Being a Doctor is Tricky

Medicine sometimes means walking a fine line and this is a classic example

[@Thesilentone88]

"Finances involved" nuff said

[@tkdevlop]

Basically no scan for broke people

[@pandorahunter]

Exactly

[@Asguard82]

This is why you need a universal health care system.

[@hilarioperez1695]

Well cts arent that expensive when it comes down to diagnostic radiology. You better believe you never get cancer. Oh god you better PRAY EVERYDAY you dont get cancer. Because the test to see how your cancer is doing and to see if any metastasis has occurred. Cost more than the average person would pay for their rent in a month. Shit the injection alone cost 2-5 thousand dollars and the isotope that is used in the injection has a half life of like an hour. So if we dont get the patient injected and in the machine in a certain amount of time. Oh boy we just wasted 5k. Now imagine if you had to pay that outta pocket. And you were late to your appointment.

[@hilarioperez1695]

Look up PET/CT and Nuclear medicine scans

[@boring_elderly_millenial]

I never want to be brushed off. As a paycheck to paycheck broke person, if it was bad enough to cause me to miss hours of work (and pay) it is because something is really wrong. But I get sent home, have to pay a doctor's bill, and don't get to find out what is wrong until it's bad enough for me to end up in the ER.

[@SapphicSammy7]

That's why it's so important for the Doctor to consult with the patient and ask their opinion.

[@wholeNwon]

@@SapphicSammy7 I already know what my opinion is. I want the doctor to TELL me what I SHOULD do. Period.

[@wholeNwon]

Absolutely right.

[@SapphicSammy7]

@@wholeNwon yeah and that's also kind of an issue, I hate when doctors give me TOO MUCH say in what happens. I trust my doctors opinion because that's what we should do, trust the professionals. But I do think asking the patient what their opinions and preferences are rather than ordering them. For me it would look like me and the doctor coming up with a choice that I'm happy/comfortable with and will also be the most effective. c:

[@brandillysmom]

That’s what I would want for myself and loved ones. To feel like I’m part of the treatment process, not just a subject with no autonomy

[@valsblackcatsrule8740]

I love when my doc includes my anxiety to my treatment. And, when they realize that costs are a major factor when determining what to do. Even with decent insurance, I can't afford a lot of co-pays for physical therapy. My family's budget just can't take that. 😢

[@lauranagy]

That's awful. Guessing you are American?

[@drsuessl]

😢

[@valsblackcatsrule8740]

@@lauranagy yes. You would think that such an advanced country would have better health care.

[@nathaliea_girl4616]

This reminds me of what dr Mike said: “If I told you this was nothing to worry about, would you feel fine going home or is the pain stopping you from doing something you need to do or are you still worried” or something along those lines I think it’s a very powerful question

[@sjfrench8034]

I tend to feel most comfortable when the doctor says something along the lines of “I don’t think it’s anything to worry about, so we can just monitor it and make a plan from there. But if you’d feel more comfortable if we got testing done, then that’s an option too.” Then I can tell them that yes, I want the test.

[@fariahcriss5696]

This! This is why I can't accept the "but it's tricky :(" cop out from doctors. If you don't know what a patient would prefer, just ask. It's really that simple.

[@m136dalie]

​@@fariahcriss5696 The problem that the average person is unaware of is a thing called "incidental findings". Classically this will be something like a kidney cyst, diverticular pockets in the colon, empty sella on MRI etc... Patients with symptoms who are overly eager to find a cause will request imaging that will find one of these incidental findings that are not the cause of their symptoms 99% of the time. But these patients who are eager to find a cause will usually attribute their symptoms to these incidental findings & spend a lot of time/money unnecessarily getting work up for these. Then ultimately the frustrated patient finds themselves in the same position, with no answers, after spending months & lots of $$$ on unnecessary tests (not to mention unnecessary radiation). These things are important to consider and a lot of the time the best thing to do is nothing. Myself as a doctor I've had symptoms in the past that would be concerning to a regular person (if you went on Google it would tell you that I had bowel cancer). I decided to sit on it and wait, and the symptoms went away on their own. No unnecessary radiation or colonoscopy needed. Sometimes watchful waiting is in fact the best approach, despite how unpopular it is with patients.

[@woefulmelancholy]

✨ communication ✨ ​

[@ahbutler57]

Sorry, but sometimes you just don’t know. It’s different if it’s a car and you’re not sure if it’s the transmission or something else. With a human, you need to be sure. You have many other factors to juggle, including cost, insurance coverage, etc. It’s tough to get a non-answer or wait for it, but that is life.

