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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. Jenrose

    After making a major, life-threatening mistake in my care (a doctor glossed over my leg pain, despite me asking specifically if it was a DVT, I had an embolism a few weeks later), my doctor shifted from writing her notes after the fact to dictating her notes in front of me. This meant I could correct things immediately, while she was taking notes. My care improved dramatically. It did not take long, but it did mean no misunderstandings. My health is much better now than it was then.

    August 24, 2010 at 01:26 | Report abuse | Reply
    • schizochick

      I was 10 years old and 5'7" tall and weighed 150lbs. You can't tell me that I wasn't an anomaly. Still all of my problems were over-looked and attributed to stress, nerves and "emotional problems". I never grew any taller and my weight fluctuated by about five pounds plus/minus. I was taller than my mom at age eight.

      C'mon.

      August 24, 2010 at 02:59 | Report abuse |
  2. Sandy

    I joke with my sister that I'd better stay healthy for the next few years, but it's no joke. Why do I say this? Because I'm overweight and approaching menopause. Any symptom that I report that can be attributed to either condition is, and that's a problem because when the symptoms are brushed aside and are not seriously considered any underlying condition can become much worse, until it becomes so serious that the doctor can no longer ignore it.

    For years my mother-in-law's indigestion and husky voice were blamed on being overweight and smoking too much - until the tumor in her larnyx kept her from breathing easily and was discovered in stage IV. I've wondered for years if higher death rates for obese patients are caused by their obesity or the tendency of doctors to dismiss symptoms they would investigate in other, thinner patients. Missing the diagnosis early leads to poorer outcomes for everyone..

    The bottom line is that if you feel sick and know that something is wrong you have to be a pest and fight to be taken seriously.

    August 24, 2010 at 01:36 | Report abuse | Reply
  3. JEB

    @ Brandon – Being 10 lbs overweight does not make you fat. For good or bad, smoking is my choice. But when I go to see the doc because I pulled a muscle in my back, I don't need crap about the other 2! I'm paying to be treated for my back, not everything else that has nothing to do with my back.

    August 24, 2010 at 01:54 | Report abuse | Reply
  4. Faith

    It's absolutely stunning how every good doctor in the US seems to be posting here... not one of the doctors posting will say "yanno sometimes I do tend to rush through and push people aside, I get frustrated with repetitive complaints that could be solved with diet/exercise/etc" - c'mon. Be honest. Stop trying to convince us that you're The Best Doctor Ever.

    August 24, 2010 at 02:06 | Report abuse | Reply
  5. R

    I am not sure why we focus so much attention on the subject of doctors interpreting what we say.

    It happens with every profession. Computer problem? The geek is probably jumping to conclusions early. Lawyer? I can't tell you the number of times counsel has missed essential facts. Doctors? Well their job is to focus and synthezise the data a patient often doesn't know how to express.

    Every professional is human and makes mistakes.
    The medical record is yours. You should know what is in it and should talk to your doctor about what you want included if it seems lacking. It is not that you should supplant the doctor's opinion (she may often have a more expert understanding) but there is no harm (please chime in) in allowing a patient to have a section of a record where they can add other pertinent information especially as we move to e records.

    August 24, 2010 at 02:24 | Report abuse | Reply
  6. Winter

    I have been struggling with health issues for the last 3 years. I have had doctors roll their eyes, brush me off, and even skip many tests to label me with something I may or may not have, because it is unprovable. They were assholes.

    I've also had some very amazing doctors that take the time to listen to the complaints I have, try to reassure me and honestly try to work out the issues that I am having.

    The moral of this story is that some people are assholes. It has nothing to do with the profession, having a God complex or wanting more money for less work. Assholes are just assholes and you're going to meet one every so often at a restaurant, a store, a small business, or a doctor's office. If you don't like your asshole waiter, don't eat there. If you don't like your asshole landscaper, find a new one. If you don't like your asshole doctor, shop around until you find one that fits.

    August 24, 2010 at 02:54 | Report abuse | Reply
    • Ellen J.

      The problem Winter is that some of us do not have a choice. I live in a small town with only a handful of doctors and every last one of them is a worthless piece of human trash. Utterly rude, uncaring, and prejudiced.

      August 24, 2010 at 13:19 | Report abuse |
  7. Byron

    I'd agree that physicians serve the public, but physicians are not public servants. Public servants are elected and, supposedly, directly accountable to their constituencies. Public servants are told by these constituencies how to do their job. Doing a job that does the public good does not a public servant make. Physicians are no more public servants than teachers, police officers, or postal workers. Physicians should not be told how to do their job. This distinction needs to be made much more clear.
    I'm sorry for all the people posting that have had issues with their physicians not listening to them. Of course physicians should listen to their patients; it's good medicine. Not doing so is bad medicine. Obtaining information on chief complaints, history of present illness, family history, surgical history, social history, medications/allergies, etc is essential to the practice of health care. However, talking with a patient (or patient advocate) that may think that everything they say is gospel simply because they've browsed a few signs and symptoms on Wikipedia makes medicine way more difficult on physicians than it should be.

    Many people feel so entitled when they enter a doctor's office or hospital that they want to tell the doctor what to do. That's no different than going to a lawyer for legal services and then 1) refusing to follow their advice because you don't think it's applicable to your situation, 2) expecting the best representation without paying for it, or 3) telling the lawyer how the evidence should be argued when you know little of legal procedures.

    I want to be clear on this. I don't even care if it sounds elitist. When you see a doctor for a medical problem, the doctor is not your equal. They are your superior. As a general rule, physicians know more medicine than patients because physicians are educated and trained in medicine. Patients, generally, are not. Patients should respect this and learn to work WITH doctors in order to improve their health – not the other way around. The doctor isn't the one that is sick, ill, injured, hurt or otherwise in need of remedy – the patient is. Part of a physician's job indeed requires getting information from the patient. Nevertheless it is still only part of the job. The other part is actually figuring out what is wrong with the patient (using physical diagnosis, lab tests, taking samples) so that appropriate treatment can be given AFTER we've heard what you had to say. It's stunning that people forget these simple facts!

    If you don't like this, then I suggest you fulfill medical school entrance requirements (courses in biology, organic chemistry, physics, and general chemistry), take the Medical College Admissions Test, get into medical school, fulfill their course requirements, pass the three steps to the United States Medical Licensing Examinations, and complete a residency so you can legally practice medicine for yourself and your family in the U.S.

    August 24, 2010 at 03:35 | Report abuse | Reply
    • Amy

      Wow Byron,

      " A doctor is my superior". I had to think about that one for just a minute. As a nurse I suppose a doctor is my superior...technically. However, It isn't the amount of authority or superiority that we have, it's the way we use it that is the measure of whether or not we are a succesful practitioner. It is a sad thing when in our country people opt to not see the doctor for fear of just being another file in the basket. I know...I am a nurse and also " just a file in the basket".

      August 24, 2010 at 09:47 | Report abuse |
    • rbnlegend

      How is a doctor going to know more about treating my problems, when they don't even listen to my symptoms? Was there a class in medical school about me? Did a doctor read a book about my wife's health, so he doesn't have to read her medical history, examine her, or listen to her symptoms? My doctor may have a great education, but if she is trying to treat a sprained ankle because she sees a crutch, and the problem I am telling her about is my back, that education is not going to do any good.

      You are demonstrating the problem right here. People are complaining about doctors not listening, and you are explaining how well educated doctors are. Pay attention and you may be able to focus that education where it can do some good. As it stands you aren't part of the soloution, which means....

      August 24, 2010 at 10:51 | Report abuse |
    • ME

      I am not a vengeful person but for people like you Byron, and others, I surely wish a very serious illness upon. I hope one day you wake up with a terribly painful condition and end up seeing a rude and hateful doctor that refuses to treat you. That makes you feel like subhuman. That rolls his eyes at you. I hope someday you will see what many of us go through. And when you die, you will find you are not a god, but rather will turn to dust as the maggots eat your worthless body like a dead skunk in the road because that is all you are worth.

      August 24, 2010 at 13:23 | Report abuse |
    • Byron

      Amy – Parishioners go to their pastors (their superiors) for spiritual advice. People go to mechanics (their automobile superiors) for car-trouble. People go to librarians (their library science superiors) for help with research projects. People call IT departments (their technologic superiors) when their computer breaks down. People go to the grocery store cashier (their superior) when they can't find what they need in isle three. Individuals go through training in order to have a skill set to help others that do not have the skill set. This is the type of superior that I'm referring too. People seem to interpret my use of superior as "better than" and that is not how I am using it at all. I argue that physicians that try to act better than their patients are not doing the medical profession any favors.

      Amy (cont) – What I feel is missing is that many patients aren't willing to work "with" physicians. I'll use rbnlegend as an example. Yes, the doctor should listen to his complaint of back pain. What rbnlegend fails to realize is that it's possible that his back pain is due to compensation because walking with his crutches and having a broken ankle certainly screws up normal alignments and adds stresses to the body that are not normally there in an uninjured person. Hence, the real problem that needs addressed is, in fact, the broken ankle and how he's ambulating . If his attitude is, "Hey, it's my back, not my ankle that hurts. You aren't listening to me doc!" Then when the problem isn't solved he feels underserved by the physician and continues to complain. In this regard, the patient felt that simply because it's their body that they knew better. The patient felt marginalized. The doctor is irritated. No one benefits because the appropriate structure for practice medicine hasn't been maintained.

