What is up with doctors?

[Parker Martin]

I think there is a huge variance in quality between doctors.

 

I grew up going to a doctor who is known as one of the best in the area. While I was in college, I was away and had to see other doctors. I once got ill and spent a month bouncing around from doctor to doctor before going home on break, seeing my regular doctor, and getting a correct diagnosis: mono. My regular doctor was furious that the other doctors hadn't caught such an obvious case, especially in a college town where mono is extremely common due to so many students living in close quarters.

 

My mother used to travel back to this doctor for her checkups even when she lived over a thousand miles away.

 

Most doctors are mediocre, and it's worth finding a good one.

 

(But never expect a doctor to know anything about nutrition. That's a lost cause.)

[stripe]

(But never expect a doctor to know anything about nutrition. That's a lost cause.)

 

At my child's 12 mo appt, I mentioned feeding him blended vegetable soup. The nurse got all aflutter that he needed to have whole carrots because blending got rid of the fiber.

[littlebug42]

I don't have faith in many doctors. I don't deal well with arrogance and I have to have a doc that has respect for my viewpoints especially when it comes to my children. We drive 12 hours round trip for my daughter's orthopedist and he is her third ortho (she is 8). I trust completely that he has my daughter's best interest at heart. I have finally found a ped that I like and respect. My OB has delivered both my children and has been my doc for 15 years. I just don't keep looking until I find docs that fit our needs.

 

One of the best experiences I ever had with a doctor was when I was pregnant with my oldest daughter. I went to my OBs office but he wasn't in that day. One of his younger partners was there and when she looked at my back, she said, "You know what. I am not sure what that is. It might be shingles but I need to look it up". I can respect that way more than I can when docs don't let me in on the guess.

[Mom0012]

I use Quest. They have a patient interface on their website (and a smartphone app) so I get results when my doc does. (and I can email them to a new doc sitting in his/her office if I choose) Those records are yours. You do not need permission (or a middle man) to have copies.

 

Actually, I have had a lab tell me they could not release my son's results to me. They could only release them to the doctor who ordered them. This was years ago, though. I was furious because this was an alternative allergy test and the doctor wouldn't give them to me without another appointment (which was not covered by insurance). He said they were complicated but it was a simple report which listed what things he was allergic to. He just wanted more money for another appointment to read me the results.

 

Lisa

[texasmama]

So the elderly and mentally handicapped should be so responsible for their own health care as well?

 

If the elderly are in such a place as not to be able to discuss/remember their medical issues, then they need a family advocate, as do the mentally handicapped. These vulnerable populations do not always receive an advocate, but I would argue that one is needed in some cases.

 

I go to the doctor with my dad now because he stayed with an older doctor whom he liked but whom was mentally "slipping" and misdiagnosed the blood clots in his legs as emphesema (sp) when he has not smoked a day in his life. She put him on Singulair, to which he had a psychotic reaction. Another doctor did surgery on his knee, bothched it, redid it and then told my dad he had rheumatoid arthritis. I argued with my dad about both of these diagnoses. He is now in the care of a primary doctor I chose (and know personally) who is very competent and careful. I still go with him to all of his appointments. I will be doing the same with dh's elderly grandmother soon.

 

So no, of course the elderly and mentally handicapped should not be so responsible for their own medical care. Yet, sometimes, they are. My dad's situation could have caused his death. His blood clots went on for over a year until he was finally diagnosed, sent immediately to the ER and operated on (mesh screen). I believe that most other docs would have caught the situation sooner. He has now allowed me to be his advocate, and this is needed. I wish everyone had a passionate and able advocate for their medical care.

[Nestof3]

Some people have been comparing the doctors to mechanics but charge 100/visit. Seriously, I don't many mechanics who spent 12 years in school and come out with $150,000+ in debt. I don't think that is a fair comparison. Especially when cars come with internal computers to talk to the mechanic and we only have a human's very fallible recount of the illness/condition.

 

My points in comparison were first the paperwork a person receives. My inlaws are elderly, and by the time they get home, they have no idea what has been done to them. If they had taken their car in for a diagnostic test, they would have been given a piece of paper saying the tires were balanced, the break pads will need replacing soon, etc. A simple piece of paper like this should not be that difficult. It would have saved my friend's eye sight if his specialist gave him his labs because his platelet count was dangerously high. The specialist contacted the general physician who was supposed to call my friend to make an immediate appt., but the general physician never called. He had a massive stroke a few days before graduating with his masters in electrical engineering. He is now blind.

 

He was getting regular testing done because of his juvenile diabetes. Had they given him a printout with the actual levels and the desired levels, being an intelligent person, he would have inquired about this. He knows what platelets do.

 

I had to find out from my insurance company that my obgyn diagnosed me with fibrocystic breasts (after one lump was found; I've never had another lump). A little printout saying this along with a definition of it would have been helpful.

 

And yes, doctors pay a lot in medical school. That doesn't mean I shouldn't get their undivided attention when I am paying $600 an hour for their service.

[dancer67]

I am very glad someone started this thread. I want to share a story that happened to me, which sent me over the edge and into the Health Anxiety I live with every day now.

 

In November of 2006 I started having pelvic pains. So automatically I think it is GYN related. I made an appt with the GYN and had to wait a few weeks, so in the meantime I went and saw my PCP(One I do not have any longer). She DX me with a UTI. Put me on antibiotics and sent me home. Never called to tell me that the lab report was negative and I was on anitbiotics for nothing.

 

So the pain is getting worse. I go the the GYN. He tests everything. There is nothing there. He then sends me off to a GI Dr.

 

I go tot he GI Dr. and he says since I am only 39(at the time) I am to young for a colonoscopy, so we will do a sigmoid in the office. I had to wait a month. In the meantime, I am not eating, not funsctioning, laying in bed, vomiting.

 

My DH takes me to the ER. There, they do a CT scan, bloodwork. All is fine again. They won't even give me something for the pain, because they do not know where the pain is coming from. I go home and wait. In pain once again.

 

Finally get to my sigmoid. He finds nothing either. He now tells me to see a urologist. I could have interstital cystitis. So off I go again, waiting once again for another appt, now we are at the end of December. I have lost 20 pounds, and miserable.

 

Urologist says doesnt sound urology related and to go BACK to my GI dr.

He said if GI Dr. did not find anything, I am going to just have to learn how to manage this pain on my own.

 

I actually broke down, and was hysterical. I threatened suicide. I knew something was wrong with me, and there was no way I could live like that. So just let me die.

 

They overheard me say that, and my husband was scared for my life, so I was placed in a Psych unit for a week. Still with that stomach pain. They drugged me up, told me it was in my head.

 

It wasn't until one nice nurse, who thought this was absolutely unexcusable, called my PCP. She happened to have her office in the same hospital I was in. And she demanded she get down there to see me. My PCP was a little disgusted, but this nurse was not letting it go. It was the PAIN that landed me in the psych ward to begin with.

 

My PCP comes down and sees me in my room. She is not happy, and ask me what my problem is.(in a snotty way). Once again for the umpteenth time I tell her where the pain is. So she says "It is probably just IBS", writes me a script and leaves.

 

My roomate says "Wouldn't that be shi*** if IBS is all it was this whole time? No pun intended".

 

After two days on IBS meds it took the edge off.

 

I ws released, and called the GI Dr when I got home. They switched my IBS med. This was now mid January. I started on Librax and have been pain free ever since.

 

All that caused me weeks of pain, losing part of my life, thinking I was dying, ended up in the Psych ward,NOBODY would help me and it was JUST IBS!!!

