Doctor says doctors terrified to step out of line

[Geffers]

Excellent presentation by Dr Suneel Dhand as to why doctors generally all think the same, why they are, in his words, terrified to step out of line.

He trained in UK but currently works in US and is an opponent of 'pills for everything'.

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Geffers

 

[Retro]

So, rot and corruption are at the root of the medical profession, who knew? It helps explain why they behave as they do sometimes during appointments, especially with advice, or in what treatments they recommend.

What I don't get, is that people wanting to become doctors know about the huge debt that they'll be getting into, so why do they do it? This should be a death knell for this profession. Would be nice to know more details about this situation. Is the loan deferred in some way perhaps? I have no idea.

 

[Tiffany]

Medical doctors are all in that box, and if you challenge them to think out of that box, they will twitch.

On why doctors tow that line is probably because they do have that student loan to pay for and why would they want to lose their license for a patient that challenges their authority (oh, they really hate that) or a patient that asks for alternatives (that's always an immediate eye roll). Doctors are glorified pharmacists, in my opinion, except for the emergency room physicians/surgeons and those doctors that put people back together after a major accident, whom I'm grateful that they can put people back together as their talent takes amazing skill.

 

[Geffers]

Never ceases to amaze me the amount of pharma ads on US TV. I've seen a break where every advert is for a treatment of some kind. Even if you are well they want to sell you a pill to keep you well.

 

[Tiffany]

It's ridiculous the ads on TV.

Warning Rant coming:

It's also getting frustrating in the US on how you are now required to go to a specialist for every med you are on. I just went through that today at a doctor's appointment. If you're an ENT, you can only prescribe ENT related meds. If you're a Pulmonary doctor, same. I miss the days I could go to one doctor for everything I needed. Now I have to go to my general doctor or a specialist for a simple nasal spray. Good grief and copay's are also really extreme. Not to mention how time consuming all of these appointments can be and don't think you can come back next year as they want to see you every 4 to 6 months, or they won't refill your prescription. The US Big Pharma comprises about 30% plus of our GDP. Ya think American's have issues? Too many meds and very few doctors are offering solutions. Those doctors that do offer solutions (naturapaths, osteopaths, functional medicine) are usually not on insurance and are extremely expensive and even then, no assurance that all the money you spent helped resolve a malady.

End rant~

 

[Retro]

Tiffs, I wonder if it's gone like this because of advancements in medical knowledge, ie mankind now knows a lot more than in those days? Could it be a way of making more money? Avoiding liability?

I don't know, but I suspect that medical advancements might have something to do with it.

I believe it's similar in the UK. tbh, I don't really remember my doctor visits in the 80s and 90s, but they do refer one to specialists for a lot of things now.

We don't get the same medical ads that you do though as I think they're much more tightly regulated over here.

 

[live627]

Combination of liability and money.Mostly money.

New Zealand is the only other country to show pharma ads on tv afaik.

 

[Tiffany]

Tiffs, I wonder if it's gone like this because of advancements in medical knowledge, ie mankind now knows a lot more than in those days? Could it be a way of making more money? Avoiding liability?

I don't know, but I suspect that medical advancements might have something to do with it.

I believe it's similar in the UK. tbh, I don't really remember my doctor visits in the 80s and 90s, but they do refer one to specialists for a lot of things now.

We don't get the same medical ads that you do though as I think they're much more tightly regulated over here.

Healthcare is a big machine in the US. I would say that the rules changed right before covid that now you couldn't go to your GP (general practitioner) anymore for a variety of services that you're accustomed to, except for the basic meds and tests. Without a GP, if you have to have surgery, you will have an issue because the surgeon has to have consent from your GP to perform surgery. Now I have a GP that I have to go to once a year for really nothing more then what my specialist does already, but it's a compliance thing. Also here in the US if you haven't seen your doctor in over two or three years, you no longer are a regular patient and if you come back, you are now a new patient and sometimes that doctor isn't taking new patients anymore. I've been through that too. It's absurd.

Combination of liability and money.Mostly money.

New Zealand is the only other country to show pharma ads on tv afaik.

Agreed, mostly money.