[@Hi_Im_Akward]

Yes, my doctor will say "it's most likely xyz, if you want more testing done we can do abc but I don't think this is life threatening so you can think about it".

[@roarimadino8544]

I went in to the urgent care at the end of last year with abdominal pain, not a lot but my sister had just had her appendix rupture in spring so I was freaked out. Got a scan and was told I had a stone in my appendix, got it removed in November and than two days later I get a call from the doctor telling me that it wasn't actually a stone but a tumor! Thankfully all cancerous cells were removed and I've been okay ever since

[@c0ltz450]

Wow, you are so lucky and smart to check it out right away. For must people it would end up being nothing, but in cases like yours, you avoided so much pain and suffering. Good for you and I hope you stay healthy for the rest of your life.

[@roarimadino8544]

@c0ltz450 yeah! I think my little sister having hers burst put me on edge, I have pain daily and it wasn't that abnormal but the location of it was what freaked me out and got it checked

[@Joy21090]

Recently I was taken by ambulance to ER A, at which they did some labs and a CT scan. Decided I had viral gastroenteritis and sent me on my way. Four days later I was much sicker, and saw my Primary Doc. He said, "You're a mess. I'm sending you straight to the ER." So I went to ER B. There, they were loath to do another CT scan in only 4 days' time. Either the Dr genuinely believed me that I had diverticulitis, or Doc just wanted me out of the ER. I don't know which. But Doc treated me for diverticulitis and I was like a brand new person the next day. So I had like both things -- "wait and see" with CT scan, and immediate treatment without CT. Such a journey.

[@A---ti3zz]

I was admitted with “mild uncomplicated diverticulitis” the next day my bowel perfed. Diverticulitis is no joke

[@Joy21090]

@@A---ti3zz It's awful! I am surprised they admitted you right away. I've had it many times and always sent home.

[@A---ti3zz]

@@Joy21090​​⁠they didn’t. I had it for six months. It took five months for them to find it and then a month of oral antibiotics that never got rid of it so they admitted me for iv antibiotics. Perfed the next morning. My CT scan in the ER said mild uncomplicated diverticulitis. I don’t know how a person goes from mild uncomplicated diverticulitis to a perforation in less than a day. Seems like the radiologist missed something

[@Joy21090]

@@A---ti3zz Oh my heavens! That's extremely scary. I hope you are completely well now.

[@A---ti3zz]

@@Joy21090thank you! Lost a part of my colon and had to have a colostomy for 4.5 months; I’m convinced nothing good comes from surgery on a persons gi tract. Hope everything is going well for you!

[@channlerharu5569]

As some one who gets annoyed at oh come back in a few months it’s usually because it has been a few months

[@RiverWoods111]

I drove myself to Urgent Care who told me I should go to the ER because they couldn't didn't have a CT scanner to see if I had appendicitis. I waved an ambulance and drove myself to the ER. The whole way to Urgent Care and the ER I was trying to convince myself that I was overreacting, and completely freaking out that I wasn't over reacting, because if I got admitted to the hospital who would take care of my dog. Well, I needed emergency surgery, and I made a best friend with my neighbor who dropped everything to come and get my keys to my house and then drive me home after surgery. I have driven her to a couple of things and she has driven me to several procedures now. I have no idea why I waved ambulance because I have 100% coverage and none of the surgery cost me a dime, and the ambulance didn't either. I think it was me trying to convince myself I wasn't that sick, and I was just overreacting because, in the back of my brain, I knew I had a dog at home that I didn't know what to do with if I ended up in the hospital.

[@darcistephenson5359]

I was life flighted to a hospital last year and my husband had to drive the 2 hours up. He stopped first to take a video of the helicopter then raced home to make sure our neighbors could watch the dog before he drove up to check on me. I wasn't mad😅

[@c0ltz450]

​@darcistephenson5359 I too love helicopters and I would also take a video of the helicopter. They are really cool machines/vehicles. I wish I could fly them.

[@ДаниилПопов-у3з]

What do you do for living to have a 100% healthcare cover?

[@SciFantasyFreak]

​@@ДаниилПопов-у3з^this. I want to know too...

[@mellie4174]

Theeeeeennnnn maybe ask the patient what they envision about their treatment, what they're hoping for in treatment, what stesses them out and give them options! Let them decide!

[@A_T216]

I love my doctor for this reason. She really listens to my concerns, suggests to me options, and we figure out what would be most actionable and helpful if more than one is feasible for me. She's the best doctor I've ever seen, and I feel so lucky to have become her patient. I'm glad you apparently share that philosophy with her!

