That article was actually quite a good read. It raised a good point. The author mentions a patient who complains and plays the dominance game because he feels the "squeaky wheel gets the grease". The author, as most doctors would probably agree, points out that the effect is quite the opposite.

I had a patient do this to me once. Obviously, I'm just a third year student so I can't sign off on the charts myself, but I had diagnosed the patient with rheumatoid arthritis and had the attending check all the tests and examine the patient. The attending agreed with me and I was told to carry on with the suggested treatment. The patient then proceeded to tell me that they KNEW, not thought, but KNEW it was not arthritis but instead an old injury which, as is always the case, they need morphine or something similar for. His justification was that he had read articles online and in a medical journal. While it is certainly great to have an educated patient, it is a hindrance to the doctor when a patient reads the equivalent of a semester of medical education and then assumes they know better than the doctor. Who is being the arrogant and condescending one in this case?

Often, however, as the author points out, there are patients who will calmly and rationally ask questions, even in the face of your diagnosis, about their treatment. They often qualify it with research they have done. I LOVE these patients, truly. It's nice to have stimulating conversation with a patient, even if they disagree with you. It's easier to explain your standpoint and why you feel a certain treatment is best. These patients don't become aggressive and don't make the job as physician harder, as opposed to the previous example.

In short, be kind. We're just people like you. You don't read a few articles and books about rocketry and then write critical letters to your space administrators, telling them how YOU would do their job and how you know so much more than they do about space and rockets, do you?

~Mariella

[edit on 4/23/2006 by bsl4doc]

Originally posted by Landis

Near the bottom of the article this guy talks about patients playing the "dominance game". Is it dominance or is it assertiveness? "Doctors" frapping hate it if you know more about your disease or your medications than they do. What they hate more is when you call them on it.

A lot of people do a heck of a lot of research on their own diseases and medications, etc. They want to know every detail about what is going on with their bodies.

"Doctors" can't stand it when you know something they don't. The messiah complex is alive and well in the "medical" community.

Wow this is so true!

I now understand why my doc ignores me and even gives me snide looks when I suggest and talk about possible reasons for my symptoms.
She yelled at me once cause I wouldn't believe something she told me which was an out and out lie.
I have osteoporosis and I also have bad muscle and joint pain, she said it was the osteo causing it, not true osteo causes no pain. (I have symptoms of Gulf War Illness). She also told me I research my medial problems too much...LOL

Unfortuneatly I go to the VA and you see nothing but student doctors that change every 6 months. I overheard my doc telling another patient her time was up and she was on her way to a real job
I guess vets are not real patients?

You're right, that example you gave was being a bad physician. However, you also gave an example of yourself being what I would call a bad patient. If I was your doctor, and you were telling me it is not osteoporosis causing the muscle pain simply because you haven't read about osteoporosis causing muscle pain, I would tell you the same thing, you are studying medial symptoms too much and not looking at the nature of the condition.

Osteoporosis, while not commonly associated with muscle pain, can in fact cause it. Often, if the bone matter is degraded near a joint or muscle connection, this can put extra stress on small fibers of the muslce. It's basically putting all the work effort that would normally be spread over 100 connective fibers onto 75 or 50. This can definitely cause muscle pain.

Like I said, the doctor you mentioned was being a bad doctor by being rude and making snide comments. However, it helps to keep this in mind, I certainly do: "Everyone has a back story". Whenever I come in contact with someone being rude or going out of their way to be condescending, I just take into account that it's not ME that's causing it, but probably they have had a bad day, week, etc. . Perhaps your doctor got some bad news that morning and just didn't feel like walking you through the basics of the multisystem effects of osteoprosis? Or perhaps they were feeling ill and just had a bad temper? Either way, if you felt slighted by this doctor, you should ask for a second opinion or switch docs, if possible. That can never hurt.

~Mariella

[edit on 4/23/2006 by bsl4doc]

[edit on 4/23/2006 by bsl4doc]

[edit on 4/23/2006 by bsl4doc]

Originally posted by bsl4doc
You're right, that example you gave was being a bad physician. However, you also gave an example of yourself being what I would call a bad patient.

Thanx for that info that was interesting.

