OT: sort of - do you trust your doctor?

It's true that Dr Google is worse than most real drs.... but most real gps or the consultants I have met are not well trained in the conditions me and my family deal with - if they have even heard of them before - and it's not like they are rare. My partners mum could get an honorary degree for her knowledge of ME. My bf would be undiagnosed and I'd be under treating my sleep apnoea if it wasn't for the info and support online..

I think in general, my research gives me a base level of knowledge so I can understand the complex stuff the Dr may go on about. Or at least know what questions to ask - and have the confidence to be an advocate.

I suppose the difference is someone who understands how to research, how to interpret headlines and find the science, and uses that to compliment their health care, and people who just Google randomly, and take as gospel anything they find,and can't be persuaded they aren't dying of X Y and Z at the same time. I see that a lot at work 'well my friends sisters nephew saw it on the daily mail website, so I stopped taking this *life protecting completely safe* medication without telling my dr'. Now that drives me crazy. Like we can all make decisions, but you do need to keep the right people informed of them!

jnk... wrote:which seems to me to happen about 83.4 percent of the time,

by an amazing coincidence, 83.4% of statistics are made up on the spot!

lilly747 wrote:Why pick on just the journalist, many doing research are not doing any better at getting the truth out.....might ask, Where's the funding coming from????

"Doctoring Data: How to sort out medical advice from medical nonsense.. " by Malcolm Kendrick

True that! You can't get good press talking sense.

I guess I'm stuck in the past, back when some journalists at least attempted not to be just another part of the entertainment industry.

Maybe it's simply over my head. I mean . . .

Part of the problem of the premise to me is that part of the job of a doctor is to help a patient judge the risks of treatment decisions the patient makes. Some patients will take the risk of a riskier procedure if the possible positive outcome is worth it to them. The doc may even warn against the procedure the patient chooses. In many cases, the person is consulting the doctor because there are already life-threatening conditions that need to be addressed, making the risk of the surgery worth it, including the risk of human error during the performing of it. How can that possibly be compared to other CAUSES of death? And as more lifesaving procedures become available, more people are going to be facing end of life in a hospital setting rather than in bed at home while trying nothing medical to fix anything. By that measure, medicine itself will be "killing" more and more people as more and more choices become available.

My understanding is that as a general rule, when you know the statistical outcomes of a procedure, the human errors that can occur in conjunction with it are already factored into the numbers. The old adage about 'the operation was a success but the patient died' is more than an adage; it is part of what medicine is about today. If the procedure often prolongs life beyond the point that the disease state would have ended the life, it is unfair, in my opinion, to say that the operation was the CAUSE of death. Maybe it was, technically, but maybe it was the right choice anyway.

When heroic measures are taken to save a life, the heroic measures may have a high possibility of ending the life, but may still be the best option available to medicine. If you start attempting to hold all medical people so accountable that they have to weigh whether they might be blamed for everything they do, the logical choice for them becomes for them to do nothing, just so they won't be blamed later. Every serious surgical procedure has the risk of death or else it wouldn't be considered serious. So even if you had all the data in hand, you could make any statistic up that you wanted to out of it, because of how subjective the judgment would be on whether another approach would have been better, whether the approach chosen could have been more skillfully handled, or whether something else can be blamed.

Either way, it all helps keep the lawyers and insurance people in business to keep the economy humming along. And all the administrators know you can't keep any records of anything that could be used against the hospital or the doctor by one of those entities. So I doubt decent data will ever be available--there is too much at risk so that people have to keep cooking their numbers anyway to cover their own. Which is the issue the "study" people may be trying to get at. It just strikes me as an odd way to go about it. If the problem is that people are cooking their numbers, you don't fix it by choosing to cook your own.

Trust, but verify.

And remember: They only PRACTICE medicine.

