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August 23rd, 2010
12:43 PM ET

What does your doctor hear when you talk?

Whenever a patient asks me about the side effects of a particular medication, I point to the very long roster of symptoms listed for the drug. “It’s anything any patient has ever experienced,” I say, then try to help prioritize the symptoms into the more common ones versus the rarer ones.

This list has always represented for me the presence of the patient’s voice in medicine. It turns out, though, that this is not the case. Not long ago I was reading article in the New England Journal of Medicine, and I learned that these side effects listed on the package insert are not the ones the patient actually complains of. No, they are the symptoms the patients’ doctors choose to report, the doctors’ impressions of what the patients are describing.

Of course, doctors have always filtered patients’ words. Some of this is the result of the historical difference in lay versus medical language. A patient may say that she had trouble breathing, though did not cough up any blood. The doctor would then write that “the patient admitted to dyspnea, but denied hemoptysis.”

Doctors often prioritize patients’ symptoms differently from the way patients do. A patient may be most concerned about a painful ingrown toenail, but the doctor may focus on the anginal symptoms of chest pain instead.

And then doctors may—diplomatically or not—casually toss some patients’ concerns aside entirely. I have been guilty of this myself. I have some patients who seem to stockpile hordes of complaints for me, unloading them in heaps during our 15-minute visit. I listen and nod, but choose not to enter into the medical record the ones that seem clinically insignificant.  This stems from both the reality of the time crunch, and my clinical experience that most of these minor aches and pains are self-resolving.

But maybe I’m wrong. Maybe I’m doing a disservice to my patients by acting as a filter.  A growing body of evidence suggests that the gap between what patients say and what doctors document can be ample. Patients often report symptoms much earlier than did doctors. Several studies have shown that patients’ report of symptoms correlate more accurately to actual health status than did the doctors’ reports.

Some researchers are suggesting that patients be given a direct avenue for their voices to be heard. For clinical trials assessing new medications, why couldn’t patients enter their symptoms directly into a drug database rather than telling the doctor and then having the doctor decide which symptoms should be entered?

And for regular medical visits, perhaps there could be a section of the computerized medical record for the patients to access directly to list all concerns. This would be a legitimate part of the record, and then I would have my part in which I’d place my clinical impressions of these symptoms.

Seems like a good idea to me. I bet that we’d uncover many more side effects sooner. It would also remind us, that doctors need to view patients’ words as primary data, and that we should be careful about filtering the patient’s voice too much.

Danielle Ofri is a writer and practicing internist at New York City’s Bellevue Hospital. She is the editor-in-chief of the Bellevue Literary Review. Her newest book is Medicine in Translation: Journeys with my Patients.

You can follow her on Twitter and Facebook, or visit her homepage


soundoff (275 Responses)
  1. Steve

    First of all, I pay your salary DOCTOR. Do not act like you are a God because you are far from it. Listen to my issues and use your fancy medical knowledge to help accordingly. I don't pay you to ignore me. I am sick of scumbag arrogant doctors that act the way they do. I give them ONE CHANCE and if they act like a complete tool then they are fired.

    August 23, 2010 at 13:31 | Report abuse | Reply
    • Ragu

      OK Steve. It sounds as if your firing of the doctor is actually to the benefit of the doctor.

      August 23, 2010 at 15:29 | Report abuse |
    • Andrew

      Good luck with your health care Steve! Oh and tell the restaurant that you pay the chef's salary so you want a special meal too. That'll get you top notch service I'm sure of it.

      August 23, 2010 at 15:38 | Report abuse |
    • SHC

      EXACTLY. Doctors need to start treating patients like paying customers, which is exactly what we are. If doctors were in any other service profession, they'd be fired for being aloof and arrogant.

      August 23, 2010 at 17:02 | Report abuse |
    • Janice

      Actually Steve is right. They ARE our servants. You need to listen to what I have to say.I agree with the bottom poster that said if they were in any other business, they would be fired! I think there are several websites dedicated to giving good or bad reviews for doctors. Its time for them to be called to account for their bad behavior. The good ones should have no problem with this. Its only the bad doctors that would.

      August 23, 2010 at 18:59 | Report abuse |
    • Pablo

      The real problem is compounded by the fact that after they failed to listen to you they then document what THEY want to say in your medical record and you may not even know they aren't capturing your issues properly. Always ask to see what they document in your record for each visit and review at least annually your medical history. If your doctor isn't getting it right then you can have them change it.....

      August 23, 2010 at 19:19 | Report abuse |
    • Matt

      95% of all physicians have never lived any life other than that of very upper middle class to wealthy. On top of that most physicians look at their patients as a means to a very very good pay check. The majority of doctors further more think nearly all of their patients are pathetic. Think I'm wrong...I am a hospital administrator and I deal with patient complaints and phyician responses everyday. Good luck getting screwed because medicine is administered by a bunch of arrogant, rich pretty boys and girls who don't give a crap about you; only that you won't sue and not pay.

      August 23, 2010 at 19:24 | Report abuse |
    • joe

      Matt-
      Wow. I mean, wow. I would love to know where you got those figures from. "Pretty boys?" You have obviously never seen me. "Very upper middle class to wealthy" upbringing? You obviously have never seen the house I grew up in, either. Besides – you are an administrator. The same type that I have to defend every decision to, in your never-ending quest for "cost containment." You are a hypocrite. Administrators only care about one thing – turning a profit for the hospital. Who the hell are you trying to kid? Just admit it – you are jealous because you couldn't get into med school.

      August 23, 2010 at 20:29 | Report abuse |
    • Andrew

      Matt makes his living off the backs of the physicians who treat patients at his hospital, take calls at all hours, risk litagation with every patient they see and then he has the gaul to criticize the very people who do the actual "in the trenches" work. And to all who think physicians are "public servants"... whatever. Customer service industry...yeah, sure. Public servant No freakin way! When you pay the entire salary of your physician then you can demand 100% personalized open access care. Otherwise take a number. And lastly, for all those complaining here... you need doctors more than they need you. There will always be grateful patients who appreciate hard work.

      August 23, 2010 at 21:48 | Report abuse |
    • wow

      Steve, all doctors are gods. Weep, wail and gnash your teeth, for doctors shall judge you, bwahahahaa

      August 23, 2010 at 22:11 | Report abuse |
    • mike

      doctors can't spend all the day to listen to patients, people have to understand that , they have to be quick, because the time an 80 year man take to tell you that he fell yesterday , the doctor overhead is running, his nurse and his receptionist and every body else in the office is getting paid (in the mean time you want him to listen to patient how he fell and how he called his family and how his son came over and they called 911,,,,,,,,,,,,,,,,,,,,) good luck.

      August 23, 2010 at 22:21 | Report abuse |
    • JEB

      I agree with Steve. I pay $193.00 an office visit to my family doctor just to have him tell me, "Stop smoking, get more exercise and lose weight." It doesn't matter what I go in there for he seems to think those 3 things cure all. If it's more than a sore throat or earache he sends me to a specialist anyway. These family doctors are nothing more than scam machines.

      August 23, 2010 at 23:12 | Report abuse |
    • brandon

      Do you realize how much of a negative imoact being fat and smoking has on your health? Those are two things you can stop doing/being, and you wouldnt have to go to your family doctor except when you really are sick.......

      August 23, 2010 at 23:52 | Report abuse |
    • A.

      @Matt: I am a second year medical student. My mom is an elementary school teacher and my dad is a retired state worker. They are great parents but are unable to put any financial contribution toward my medical education. I will be graduating with over $300,000 in debt, which is typical nowadays. If I was really concerned with making money, I can think of many better fields to go into. Sorry if you've had bad experiences but please don't paint all of us with the same brush. I certainly don't fit into the "arrogant, rich pretty boys and girls" category.

      August 24, 2010 at 00:11 | Report abuse |
    • KC

      When I got copies of my medical records, there wasn't a single page that didn't have at least one outright lie on it. When I confronted the doctor about it, he admitted that he'd dictated what he chose to remember, not what I actually said, because he hadn't bothered to write anything down during the appointment. I had a virus, but he chose to interpret all my problems as "depressed divorcee". When the virus wasn't cured with anti-depressants, he verbally abused me for "not wanting to go back to work" ... actually, I WAS working, at home, and as much as my health would allow. That didn't fit what he wanted to hear, so he changed the subject every time I tried to tell him how hard it was for me to do my work when I was so sick that I could only sit up for a few minutes before passing out.

      Here's what's really wrong with me: http://cfs-facts.blogspot.com/ - just as I told him, I have a virus, I am not depressed.

      August 24, 2010 at 01:07 | Report abuse |
    • Matt

      Not all physicians are of the group I described which is why I left 5% open for interpretation. And by the way I graduated Summa Cum Laude from Penn State with degrees in Health Care Administration and Biochemistry, and an MBA from the Wharton School of Business. I got a 42 on my MCAT and luckily realized medicine wasn't for me before I spent "300 grand" on it. There is always a Disney story of some guy working hard and making it while his parents cleaned toilets, but the real world is overwhelmingly just like I described. Not all of it obviously, just like not all physicians are arrogant and self serving.

      August 24, 2010 at 01:20 | Report abuse |
    • Karen

      Working for them can be a b!tch too. Seeing the doctor, I wonder what their thinking or do they really care. Doctor: Hmmm, will the insurance pay me for this visit? She is here for drugs? She's a hypercondriac, I will prescribe antidepressives and refer to psych. She's not my relative, so why should I care?
      It makes me wonder..

      August 24, 2010 at 02:09 | Report abuse |
    • Will

      Your angry with doctors with their 'fancy medical knowledge?' Is the doctor using words you don't understand? If so, that is called medical terminology? Would you prefer being treated by a high school drop out?

      August 24, 2010 at 07:23 | Report abuse |
    • Brian

      Glad you could get that off your chest, Steve.

      August 24, 2010 at 08:00 | Report abuse |
    • Jesus

      Tell him'her that you have no insurance or limited coverage, They always tune into that in formation.

      August 24, 2010 at 08:00 | Report abuse |
    • rbnlegend

      Brandon,
      Ok, I'm with you on the smoking. But being overweight is both a cause and a symptom of health problems. Doctors ignore it as a symptom, and dismiss overweight patients health concerns because all they see is the weight. Ask any overweight patient. Doctors don't hear when you talk. They don't read your history in any detail. They diagnose their first impression and move on to the next patient. It's a volume business. It's not that they don't care, but they are under pressure, they have an unending queue of patients piling up and every moment they spend on one, is a moment that 5 more are waiting.

      August 24, 2010 at 08:06 | Report abuse |
    • John

      Most people miss the point. Doctors don't care and never have! But don't blame the medical field. We created these monsters. You and me. Next time one of these self-regulated God figures yanks your chain . . . yank back!

      August 24, 2010 at 08:13 | Report abuse |
    • Sue

      I couldn't agree more with you,it seems to me that doctors think they are God after a couple of years in their pratice,my husband and I go to the doctor come home wondering why we went,you have to figure out on your own how to handle it,oh to have the family doctor I had for 30 years,he listened,went to his little phramacy he had in office,gave us a pack of pills,may I add for 6.00 total office call,we went home feeling we'd been heard and taken care of,now you talk to them or their lap top computer pay 160.00 a call on average,and as I said above go home,think why did I go,just hope your body can heal itself.

      August 24, 2010 at 08:32 | Report abuse |
    • ap

      Well, if you all think it's such a great deal being a doctor, feel free to give it a shot. All of you would fail.. miserably. The simple truth of the matter is that a growing number of physicians would stop medicine altogether if given a chance. Don't think your insurance's $60 reimbursement is buying any Ferraris or country club memberships. Some AT&T junior executive is making more than most doctors and his nights and weekends are free.
      You guys need to wake up to the new reality facing physicians in this country. It's not the lifestyle or the paycheck you're thinking of.

      August 24, 2010 at 08:35 | Report abuse |
    • Doctor

      That same attitude is what have gotten America into this huge healthcare mess.

      August 24, 2010 at 09:19 | Report abuse |
    • Missy D

      To Steve...first of all when you walk in with 20 complaints for 5 major diseases and expect a miracle to be cured in 15min...you need to get a grip! Did your lazy ass ever think to take care of yourself to avoid any of those 5 major diseases?! NO...you expect to be coddled and taken care of like a baby. You expect the medical community to cure everything that ails you.....start by taking care of yourself! I work in the medical community and AM TIRED of seeing patients like you whine and cry about every little thing that ails you. Quit clogging up the Emergency Rooms with your cold symptoms and ingronw toe nail pain!

