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Some doctors have deep contempt for patients

SOC

Senior Member
Messages
7,849
My answer is education. Education in scientific and critical thinking. That's all. We should learn to be cautious sometimes and we should all be able to follow scientific debates. It's not about beeing actual scientists.
I don't want us to be scientists. It's a completely different kind of work. What I want us to be is more aware of what science is and how the scientific world works. We should be trained to be cautious about the facts, we learn. A lot of them will stay facts, but some of the theories we learned in med school will be turned on their heads in our lifetime. A lot of doctors have never thought about the fact, that psychosomatics has indeed a very hard time to prove its main concept and fails at a very basic level to do so. It cannot disprove it's own hypotheses.

This is my thinking as well. I don't have a problem with physicians not being scientists. I think it's more important that they have intelligence, knowledge, vast clinical experience, and skill in the art applying the limited knowledge that exists in medicine. I do, however, have a problem with physicians being unable to use basic scientific and critical thinking -- logic, statistics, and so on.

Critical thinking should be a part of the curriculum. It should be integrated into every course, not taught as a one semester class. I know it can be done. We do it in engineering even at the undergraduate level. It shouldn't be hard to teach to the older, more educated medical students. Of course, you'd have to find medical school profs who know enough critical thinking to integrate it into their courses rather than teaching prejudiced, opinion-based dogma. (Yes, I'm looking at you Dr Forbes).

I also have a problem with physicians claiming to be scientific authorities when they don't have scientific training. Too often physicians try to use that card to intimidate patients into not expressing their concerns -- the "I'm smarter than you, so shut up" ploy. It may work on the average patient (unfortunately), but it makes the physician look stupid and dishonest to any trained scientist. Stupid and dishonest is not what I want to see in someone responsible for my medical care. I can work with someone who says, "I don't know, let me connect you with someone who might." l can't work with someone I know is lying to me.
 

Hip

Senior Member
Messages
17,824
I think the idea of physicians all becoming scientists is unrealistic.

First of all, the timescale on which science is done is a very slow one by comparison to clinical medicine. Even the smallest steps forward in science occur over a timescale of months or years. Whereas in the UK the average time a GP spends with a patient is 8 to 10 minutes. You can't realistically expect any useful science to be performed a timescale of 8 to 10 minutes.

And secondly, even if by some magic you could compress 6 months work into 8 minutes, what kind of scientific activity would be of any use to individual patients? I cannot think of any. Sure, as a doctor, you can dedicate some of your time to studying a particular disease for example, and you may make some advancements in understanding and treating that disease. And there are doctors — e.g. John Chia — who combine such research work with their clinical work. But as @Butydoc mentioned, whether a doctor does this is down to time and his or her particular talents.

But I cannot see any scientific work or scientific activity being applied in the 8 to 10 minutes that GPs have with each patient, or even with the 30 to 60 minutes a specialist may have with a patient. Unless you can give me an example of how you see such super-rapid science working.
 
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SOC

Senior Member
Messages
7,849
But I cannot see any scientific work or scientific activity being applied in the 8 to 10 minutes that GPs have with each patient. Unless you can give me an example of how you see such super-rapid science working.
I don't think anyone is suggesting physicians do scientific research during patient appointments. That is indeed unrealistic. The point is that they should be capable of scientific and critical thinking. They should understand basic principles of science like correlation is not causation and opinion is not fact. They should know that sound evidence (not dogma or personal opinion) is necessary to draw conclusions, and what sound evidence is. They should be able to evaluate the limitations of the data they have in front of them. Proper scientific and critical thinking shouldn't take any more time in a limited appointment window than illogical, dogma-based thinking. It's not about the time spent, it's about the quality of thinking used.
 

chipmunk1

Senior Member
Messages
765
I have been a family physician for43 years.
Have practiced in rural Nova Scotia, the Canadian Arctic and Mississippi.
I am sorry but I don't buy any of this!

fibromyalgia (which I call fibro- my life sucks!),

i am sorry to hear that.

attention deficit disorder

Another fad around since 1935 or so. Beat them up a bit and they will get out of it very quickly.