LOL 10 years ago I was sitting in my accountant's waiting room and reading a magazine put out by a local hospital, a very prestigious local hospital. They had an article on check lists. They were very proud to have added this new innovation, over the complaints of the doctors, to their surgical rules. They burbled on about how this decreased the error rate amazingly in OR! A check list! With the name of the patient and the surgery to be done, the name of the doctor and the nurses. This was read out loud and checked off. This was the brand new surgical innovation, which the doctors fought! A check list. And it made a difference!

Mum's The Word wrote:Trust, but verify.

And remember: They only PRACTICE medicine.

Absolutely!

Also agree with every one of jnk's posts. He said all there is to say.

I trust my doctor completely, still she does not have the final word. It's my life... I make the final decision!

Lucyhere wrote: . . .said all there is to say. . . .

Problem is, I generally say much MORE than there actually is to say!
Not sure why that one fired me up so much today. I almost spilled my fourth cup of coffee while typing all that.

In general I do not trust anyone, especially anyone controlling my health. But, I learn respect for some of my doctors. If they show my right off that they don't want that respect, then will not stay with them at all.

I haven't read the study but will try to get a copy for my own information.

I trust my own doctors because, over the years, I've fired all those I couldn't trust.

My model of medicine for me and my family is to consider all doctors as either sub-contractors or consultants.
The patient is the general contractor and is, eventually, responsible for the health outcome.
Your pick the best consultant / sub-contractor to solve your problem and go with their expertise while always doing due diligence on their performance.

The one exception to that rule is traumatic injury in which the patient is unable to take part in the decision making.

JDS74 wrote: The one exception to that rule is traumatic injury in which the patient is unable to take part in the decision making.

About that: a month ago I felt some strong arrhythmia and went to the urgent care of my polyclinic so that at the very least my cardiologist can have the data (EKG, etc.) of the event as they share a common computer-records system. The urgent care doctor panics and tells me I'm in atrial fibrillation and sends me across the street to the ER in the hospital (had to call a friend, they wouldn't let me cross the street on my own, or have a nurse accompany me!) Anyway, in the ER the doctor confirms the diagnosis (he had all the info sent over by the urgent-care doctor) and tells me they need to get me out of it (the arrhythmia) ASAP. But - he doesn't tell me what he'll do, and possibly an alternative, he just lists two options (medication or defibrillation) and asks me straight out to choose one! I have no way to get information and there is no time, anyway. Luckily, I had some prior research done and I do have a good general medical background, so I chose defibrillation (I wasn't going to get pumped with nasty drugs and spend days in the hospital), and it all, luckily, went well (one needs the occasional reboot). My point, other than what has been discussed here (have knowledge, make your own informed decisions) is: doctors nowadays will actually encourage patients to make their own decisions; they know how things are going. Maybe they sensed that I was capable of making such decision, but it is a good sign, either way.
Know your body and gain knowledge!
McSleepy

The above was said by a number of people here in similar ways... but as someone who worked for doctors for over 30 yrs, I think it's important to keep in mind that your doctor went to school for a long time and then interned and practiced for even longer. You might reference Google, etc. for answers, but what you need to keep in mind is that your doctor, when making a recommendation or judgment about something, is also calling on a whole lot more knowledge both about whatever is being discussed - including your particular history including lots of lab work, etc. - than a few internet hits that you, not scientists, interpret in your own ways. It's great to be able to learn by doing 'research' on the net, but remember, it ain't med school.

This is MY body and I am in charge. In a trauma where I need immediate and specialized help, the doctor is king. If I have a heart attack or a stroke and need immediate and specialized help, then the doctor's expertise trumps. But no doctor knows my body as well as I do and no doctor cares as much about my body as I do. In non-urgent situations I expect my doctor to discuss my history with me (I know way more about my complex medical history than ANY doctor has time for), my lab work (I have it for review online). I have a science degree in a health care profession. I took the same anatomy, physiology, chemistry and biology as the pre-meds. I am fully licensed in a health care field and worked in hospitals for decades. I can read and understand any peer-reviewed study my doctor can and I have a lot more time to read the ones that pertain to me and my particular situation than my doctor does.

