<p>1.)
[quote]
BDM has severely debunked this
[/quote]
What have I debunked exactly?</p>
<p>2.) Sometimes people are late for reasons other than trying to make a dramatic entrance.</p>
<p>Well, what if....</p>
<p>He's arriving at the office after making rounds at a hospital, has to consider 10 or more med refill requests, lab results, and urgent phone calls as he puts on his "uniform", and has to consult with his office staff about the extra patients "squeezed in", or the one without authorization for the visit, etc, before greeting his first patient.</p>
<p>Just saying...</p>
<p>The idealistic view of med school and interships.(to BDM) Shouldn't doctors try to fix a schedule where arriving on time is possible? SYSTEMATICALLY arriving late is what I don't like. Some arrive so often 30 minutes late that secretaries can always can attest for it.</p>
<p>Shrinkrap: Hopefully, what you are saying is true, but saying that a doctor rarely relaxes is contrary to everything I have seen during my shadowing experience. He goes upstairs to read magazines, then leaves 30 minutes early to go to lunch to arrive thirty minutes late (try to compare it to my mother burning half of her hand while cooking for 18/20 clients)</p>
<p>What is this doctors specialty? How was this "shadowing" arranged? How long has he been in practice? Man, around here, a doctor like that would be freaking out about not having every appointment filled if he was in private practice, and if he/she worked for someone else that "magazine time" would probably be double booked!</p>
<p>BDM; I honestly look back and regret not appreciating the teaching more. I had some great teachers and I regret every lecture I skipped. Yeah, I did...in my fellowship.</p>
<p>I prefer not disclosing any informations likely causing indictment. However, I have seen this behavior also outside of my shadowing experience, and while being a patient (not very pleasant to arrive 30 minutes in advance to wait 1h for the doctor to arrive) I think we are making the effort to arrive early, but the doctor should also make an effort to arrive on time.
The specialties include: Ophtalmology, internal medecine, family practice, ear/mouth/nose problems(don't know what it's called).</p>
<p>not very pleasant to arrive 30 minutes in advance to wait 1h for the doctor to arrive</p>
<p>Agreed, and I don't think I would. I have certainly left in such situations, and after a lot less time than that!</p>
<p>Not all of my experiences were bad, but the majority were.
For example, I had known a cool (caring, don't make you feel inferior or like a beggar...) cardiologist and dermatologist (specialized in aesthetic surgery of the skin) but they were unfortunately representative of a minority I have known.</p>
<p>
[quote]
The idealistic view of med school and interships
[/quote]
You're going to have to be more specific, as I consider myself rather idealistic about the practice of medicine. Certainly you're working very long hours. That's obviously true. And certainly the economic reality of physicians is not a sunny one given that most of them had better alternatives and therefore are, in a very real way, paying money (an "opportunity cost") to be physicians.</p>
<p>In other words, what are you talking about?</p>
<p>I am not talking about the practice of medecine. Of course, if you were not idealistic about it, you wouldn't choose to become a doctor.
I am talking about medical school and the making of a doctor, how strenuous it is, how mentally painful with its raw memorization, sleepless nights.
For example, 95% of the hospitals don't comply to basic health mesures for their interns (obliging interns to work more than 30 hours straight, making interns work much more than 80 hours a week).
Personally, I have nothing against this. A doctor is responsible for many persons' life, and if curbing pains for other people involves sacrificing your sleep and youth, then it is a path that should be done.
However, I am more concerned about the "inhumane" aspect of interships, and what it can further cause. I am concerned such approach can deteriorate an intern's altruism etc... Especially significant to me was the information provided in post #15 , by my$0.02.