 

[Astro What]

I just went through that today at a doctor's appointment. If you're an ENT, you can only prescribe ENT related meds. If you're a Pulmonary doctor, same. I miss the days I could go to one doctor for everything I needed. Now I have to go to my general doctor or a specialist for a simple nasal spray.

Is that because of your insurance? I have no issue getting specialty medications prescribed by my family physician. Granged, he is not a GP but a specialist, but he has prescribed medications for issues that he's not certified in.

 

[Astro What]

Also here in the US if you haven't seen your doctor in over two or three years, you no longer are a regular patient and if you come back, you are now a new patient and sometimes that doctor isn't taking new patients anymore. I've been through that too. It's absurd.

That's a physicians office thing. Having helped for years with several medical practices, they have a target goal of active patients that they shoot for. Those that only come in once a year or so are basically a money loss for them, so they would rather get someone in that actually helps keeps the doors open by coming in semi-regularly to be brutally honest. Then you do have the fact that in the US, we are recommended to get at least one annual wellness check a year.
The clinics have to make money, and they don't want to overload the clinic(s) in case of something like Covid so that they can't see patients and have to turn them away.
Medicine, like anything else in this world, is a business.

 

[Tiffany]

Is that because of your insurance? I have no issue getting specialty medications prescribed by my family physician. Granged, he is not a GP but a specialist, but he has prescribed medications for issues that he's not certified in.

I used to be able to get medications from my GP, prior to Covid, meds usually prescribed by a specialty doctor. I was happy with my GP that would take care of an ENT medicine for example, saving me the time, and copay to go to another specialty doctor. This has not been an insurance thing requireing me to go to a specialist. It's a system wide doctor thing.

That's a physicians office thing. Having helped for years with several medical practices, they have a target goal of active patients that they shoot for. Those that only come in once a year or so are basically a money loss for them, so they would rather get someone in that actually helps keeps the doors open by coming in semi-regularly to be brutally honest. Then you do have the fact that in the US, we are recommended to get at least one annual wellness check a year.
The clinics have to make money, and they don't want to overload the clinic(s) in case of something like Covid so that they can't see patients and have to turn them away.
Medicine, like anything else in this world, is a business.

This is by new design, so patients go to all of the speciality doctors beyond their GP. I can site numerous instances of this issue. Perhaps this is more profound in a large metropolitan area where there's a lot of physicians? I'm very famiiar with both the medical and dental field. Yes, it's a business.

 

[Astro What]

It's a system wide doctor thing.

Maybe where you are located. I can still get medications from my family practitioner. He's a licensed doctor able to proscribe any legal medication, including THC here in Texas.
I'm curious, are you using a practitioner that owns their own practice, or one that is a member of a group of doctors that may be under the umbrella of a local medical group? My practitioner owns their own practice.

 

[Tiffany]

Maybe where you are located. I can still get medications from my family practitioner. He's a licensed doctor able to proscribe any legal medication, including THC here in Texas.
I'm curious, are you using a practitioner that owns their own practice, or one that is a member of a group of doctors that may be under the umbrella of a local medical group? My practitioner owns their own practice.

That's great that your doctor has broad authority to prescribe any medications and perhaps that's the difference; private versus group practice? The doctor I had for over a decade was in private practice and then she sold it to the Texas Health Resource Group. I think my doctors are part of a group now.

I don't know, they all say you go inactive after two to three years if you don't return. I had one doctor that I went to for nearly 10 years and hadn't needed to go to this doctor for two years. When I scheduled an appointment, my registration was treated as if I was a new patient again. Sigh!

 

[Retro]

I don't know, they all say you go inactive after two to three years if you don't return. I had one doctor that I went to for nearly 10 years and hadn't needed to go to this doctor for two years. When I scheduled an appointment, my registration was treated as if I was a new patient again. Sigh!

You know, another way to look at this is that one mustn't be too healthy, or you get reset. The workaround is to make an appointment after something like 1.9 years for a "check up", or fake some vague sickie, like lack of energy or something. Ridiculous.

