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by tetramer
912 days ago
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As you've said, the human body is complex. We don't always know what's wrong - of course we do our best with the tests we have, but often we're ruling things out and are left without a clear answer. When I try to tell patients that "I don't know", they're frustrated with me. And frequently, it's the patients that are mad that I don't have a pill or procedure that can fix it immediately. You say that doctors like diseases that we can treat...well, of course we do. I want to help people! Why would I enjoy having to tell someone they're feeling badly but I can't figure out why with my current available tests and data? It doesn't mean that the symptoms aren't real, I just don't know what's causing them. People think modern medicine means we have all the answers, but that's not the case by a long shot and the vast majority of human experience and condition is still unknown, and I do wish people understood that more. (And, side note, insurances put up a fight with a ton of doctor-prescribed orders as well, it's a huge problem in the system. I'm sure all healthcare workers would love universal dietitian coverage.) |
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One of my best experiences with a doctor was when he told me he believed my symptoms were real, but he didn’t know what caused them. After being told I was healthy repeatedly even though I had very real symptoms, just being believed was a relief.
Different patients want different things. Some want a quick fix. I don’t. I want to get to the bottom of it. Maybe try to ask some questions up front to gauge which type of person they are, so you can know how to give them bad news?
The other problem I was referring to was not that doctors like diseases that they can treat. That’s a misrepresentation of what I said. I was talking about how they seem to only like diseases with a VERY clear-cut diagnosis and standard treatment, where they can run one test, then write a prescription and solve the problem. Boom. Next! But anything that’s slightly more complex than that or has any grey area, and they don’t have the patience or mindset to troubleshoot the problem.
As a software engineer, I find doctors’ lack of curiosity very difficult to deal with. You get the strong sense that they’re just looking up a flow chart, but when things don’t fit the flow chart they have no method for dealing with that uncertainty, so they give up. I guess part of the problem is that easy fixes are the only thing that can fit into a twenty minute visit. Seems like there’s no time to be curious.
I don’t expect miracles. I know that modern medicine still doesn’t have anything close to all the answers. I suppose I just want doctors to get more comfortable with uncertainty and learn how to manage that uncertainty better. Don’t act certain about things they can’t be certain about, and be more curious when the patient in front of them doesn’t fit the diagnostic flow chart.
I understand that you’re all in a difficult situation though. Dealing with insurance B.S., difficult patients, legal risks, hundreds of thousands of dollars in school loans… I don’t envy you at all. But I can’t act like the current situation is working. It’s not.