The thing is that doc sent me to a specialist, who've I've seen only once so far, and I ask him about the joint/muscle pain and if it was the osteo causing it and he said no. And everything I've researched also mentions no pain.
The only time it causes pain is when you have a fracture, which I do in my back, and that pain is different to the other pain I have.

So who do I believe?

As far as her having a bad day, yeah that's possible but it wasn't just that one example I stated. Basically she ignore any symptom I had that she couldn't find in a blood draw. I also have bad fatigue and memory probs and mentioned them often but was basically ignored.

It's just frustrating when you only get to see your doc every 3 months for about 10 mins and then you are ignored when you try to explain what you have probs with. Admittedly that's as much a fault of the VA than the doctor.

If I were you, I would definitely believe the specialist over the hospitalist. Like I said, osteoporosis isn't commonly associated, but it does happen. However, if your specialist saw something that indicates otherwise, I would go with that. Without seeing your charts, knowing your history, tests results, etc. it's pretty much impossible for me to make any solid suggestion, but obviously your specialist has these and can make a more educated decision .

Yeah, I understand how frustrating your predicament is. I've heard horror stories about American veteran hospitals. It seems like the place that doctors who couldn't cut it in public medicine often go to. Very unfortunate for them, but moreso for their patients.

~Mariella

Thanx bsl4doc....

Basicaly the VA are training hostpitals, and we're are the guinea pigs they train on. I hate going to the VA, they don't even know how to ease your mind about things.
A couple of yrs ago they operated on my nose to fix a deviated septum and they made it worse...LOL...I ain't going through that again, I'm sure you know the procedure for that operation.
Never let the VA operate on you, I had to learn the hard way.

Oh well I guess I should try to get a doctor outside the VA system.

[edit on 24/4/2006 by ANOK]

I find it reassuring to read that some of you approach the medical profession with the best of intentions. However my personal experience in law enforcement, sadly, is that some of the patients who visit doctors complaining of pain and then suggesting that painkillers will do the trick are just people looking to get scrips for meds they (or friends/family) want to abuse. Quite frequently even here in the small town where I work, I encounter people abusing a relative or friend's prescription painkillers, usually with the full consent of the legal prescription recipient...and sometimes even SOLD to the user by the patient.

I have more complaints about dentists than I do doctors. You know the old joke, what's a dentist? a med school drop out....thats about right.

I have had them put me in excrutiating pain, to which after I have literally cried over the phone they give me pain killers. (Toothaches are the worst pain ever!)

the tooth died and needed a root canal, so I just told them to extract it.

My mother goes in to have the dentist pull ONE tooth! and because she has gum disease, they think the best option is to pull them ALL out and give her dentures. Well she refused and they tried to talk her into letting them pull two instead of all. by this time my mother was angry and told the she wanted ONLY the aching tooth pulled.


Medicine is almost more about money than anything else. sorry....thats the impression i get anyway, especially from my dentists who also (take naps in their car between patients :@@

I find it reassuring to read that some of you approach the medical profession with the best of intentions. However my personal experience in law enforcement, sadly, is that some of the patients who visit doctors complaining of pain and then suggesting that painkillers will do the trick are just people looking to get scrips for meds they (or friends/family) want to abuse. Quite frequently even here in the small town where I work, I encounter people abusing a relative or friend's prescription painkillers, usually with the full consent of the legal prescription recipient...and sometimes even SOLD to the user by the patient.

I can absolutely back that up with personal experience. When I did my 8 week clinical rotation in emergency medicine at the beginning of my third year of med school, I would say about one in every five people we would get would just be trying to get narcotics. At LEAST that many.

~Mariella

Originally posted by therainmaker
I find it reassuring to read that some of you approach the medical profession with the best of intentions. However my personal experience in law enforcement, sadly, is that some of the patients who visit doctors complaining of pain and then suggesting that painkillers will do the trick are just people looking to get scrips for meds they (or friends/family) want to abuse.

Yes this is true and sometimes I get the impression at the VA that that is exactly what the docs are assuming when you say you have pain.
I have never asked for pain meds even though I have a fracture in my spine that obviously causes me pain, and they know that, but they have never even offered anything for it. I don't ask cause I don't want them to think I'm just after drugs, cause I'm not.
The joint and muscle pain I can deal with but sometimes I wish I had something for my back, but still I'm not going to ask.