 

Since that time I have been very afraid of Dr's or any ailments that come my way. There were so many hands in the pot trying to figure out what was wrong with me, and not one Dr was communicating with another. I was pushed around like I was on an assembly line.

 

Thank God for that nurse.

 

So this is WHY I have health anxiety. I have a huge fear of being in pain and nobody being able to help me. It has caused PTSD for me, anxiety, and a great fear of Dr's.

 

The medical community has become nothing but an assembly line, pushing you off to one specialist or another. And it should not be my responsibiltiy to keep track of what another Dr said .

 

I have a hard time accepting ANY DX. I try to stay of google because someone with health anxiety could have themselves dead and buried in 5 minutes.

 

This is why I ome here instead. Dr hive seems to be much more knowledgable then the shmucks I had before.

 

BTW, I have since changed a lot of my Dr's and things have been somewhat better. But I still do not trust them.

Edited August 22, 2011 by dancer67

[Nestof3]

Dawn,

Are you gluten free? If your mother has Celiac and you have Hashimoto's, there's a good chance you should not be eating gluten.

 

As for doctors.. They are merely consultants to me.. I am in charge of my health and my children's health. My doctors run the tests that I ask them to run. I never go in blindly. I also go to them if we have a broken bone or need stitches. Other than that, I can pretty much take care of everything else on my own.

 

 

 

I have given serious consideration to going gluten-free.

 

Yes, I do my own footwork as well, but I believe I have resources available to me and a drive to learn that I don't see in the average person. I think it is unacceptable that people are over and over again told to be their own healthcare advocate. I do it because I've learned from experience, but most people I know are not intellectually and technologically in a place to be this sort of person. Most people assume that the people with the degrees and making the bucks have the real info -- especially when doctors look at me like I'm an ignoramus for daring to tread on their turf.

 

I called my mom this morning, told her to meet with her doctor for a Vit B-12 absorption test, etc. She asked if I would come with her because she didn't really understand much of what I was saying and wouldn't remember it. Sure I will. I live down the street.

 

Many many people do not have such advocates nor should they have to.

[Nestof3]

Thank you so much. I will study up on this.

 

Has your mom heard of the GAPS or SCD diet for healing intestinal villi? It has helped so many people heal their guts and get formely allergenic food back. Our family is doing it, but we have cheated a few times. I've had so many tests done that verify me needing to do this! Just thought I'd put that out there. http://www.carlazeiteraba.com/explainingthegaps.html

[JulieH]

My thoughts on doctors have changed a whole lot in the past year. I have a brain malformation that was putting a large amount of pressure on my spinal cord and causing a TON of aweful symptoms. All the doctors kept blowing me off, particularly the neurologist.

 

Finally, my primary physician ordered another MRI and after ruling EVERYTHING possible out, sent me to a Neurosurgeon, who FINALLY listened to me and I needed brain surgery to deal with the issue. I was having *severe headaches*, drop attacks , and total numbness in my arms. It was aweful.

 

I had the brain surgery in February and am STILL recovering from it (though I feel pretty good..it's just fatigue and can't lift stuff yet)

 

It infuriates me to think about the years that I tried to tell the doctors I believed it was the Chiari malformation and they blew me off telling me it was no big deal. errrr

 

I have started going to an acupuncturist and she has helped me more than any doctor ever has.

[Nestof3]

We can't expect doctors to know everything about every obscure situation just off the top of their heads. They don't always have a chance to google for extended periods of time before offering their educated medical opinions to confirm if their best guess is right or wrong based on every single case study available. Even among highly skilled medical doctors, there can be differences of opinion, so if a website disagrees with your doctor it may not always clear if the website or the doctor is right. Like you, I do lots of research on internet before seeing a medical professional and then I usually check what they've told me against other sources. Not even the best of doctors knows everything, (but off the top of their heads know a lot more about medicine than I know.)

 

A general physician should know the possible causes of conjunctivitis and understand the importance of not prescribing antibiotics twice in a row if not necessary.

 

Actually, he had already been taking an antibiotic and prednisone for finger swelling -- they were unsure whether he had an infection or an allergic reaction to something, but his finger was so swollen he almost had to have his ring cut off.

 

He was then prescribed a different antibiotic for his eye, so I had him call the doctor back and ask if he should take two different antibiotics at the same time. He was told to stop taking the first but start taking the second.

 

For my son's perioral dermatitis, he was given topical steroids. These made the condition far worse as steroids can actually cause perioral dermatitis.

[MeaganS]

I recently went to the doctor with my son. A medical student/resident was there and conducted part of the exam. I knew more about vaccines than he did. Specifically, my 'stumper' question was -- 'The Hep A vaccine consists of two shots, right?' He was baffled. Had no clue. At least he had the decency to look embarrassed.

 

Um, that is a student you are talking about. He's there to learn that stuff and shouldn't necessarily already know it.

 

Of course, my husband is currently a med student so I'm a bit biased, but am totally amazed at the number of people on this thread who say that they don't know anything. I guess that my husband's 12-14 hours of studying a day isn't for anything...

 

There is so much information out there. So much medical knowledge that no one could possibly know everything and catch everything. Now if we are talking about bedside manner, that is different, but I don't think anyone can expect a doctor to pick up on everything. It is impossible. There are good doctors and bad doctors, but I believe most doctors do want to help people. I know my husband does. That's why he's in medical school. He was in business before and hated how pointless it was, so he's in medical school now so he can make a difference in people's lives. And he's not the only one.

 

From a patient's point of view, I completely understand the frustration. My daughter's first pediatrician was amazing! He listened and helped us as much as possible. The fact that he seemed genuinely concerned about her and did everything he could to help her made all the difference to us. Her new pediatrician is a joke. I've yet to have a great OB, and my husband is struggling with some chronic issues that doctors can't seem to figure out.

 

There are many things wrong with the medical field. Insurances and current policies have made it very difficult for a doctor to be able to do their jobs. They have to constantly worry about being sued and have to be incredibly careful about what they say and do. They have to synthesize a remarkable amount of information and do it all while being nice. I believe there are jerk doctors out there, but I also believe that most of them are doing the best they can.

[Nestof3]

My inlaws have always been like this -- they are just not well-educated people. They are of the old school mentality that doctors are the professionals. My father-in-law was expected to know about carpentry and the home-buyer was not required to learn code and about building procedures to make sure what he was doing was correct.

 

They're from a small town, very base education, etc. Where would they learn medical information from? They've never been to a library. They have no computer.

 

Doctors should be our health advocates. I'm perfectly fine studying on my own and helping my family, but that is a luxury in my opinion.

 

If the elderly are in such a place as not to be able to discuss/remember their medical issues, then they need a family advocate, as do the mentally handicapped. These vulnerable populations do not always receive an advocate, but I would argue that one is needed in some cases.

 

I go to the doctor with my dad now because he stayed with an older doctor whom he liked but whom was mentally "slipping" and misdiagnosed the blood clots in his legs as emphesema (sp) when he has not smoked a day in his life. She put him on Singulair, to which he had a psychotic reaction. Another doctor did surgery on his knee, bothched it, redid it and then told my dad he had rheumatoid arthritis. I argued with my dad about both of these diagnoses. He is now in the care of a primary doctor I chose (and know personally) who is very competent and careful. I still go with him to all of his appointments. I will be doing the same with dh's elderly grandmother soon.

 

So no, of course the elderly and mentally handicapped should not be so responsible for their own medical care. Yet, sometimes, they are. My dad's situation could have caused his death. His blood clots went on for over a year until he was finally diagnosed, sent immediately to the ER and operated on (mesh screen). I believe that most other docs would have caught the situation sooner. He has now allowed me to be his advocate, and this is needed. I wish everyone had a passionate and able advocate for their medical care.