      Amy (cont) – I completely agree with everything in your response to my post, and in my experience, nurses have it worse than doctors. Nurses know a lot of medicine and during my first rotations, I deferred to their experience when making decisions. Nurses certainly are more informed than the lay public. Yet patients seem to think it's ok to abuse and treat them as lackeys. This is the same issue that physicians have, albeit in a less severe manner. I'm sure there have been times when you wanted to say, "Look, I'm your nurse and I am trained to help you...but I can't do my job because you are making it difficult. Tell me what you need, what's wrong, and I'll think of a solution. If it doesn't work for you, then we can reassess. Until then, shut up and let me do my job."

      rbnlegend – I did a great job at demonstrating the problem. You read and interpreted what you wanted and then provided an example to support an argument that has no bearing on what I was talking about. I clearly state that physicians should listen. Later I, again, clearly state that examination needs to take place after (it was even in caps...) listening to the patient in order to generate appropriate treatment regimes. I also clearly state that patients should work WITH (again, in caps) their doctors. What I don't understand is how you arrive at the conclusion that I advocate not listening to patients. So I don't have to type it out again, please read paragraphs 1 through 3 of my original posting. You may not agree with me, but my words are without guile. I'm not trying to fool anyone here. Don't try to interpret or spin it any way other than what my words actually indicate. This time, please read and try to understand what I wrote. My delivery could be apart of the problem, but my philosophies on medicine definitely are not.

      ME – What you typed to me was over-the-top nasty. You should be ashamed because it was uncalled for. Never did I insinuate that I was god. Never did I imply that it was OK for physicians to roll their eyes and not listen to their patients. I certainly didn't say it was acceptable to treat a patient as subhuman. Disagree if you will, but your wish that hideous things befall me obviously comes from a place of evil that you'd like to pretend doesn't exist. Neither your mind, nor your heart understood my post. Given your response, I doubt your soul did as well since it's likely as dark and, truly subhuman, as the rest of you. So, by all means, keep clinging to the belief that you aren't a vengeful person...because in reality, you are far worse.

      August 24, 2010 at 15:07 | Report abuse |
    • Amy

      Byron,
      Well I am certainly glad to hear that you weren't being snotty when you said " superior"..LOL. I was begining to wonder about you. I agree that if doctors and patients worked together for an optimal outcome, then overall satisfatction for both parties would be greater. So, that being said, how do doctors...as superiors....improve the communication and dynamic between him/her and the patient? I wonder...do young doctors receive any communication training while in school? I've now switched to education and find that there is way more stress on intervention and communication, conflict resolution, etc than I ever learned in nursing school.. Seems like it may be a place to start to make things better. I also hope that in your practice you take just an extra second or two to connect with your patients ....it will be worth it, both for them and for you.

      August 24, 2010 at 23:55 | Report abuse |
  8. Kikme

    Doctors are not gods and they should listen to their patients.
    I know when I need an x-ray and when I don't. I know when I am seriously hurt and when I'm not. Unfortunately, doctors don't like to be told what to do by the people who are injured.
    e.g.I was in a mt bike accident and ripped myself up kissing the trail (it happens!) the emergency doctor wanted to take an x-ray because he thought I might have broken my cheekbone – I know what that feels like and told him I was sure it was not broken- he insisted anyway – I was correct. Nothing broken. I did request an IV because of blood loss but he refused to give me one, I passed out exiting the emergency room door after being released. Lots of blood loss = low blood pressure= electrolite imbalance = need for IV (this is not rocket science!). I woke up with an IV in my arm on an emergency room table.
    I was in a car accident where I hit a deer – I hurt my back – I asked the doctor to take an x-ray because I was sure I had injured more than just the herniated disc in my lower back – he refused. I now have fused vertebrae in my neck that he was unaware of because he refused to take an x-ray.
    Doctors can be arrogant a##holes. I KNOW where I hurt. I KNOW when it's pretty serious and when it isn't.
    I can no longer mt bike because I now have chronic back pain from the offset fused vertebrae in my neck that pulls my entire spine and skeletal structure out of alignment and the lower disc sits on the sciatic nerve and the rest of my bones scrape in their sockets causing inflammation.
    According to the osteopath – my fused vertebrae are inoperable because of where they are located. I just have to live with the chronic pain for the rest of my life.
    Did I sue the arrogant bas$#rd – No. Why? Why should I? He's already coverd by malpractice insurance, if he was fined, he'd just raise his prices, which would then be kicked back to the insurance companies, and then my premiums (already outrageously high) would go up. It's a no win for the patient. So doctors can just suck it in my book.
    I no longer go to doctors for anything other than if they carry me to the emergency room – unconscious.
    I'd rather die than see another doctor; at least dead, I'd be out of pain.
    Doctors really need to start listening to their patients. The patient lives in their bodies and knows where it hurts.

    August 24, 2010 at 03:48 | Report abuse | Reply
    • Bobby-future doc

      you sound like you have it al figured out. If youd like, you should apply to medical school. People seem to think there is a fat paycheck waiting and getting there is a cake walk.
      Its collaborative care. Did you know that if you got the X ray YOU requested for your lower back you STILL wouldn have seen your neck? No? You didnt know there is a SEPERATE xray for the cervical spine? Oh. Wel thats strange. You made it seem like you know whats wrong with you when and how to treat it. I've personally learned to start IVs on myself and classmates. If youre really good at that too,you can absolutly garner up the materials yourself. Fee free sir.

      August 24, 2010 at 06:56 | Report abuse |
    • You Love it

      Hey Bobby Future Doc: Are you accusing this man of lying? He just told us his experiences and you dismiss it as nothing. He went through a terrible ordeal and instead of saying ' oh I am sorry you went through that' you continue to blame him. I can see that medical school teaches all of you to behave like complete pricks. I DEMAND xrays because I pay for the freakin tests. DO IT. I am not asking you I am telling. Get it? You are my servant doctor. I hired YOU to treat ME. Not the other way around. If you are to stupid and arrogant to fix me, then I will report you and do whatever I can to strip you of your medical license. I also tell everyone I know to never see that doctor so that eventually he and his miserable practice can go under. I have done it and I will do it again. Don't screw with me.

      August 24, 2010 at 13:27 | Report abuse |
    • Byron

      You Love It – "I DEMAND xrays because I pay for the freakin tests. DO IT. I am not asking you I am telling. Get it? You are my servant doctor. I hired YOU to treat ME. Not the other way around. If you are to stupid and arrogant to fix me, then I will report you and do whatever I can to strip you of your medical license."

      No, medical school does its best to maintain humility and niceties. It's people like you that turn us all into pricks. There are specific protocols that we are legally bound to follow. The physician should have listened to him and taken his complaint seriously, true. But, do you even know what can happen to a person with a broken clavicle that isn't caught by the attending physician? Likely not. It's likely the patient didn't know either. You know who does? The physician. And NEWSFLASH – the physician is NOT your servant. You don't get to demand anything. Your job, as a patient, is to inform and request. You pose a problem, then we assess to the best of our ability, and then we treat. If it doesn't work for you, then feel free to question and work WITH us for a different treatment regime. You seem to forget that when you are injured, YOU need US...not the other way around. There will always be another injured person to treat that isn't sneering at us, spitting in our eyes, and kicking our shins as though they've just bought us off the slavery block. Of course we don't listen to patients like you! If you are too stupid and arrogant to see that, then I'm sure you can see where this is going...

      August 24, 2010 at 15:20 | Report abuse |
    • Bobby-future doc

      "you love it"
      Oh i'm not calling him out. I'm being genuine. He seems to have known EXACTLY what was wrong (although he did peg a very incorrect spot for that Xray).
      I wasn't kidding. If I think I can do a better job, I do it. I work on as much of my car as I can, but you see there always comes a point where a person who has dedicated themselves to the mechanics and inner workings of a car will know more than me and I will have to relent and bring my car in for repairs.
      He (and you) very obviously have something against doctors in general. There are bad ones, there are good ones, but please don't generalize.

      Oh, and if my school was educating me to be a prick, I'm sure my response to you would have sounded alot like what you just wrote. Alas... I take the high road

      August 24, 2010 at 23:30 | Report abuse |
  9. Jim

    Doctor, why do you think we heap our many issues on you all at once? Perhaps because we're busy people too, who can't afford visit after paid visit to the doctor. Should we really schedule a separate visit for each issue we have, when we've been forced to ignore some as 'not important enough' to schedule a visit since we can't afford to miss any work right now? We know you'll probably ignore some of our issues, as you always do, so maybe we won't bother to bring them up in the 30 seconds we get to talk to you out of each 1-1/2 hours missed work at the appointment (can't get in to see you until 8:30, you're already 15 minutes late, called back, weighed and blood pressured, sit for another 15 minutes waiting, 30 seconds to talk, another 10 minutes for (a) prescription(s), rush to work.
    Would it really be so hard to pay us your full attention while you see us? We're busy too!

