Who here works in medicine?

jnk, thanks for that link. I viewed the teaching module on the site, and if that's the extent of what the doctors-to-be are taught, it isn't surprising that patients have such a hard time finding medical types who can be helpful about our situations. Wow.

So Well wrote: Jon can defend his own posts but I will say he sure as hell did not say what you just accused him of saying.

So Well wrote: I hope everyone questions what their doctor is telling them and what the doctor is not telling them and operates as a self-empowered patient. That is a far stretch from "ignoring all medical advice" as you so deceitfully rephrased it.

Thanks. I appreciate the help - especially from someone from Palo Alto! This is the "help each other" attitude that I'm afraid Calist will ruin in time if left to his own devices.

JayC wrote:WE are the ones living day to day/night to night with whatever things we are medically dealing with........WE know more detail than a textbook read offers.....we are not textbooks and textbook cases are likely not how real life mostly plays out. Medical professionals would do well to grasp all of this......... we would ALL be better off the more this were the case!!

Well said too! There are a good deal of people here who see the way medicine is headed and are taking control of their own lives. This is remarkable even in the 21st century! Sleep medicine is very much driven by profits and ignorance. Certainly many non-specialist in medicine know nothing of what our problems involve. The specialists are running people through sleep-mills cranking them out for insurance reimbursements and equipment costs. Many of the new people coming to this board have been totally ignored and uninformed by their physicians. This is really shocking.

jonquiljo wrote:

So Well wrote: Jon can defend his own posts but I will say he sure as hell did not say what you just accused him of saying.

So Well wrote: I hope everyone questions what their doctor is telling them and what the doctor is not telling them and operates as a self-empowered patient. That is a far stretch from "ignoring all medical advice" as you so deceitfully rephrased it.

Thanks. I appreciate the help - especially from someone from Palo Alto! This is the "help each other" attitude that I'm afraid Calist will ruin in time if left to his own devices.

JayC wrote:WE are the ones living day to day/night to night with whatever things we are medically dealing with........WE know more detail than a textbook read offers.....we are not textbooks and textbook cases are likely not how real life mostly plays out. Medical professionals would do well to grasp all of this......... we would ALL be better off the more this were the case!!

Well said too! There are a good deal of people here who see the way medicine is headed and are taking control of their own lives. This is remarkable even in the 21st century! Sleep medicine is very much driven by profits and ignorance. Certainly many non-specialist in medicine know nothing of what our problems involve. The specialists are running people through sleep-mills cranking them out for insurance reimbursements and equipment costs. Many of the new people coming to this board have been totally ignored and uninformed by their physicians. This is really shocking.

jonquiljo said - - -

Sleep medicine is very much driven by profits and ignorance.

The specialists are running people through sleep-mills cranking them out for insurance reimbursements and equipment costs

My reply - - -

ha ha ha - I like your style very honest and straight to the point.

Have a great day I know I will - Chopper.

jnk wrote:A shoulder shrug may have been his most honest response:

"The most recent survey of the four-year medical school curriculum reveals an average of less than two hours of formal education directed at sleep, even at Harvard Medical School. The average medical student graduates with little information on either the identification or the treatment of sleep disorders."

http://sleep.med.harvard.edu/what-we-do ... -education

Wow, I think I mentioned before that my son,an Internist, who attended med school at Mt.Sinai in NYC over 20yrs ago told me he had about a 2hr course in sleep medicine in his 3rd year during his pulmonary rotation. Our Primary who is of the same era attended NYU and told me the same thing. They both can and do very well in diagnosing OSA given a patient's symptoms and their own practice experience and they enjoy the results they see(lower BP, normal blood levels,EKGs,etc) in successful patients they referred for sleep studies, but they know very little about the treatment. When I went running to our Dr with our problems getting a data-capable machine from the DME and why I needed it, he looked confused and told me to just tell his nurse what I wanted on the RX and he would sign it. I'm saddened that nothing has changed.

I would rather an honest "I don't know" than some coddling "don't worry it is probablly nothing".