[MeaganS]

NM, I'm pregnancy hormonal and being weird today. I think I will stay out of anything even remotely controversial for the next few days.

Edited August 22, 2011 by MeaganS

[Slartibartfast]

 

I go tot he GI Dr. and he says since I am only 39(at the time) I am to young for a colonoscopy, so we will do a sigmoid in the office.

 

What? Why would you be too young for a colonscopy? I had one at thirty.

 

I am sorry you had that experience. :( I had IC and I was pretty much at the same place you were when you were diagnosed. Pain takes a terrible toll on your emotional well being.

[Alice]

I'm sincerely sorry so many have had bad interactions with doctors. A few observations from someone in the field...

 

*Medicine is an art and a science. I think a lot of times both doctors and patients forget that. Yes, ideally I'd always make a diagnosis perfectly the first time. Ideally, I'd be smart enough to remember every possible constellation of symptoms and diseases. But a lot of times people don't follow the textbook. Their symptoms are different from the typical, they don't tell us their actual concerns, we ask the wrong questions, etc. Experience comes into play here, sometimes we have to go more on gut feelings rather than what the best decision would be scientifically.

 

An example would be a baby I took care of in the hospital, who was about 15 months old. He had a fever for about 9 days but came in at about day 7 or 8 of the fever. We admitted him and began the standard "fever of unknown origin" work-up. We did blood work and urine, etc. He had no vomiting, no other symptoms, was eating normally and didn't seem to be in a lot of pain. He was a little fussy like a lot of kids with fever are but nothing excessive. The first morning that I saw him I thought he seemed a little uncomfortable when I examined his belly. At this point it could have been a lot of things, in most of these cases we don't figure it out but the fever goes away and we assume viral cause. I had a gut feeling that this was something more and felt like his belly exam was off. I ordered a CT scan. The residents and students thought I was nuts, I could tell but even though it wasn't the next thing to do on the work-up algorithm I felt like it was likely to give us an answer. Ended up he had appendicitis with an appendix "the size of a hot dog" that the radiologist and surgeon both said was the biggest they had ever seen. He SHOULD have been in a lot of pain and refusing to eat or even vomiting.

 

I think medicine is becoming more and more impersonal and dictated by algorithms and checklists and protocols. We have asthma pathways and fever in a neonate protocols and dehydration protocols at the hospital I work at. These are good in that they help us not to forget things and ensure that every patient is given "the standard of care" despite their doctor's failings. But they can be bad too in that sometimes when someone is on a pathway or protocol doctors forget to listen to their patient's individual concerns. Many times I've ordered that a patient not be on the asthma protocol because I know them and know they respond differently than most to the meds.

 

*Medicine is a science and science is imperfect. In science, you are supposed to make mistakes. Observing that something doesn't work is ok. Sure, no one wants to be an experiment with their health (and no one should be). But I hear all the time "the doctors used to say this and now they say something different...therefore, they clearly are stupid and can't be trusted." A great example of this is the recent feeding recommendations for infants. We used to recommend waiting to feed the most allergenic foods until after 1-3 years in order to prevent food allergies. Years of observation have shown that it did not prevent food allergies. Allergy and Immunology is probably the hottest area of medicine right now and still very much evolving in our understanding. So now we recommend feeding those foods whenever you want. Were we wrong before? Yes. Could we be wrong now? Sure. But we have to make suggestions and recommendations based on the best scientific knowledge at that time. As scientists of a sort, we are ok with the idea that the knowledge can change.

 

*Medicine strives to find a balance between treating the individual and the group. I'm not even going to wade into vaccination which is the prime example of that. But as a doctor I have to try to treat the individual in my office but often with recommendations that are made based on what is best for a group. Just to make up statistics in a field not my own: If 98% of colon cancer is found on stool guiac and not colonoscopy than insurers and people who make public health recs might suggest just doing stool guiacs for screening. That works for the population but not for the 2% of people who aren't found on stool guiac. There is no way for me to know if the patient in my office is in the 2% or 98%. That's a made up example but there are decisions we make all day that are similar. That's where that art of medicine comes in, but it's not always simple.

 

*The med student who posted earlier does have a lot to learn, hopefully. But one point made was that for every person who comes in armed with the latest research and information that is reasonable we have 10 people who come in with demands or requests that are not reasonable. For every patient who has thoroughly researched vaccines I have 10 patients who are "worried because I saw it on Oprah". I can respect the first, the second I find frustrating. It's not a good excuse but sometimes after a morning of dealing with people demanding antibiotics for their child's cold because they are going on vacation and want it "just in case" I am not always as patient with someone who comes in with reasonable demands.

 

*Medicine is getting more and more impersonal. I have many patients who go to Urgent Care for the convenience but then are upset with me because I don't know the history of all the infections their child has had. Choice is good and I like people being able to see a specialist without seeing me first, I hate being a "gatekeeper". But it also means that people doctor-shop more and more. Sometimes for valid reasons, sometimes just because they are impatient with small things or not willing to take the time to build a relationship. This goes both ways, many things about the modern medical system make it tough for patients to develop a relationship with a doctor even if they want to.

 

If you read all that, I'll just add that I don't mean to excuse those in my profession that either never should have been there or need to get out. It makes me angry to read about doctors who give the whole field a bad name. At the same time, I wanted to say that so often on this forum I find an antagonism to medicine that astonishes and saddens me. It's always interesting to me to read these threads and educational. I find that IRL also the homeschoolers I meet are more anti-medicine than people in other circles. I wonder if it stems from thinking that we can do it all ourselves and being by nature somewhat anti-expert.

 

Regardless of the bad apples in the barrel, it's still a profession that I love and am proud to be part of. It's messy and imperfect, but then so is a lot of life.

[Slartibartfast]

To play devil's advocate (and defend my career...) I will say that for every patient/patient's mother who shows up with a plausible diagnosis, there are about 5-6 who show up with a viral cold, demand antibiotics, and call us idiots when we tell them antibiotics won't help, no matter what WebMD might say. I'm on pediatrics right now, and just two days ago I had to argue with a woman that her daughter had perfectly normal mosquito bites on her legs, that she doesn't need plastic surgery to look at them, and that she won't have psychiatric issues from a tiny scar on her knee if she develops one.

 

Not to mention the women who don't want to vaccinate their kids- and therefore put their own kids as well as everyone else's at risk- they just make me want to scream. No, I don't care about what your naturopathic, holistic, "cares about the whole person but has never heard of evidence-based medicine" best friend told you. I'm not trying to make money off of you- I'm trying to make sure that when your 4 year old gets Pertussis and plays outside, she doesn't give it to the child whose immune system was beaten down by cancer or to the newborn who still hasn't had his shots, potentially killing them both. But hey, going unimmunized is "more natural". Sure, so are viruses and bacteria, but we're trying to avoid them.

