[kome]

I am very happy about the professionalism and the humanity of Italian doctors and the Italian national healthcare service.

Of course there are problems, waiting lists, lack of funding. But damn, it's good and (mostly) free. I feel lucky.

Perhaps there are regional differences, but in my city, it's really good.

[ItsMe000001]

What do you base your judgment on? I think it heavily depends on what you needed services for thus far. I know people who thought just like you - until they themselves or a relative really needed them. Then they changed their opinion. But even then it depends on what exactly the issue is, I know at least one serious cancer case who got everything they could and then some for free - and they had money and shopped around, incl. specialists in the US checking out if it was worth going there for private consultations paid out of their own pocket, who told them they had top specialists right in front of them near where they lived (in Germany, a university clinic).

I think variance is big and individual examples are useless unless you have the exact same problem in the exact same locality as someone else. But I think it's safe to say that anything falling outside standardized diagnosis may not work out so great. I had to do my own research myself and beat a professor's (of medicine) prediction and amazed a few other doctors with "miracles", but I did not actually do anything special, just what I thought was kind of obvious after some research. When you fall into one of the many blind spots your experience will be bad, if you fall into one of the categories which are "standard" you'll probably be one of those people who are very satisfied by what the system provides.

One has to understand how doctors are trained and what the system they work in forces them to do (and what not to do). Once you understand that you may get more satisfaction. For example, doctors prefer treating immediate problems. If you come with a long and varied history, they don't have a time for that, and often they would not know what conclusions to draw anyway - the body is complex and even if they had a hunch, the more possibilities there are the harder it is to diagnose. Also, expectations of expectations: Doctors know (sometimes learned the hard way) that people expect miracles or at least solutions from them when in reality they themselves often don't know.

Finding the cause of a problem may take months or even years of commitment (in retrospect, after a diagnosis, it's always clear of course, "why didn't we think of that sooner"). Few patients have the resources, the patience(!) and will to slowly and iteratively work on a problem, especially when success is highly uncertain. I only solved the one I myself had because I took some very radical steps that set me back income-wise for a decade at least and cost me a few social connections. The majority of people would have gone with "placebos", symptom-covering "solutions" for immediate problems, instead of choosing the great uncertainty (and when I started it was very uncertain indeed and everybody advised me to be "reasonable" and not throw my life away to chase ghosts but listen to the doctors). If I was a doctor I would never treat someone like me - because it would be highly unlikely that the person would be as extreme as I was and give up so much of their current life for very uncertain future benefit. So what doctors offer also is a mirror of what patients expect and are willing to invest (and I don 't mean money, the time and effort under uncertainty is much harder to bear).

.

By the way, my tonsils disappeared by themselves! I went to nose and throat specialists a few times during the last decade because during my long recovery I had plenty of throat issues. At some point they wondered why my tonsils where so tiny, and during the last appointment last year or so I was asked when they had been removed - they weer gone. I never had surgery, and I'm sure I still had them a decade ago. No use asking, nobody knows what happened. They were definitely never removed (or the doctor three years ago would not still have found them to be unusually small, and the next one three years later that they were not there at all).

[kome]

> What do you base your judgment on?

The experience of various family members at different stage of their life (we had to deal with childbirth, cancers, complex surgeries, broken bones, and simply old age, etc) and my experience in living in different countries. I am happy of my city hospital.

[ItsMe000001]

> childbirth, cancers, complex surgeries, broken bones

That's all pretty standard, all of those I'd trust most modern hospitals with. Yes there can be big differences, but at least all of those are part of the standard things modern medicine excels at. Anything ER, surgery, child birth. Cancer treatment is more variable but there's standards, they know what the problem is, they know what to do for diagnosis, and treatment is pretty standardized and most variance is how much they are willing to experiment with the latest (and most expensive) treatments.

Try having anything that is systemic and not easy to see (or invisible to any biomedical imaging). Each time you have a clear diagnosis for which doctors can go to their catalog of appropriate treatments you are lucky. Anything obviously and visibly broken (incl. by using imaging tech) is "the easy stuff".