Ok it's quite new introduced 1943. We used to call that bad parenting.

premenstrual dysphoric disorder

we used to call that hysteria. these were the times when we still practiced real medicine.
 

Sean

Senior Member
Messages
7,378
Umpteen thousand years later the seductive allure of power has metastasized into a global Empire determined to maintain control by smashing resistance one society at a time. Starting from the top and following the example set by Our Dear Leaders, the principles of domination and coercion permeate pretty much the whole society, including medical education.
You keep that up and there will be a revolution, comrade.

:ninja: :ninja: :ninja:

;)
 

leokitten

Senior Member
Messages
1,542
Location
U.S.
Remember what we think of as "good labs" are often private tests from ME and CFS doctors and therefore are worthless to these doctors.

We just doctor shopped until we found one that diagnosed a fake disease and talked us into paying money for worthless tests.

For some of us, in particular the viral subset, the most compelling labs are standard stuff from Labcorp and Quest. My virus antibodies, NK numbers and function were so bad no physician unless he was completely incompetent could deny that something very serious was wrong.
 

Hip

Senior Member
Messages
17,824
The point is that they should be capable of scientific and critical thinking. They should understand basic principles of science like correlation is not causation and opinion is not fact. They should know that sound evidence (not dogma or personal opinion) is necessary to draw conclusions, and what sound evidence is.

Are you saying that medical diagnosis performed by primary care physicians is not critical thinking?

And I think most doctors will fully appreciate correlation does not automatically imply causation.

As for sound evidence versus personal opinion, I think you will find that personal opinion pervades even the highest levels of science. That's because often there is insufficient evidence, and that's when personal opinion plays a role.


Proper scientific and critical thinking shouldn't take any more time in a limited appointment window than illogical, dogma-based thinking. It's not about the time spent, it's about the quality of thinking used.

Heavy duty rational thought often takes a lot of time, and moreover, the deepest rational processes often take place in the unconscious mind rather than the conscious mind. This is why scientists will often see new inter-connections or answers to problems when they are very relaxed and out walking, or perhaps having a nice hot bath. I have heard more than one physicist say that they have their best ideas while in the bath.

Certain types of unconscious thought cannot be rushed; they have their own timescales, and the answer will pop into your conscious mind as and when your unconscious mind is ready.

This is why an engineer may suddenly wake up in the middle of the night and realize that there is a major safety issue with the bridge he or she is designing. This is the unconscious mind at work. A good engineer will always be doing this. Their unconscious mind will always be working on problems, even when sleeping.

I think the highly rushed schedule of primary care physicians will not allow for this type of long-timescale thinking. Unless we change the set-up, and allow a doctor to take a nice long relaxing walk between each patient he sees.
 

Butydoc

Senior Member
Messages
790
I don't think anyone is suggesting physicians do scientific research during patient appointments. That is indeed unrealistic. The point is that they should be capable of scientific and critical thinking. They should understand basic principles of science like correlation is not causation and opinion is not fact. They should know that sound evidence (not dogma or personal opinion) is necessary to draw conclusions, and what sound evidence is. They should be able to evaluate the limitations of the data they have in front of them. Proper scientific and critical thinking shouldn't take any more time in a limited appointment window than illogical, dogma-based thinking. It's not about the time spent, it's about the quality of thinking used.
Hi SOC,

I'm not sure what a medical scientist is and their breath of training. My own personal experience as resident in surgery required me to perform research and attend journal club. I'm not sure if all residency programs require research but journal club is generally required in most programs. A journal club involves the residents and attending staff to meet regularly and discuss the merits of the articles published in our journal and related journals.
This may not reach the level of a full scientific review but certainly involved critical reasoning and analysis. The concept of correlation vs causation I'm sure is understood by most residents. The real problem is that many physicians don't keep up with the literature and only rely on their clinical acumen.