 

I'm not saying doctors are inherently perfect- far from it. I wouldn't characterize it as "shooting in the dark" but we certainly don't know everything and that's ok. Being a good doctor I think is more about listening, knowing what resources to turn to in order to figure out what's wrong, and then consulting the patient as far as the plan is concerned. It's true that doctors don't communicate with one another and often have no idea who has done/given what and when and why. Hospitals with electronic medical records really improve that, but it's still not perfect and not everyone is close to one of those. Sometimes it's up to the patient to show up with a list of medications she's on, so the doctor can figure out what should happen next. I can't tell you how many people, when asked what medications they're on, omit/forget one, call things "oh it's a little white pill...", or don't tell me about the weird herbal remedy they were prescribed that messes with the levels of all their other meds. Everyone should communicate better- doctors and patients. I had a patient once in ob/gyn clinic who showed up for a totally generic-sounding issue who told me after a 20 minute chat about that generic problem that oh by the way my kidneys are failing because of this chronic disease and oh by the way I'm on high dose chemotherapy for this other thing. I basically had to tear the piece of paper and start everything over again, and was 40 minutes late to see the next patient (who was rightfully annoyed) because I had to pry information from this one woman.

 

So my advice, as someone both on your side and on the "other" side is that it's very good to be an educated consumer of your health. If you don't think your doctor is listening, you have every right to find a new one or express your displeasure. If you think he/she dismissed your concerns, same thing. If you think you know what's wrong, do tell your doctor, but if you still dont think he/she is addressing your issues, feel free to find someone who is more specialized in the field you need.

 

I find your attitude unprofessional.

 

Many people are not "free" to find a specialist because they have an HMO. Many people cannot "shop" for Doctors because of the type of insurance they have or they are limited in choices due to living in rural areas.

 

You may have had patients who were less than forthright about their issues but as I mentioned earlier, it took over twenty years for me to be diagnosed with what is known to be pretty common.

 

There are many reasons that someone would not have chosen to get the pertussis vaccine, many of them having nothing to do with what is "natural."

Edited August 22, 2011 by Sis

[RahRah]

It's not just the family practice docs but the specialists also. Took dd to a pediatric hematologist for anemia & testing for MTHFR (genetic mutation that interferes with the absorption of folic acid). She was positive for the MTHFR and doc told me to make sure she gets folic acid and test her homocysteine level when she's an adult.

 

Multiple sources on the internet state that people with MTHFR should take methyl-folate (special form of folic acid that bypasses the conversion) for the rest of their lives. I'm going with what's on the internet. If dd follows the doc's advice, she'll be at risk for stroke, heart disease, miscarriages, etc. because the normal folic acid cannot be converted because of the MTHFR.

 

Took extra iron to correct the iron deficiency for 2 months. She was dismissed and told to take 15 mg of iron/day and add an additional 65 mg during her period. She didn't take the iron - just the methyl-folate. Fast forward a year - had a blood test at her last checkup and her iron's fine. I shudder to think of all that iron in her body if she had followed the doc's advice and taken the iron pills.

 

You made the right call....we haven't had DS tested for MTHFR (both DH and I have different copies of the gene - we know for sure DS has one of the A1298C, DH is homozygous with that one - it's 50/50 he has the C677T from me - if he does, he's compound heterozygous and will be a very high risk for heart attack and stroke in adulthood without adequate folate, B12 and B6).

 

Anyway - he gets 1 metanx 3 times a week, eats choline rich foods (methyl donor), and 1 B-complex 3 times a week (to include what's not in the metanx - riboflavin - and the spectrum of B vitamins, which are all needed in the folate cycle). We'll have him tested when he's a teen - but for now, we're making sure he is getting the high levels of micronutrients he needs.....and interestingly, he loves vegetables - high folate - on his own, so he eats well too. In a few years, when he gets to 100 pounds, he'll go to 1 metanx a day and a b-complex daily too.

[scrappyhappymama]

Most recently, we went through an issue with milk and soy protein allergy with our youngest (mos. old DD). Our new pediatrician was of no help. I asked if we should see a pediatric gastroenterologist, he didn't think it was necessary. He didn't really even think it would be very helpful to switch her to an elemental formula. I did it anyway, and DD has gone from having 10 liquid stools a day, and being absolutely inconsolable to being the happiest baby on the planet. She is now thriving. On our most recent visit to the pediatrician I asked him to write a letter to our insurance company to get some coverage for the formula. He said, "It will be hard to document the necessity for the formula, since you didn't go to a gastroenterologist." Ugh!!!! He also missed my younger son's wheat allergy. I'm so tired of having to figure everything out.

 

 

Three of my sons have had milk-soy protein allergies. Only one doctor we have ever seen has taken it seriously, and she was a pediatric allergist at a major children's hospital that it took us over six months to get in to see. She was actually researching milk-soy protein allergies and my oldest soon was part of her test group. She also had an awesome nutritionist on staff who helped me figure out what I could feed my toddler, especially since he had already weaned. Unfortunately, we moved away, and any doctor we've seen since has dismissed my sons' issues as:

-irrelevant because they are "only" (severely) gastrointestinal or

-imaginary, since they do not show up as a "true" allergy on blood testing

-lactose intolerance (NOT the same thing at all)

 

I had to figure out on my own that in addition to the milk & soy issues, my third son had an intolerance to corn. It took a long time, but an elimination diet on both our parts finally pinpointed the problem. The only recommendation his ped at the time had given was to wean him and put him on toddler formula. A milk.based. toddler formula. :001_huh: I reminded her of his milk-soy protein issues and she told me that he didn't test positive to that on the blood test (it can't be diagnosed that way) and formulas have the bad stuff from milk filtered out and are made to be gentle for babies so he'd be fine. It was ridiculous.

 

The good news with milk-soy protein issues is that our original allergist recommended extreme vigilance in keeping these out of our son's diet and if we did, he would possibly outgrow the allergy. Fortunately, with the first two, they both did outgrow their allergies by age four. Her theory is that some children's guts just aren't able to handle these proteins at a young age, but that they can mature into it if not constantly re-exposed to the offending proteins.

 

Sadly, one of the only exposures one of my son's had to SOY was in that same children's hospital. My son was hospitalized for an unrelated issue and he had to be sedated for a test. In the pre-operative screening, we discussed his allergies first with the nurse and then with the doctor when asked. Both asked specifically WHAT his reactions to milk and soy are, and clarified that he did not have anaphylactic reactions but primarily gastrointestinal. I *should* have asked more questions and done more research ahead of time, but trusted they would say something to me if there was an issue. Well, within hours of his procedure, he started vomiting and having severe diarrhea. When he has the allergic reactive diarrhea, it's not just inconvenient; it causes hideous blister like rashes that devolve into open wounds that are very painful. Finally we figured out that the sedative they used on him, Propofol, is in a solution of SOY OIL. The doctor and nurses KNEW that my baby was allergic to soy, but since it was a non-life threatening reaction that we'd have to deal with at home and not one they'd have to deal with there in the hospital, they did not CARE. His allergist admitted this to me after I called her panicking at the severity of his reaction to having soy injected directly into his blood supply for hours! She also said that they *could* have used another sedative instead that was not soy-based, but the recovery time afterwards is longer, and his procedure was later in the day... so they probably didn't want to have keep him and monitor him longer because of using the other sedative. :cursing: He was sick for weeks.

 

What really gets me is the amount of bad breastfeeding advice I have received from doctors and nurses.

