What is your opinion of doctors?

Question

A long time ago, I lost faith that doctors are generally competent, or care about their patients. For example, you may have to wait a week to get an appointment, and then, when you FINALLY get "an audience with the king", he gives you some superficial, cursory "examination", and he just mouths some platitudes about getting rest or some such thing.

Right now, I may or may not have a meniscus problem in my knee. I may or may not have a problem with my ACL. Either I should walk unless it hurts, walk only short distances, or lay in my apartment for three weeks without stepping outside. I'm not sure. That is the recommendation of three different doctors.

Why does it seem like doctors don't really have a grasp of human anatomy? When they can pinpoint the exact point where something hurts, and they can feel the soft tissue around the area, it should be self-evident. Even my massage therapist had a different answer.

Are doctors just ambivalent?

If anyone else answers, please try to answer this puzzling question I have: the massage therapist at my gym gave me a massage on my legs. He noticed that certain areas around my knee where a different color than the rest of the skin. Therefore, he deduced that the blood was not getting there, and hence that area was the source of my problem. He didn't know the name in English, but he thought it was "pes anserinus" in Latin. If a massage therapist is more observant than a doctor, what does that say about the medical profession?

I am shocked when I go to a doctor, and they seem like they're just going through the motions. They seem to have little interest in your case. I've tried switching doctors many times, and one is just as bad as the next.

One time, I was in a consultation with perhaps the top neurosurgeon in Chicago. I asked him if a certain exercise is good or bad for my back. He said, "I don't know, I'm not an orthopedist". HE KNOWS ANATOMY, RIGHT???

Answer 1

well, let me provide you an opinion on doctors by a doctor (an orthopedic surgeon no less), and also make some social commentary.

i can certainly understand the frustration from the patients' standpoint. there is truly a very wide spectrum of doctors out there, dumb ones, smart ones, ambivalent ones, passionate ones. one must remember that doctors are only a segment of the normal population; yes, we are more "educated" which just indicates that we spent more years in school. this doesn't equate to more intelligence, common sense, desire to save lives. there were plenty of less than bright people in medical school, as well as near geniuses. however, after all those years of training one would expect some "expertise" in their respective specialties.

i also sense a significant deterioration in the patient-physician relationship due to many factors. people in our today's society are much more entitled. one clear example is the comment made by the nurse above, "I go into my doctor and tell him what I want. If he won't give it to me, I will find another doctor." in today's legal climate, doctors are all forced to practice defensive medicine which is not only exceedingly expensive, but also not necessarily best for patient care. and in today's economic climate, some doctors' way of practice is altered by other forces, ie the insurance company or the hospital (which may explain why you haven't had a MRI yet or referred to an orthopedic surgeon; and also why doctors spend 1 1/2 minutes with each patient after waiting 3 weeks for an appointment). one more important factor involves people who have secondary gain or have no reasons to "get better". unfortunately, in specialties especially like orthopedics, there are many patients who just want to take advantage of the system and would much rather just be on disability for the rest of their lives for anything and everything. so you can imagine, doctors have multiple issues to deal with other than your knee.

i do agree with the nurse above in that in today's health care system, one must somewhat take charge and use physicians as consultants. for the most part, short of life or death situations, doctors should be there to educate, provide options and recommendations.

in your problem specifically, i get the impression that none of the 3 different doctors you saw were orthopedic surgeons. an ACL rupture and to a slightly less extent, a meniscus tear should be fairly simple to diagnose by an orthopedist with some basic physical exam maneuvers. but this may be very difficult for a primary care physician to do. so if you did see 3 orthopedists and none of them were concerned enough to order a MRI or provide some other modality of care, then it is not likely that your meniscus or ACL are involved.

with all that said, don't know what to say other than good luck with your knee and try to find a good doctor.

Answer 2

Neurologists handle above the shoulders, orthopedists handle below the shoulders. These are very specialized fields. As for an orthopedist - you need a sports medicine orthopedist and an MRI. It might well be that your primary care doctor will need to order the MRI first or at a minimum - x-rays, although x-rays will not show soft tissue. Simple as that. I always go sports medicine when it comes to ortho. I have had 4 knee surgeries - 2 reconstructive both knees and the other two repairing a torn meniscus - also both knees. Depending on your age, and also depending on whether you actually sustained an injury to your knee - it could be degenerative process i.e. arthritis in the joint. You don't mention a clicking sensation. You also don't mention instability in the joint. You also don't mention an injury.