Best,
Gary
 

Hip

Senior Member
Messages
17,824
The real problem is that many physicians don't keep up with the literature and only rely on their clinical acumen.

What would you say the reason is for this, Butydoc? Perhaps because there is a lack of time, and that there are no periods specially allocated to training?

When I worked in software programming for a major corporate, we would often get sent on training courses to learn new computer skills and computer languages. Perhaps one or two weeks each year would be spent in such training. During those weeks, you would usually be away from the office, and away from the normal hectic work schedule, so you could relax, and this relaxation I found would allow you to quickly return to the old student / learning mode during the training period.
 

Butydoc

Senior Member
Messages
790
What would you say the reason is for this, Butydoc? Perhaps because there is a lack of time, and that there are no periods specially allocated to training?

When I worked in software programming for a major corporate, we would often get sent on training courses to learn new computer skills and computer languages. Perhaps one or two weeks each year would be spent in such training. During those weeks, you would usually be away from the office, and away from the normal hectic work schedule, so you could relax, and this relaxation I found would allow you to quickly return to the old student / learning mode during the training period.
Hi Hip,

Our specialty and the state require us to have a certain number of CME credits (continued medical education). Every specialty has a major medical conference and several smaller conference each year. There are plenty opportunities for physicians to stay current. Our conference are generally held in desirable places where there are other recreational activities. There is really no excuse for a physician not to stay current. In all professions there are those who are very committed while others not so much so.

Best,
Gary
 
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Messages
10,157
Physician should be knowledge + empathy. A person who cannot empathize may well be confined to his lab.

Empathy is the capacity to understand what another person is experiencing from within the other person's frame of reference, ie, the capacity to place oneself in another's shoes.

As a nurse, I can say it is impossible to put yourself in another's shoes. How can you know what a person with cancer, ME, diabetes, heart disease is experiencing unless you are suffering from those things yourself. What a doctor can be is sympathetic and not dismissive. I hate when doctors pretend to know what I am experiencing. I think the knowledge thing is so much more important. Understand me and my illness, I don't care if you can be empathetic. You don't have to understand me to treat me is my bottom line. I don't remember a time where I said 'I understand what you are going through' to one of my palliative care patients because in short I did not know what it is like to have a few weeks or days left to live. I listened to how they felt and used my knowledge to make their last days more comfortable.

Doctors need to stay current. There is nothing worse than going to a doctor who has no idea of the latest ME research. They can sit there and tell me how much they understand my circumstances. I don't want or need that. I want them to be on top of the latest research.
 
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Never Give Up

Collecting improvements, until there's a cure.
Messages
971
Hi Hip,
There is really no excuse for a physician not to stay current.
Within their specialty, yes, however, ME/CFS does not belong to any specialty. Who will stay current on it? The general practitioners have so much to keep up with that I believe they rely on clinical guidelines, rather than staying up to date with the latest research on every disease and condition that comes their way. If they we're to take an interest in ME/CFS, say after seeing a patient with it, they would find a confusing mess, due to contradictory definitions, poor quality research design, and a complete lack of proven bio markers and treatment protocols. It takes vast amounts of time and dedication to sort through it all and come to any useful conclusions. It takes having a strong personal motivation to do so, like being sick ones self, or having a sick loved one. It is unrealistic to expect anyone else to do it.

I think the IOM report goes a long way, certainly not as long as needed, but a long way, nonetheless, in serving diagnostic tools, delivering an edict to respect the illness, and to treat the symptoms to relieve the suffering of the patients.
 
Messages
2
Very simple yet no doctor gets it! It takes a team of caring doctors to try to help get CFS patients their lives back, but today they are "top producers" making money for the hospital. They are no longer trained to diagnose an illness or disease so they write depressed in the file and hope you go away . I am beginning to think holoIstjc may be the only help.hard to understand millions of CFS patients around the world for a very long time (1990's I believe) and no cure? Too much money can be made of us. A Dr near DC overcharged several hundred dollars above insurance because it is complicated! Exhausted and tired but not giving up.
 