 

 

:iagree::iagree::iagree:

 

My good friend's baby boy contracted Botulism and was very, very sick and hospitalized for several months. During this time, she pumped faithfully and he was given her milk through a feeding tube. Once he was finally recovered enough to come home, he suddenly started having bloody diarrhea. Some of the doctors told her she should quit breastfeeding him and put him on soy formula. She called me in tears, because after pumping so long to continue to give him breastmilk during his illness and finally getting him nursing again, they wanted her to just wean him like that because of a *suspected* sudden dairy allergy. One doctor told her he was probably just allergic to her breastmilk. :blink: I, who am in no way a trained medical professional, just a mom who's dealt with years of dairy and soy allergies and associated breastfeeding issues, suggested that if he had problems with milk, then he was likely to have issues with soy as well because of the similarity of the proteins. She asked her doctor about this and they agreed and said she needed to wean and put him on expensive "safe" formula that would cost them $800 a month and not be covered by insurance. The doctors were also insistent that this had "nothing" to do with the botulism. Despite the fact that botulism by definition destroys the villi in the intestine and causes malabsorption and other major gastrointestinal issues. I suggested to her that perhaps rather than a sudden, unexplained dairy allergy, perhaps her son was just temporarily intolerant of milk because of the damage to his intestines from his ordeal. She decided to go on the Sear's elimination diet to see if it would help her baby heal and the bloody diarrhea to cease. Her ped agreed to let her "try this unorthodox approach" rather than the protocol of weaning and formula. Happily, her adjusted diet helped and baby's diarrhea resolved and she was able to continue breastfeeding him. A few weeks later, her doctor was amazed by the results and congratulated her for her tenacity and commitment to breastfeeding her baby. The doctor's defense was that she had heard of elimination diets helping, but that most moms wouldn't actually do it, so instead they just recommend weaning and formula, but that my friend's results encouraged her to actually offer this as an alternative in the future.

 

Not to mention the women who don't want to vaccinate their kids- and therefore put their own kids as well as everyone else's at risk- they just make me want to scream. No, I don't care about what your naturopathic, holistic, "cares about the whole person but has never heard of evidence-based medicine" best friend told you. I'm not trying to make money off of you- I'm trying to make sure that when your 4 year old gets Pertussis and plays outside, she doesn't give it to the child whose immune system was beaten down by cancer or to the newborn who still hasn't had his shots, potentially killing them both. But hey, going unimmunized is "more natural". Sure, so are viruses and bacteria, but we're trying to avoid them.

 

 

You know, I really respect folks who make an informed decision that vaccines are right for their family. I even respect doctors who truly believe it is the right thing to recommend to their patients. But, it is really dismissive and presumptuous of you to assume that parents who decide not to vaccinate their children do it from an uninformed, selfish, "never head of evidence based medicine," or natural at all costs position. Most of the parents who do this are highly informed or have had personal experiences with vaccine injuries. REAL vaccine injuries, you know, the ones that are provided for in the vaccine inserts and tracked by the VICP. Not to mention the vaccine injuries that haven't been discovered, proven, or adequately documented YET. New issues are discovered all.the.time. in medicine. How many doctors in years past recommended infant/children's cough medicines? The first Rotavirus vaccine? The DTP? Thalidomide and Bendectin?

 

Or how about let's go more recent, Orajel? One of those "internet wackos" who "think they know better than the doctors" posted this warning about Orajel: http://www.hippiedippiebebe.com/health/orajel-benzocaine-safe-babies/ It wasn't until TWO YEARS LATER, this past April, that the FDA put out a warning about the exact same issues with Orajel: http://www.fda.gov/Drugs/DrugSafety/ucm250024.htm

 

So you'll have to forgive us uniformed and annoying moms who don't trust that everything a doctor might recommend to us is SAFE for our children just because you say so. And if you don't want your future patients to put you into the same category as many of the doctors we are discussing in this thread, perhaps you want to consider LISTENING to and having compassion for the real concerns of your patients rather than just wanting to scream.

 

Most recently when asked about food allergy testing, the doctor said "I don't believe in that, what are you going to do anyway, stop eating the food forever?"

 

 

:blink:

[dancer67]

What? Why would you be too young for a colonscopy? I had one at thirty.

 

I am sorry you had that experience. :( I had IC and I was pretty much at the same place you were when you were diagnosed. Pain takes a terrible toll on your emotional well being.

 

 

Tell me about it. I recently had a colonoscopy(2 weeks ago). He should have just done it then. I was so disgusted with that office I have since changed GI Dr's.

 

Being in pain is not fun at all. Especially every single day. And in your stomach you dont feel like eating or doing anything. I pretty much stayed in bed, slept and wish I wouldn't wake up. It was that bad.

 

I lost three months of my life over that. And really thought I was dying of some horrible disease.

 

So now when I see a Dr., I freak out, and automatically think I am going to be DX with a death sentence.

 

Most people who have headaches can say it is just a headache. Myself, I would be thinking brain tumor and have my funeral planned out.

 

Terrible way to live.

 

And the thing is, when you have pain somewhere, I don't even know where to go. Let's say I am having jont pain. Where do you start? PCP who may send you for bloodwork, more waiting. Nothing. Maybe an orthopedist, more waiting for an appt(sometimes up to three months), then see them and nothing. Then off to a rheumatologist, wait again for the appt. Where does it end?

 

With ALL the freaking medical technology we have today, the one thing they have NOT fixed is getting a DX quickly.

 

In the old days, before specialists, your hometown Dr. would admit you to the hospital, run all the tests there, and fix the problem right away.

 

My grandmother had her gallbladder DX this way. Hometown Dr. said he was going to admit her for tests, and 2 days later her gallbladder was out. She went home and healed and that was that.

 

Can you imagine how long that would take today? Waiting for appts, tests, test results, more specialists.

 

This subject is touchy for me. Makes me so darn angry.

[Murmer]

I agree...over 6 weeks if GI to go out of town and find out from someone else it was a milk allergy...ditto with her ADHD where the dr just said to wait another year. Grrr...basically dr are just practicing medicine and they cannot be expected to know everything...I just wish they would refer more to specialist that do...I had to beg for the allergist (who by the way also didn't believe dd had a milk allergy until the RAST came back super allergic)

[stripe]

Um, that is a student you are talking about. He's there to learn that stuff and shouldn't necessarily already know it.

 

Um, I never said he was awful or generally ignorant, but it was obvious to both of us that I knew more and he had nothing with him that he wanted to consult to find out. I understand the point of a resident being there to learn. But one should not on the one hand say all patients are ignorant and doctors are gods, and on the other hand send ill-prepared residents to deal with patients alone. I was very nice to the young man and felt I'd done my good deed by helping train him to work with babies and their mothers. And I do think It would be prudent for someone to learn a bit about regular vaccines before talking to a patient's mother about them! I am not his professor.

 

The other doctors and nurses I mentioned in this thread were all fully trained and should have known better, so, um, yes, I do fault the doctor who dismissed my relative's cancerous facial growth for being ignorant.

[Slartibartfast]

 

Most recently when asked about food allergy testing, the doctor said "I don't believe in that, what are you going to do anyway, stop eating the food forever?"

 

 

Oh right....because eating food you are allergic to gets such great results? Did you switch Drs after that?

[weddell]

Most of the drs I have had have ranged from adequate to great. I love our allergist.

 

I did have one doctor in high school that was just horrible. When I was 16 I had a kidney stone (they run in my family). It was diagnosed in the hospital and I was referred to a urologist. My dr, a family practice dr, knew this. I had a followup appointment with her about it and it was in my chart.

 

2 year later I came to her (the family practice dr) with side pain. It wasn't as bad the kidney stone I had had before so I didn't make the connection. It was interfering with my job and summer school and I was in pain. During the appointment I was upset because I was getting behind with school work and missing days at work and I started crying. She diagnosed my side pain as depression and gave me a referral to a psychiatrist (I never went, I wasn't depressed). It was another freaking kidney stone! Who misdiagnoses a kidney stone as depression, especially when there is a history of kidney stones in the patient's chart!

[DusksAngel]

Most of the drs I have had have ranged from adequate to great. I love our allergist.