      August 24, 2010 at 10:26 | Report abuse |
    • Agrees with Steve

      @ Missy D: Apparently you need to clean the wax out of your eye sockets because he said none of what you are babbling about you stupid ho. He didnt say he has 5 diseases. He didnt go to emergency rooms. Apparently you are some fat middle aged dyke who has no life and cant get any. Don't take that out on the rest of us.

      August 24, 2010 at 11:50 | Report abuse |
    • Dr. Steve

      We try our best to listen to everything but a lot of what a patient says is irrelevant to their condition and to the treatment. Because of the intense education and our experience we usually know exactly what is wrong and what the course of treatment is within the first few moments. We see a lot of the same things and most of the time the condition is a very common one. Most medicine is not like what you see on "House".

      August 24, 2010 at 11:54 | Report abuse |
    • Dr. Steve

      Sometimes even we get treated in a manner we dont appreciate when consulting with another doctor. It happens to everyone. Sometimes I dont get good service at a nice restaurant but I get fantastic service at a Subway. It is what it is. Do what we do and simply dont go back. Find a doctor who you connect to. Remember when it comes to being a consumer you vote with your feet.
      Furthermore, the busiest doctors I know of are also some of the biggest jerks. For some reason it seems that subconciously patients almost like doctors who treat them in an inferior manner!!! (Myself= very nice, very educated, very good service and still never as busy as the jerk up the road!)

      August 24, 2010 at 12:02 | Report abuse |
    • C A

      Dr. Steve:
      No, doctors DON"T always know within the first few minutes. I spent more than six years being seen by a PCP, plus two other speicalists after complaining of stomach pain, edema in hands, feet and face; and difficulty breathing. I was repeatedly diagnosed with ulcers and asthma by the doctors because I was overweight (fat person + difficulty breathing = asthma is a common equation, I've found). But I finally found an endocrinologist who listened to what I reported and thought outside the box. Turns out, I have a severe daiiry allergy that caused ulcers in my stomach, swelling in my limbs and difficulty breathing. One year later, and a vegan, dairy-less diet, resulted in me not having to take FOUR meds I'd been prescribed (including an inhaler that left me vomitting after I used it). I'm grateful that my PCP actually apologized for not picking up on it and she's been very diligent about listening to me since. A little humility can go a long way.

      August 24, 2010 at 12:48 | Report abuse |
    • IDon

      Most intelligent comment on here Steve! Most Doctors are scum, they rank right up their with Lawyers, Insurance Salesman, Used Car Dealers, Mechanics, etc. Anyone know of good doctors in the Hudson Valley of NY please let me know because I have yet to find one

      August 27, 2010 at 12:15 | Report abuse |
  2. ThunderSAM

    A database to enter symptoms sounds like more laziness on the medical professionals part. I think its a horrible idea. Enough of the dependency on technology which takes people out of the picture and puts it into the hands of a faceless, heartless machine. I am glad I found a good caring doctor that listens and respects his patients. They are a dime a dozen these days.

    August 23, 2010 at 13:33 | Report abuse | Reply
    • Mike

      You do know that a dime a dozen means they are really easy to come by, right?

      August 24, 2010 at 00:29 | Report abuse |
    • debij

      You DO realize that the database the author was referring to is not for diagnosis but to report side effects for drugs prescribed by a doctor or during medical trials, right?

      August 24, 2010 at 16:20 | Report abuse |
  3. Kerin

    You are so right Dr. There are not enough doctors out there listening to their patients. You can actually learn a lot from your patients and their symptoms. I have been undergoing tests for 15 plus years only to find out that I have Fibromyalgia. If they had really focused on what I was saying, they could have saved the health care system hundreds of thousands of dollars, not to mention what it put me through. I hope more doctors start paying attention to what their patients have to say. I know the health care system is inundated with people versus doctors, but it needs to change for everyone's sake.

    August 23, 2010 at 13:36 | Report abuse | Reply
    • Brandon

      Karen, we do all of those tests on you to cover our own butts. Ive pt would stop threatneing to sue over the smallest issues, this wouldnt be the case. we rule out everything that we think could be wrong with you, so you have no ground to stand on when trying to sue us. It is a shame that docs have to do this. Who do you blame? The doc for covering his and his family's butt? Or the multitude of americans that will take advantage of malpractice?

      August 23, 2010 at 16:06 | Report abuse |
    • Tara

      Brandon: You are not a doctor, give it up. If you were, your attitude speaks volumes. You represent the many jerkwad doctors that all of us have to deal with. You are nothing but a public servant. If its too much work for you to listen to your patients that pay your salaries, then find another job.

      August 23, 2010 at 17:13 | Report abuse |
    • HK

      Ever heard of hypochondriacs? There are plenty of them out there, and there's plenty of people who show up at the doctors office thinking they've got TB because of a simple cough, or that they're got a brain tumor because they have a headache. With wikipedia and all the other wonderful websites out there listing exotic diseases no one had heard of and their symptoms (most of which are nonspecific such as headaches, fever, nausea, cough), more and more people are showing up at their doctors office for no good reason. It's no wonder that doctors tune out so many of their patients, I would too if I have to deal with so many patients who believe they have a medical degree, when all they've got is wikipedia.

      August 23, 2010 at 17:52 | Report abuse |
    • Victoria

      @ HK: Actually, more and more people are sick with the most random illnesses and issues. It is pure laziness for a doctor to want to do any work to investigate the condition. It is not up to the doctor to find out if someone is a hypochondriac. That is incredibly insulting. If I come in complaining of excrutiating pain in my hip, I DEMAND that they investigate. Who the crap is he to not believe me? That is why he is a doctor! To HEAL PEOPLE !!!!!!!!!!!!!!!!!!!!!!!!!!!!!

      August 23, 2010 at 19:04 | Report abuse |
    • J

      first fibromyalgia is a diagnosis of exclusion, there are no tests or labs that can be ordered to see if you have it, and the symptoms are so non-specific that you need to be worked up for many other possible causes, and there is an ongoing debate as to whether or not this is actually even a medical illness or possibly a psychological one.
      second i can't believe anyone complains about how much money doctors make. Do you have any idea how much time an effort goes in to learning medicine, how many hours we have worked only to be able to lose our jobs and liscences should we make a mistake. There is a reason doctors are paid alot. Its because it takes a tremendous amount of time effort and loans (average 200,000) to become a doctor. Healthcare is important, but people act like they are entitled to our services, you could have chosen to become a doctor then you could have diagnosed yourself, but you didn't, probably becuase it was too hard, or it would take too long, or it wasn't worth the effort for the amount of money.

      August 23, 2010 at 21:36 | Report abuse |
    • Lilly of the Valley

      @ Kerin. Been there, done that regarding fibromyalgia. It only took my drs. a year to figure it out in the early 1990's. You best find yourself a good rhumatoligist. That disease has been around a couple of decades now. There are many treatments now. Just saying...

      August 23, 2010 at 22:22 | Report abuse |
    • junk g

      Kerin, fibromyalgia is a diagnosis made only after all avenues of differential diagnoses are eliminated. They could not have given you that diagnosis simply from listening to you. They listened to you which is why they ordered all of those tests. Fibromyalgia is not even a 100% across the board accepted diagnosis...it is merely a conglomeration of symptoms for which no other cause can be found. If your doctor wasn't listening to you, they would have sent you to a psychiatrist.

      And to everyone else...do you know how many years of life a person gives up to become a doctor? 12 years. 12 years of HARD work, insanely long hours, and a massive amount of mind power. I have been through it...have you? You have absolutely no clue what it is like to become a physician and what you SEE as a physician.

      In addition to the 12 years, add between 200-300 thousand dollars in debt. Sure, some people get into it for the money. But I don't know a single primary care physician that didn't get into it because he/she cares about people. People like all of you. And while I don't know any PCPs that got into it for the money, I know a whole lot who want to get out because they sit there day after day LISTENING to patients who don't want to hear, "Lose weight. Quit smoking. Exercise." Cure all? You bet they are the cure for chronic aches, pains, and illnesses. But unless you go to medical school, you don't have the direct knowledge of exactly how the body functions and the pathologic basis for disease. And if you aren't going to listen yourself, do the physician you have hired to pass that knowledge on to you...I guess you can go on living with those aches and pains. Go ahead and fire the doctor. He or She will probably thank you for it.

      I, for one, can't stand to see another human suffer, especially at his/her own hand.

      August 24, 2010 at 01:11 | Report abuse |
    • Docs, get with it.

      @Brandon, if you spent a couple extra seconds caring you might have spelled her name right. Kerin, not Karen.

      Fact is, we're not ordering food at a restaurant. We trust Doctors with our lives and they not only get our trust but they ALSO stand to make a lot of money for it. There are MANY reasons we expect doctors to operate on the highest levels and it's not asking too much for them to do that. When there's malpractice, they should absolutely be held accountable. Don't like the standards, please don't be a doctor then. It's not a hobby job. It's not even just a career. If you want to be in a profession where you help people, please make your first priority our well being and peace of mind, not your schedule.

      August 24, 2010 at 01:42 | Report abuse |
    • rbnlegend

      Sure, there are hypochondriacs, and yes, a lot of people need to lose weight. That doesn't mean that the doctor can skip the doctoring. My mother in law was constantly worried about her health, and got the hypochondriac brush-off. She died of pneumonia because by the time it was taken seriously, it required critical care, mechanical breathing assistance, etc. It could have been treated when it was less serious, but it was just her usual complaining then. My wife has been trying to lose weight for 12 years, and telling doctors something is wrong with her. After 4 years of trying to get an appointment with a local doctor with a reputation for diagnosing hard to diagnose patients, we find she's had strep for as long as her medical records can document, and we find that she has celiac. The step could have been uncovered by spending the time it takes to read the whole folder. The celiac is harder to spot, but not once you get past the older body of knowlege that says it only shows up in underweight patients. This doctor was the first doctor to spend more than 5 minutes on her medical history. This doctor was the first to say "you are overweight, but that's a symptom, not the cause of the problem". This was, in short, the first doctor who took the time to look at anything beyond the first impression.

      I read a very interesting piece recently by a doctor. He was writing about patients with chronic problems and no diagnosis, or poor diagnosis. He said that doctors want to fix problems and make people better. They want to be the rock star, the hero, the god in the white coat, The Doctor. They know when they see an overweight person in obviously poor health with an inch thick folder and a depressed facial expression, that this is going to be a case where they can't be that rock star, and they just want to get past this one, so they can deal with someone they can fix quickly, within their established body of knowlege. It takes a real effort to sit down and dig in with someone that they know they probably can't fix, and can only mitigate some symptoms, and it's so much easier and more gratifying to get to the case that makes sense and can be resolved.

      August 24, 2010 at 08:43 | Report abuse |
    • rbnlegend

      If I tell the cook that I want a special meal, and have these requirements for my meal, at any decent restaurant, the kitchen will take the extra steps that it requires to make that special meal. Especially if I am paying $100 for that meal, but often even if I am just paying $12 for the entree. The doctor will laugh at me, and leave me waiting in the silly paper gown, but the restaurant is there to provide service and actively wants to give me a great meal. That's what they do.

      And fibromyalgia is often the diagnosis of last resort. We can't figure out what's wrong, and you more or less have the right collection of symptoms, looks like fibromyalgia. We can't do much of anything for you, and you are going to be miserable. Here's some painkillers and a handicapped parking pass, join a support group and come back in 4 weeks. That was one of my wife's incorrect diagnosises.

      August 24, 2010 at 08:49 | Report abuse |
    • elliepants

      Actually, I did go to the doctor regarding headaches I was having and found out I had a large brain tumor. If my doctor had dismissed me as a hypochondriac instead of sending me for an MRI when the meds she usually prescribed for migraines weren't working, I'd most likely be dead right now.

      August 24, 2010 at 09:49 | Report abuse |
    • beejeebus

      you do know that fibromyalgia is a diagnosis of exclusion don't you? Fibromyalgia is often difficult to diagnose since its symptoms overlap with many other rheumatic conditions. There is no diagnostic testing for this condition. So all those doctors you went to were making sure you don't have something else that could be worse or treated differently. Don't judge unless you are fully informed.

