Is it a problem that doctors dont pursue questions regarding disesases and treatments??

Question

I have to answer these questions for an assignment.. any help will be greatly appreciated!!

Is it a problem that medical doctors so often choose not to pursue questions they have regarding diseases and treatments? Or is this just an unavoidable circumstance or being a busy professional whose time is highly valuable? How might a hospital or clinic make it easier for doctors to find the answers to questions that come up in the course of examining patients??

THANKS!!

Answer 1

Is it a problem that doctors don’t pursue questions regarding diseases and treatments?

Yes, it is a big problem and it can lead to a misdiagnoses. Doctors used to have the time to talk with and examine their patients. With the institution of the HMO system doctors are budgeted to only 15-20 minutes. The don’t even have time to check your vitals, a nurse does that before you see the doctor. Now days the doctors have to work fast to make their quotas.

HMOs have made health care cheaper, but nowhere cheap enough, and at a great cost. Patients just don’t get enough time with their doctors to insure that they get adequate treatment, and by seeing so many patients in a day they start to blur together.

I belong to the world’s largest HMO organization; the Veterans Administration, handling patients in all 50 states and world wide (care can be provided at any base with the proper facilities). The US Military has to run its health care like an HMO as well. It is the only way that they can provide care to all active duty members and their families for free (most of the time—some family members can be charged some fees). Currently I am seeing 5 clinics in a major facility so I know about HMOs I have also seen the rushed practices of HMOs percolate down into the private practice. Doctors in private practice have to keep costs low and see a lot of patients so they can compete.

Americans are burdened with the “Puritan Ethic” a product of our ancestors who came over on the Mayflower. Very few Americans are descended from those early colonists, but they have all been influenced by it. This ethic says that adults must work hard all their lives, be proper religious folk, take only the minimum of time off, and yet somehow raise a family. Getting sick is just not an option.

My parents were first generation immigrants; my grandparents all immigrated to America. They lived in the North East where this ethic thrived and was expected of all immigrants. My Grandfather died in his 40s, probably from a heart attack. He never went to see a doctor so I will never know. My father was a long time smoker and he probably died of lung complications induced by smoking. Despite feeling weak, despite having to wheeze he didn’t want to go to the doctor. So he died in his 70s.

Illness was never an excuse in our family. According to my mother, “If it isn’t broke and bleeding then there is nothing wrong.” I came down with an ear infection so bad that I couldn’t sleep. It turned out to be a double ear infection, but it took my mother several days before she was willing to take me to the doctor. My dad had a good job with full health coverage so money wasn’t a problem. She didn’t want to admit that I was sick and trying to “pull one over on her” by ditching school. So it was no surprise that my father didn’t go to the doctor.

When she gave birth to her last two children she was at work in the morning and in the hospital that afternoon. A little thing like being pregnant didn’t keep her down, or put her into bed for long.

Combine the Puritan Ethic with a short doctor visit and few patients get a proper visit. They don’t want to admit they are sick and the doctor doesn’t have time to pry it out of them. Often they will have waited until a major problem has grown to the point where it can’t be ignored. They only go to the doctor when it is absolutely necessary.

I have a disabling illness that prevents me from working. But, in the early days I was accused of faking it. Once even a doctor called my boss to tell him I was faking it. A few years later my illness became a recognized illness and after a long struggle I have won disability from the Veterans Administration and from Social Security. I need it because I simply cannot work. I tried for years, I won’t go into the boring (and depressing details), but before I won my disability awards I was investigated thoroughly, I have had endless tests, seen over 100 doctors… Yet here I am trying to convince you that I am not a hypochondriac. A few people are, but far more get accused of being ones. This is just one more factor that makes it hard to go to a doctor.

Now add the mystic of the medical profession. It is a very complicated field with a lot of specialized knowledge and it requires a minimum of 8 years of study, including an internship before the students are fully doctors. We have a lot of respect for doctors in our country, because we respect advanced education. Ask any parents and they will tell you that their children are going to college. Even poor inner city kids want to go and they will try to excel at sports so they can get that golden scholarship. To get to college is the only road for success, or at least most people see it that way. A few have done without, but they are the exceptions. So when a person becomes a doctor they are at the pinnacle of education. How dare they, the lowly patient complain or contravene the doctor! It is almost sacrilege. The feeling is that the doctor should know what is going on better than the patient, that’s what all those expensive tests are for.

Finally we throw in our advanced medical science and the “wonder drugs.” Doctors in the 20th century made vaccines for all sorts of diseases, diseases they had a very high death rate. I had an uncle who was put into a wheelchair by polio. Now days a few injections will remove all those problems. Small Pox, the Measles, the Mumps, Polio have all fallen under the development of the “wonder drugs.” Few people understand exactly how these drugs are made, but they all know that they are only made after a very long and very expensive series of development, redevelopment, tests, and clinical trials. In WW1 disease was almost as big a killer as combat. President Roosevelt; “This day will live in Infamy” spent most of his time in a wheelchair, but he hid it from the average American.

Once all these problems were neatly swept under the carpet, once the flu changed from a killer into a minor annoyance; the doctors of medicine became minor deities in American society. You don’t have to tell a doctor what’s wrong, he only has to look at you and examine the tests and he will know everything—this is a very common belief.

Combine all of this and when a patient sees a doctor they expect the doctor to automatically know what is wrong and have a special pill ready to give them a cure. So why waste the doctor’s valuable time complaining, another words describing your symptoms and problems. Doctors don’t think they are gods, but they have grown to understand that they are powerful pillars of the community and huge sources of knowledge. Some states even issue doctors special MD plates so that the police know not to ticket then if they are illegally parked. Clearly these people are special.