 

I did have one doctor in high school that was just horrible. When I was 16 I had a kidney stone (they run in my family). It was diagnosed in the hospital and I was referred to a urologist. My dr, a family practice dr, knew this. I had a followup appointment with her about it and it was in my chart.

 

2 year later I came to her (the family practice dr) with side pain. It wasn't as bad the kidney stone I had had before so I didn't make the connection. It was interfering with my job and summer school and I was in pain. During the appointment I was upset because I was getting behind with school work and missing days at work and I started crying. She diagnosed my side pain as depression and gave me a referral to a psychiatrist (I never went, I wasn't depressed). It was another freaking kidney stone! Who misdiagnoses a kidney stone as depression, especially when there is a history of kidney stones in the patient's chart!

 

Probably the same doctor who kept prescribing penicillian to someone who was allergic to it.

[rwjx2khsmj]

I'm sincerely sorry so many have had bad interactions with doctors. A few observations from someone in the field...

 

*Medicine is an art and a science. I think a lot of times both doctors and patients forget that. Yes, ideally I'd always make a diagnosis perfectly the first time. Ideally, I'd be smart enough to remember every possible constellation of symptoms and diseases. But a lot of times people don't follow the textbook. Their symptoms are different from the typical, they don't tell us their actual concerns, we ask the wrong questions, etc. Experience comes into play here, sometimes we have to go more on gut feelings rather than what the best decision would be scientifically.

 

An example would be a baby I took care of in the hospital, who was about 15 months old. He had a fever for about 9 days but came in at about day 7 or 8 of the fever. We admitted him and began the standard "fever of unknown origin" work-up. We did blood work and urine, etc. He had no vomiting, no other symptoms, was eating normally and didn't seem to be in a lot of pain. He was a little fussy like a lot of kids with fever are but nothing excessive. The first morning that I saw him I thought he seemed a little uncomfortable when I examined his belly. At this point it could have been a lot of things, in most of these cases we don't figure it out but the fever goes away and we assume viral cause. I had a gut feeling that this was something more and felt like his belly exam was off. I ordered a CT scan. The residents and students thought I was nuts, I could tell but even though it wasn't the next thing to do on the work-up algorithm I felt like it was likely to give us an answer. Ended up he had appendicitis with an appendix "the size of a hot dog" that the radiologist and surgeon both said was the biggest they had ever seen. He SHOULD have been in a lot of pain and refusing to eat or even vomiting.

 

I think medicine is becoming more and more impersonal and dictated by algorithms and checklists and protocols. We have asthma pathways and fever in a neonate protocols and dehydration protocols at the hospital I work at. These are good in that they help us not to forget things and ensure that every patient is given "the standard of care" despite their doctor's failings. But they can be bad too in that sometimes when someone is on a pathway or protocol doctors forget to listen to their patient's individual concerns. Many times I've ordered that a patient not be on the asthma protocol because I know them and know they respond differently than most to the meds.

 

*Medicine is a science and science is imperfect. In science, you are supposed to make mistakes. Observing that something doesn't work is ok. Sure, no one wants to be an experiment with their health (and no one should be). But I hear all the time "the doctors used to say this and now they say something different...therefore, they clearly are stupid and can't be trusted." A great example of this is the recent feeding recommendations for infants. We used to recommend waiting to feed the most allergenic foods until after 1-3 years in order to prevent food allergies. Years of observation have shown that it did not prevent food allergies. Allergy and Immunology is probably the hottest area of medicine right now and still very much evolving in our understanding. So now we recommend feeding those foods whenever you want. Were we wrong before? Yes. Could we be wrong now? Sure. But we have to make suggestions and recommendations based on the best scientific knowledge at that time. As scientists of a sort, we are ok with the idea that the knowledge can change.

 

*Medicine strives to find a balance between treating the individual and the group. I'm not even going to wade into vaccination which is the prime example of that. But as a doctor I have to try to treat the individual in my office but often with recommendations that are made based on what is best for a group. Just to make up statistics in a field not my own: If 98% of colon cancer is found on stool guiac and not colonoscopy than insurers and people who make public health recs might suggest just doing stool guiacs for screening. That works for the population but not for the 2% of people who aren't found on stool guiac. There is no way for me to know if the patient in my office is in the 2% or 98%. That's a made up example but there are decisions we make all day that are similar. That's where that art of medicine comes in, but it's not always simple.

 

*The med student who posted earlier does have a lot to learn, hopefully. But one point made was that for every person who comes in armed with the latest research and information that is reasonable we have 10 people who come in with demands or requests that are not reasonable. For every patient who has thoroughly researched vaccines I have 10 patients who are "worried because I saw it on Oprah". I can respect the first, the second I find frustrating. It's not a good excuse but sometimes after a morning of dealing with people demanding antibiotics for their child's cold because they are going on vacation and want it "just in case" I am not always as patient with someone who comes in with reasonable demands.

 

*Medicine is getting more and more impersonal. I have many patients who go to Urgent Care for the convenience but then are upset with me because I don't know the history of all the infections their child has had. Choice is good and I like people being able to see a specialist without seeing me first, I hate being a "gatekeeper". But it also means that people doctor-shop more and more. Sometimes for valid reasons, sometimes just because they are impatient with small things or not willing to take the time to build a relationship. This goes both ways, many things about the modern medical system make it tough for patients to develop a relationship with a doctor even if they want to.

 

If you read all that, I'll just add that I don't mean to excuse those in my profession that either never should have been there or need to get out. It makes me angry to read about doctors who give the whole field a bad name. At the same time, I wanted to say that so often on this forum I find an antagonism to medicine that astonishes and saddens me. It's always interesting to me to read these threads and educational. I find that IRL also the homeschoolers I meet are more anti-medicine than people in other circles. I wonder if it stems from thinking that we can do it all ourselves and being by nature somewhat anti-expert.

 

Regardless of the bad apples in the barrel, it's still a profession that I love and am proud to be part of. It's messy and imperfect, but then so is a lot of life.

 

This is beautifully written and speaks to what I'm looking for in a doctor. What I really want is someone who is willing to partner with me treating me like a intelligent person who wants to do what is best for her family and personal health and is not willing to be treated as a time slot, a list of symptoms or a statistic on a chart.

 

Thank you for the respectful and thoughtful response. I wish you were a doctor I could see IRL!

[celticmom]

I sincerely hope your attitude changes as you interact more with patients. Really.

:iagree::iagree::iagree:One of the things that I dislike about going to the doctor is the overwhelming suspician that there must be some class in their medical training that teaches them how to be condescending.

[Elinor Everywhere]

Oh, and that's after paying $100 to see the general physician to make a referral to a specialist.

 

Not everyone's health plan requires a referral. I see a specialist now if one of us has a problem (not one that is fixed by an antibiotic or other quick-fix pill), and I know we're lucky that we can call a specialist directly if he/she accepts our insurance.

 

Too many times my family doctor has misdiagnosed me, or, I see him on something I think is fairly simple (toenail fungus, for example), and he tells me to see a specialist. I can do that without spending the $45 co-pay and wasting time going to him in the first place. Now, the only time I use the family doctor is if I already know the problem, and just need meds. He loves to write prescriptions...:tongue_smilie:

[Elinor Everywhere]

I have come to the conclusion that my Primary Care Physician is just awesome, and I will be very very sad when he retires, LOL. My Dr. has all his paperwork on a laptop that he brings to the appt. He adds in everything that my holistic nutritionist tells me to do/take. He will order any labs I request, but will not order MRI's, X-rays, etc. unless absolutely needed b/c of radiation. All of my lab results are sent to my account on the hospitals online chart system and stored there indefinitely. He will listen to whatever conclusions I have come to after Googling my symptoms. Then, he checks me out and tells me if I was right or wrong.