      August 24, 2010 at 11:11 | Report abuse |
    • FIBROMYALGIA IS ABSOLUTELY REAL

      Bajeebus, you could not be more wrong. Fibromyalgia is a set of REAL symptoms that span everyone who has the condition. I have dealt with this terrible and debilitation condition for over 15 years. It has completely ruined my life. I used to be very active, did alot of volunteer work, traveled, partied, did everything a normal young woman does and then over the years, pain started taking over my life. Now I am unable to have children. Not because I physically cannot but because I had to make the hard decision with my husband to not bring children into this world if I cannot take care of them. My fatigue is unbelievable. I am in my20's and more around like a 90 year old. Do NOT EVER EVER say this is not a real condition. I cry many times because of being in so much horrific pain. NO IT IS NOT PSYCHOLOGICAL> I DO NOT HAVE DEPRESSION. Do I get depressed because of how miserable I feel 24/7 ? You bet your freaking life I am. But I still force myself to work, take care of my husband and ill parents.
      Most of us with Fibro used to be very active and happy people. I am part of a support group with hundreds of us with fibro. Men, women, young, old. We have all tried it all. Acupuncture, massage, biofeedback, pills, vitamins, yoga, exersize, this that this that this that!!!!!!!!!!!!! Pain killers dull SOME of the pain and allow me to work and smile everyday even though it hurts.

      I FUNCTION with the pain meds. I cannot without. They are an absolute necessity for me. They do not make me loopy in the slightest. Study after study shows that people with real pain for the most part do NOT abuse the pain meds because it goes right to the pain. Its not used to get high like it does for people without pain.
      Also , you have to come at this illness in multiple ways. I use one pain medication daily as well as many pure vitamins and minerals to help the other complex issues I have. I get massage, exersize as much as I can... IN PAIN. I never feel better after exersizing but I do it anyways.

      People who deal with chronic pain are real soldiers. I challenge anyone who doubts to feel my pain for just a day. They would not believe what I have to deal with day in and day out.

      So please, do not discredit this illness. It is very real.

      August 24, 2010 at 12:05 | Report abuse |
  4. John

    Good for you Thunder, I am glad you found such a doctor. But if the doctors are "choosing" what they enter then they are skewing the results and maybe allowing drugs out there because inaccurate information is being posted about the drug. If someone is participating in a clinical trial then that should be a part of it as well. Ever play a game where everyone sits in a circle and one person says something to the person next to them. By the time it gets back to them, it is completely different. Doctors are MORE god when they get to "choose"what to put down and because of the "laziness" you mention are more apt to give very inaccurate results which is a bigger problem than having patients enter it.

    August 23, 2010 at 14:02 | Report abuse | Reply
  5. Ingrid

    It sounds like Dr. Danielle Ofri is not a good doctor. I'm glad she put her name on this piece of filth article so that her patients can steer clear of this person. She needs to have her license stripped.

    August 23, 2010 at 14:13 | Report abuse | Reply
    • Michelle

      Care to qualify your reasons for this insinuation? I'd be curious to see why you'd justify stripping her medical license.

      August 23, 2010 at 14:30 | Report abuse |
    • Dave

      @Michelle: Her comment probably has something to do with what the article says about doctors not really paying attention to their patients. Did you even read it or are you spouting off your stupid mouth as if anyone gives a crap what you think? Troll.

      August 23, 2010 at 14:57 | Report abuse |
    • Brandon

      Hmmm sounds like what you are doing now Dave.

      August 23, 2010 at 16:12 | Report abuse |
  6. Lynne

    I think that this is a wonderful topic for discussion. I have multiple serious health problems, and have LOTS of visits to lots of Drs. (Endos, Orthos, Rheumys, Neuros) and it's amazing the differences at each visit. My Rheumy is GREAT, and so is his staff. He always listens, and you can tell he's engaged, and his brain is working on your problem right in front of him. On the other hand, My neuro... Ugh. You really have to work to keep her focused. Sometimes I don't know where her mind is when I'm talking to her, but it certainly isn't in the room with me!

    Some Dr's could really use some help with communication skills... particularly listening... although there are some good Docs out there! Maybe "listening and paying attention" 101 in med school, with refreshers?

    August 23, 2010 at 14:13 | Report abuse | Reply
    • Veggiehead

      Specialists can be like the blind men and the elephant - one examines the tail and envisions a rope. One examines the trunk and says it is like a tree, etc. It often falls to the patient to bring different aspects of a complex physiological problem together. Ideally, your primary care physician would do this for you, and that is how medicine used to be practiced. But I have found that physicians are, these days, unwilling to step into the responsibility (read: liability) zone of another physician. Things can be missed, and problems inadequately treated. Too frequently, the suggested treatment for a malady is medication, since that is the easiest and quickest way to move the patient along. But the meds might treat just one aspect of a bigger problem. And taking medication every day is no solution, in my opinion. It degrades the quality of my life rather than improving it.

      I ended up taking things into my own hands and seeking (very effective) treatment outside of western medicine. Acupuncture, yoga, therapeutic massage, and physical rehab have helped me to change my body physically, to actually lessen the pain rather than mask it chemically. While a few medical groups are embracing alternative therapies - and offering them in-system so that they might be covered by insurance - this needs to happen across the country.

      August 23, 2010 at 14:34 | Report abuse |
    • A.

      Hi Lynne,

      I am a second year medical student. You would probably be happy to know that, throughout first and second year of medical school, medical students have "standardized patients" to practice clinical skills, communication skills, etc. Basically these are actors that are paid to come in and pretend to have a medical problem. After we take the history and physical, we are graded not only on the quality of our physical exam, but also on our listening skills, empathy, etc. Essentially the standardized patient tells us if we were able to establish a good rapport with them, how we could listen better, how we could be more empathetic, etc. Hopefully if this becomes standard practice at more medical schools, there will be more young physicians who have the communication skills you are describing.

      August 24, 2010 at 00:16 | Report abuse |
  7. Veggiehead

    After a couple decades of having doctors dismiss my reports of pain as "just" this or that, I stumbled upon an excellent internist who took me seriously and referred me to the specialists I needed all along. Multiple MRIs revealed physical changes in my brain and neck, and damage to my vertebrae. It is my opinion (and I have heard doctors express this sentiment as well) that the complaints of female patients are more likely to be ignored than those of males, and especially those of females over the age of 40 or so. As a woman, I have seen doctors (mostly males, but some females, too) glaze over or even smirk as I tried to get across just how much pain I lived with. My current primary care physician seems to pick up on every nuance. She has never been dismissive about any problem I reported. I put that down to good listening skills, a natural capacity for empathy, good training and (I suspect) the liability-avoiding policies of the medical group for which she works. All details of each office visit are immediately entered into the computer, by the physician. The information may be translated into med-speak, but it's there, and I have access to all reports.

    August 23, 2010 at 14:13 | Report abuse | Reply
    • Truthisoutthere

      I agree veg. Many male doctors look at women now like they did in the 50's, as a bunch of dramatic and emotional wimps. Screw YOU! I am a person with real pain and issues. I told a doctor once that did not believe my pain that I would gladly take a baseball bat to his back to see exactly how I felt.

      August 23, 2010 at 15:00 | Report abuse |
    • Lily

      You're absolutely right that women's self-reports are taken less seriously by doctors than men's are. And it makes a big difference, because women are more likely to suffer chronic illness and more likely to have debilitating chronic pain. There are a lot of women out there, especially (but men, too, I realize) who are unable to work ONLY because they are not getting appropriate treatment for their health problems. A correct diagnosis and appropriate care can often make an otherwise disabling condition fairly easy to live with and get someone back into the work force.

      August 23, 2010 at 16:28 | Report abuse |
    • E

      and people need to change doctors when one isn't listening. It took 4 doctors telling me I could not be having the problems I was having before I got one who finally said that of course I am having the pain, the ultrasound shows it, unlikely and impossible were two different things.

      August 24, 2010 at 08:35 | Report abuse |
  8. Michelle

    Yeah, it would be nice if all doctors LISTENED to their patients. I'm a biologist myself, with a biomedical background – very intelligent, and I know what I want for myself.

    My GP sent me to a reproductive endocrinologist this past January with a painful enlarged cyst, just a fraction too small to officially warrant surgery. I've got PCOS. I get cysts on both sides, but the painful, enlarged cysts have only happened on the right side since I started having these issues when I was 14. I'm 30 now. The specialist doc basically asked me when I wanted to have babies. I DON'T WANT KIDS. None. NEVER. I want the painful cyst to be removed. It's like a stabbing burning pain through the lower right abdomen (and yes, they checked, it's absolutely NOT appendicitis, thank you). However, as soon as I informed him that I was not there for fertility treatments for PCOS, just to deal with the pain issues, he brushed me off, gave me birth control (which gave me horrible mood swings and suicidal thoughts), and said, "Just wait for the cyst to burst on its own."

    Now, call me ignorant, but a bursting cyst can turn into a medical emergency. Risk of internal bleeding and infection, as well as the patient going into shock from the pain. I know – it's happened before. Additionally, it's been 8 months since I complained about the pain from the cyst initially, and it's STILL THERE. Still hurting. Still feels like a hot knife slowly working its way through my right pelvic area. And they won't remove it. Nope – they just want me to try a new type of birth control pills and they've got me on metformin, and "wait for it to burst."

    Someone tell me why my complaints are being brushed aside. I'd really like to know. I've got insurance. I'm paying for this. And I've been taken to the ER multiple times because the cyst pain got so bad that there was no way to be certain that it wasn't appendicitis. The docs are happy to give me drugs, hormones, metabolic aids, and all sorts of stuff, but not to actually FIX the problem I came in for.

    Even better was the time I went to a doctor with rectal bleeding that hadn't stopped for a month, and he wanted to diagnose me with "stress," "anxiety," a "mood disorder," and a "type-A personality." He didn't even check to find the cause of the bleeding. A colonoscopy and an anorectal manometry test later, a GI doc finally looked and said, "Oh, you've got a fissure."

    I should sue for unnecessary suffering.

    August 23, 2010 at 14:27 | Report abuse | Reply
    • Veggiehead

      Based on my own experience, I'd say you need a female doctor. It shouldn't make a difference, but the difference can be huge.

      August 23, 2010 at 14:37 | Report abuse |
    • Michelle

      Veggie, it's hit-or-miss with female doctors, too. My current GP is a female, and she's awesome (sadly, she's not someone who is qualified or capable of removing the cyst – she's not a surgeon) and supports my wishes to get the cyst removed (in fact, i contacted her again today, asking for a new referral for someone who can remove the cyst), but I've had excellent male doctors, too. I've also dealt with idiot men and idiot women. And some women are even more convinced than men that my ovaries are only meant for breeding.

      It was a male doctor who wanted to talk about "stress" and "mood disorder" instead of treating the damned rectal bleeding that I came in for.

      It's really just a matter of who you get, and whether they take you seriously.

      August 23, 2010 at 14:42 | Report abuse |
    • Angela

      Wow Michelle, that is horrific! This happens all too often. Doctors are like mechanics and lawyers. They are a necessary evil. They know that we cannot represent ourselves in court, perform our own surgeries, or ( especially nowadays) fix our own cars because they are too digital. Sad.

      August 23, 2010 at 15:04 | Report abuse |
    • tom

      Michelle, I'm sorry you went through much pain and suffering, but I can garauntee that your story is exaggerated. Its impossible that you went to the doc with a chief complaint of bleeding per rectum and didn't get a visual inspection of your anus, a digital rectal exam, CBC to rule out anemia (for a month's bleeding) and hemoccult testing. These simple, quick studies are done at even the most basic primary care offices. Is it possible that all these tests were done, and came back normal? If so, what do you expect your doctor to do? The fact that your doctor referred you to a specialist should suggest to you that he/she cared enough to figure out what the problem was.
      Furthermore, if a colonoscopy ruled out Crohn's as a cause of your anal fissures, then its possible that they were due to constipation. Based on your agitated post, it could be possible that you indeed have a type A personality.

      August 23, 2010 at 20:43 | Report abuse |
    • wow

      wow, michelle, for someone who has so-called biomedical knowledge, your lack of understanding is remarkable. Sounds like you were getting appropriate treatment for your PCOS. And frankly, you sounds like a narcotic addict. I wouldn't give you opiates if I were that specialist.