I have a genetic disorder that my doctor has probably only seen one or two cases of in her entire career, and one of them is me. I know way more about it than she does, particularly how this syndrome manifests in me. Part of the genetic syndrome I have is a congenital heart condition. When a cardiologist prescribed statins for me because "we just don't know what the risks are for people with congenital heart lesions" (in other words there was NO data that they would be helpful for someone in my situation, but since the standard of care was statins he was going to prescribe them) I was able to point out to him a peer-reviewed study showing the individuals with my particular heart lesion got WORSE on statins--the study had to be stopped because of adverse outcomes. But under your theory I should have trusted his "superior knowledge" and taken statins because he went to medical school and I did not??? Or perhaps I should not have paid attention to the study because I found it on the internet (PubMed)?

My primary care doctor and I have an agreement that if my self advocacy is getting "out there" she will tell me. She has never had to, so far. I'm not saying I don't listen to her advice, but I make an educated judgment of my own.

I have my second child because I read, study and advocate for myself. I read up on (what were then) new treatments for PCOS, showed a peer reviewed medical journal article to my primary care physician and asked for an appropriate referral. He had never heard (this was 16 years ago) that PCOS was actually a metabolic disorder and that a diabetes drug (metformin) could help. When I brought this to him, he said "Well, I never heard of this . This is really cutting edge, you know?". By following that cutting edge I was pregnant without fertility drugs in 6 months after a lifetime of infertility. If I sat around waiting for my doctor who would not be exposed to mainstream articles about this approach to treating PCOS for another decade, I'd have only the one child who was conceived by heartbreaking and expensive years of fertility treatments we could not go through again.

I did the opposite of a doctor's advice (he prescribed an 800 cal/day low fat starvation diet) to successfully lose and keep off 75 lbs. The medications a doctor prescribed for chronic pain caused GERD, the treatment for GERD contributed to worsening of my asthma and gut issues. I got myself off all of those medications, I'm pain free and healthier now than ever.

I could go on with many more examples. I consider myself a careful health care consumer, not a passive "patient". I seek doctors who are up to the challenge of working with an informed patient and who enjoy that. No, I didn't go to medical school, but that doesn't mean I'm unqualified to make well-educated decisions about my own health.

Yup, I do.

I'm lucky enough to have a cardiologist as my primary (heart is just perfect thankyou, and I do love getting good grades on the ecg).

He's a listener and he keeps up with the latest. (Doesn't care for fish oil as do I, but that's minor.)

Doc before this one was great as well. Only left his practice because I moved out of state.

Lucky? I believe so.

.

I just have to add that with the exception of CPAPTalk and some low carb groups, I can't stand most online support groups because it's full of people whining about how sick they are and how their doctors cannot find the right combination of medications to "fix" them. They follow their doctor's directions which may not work, and never think that perhaps they might be able to do something in their own best interest.

Often they don't know anything about the medications they are taking like side effects, contraindications, and what the expected benefit will be. They get sicker and sicker as they take more and more drugs and follow the treatments they are instructed on through the anointed ones who have been to medical school.

Medical science IS beginning to recognize things like saturated fats are not going to "clog your arteries", high carb is not necessarily good for diabetics, statins are not effective at preventing heart disease. But it can take another 10 or 20 years until this info filters down to the physicians on the front lines. I'm not waiting around for the people who went to medical school to get it. I am TAKING BACK MY HEALTH now!!!

And so far, with enormous success!

After firing a number of doctors, (A PCP who was getting senile, a female doctor who thought
severe dysmenorrhea was something I "had to live with", and an ophthalmologist who was "handsy"),
I can now guardedly say, "So far, so good".

The stories are endless so I'll keep mine to just one. Worked in the pathology dept of a hospital and was asked to stay late into the evening for an add-on brain biopsy to process a frozen section to look for cancer. Biopsy #1 Left Side - Normal brain tissue. Biopsy #2 Left Side - Normal brain tissue. Biopsy #3 Right side - Malignant brain tissue. Oops!

I respect the knowledge doctors have spent many years accumulating, yet acknowledge their humanity. Trust? That's a hard one.