I do remember feeling that he cared........but the bottom line is I left that office with no direction. He did give me a piece (non-restorative sleep) and that appears to have been a guess conclusion since I had no sleep study done by him or any suggestion to.

Compassionate with patients, but medically it seems to me that he could have, and should have sent me in a direction when he sent me out the door. He sent me out his door still suffering, with no direction, and I suspect without doing or even mentioning tests that would address the area of sleep. Is it unreasonable or harsh for me to think that he dropped the ball regarding me?

If there is no test, say so. If he is thinking insurance problem or cost...say so, although that is not his first concern, I am. If CPAPs were being developed and recognized for home use slightly before the year in question, does that not say that testing in the area of sleep was happening at that time? If I didn't rise to the level to warrant testing (!!), he should say so. If a different specialty might know more about the area than he, then send me off in that direction, even informally. He did none of these things.

Nice person, but medically he dropped the ball in my case. And I lost 20 years more. This is not harsh, it is my reality.

J

jnk wrote:A shoulder shrug may have been his most honest response:

"The most recent survey of the four-year medical school curriculum reveals an average of less than two hours of formal education directed at sleep, even at Harvard Medical School. The average medical student graduates with little information on either the identification or the treatment of sleep disorders."

http://sleep.med.harvard.edu/what-we-do ... -education

DoriC wrote: . . . he looked confused and told me to just tell his nurse what I wanted on the RX and he would sign it. . . .

I respect a doc willing to show confusion to a patient. And I consider the "you dictate it and I'll sign it" approach in dealing with an OSA patient to be a sign of uncommon humility and helpfulness, which I especially respect in those who work in a business (the medicine business) in which too many like to play God. It is a sad reality that we as OSA patients MUST know more about this stuff than our primary docs. Fortunately, thanks to the generous people on this board, for example, that is not that hard to do.

Thank you for the Internet, Mr. Gore.

SleepingUgly wrote:My motto: Never put your fate solely in the hands of people who care less about it than you do.

A lot of wisdom in one sentence. And it sums up the experience of a lot of members here.

What an interesting turn this thread has taken.


One thing that hasn't been mentioned is the number of doctors, nurses and other health professionals who are burned out and don't like what they are doing. I've recently needed new doctors, and I'm amazed at the number who, when they discover I'm a retired doctor, make some kind of comment like, "Boy, you're lucky." I've heard this from young doctors who still have 20-25 years to go. Most don't see anything on the horizon that is likely to improve their working conditions, and many are pessimistic about their own futures or are looking for a way out.

Patients who do not become informed advocates for their own health care are risking their own health. That can be a significant task if one has several conditions. Many people don't have the necessary literacy skills.

Thank you for the Internet, Mr. Gore.

I know jnk is joking here, and Gore didn't invent the internet.

But he did invent the Al Gore ithm, didn't he?

But he did invent the Al Gore ithm, didn't he?

jnk wrote:

DoriC wrote: . . . he looked confused and told me to just tell his nurse what I wanted on the RX and he would sign it. . . .

I respect a doc willing to show confusion to a patient. And I consider the "you dictate it and I'll sign it" approach in dealing with an OSA patient to be a sign of uncommon humility and helpfulness, which I especially respect in those who work in a business (the medicine business) in which too many like to play God. It is a sad reality that we as OSA patients MUST know more about this stuff than our primary docs. Fortunately, thanks to the generous people on this board, for example, that is not that hard to do.

Thank you for the Internet, Mr. Gore.

Just wanted you to know that there is a real mutual respect we share with our beloved Dr of 15years and he's never been wrong yet. Although he looked a bit "confused" when I got into the data reporting and auto features I wanted, we had to have a long conversation first until he was convinced that I had done my homework and that he understood and was comfortable with my request. I should have included that in my post. Believe me, he has slapped me down several times when I've "suggested" a trial of some miracle drug or treatment I'd heard about!