 

[Tiffany]

You know, another way to look at this is that one mustn't be too healthy, or you get reset. The workaround is to make an appointment after something like 1.9 years for a "check up", or fake some vague sickie, like lack of energy or something. Ridiculous.

Lol, so true! I suppose I can do that to keep a good doctor, good plan!

These days it's a shot in the dark when you choose a specialty doctor for something new. I had a nurse-tech, whatever they call themselves these days, go over a lab on the phone today. What I saw on the lab report didn't jive with what she said the doctor said because I had already looked at the report in the portal. So I told her to please send me the doctor's notes in the portal so I can review what the doctor said. She sent them. I had to respond back in the portal today, back to the nurse-tech (whatever) because she seemed to give her own interpretation, which was different than the doctor's notes. I'm tired of being my own doctor all of the time. If I wasn't so smart in the medical field, can you imagine what happens to people that don't know any better?

 

[Geffers]

When my late wife was on cancer treatment all medication was prescribed by local doctor, obviously chemo was administered by hospital. Cancer nurses actually suggested an alternative pain medication which doctors were happy to prescribe.

Geffers

 

[Astro What]

I don't know, they all say you go inactive after two to three years if you don't return. I had one doctor that I went to for nearly 10 years and hadn't needed to go to this doctor for two years. When I scheduled an appointment, my registration was treated as if I was a new patient again. Sigh!

Look at it similar to those vehicle or RV warranties that require you to bring the product in yearly for a "checkup" so that they can head off any issues they might find before it becomes even more expensive. A yearly wellness check is honestly not that big of a thing and should be done by all.
I'm assuming since you apparently don't go to the doctor regularly that you also avoid the suggested yearly mammograms?
That's like someone that has a history of polyps or colon cancer in their family ignoring the suggestions of going in for regular screenings.
There is a reason it is referred to as preventative medicine.

Our family physician is just as likely to push you towards a holistic path as one involving medication.

 

[Tiffany]

When my late wife was on cancer treatment all medication was prescribed by local doctor, obviously chemo was administered by hospital. Cancer nurses actually suggested an alternative pain medication which doctors were happy to prescribe.

Geffers

I'm sorry for your loss. That was a very difficult time. it sounds like your experience went well and was well coordinated under such very sad and emotional circumstances.

I'm assuming since you apparently don't go to the doctor regularly that you also avoid the suggested yearly mammograms?
That's like someone that has a history of polyps or colon cancer in their family ignoring the suggestions of going in for regular screenings.
There is a reason it is referred to as preventative medicine.

Our family physician is just as likely to push you towards a holistic path as one involving medication.

Sorry, AW but you are assuming way wrong about me. I'm very well versed in medical care, medical terminology/anatomy, alternative care, functional medicine and highly involved in preventative care on a daily basis for myself, my family and even my dogs. My families background in health and wellness is extensive. I don't appreciate your insinuation and assumption that I don't practice regular medical care as you don't know me.

Without going into my personal health, I'll just add that there are sometimes a specialty doctor is needed for a time and sometimes not, hence my lapse in this one particular doctor. So when I stated that I had to register as a new patient, I was complaining only in the sense that it was a formality as everyone always has to update their medical history with their regular physicians every year.

 

[Astro What]

Sorry, AW but you are assuming way wrong about me. I'm very well versed in medical care, medical terminology/anatomy, alternative care, functional medicine and highly involved in preventative care on a daily basis for myself, my family and even my dogs. My families background in health and wellness is extensive. I don't appreciate your insinuation and assumption that I don't practice regular medical care as you don't know me.

You miss the point that was being made. What is the issue going in for a yearly wellness exam was the point. If that's too much trouble then it would seem that other regular recommended checkups would be also.
Also, not entirely sure if you are complaining about a specialist doing this or your regular practitioner?
From some of your statements it appeared that a doctors office visit apparently was something only needed when you feel sick? When in reality, it should be part of a regular preventive maintenance routine just like a colonoscopy or a mammogram. Now if it is a specialist visit, I can somewhat understand that aggravation, but it is part of protecting themselves from the ever-present lawsuits.
I don't know what kind of insurance you have, but mine covers both a family practitioner and specialists. I go to my family practitioner for routine stuff and then follow up with a specialist for anything that requires their knowledge.