      August 23, 2010 at 21:50 | Report abuse |
    • coupon cook

      I totally get what you are saying. 1 week ago I was finally diagnosed with a rare disease of the adrenal glands. Three years of complaints, A GP (said depression), an Internist (who said I had anxiety and told me to go have a cup of coffee), 3 GYN's. Finally the 3rd GYN took me seriously and ran a test that isn't usually run. I was soon reffered to Endocrinology and he gave me a diagnosis. All because one CBC didn't show anything. I have been overlooked and made to feel like a hypochondriac. male doctors don't typically listen to female patients. Not sure why, but I believe it. The GP I went to, loves my husband.

      August 24, 2010 at 00:44 | Report abuse |
    • E

      I have ovarian cysts that happened while I was on the pill, after four doctors telling me I couldn't be having them I found one who helped, and by switching pills they have entirely stopped. The pill does work if you can find the right one and there are dozens out there. They also can stop the mood swings, cramps, etc.

      August 24, 2010 at 08:40 | Report abuse |
    • rbnlegend

      Look at that, doctors who can dismiss your concerns right on the internet without even seeing you. Who says you need to pay a lot of money to be treated badly by a doctor. I especially like the doctor who can tell you that you didn't have the experience that you had. It must be awesome to have that power of knowing what another person has experienced better than they do, without even seeing them. You are narcotic seeking, uptight and making the whole thing up.

      August 24, 2010 at 09:21 | Report abuse |
    • Andie

      @ RBN LEGEND: I know !!! I cannot believe 'wow' and 'Tom'. What a bunch of idiots. Who the frack do they think they are calling this woman who poured her heart out a liar? They don't know her from Adam! I hope the both of you get a terrible illness and you die a slow and painful death you heartless slugs!

      August 24, 2010 at 12:12 | Report abuse |
  9. cj

    Ok 9 months and 3 doctors later someone noticed that my 40 year old husband's symptoms were real. A rash and runny nose that would not go away were a result of stage 4 lymphoma. If the first doc had just checked his blood there would have been a low red blood cell count. Instead drugs for alergies. Yes my husband is dead.

    My husband noted that his symptoms had been repeated 3 times before the doc said you have had this cold how long? Maybe docs should not call it "patient complaints". The wording of a chart, complaints, patient denies etc makes the patient sound like a questional witness instead of expert one. The cycle gets worse when docs dumb down what they tell the patient. When the next doc does a history the patient doesn't know how to properly describe their condition. Frequently the patient sounds dumb b/c the doc dumbed it down.

    August 23, 2010 at 14:46 | Report abuse | Reply
    • UNKNOWN

      That is terrible. I have no words other than.. I am sorry for your loss. I feel I may be heading down this path with my husband too....

      August 23, 2010 at 15:09 | Report abuse |
    • SHC

      Inexcusable. All you need to do is watch "Mystery Diagnosis" and it's quite clear that doctors do not listen to their patients. We're all hypochondriacs in their eyes. It's getting the the point where I can only afford to get tests every other year... my insurance is so crappy. I'm sure they'll eventually figure out what wrong with me; and then it will be too late.

      August 23, 2010 at 16:59 | Report abuse |
  10. Garry

    I am in full agreement on the need for doctors to listen to their patients and not dismiss what they say. I have two who do that, a cardiologist and a general surgeon. Because of the way they treat me and respect my opinion, I will follow these two doctors to the ends of the earth it necessary for my care.

    August 23, 2010 at 14:48 | Report abuse | Reply
  11. Janice

    This article just reinforces the hypocracy in medicine today. Most "doctors" have overblown egos, that sorely need to be reined in. I feel the only way to get through to these folks is to hit them in the pocket book and refuse to continue going to them. Even when you know your body and refuse to do something just watch them totally become highly irritational idiots.
    Remember when becoming a doctor was a humanitarian calling? Now all these overeducated folks want is to become millionaires. Enough said!

    August 23, 2010 at 14:50 | Report abuse | Reply
    • wow

      janice, you are just a hypochondriac. I don't want to listen to you. You are just a crazy woman.

      August 23, 2010 at 21:51 | Report abuse |
  12. Me

    'Patients often report symptoms much earlier than did doctors. Several studies have shown that patients’ report of symptoms correlate more accurately to actual health status than did the doctors’ reports.'

    WOW!!!!!!! Do you mean to say that the patient knows what is going on with THEIR BODIES better than the doctor? Un-freaking-believable!

    August 23, 2010 at 15:14 | Report abuse | Reply
  13. Jill

    This discussion couldn't have come at a better time. I am in the middle of this with my primary physician. I having been going around with him the better part of 2 years about pain related to spinal fusion in my neck,bulging disc below the surgery site, chronic pain and permanent nerve damage in my shoulders. I have been through meds. I wish I could go back on pains meds, but most drs. will not prescribe them, lest you become addicted. Have been in physical therapy every year and have capped out the benefits every year. I have been to 2 neurosurgeons... one who hustled me out of his office in 10 minutes, with all he could do was offer me muscle relaxants. I was very upset, it was his first day at this office and didn't have my records from the dr who did the surgery. He was very rude when I couldn't produce answers fast enough (actually motioning to me to go faster). He was incredulous that the surgeon did surgery after all other courses were exhausted. Didn't actually get to tell him that the surgeon cuts his chops at Bethesda and Johns Hopkins, so it wasn't a podunk doctor that did the surgery. Anyways a second opinion with another neurosurgeon, who I waited 2 hrs to see (wait because he was an hour and a half away)really didn't take me seriously either. Was sent to a rheumy because prim dr thoughy may psoriatic arthritis, prednisone gave me palpitations,tried Enbrel that went well until after 6 doses had a bad reaction (puffy eyelids,sore in every joint not limited to the initial complaint. Long story short, rheumy told me there was nothing else that he could do for me, suggested I go to Mayo or UI at Chicago. I kicked up a fuss, not knowing what to do,left with no diagnosis given. His office called my prime who wants me to come in to talk about my "chronic pain". Oh, and he will not call you back personally, he lets his pitbulls in scrubs do that. When I asked to have a phone call back from him, they either say he's not going to do that or when I ask to speak to him right then the nurse says I'm not going to do that. Unfortunately I live in a small town and he knows he's the only game in town. That's what it is,it is all a game. Turn and burn patients, collect the copay and the insurance payment, cut them lose when they challenge you about their diagnosis... Sorry for the novel!

    August 23, 2010 at 15:49 | Report abuse | Reply
    • RJ

      Sorry for the novel?? I bet your doctor isn't the only one who doesn't want to talk to you.

      August 24, 2010 at 01:22 | Report abuse |
  14. The_Mick

    As a scientist, I have always pleased my doctor by describing symptoms objectively and carrying in a table of recorded bp, pulse, etc. readings. Part of the problem with people in general is that they tend to be very subjective: "My sugar level is always under 100 when I wake in the morning," etc, so the doctors HAVE to make some changes in reporting information.

    August 23, 2010 at 16:36 | Report abuse | Reply
    • Faith

      Funny, I went to a doctor with a BP and Pulse chart showing how my pulse went from 76 lying flat to 160+ standing up, as well as a list of things about my body that were not behaving the way they should have been. The doctor glanced at the two pages that I'd spent quite some time getting carefully written up...and tossed them aside and proceeded to lecture me for being "too thin" with an obvious hint at an eating disorder. No amount of trying to explain that I DO eat, I eat a LOT, and I've always been thin would get her to listen to me. I'm small, not emaciated. I left the office so thoroughly furious that I've just dealt with the constant exhaustion, wooziness, aches, nausea...to avoid having to feel that way again.

      August 24, 2010 at 01:55 | Report abuse |
    • G

      Faith, you're probably hyperthyroid. Go see someone else and get a thyroid profile drawn.

      August 24, 2010 at 09:11 | Report abuse |
  15. Bob

    I would love to see more Doctors trained in promoting health, than just treating disease.. our healthcare system is basically sick care.. More holistically trained doctors, i would like to see..

    August 23, 2010 at 16:43 | Report abuse | Reply
  16. Hazelnut

    One of the must frustrating things to me is to sit in the waiting room for 30-45 minutes after my appointment time even though I arrive at least 15 minutes early to allow time to fill out paperwork, and then have my doctor rush through the appointment and have me out the door while I'm still asking questions. Doctors should allow for more than 15 minutes with each patient. If patients seem to "stockpile hordes of complaints", maybe there is a reason for that... perhaps because they don't want to have to waste an hour of their day waiting for a 15 minute appointment. A lot of people have to miss work for appointments. Or maybe it's because some people have a co-pay for each visit and cannot afford it. Whatever the reason, it's still your job to listen to all of the complaints and find a solution, no matter how long it takes.

    My mother went to the doctor in the spring complaining of tightness in her chest. Her doctor was too busy talking about moving that he didn't even bother to listen to her heart. Instead, he prescribed her a muscle relaxant and sent her on her way. I'm no doctor, but given the symptom, even I know to check the heart. It turns out she was having mini-heart attacks all week long. She ended up in the emergency room with a 99% blocked artery and had to have a stint placed. She's lucky she made it through the week.

    I don't take it lightly when a doctor fails to listen to their patients. It could be life threatening.

    August 23, 2010 at 16:49 | Report abuse | Reply
    • A.

      Hazelnut,

      As a second year medical student, I share your frustration about the 15-minute visit problem. Since starting medical school, I have learned that primary care docs keep the visits short so they can cram as many patients as possible into the day. This is not so they can make more money; rather, it is so they can keep the doors of their practices open. Many medical students are graduating with $250,000+ of debt; that plus the cost of running a medical practice makes it so that most primary care physicians are not seeing a huge take-home pay. Many of my classmates and I would love to go into primary care, but hesitate for the very reasons you are describing. Personally I would love to be a primary care doc. I love talking to people as much as I love medical science, and I would love to spend a good long time with each patient, but as of now, I literally could not afford to do so. I am not trying to give you excuses, because I certainly agree that things need to change. Rather I wanted to say that medical students (and many physicians) share your frustration about the short visits. What happened to your mother is a terrible reflection on our health care system. I hope she is doing better now.

      August 24, 2010 at 00:06 | Report abuse |
    • ps340829

      Hazelnut, unfortunately, it's insurance companies that mandate how many patients or hours a physician sees or keeps in a day. It's not the doctors. And the insurance companies have unrealistic expectations for what doctors can do with the amount of patients they can see in the amount of time given.

      August 24, 2010 at 09:57 | Report abuse |
  17. Thomas

    For what it costs to spend 10-15 minutes with a doctor the S O B better be listening to whatever comes out of my mouth. They can have their God complex on their own time.

    August 23, 2010 at 16:51 | Report abuse | Reply
    • SHC

      Money is their God.

      August 23, 2010 at 16:56 | Report abuse |
    • YES

      I agree 100%. Its funny how the people who do the most good get paid the least and those that do the least get paid the most.

      August 23, 2010 at 17:06 | Report abuse |
    • joe

      Yes-
      You are right. Our elected officials get very well compensated for doing nothing.

      August 23, 2010 at 21:12 | Report abuse |
  18. SHC

    Doctors have five minutes to spend with each patient (at least in the city), have heard every story before, and know exactly what's wrong with you before you even walk in the door. They send you from specialist to specialist, getting kickbacks from each appointment and test. Thousands of dollars and several years later, you still have no answers and are still getting bills from the specialists. As I approach middle age, I realize I will need to leave the South and move closer to the Canadian border. I'll pay cash for medical procedures there which cost even more in the U.S. using my health insurance.

    August 23, 2010 at 16:53 | Report abuse | Reply
  19. marsha

    I am sooo sorry to hear how some of you are being treated by your primary and your specialists. I love my primary and I know she feels the same about me..or why would she give me her personal email and cell number. My endocrinologist is great too. I think they are the reason why I haven't moved. It is so hard to find a great doctor.

    August 23, 2010 at 16:57 | Report abuse | Reply
  20. tony

    It's called narrative medicine doctor.....and you fail!!
    The whole point is, that after years of experience, you filter relevant from irrelevant.
    It's not a vice..........it's the WHOLE POINT

    August 23, 2010 at 17:10 | Report abuse | Reply
  21. Graverobber

    This chick sounds like some 20 something fresh out of medical school with an ego the size of California. No doubt a privileged twit that deserves none of what she has.