 

Please have your doctor move to Phoenix asap. I want him. :D

[Krista in LA]

ITA. I gather info before I go in for anything.

 

What really gets me is the amount of bad breastfeeding advice I have received from doctors and nurses. I had already read a lot of breastfeeding books before having my first bf baby and so I knew to disregard the bad advice. But I've wondered how many bfing relationships were sabotaged by doctors and nurses telling women who didn't know better things that are untrue.

 

:iagree:

 

Or the ped who told me that green poop was normal and to give a bottle of water to my 2mo between feedings because he was nursing so often. It really was a foremilk/hindmilk imbalance and he just needed to nurse on one side at a time for a while.

[linguistmama]

I don't expect a doctor to know everything about every drug and illness. But when we go in with something that is fairly common I expect them to be helpful. Both of my kids have had food allergies. Regular doctors dismissed it. When we saw an alternative doctor it was one of the first things he tested for. Yeah, 15 different food allergies, that might be affecting them a little bit! It is not unreasonable for me to expect a ped to have some basic knowledge about allergies.

[jenangelcat]

Oh right....because eating food you are allergic to gets such great results? Did you switch Drs after that?

 

We don't have a family doctor. The waiting lists are several years long. He's one of a handful of doctors that work at the ER. It's them or nobody.

[Mom-ninja.]

I know exactly how you feel. I've been sick for two years, and my Dr. first told me to learn how to control my stress and emotions because my stress was causing me to get sick. Then she told me, based on test results I had done, that I had an overgrowth of bad bacteria in my gut and she told me to take probiotics for the next 18 weeks to see if I got better.

 

Well, I finally went online and started looking up all my symptoms. Based on every.single.symptom I have everything pointed to celiac disease. I made an appointment with a GI, and he had me tested for celiac. Yep, sure enough,I have it. :glare:

 

I am not happy at all that my primary missed it. I mean, I had just about every darn symptom. It took me all of five minutes to narrow it down to celiac.

[LittleIzumi]

Yep. I tend to do the research myself, go in, tell the doc what is going on, and then get their opinion on what should be done for what I've already diagnosed, lol, and then decide if their advice is sound. It's sad that this has become necessary, but the experiences I had with earlier docs... yeah, dd would have wound up right back in the ER if I listened with my ears instead of my brain.

[5KidzRUs]

Reposting ...

[lea1]

I use Quest. They have a patient interface on their website (and a smartphone app) so I get results when my doc does. (and I can email them to a new doc sitting in his/her office if I choose) Those records are yours. You do not need permission (or a middle man) to have copies.

 

:iagree: I have always simply asked for a copy for my records. We keep all copies of any type of lab results or tests of any kind in our files.

[Nestof3]

My mom made an appt -- the doctor agreed to discuss the need for a Vitamin B12 test.

[lea1]

Any profession has people who are good at what they do and those who are not. How many of us have taken our car to a bad mechanic or has known someone who did? Oh my goodness, the amount of money my brother, who is on disability and could not afford this, has recently wasted on a horrible mechanic!!

 

With doctors, there are those who are simply not very good at what they do, who do not do any continued research or stay up to speed on the latest studies and new information or new drugs. We all hope not to get one of these.

 

Most doctors are required to see one patient every 15 minutes, or that is how they set up their own practice, if they are trying to make money (which is a challenge in doctoring these days - although I do know of one who is clearly just in it for the money). Really, how much can you do in 15 minutes, especially if communication is not perfect, which it usually is not. Believe it or not, the 15 minutes per patient even includes all of the paper work that must be completed, mostly online these days. It also includes any time that the doctor would need to review your chart. The 15 minute slots for patients are set up back to back. Do you think most doctors will have the time (or take the time later) to accurately update the patients records?

 

If they are required to see one patient every 15 minutes and the patient has many issues, they are frequently required to only handle/treat the main issue for which the patient came in and the patient is to make another appointment for any other issues. If you had a problem that was causing many symptoms, it might be hard to pull them all together and create an accurate diagnosis with only 15 minutes and while only focusing on the main issue.

 

These are a few of the reasons I think there are so many seemingly 'bad' doctors who seem to miss things.

 

My husband is a family doctor (MD). He is a very thorough doctor and has had real issues with this 15 minute rule, to the extent that he will not work for these practices, is currently at an urgent care and planning to start his own practice. He also spends countless hours reading medical journals, studying information online, developing ways to be more efficient and exact when gathering and giving information, etc.

 

It can be a frustrating job, as there are lots of people who do not provide all of the information up front, they waste your time and then happen to remember something when you are already 15 minutes into the appointment. He has had countless people lie about meds they are taking or have taken. Someone will come in for something small and they will have 9 or 10 other very serious health concerns. He has provided referrals to specialists only to have them not follow through. And it goes on and on. It's part of the job but they do deal with a lot of cr*p.

 

The thing about doctoring is that, if they are going to be great doctors, it really must their whole life. It is just not a job that they can leave at the office when they come home. To be good at it, they must stay current with the various medical journals and other available info online. They must be good listeners and they also must not have a huge ego. Those with big egos already think they know what is wrong with you before you even finish telling them about your symptoms or your experience and they certainly don't want to hear what you found on the internet, which they (those with big egos) believe is mostly wrong...and they are always right.

 

There are so many important traits that must align to make a great doctor, one could see why it would be hit or miss when trying to find one. Fortunately for me, I married a great doctor:lol: (plus my sister is a great nurse;)).

[WishboneDawn]

We don't have a family doctor. The waiting lists are several years long. He's one of a handful of doctors that work at the ER. It's them or nobody.

 

Oh wow. I know there are doctors up our way who are accepting patients but that's in Elmsdale by the airport. Probably quite a drive for you guys.

[WishboneDawn]

Yep. I tend to do the research myself, go in, tell the doc what is going on, and then get their opinion on what should be done for what I've already diagnosed, lol, and then decide if their advice is sound. It's sad that this has become necessary, but the experiences I had with earlier docs... yeah, dd would have wound up right back in the ER if I listened with my ears instead of my brain.

 

I don't think it's sad at all. I think there was too much weight on the doctors' shoulders for a very long time. They can't know everything and we should be partners in our own care.

 

All doctors will have gaps in their knowledge. All doctors will make mistakes and some will be biggies. I think a lot of the problems in this thread are more with our expectations of doctors rather then the doctors themselves.

 

Personally, I have a fantastic doctor. I know very well she doesn't know everything and will likely screw up at some point (and gives needles like she's throwing darts :D) but the most important things are that we have a great relationship, she listens to what I know and is an advocate for her patients in the health system. We'll get through the symptoms and treatments together but it's the other qualities that make her invaluable.

[mommymilkies]

I feel your pain. It took 4 doctors to finally figure out my 3rd child had profound hypothyroidism. Her tsh was 617 and she was below the 0th% in height/weight. I just kept being told to give her iron pills and make her eat more. :glare:

 

Oh, and yesterday my 3 yo went to the doc for a suspected bladder infection (stomach pain, urinating pain) and we were given the dosage of laxative she should have. She poops 3-14 times a day. She is NOT constipated. :lol:

[PIE!]

I'm sincerely sorry so many have had bad interactions with doctors. A few observations from someone in the field...