M.D.Hosehead wrote: One thing that hasn't been mentioned is the number of doctors, nurses and other health professionals who are burned out and don't like what they are doing. I've recently needed new doctors, and I'm amazed at the number who, when they discover I'm a retired doctor, make some kind of comment like, "Boy, you're lucky." I've heard this from young doctors who still have 20-25 years to go. Most don't see anything on the horizon that is likely to improve their working conditions, and many are pessimistic about their own futures or are looking for a way out.

Just curious, did you retire after medicine or did you get fed up and go into something else? The reason I ask is that so many people I knew from college that went to med school (mid 70's - those that I kept up with) left and went into other fields. I can imagine it must be difficult to stay in that field for a number of reasons - especially these days. There seems to be so much "payer" (insurance company) meddling that you can't do your job anymore. Also, I've been told by lots of people practicing that the pay can be so mediocre that even living in my area of the US can be unaffordable to many MD's - especially the "younger" ones that have still a lot of debt and obligations to pay off. I know money is not a goal to many people, but you still need to bring in enough to pay basic necessities - especially if you have a family with kids.

I guess I would "burn out" with a bleak economic future that (given our directions in heath care) is only going to give more power to the payers and not to the doctors or patients. Hell, I just look at my sister's kids getting out of a 4 year college and fighting like wolves for a FT job that pays a starting salary that is the same as I was looking at in 1980. Even after 4 years of undergraduate they owe a ton of money - a lot more money than I ever did.

I guess we are so desperate to pay for everyone's health care in this country that we can't pay a little more attention to those people that are supposed to provide it. Someone told me a few years ago that 20% of graduates at Stanford Medical school were not going into medicine (their daughter was graduating at the time). I don't know how accurate that number was, but anything close is tragic.

I found a niche I liked, but nevertheless, I retired a soon as I thought I could afford to. I chose more freedom and less money. One of my partners, who also retired early, has seen too much of his nest egg evaporate, and has gone back to work.

Another colleague, who had good disability insurance, developed fasciitis, and chose to retire disabled in his 50's. Had he loved his work, he could have continued, adjusting his practice to fit his capacities. Insurance companies that wrote disability policies assuming doctors want to work as long as possible, are facing more disability claims than their actuaries had predicted.

I don't want to exaggerate. Probably, the majority of doctors are satisfied with their lives, but I don't sense the enthusiasm that used to be there. There aren't as many that love their work. JMO

You don't have to take my word for it, though. Ask your own doctors what they think of the future of their profession. Would they make the same career choices if they could have a do-over? Do they hope their children become doctors?

There are some GP doctors that have abandoned insurance. I saw a video of one such doctor talking about his practice. I think he actually likes practicing medicine a lot better without insurance. He charges $50 for a visit with a patient, and that's really affordable for most people. He takes whatever time he needs with the patient. His staff and overhead are greatly reduced because he doesn't need anyone to fill out forms and communicate with various insurance companies, and he spends no time on the phone explaining to an insurance company why his patient needs a particular medical service. He seems to love his practice. He says that the additional time he spends with patients has resulted in better health for them. Even without taking insurance, he still has Medicare patients come to see him. They are just self-pay for his services.

His waiting list is quite long. I wonder why.......

I bet we will see a lot of primary care providers go to this model.

jnk wrote:...Thank you for the Internet, Mr. Gore

Calist wrote:I thought it fitting to have a meet and greet. A quick getting to know you just for the medical professionals.

Hi, my name is James Stillwell I am an RPSGT and a REEGT. I have about 20 years experience in medicine and I work in Denver at the National Jewish Center for Respiratory Care.

Forum Admin Edit:

Hello Johnny,

We were alerted this morning that you have a user, calist, that is saying that he is an employee of National Jewish Health. He lists his name as James Stillwell and says that his employer is National Jewish Health. This is NOT the case. He is not employed by National Jewish health and he is giving out false medical information and is being abusive to other users.

<Email Continues>

Thank you,

<Name Removed>
HR Assistant

For those who don't know this was a question that got Calist banned. He posted a similar question yesterday.
See this post from admin viewtopic/t56555/Calist-Banned.html

Maybe he's not a doctor, but he plays one on TV