    August 23, 2010 at 17:16 | Report abuse | Reply
  22. Bennett

    The difficulty is in training up a whole new generation of Docs to think and act differently. Not every medical school does this. Not every residency program fosters this. Bad role models promote bad behavior...it's so easy to fall into the trap of acting like House when the patient wants Patch Adams.

    I'm involved in redesigning the medical student curriculum at our medical school...but you'll have to wait for about 8 years to see if the Docs that come out are any better than what we did before. I'm teaching patient-centered care – discover, validate and address patient concerns. Explain things. Negotiate a plan. It's really not that difficult. There are about 70-80 communication skills that can be taught to Docs that ought to remove just about every patient complaint about their doctor – it's just so sad that so many Docs don't even know what they are, never mind are able to use them.

    The patient shouldn't have to advocate for themselves to make up for the inadequacy of their doctor...but I can see from the comments above it's all too common. Patient-centered care means more accurate diagnoses, better follow-through of plans and more healthy patients – not to mention happier Doctors and fewer lawsuits to boot. This has been shown in research studies for over 30 years – why we haven't been training Docs like this for over 30 years beats the hell out of me.

    August 23, 2010 at 19:38 | Report abuse | Reply
    • rbnlegend

      I'd love to see a House, bad attitude and all, so long as he is driven to discover the underlying problem and not make a 5 minute diagnosis and see in you a few weeks. It'd be nice if I could get a pleasant attitude to go with it, but that's totally optional. The new doctor my wife found who is motivated like that told us "I may end up making you wait for a long time, and I will be running later as the day goes on. If that's a problem, you will have to find someone else." but we are ok with that, because once the doctor got around to seeing my wife, the doctor spent over an hour going over records, asking questions, and doing the work that it takes to actually diagnose a problem, rather than looking for a diagnosis code that fits and sending the patient out to billing.

      August 24, 2010 at 09:31 | Report abuse |
    • Medic

      The thing about House, though...all his patients die at least once. He's also the guy that everybody is complaining about – rude, curt, with no time to spend actually listening to his patients.

      Unfortunately, that's the role model that medical students have these days.

      August 24, 2010 at 09:55 | Report abuse |
    • Biff

      As a chronically ill person who is in and out of doctor's offices, I think I would hate that show House. I have seen bits and pieces of it and the last thing I want to do is entertain myself with something that is all to real and TRUE about doctors.

      August 24, 2010 at 12:30 | Report abuse |
  23. Kaci

    I have been to 4 doctors concerning my thyroid. Do they listen? No.....each time I tell the doctor I am allergic to the medicine synthroid, but none of them want to hear that. So, finally I just quick taking anything it.....wait and see right now, I sure don't feel any worse For not taking the medication. Synthroid, and Armour, there has to be more out there for this problem. Armour brought on symptoms like RA, after I stopped taking it the symptoms quit. I don't know....there all in it for the money....they never listen....and they definitely don't want to Hear of any problems with the drugs.

    August 23, 2010 at 19:49 | Report abuse | Reply
    • joe

      Kaci-
      I envy you. You know, because you don't work for money, just satisfaction.

      August 23, 2010 at 20:22 | Report abuse |
    • Bobby-future doc

      Kaci, I'll be honest, if I wanted money, medical school would have been FURTHEST from my mind. Why wait? Why spend 10 years of my life stuck in a book sacrificing family and friends and relationships? I have friends in business making more than I will doing less and truth be told... their goals are a lot less noble than saving lives... rather mergers and aquisitions

      August 23, 2010 at 23:50 | Report abuse |
  24. Ragu

    You guys are dumbasses

    August 23, 2010 at 19:57 | Report abuse | Reply
    • Ragu

      no wonder your doctors don't listen to you.

      August 23, 2010 at 19:59 | Report abuse |
    • Dale

      Ragu? Please go off yourself. Thank you.

      August 24, 2010 at 12:32 | Report abuse |
  25. Anonymous MD

    The reality of the situation is that, to some extent, everyone who has posted their opinion here is right in some way.

    Yes, there are some doctors who are arrogant and don't listen to their patients. But there are also some patients who are hypochondriacs and repeatedly waste doctors' time with a laundry list of "symptoms" that are actually descriptions of normal bodily functions, leaving us less time to spend on patients who have real problems that need to be addressed.

    As a patient, I want a doctor who listens to me and takes me seriously. As a doctor, I want a patient who treats me with the same respect I treat them, not someone who comes in with a chip on their shoulder because of a previous bad experience. We all lose when we develop biases against groups of people (patients or doctors) based on the worst examples of each group. And when the patient or the doctor comes in to the encounter with some prejudice, both parties lose and no one gets good health care.

    So doctors, give the patients the benefit of the doubt and treat them as you would want to be treated. Listen to what they ae saying with respect and concern. And patients, give the doctors the benefit of the doubt that they truly are trying to help you, unless you have a real reason to think otherwise. All this name calling just hurts everyone. Doctors as a group don't deserve to be bashed any more than any other group of people do.

    August 23, 2010 at 20:03 | Report abuse | Reply
    • joe

      A very well-measured response.

      August 23, 2010 at 20:16 | Report abuse |
    • tom

      I coudn't like this post more.

      August 23, 2010 at 20:46 | Report abuse |
    • Jacob Murphy

      I agree with Joe and Tom. Good response – clearly from someone who understands both sides of the issues.

      August 24, 2010 at 07:56 | Report abuse |
    • Sortiri

      best read yet!

      August 24, 2010 at 08:09 | Report abuse |
    • Previous employee

      I worked in a medical office and there is a big difference in each doctor, as a patient, if there is not a good "fit" between you and your doctor, you need to find someone else. Personality and skill have to match your needs, you might have to go to several different doctors to find the right one. But just as all patients are not the same neither are all doctors, so neither group should be painted with one brush.

      August 24, 2010 at 09:21 | Report abuse |
    • Anonymous Patient

      MD: 99% of the doctors I have seen in my lifetime were all rude and inconsiderate. If I have 2 out of 50 that were nice, would I be wrong to be a tad angry and frustrated with doctors in general? We are not talking about a bunch of rude waitresses at a string of restaurants. We are talking about people who have the power of life and death in their hands. We ask that they listen and help. That is their job. Ask any random person on the street. The majority of us have had horrible doctor experiences. This is not the exception but rather the unfortunate rule it seems.

      August 24, 2010 at 12:36 | Report abuse |
  26. George

    I am a 4th year medical student, going to be a Dr. next year, God willing. But I have never, ever, heard a Dr say anything related to wanting to screw a patient over. Many of the Dr's I have worked with the exception of a very few, are compassionate, God fearing individuals, who put their patients first. Because you see them for a couple of minutes a day, does not mean they are not thinking about your case for the rest of the day, researching the latest treatments, ruling out differentials, trying to provide the best medical service evidence based medicine recommends.

    August 23, 2010 at 20:11 | Report abuse | Reply
    • GET OUT OF YOUR BUBBLE GEORGE

      Okay. So if you have not gone through it, it must not be true then right? Since YOU personally did not have to live in a concentration camp, then they must exist. Since YOU did not get killed on 9/11 then it must not be true right? People are not making this up for no good reason. Get out of your bubble and wake the freak up dummy.

      August 24, 2010 at 12:39 | Report abuse |
  27. joe

    Wow. I never realized what a bastard I am! I am a surgeon, so I guess I come from a "priviledged background," I have a "god complex," but I am merely a "public servant." You people should come and see me, then you wouldn't be making such rash generalizations. What some of you fail to realize is that when a surgery is botched by another physician, there is sometimes nothing to be done about it. Research who you allow to operate on you, then maybe you will be happier with your outcome. And I love the comments about how I should listen to and diagnose numerous complaints, but then the very same person turns around and complains about having to wait for an appointment. When you make an appointment for X, I schedule time for X. When you spring Y and Z on me, that makes me late for everyone who is behind you. You see, I schedule more than two patients a day, because there are many people who need help. If every doctor in the country set aside an hour for each patient they saw, how long would the wait be for an office visit? Six months? Then I would be a bastard for that. There is no winning in the court of public opinion. All I can say is six years in a surgical subspecialty with one complaint – because I couldn't do an elective surgery within a week. You know, before the patient had a cardiac stress test and saw her medical doctor. Although after reading here, that is simply a testament to my greediness and pursuit of money. As if all of you hypocrites work for the love of your job, and not because you need a paycheck. Grow up! If you don't like a doctor, find one who listens. We are still out there if you look. Just remember that the physician-patient relationship is a two way street.

    August 23, 2010 at 20:15 | Report abuse | Reply
    • Janine

      I think what we need to talk about here is that not all "doctors" are the same. Some doctors have MDs, some have DOs, and some are nurse practioners (and, yes, they too can get degrees that make them a "doctor" just as your dentist can).

      I find that the main problem is with MDs who are not specialists. I have never had a problem with an MD who was a specialist–because that person (and this includes the surgeons I have had) know their particular area very well and are not surprised when patients report issues. The pain management doctor I saw was in no ways surprised when I reported not being able to lie down, pacing because it was the only thing that gave me relief, and getting (at best) two hours of sleep a night. He gave me medication that helped and also provided a treatment that helped.

      My MD, primary care physician, had rolled his eyes at me and scoffed when I reported these symptoms. This is the same MD who told me the medication I was taking could not cause weight gain (checked WebMD–it is one of the first side effects listed now–I don't think it was then, which is why he ignored me). This is the same MD who scoffed when I reported having trouble with digesting anyting remotely sugary because my blood sugars were (then) fine–I am now diabetic. This is the MD who–by ignoring my concerns about pain, metabolizing sugars, and weight gain from the medication he had prescribed–has shortened my life by about 30 years.

      Now, I see a DO–and she is a delight. My daughter has been to see nurse practitioners (as they are inexpensive), and they take the time to listen. It is my opinion that MDs who are GPs are trained in such a way as to ignore patients and to concentrate instead on their tests, not wanting to admit that the tests are often wrong. When one goes to another doctor, and finds out what is actually wrong, the MDs never find out (because they don't share information). Or, the MDs think that the other doctor is wrong and just caved in to the patient's whining. The real problem is that MDs are not in a system which allows them to see just how frequently they are completely wrong–their isolation from one another and from the outcome for patients they have scoffed at keeps them convinced they are perfect.

      I think that MDs who are specialists are often just fine–one runs into the occasional creep, but then, any profession has real creeps in it. But, MDs do not make good primary care physicians because THEY DO NOT LISTEN TO PATIENTS. I think that patients should first see nurse practioners or others who are specially trained to listen, glean the important information, and then send the patient on if needed. I also think that most of us should have DOs for primary care. Let the MDs become specialists so that they can make more $$$ and pay off their loans and relieve them of the need to listen to patients prattle. Fair enough?

      August 24, 2010 at 04:21 | Report abuse |
    • rbnlegend

      Joe,
      I understand what you are saying about time and all, but at the same time, if the doctor spends 5 minutes with a patient, doesn't look at the history, doesn't listen to all the symptoms, dismisses the patients concerns, and fails to diagnose the problem, how does that help? He may see a lot of patients, but it does them no good. There's some balance between the two extremes that is needed. Sometimes a patient needs to be able to schedule time with a doctor and expect to actually get an hour, or two hours, with that doctor, just to get the diagnosis. If you are a surgeon and a specialist, by the time they get to you, the problem is narrowed down, and you probably do allocate roughly enough time to do what has to be done. You certainly allocate enough time for a surgery, plus routine overage, right? You don't get 45 minutes into a surgical proceedure and say "oops, times up, I have to go to the next case, this looks good, schedule a follow up in two weeks" you allow enough time and when there is something unusual that causes the proceedure to run over, you do the whole proceedure, with just as much care for the very last step as you did for the first. That's not the case in general practice. That's not what most of us see. The first sentence out of your mouth, combined with weight and gender is your diagnosis, sometimes less if the doctor interrupts you, or misunderstands you.

      Last winter I threw my back out shoveling snow. My second visit to the doctor, I had a crutch with me, because it made getting around easier and gave me something to hold onto when the spasms hit. The doctor wanted to treat my leg, or foot, and wouldn't listen to "it's not my leg, it's my back," because she saw the crutch, and crutches mean legs or feet. I'm not saying you are a bad doctor, but I am saying that in my experience, doctors who listen to patients are few and far between.