When dealing with these specialists, you might want to write down what is happening with your knee, if you injured - how you injured it and when - before going to the doctor. Sounds like you might not be specific enough. As for the movements they do in the office, those actually are viable aspects of the examination. They're checking the flexibility and surrounding muscle strength of the joint, and so forth. Try being very specific with the next one and I would seek an orthopedist who specializes in sports medicine. If the only problem is arthritis - the worse thing you can do is not walk. Walking helps to keep the surrounding muscles, ligaments and tendons strong which supports the knee. When those get weakened, you are more prone to injury and will experience more pain if degenerative process is the issue for you.

Sports medicine ortho - I wouldn't see anyone less qualified than that as they have kept me walking quite well.

Answer 3

I think that doctors try as hard as they can for each patient (of course, there are exceptions to every rule). So many of the same symptoms are caused by different conditions, it can be hard for them. I can say with a clean conscience that all doctors care about you. No doctor wants you to be sick, or feel pain.

Unfortunately, everyone makes mistakes. That's why you shouldn't take the doctor's word offhand, but try and do some of your own research. After they have made their diagnosis, speak up, and ask if you think it could be such-and-such disease. If they say no, ask them what signs are missing, or show that you don't have it.

But it is not only that. For some conditions there are various treatments, and just because you don't get the same answer from two different doctors doesn't mean either of them is wrong. A doctor has been through medical school, and has done the work, and I'm sure that they are perfectly capable and willing.

Answer 4

I think it depends a lot on the doctor. Many are less competent than others. Some are very good. You need to shop around, as you would for a good plumber or a good mechanic.

I use a GP who is overworked and I have a hard time getting an appointment, but most of my visits are routine, so I can work with some lead time. He knows me, knows my family, cares about our health. But I do have to wait as much as a month to see him unless it is an emergency, in which case he'll usually work me in the same day.

I also see a urologist who performed surgery on me a few years ago. I swear by this guy. He has done kidney transplants on NBA stars and is almost famous.

Any doctor who suggests natural healing as the best way to deal with an injury is cooperating with nature, and I approve of that approach. Surgery should be a last resort. I also am an advocate of preventative health care as the best way to maintain ourselves.

If your doctor isn't giving you help you are comfortable with you should see another doctor or ask for a referral to a specialist. Your knee problem should at least merit an X-Ray or some sort of imaging for proper diagnosis, if it has been a chronic problem. This can get expensive, but knees and joints are a weak point--especially as we age--so it might be worth it to get a good diagnosis by a specialist.

A good GP should have a fair grasp of anatomy, but should also know where his or her weak areas are, and should not try to treat conditions in those areas. I would not expect a GP to do a heart transplant, for example, or to diagnose complex bone or joint injuries.

I would seriously consider following the advice the doctors you have seen have given you, especially since three of them have given essentially the same advice.

And trust a doctor over a massage therapist just as you would a surgeon over a tailor. The massage therapist may have some good ideas based on experience, but the clinical knowledge will be very limited.

Good luck and I hope you feel better soon.

Answer 5

Wait a minute, you trust a "massage therapist's" anatomy knowledge over a physician who spends the first year of medical school actually disecting a human body? Then another 3 years of med school, 3-5 years of residency, then perhaps additional years of a fellowship. (Compared to maybe 6 months of 'Massage School' - not even required in many states)

Yes, pes anserine is the actual name of a muscle. Massage therapists are always going to find a muscular reason - it is the only thing they can treat! Of course did that person tell you about the relationship of the pes, the MCL, and the medial meniscus?

Physicians receive only a little training in regards to modalities and rehab. That is why they refer patients to physical therapists and athletic trainers for treatment.

Why is it when a physician doesn't tell you what you want to hear, the doctor "is no good"? Patient non-compliance is one of the largest reasons people don't improve with basic orthopedic injuries.