Your satisfaction also depends on how willing you are to accept whatever the doctors tell you!

If I had accepted the verdict some ten years ago I would never have found that there actually was a relatively easy to identify and treatable cause for my issues. If I had accepted the endocrinologist's recommendation for surgery to remove the nodule in my thyroid, and part of the enlarged thyroid too, I would have had a happy surgery experience, because they are good at hat. But I didn't - and the nodule disappeared and the thyroid shrank back to normal to the great amazement of the endocrinologist. I don't mean to criticize your assessment, I'm happy myself too - but I had to do all the heavy lifting myself, it's just that I know how to use "the system" and how to get what I want from it and not asking for things they are bad at delivering. If you always accept what they tell you psychologically you will be a satisfied customer and life is easy (even if the problems persist, but if you accept them as inevitable your mind learns to ignore them pretty well). If you don't know and never assume that things could be better you'll always give top-rates.

I was extremely satisfied (no exaggeration) and full of unshaken trust in all doctors for almost 40 years, and I had things like jaw surgery to correct an under-bite. I went into this surgery as if it was an appointment for a hair cut, they did not even give me anything to lower anxiety even though they had planned to - my trust was complete, and for things like surgery it still is. Only when I had a problem where there were symptoms but no known cause did I hit a wall and had a very rude awakening.

[magicalbeans]

What was the issue in the end? And how did you solve it?

[ItsMe000001]

There is a huge backstory, but there was a point when a lot of tiny problems that I had ignored for decades as "part of life", "stress", "everybody has small problems", "too much computer work" or attributed to external factors like "the cold viruses have gotten worse over the last twenty years" reached a crisis point in the form of problems with the digestive system so bad I had it checked out, from both above and from below. At the end of it all was the prediction by the professor of gastroenterology whom I had consulted (yeah, I thought the grand title would not hurt and it was almost within waling distance from where I live) that I would have to take PPIs for the rest of my life.

I looked it all up and read a lot online afterwards, his procedures were immaculate and complete including all the blood work he had ordered, beyond a normal checkup, left nothing left to ask for given the symptoms I had presented. His diagnoses was 100% correct and according to all guidelines in the modern medical world, whether you are in Europe or the US.

Except that nothing made sense.

He completely ignored when I told him that I had never in my life had so many issues as with the PPIs. He asked me to be patient, just a few more weeks and we could lower the dose. But in addition, I felt that 99.9% of all my problems were "unaccounted for" in that diagnosis, that it only was about one tiny issue, but I felt it was much more systemic and that the recommendations would do nothing whatsoever towards finding a solution. It was putting buckets under the leak instead of finding the leak in the roof and fixing it. But I found that it was perfectly normal not to look for the deeper explanation, the cause of problems such as I had had!

First thing I found after a few weeks was that I had a huge candida outbreak. The professor had ignored the symptoms, I found the description on some website that I thought was entirely bonkers and esoteric, which is why I ignored it at first. But after weeks of no solution, and it got worse, I went back to that website and checked other ones too. I thought, it must be candida! I got an oral anti-fungal (cheap, no recipe required) - and within 15 minutes I had confirmation that it was a fungal infection. I went to a doctor with the diagnosis and got it confirmed, and I even got systemic anti-fungals (fluconazole based), all of it with huge success.

HOWEVER - I soon learned that a fungal infection isn't a cause, it is itself only a symptom. The only thing I found that was a remote possibility was: heavy metal poisoning. I did a test, I searched for specialists, I had to go travel a few hundred kilometers to an environmental medicine doctor at a university clinic, he said I'm a gray area case and I must have something else but that I should start chelation. He never found anything else, and ALL problems I ever had slowly disappeared, including miracles such as the thyroid thing. The prediction about "PPIs forever"? I have not taken one since 5 weeks after the professors prediction and my gut health now is PERFECT, like I never knew it, not even in childhood.

[magicalbeans]

Which heavy metals did you test for? And what do you think was the source?

[dvtv75]

> By the way, my tonsils disappeared by themselves!

You're not alone there: my partner's tonsils "dissolved" when she was younger. I've never heard of this anywhere else until now.