    August 24, 2010 at 04:22 | Report abuse | Reply
    • Bobby-future doc

      You are absolutly right, and i really mean that. The next time you wait, understand its probably because th person before you got that same treatment, NOT because the doctor was padding a paycheck as you all seem to think

      August 24, 2010 at 07:03 | Report abuse |
  10. islandboy808

    What half of you people interpret as a god complex is the standard that a doctor has to look confident. If the doctor actually said "I don't know to you all and started to squirm" you think you would say "its alright"... hell no. Some of you would complain your heads of and act like "your suppose to know, your a doctor." Well, not all doctors know the illness god gives us. This is why they have to put up that confident facade because otherwise you all would look down on them. You have the expectation that doctors know everything and it made them develop that fake confidences which is interpreted as a "god complex." Some of you think the doctor is your servant! That is some big talk... I don't believe you really act like servants in your respective careers so don't judge (i.e. lawyers, teachers, social workers etc... I get B.S. even though I am their customer). FYI I'm not a doctor but have been through the same B.S. a few times too but still understand them.

    August 24, 2010 at 06:00 | Report abuse | Reply
  11. Caeser

    While I'm sure in my own mind that most Dr.'s are sincere in their desire to heal the sick and injured,I can't help but feel that there are some who's motivation is otherwise(based on my own personal expirience).I understand that communication issues exist and should be minimized,this is true in any workplace.The true indication of a Dr.'s intent is whether they take their hippocratic oath seriously or are they in it strictly for profit.
    I wonder how many of you,like me felt as if I was the "nipple" connected to BCBS and the Dr'.s intent was to suck for all he was worth,even if it meant the loss of vehicle,home and job and in my own case nearly a foot.Thousands of dollars in expenses and many days of lost wages when in the end all that was needed was a simple antibiotic.

    August 24, 2010 at 06:08 | Report abuse | Reply
  12. DD

    I can honestly say that this is sadly true and it hardly matters how long you have being seeing a doctor for it to benefit your treatment. I myself am recently going through a rough patch health wise and of course went to my "trusted physician" of many years. I always pay on time and I have good health insurance, I never ask for anything special, but I was hoping since I had been a patient for well over a decade- I could at least be listened to, and no- I'm not a bored, lonely person looking for a conversation. I'm a 30 year old professional/ full time college student with a lot of items on the agenda, so I don't have a lot of time to spare regularly, heck the only reason I'm taking the time to write now is because I understand the gravity of the topic. Back to the story, well I tried to tell him what was going on, and within a minute's time, he decided I should be referred to a specialist! Within a minute's time! AND he took up most of the minute! Now, I'm not a fussy person what so ever. I'm not there to be coddled in anyway. I'm a tough as nails kinda gal, so there was a very, very important reason to be there. Anyhow, he referred me, left the room, had the assistant check something minuscule, he came back to briefly go over the results with little more detail, and I barely- just barely managed to convey to him the seriousness of the situation. I had to interrupt him and very, very quickly went into great detail about what prompted such a sudden visit ( I usually get a check up every couple months or so). I had explain in as few words as possible what had happened. I felt like an auctioneer- literally. Now, I know he's busy- but could he have had at least the common courtesy to let me finish a sentence? At least one sentence? Dear God in Heaven!! That's not too much to ask I hope! And then when he finally heard what I had to say- his eyes widened and he slowed down a bit in his demeanor and decided to run a plethora of tests because of the seriousness of the symptoms. I just couldn't believe I had to justify my very reason for being there! I mean, I've been going to this group, seeing this doctor for over a decade- shouldn't that count for something? Anything at all? Heck, at least give me the benefit of the doubt! I'm not rude at all, I'm very nice, but if I need help, please listen! Now, I myself wanted to go into medicine. I have always ,since I can remember, have had a talent for the sciences. I have a particular talent for recognizing the mechanics of the body- for that is exactly what biology is truly is about- the mechanics of the body. I'm a current biology major, but from all I've seen, from all I've been made to understand I don't think I want to be in medicine anymore- not from what I've witnessed. I used to know wonderful, caring, sweet physicians who were my inspiration, but have long since passed on. They truly were everything I wanted to be, but now it seems most people are in medicine are only in it for the money, not for the vocation itself. I didn't just want to be a doctor- I wanted to be a GOOD doctor. I consider medicine a sacred vocation, and to be in that vocation would be to serve your patients whole heartedly, and yes there are bad situations- but EVERY job has bad situations and bad customers. I know it requires tireless commitment, remarkable patience, late night calls, and working days at a time. It's not a perfect world and it's not an easy job at all- all this I know and yet I still wanted to be a doctor. I had been made to promise to a few physicians I know that I would be their doctor when I became one because they are well aware what type of person I am and that they could trust me with anything and anyone. However, going further in, I grew a distaste for it all. I found myself cringing and not due to some particularly perplexing assignment, but instead due to the demeanor. I know desensitization is required in order to continue in practice, however there are limits even for that- at least before you start losing your soul, humanity, and purpose in life anyway. I remember one professor told me- it's very easy to lose your soul in this profession- tread carefully. Perhaps the price for this vocation is too high after all.

    August 24, 2010 at 06:40 | Report abuse | Reply
  13. Bobby-future doc

    it can be because of how unbelieveably taxing the system is. Im not complaiing, I've chosen this... but after an evening of reading some of the comments on here you have all made it a bit harder to walk out the door to 8 hours of lecture and anoth 8 hours in books and research materials. And yet I will.... because I love medicine and I love what I do. I hope when you all roll out of bed and head to work, all those with incredibly negative comments about doctors.... I hope you do so with a HUGE smile on your face and nthing but positive attitude.... Because should I see you in your place of work, I'm going t hold you tothe standards that you feel my profession falls flat on. Then you may cast the first stone.

    August 24, 2010 at 07:00 | Report abuse | Reply
    • Jacob Murphy

      Feel free to hold me to the same standards. I am a business consultant and I take my job VERY seriously. I know that the advice I give can mean the difference between people keeping their jobs or being laid off. I hold myself and my own staff to a very high standard. I spend a huge amount of time with my clients – prior to a contract being signed for services to be rendered – understanding their needs.

      This is what I do for a living, but it's also what I enjoy doing. I love working with my clients and helping them through the expertise I've developed. In order to keep it up, I employ a considerable amount of effort reading about the latest thinking in business consulting and education.

      Quite frankly, I cannot say the above statements are reflected in most of the physicians' behavior I've seen. If you're one of the exceptions to my experience, kudos to you.

      August 24, 2010 at 08:23 | Report abuse |
    • DD

      I agree with Jacob Murphy. I too work in business and am extraordinarily professional, compassionate, and patient. Business can be a very, very stressful field as well and I never, NEVER hold someone else to standards to that which I myself cannot reach and maintain. That is why I am astounded by the magnitude of the egos, the self justification of bad behaviors in any profession, and the disregard for the legitimate complaints some customers (patients are customers) have. If I were to behave in the way some doctors have, it would be indefensible- and rightly so, however, I understand that the only reason people seek a service or help is because they usually actually need it. I know that not everyone has a job that is as immediately critical as in the medical profession (* insert ego trip here*) however, they do have critical functions to attend to as well- especially regarding their health. Think about it, if the lawyer did not go back to work because he was not helped- then who would defend in a malpractice suit? If the financier did not go back to their office- who would review for medical school loans? If the teacher did not go back to work- would that child really learn as well or effectively as they could have? I think not. I don't think doctors realize that while not everyone has a job that is directly as critical- "everyone else" does the jobs that are needed in order to maintain a functioning society.

      August 24, 2010 at 11:26 | Report abuse |
  14. Jyo

    Not all doctors really listen. I have diabetes because it was in my genes and is being carried from past 4 generations..who knows may be more. I am a native of India and he blames on my food habits. I am a vegetarian who eat dairy products. All my life i ate really good food. He blames on my indian Food. I agree to some extent but i being a vegetarian, i dont think my diet is bad. Because i really keep watch on my diet and health. He encourages me to eat meat instead. My family does eat meat its only me out of my interest, chose to eat veg. I wonder how did doctor assume eating vegetables, moderate rice, wheat flat bread is the only cause of my condition. Before even looking into my readings, my genetic history, he started blaming on indian food, Rice.. etc. How can i trust such doctors.

    August 24, 2010 at 07:16 | Report abuse | Reply
    • Eva

      JYO: Answer me this, is your doctor a middle-aged white man? I am sorry to say but they are the WORST doctors of all. I go out of my way to see an indian or hispanic doctor and I am a WHITE FEMALE MYSELF! Why? Because they are racist. How can he blame it on Indian food? I bet the fool can not even name a single Indian dish. Americans, WHITE AMERICANS have the most horrific eating habits and the ones in power are destroying the populace by destroying our atmosphere, poisoning our food and water, and they have the audacity to blame it on some curry? What an imbocile.

      August 24, 2010 at 14:49 | Report abuse |
  15. Laffitupfzbl

    I respect a doctors' education. I also respect the fact that sometimes doctors can be late due to emergencies. But I have fired 4 doctors for chronic lateness. There can't be an emergency that coincides with every visit I make, the doctor just has bad staff or policies.