Answer 6

As the first poster said there are some excellent drs out there and then there are drs out there that aren't so good. It does take work to find a good dr that is willing to listen and help the patient to try and find out what is going on. Sometimes it can take a while to find out what is wrong and that may mean trying several different drs before finding the right one to help figure out the problem.

As for waiting a week or two to get an appt I don't mind it if I'm not having a non-urgent problem when it comes to some of my health problems but I always have appreciated when my one dr that I see on a regular basis tells the staff to work me in if she feels I need to be seen sooner than normal.

I think that sometimes drs give some of the answers they do because they just don't know the answer. This is why I wish more of them would just tell us they don't know if they really don't know. I'm glad that my team of drs does this for me because I would rather hear "I don't know" or "try asking your other drs to see if they know" if the one dr I ask doesn't know.

As for pinpointing the exact area of where something hurts sometimes that's not always easy to do which is why they have to ask different questions like the general location of the pain, how long it lasts, what is it's intensity, what kind of things make it worse or better. Things like that. Because they are being like a detective to try and help you (the person that goes to them that is) solve the mystery. Some injuries and such are not always self-evident, another reason they have to ask questions to get clues.

There's a program on Discovery Health called Mystery Diagnosis and one of the things that I'm glad to see on there is that the drs that are interviewed for the pieces done will often say that they don't always know the answers.

It takes work to find a good dr to help take care of a problem and it's not always easy to do because it means that you may have to try several of them before finding the right one. And yes for some that may mean getting 3 or 4 different opinions before finding the right answer.

I think that they can be useful and good, especially if they are good listeners and are willing to take the time to answer the patients' questions.

Answer 7

I am totally with you here . . .

These days I only go to the doctor if I know there's a need for antibiotics (bacteria they can test for). Otherwise, I'm sticking to the homeopathic route.

I've been diagnosed with four or five different ailments, none of which is "heal-able." All of which require many expensive meds (with side-effects).

After the bounce around for a year, with bad effects of the meds taking over my life, I finally "detoxed."

Have you done all this: The torn meniscus represents a mechanical block to normal joint motion. If the meniscus is torn in the peripheral thirty percent, the blood supply is adequate to permit healing if the tear is repaired in a stable fashion. If the tear is in the inner zone, with less blood supply, the likelihood of a repair healing is diminished but not eliminated. Newer techniques to provide stable repairs and increased nutrition to this tissue have provided a high rate of healing. Due to the supreme importance of the meniscus in knee joint function as described above, every effort to repair torn menisci is now made at the time of arthroscopic surgery..

Are you using a brace?

I use Web MD a bunch.

I think that most of them are indifferent.

Do you think if we had a money-back guarantee system in place they might work for that big money?

Answer 8

A lot depends on the patient's attitude when they come to an office. If they have a chip on their shoulders, then they'll likely be mad at the doctor, regardless of what he/she says.

Subspecialists are so immersed in what they do that they're not "up" on something outside the specialty. Does it make sense to ask your cardiologist about your hepatitis? No. Should you ask your orthopedic surgeon about your heart failure? No.

Sometimes rest IS the best thing. It's amazing how many patients don't want to hear that and want SOMETHING done.

Answer 9

This is a very good question. Our role in our healthcare is changing. It used to be you followed your doctors orders without question. Now...you have to be in charge of your own healthcare. Do research. I only use doctors as a consultant. If you approach it this way, you will have more control. YOU know what is working and what isn't. They can only really give you their opinion anyway. I go into my doctor and tell him what I want. If he won't give it to me, I will find another doctor. Of course this is not the system to use when seeking pain relief. You can't go from doctor to doctor asking for pain medication. That is actually illegal.

Answer 10

well I understand your frustration. I have had headaches and gone to many doctors and they have no clue. I can't understand why that is an acceptable answer. I have had blod work and an MRI and they can find nothing. I have some symptoms of one thing and some of others but not enough of one to diagnose me....one claims that I have tension headaches and she didn't even test me...lol
I get scared because I could be sick but they have no clue....I have to laugh.
But some doctors are great....just not the ones I have seen...lol