      August 24, 2010 at 09:47 | Report abuse |
  28. John

    I say we make doctors illegal and let all the idiots die.

    August 23, 2010 at 20:45 | Report abuse | Reply
    • Bobby-future doc

      Well John, keep that in mind next time you are sick/injured. If you feel that you can set your own broken bone, remove a gall bladder, investigate your symptoms and properly diagnose and treat what you have, then by all means, please do. Should you get stumped (it can happen... a doctors education is 8-10 years long not counting college and fellowships... and some of those books are pretty big and detailed), please come and see one of us. Because even though you say we should be banned/killed/ect, we will still treat you, because what is what we do.

      August 23, 2010 at 23:47 | Report abuse |
  29. Sonya

    I have numerous complaints about doctors including how long they expect you to wait even though you arrive on time or early. One time I waited 4 hours just to have my blood drawn. I've seen dermatologists that don't even speak at all. The nurse practioner does all the prep, asks about symptoms, records notes, etc. and the doc comes in for less than 2 minutes to perform the treatment then promptly leaves! In that kind of situation there's no chance to ask the doctor anything. There are so many bad doctors out there who really don't care about their patients. It seems they are there simply to collect a paycheck just like the cashiers at Walmart! I don't trust doctors and I think patients are far better off researching their symptoms online. You get much better, more detailed information by researching symptoms yourself. My mother suffered for years and years before finally finding a doctor who diagnosed her with hypothyroidism. It should not have been a mystery to any doctor she'd seen because we have a family history of Thyroid disease. My Grandmother died 2 years ago of bladder cancer. She had a doctors appointment once a month for years with the same doctor and every month she told her doctor about her horrible bladder symtoms that were keeping her up at night. This stupid doctor kept prescribing her antibotics for bladder infections that only treated her symptoms. He never investigated further until finally she was diagnosed with a very advanced case of bladder cancer. She finally went to a specialist who gave her and my uncles the devastating news. Had she been diagnosed sooner, she'd still be alive to today. She had a very strong heart, great blood pressure and was not on any medication until she got cancer at the age of 83. Many doctors do the absolute minimum that the have to while they are in the room with you and then get the heck out as fast as they can. The only time they actually want to talk to you is when they are trying to drum up new execuses to bill your insurance. This is a fact.

    August 23, 2010 at 20:46 | Report abuse | Reply
    • joe

      Sonya-
      It is not "a fact." While I am sorryfor your loss, that's like saying that because a cop was rude while giving me a speeding ticket, that that equates to all police officers abusing their authority. Or, because someone was held up by an African American, that can only mean that all African Americans are criminals. Offensive, isn't it? Well, when I stay up at night worrying about my patients and fretting over what to do next, that too is offensive. Just because you say it is so does not make it a "fact."

      August 23, 2010 at 21:04 | Report abuse |
    • Dana

      JOE:

      Its obvious you are one of the rare good doctors. That is good for you ! But, the facts speak for themselves. Most doctors are self-righteous scum. Time to accept that. Be the best doc you can be but don't dismiss the fact that crappy doctors exist.

      August 24, 2010 at 12:43 | Report abuse |
  30. Reesagirl

    I'm all for being your own advocate and I truly try to stay informed about health issues and be straightforward with my doctors as to my symptoms and concerns. I try to be as knowledgeable as possible about the conditions I have so I can speak intelligently with my doctor and together determine a good course of treatment. That being said, I don't have the benefit of years of medical training, so at some point, I expect the doctor I see to tell me what's wrong and how to fix it. Maybe I'm crazy but isn't that what they are there for? And how can they treat me if they don't listen? I've had my health jeapordized more than I care to think about by doctors and staff who couldn't be bothered to listen. Once, while pregnant, I had to go to the ER when I began bleeding to find out I was a negative blood type and needed a series of shots to help me carry my baby full term...something my OB-Gyn knew two weeks before and neglected to follow up on!!! I've had doctors run all kinds of tests because they could, not because they were needed, and doctors who prescribed medication for something that wasn't remotely related to my symptoms. I've had doctors that tell me to do something but won't or can't tell me why. It's beyond frustrating as they are supposed to be the experts, but instead, we as patients are treated to enough bad ones, that we can't trust the good ones, IF we can find them. And who loses in the end? We do, as our health deteriorates and eventually our insurance drops us due to all the tests we get run and we can't afford medication, and on and on. Doctors please note, yes, we know there are hypochondriacs out there, but please really listen to us before you decide we all are. Some of us are seriously trying to be healthier people and need your guidance and expertise to accomplish that. In a perfect world I guess...

    August 23, 2010 at 20:51 | Report abuse | Reply
    • joe

      You are correct that knowledge is power. When I am discussing a treatment plan with a patient, I give them all options beginning with doing nothing, and increasing up to complex surgery. I give them the pros and cons of each option, and get their input. Then, THEY make the decision. It is not my body – it is theirs. I am there to offer them treatment options, and with my help, they decide what is best for them. That being said, you would be amazed how many people act horrified by this – "Well YOU'RE the doctor!" I wonder how many people like that are smearing us on this discussion board. Do you go to buy a car without researching it? A diamond engagement ring? Probably not. Why would your body be any different?

      August 23, 2010 at 21:10 | Report abuse |
  31. DaveSo

    I've been blown off by too many doctors during the visit. One was telling me stuff as she was running from the room for her next appointment. Guess what?
    They have to se a specific amount or more of patients per day. They cannot spend much time with each so they don't have time to LISTEN.' They all seem preoccupied. Too much on their plates?

    If I had a choice, I would never go to another doctor in my life. Thing is , I don't have a choice ... so now, that is really a dilemma, isn't it ? Big bucks, a bunch of which insurance doesn't cover, and crappy service. I honestly wonder what's up with how quick they throw a bunch of pills at you. Treat the symptoms and let the cause take a good hold on your body. That way, they can milk you for every dime you own.

    August 23, 2010 at 21:46 | Report abuse | Reply
    • sampler

      Due to the way that U.S. health system is setup, a doctor does NOT have a financial incentive to cure you or find the cause of the issue. They get paid by the procedure and thus the more drugs they prescribe, the more issues you will have, the more procedures he will do, the more money he will make. Curing you is not in his benefit because curing you means losing a repeat customer...

      August 23, 2010 at 22:42 | Report abuse |
    • Bobby-future doc

      I would be interested to know about your diet, how often you engage in physical activity, your ht and weight, do you smoke, do you drink, ect...

      If you live a healthy life style, then bravo. This is a general point...
      When people don't care for themselves, a doctor ls left with less and less treatment options. We need to be more and more invasive. A person's best means to health is NOT their doctor... its caring for themselves. Much like a car... if you change the oil/brakes regularly, drive it properly, and care for it, it will last. When you don't and you bring it in to work on it, it is no surprise that the repair list becomes more and more invasive and costly... So, Dave... If you are healthy, bravo, and I apologize for whatever brings you to a doctor. If you do not, then you are creating your own peoblems, or at the very least making things worse.

      August 23, 2010 at 23:42 | Report abuse |
    • rbnlegend

      If you are healthy, you don't come to a doctor with chronic hard to diagnose health problems. If you are going into medicine looking forward to healthy patients, you are going to be disappointed.

      Take a look in your medical books. How many medications list weight gain as a symptom? What are those patients supposed to do when, after 5 years on medications that cause weight gain, their doctor wants to treat their weight and not their health problem? How many health problems cause weight gain? Do you think that those patients can lose weight with diet and exercise, when they are in misery due to their health problem, which is causing the weight gain in the first place? If the patient has arthritis and standing up causes severe pain, how are they going to lose weight so that you will be able to see their arthritis? If they have PCOS, and have been dieting for 3 years, are you helping them by telling them to lose weight? Is the patient going to cure meningitis by going on the south beach diet? Is a little extra time in the gym going to put their cancer into remission?

      August 24, 2010 at 09:58 | Report abuse |
    • Dana

      @ Bobby-future doc: Did you read what Rbnlegend said? You are going in the medical field to treat ill patients. What the crap else did you think you were doing !!??! People don't go eat at a restaurant if they are already full! Oh, and stop blaming the patients already. Yes there aer people who smoke, drink excessively, etc but don't lump everyone in the same category. I have a major pinched nerve in my back. I am in excrutiating pain daily. Am I overweight ? NO. Am I sedentary? NO. Do I smoke or drink? NO. Does that mean I wont have any health issues? NO! Where have you been? You can do everything possible and still contract Cancer or something else and it is not your fault.

      August 24, 2010 at 12:49 | Report abuse |
  32. charls

    The way doctor's and other medical professionals gather information about patient's problem is completely wrong. It would much better if the patients had an interview before seeing the doctor. What should be done is have the patient have an interview with a computer touch screen showing the human body. The patient could point out their particular problem and the part of the body that has the problem. Each part of the body would produce a list of questions that body part. The patient then could answer the questions. All of the information given by the patient could be saved for future use. The computer could analyze the description and give the doctor a possible list of problems and possible solutions. When the doctor and patient meet, they could the specific problems that the patient has identified. Of course the doctor could explore other problems when talking to the patient but at least the concerns of the patient could be addressed. Doctors are human too and can forget important questions while a computer will always ask about them. The computer is just a tool to allow doctors to better serve their patients.

    August 23, 2010 at 22:05 | Report abuse | Reply
    • wow

      All you people are doctor haters.....snffff.snnnfff. haters hate

      by the way, I hate all you haters !!!!

      doctors rule !!!!!!!!!!
      they are the best ever, they are underpaind, awesome aweseom
      best awesome , awesome, awesoem,
      best
      best
      best

      August 23, 2010 at 22:12 | Report abuse |
  33. sampler

    Given my experience working for a health insurance company, when I go to the doctor I treat it the same way as when police officers pull you over for speeding. Keep it REALLY short and only focus on the item that is causing you the issue. Remember, anything in your medical record CAN and WILL be used against you by the insurance company.

    Does that mean that the doctor does not have the whole picture - absolutely, does that also mean that it might endanger my life and health, again yes. So why don't I want to provide the full picture - because once your medical record goes to electronic format where it can be shared by all doctors, it will not be long before it will get compromised. If we can't secure our credit information then we have no chance of securing medical information regardless of the laws protecting it - THAT IS A FACT.

    August 23, 2010 at 22:36 | Report abuse | Reply
  34. glen

    first off - i am a doctor, second - i am a specialist; now that i have gotten that out of the way i have a few recs for people when seeing their doctor - the most important aspect of finding a good doctor is finding someone you are comfortable with - sometimes it is a doc with personality,smetimes it is one who listens, sometimes it is one who focuses only on the issues - and maybe reassures and maybe tests a lot - it all depends on a patient's personality what he or she will like; but i think the most important thing that can be done to assure patient satisfaction and happiness is an open line of communication - patients should be able to question why a test isbeing ordered and what impact it will have, and patients should have access to lab data and other tests that have been run on them. i take care of many comlplicated patients and the ones that do best are the ones that take time to understand their diseases, understand the treatments and what the results of the treatments mean.

    August 23, 2010 at 22:48 | Report abuse | Reply
  35. Bobby-future doc

    I am currently in my second year of medical school and have some thoughts, but before you judge me and where I came from I'll offer up some of my background
    -I'm not priveledged. Less my father, I am the first one in my family to go to college, first to go to grad school, and now first to go to medical school. I have earned every step of the way with hard work, scholarships and jobs.
    -I am not young. I decided to go to medical school at 27, I am now 28.
    -I have worked every job from painting houses, waiting on tables, as an EMT on an ambulance, and all between.

    That said, I have a few observations:
    -people want everything and nothing. People want to be first in line for treatment, have every test under the sun done, all to rule out what sadly may be a remote possibility and yet a very harsh reality. Yes. This costs money. Yes you deserve all the care in the world. Yes we try to provide just that, but as you all so aptly point out... we are not God nor do we pretend to be.
    -the 45 min you spent in the waiting room was because the person before you needed 45 min. While it was not convinient for YOU, it may have been important for THEM. Just as tomorrow will become today, the patient you will be is the person I just saw. Each and every patient is important and deserves time. That being said, please don't complain about the wait... You dont stop in the waiting room to apologize to the rest of the people waiting do you? Because I have news for you... you're the one who took up 45 min.
    -you scoff at my paycheck... I will spend over a quarter million dollars on my education, MYSELF, out of my pocket. I have sacrificed friends, family, my fiancee's sanity, EVERYTHING, all for what I consider to be the supreme priveladge of caring for my fellow man. There is no more noble thing. Be that as it is, please do not chastize me for being paid for time served, especially when a single mistake will end my career. I embrace it knowingly, but for that sacrifice, we have earned what we get.