    Chronic lateness is strike #1. Not listening to me is strike #2. My current doctor is on the chopping block. I began to have menopausal symptoms in January. Since I am only 38, she did not believe it could be menopause. I told her early menopause runs in my family and it's no surprise to me. 6 months and several dozen tests later, she finally said "Well, I guess we're dealing with menopause – is there a history of early menopause in your family?" ARGH! So I am currently doctor shopping again. It's pretty easy to listen to your patients, docs. You just have to set aside the ego. Try it sometime.

    August 24, 2010 at 07:24 | Report abuse | Reply
  16. Rich

    No need for a treatise here. I had a doctor who, though well intentioned, did not listen to me. It was not a question of me believing I was more expert than her but rather that I sought be to be a participant in my own health care. She was less than sanguine about that but it primarily her staff that was dismissive. So, after 25 years with the same MD, I simply said thanks, I'm leaving, please send my records to my new doctor. I haven't regretted the switch. My new doctor is very engaging, an active listener, and is neither patronizing or dismissive. After all, it's MY health care.

    August 24, 2010 at 07:30 | Report abuse | Reply
  17. badger5079

    @ JEB:
    your doctor tells you to stop smoking, lose weight and get some exercise because those are the most important things you can do to improve your health. However, you choose to ignore the doctor's advice and want a magic pill or potion to make you healthy. No pill can get past the damage you are doing by smoking and being overweight and not exercising. Do you dny that these lifestyle changes are the most important changes you can make to better your health. If you agree, then why do you dismiss the doctor's advice?

    August 24, 2010 at 07:47 | Report abuse | Reply
  18. docwhocuts

    Not to sound exactly like the doctors you think you understand.

    I have a waiting list to see me in the office 4 months long for colon resection alone.

    I am not required to take call, but do so out of commitment to society. It is also the only way I can do any pro-bono work in the US because lawyers have seen to it that I have to PAY ADDITIONAL MONEY to see patients for free.

    The "respect" some of you say you have for us is almost never observed.

    Doctors aren't lining up to accept patients, as pateints become more and more complex (a RESULT of cutting edge care, ironically) and billing becomes beyond exceedingly complex... we have less time for you.

    I used to love getting a call from the ER... good case, help society, feel good inside all day.... now it's just stress, 50% chance I will get paid a penny. ER cases sue 4X more often. They are "emergencies"... with KNOWN WORSE OUTCOMES... but they are considered in our NIQIP database alongside elective cases.

    Excluding pure good will, there is almost no incentive at all to see new patients... excluding those that no one else can handle... I take those out of pure academic interest.

    Can you imagine having a special niche... that you've taken to an art.... perfected over decades... published countless articles about...

    40 years of mastering something so unique, difficult, sensitive, specialized... with life threatening/saving consequences.

    Yet just about all my patients came into the office with a stack of google printouts... sit down, and start lecturing.

    You know what I did, started making them strip down in the exam room before I'd see them like I did in the 80s... at least THEN we can have a DOCTOR patient discussion....

    August 24, 2010 at 07:49 | Report abuse | Reply
    • susanbellnc

      Sounds like you're a specialist. I understand it's tough for doctors as well, and right now in dealing with several with my husband's illness, I will say most are doing great job...especially when it comes to the specialists. My biggest problem is with the general practitioner we both saw. I no longer do as he did not listen to me and I ended up having major surgery because of it. He seems to listen a bit more to my husband, although at times we've wondered. I believe in researching your symptoms/illness and having a knowledgeable (as much as can be) discussion with your doctor. Google notes...no. The AMA, NIH, etc...they all have sites that can be accessed for info.

      What I want to know is why if one patient upsets the doctor for whatever reason, he/she feels the need to take it out on the rest. All we are doing is trying to get well/stay healthy.

      August 24, 2010 at 08:20 | Report abuse |
    • henry

      Your "name/handle" says it all docwhocuts. Thinking of slicing and dicing before you even know the patients name or concerns. In only a few years doctors will be on par with lawyers as most disrespected by society, they are all so greedy with big egos. All about the $$$.

      August 24, 2010 at 09:12 | Report abuse |
    • Kelley

      ER doctors are the worst ! They NEVER listen to the patient ! Just look at the person, evaluate who they are by the way they are dressed, etc., and then treat them like a piece of meat anyway. Oh, and toss lots of pain killer around to shut them up, too, because nothing's more distracting in the ER than a patient who is constantly trying to tell you their symptoms or medical history. My daughter sat in the ER with blood dripping from her chin after falling out of the shower and nearly killing herself hitting her head on the toilet – she was 14 and scared – the ER doctors were outside watching a helicopter take off, then stood around BS-ing after it was gone. I had to get on my phone and call my husband to tell him in the loudest voice I could that our daughter was alive but bleeding all over the ER without so much as a piece of gauze from the nurse, who continually ignored me when I'd try to ask her for help for my daughter. WTF? Put yourself in the patients' shoes for once. You aren't God. Some of us are actually intelligent and educated and can understand what you are talking about. Stop talking down to us. Stop ignoring us. We aren't in the ER for schitzengiggles.

      August 24, 2010 at 09:59 | Report abuse |
    • Tyler

      Well docwhocuts, you are on par with the rest of the rude doctors around. Congratulations. You said you take new patients only for 'academic' reasons? Wow. Just wow. Please go walk in front of a bus.

      August 24, 2010 at 14:54 | Report abuse |
  19. Justin

    DO NOT talk to your doctor! Your doctor will change the billing code to reflect him as diagnosing you instead of simply addressing your concerns.

    I went in for a physical covered 100% by my insurance. I asked some questions, it got coded as an normal office visit, and then I was charged $545.55 total because I had not yet met my deductible for non-routine health checks. Not to mention, Aurora Healthcare refused to let me speak with the doctor to correct it. Consequently, I no longer trust him and will not go back. How can one proceed when there is no trust?

    August 24, 2010 at 07:50 | Report abuse | Reply
  20. Need2Read333

    I am disgusted by how dismissive I've seen doctors be to 35-50 year old women. It is as for the majority of them don't believe ANYTHING that this particular group says. As a 40-someting, I've been blown off on several occasions, only to later be diagnosed with something significant (though easily dealt with) AFTER it's reached chronic point. I understand that physicians deal with time crunch, financial demands, staffing issues, etc., but this is MY body and I have neither time nor inclination to report in detail the SAME situation to nurses and resident MDs, only to have the treating physician have NO clue why I'm even there!

    August 24, 2010 at 07:54 | Report abuse | Reply
  21. Dystopiax

    When it is your turn to speak to your doctor, remove your watch and say: "I am waiting for the second had to reach 12." Begin speaking. For good doctors, the average chunk of silent listening time is 20 seconds. Many doctors feel the need to interrupt before that time. When the physician challenges your perceptions or conclusions, is this done with courtesy or sneering contempt? Female patients are more often exposed to the latter. Doctors have a tendency to become dictators in dealing with patients, putting stuff into your body that should not go into a toilet. They hear the word "no" as an insult.

    August 24, 2010 at 07:57 | Report abuse | Reply
    • Jacob Murphy

      Regarding your comment about females encountering issues more than males... I agree.

      My wife often asks me to join her in the examination room for no other reason than my presence appears to dissuade the physician from being contemptuous. She is far from being a shrinking violet – she holds a PhD in the sciences, teaches at a university and consults with large corporations. Yet, she often feels belittled and talked down to by many physicians. I know she's not the only female who feels this way.

      August 24, 2010 at 08:14 | Report abuse |
    • rbnlegend

      Jacob:

      We could form a club. I do the same thing. Doesn't matter what or why, if my wife sees a doctor, I go with her. Since I started doing this, she finds they listen better and take her more seriously. I've seen them ignore her question, and then when I re-phrase and repeat it, they are full of answers. It's bizarre.

      August 24, 2010 at 10:05 | Report abuse |
  22. susanbellnc

    I had a doctor that hated it when someone came in and had done any research on their own. This same doctor also chalked up every symptom I had to my being overweight. Yes, I know I need to lose weight, but that doesn't mean every ailment is caused by this. I had "female" issues, I'll say to be polite, for years. He always said I needed to lose weight. Then came the day he looked at me and said "As a woman, it's just something you have to deal with." I wanted to slap him. Instead, I went to a new doctor. After tests, they found huge fibroids that by that time meant I needed a hysterectomy. The lining to my uterus was even perforated and my new doctor was upset by how advanced the case was. I was 37 years old at the time, and I have no children. Wanted o keep that option open for a bit longer, but because of a doctor that would NOT listen to me, I wasn't able to.

    Talk like crazy to your doctor. If he/she doesn't seem to listen, find a new one. Don't wait. And write things down for those times when they don't. And research....knowledge is power.