Why enroll persons with the will to help people and then damaging this determination? It makes no sense to me.</p>
<p>This inhumane approach to medecine could be a reason why doctors sometimes behave unethically, and I think it is very unfortunate for the art of medecine to suffer this.</p>
<p>To Shrinkrap:
Can you give me indications about the physician forum? I would like to get an idea how physicians feel disrespected by their patients. So far, I have NEVER seen a patient manifestly disrespecting a physician. Instead, I have seen a LOT of patients respecting or even idolizing physicians, so I was kind of struck by your statement.</p>
<p>"In fact, they were either patronizing (perhaps, even condescending), self-centered (doesn't seem to care about their patient's suffering), immoral (cares more about the money brought to their office), antisocial (avoids contacts with their patients by seeking refuge in their office and leaving all the "social" work to be done by their secretaries though they had nothing to do at that moment) or arrogant (makes the patient wait for NO reasons to possibly make the entry into the patient room more "spectacular")."</p>
<p>I respond to this statement by asking you one question: have you ever done volunteer/professional EMS before? Do you not understand how much whining and complaining you hear? The doctor's office is not a place of refuge for you to pour your guts out because mommy doesn't love you, its a place to be diagnosed and treated. Additionally, do you think a doctor would be able to perform his/her best if emotionally attached to a patient? I don't know about you, but I always prefer to keep my business life separated to my social life. In response to your other statement concerning money, you obviously aren't aware of what doctors now adays have to go through just to get money from an insurance company.
In conclusion, I agree with you that doctors have become somewhat apathetic towards their patients, however, you must take into account what they have to deal with on a daily basis. If you are lucky, you can find a doctor who, despite these inherent problems that he/she must deal with, will be opposite of those doctors you have described.
Don't think I'm just babbling. I do know what I'm talking about. I am an EMT and see whiny patients every day, my father is a doctor and I see what he has to go through just to get $300 for a hernia operation, and I volunteer at a hospital and am consistently exposed to the doctor/patient relationship.</p>
<p>A couple of things:</p>
<p>It's easy to become jaded in medical school. It's a strenuous process. It's also easy to develop a little bit of an ego because people tell you things they don't tell anyone else.</p>
<p>Patients don't always treat doctors very well. </p>
<p>Dealing with surgeons is a lot different than dealing with general internists is a lot different than dealing with radiologists and so on and so forth.</p>
<p>Most medical schools (I'd be shocked if it wasn't all) do have courses on "bedside manner" type stuff. Realize that the concept of Patient Centered care wasn't formalized until the 1970's and didn't make its way into medical education until the 80's, and really become ubiquitous until the 90's. Older docs aren't necessarily going to have been formally educated in that paradigm. Step 1 of USMLE does have questions that directly ask how a physician is supposed to respond in a given scenario.</p>
<p>Relationships are important, but doctors see really sick people on a regular basis and getting too caught up emotionally with every single patient just isn't feasible. That distance shouldn't be interpreted as coldness, but as a way for a physician to get through their day.</p>
<p>Just because a physician doesn't appear to be doing anything doesn't mean they're waiting for a grand entrance or other nonsense. If you were to check the doctor's lounge at the hospital I'm currently doing my surgery clerkship at, you'd probably be upset at the numbers who are sitting around reading the paper or watching the Golf Channel. But they're busy waiting for OR's to turnover, for the result from that last CT scan, or for the patient to arrive. Despite what most people imagine, surprisingly little of medicine is time urgent. Watchful waiting is sometimes the best strategy. It's been said, "the physician's job is to entertain the patient while nature cures the disease."</p>
<p>Why should physicians have to deal with setting up their schedules and answering phones? Wouldn't the patients already there to see the doctor be upset that the doctor is spending his time on those things rather than actual medicine?</p>
<p>Thanks Bigredmed, that remodelled the misconceptions I could have had during my shadowing experience.
It's been said, "the physician's job is to entertain the patient while nature cures the disease." Interesting point that I didn't know before.</p>
<p>Also, I shadowed an old physician, so he may well have not been through the medical education as it is nowadays.