Is it the specialist that you follow up with that are looking at you like a new patient after a few years of not seeing them? In certain situations I can see where that would be a correct process as far as intake as you have several years of medical history that they are not aware of and need to know before your visit. That happened with me with both the cardiologist and neurologist after a few year period of my initial visits and a latter follow up at the recommendation of my family physician. And I was looked at as a new patient because medically to them, I was. They had not seen me regularly so a new workup was required. Frustrating? Yes. But good practices from the position of liability for them, also yes.
Detailed healthcare information is not generally shared in a centralized database available to all practicing physicians currently. Although they are working on something like that here in Texas to ease sharing of patient data between practices that does not involve an office having to send the records manually. Currently the physicians offices have to opt-in to the ability and it still does not share all data because of the wide variety of software being used by different hospitals, care groups and independent physicians.
This I am fairly versed in since I continue to provide IT services for a few local clinicians and their office.

EDIT:
I should note, my family practitioner is also a specialist and not a GP.

 

[Retro]

@Tiffany @Astro What I'm finding your discussion an interesting insight into how American healthcare works and am quite happy for you to continue. However, please remember that you're discussing your personal circumstances in a public area of the forum, so you may end up getting carried away and start giving away more personal info than you intend to. Therefore, you may wish to start a pm thead about this and continue there. This is totally at your discretion of course and if you do, I'd be interested to be part of that conversation if you're ok to include me. I'd be happy to share my experiences of the NHS which are mixed, but generally positive.

btw, like a certain infamous orange person, I have always aced and continue to ace every medical test 10 / 10 or better, so there's not much to say really since I'm just so great and better than everyone.

 

[data66]

I've been in pain for several years after a surgery at the hospital here. Note that this hospital has a ton of clout and owns all of the hospitals and clinics in this area. I cannot find what happened during the surgery. The doctor told me that a handful of other patients all had issues from surgery that day and he wanted to find out why. He then left two weeks later (I wonder what else I may have learned from him as he was a pretty straight arrow in regards to what he wanted to provide for patient care). I'll wait til I can move to Florida to try and get this fixed so I can hopefully live a normal life again. Not all medical care is good. Some doctors have to go with the flow when the hospital has so much power.

I recall several years ago when some doctors got together and did a "factoids" anonymous printout on what was going on with this hospital. It didn't take long for them to be outed and forced to leave the area. Not naming names as this is public. I would prefer not to disappear.

 

[Tiffany]

You miss the point that was being made. What is the issue going in for a yearly wellness exam was the point. If that's too much trouble then it would seem that other regular recommended checkups would be also.

Since we seem to be on a discussion carousel and I believe you are well meaning, I'll just add that I agree with the necessity of yearly wellness checks from various physicians like a general practitioner to a specialist depending on someone's health challenges as they are very important. We can agree.

@Tiffany @Astro What I'm finding your discussion an interesting insight into how American healthcare works and am quite happy for you to continue.

btw, like a certain infamous orange person, I have always aced and continue to ace every medical test 10 / 10 or better, so there's not much to say really since I'm just so great and better than everyone.

Healthcare in America has it's issues indeed. Lol on your scores!

I've been in pain for several years after a surgery at the hospital here. Note that this hospital has a ton of clout and owns all of the hospitals and clinics in this area. I cannot find what happened during the surgery. The doctor told me that a handful of other patients all had issues from surgery that day and he wanted to find out why. He then left two weeks later (I wonder what else I may have learned from him as he was a pretty straight arrow in regards to what he wanted to provide for patient care). I'll wait til I can move to Florida to try and get this fixed so I can hopefully live a normal life again. Not all medical care is good. Some doctors have to go with the flow when the hospital has so much power.

I'm heartfelt sorry you have been living in so much pain and your surgery has left you with no certainty or resolve for your pain. It sounds like there was something seriously going on the day of your surgery if others are suffering too. I hope you can get to Florida very soon and find a really good doctor that cares and is willing to be a good detective to explore your issue and finally give you some relief. Pain is very hard to live with 24/7 and you deserve some answers and relief.