    August 24, 2010 at 08:12 | Report abuse | Reply
  23. Jayden Harlow

    If, as a woman, you really want to have your symptoms ignored, tell your doctor you have a history of depression. You'll pretty much have to have exposed bone to get taken seriously. I know doctors hate it when we do our own web research, but we wouldn't have to if they would be more proactive about investigating our symptoms. About a year ago, I experienced serotonin syndrome. The mydriasis caused me severe light sensitivity and headaches and made it nearly impossible for me to read or work at my computer. I wasn't diagnosed until I brought in an article I found on the internet six months later, and none of the doctors I saw gave me any kind of pain killer because they saw my "pain" as really being a symptom of my depression. Even after I went off SSRIs (I'd been shifted among four different ones over the course of a year and had earlier had an allergic reaction to a fifth) and saw my symptoms disappear overnight, another doctor told me I probably hadn't had serotonin syndrome at all and should really just keep trying new SSRIs until one worked.

    The popularity of sites like WebMD didn't emerge in a vacuum. It's the direct result of many doctors' poor ability to listen to their patients.

    August 24, 2010 at 08:28 | Report abuse | Reply
    • rbnlegend

      Doctors know medicine in general. If your problem is at all obscure, if you have more than one problem, or if there is new research on your problem, you probably have more information on that specific subject than your doctor does. They have to track and stay up to date on everything, which means they don't know specific problems in depth, unless it's a specific problem they see every day. You just have your own health to keep track of. The tricky part being finding the right subject to research and track.

      August 24, 2010 at 09:10 | Report abuse |
  24. Cavendish

    Wish the doctors would listen more. Three different doctors blew off my list
    and now I have found from doctor number four that I have a serious medical condition, that will probably kill me.
    If the doctors would have listened to me from the very beginning my chances at treatment would have been loads better
    because my condition would have been caught much sooner. My husband and I have lost repsect for many in the medical proffession because of this, it feels like those first three doctors had a hand in making sure I don't surrive.
    They could have caught this much sooner, if only they had just did the job they over charged for!

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

      I had breast cancer 6 years ago... last year, as a preventative measure, I asked my docs to remove my ovaries because I had noticed quite a few changes in my body including excessive back pain and was concerned about ovarian cancer. I had tests done which came back inconclusive; no cancer, but no reason for my lower back pain either. My GYN agreed that I should have my ovaries removed, but my oncologist said no, because she said I was too young for menopause. !!!!! Well – guess what? During a routine exam my GYN "discovered" that my ovary was enlarged. I had an operation several months ago to remove a tumor from my ovary which was 14cm in length and 7cm in width.. the ovary itself was roughly 7cm X 7cm. The ovary was HUGE, and the tumor attached to it was HUGE, and it adhered to the other ovary, and my colon, and my bowels, and my appendix, and several other areas of my abdomen. 6 hours of surgery to remove it AND to sew up my bowel which burst in surgery. I lost 10 weeks of work. All because the doctor (oncologist) wouldn't listen to me, or believe that I – a patient – could possibly be aware of my own body enough to know there was something wrong ! To ignore back pain simply because you find nothing is not a solution. DON'T LET YOUR DOCTORS RUN YOUR HEALTHCARE ! They don't care AT ALL ! Be proactive!

      August 24, 2010 at 09:42 | Report abuse |
  25. Bud

    I only use VA doctors and that's the problem. It seems I only get assigned what I call "center-dot" doctors. People from India. And, NO, these people won't listen to more than the first 3 words that come out of your mouth. Then, it's off to the races for them and they're so single sighted with tunnel vision, it's almost scary when you first see them. Yet, I've had ht happen over and over with the same background doectors on several occassions. It's got to be something "cultural" because it sure isn't anything medical or educational that I've ever seen in my past. I'd rather have a combat medic treat me.

    August 24, 2010 at 08:45 | Report abuse | Reply
  26. Jessica

    I would applaud a system in which patients could enter their own data on their record about problems they are experiencing. I would take it a step further and make it mandatory for access to insurance – as well as updating daily our lifestyle habits (such as eating, exercise, sleeping habits, ect). I dont even care if our primary care doctors dont bother to learn about us as patients, they arent bothering to learn right now...so nothing will change in that regarding. BUT.. At some point, far too many of us will get cancer or something just as serious...and our records are currently not accurate because of doctor filtering...we need an accurate picture in order to really find out WHY these illnesses are so pervasive. How on earth can the medical community find any true link as to WHY cancer is occuring, when they have such an imcomplete picture of people who are diagnosed with cancer. It's obvious the medical community doesnt know what the pertinent questions are to be asked in order to find the answer...so maybe we'll stumble upon by just letting us patients greatly detail our health in all its glory and embarassment? I've no doubt many patients will lie about their consumption of "bad foods" and will greatly inflate their actually efforts in the exercise dept...and many may overexaggerate pain and others will underestimate their pain...that will all happen and muddy the picture, but it should still be much clearer than it currently is.

    August 24, 2010 at 08:46 | Report abuse | Reply
    • rbnlegend

      Most doctors won't read it, even if you do have the chance to enter it correctly. Having just spent time with a doctor who did actually read medical records and investigate, and who spent more than 10 minutes on diagnosis, it cast a sharp contrast on every other doctor I've seen in my entire life. Don't expect them to do anything but skim over your case.

      August 24, 2010 at 08:51 | Report abuse |
  27. Kathrynne

    That "filtering" has essentially ruined my life. I first started complaining of neck pain to my pediatrician before puberty. He blew it off, as did every doctor I saw for 30 years. The filter said that I WAS a pain in the neck, not that I had one. Strangely enough, in my 20s I began complaining also of numbness and tingling in my hands while still mentioning the neck pain that I'd been treating with OTC meds. Without testing I was diagnosed with carpal tunnel syndrome because I type.

    All the while the pain progressed, the CT braces did no good, I limited my keyboard time to a couple of hours per day and kept updating each doctors on the neck, the hands, the shooting pains from pinched nerves, etc. It wasn't until I reported something like an electrical ZAP going DOWN my arm that a doctor actually asked, "Oh. And your neck hurts, too?" EMG and MRI were scheduled immediately. No carpal tunnel, but I really did have three bad disks in my c-spine. For 30 years.

    Three cervical spine surgeries later my hands will forever tingle. The spinal cord damage done by the filtering of multiple doctors over the course of decades is permanent.

    I now use a practice that listens. No filters. How's my pain? Am I weaning down the pain meds okay? Is it a problem? I may need pain medication until the day I die–possibly for 30 years afterward to make up for the filters.

    August 24, 2010 at 09:04 | Report abuse | Reply
  28. henry s

    I am tired of the patient being blamed for their illnesses. People get cancer that was not their fault, and people get old and the body starts breaking down. It is all not just diet and exercise, it is genetics, it is aging. It is a myth that if you eat right and exercise you will be forever young and healthy. I like a doctor who has gone through a serious illness themselves and was a patient, then they finally get it and know how to interact with patients. The other ones are mostly dumbasses or young hot shots who have never been seriously ill. They are so ignorant of pain and illness, they are almost useless.

    August 24, 2010 at 09:08 | Report abuse | Reply
    • Kelley

      YES ! That's exactly it – unless a doctor has suffered themselves at the hands of other doctors or in the grips of disease, they don't understand the patient's POV.

      August 24, 2010 at 09:33 | Report abuse |
  29. Richard Sager

    Dr. Ofri makes some good points and while I think that the ideas purposed here are good in theory, they may need to tweaked. I say this as an Information Specialist (Read as Library Assistant) at a College that has Degrees in Nursing, Respiratory Therapy, and Health Information Management. Some patients will overload the system with complaints not related to anything truly medical in nature. As far as allowing patients involved in clinical trials, yes they should have a direct say in any side effects or symptoms, and that the drug manufacturers should be cut out of that part of the loop. The information gathered during a clinical trial should be controlled by an independent third party at the manufacturer’s expense, but not under their control.
    Furthermore, the information in this article is unfortunately all to true for the average Doctor/Patient relationship. Doctors are not the know all be all experts in YOUR healthcare, highly trained yes, but they do not know more than you, when it comes to your personal health situation. To be informed is to be proactive; always ask questions, always stay informed. However, you should also remember, that your Doctor (and most Doctors in general) truly want to do the right thing. So talk with your Doctor, get to know them as a person, then decide if they are working for your benefit or theirs.

    August 24, 2010 at 09:11 | Report abuse | Reply
  30. Kelley

    Doctors who don't listen in their offices apparently aren't listening here, either, what I gather from their responses to some accusations.

    I hate doctors. I have met very few who treat patients like human beings. I have met fewer nurses who treat patients like human beings.

    Think doctors don't listen? Try a hospital nurse at midnight on a weekend... I think hospitals troll graveyards for ghools to work the overnight shifts on weekends. They don't listen, period. I had surgery recently and had a tube in my throat. It was fine, no problem, until the overnight nurse played with it and shifted it from front-to-back to side-to-side. When I complained about the pain (I could hardly talk because the tube was pressing so hard against something in my throat) she would keep telling me that I had a tube in my throat and I was bound to feel it. When I started gagging and puking because the tube was pressing so hard in my throat it triggered my gag reflex, she told me to stop vomitting and she'd remove the tube. When I told her the tube was causing me to gag and puke, she laughed and told me AGAIN that I had a tube in my throat and was bound to feel it. The next nurse told me – IN A VOICE YOU'D USE TO SPEAK TO A 2-YR.-OLD – that I had a tube in my throat and I was going to feel it. When I explained to her that the other nurse had shifted it and caused it to move which in turn caused me pain, gagging and vomitting, she rolled her eyes and told me to stop vomitting and she'd think about removing the tube! As a consequence, when the tube was FINALLY removed the NEXT DAY, my throat was so sore I couldn't talk or swallow more than liquids for another two days. Extra suffering, heightened weakness and an extra day in the hospital BECAUSE THE NURSES DIDN'T LISTEN !