Rvanson

Senior Member
Messages
312
Location
USA
There are more doctors who feel this way than would care to admit it but this is a particularly stunning quote. Its Breathtaking the abject stupidity and ignorance this man displays especially now that we ALL (except for this idiot) know how dizzyingly complex human health is, both good health and poor. To settle on the, "these people are just lazy" explanation, my god what century is this guy living in.

Multiple Sclerosis patients were treated in much the same way, at one time. I have no use for fools like this quack.

I have been my own doctor for many years now, and have read many, many thousands of words in medical text and research to treat myself, since there are so many quacks like this man. I have worked for most of the time, since
my own Dx of CFS, without the "help" of idiots like this "man".

Most doctors are less then helpful at best, and outright incompetent at worst. Example: I had a left ear infection in Nov.
of 2014. I was in pain and feeling sick and dizzy, but it was on a Friday, so I went to the ER of my HMO since i couldnt
see my PCP.

The doctor, an MD, there didn't find anything wrong with my ear. The following day I went to an ER not on my HC plan, and a PA , not and MD, diagnosed my ear infection right away, and Rx'ed me some antibiotics right away. When I received the bill, I sent it to my HMO, with a note attached making it quite clear that the bill was up to them to pay.

I dont pay for incompetence or mistakes, by or from, anyone including myself. I expect the same from others, when
they screw the pooch.
 

lauluce

as long as you manage to stay alive, there's hope
Messages
591
Location
argentina
Multiple Sclerosis patients were treated in much the same way, at one time. I have no use for fools like this quack.

I have been my own doctor for many years now, and have read many, many thousands of words in medical text and research to treat myself, since there are so many quacks like this man. I have worked for most of the time, since
my own Dx of CFS, without the "help" of idiots like this "man".

Most doctors are less then helpful at best, and outright incompetent at worst. Example: I had a left ear infection in Nov.
of 2014. I was in pain and feeling sick and dizzy, but it was on a Friday, so I went to the ER of my HMO since i couldnt
see my PCP.

The doctor, an MD, there didn't find anything wrong with my ear. The following day I went to an ER not on my HC plan, and a PA , not and MD, diagnosed my ear infection right away, and Rx'ed me some antibiotics right away. When I received the bill, I sent it to my HMO, with a note attached making it quite clear that the bill was up to them to pay.

I dont pay for incompetence or mistakes, by or from, anyone including myself. I expect the same from others, when
they screw the pooch.
Hi! I always wanted to know good examples of diseases who followed the same path of negligence and disbelief than now ME is facing but where then accpted as real and organic in nature. Do you know where can I found information about such cases? thank you!
 

Rvanson

Senior Member
Messages
312
Location
USA
Hi! I always wanted to know good examples of diseases who followed the same path of negligence and disbelief than now ME is facing but where then accpted as real and organic in nature. Do you know where can I found information about such cases? thank you!

No I do not. I have concentrated my energy, or more specifically a lack thereof, on finding a cure for myself. I have lots of information on things that have helped me, but not a cure.

I am currently investigating the use of nitroglycerin and the nitrous oxide connection/cycle, and am awaiting its arrival
in the mail. I am not going to wait for these quacks to find a cure for CFS. If I did that I would likely be very old or dead.
I want my life back, and no fool who simply has an MD license is going to stop me and neither will anyone else.

We all know that CFS is real. SPECT scans have shown it to be real, but research into a cure, or even
acknowledging that its a real disease and that we are not lazy nor depressed, is still a long way off in the institutionalized medical systems. T

I promise that if I find a cure, all of you will know about it. That is the best that I can do. I just happened to find
out about how MS patients were treated, before they were accepted as ill people, in the course of my studies,
lauluce.