"Patients don't always treat doctors very well." I really have to disagree with this (unless you are talking about crisis in the ER or whatever). I don't know how it is in the US, but in France, doctors are MIGHTY well respected. I can't even think about another profession I have seen to be so respected. The main reason is that so many people believe in the "superhuman" nature of the doctor, the intellectual who devotes his life to the public safety and health. In Vietnam, the two most respected professions are that of a doctor and that of a teacher (yeah, pretty traditional). Of course, this respect is warranted. Besides, I just don't see why a patient in his right mind would not respect a doctor: he relies on his doctor to feel better (or even survive), so it's common sense that he will respect the doctor. Disrespect occurs with every profession, but much less with the profession of a physician.</p>
<p>"Why should physicians have to deal with setting up their schedules and answering phones?" Well, what I mean is that the doctor could at least call their patients into the consultation room, or be ready in the consultation room when the patient enters. This did not happen, even when there was only one patient.</p>
<p>The psychological aspect of medecine should also be important, and it's not by distanciating from patients or avoiding them that doctors will create a comfortable patient doctor bond. If the doctor could be less showy, less overbearing, less "superhuman", the patient would be more comfortable and more likely to cooperate. Thus, I have witnessed that in France, doctors seek more "contact", and identify themselves more easily to patients than in the US, especially when I see here a physician who just avoids his patients or try to distanciate himself.</p>
<p>"its a place to be diagnosed and treated", So why make it so conditional, so solemn and beyond the power of the patient? It seems like the overacting done by some doctors suggest more than that.</p>
<p>But I would like to return to the gist of this thread, which deals with how med school can detract your own ethics and blow up your ego. Post #15 and #16 is particularly relevant to this thread, so anyone can voice their own insight on this matter?</p>
<p>My two cents:
Like anything else in life, medical school will only transform you insofar as you let it - be it for the better or for the worse.</p>
<p>"You see Dr. Wen in there? He's explaining to that family that something
went wrong, and that patient died. He's gonna tell them what happened,
he's gonna say he's sorry - and then he's going back to work. Do you
think anybody else in that room's going back to work today? That is why
we distance ourselves; that's why we make jokes. We don't do it because
it's fun. We do it so we can get by."</p>
<p>Dr. Perry Cox on Scrubs</p>
<p>"To Shrinkrap:
Can you give me indications about the physician forum? I would like to get an idea how physicians feel disrespected by their patients. So far, I have NEVER seen a patient manifestly disrespecting a physician. Instead, I have seen a LOT of patients respecting or even idolizing physicians, so I was kind of struck by your statement."</p>
<p>I suppose the overall idea is the sense of the patient as a "customer" who is always right, a consumer of goods that can be ordered like burgers and fries. Examples might be things like calling up your doctor in the evening requesting/demanding antibiotics. You "know" your child's cold is going to "turn into" pneumonia. You are out for the eveining so coming in won't do. Just phone in the antibiotic, doctor, or I'll find a doctor who will. If you do not, you are a money grubbing idiot, and perhaps I should report you to the medical boards, or some administrator. Sometimes it can include name calling or threats for failure to prescribe pain meds, but this is not common. Sometimes it is noncompliance, followed by a worsening condtion, followed by threats to sue. None of these seem as outrageous as what I sometimes read on physician only boards. Perhaps it is because I do not often have these issues, but I am in private practice and get to call alot of my own shots.</p>
<p>Wow, that's awkward. Usually, we are more concerned when the doctor HAS to prescribe strong medecines_meaning you have a serious illness. Now, it's the opposite. They are actually demanding for strong medecines.<br>
Did you know that my family always tried to avoid antibiotics as much as possible? As surprising as it may seem, we might well be a minority now.</p>
<p>Would you consider the profession of a doctor as to be generally less respected than other professions in the US?
If so, US doctors are very unfortunate since French doctors get such a great respect for their work.</p>
<p>Ky-anh Tran,</p>
<p>Doctors are respected in the US. Very much so. But you know what? It doesn't matter how much respect a person has for someone else when they're being told they have cancer. They're not very likely to be nice.</p>
<p>Doctors deal with illness, death, and pain every day. They have to live in some sort of middle ground between sympathy and aloofness to get by. I suspect that you want doctors to be "friends" as much as they're physicians, but it just can't happen. Not when the "friend" on the patient side is threatening the doctor for telling him that he's got maybe a few years left to live.</p>
<p>BDM,</p>
<p>Good quote. I just watched that ep. a few days ago.</p>