    And doctors don't listen either – why listen to a patient who is most likely ignorant and uneducated? Patients aren't capable of understanding anything medical... You're getting paid by the insurance company, so what do you care if the actual patient is yabbering away at you with symptoms, and questions, and concerns. Who cares about what patients think? You're too focussed on that hot piece of a$$ you just met, or your golf swing.

    I hate doctors. So very few are in the business for healthcare. Most are there for the money and the cars and the house and the hot a$$ you get with money and cars.

    August 24, 2010 at 09:29 | Report abuse | Reply
    • Bobby-future doc

      Kelley- you reiterate that you hate doctors. You HATE the system and you feel doctors are in it for the money and as you put it... "ass". I have yet to hear a constructive solution/idea/coherent thought out of your posts. I apologize for your experiences. I offer the same condolences to every single person on earth who has experienced pain and suffering ... INCLUDING doctors, who-in case you weren't aware- are also patients at moments in their life.

      I'll reiterate this.... If I wanted money Kelley, I would be in a different field. How often is a financial advisor sued for losing a persons money? Thats right, never. I will save tens of thousands of lifes, but it will take a single late night mistake, following hours and hours of work-mentally and emotionally exhausting work- to end my career. To strip me of EVERYTHING I have dedicated a decade of education to. So while sure, there are always exceptions to the rule, a majority of us do this because we love it, and still choose to do it, even when people like you come blasting down the doors crying foul.
      Should I see you in a hospital- I will smile, I will listen, and I will treat you just like every other patient I will treat; will compassion and zeal and dedication to my craft.

      August 24, 2010 at 11:28 | Report abuse |
    • Tyler

      Bobby, would you shut up already? No one cares what you think! Stop defending doctors as if it is your God-given right to do so !!!!!!!!!!!!! We are not making this stuff up!

      Kelley, I am sorry you went through that. It makes me angry to hear these stories because I myself have gone through this too. I would have vomitted in that nurses MOUTH to make her wake UP! What a complete turd.

      August 24, 2010 at 15:08 | Report abuse |
    • Bobby-future doc

      tyler-
      People don't seem to indicate what THEY do on here so I'm left to guess professions. What is it you do? If I belittled you for it, even though you personally loved what you did, would you get a bit testy? Probably and rightfully so. I take offense someone insiuates I do this for money. THAT was what my comment was geared toward if you cared to read it.

      August 24, 2010 at 23:34 | Report abuse |
    • Tyler

      Bobby: What I do for a living is irrelevant. The point is that I hear people compain about my field as well. Do I sit there and whine and say ' Why !? We are all nice ! You big meanie!' How gay is that? I myself am proud of the work I do in my field but I also have brains to recognize that if someone has a bad experience over and over and over again with say lawyers or doctors, they have every right to be sheepish about seeing one. Doctors do not all come out of a mold a certain way. There are many bad doctors out there. Some good, some bad. Why is that so hard for you to grasp? *Sigh*.

      August 25, 2010 at 12:37 | Report abuse |
  31. ANon

    Oh, the irony. The doctors on here are all trying to stick up for their fellow doctors while many, many patients explain the hardships they have been through because of bad doctors. Yes, we all know that there are good doctors who care about their patients and we all know that medical school is expensive and difficult. The problem is that doctors are compensated completely fairly for their work and yet still typically think that they are owed more. In my experience, doctors think that patients should take their word on whatever the illness or non-illness may be and that is the end of the story. This does no good because the patient knows whether or not their symptoms are improving yet many doctors continue to try to force the original diagnosis. My husband spent over 2 years passing kidney stones constantly (over 200 which means dozens of ER visits and a mortgage's worth of medical bills even with insurance) before doctors even tried to determine the cause. I can't tell you how many times I heard "he is too young, he can't have kidney stones or gout". Well, excuse me for not understanding the rules of a disease. It turns out that he actually has a very rare genetic disorder that causes his body to constantly produce kidney stones and gout flare-ups due to an enzyme deficiency. Even with this diagnosis, most doctors try to dismiss his complaints of pain as drug seeking. Doctors can devastate a patient's life by making this note just once in the medical records yet they are so quick to jump to that conclusion.

    August 24, 2010 at 09:44 | Report abuse | Reply
  32. Wanda S

    A pain management doctor prescribed methodone, 10mg to be taken along with vicodin to get me through til back surgery in late September. The surgery is needed to fix something that my body rejected after the December back surgery. Three-four days after starting the methodone (no I'm not a heroin addict, it's just a pain medication) I started retaining water horribly and having breathing issues. After a week, I had no more facial feature, my legs went straight from my knees down and I couldn't breathe. Off to the hospital for me. Hospital stay of 4 days. Respiratory treatments, constant oxygen, prednisone, lasix night and day (no sleep). I finally got rid of the swelling and could come home but I'm still using oxygen. The doctor's comment was "methodone wouldn't have caused that what else were you taking?" He wouldn't even listen to me! He wasn't even going to give me vicodin (100-325) to get me through til surgery until I promised to only take 3 a day. He refused to listen! I checked methodone on web site, first side affect is breathing issues. Why do doctors do stuff like this??

    August 24, 2010 at 09:44 | Report abuse | Reply
  33. Kelley

    I don't think that any of the posters claiming to be a doctor actually is one: their arguments are too poorly articulated. Have fun in your fantasy worlds.

    August 24, 2010 at 09:51 | Report abuse | Reply
    • Bobby-future doc

      And what do you do, I wonder? What is your employment Kelley?

      August 24, 2010 at 11:31 | Report abuse |
    • Jungle Jim

      I tend to agree Kelley. Bobby- future doc is a troll. I have seen him on other boards too.

      August 24, 2010 at 15:19 | Report abuse |
    • Bobby-future doc

      Jungle Jim-
      No troll.... just a guy who continually tries to justify my choice to be a doctor when I read posts like Kelleys.
      You know, most stories on here are tragic. As a matter of fact I'm playing devils advocate here.... I am trying very hard to be the doctor that listens. I'm trying to be the doctor who digs deeper into your health concerns so we AVOID stuff like this. I would like to work WITH my patients on their health, not bark orders at them, or take orders from there. Please read my prior posts and you won't be so hasty to judge.

      August 24, 2010 at 23:39 | Report abuse |
  34. O-C

    I haven't read any of these comments and am not commenting on them in any way. What I have to say is just inspired by this article.

    I just feel like shouting, "UMMMM NO SHIT YOU SHOULD ACTUALLY LISTEN TO US AND NOT FILTER WHAT WE SAY!!!" As a doctor, you are relied on by patients to hear what we have to say and provide the best possible advice and care. IT'S YOUR JOB TO DO SO. It is my opinion, based on my experience, that doctors listen to symptoms and prescribe whatever drugs and chemicals will change your brain chemistry to no longer be aware of those symptoms. The focus needs to be on finding the problem, whether it be diet or life-style related, and providing mechanisms for resolving that problem. I don't want my issues to be covered up or masked with medication, I want them to be dealt with completely and from the source. Doctors needs to be less selfish and more concerned about the well-being of their worried patients who are seeking help. Also, drugs and chemicals that deal with some symptoms while creating more are NOT helping society. Doctosr and patients alike need to stop looking for an easy, quick, and convenient fix. The way we live our lives and the way we treat our bodies and minds is the biggest factor to our health. Our brains control everything – pain, emotion, bodily functions, immunity, etc, etc, – and the food we eat is what fuels it. So often a problem can be fixed by focusing on how you live your life and what you give your body to work with.

    Anyways... These are just my thoughts!

    Cheers!

    August 24, 2010 at 09:59 | Report abuse | Reply
  35. ccos

    I have been saying for years that doctors STOPPED listening to their patients and instead listen to the Pharmaceutical companies. Doctors routinely deny seriious side effects that patients complain about until enough people refuse to take the drug. It is starting with Lipitor; go online to see how this drug has adversely affected so many people. It was the big Pharma's that decided what our cholesterol levels should be so they could sell more of their cholesterol-lowering drugs.
    All you have to do is to read how they were even proposing putting these drugs in our water supply and/or dispensing them at fast food restaurants. Really??

    August 24, 2010 at 09:59 | Report abuse | Reply
    • gjrjp345uptupg

      You are so right. Drug companies pay top dollar and make top dollar to hawk their poison. Lipitor is a crock. Avandia is a crock. Millions die needlessly every year from drugs they did not need or had horrible side effects.

      Pharm Companies are also in bed with the politicians. This is how they can lobby and lobby the crap out of stuff to get their way. Make no mistake they are not in the business of healing.

      If everyone was healthy , they would be out of business. They want us all to die but slowly.