The patients are intimidated, the doctor is rushed, the patients don’t want to even visit the doctor because it is an admission of weakness (men are the worst), the doctors are hugely confident, and the patients are expecting a miracle cure. So your average patient doesn’t communicate well with a patient.

IN TRUTH, medicine is called a practice because doctors are still learning, they are always learning. In the past 20 years medicine has progressed by leaps and bounds. Cancers that were once untreatable can now be treated with focused treatment. Genetics is opening a huge new frontier to targeting specialized cures. But, along with all of this the procedures are changing. So are the drugs, some that were once used as a matter of course (Phen-Fen) are not banned by the FDA, surgery is changing, and methods change, we even take a patient’s vitals differently. It is impossible to stay on top of it all. Most doctors try, but this is time consuming, and the time available is reduced with a full load of patients. The new “young Turks” with all the latest information and the knowledge of new procedures are always a threat to the doctors. This pressure from below is heaped on with pushy drug companies promoting their products, the needs to keep costs low, and so on. The pressure can be enormous.

All of this makes the make the doctor’s job and the patient’s job harder. Having an illness, especially a chronic one is at least a part time job for the patients. No one knows how they are feeling and a lot of things are very subjective. These patients must work with the doctor to find a treatment.

THEREFORE there is a major problem of communication in our health care system. A gap created by many factors aggravated by HMOs. This is a big problem with no easy cure. Getting over all the factors is going to be a big job.

I can’t tell you how other people handle it, but I can tell you how I do. I am a fairly well educated person with a personal computer and a good word processor. When I go to the doctors I bring a 1 to 1/2 page typed letter with me. Before anything happens I give it to the doctor (never a nurse). I have yet to meet a doctor that won’t read it. In my short essay I tell them how I am feeling, what is wrong, and what I want done about it. I NEVER leave the doctors saying, “Oh, I wish I had told them this…”

I have requested a change in medication, new medications, and the stoppage of medications that aren’t working. Most of the time the doctors will agree with me, if not then they give me a sound reason why. The doctors like it because I keep it short and to the point, I address my problems, and I keep a copy of that page on my computer—giving me a record of the visits. Since I am working with 5 clinics I also include a list of all my medications and the over the counter medications I take. The doctors have most of that information available, somewhere in their records. But, when I give my essay to the doctor I KNOW that they know every drug I take. I reduce the risk of receiving drugs that “don’t play well” with each other.

On my last visit it was my first visit with this doctor and she actually thanked me for my essay. It answered a lot of questions she had, it gave her a time line of my problems, and it made it clear what I wanted to do and what I felt was my problem. It made the appointment more efficient, and it showed my involvement. I was willing to go an extra step to work WITH my doctor. Most patients want the doctor to work on them. They don’t realize that it has to be a two way street.

Sure the doctor knows more, and has the tests that can tell him a lot, but they need my input as well. I take the time to research my condition, to look at the drugs I take and to be an informed patient. When I am given a new medication I research it (pharmacists make that very easy). When I have a problem I look into the treatments and I try to find a way to solve the problem. Of course the doctor takes the lead in all of this, but I come further than most patients do when I visit the doctor.

This is MY plan, and it works for me. I still have a lot of problems and there is no cure for my condition, but I do what I can to help myself.

What we need to do is to make the patient a part of the care team, the most important part. The doctor is the leader, but patients can’t be passive. So many doctors see passive patients that they get tired of them. When they see a patient that takes an interest in their own health then this makes the doctor happier, at least they don’t have to do all the work.

But, there is one problem with this; the drug-seeking phase: just like grief dealing with a long term medical condition has phases that the sufferer has to go through. For the doctor the most difficult phase is the drug-seeking phase, when a patient thinks that there is some magical cure and they do everything to find it. They become demanding and are willing to take more risks than the doctor is comfortable with. These patients are always a pain in the rear to deal with. They are never satisfied and they make the doctor feel like the patient is thinking that they are not doing their job. These patients are OVER INVOLVED with their health care and can easily alienate the rest of the health care team.

I am past that phase, but it took years. Like most patients I ran from pleading, “doctor heal me” to almost shouting, “doctor why can’t you heal me!” Acceptance is always hard and the person always feels that it is through some fault of their own (that puritan ethic again).

As with most things a balance is required. The patient has to be more involved in their case. They also have to admit that they need help, and they can’t think that the doctor knows everything and has a cure. Sometimes they can, removing an infected splinter is easy and a treatment of antibiotics often gets the patient back on there road to being well. When the problem is more complex though then the patient has to work harder. They also have to realize that doctors are no the “font of all medical knowledge.” Doctors make mistakes, and without the patient’s input this can become more of a problem. But, there has to be a balance. Since most people don’t know how to be a patient they make lousy ones. How often have you seen the stereotype where the active patient ignores the advice of the doctor and starts working again? If you can figure out a instruction method on how to actually be a patient then you might find a solution to this problem.

Answer 2

If the doc is like this w/ all the info now on the web and all the books that are available in the office's than it is a crappy doc most hospital's and office's have a huge library of books and web site's specifically for there fields

Answer 3

Most of the time, its because of a busy schedule. Rarely, the doctor knows nothing. They don't answer questions like that unless they are asked, thats where you come in.

Answer 4

It's up to the patient to ask questions on whatever he doesn't understand. If the doctor doesn't know the answer, it's up to him to find it for the patient.

Answer 5

It is a doctors responsibility to ask and find out..if they don't then find a new one cause he's not doing his job and why would you pay someone to do a job, if there not doing it?

Answer 6

if a doctor doesn't answer ur ?s then he is either trying not to speculate or he just doesn't know in which case u need a new doctor.