    I have spent my life striving toward this goal. Someday I may care for one of you. I will give of my time, I will exhaust my mental and physical well being to be the most competent and caring doctor you will ever meet. No, not all of us think like that... then again, not every grocery store clerk has a smile on their face. We all do the best that we can...
    I just emplore those posting on this forum complaining of wait times/mean doctors/ect... take a moment and reflect on how the doctor you think has put themselves on a pedastal is really nothing more than the kid next door to you, the boyscout who worked their way thru college, the one who sacrificed more than 10 years of his life, all to take care of you and those you care about....

    an one final note.... because I can't reiterate it enough....
    The waits you experience in a docs office may just be because the doctor is giving an attentive ear to the patient before you... the very same treatment you expect, and deserve.

    Thanks for listening.

    You may chastize

    August 23, 2010 at 23:30 | Report abuse | Reply
    • Elena A

      Bobby-future doc – keep it up! There will always be those abusing the system, complaining about the system, etc. I like this article, not because it makes many people get defensive, but because it offers some constructive criticism and ideas on how to possibly improve the system. Many of the defensive responses from both the patients and the medical professionals do not go there. Also, people forget that doctors and nurses get 'sick' too and make the worst of patients. They know what should be asked, documented, and done, and wow if it does not!
      I am an RN in the military, currently training to be a family NP, and our 'free' healthcare system has its own set of good and bad. Mostly, the patients are very appreciative and it's great to be a part of their life when they need you most. Many docs wish for a $5 copay because that might stop those coming in for literally every time their 2 year old has a stuffy nose. Many docs wish to pay $5 to those who forget to come in to follow up on their Diabetes. 🙂
      My advice to patients – if you worry about what the doc is filtering or writing down, then exercise 5+ days/week, eat healthy, drink a glass of red wine, stop smoking, love your spouse, breastfeed your kids, read, go to your preventive health appointments. This will keep you and your family out of there and if you do break down, your doc will know that something is truly not right with you.

      August 24, 2010 at 09:29 | Report abuse |
    • rbnlegend

      Bobby,

      I appreciate your hard work and I hope that when you are in practice, you are able to put those ideals into practice. If the doctor is late, but then is willing to spend extra time with me (or my wife) to resolve a problem, I am ok with that. It's when I wait an hour for a doctor who won't give me five minutes to explain my problem, and doesn't ask the obvious questions, that I really have a hard time giving them the benefit of the doubt.

      Elena:
      My wife was spending 1-3 hours in the gym every single day, eating healthy, never smoked, getting enough sleep, basicly living a healthy life. Then she started having chronic flu-like pain that reduced her ability to go to the gym. As you know, muscle weighs more than fat, and someone with a heavy exercise routine can have a high BMI with a low body fat percentage. The reduction in exercise led to weight gain and muscle loss, and the increase in pain further reduced her capacity for exercise. Two years later, doctors wouldn't listen to her symptoms and just told her to lose weight. 12 years later we find out she has celiac, and chronic strep. It would have been nice if a doctor had paid attention to the symptoms, and not the weight.

      August 24, 2010 at 10:18 | Report abuse |
    • Elena A

      rbnlegend – I'm sorry to hear that it took this long for someone to connect the dots, but sometimes that's what it takes. As much as we would want to run every test available to see why one is having flu-like body aches, etc, it's not cost effective. Certain conditions can be recognized as having a triad or a certain combination of symptoms, but even then, it's only a certain % of patients. As medical professionals, we have to also be responsible and keep the healthcare costs down. This is why most of the time, we have to wait and see if certain symptoms will resolve on their own. It's a sign when they do resolve – it means you don't have the big bad stuff. For example, it's when you do have diarrhea for more than 2 weeks is when we wonder if it's something we should look into. This is why Bobby and I will spend a few more years in the library and touch a few more patients, and even then we won't know everything. There will never be a day when we won't learn something new. If Bobby learns something new, he better share it with all! 🙂

      August 24, 2010 at 11:21 | Report abuse |
    • Eve

      Elena: Don't be a self-righteous snob. You sound really ignorant by the way too. I do all of those things listed. Did that prevent me from getting cancer? No it did not. So you see, not everything boils down to the patients actions. We do not live in bubbles. We are affected by the poisons put in our food, water, and air supply. If you had even an ounce of intelligence you would understand this. I feel though that this is all going over your head.

      August 24, 2010 at 13:00 | Report abuse |
  36. new md

    it is unfortunate that so many feel as though their physician has a God complex and that we are only in it for the money. for those you that do I would say you should find another doctor. i personally am thankful each and every day for the priviledge to practice medicine. i know my patients trust me with their life and I try and treat every patient as though it were my family member. the unfortunate reality is that we are just people to. we are not perfect, we make mistakes, and we do not know everything. i think it is the patient who seeks a god like figure in their physician who is never wrong and cures all........if this is you, you are in for dissappointment.

    as for the money isssure, you are right docs make good money, however, we are not millionairs like most people think. the average doctor makes around 200-225K. Some make more others make less. But lets put it into perspective. We will complete 4 years of college, 4 years of med school, and 3-7 years of residency. We will be on avg 31-35 years old before we start making that kind of wage. We will work nights, weekends, holidays at around 65-80 hours per week. The average doc will also have 250K+ in student loan debt.

    Dentists on the other hand will do 4 years of college and 4 years of dental school. They may choose to complete one year of residency if they wish. They will work NO nights, weekends or holidays. They will work 40 hours per week and 4 days per week. They will also make on average 200-225K but No one seems to mind. they dont think dentists are in it only for the money, etc.......

    This should show you that doctors are not the ones robbing you blind. If you think we get any money from the scans or tests we order, you are wrong. The hospitals are the ones who pocket all the money. Next time you are in the hospital and charged 5K per day, take a look at the bill. Your doc may have gotten paid 250.00 of that 5K you paid. If we made all that money docs would make millions of dollars per year, not the avg 200K (which is still good, im not complaining).

    August 23, 2010 at 23:31 | Report abuse | Reply
    • charls

      Congratulations, you are well on your way to being an arrogant doctor. You say that you have $250,000 in debt but that you will earn in excess of $200,000 a year for the rest of your working life. No other legal investment in the world will give you such a return. You will be in the top !% of wage earners in the US and the world. You will have job security that the average person can only dream about. A doctor visit lasting 5 minutes cost me $140.00; for most American that is 6 or 7 hours of work. Some doctors work more than 40 hours a week but it is their decision to work extra hours. They surely get paid for those extra hours. My son drives a truck and works 50 to 70 hours a week for 1/5 of what you do. When I was going to college, I met a doctor who worked 40 hours a week at a college clinic and made 4 times what I made when I graduated from college. I asked her why she worked at the college clinic, she told me that she wanted a job that only required 40 hours a week. Our medical system sucks. We should hire the French to run it instead.

      August 24, 2010 at 06:16 | Report abuse |
  37. Bobby-future doc

    Read my mind. Well said.
    (and please forgive spelling errors. I'm sure grammar cops will cite spelling errors, but a slow connection can lead to misspellings)

    August 23, 2010 at 23:33 | Report abuse | Reply
  38. Ian

    Most doctors don't rush because they want to bill more. Most doctors rush because they've got tons of patients to see. The simple truth is that we don't have enough doctors to satisfy the demand. The vast majority of doctors work anywhere from 50-80 hours per week, often working on nights or weekends. They don't take leisurely lunch breaks and most don't have tons of vacation. Patients still have to wait weeks or months to get appointments.

    Trust me, it's not getting better. With the aging of the US population, and an epidemic of obesity (and consequent diabetes, heart disease, etc), people are living longer but with more chronic conditions. Those visits take longer, but there is less time to spend on each complaint or condition. Add to that the fact that we will have more people insured and trying to make primary care appointments, and waits are only going to increase.

    August 23, 2010 at 23:34 | Report abuse | Reply
  39. patientsville

    For thousands of unfiltered reports of real-life patient side effects, try visiting PatientsVille.

    August 23, 2010 at 23:39 | Report abuse | Reply
  40. mmorrison

    Also, be sure to get copies of your medical records from your doctor on a regular basis, to see what is (and is not) in your records. Sometimes people apply for disability benefits, confident their medical records will back up their claim, only to find out their doctor has written only the sketchiest of notes about your condition and left a great deal out.

    August 23, 2010 at 23:48 | Report abuse | Reply
  41. peaceandlove

    Doctors have to deal with the unintelligent, illeterates, and those unwilling to take the time to learn about their condition, problem, etc. They act like they just go in there and the doctor is God and should, by some miracle, fix them.

    There are some meat head doctors, but MOST ARE KIND AND COMPASSIONATE and there 100% for the patients. If your brain is not capable of understanding what the doctor is trying to tell you or giving you options so that you can analyze it for yourself and come to a decision that is best for YOU, then do not go to the doctor in the first place. Just go die out in the streets.

    August 23, 2010 at 23:52 | Report abuse | Reply
    • Genesis

      @ peaceandlove: The irony of your name and your comment is baffling.

      August 24, 2010 at 13:06 | Report abuse |
  42. GI

    Anonymous MD said it best. Please review his post at 20:03.

    August 23, 2010 at 23:58 | Report abuse | Reply
  43. Amy

    Great idea Doc: Have the patients enter their concerns. I Already do that on WebMD...for free. My usual experience with doctors is that they enter the room with a preconceived opinion of my concerns. I generally come out feeling like I'm an annoyance more so than a paying customer. I am so tired of being poo-pooed away, and ignored. Yes, I am overweight..yes, I need to lose weight..got it. Now what does that have to do with my sinus infection? Should I pay you for stating the obvious? I rarely go to the doctor anymore unless I know that my body can't fight off whatever is making me sick. Then I go to urgent care where I receive WAY better treatment. It costs a bit more, but I will pay for treatment...instead of paying for nothing.

    August 24, 2010 at 00:02 | Report abuse | Reply
    • peaceandlove

      Hi Amy,

      I noticed that you said you were overweight. I do not mean to single you out on this, but usually too much adipose in our bodies leads to other complications. Just like if you were to take a pill, there are side effects. While the sinus infection may not be a result of your weight, it could be. Also, I understand everyone's lives are different, but try to devout at least 30 minutes (initially) to something that you enjoy doing physically. Not everyone likes to go to the gym, but maybe you like the outdoors? Becoming physically active is the most important thing to eliminating illness and disease along with eating plenty of fruits and vegetables. Also, a lot of the meat nowadays is loaded with added hormones, which is not good for you in the long run.

      Becoming sick has a lot to do with stress and not eating properly. Meditation and healthy eating should eliminate all your visits to the doctor.

      August 24, 2010 at 00:14 | Report abuse |
    • Amy

      Peaceandlove,

      Thanks for your concern. Again, I have to say that people will focus on the obvious. I am not intending to attack you here, but to simply state something that bugs a lot of people. And, I am not going to get into a discussion about being overweight. The problem is that the focus turns to the excess weight ALL the time. For instance, I went in with a sprained ankle. I got a lecture on being overweight. Now, I understand that I would be healthier with less body fat, but the focus that day should have been on my ankle. Stating " you should lose weight" in response to a sprained ankle is nonproductive. First, it makes the patient feel unheard and untreated. Secondly, it is unrealistic. By that I mean that if the patient's focus and concern is the ankle, then losing weight in the time period of healing a sprained ankle is pointless as so little weight will be lost in 2 weeks that it won't really make a difference. I guess with this rambling I am just trying to assert that there is more to a person than what he or she looks like. Talk to the patient, act as though you want to heal them. Act like your interested and not just there for your required time. Isn't it better to suck it up and have patients go away feeling better ...even emotionally better...than to go away feeling neglected? I understand the pressures of being a medical professional...I am a nurse. I have also had times when I have felt annoyed with a patient or a client, but in the end they are just people, and people have flaws. A doctor is there for just a short bit, so put on the happy face, and be professional for crying out loud.

      August 24, 2010 at 09:27 | Report abuse |
    • Phil

      Hey Peaceandlove: Why are some of you morons under the assumption that you can just wish stress away and then you are magically transformed into the picture of health? Where do you get this nonsense? I work out at the gym 4 times a week, eat organic foods and am generally a happy guy. Does that mean my arthritis is magically healed? No. What is wrong with you? Things just happen! That is life. But when I pay money out of my anus to see a doctor to help me, that turd better listen to what I have to say and treat me.

      August 24, 2010 at 13:10 | Report abuse |
  44. Ben

    Um... I don't truly understand the problem? Firstly, clinicians are human and as error prone as you or I – difference is that if I make an error, I just have to recode and recompile... They have to try and resuscitate and inform the next of kin.

    Medicine is more of an 'applied statistics' than it is an actual science – they listen to the symptoms patients report, look for signs on physical examinations and

    When you visit a doctor or nurse practitioner you are visiting a highly technically skilled individual for their opinion – an opinion informed by a massive body of statistics we know as modern medicine. You are not asking them to fix you a burger or clean your house. You are asking them to render their expert opinion, years in the making.

    The fact that their medical opinion indicates that the likelihood of something being wrong with you is minimal is something to be overjoyed about. If they filtered it (as all healthy human brains do any for sensory perceptions; determining signal from noise) it means that it is a, all things being equal, a nonissue.

    August 24, 2010 at 00:20 | Report abuse | Reply
    • beejeebus

      well said

      August 24, 2010 at 14:20 | Report abuse |
    • Robin

      Yes, but in order to help they need to LISTEN. That is the entire point of the article!

      August 24, 2010 at 14:34 | Report abuse |
  45. Dyan

    To doctors everywhere:

    I am a person. NOT a walking lab result. Please listen to me and treat ME! Lab results are a great diagonistic tool, but they are only one tool at your disposal. They should not be the last word in whether you take my concerns seriously.

    August 24, 2010 at 00:31 | Report abuse | Reply
  46. Jacob Murphy

    My wife went into our family physician's office last month for a check-up. This physician is on staff at a family clinic and has seen my wife several times before this event.

    At the start of the visit, the nurse took my wife's 'vitals' – height, weight, bp, pulse, temperature – and input it into her electronic chart. The physician then came in and sat down in front of the computer, but was interrupted when the nurse came in and asked for some information on a previous patient. The physician pulled up the previous patient's records and gave the nurse the information. He then looked at the computer screen again, and started to talk with my wife. He said "So, it looks like you've lost some weight... you're down from 195lb to about 185lb." This was then followed by several more vitals and other information.

    My wife is 5'4" and 110lb. There is NO WAY a healthcare professional should look at her and think she weighed nearly 200lb. And that's the problem – he didn't look at her, for nearly 5-10 minutes. When my wife interrupted him to say that he must be looking at the wrong chart (the previous patient's), he paused but then continued rattling things off the wrong chart.

    Not all physicians are as incompetent as this man... but most physicians we've encountered are as obtuse. Physicians wrestled the right of prescription away from pharmacists long ago, which gives them the power to act (collectively) as over-trained monkeys.

    There are good physicians in this world, but they are few and far between. Personally, I think it's the academic medical community's fault. Med schools are more interested in bringing in the best students on paper, rather than those people who could be the best healers.

    August 24, 2010 at 00:36 | Report abuse | Reply
    • eric

      You might want to take a look at Anonymous MD's post at 20:03. Stop the bashing and generalizations. If doctors are so "obtuse," you must be better and smarter than they are. In that case, you don't need a doctor...your light and knowledge should allow you to treat yourself.

      August 24, 2010 at 01:10 | Report abuse |
    • Jacob Murphy

      Actually, Eric... My wife's hypothyroidism HAS been treated by her most effectively through her own methods and education. She is not an MD, but she does have a PhD in chemistry with an MS in biochemistry.

      And, it is not a generalization to say "but most physicians WE'VE ENCOUNTERED are as obtuse." The term 'generalization' refers to an inference about a total population made from a statistically insignificant sample. My statement was both accurate and precise, as it referred only to an analysis of the sample itself.

      August 24, 2010 at 07:55 | Report abuse |
    • Amy

      Kudos to you Mr. Murphy!
      As someone with a popular last name, I also run into the " wrong file" error.. A LOT ! Went for some physical therapy one time and was asked how the pregnancy was going...Uh...I can't have kids...oops....
      I agree with you about the problem lying in the new doctor's taining. As a nurse myself, I find that mentoring in the " caring and attentiveness" area is severely lacking. In fact, that's why I have chosen to step back from the profession. It is a shame.

      August 24, 2010 at 09:34 | Report abuse |
    • rbnlegend

      First, it's amazing that someone would try to say it's ok to be reading a chart for a patient that is the wrong weight and height. Secondly, when my wife got pregnant with our daughter, she went in to start the whole routine of medical care around being pregnant. She had her first baby related appointment scheduled, but then they canceled it because her chart showed a negative result on the pregnancy test. That result was from a test that had beend done 18 months earlier. Of course they offered to re-schedule her appointment when the mistake was discovered. First appointment available? Three months away. Fired! On another occasion I went to my GP for a sinus infection. Routine, happens to me the same time of year many years, thanks to allergies. Went back into the doctors office and the nurse said "Oh, we already have your vitals, ok, we can put you in an examination room" I told her that no, they hadn't taken my vitals, but there it was on her form, so they must have taken my vitals. I was there, and no one took my vitals. We had that discussion for a while, with her trying to get me to go to the exam room the whole time. I was passed off to another nurse, who immediately noticed that my vitals were from the same date, a year earlier. At least on that one the system worked, but it wouldn't have it I were less stubborn.

      August 24, 2010 at 10:31 | Report abuse |
  47. Steve

    Most of the disconnect between the doctor and the patient comes from the fact that the patient has a medical complaint and the doctor is usually busy in the back of his head figuring out the most expensive way to code the charges, rather than actually have any concern of what may be wrong with his payday...sorry, patient.

    August 24, 2010 at 00:39 | Report abuse | Reply
    • Bobby-future doc

      whole heartedly disagree there Steve.
      I'm not saying it doesn't happen. I'm sure that it does. Just as I'm sure when you roll out of bed in the morning, you may well be concerned with work as a means to an end... namely a means to pay your morgage/rent/what have you. Do you have to be compassionate in your line of work Steve?
      I personally view it as mandatory in my field. I don't think you can be a good doctor without comassion. Please refrain from generalizing though... I'm not sure what it is you do for a living, but I wouldn't draw generalizations about you if I did.

      August 24, 2010 at 00:43 | Report abuse |
    • Dr. Steve

      FYI...we spend a lot of time and money going to school and are frequently paid the same or less than people who have a fraction of the education. It is unfortunate that you have such horrible views on healthcare/doctors because most of us are good people. And if you wanted to try to debate our focus on money I dont think your arguments would stand much ground. Sometimes WE ARE thinking about coding and so forth while examining a patient. That is true. Do you know why? Because we are trying to figure out how we are going to treat the patient after the exam is over considering they have an HMO! Patients complain sometimes over lack of time with a doctor or lack of effort but you dont understand our situation. For an office visit one HMO is now charging the patients a $35 copay and paying us $2.10. Basically we lose money when we see those patients. DO YOU LIKE TO WORK FOR FREE? Neither do I. Please understand that in the last three years it has gotten really bad with the HMO plans and patients, due to the economy and ignorance, are switching to them.

      August 24, 2010 at 12:15 | Report abuse |
    • Dr. Steve

      You want to blame someone blame the HMO's and the patients who have them.

      Ever notice how when you call for an appointment most offices want to know what insurance you have first? Why do you think that is?

      HMO's tell us how to treat you without them ever examining you. A doctor 3,000 miles away tells me how to treat you and what I am allowed to do. I have two options...one, give you substandard care as per your HMO policy dictates...two, give you the care you need but not get paid for any of it.

      Oh and by the way, if you come to see me and you have an HMO I will get scrutinized by the company for treating you. Every year we are reviewed and judged on how many HMO patients we saw and how healthy they are. So if you are lazy and sick a lot I get in trouble and get down graded as a provider. I can even get dropped from an insurance company for that which is like a permanent black mark on my record.
      99% of the time I choose the path of not getting paid and of getting downgraded. So please be more selective with your slanderous ways!

      August 24, 2010 at 12:22 | Report abuse |
  48. chris

    Dear "peaceandlove"
    Nice sentiment, but you purpose that "meditation and healthy eating should eliminate all visits to the doctor". Come on now! I agree we are a nation of unhealthy eaters, and we should pray more, but you have gone to an extreme. I pray daily and eat very healthy and know many others that do, but there are still genetic components that cannot be eliminated from the overall picture. With a cholesteral level of 123, a healthy weight and a regular exerciser, I still had a heart attack at the age of 45 (and I'm a woman). It's all in my genes. If I don't go to the doctor, I'll follow my father's genetic code right to the grave. Sorry, that is just bad advice. I'd like to live to be a good old age, praying and eating right to the very end, but I'm going to follow my doctor's advice every time I visit, which is regularly.

    August 24, 2010 at 00:41 | Report abuse | Reply
  49. schizochick

    I complained of crippling fatigue, chest pain, joint pain, I had edema in my legs and arms, noticeable swelling of my face, I was hoarse, I felt like there was something caught in my throat all the time, I couldn't lose weight and the Dr. was always telling me to lose weight. Then I went crazy and ended up in a mental hospital.

    The nice people there decided to put me on lithium. But before they could do that they needed to run a test on my thyroid. Guess what? I had Hashimoto's Thyroiditis. My TSH was 217. It's supposed to be between 5-.5 range. The Dr. couldn't believe that I was even walking. All the suffering that I'd gone through and complained about since I was 10 years old and fell on deaf Dr.'s ears could have been resolved with a little pill had they only tested me. But no Dr. thought to test a kid because only middle-age women have problems with their thyroid...apparently. I know the Dr. that diagnosed me was flabbergasted. From all the information you find on the internet or from all the information you hear on TV you wouldn't dare think that anyone young *ever* had a problem with their thyroid.

    Both of my children have Hashimoto's Thyroiditis. My son was diagnosed and put on Levoxyl at age 12 and my daughter was diagnosed and put on Levoxyl at age 13. Because I knew the symptoms to look for and the tests they needed.

    Because of how I was treated as a child I came to distrust all Dr.'s and go to them only as an absolute last resort. Because there is still a part of me that feels like they look at me as a hypochondriac (even though I wasn't, they just didn't know what was wrong). No one should have to go through that, especially a child. Particularly when something is wrong. I don't know what would've happened had I not ended up being screened when I was, but I think I was lucky.

    August 24, 2010 at 01:03 | Report abuse | Reply
    • Jacob Murphy

      Schizo, I sympathize. Hashimoto's is one of the least understood diseases in the world today. It is a complex disorder, as it relates to both the autoimmune system and the thyroid system – both of which are extremely complex in their own right. You may wish to look into low-dose naltrexone (LDN) as a treatment. It has been used effectively by some physicians to treat autoimmune disorders including MS and Hashimoto's. My wife's thyroid antibody levels have dropped from over 3,000 to less than 600 in a few months on LDN. Given that 'normal' levels are less than 34, there's still a long way to go – but this is certainly progress.

      She is working with a DO at this time. There's a strong online community devoted to LDN users/prospective users.

      Good luck!

      August 24, 2010 at 08:06 | Report abuse |
  50. eric

    This is exactly the problem with people today. Everyone wants free, cheap healthcare. In order for that to happen, though, doctors can't just run screening tests whenever they want to. They have to have a sound basis and reasonable suspicion for doing so. Unfortunately, it just isn't that common for people at the age of 10 to have your condition, so the doctor's suspicion was probably very low. Yet, when doctors do run screening tests, patients accuse them of trying to turn the patients into walking laboratories and prey off of them for extra profit. You can't have it both ways. You can't have tons of screening tests on everyone and still have cheaper health care.

    August 24, 2010 at 01:23 | Report abuse | Reply
    • Jacob Murphy

      Eric, you accused me of making generalizations when I did not. I would ask that you not do the same. I do not want (and thus not everyone wants) "free, cheap healthcare" – whatever that means.

      August 24, 2010 at 08:10 | Report abuse |
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