      August 24, 2010 at 15:28 | Report abuse |
  36. Barry

    Throughout this string I see physicians repeating the mantra that they must have a high income to pay off large educational loans. I also have a relative–a dentist–who makes the same claim, but she adds that she also must pay for malpractice insurance. I can accept all of that. However, explain this to me: Why do physicians have such a high NET income–after loan payments and insurance, etc, etc, etc–that they can afford a second home at the beach or mountains, luxury cars, expensive homes, overseas vacations, 3- or 4-day workweeks, and so forth? No, folks, all of the rhetoric about loans and insurance is a red-herring, dodging the question of NET income. (My sister was living in such luxury in only 6 years after establishing her practice. She is now 51 years old and living in still higher style.)

    August 24, 2010 at 10:00 | Report abuse | Reply
    • beejeebus

      After all of the cost listed (student loan, managing a business, malpractice, etc), this is a very difficult and taxing profession. We killed ourselves going through years of school. Then we enter a high stress profession that requires long hours, exponential decreasing reimbursement, and a projected god complex. I say projected because it is the patient that expects god like powers of perception and shaman like ability to heal. When we are expected to be right 100% of the time, I expect a higher than average life style that I can come home to.

      August 24, 2010 at 15:33 | Report abuse |
  37. Luci

    I honestly don't blame the doctors for the healthcare crisis, but the administrators, drug companies and medical supply companies. I have had doctors that were totally incompetant and then some rather awesome doctors. by incompetent is the doctor did not bother reading my drug allergies before prescribing a drug to me that i was allergic to.

    Some things are super easy to diagnose and others are not. I know a lot of doctors prefer you to come to them with a specific thing at a time rather than a long list of what is wrong (i am guilty of doing that). but i think that if the patient did have a way to electronically give the doctor's office the issues they are having before hand so that the doctor could look at the overall picture before seeing the patient i think the time crunch would be much better handled and possibly spot issues.

    there is so much out there that NO doctor can know it all, which is why we as patients need to do research on our own if we are not getting the information that we want, and see other doctors if we think we have been misdiagnosed.

    August 24, 2010 at 10:00 | Report abuse | Reply
  38. PatientAdvocate

    Sorry, but I can't quote references but anecdotely the following are generally accepted;
    1) On the first encounter (your first persentation) of a major disease (heart, asthma, diabetes) you only have a fifty percent chance of a correct diagnosis.
    2) Given a correct diagnosis, you only have a fifty percent chance of your treatment plan being the current "Best Practises."
    3) For every medical encounter, fifty percent of the time there is a medical error (ranging from benign to fatal.)
    4) Physicians forget fifty percent of what they learned in medical school by five years after graduation.

    The future;
    1) Encounters and Treatment Plans are a Patient/Doctor collaboration.
    2) Patient data is electronically stored and universally (need to know basis) available.
    3) Symptom, Diagnosis and Treatment determinations are algorithmically assisted with Doctors being the final arbiter.

    August 24, 2010 at 10:14 | Report abuse | Reply
  39. Grateful

    Thank you Dr. Ferrentino and Dr. Michael Doyle, all nurses that took great care of me when I had my multiple surgeries. I am grateful for the past year when I was able to have a normal life. Unfortunately, I will need one more surgery, but I will be ok with the help of God and my doctors. THANK YOU!

    My the best dentist Dr. Strait who made my worries go away and made me look like a movie star 🙂

    That would have been my speech if I got an Oscar! P.S. My husband also took excpetional care of me, I love you.

    August 24, 2010 at 10:32 | Report abuse | Reply
  40. CJ

    I was a nurse for several years who went back to school and am now a health-care provider (not a physician). I am offended by many of the comments posted here. If you want to blame anyone, blame the insurance companies and the lawyers. Because of poor insurance reimbursement, I must see AT LEAST 20 patients a day in order to meet overhead. We are under extreme pressure to meet those demands. I routinely do not get to eat lunch, maybe get to use the bathroom once a day. If I work only 55 hours a week, not including coming in on Sunday afternoon or Saturday night to do paperwork; that is a good week. I do not drive an expensive vehicle, and the others I work with do not drive expensive vehicles. None of us play golf, because we simply do not have the time or if we did, we would rather be with our families. All of us are scared of being sued because somebody wasn't happy, or had something really odd that we missed and because of the lawyers, we HAVE to test for everything.

    I know I have made patients mad, but guess what? Sometimes that is what is BEST for you. We are here to heal and help you, not to feed your addiction or to validate your "diagnosis" you saw on the internet. There is no magic pill that will cure everything, sometimes you must put forth the effort to break the habit whatever poison you are putting into your body or give it time to heal itself. And to Kelley, I hate you had a bad experience int the hospital, but myself and the group I work with, could care less about a golf swing, or that "hot piece of a$$". We just would like to have a good, uniterrupted night sleep.

    Why do I do it? When I am in the grocery store and have a kid run up and hug my legs or a patient of family member tell you "Thank you", that is why I do it.

    August 24, 2010 at 10:33 | Report abuse | Reply
    • LOL

      That was hilarious ! Thanks for a good laugh. Funny how you try to come off as being caring and yet you STILL manage to show your arrogance. I guess it is genetic with doctors. They still manage to come off arrogant. I don't believe a word of what you say either. But good show! 😉

      August 24, 2010 at 15:33 | Report abuse |
    • Bobby-future doc

      It's thankless work CJ... keep up the good work. I was an EMT for two years and a tech in an ER for another two. Nurses are the backbone of healthcare. Thank you for all you do

      August 24, 2010 at 23:58 | Report abuse |
  41. Ray

    Going to the Doctor's) sometimes its a waste of time they don't want to know the truth of how a patient is feeling or what they may be going through, my doctor does not believe in stress leave or burn out so I choose not to talk to him or see him. When I go to another doctor or talk to my doctor friend I get the same response. Sometimes I feel like I'm the doctor and they are the patient.
    What is our health care system coming to?

    Stay healthy and no matter what happens its how you deal with it the key is stay positive.

    August 24, 2010 at 10:38 | Report abuse | Reply
  42. Medic

    I have seen the complaints that many doctors have in the pre-hospital environment. As a paramedic, my job is to correct any immediate life-threatening emergencies and get the person to the hospital. As a paramedic, I've also been met at the door by a family member who says "well, we called because X is feeling ABC, but that may be because of their arthritis in their shoulder but we really want them to be seen because of DEF. Now, I went online while waiting for you – and what took you so long, we called 911 five minutes ago! Well, I went online and I think that they have this really rare disease that you can test for and tell me right now so that I can make the appointment with the specialist..." and they just babble on not letting me do my own job. Now, paramedics are not remotely trained to know about every single disease process out there so that really isn't helpful to anybody and is wasting valuable time that could be spent treating the patient who is rapidly turning blue and rather unconscious.

    But it translates well. I am forced to filter out what I'm being told by the patient and their family to get to the root of the problem, because while the brand new goldfish may have done something cute this morning, I'll bet you my paycheck for the year (really...it isn't that much) that it isn't the cause of your chest pain. And for doctors, in the internet age, they have to do the same with every patient that walks through the door with their stack of papers from WebMD, the NIH, the Mayo Clinic website, wherever. Sometimes a cough is just that, a cough, and not pertussis, TB, lung cancer, or some incredibly obscure disease that only occurs in tropical zones where you've never been to even though you ate at a Brazilian Steakhouse the other night.

    Although yes, it is a two way street. I have seen people in the medical field take what was supposed to be a 15 minute appointment and turn it into 5 and seem to not be listening after an hour wait, but how do I know what the reason is? Maybe earlier in the day they had an emergency which caused everybody else to be pushed back and given shorter appointments. That doctor and their staff will not be leaving until everybody has been seen for the day, after all. And if it's because they decided to sleep late that morning and walk their kids to school, then that gets my ire up a bit but I highly doubt that it was because they wanted to avoid seeing patients that day.

    It also isn't their own greed for that quarter-million a year paycheck – which few doctors actually make. I have known doctors who could barely afford to feed their families and provide them with a roof over their head on the paycheck that they were making, and no, I'm not talking about feeding them at 5-star restaurants every night or paying the cook to make individual meals. I'm talking about basic chicken, frozen veggies, and rice from the Stop and Shop. Where is all their money going? School loans, malpractice insurance. The insurance companies have also decided how much the doctor will get paid for each procedure/diagnosis, and it really isn't a lot when you compare it to your total bill. Plus, the malpractice insurance companies will raise rates at the slightest hint of a malpractice suit being filed against anybody in the practice, because when a patient or their family decides to sue, they either choose to or are encouraged to file suit against anybody who could even remotely be involved. And because it's the doctors who have the "big money," that may mean the doctor who was out of town that week on his one vacation is also named because he "may" have decided to call in and discuss patients who weren't his.

    August 24, 2010 at 10:38 | Report abuse | Reply
    • rbnlegend

      Sure, sometimes a cough is just a cold. Most of the time, in fact. But if a patient comes in with a cough and a stack of papers, and they have had the cough for 2 years along with other symptoms, it doesn't help when the doctor says, in under a minute "you have a cold" and goes away. It's not your job as an EMT to be be testing for rare chronic diseases, sure. But if the patient has had a persistant cough for 2 years, you tell them to see their regular doctor in the hope that the regular doctor will do a little more than prescribe cough syrup, right? That's all the doctor does.