 

*Medicine is an art and a science. I think a lot of times both doctors and patients forget that. Yes, ideally I'd always make a diagnosis perfectly the first time. Ideally, I'd be smart enough to remember every possible constellation of symptoms and diseases. But a lot of times people don't follow the textbook. Their symptoms are different from the typical, they don't tell us their actual concerns, we ask the wrong questions, etc. Experience comes into play here, sometimes we have to go more on gut feelings rather than what the best decision would be scientifically.

 

An example would be a baby I took care of in the hospital, who was about 15 months old. He had a fever for about 9 days but came in at about day 7 or 8 of the fever. We admitted him and began the standard "fever of unknown origin" work-up. We did blood work and urine, etc. He had no vomiting, no other symptoms, was eating normally and didn't seem to be in a lot of pain. He was a little fussy like a lot of kids with fever are but nothing excessive. The first morning that I saw him I thought he seemed a little uncomfortable when I examined his belly. At this point it could have been a lot of things, in most of these cases we don't figure it out but the fever goes away and we assume viral cause. I had a gut feeling that this was something more and felt like his belly exam was off. I ordered a CT scan. The residents and students thought I was nuts, I could tell but even though it wasn't the next thing to do on the work-up algorithm I felt like it was likely to give us an answer. Ended up he had appendicitis with an appendix "the size of a hot dog" that the radiologist and surgeon both said was the biggest they had ever seen. He SHOULD have been in a lot of pain and refusing to eat or even vomiting.

 

I think medicine is becoming more and more impersonal and dictated by algorithms and checklists and protocols. We have asthma pathways and fever in a neonate protocols and dehydration protocols at the hospital I work at. These are good in that they help us not to forget things and ensure that every patient is given "the standard of care" despite their doctor's failings. But they can be bad too in that sometimes when someone is on a pathway or protocol doctors forget to listen to their patient's individual concerns. Many times I've ordered that a patient not be on the asthma protocol because I know them and know they respond differently than most to the meds.

 

*Medicine is a science and science is imperfect. In science, you are supposed to make mistakes. Observing that something doesn't work is ok. Sure, no one wants to be an experiment with their health (and no one should be). But I hear all the time "the doctors used to say this and now they say something different...therefore, they clearly are stupid and can't be trusted." A great example of this is the recent feeding recommendations for infants. We used to recommend waiting to feed the most allergenic foods until after 1-3 years in order to prevent food allergies. Years of observation have shown that it did not prevent food allergies. Allergy and Immunology is probably the hottest area of medicine right now and still very much evolving in our understanding. So now we recommend feeding those foods whenever you want. Were we wrong before? Yes. Could we be wrong now? Sure. But we have to make suggestions and recommendations based on the best scientific knowledge at that time. As scientists of a sort, we are ok with the idea that the knowledge can change.

 

*Medicine strives to find a balance between treating the individual and the group. I'm not even going to wade into vaccination which is the prime example of that. But as a doctor I have to try to treat the individual in my office but often with recommendations that are made based on what is best for a group. Just to make up statistics in a field not my own: If 98% of colon cancer is found on stool guiac and not colonoscopy than insurers and people who make public health recs might suggest just doing stool guiacs for screening. That works for the population but not for the 2% of people who aren't found on stool guiac. There is no way for me to know if the patient in my office is in the 2% or 98%. That's a made up example but there are decisions we make all day that are similar. That's where that art of medicine comes in, but it's not always simple.

 

*The med student who posted earlier does have a lot to learn, hopefully. But one point made was that for every person who comes in armed with the latest research and information that is reasonable we have 10 people who come in with demands or requests that are not reasonable. For every patient who has thoroughly researched vaccines I have 10 patients who are "worried because I saw it on Oprah". I can respect the first, the second I find frustrating. It's not a good excuse but sometimes after a morning of dealing with people demanding antibiotics for their child's cold because they are going on vacation and want it "just in case" I am not always as patient with someone who comes in with reasonable demands.

 

*Medicine is getting more and more impersonal. I have many patients who go to Urgent Care for the convenience but then are upset with me because I don't know the history of all the infections their child has had. Choice is good and I like people being able to see a specialist without seeing me first, I hate being a "gatekeeper". But it also means that people doctor-shop more and more. Sometimes for valid reasons, sometimes just because they are impatient with small things or not willing to take the time to build a relationship. This goes both ways, many things about the modern medical system make it tough for patients to develop a relationship with a doctor even if they want to.

 

If you read all that, I'll just add that I don't mean to excuse those in my profession that either never should have been there or need to get out. It makes me angry to read about doctors who give the whole field a bad name. At the same time, I wanted to say that so often on this forum I find an antagonism to medicine that astonishes and saddens me. It's always interesting to me to read these threads and educational. I find that IRL also the homeschoolers I meet are more anti-medicine than people in other circles. I wonder if it stems from thinking that we can do it all ourselves and being by nature somewhat anti-expert.

 

Regardless of the bad apples in the barrel, it's still a profession that I love and am proud to be part of. It's messy and imperfect, but then so is a lot of life.

 

Wonderfully said!

[PIE!]

Any profession has people who are good at what they do and those who are not. How many of us have taken our car to a bad mechanic or has known someone who did? Oh my goodness, the amount of money my brother, who is on disability and could not afford this, has recently wasted on a horrible mechanic!!

 

With doctors, there are those who are simply not very good at what they do, who do not do any continued research or stay up to speed on the latest studies and new information or new drugs. We all hope not to get one of these.

 

Most doctors are required to see one patient every 15 minutes, or that is how they set up their own practice, if they are trying to make money (which is a challenge in doctoring these days - although I do know of one who is clearly just in it for the money). Really, how much can you do in 15 minutes, especially if communication is not perfect, which it usually is not. Believe it or not, the 15 minutes per patient even includes all of the paper work that must be completed, mostly online these days. It also includes any time that the doctor would need to review your chart. The 15 minute slots for patients are set up back to back. Do you think most doctors will have the time (or take the time later) to accurately update the patients records?

 

If they are required to see one patient every 15 minutes and the patient has many issues, they are frequently required to only handle/treat the main issue for which the patient came in and the patient is to make another appointment for any other issues. If you had a problem that was causing many symptoms, it might be hard to pull them all together and create an accurate diagnosis with only 15 minutes and while only focusing on the main issue.

 

These are a few of the reasons I think there are so many seemingly 'bad' doctors who seem to miss things.

 

My husband is a family doctor (MD). He is a very thorough doctor and has had real issues with this 15 minute rule, to the extent that he will not work for these practices, is currently at an urgent care and planning to start his own practice. He also spends countless hours reading medical journals, studying information online, developing ways to be more efficient and exact when gathering and giving information, etc.

 

It can be a frustrating job, as there are lots of people who do not provide all of the information up front, they waste your time and then happen to remember something when you are already 15 minutes into the appointment. He has had countless people lie about meds they are taking or have taken. Someone will come in for something small and they will have 9 or 10 other very serious health concerns. He has provided referrals to specialists only to have them not follow through. And it goes on and on. It's part of the job but they do deal with a lot of cr*p.

 

The thing about doctoring is that, if they are going to be great doctors, it really must their whole life. It is just not a job that they can leave at the office when they come home. To be good at it, they must stay current with the various medical journals and other available info online. They must be good listeners and they also must not have a huge ego. Those with big egos already think they know what is wrong with you before you even finish telling them about your symptoms or your experience and they certainly don't want to hear what you found on the internet, which they (those with big egos) believe is mostly wrong...and they are always right.

 

There are so many important traits that must align to make a great doctor, one could see why it would be hit or miss when trying to find one. Fortunately for me, I married a great doctor:lol: (plus my sister is a great nurse;)).

 

:iagree: