, you're not supposed to look forward to it, I suppose, but you know what I mean.

This post contains gross generalizations, of course.
!nataS pihsroW

Re: Doctor's assumptions
« Reply #30 on: November 19, 2018, 11:00:50 pm »


What's wrong with the "Raw Internet" if you have the intelligence to parse the results? I would suggest much better than any single curated site. You would very quickly see if there was a consensus of opinion from sites you trust from the first results page, and be able to choose what seems to be the most relevant results. I'm sure you use <whatever search engine> in that manner on subjects on which you are informed.

Might as well just do that myself and cut out the middleman.  ::-)
It is what it is. It's not what it's not, so it must be what it is.

quixoticgeek

  • Mostly Harmless
Re: Doctor's assumptions
« Reply #31 on: November 19, 2018, 11:56:56 pm »
What's wrong with the "Raw Internet" if you have the intelligence to parse the results? I would suggest much better than any single curated site. You would very quickly see if there was a consensus of opinion from sites you trust from the first results page, and be able to choose what seems to be the most relevant results. I'm sure you use <whatever search engine> in that manner on subjects on which you are informed.

"Raw Internet" can't give you a prescription for the drugs you need to deal with the diagnosis...

J
--
Beer, bikes, and backpacking
http://b.42q.eu/

Re: Doctor's assumptions
« Reply #32 on: November 20, 2018, 06:49:39 am »


What's wrong with the "Raw Internet" if you have the intelligence to parse the results? I would suggest much better than any single curated site. You would very quickly see if there was a consensus of opinion from sites you trust from the first results page, and be able to choose what seems to be the most relevant results. I'm sure you use <whatever search engine> in that manner on subjects on which you are informed.

Might as well just do that myself and cut out the middleman.  ::-)

OK, my bad, I said "intelligence" when I meant and implied training, experience and intelligence, I was thinking that if you had intelligence you would realise you needed training and experience as well.

ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: Doctor's assumptions
« Reply #33 on: November 20, 2018, 07:14:56 am »
What's wrong with the "Raw Internet" if you have the intelligence to parse the results? I would suggest much better than any single curated site. You would very quickly see if there was a consensus of opinion from sites you trust from the first results page, and be able to choose what seems to be the most relevant results. I'm sure you use <whatever search engine> in that manner on subjects on which you are informed.

"Raw Internet" can't give you a prescription for the drugs you need to deal with the diagnosis...

J

A good doctor is far more than a drug dealer
“Procrastination is the thief of time, collar him.” –Charles Dickens

Re: Doctor's assumptions
« Reply #34 on: November 20, 2018, 12:26:54 pm »
What's wrong with the "Raw Internet" if you have the intelligence to parse the results? I would suggest much better than any single curated site. You would very quickly see if there was a consensus of opinion from sites you trust from the first results page, and be able to choose what seems to be the most relevant results. I'm sure you use <whatever search engine> in that manner on subjects on which you are informed.

"Raw Internet" can't give you a prescription for the drugs you need to deal with the diagnosis...

The "Raw Internet" can't give you a prescription for them (well, it probably can), but the drugs themselves will be available on the Internet somewhere.

(Not recommended obviously.)
"Yes please" said Squirrel "biscuits are our favourite things."

ian

  • fatuously disingenuous
    • The Suburban Survival Guide
Re: Doctor's assumptions
« Reply #35 on: November 20, 2018, 02:09:57 pm »
I'd certainly prefer a doctor who bothers to look things up rather than rely on what they might remember from medical school a few decades earlier.
!nataS pihsroW

quixoticgeek

  • Mostly Harmless
Re: Doctor's assumptions
« Reply #36 on: November 20, 2018, 02:17:15 pm »

Well today was an interesting appointment, not my usual GP, went in wanting a refill of meds that were previously prescribed in the UK by my NHS GP.

She didn't actually do any examination of the relevant complaint, just took my word for it that what I had been prescribed before. She didn't check that the treatment was working, or that it was the best solution to the complaint at hand.

I'm not feeling crap after this appointment like I was with last weeks Occupational Health doctor, but I'm kinda thinking that if you go in with a physical complaint, the doctor should at least look at the patient...