      August 24, 2010 at 11:01 | Report abuse |
  43. CS

    Thankfully I have a great PCP now, but that was not always the case. When I was in my early twenties, I started getting these really sharp pains in my right, upper abdomen area. This persisted for MONTHS with no relief, finally radiating to my back (inbetween my shoulder blades). At first, the pain was intermittent, but got increasing steady not only in duration but strength.

    I went to my PCP several times and each time I was told to take some antacids. After a little over a year suffering and getting zero answers (and getting ignored by my PCP), I called for an appointment as I was in constant pain. I was told by his office that there were no available appointments and to once again, take an antacid. During my many visits, I asked several times if he thought it "could be" my gall bladder (yes, I did what annoys Dr's and looked up my symptoms on the internet). He scoffed saying I was too young for that and to do what? Yup, you guessed it, take an antacid.

    I drove myself to his office and sat in the waiting room, demanding to be seen. I was sweating profusely and white as a ghost (perhaps going to the ER would have been a better idea, sure, but I was P!SSED by this point and was he!! bent on making a point). A nurse practicioner walked by, saw me sitting there and came over to see if I was OK. I briefly explained what was going on and she immediately escorted me back to an exam room.

    Guess what her first response was after actually LISTENING to me for 5-10 minutes? "Hmmm, I wonder if you're having an issue with your gall bladder?" GEE, YA THINK!? I was grateful to her because she also immediately sent me for an ultrasound of my gall bladder which indeed revealed a bad gall bladder, and I was scheduled for surgery two days later.

    After I recovered, I found another PCP and to this day I want to slap him in the face.

    August 24, 2010 at 10:39 | Report abuse | Reply
  44. O-C

    I completely agree with the idea that the pharma companies are a huge problem. I would go as far as to say that they create the problems (either chemically or by spreading fear) that they then create the "solutions" for.

    Swine flu – curious how so many types of flus were combined... Also,they spread fear by quoting numbers and saying how so many people would die... the thing is, no more died than if it were a regular flu. I will admit that people who tend to be considered more resistant to illness were at a greater than normal risk of being affected.

    We, the public and the patients, need to be far more objective and cautious of the things we are told and the way we take care of our bodies and minds.

    August 24, 2010 at 10:50 | Report abuse | Reply
    • Bobby-future doc

      Did I missread your post? Or are you insinuating that Flu recombination is a manufactured phenomenon by pharm companies... Because if so, you're a bit out of touch and should be happy people like me spend years in school to understand the actual science of it

      August 24, 2010 at 11:34 | Report abuse |
    • Oliver

      Bobby, you are part of the machine. You are just a cog. Do you honestly think they are going to tell you the truth in medical school? Come now. I have been around for many many decades. I have spoken to many doctors in a variety of specialties. I read ALOT. I research ALOT. I can tell you for absolute certainty that many diseases are engineered to control the masses. You can choose to believe it or not. Its up to you. But, it does not change the truth.

      August 24, 2010 at 15:39 | Report abuse |
  45. Satish

    I equate the Doctor to a Car Mechanic!!! Both are scumbags.. With a Mechanic you know that you are getting screwed, with a Doctor you DO NOT know that you being screwed until it is too late!!! You can equate a Doctor to a Lawyer if you want!!!

    August 24, 2010 at 11:35 | Report abuse | Reply
    • Bobby-future doc

      Fair enough. Then to you I suggest:
      -buy medical text books. There are alot. I would say that a Pathology/Anatomy/Microbiology/Pharmocology/Immunology/Psychiatry/Biochemistry/Histology background will be a minimum and MAYBE get ya by.
      -be your own mechanic. There are manuals. I personally enjoy working on my cars for what I can, you can too.
      -in a court case (which I am SURE you will run into if you offer up your medical skills to others) feel free to represent yourself. How hard can that be? I mean they even allow it in court, its your choice.

      Problem solved Satish

      August 24, 2010 at 11:42 | Report abuse |
  46. Wanda S

    CORRECTION:::: Vicodin is 10-325, not 100-325

    August 24, 2010 at 12:29 | Report abuse | Reply
  47. Riley

    to those who are bitching about all doctors being inherently evil, self-serving, pricks who don't get the concept that they're "civil servants"- in america, capitalism reigns supreme. at least that's how it is now, so don't vent your frustrations regarding finances or personal grudges against an entire professional field and expect to be listened to and sympathized with. in other words, don't be so one-sided. a) yes there are ignorant, self-serving people in any job, no one's denying that b)one bad egg doesn't spoil the rest (Matt I'd like to know where you got your statistic that 95% of physicians are rich, pretty boys, god the nerve of you to even use "oh i left 5% open" as an excuse), and c) you don't pay 100% of your doctor's salary. that would mean literally pulling a wad of cash out of your pocket and handing the exact amount a doctor needs to defray his costs and make a buck, right to him. i'll give you one concrete example. employer based insurance. you pay with your time and effort for the company to provide you insurance through some private sector company. boom. company money. d)do some freaking research and find the right/good doctor. if you have to drive to the next town over, so be it. even if its more expensive so be it. we pay professionals to see professionals. we want peace of mind via an expert, so find one even if it takes some effort. research! read reviews! be proactive! don't just settle for the nearest shrink (and christ, there are more than just 5% of doctors out there who actually care for their patients). e) if none of this makes sense, and you still hate doctors with a passion, then get off your ass, DON'T smoke or drink, exercise, and eat healthy. JEB, you'd be astonished as to exactly what that does for you. aka, you'll skip those fees. altogether. the real problem lies in the people. if we could just take our own bodies into our own hands, this country would be a lot better off. instead we don't take care of ourselves and then do what americans do best. whine and sue.

    to all those who think doctors are unquestionable heroes...everything is summed up as such:
    YES WE KNOW THERE ARE GOOD, HONEST DOCTORS. BUT ALL DOCTORS ARE HUMANS. AND HUMANS ARE BY DEFAULT GREEDY AND SELF SERVING. Corporatism + A culture that fosters unhealthiness + Human Nature = Cutting corners + Angry patients + Apathetic doctors. its as simple as that.

    August 24, 2010 at 12:47 | Report abuse | Reply
  48. AJ

    Yes, doctors CAN be arrogant and some of them do ignore patient comments. But we NEED them to interpret complaints through a scientific grid. Do you really want a bottle of pills to warn you about a "tummy ache" when the real side effect is liver or kidney damage misinterpreted as stomach pain?

    August 24, 2010 at 13:00 | Report abuse | Reply
  49. Redeye Dog

    I get my healthcare from the VA. The VA's model comes closest to what Obama's healthcare is shooting for the entire country. Well, my doctor flat out told me to "Be quiet." When I objected, she told told me that I would be given an opportunity to speak at the end of her observations. Never happened. She scurried me out the door where another veteran was waiting. I attempted to complain through VA channels and was told I always have the option to get healthcare somewhere else...

    Guess this is what constitutes veteran healthcare, today. She never heard my complaints and would NOT accept any attempts for me to contact her.. Complaints fall on deaf ears under the guise of "Your health is our top priority." However, their execution closely resembles "cattle herding" and "checking the block" along the way.

    I certainly realize that the world DOES NOT revolve around me! I am not the only patient but, when asked whether doctors listen? No way!!! I have no say in my healthcare...

    August 24, 2010 at 13:18 | Report abuse | Reply
  50. debij

    This is EXACTLY what my doctor does now that he has pretty much doubled his number of patients. He put me on a depression medication in 1998 and ignored repeated requests by me to take me off the drug because of the side effects. Finally, I got his approval to cut back on the drug to get off it ONLY by asking his nurse to recommend that I be taken off the drug to be evaluated to see if I still had the depression. Since I don't feel any differently, either I'm over the depression or it wasn't depression to begin with – I suspect it might have been peri-menapause.

    Currently, I'm getting the runaround with anon-resolving allergy/sinusitus – I've had it from the first of the year and it's not getting any better. However, I keep getting shifted to physician's assistants, and other doctors each of which prescribes an antibiotic and steroid courses. I've had 5 different courses of antibiotics since the first of the year, and am told it's an allergy – but am not given any idea to what I'm allergic.

    I'm overweight and asked him about losing weight – every exercise program says to get a doctor's permission before you start. When I ask him about which diet to use, or for other recommendations about dieting, he just says to cut carbs. He never mentions exercise plans and when I ask, he just ignores it. So how am I supposed to know what to do with dieting or exercise if no one will tell me how many carbs, what kind of exercises etc to do?

    Because I have Rhumatoid Arthritis, I get phone calls from a health service, and when I told the nurses my frustration on the process of dieting, and other issues, they told me – you need to find a new doctor if he isn't listening. My doctor is a good doctor – the problem is that he doesn't have the time he used to have. Even though there are 3 other doctors and 2 physicians' assistants besides him there, he still seems like he's too busy. If I am considering changing doctors, i'm sure others have considered it too – some actually doing it. But how to I broach the issue that his success is now starting to destroy his practice? I do know that one of them almost killed one patient because he misdiagnosed a heart attack as muscle strain because they was too busy to stop and listen.

    August 24, 2010 at 16:00 | Report abuse | Reply
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