J
--
Beer, bikes, and backpacking
http://b.42q.eu/

Re: Doctor's assumptions
« Reply #37 on: November 25, 2018, 10:00:23 am »
Oh and then there was the time my brother complained of some condition to the doctor. Doctor starts tapping away on his keyboard. After a bit my brother peers round at the screen thinking he's going to see his medical notes or something. No. The doctor was googling the condition.  :o :o

To me that would be reassuring. If it a disease or condition that they have not seen before or recently, then a quick check is a good thing

Re: Doctor's assumptions
« Reply #38 on: December 07, 2018, 08:11:24 am »
Oh and then there was the time my brother complained of some condition to the doctor. Doctor starts tapping away on his keyboard. After a bit my brother peers round at the screen thinking he's going to see his medical notes or something. No. The doctor was googling the condition.  :o :o

To me that would be reassuring. If it a disease or condition that they have not seen before or recently, then a quick check is a good thing

It's also worth remembering that Google is a damn good search tool. ISTR that the last time I went to the Quack's, the GP used Google, but the results she selected from the list were all official (for want of a better term) sites: Starting with NHSDirect and drilling down from there.  I know from my own work that the built-in search algorithms in many specialist databases are rubbish, and if Google has indexed them then it's often better to just go that route.
Life is too important to be taken seriously.

Re: Doctor's assumptions
« Reply #39 on: December 07, 2018, 09:18:24 pm »
What's wrong with the "Raw Internet" if you have the intelligence to parse the results? I would suggest much better than any single curated site. You would very quickly see if there was a consensus of opinion from sites you trust from the first results page, and be able to choose what seems to be the most relevant results. I'm sure you use <whatever search engine> in that manner on subjects on which you are informed.

"Raw Internet" can't give you a prescription for the drugs you need to deal with the diagnosis...

J

Not yet - but they(re working on it!! ;D

Re: Doctor's assumptions
« Reply #40 on: December 07, 2018, 09:24:54 pm »
Back to the OP, I have never had a man as an médecin du travail, only women (sorry, lady doctors). However I should point out that my experiences with said lady doctors seems to have been considerably better than that of female colleagues - and I can't even claim to be especially smart or handsome! Must be seduced by my awful french accent  8)

FifeingEejit

  • Not Small just Far Away at the back
Re: Doctor's assumptions
« Reply #41 on: December 07, 2018, 09:55:50 pm »
Certainly, seeing doctors in US and Canada was a lot more of a discussion and they expected you go off and do your own research and come back. Could have been the individuals, of course, but I found it a very different (and far better) experience.

That's a British attitude thing, historically doctors were seen as near god like creatures with immense knowledge.
The reality is quite different.

Managing your doctor when you go to see them isn't encouraged by that attitude and the fact we can go twenty thousand times until the right answer is hit on at random without anyone really questioning it... Where as the Americans in particular are handed a rather large bill for being there so are damn well going to make sure they get the right diagnoses at minimal cost, particularly
when the insurance cover limits what it'll pay out each year.

One of my friends qualified in Denmark, she was telling me that no matter what you have to manage the doctor, they are doing something for you, so you're in charge.
I've also heard similar from a long qualified Diabetes Specialist Nurse I used to work with, but he was a right dour bugger that had got into Nursing from being a Mechanic.

Oh and then there was the time my brother complained of some condition to the doctor. Doctor starts tapping away on his keyboard. After a bit my brother peers round at the screen thinking he's going to see his medical notes or something. No. The doctor was googling the condition.  :o :o

The GP practice computer systems do have links to medical encyclopaedias in them in some form of other, but nothing says that because they have EMIS/Vision/Torex/Whatever is they have to use the one that is there. It's also possible that they looked at it and decided to find other sources to confirm that option... OR they saw the cost of the drugs that the practice system's encyclopaedia was recommending and decided to find out what other drugs are available.

The thing to remember is that GPs are basically general problem solvers;
Got something really common, easy they see it daily or at least weekly.
Turn up with something they see once a month, year, decade and they're digging into what ever info sources they have at hand; if it happens to look like something they see every week then a miss-diagnosis is almost inevitable.


Re: Doctor's assumptions
« Reply #42 on: December 08, 2018, 05:16:40 pm »
If you want sound treatment don't go to a doctor, go to a vet. They are used to treating patients with a real value so generally try harder to get it right ( or so my dad used to say, he was a farmer). The best ones earn a lot more than doctors in consequence.

Re: Doctor's assumptions
« Reply #43 on: December 08, 2018, 05:40:19 pm »
If you want sound treatment don't go to a doctor, go to a vet. They are used to treating patients with a real value so generally try harder to get it right ( or so my dad used to say, he was a farmer). The best ones earn a lot more than doctors in consequence.

A friend, who is a vet, insisted that vets are cleverer, and have better memories, than physicians. Her reasoning was that doctors only treat one species, whereas vets usually train to treat six. Those six have very different physiologies.