[@kimkimba1131]

I understand being a doctor is tricky. So many symptoms can mean so many different things. I went to this doctor only once. I had some issues and she told me she didn't have time for all of them so pick out the two worst. She was snippy with her comments on them and didn't ask me to do a follow up. I called a few days later with bad pain in my belly area. Her nurse called back and said it was probably a bug and I'd feel better in a few days. About 12:30am I went to stand up and screamed in pain. My husband had to help me to the car and to the hospital emergency room. I was in the hospital for 5 days with diverticulitis. I have a new doctor now who listens to me and asked follow up questions.

[@pamelajaye]

I wish I knew where you find doctors like that. After 3 doctor visits, the first time being prescribed please take your blood pressure meds, the second please take these antidepressants, the third I really don't know and please come back in a couple weeks, my mother passed out in the parking lot of the grocery store and was rushed to the hospital by ambulance where they finally gave her a scan and found the recurrence of her acoustic neuroma which she had had 19 years before, which somebody might have noticed if they had checked her medical records. By the time she finally got an appointment for a surgical consult with a neurosurgeon it had been 3 weeks and she came home that night with pneumonia and back to the hospital for another 10 days after which she died. A certain amount of time later the doctor's office called to remind us of the surgery the next day and I said "don't bother, she's dead" The doctor who insisted and kept insisting that I really should get a measles vaccine despite the fact that I had already had measles and the concept that what if you get pregnant? I told the doctor I wasn't going to get pregnant. I was 23 then. I'm 65 now. I have no children. The time I got sun poisoning and I was at work and they sent me to medical and the doctor thought I had scabies and gave me quell, and I went to my regular doctor and he said it was eczema - it was. Good thing I didn't take the quell. Sometimes people need to calm down. And the time I went to the doctor with my toe having so much eczema that it was weeping and spongy and he looked at it and said I have no idea what that is and called in his colleague who had no idea either. I got a pain in my face in 1986. I'm still waiting to find out what it is. It's not sinus, it's not trigeminal neuralgia, and it's not TMJ. I had a CAT scan an MRI and evoked potentials which were aborted when they wanted to shock me behind the ankles. A neurologist said I had muscle spasms in my face - probably true. Don't know why. Can't fix it. Try this drug. Yeah that worked... But when you stop taking it, it comes back.

[@kimkimba1131]

​@@pamelajaye, Wow! Sorry you went through all that. I think doctors guess most of the time and 90% are incorrect. 😢 Hope things get better for you.

[@indigobunting2431]

Insurance and costs are always a problem!

[@occasionallyfabulous6411]

*in your healthcare system

[@catlady9123]

Not if you live in a country with Universal healthcare

[@raeandringa7260]

Hi, I agree, but I'm in the US! I'm genuinely curious if you think costs like this are universal? Most places, no matter their GDP, don't feel this and I am curious!

[@occasionallyfabulous6411]

@raeandringa7260 I live in Germany and everyone has to be insured (I think about 0.1% aren't). So everything that is medically necessary will be paid and the copay is usually no more than 10€ ($11), if you are poor you might not even have to pay that. And there is a maximum copay per year (2% of the yearly household income, if you are chronically ill 1%)

[@wendydubz6486]

If only the insurance company and bored of directors allowed Healthcare to be affordable enough that patients don't have to decide to skip testing.

[@JKiler1]

I think what's even more challenging is that involving the patient is absolutely the correct approach, but many doctors are being trained by old schoolers who would never have considered the patient's wishes or concerns.

[@chloehammond2836]

Opt for an abdominal ultrasound. I had 5 CT scans when I had abdominal pain and all turned out normal. Had the ultrasound and showed gallbladder sludge. I put off surgery for 8 months and finally decided to do it and after I had my life back no more crippling calling out sick abdominal pain. I was called overly stressed and paranoid. Listen to your body and get various tests including a CT scan but not limited to this ❤

[@ybunnygurl]

Wait you mean no one opted for an ultrasound first? My insurance would always say ultrasound and then if there's nothing conclusive CT scan. Unless you're in the ED.

[@DishwasherGremlin]

Don’t forget that some doctors get suspicious if you’re “too specific” about symptoms or pain because you know your body. I had two doctors tell me I couldn’t have strep because I had a low fever and they didn’t see white streaks- I insisted on a culture. Three days later with a high fever and NOW they say oh yeah you do have strep

[@mahoganywolf8843]

Honestly, that’s perfectly appropriate medicine. Antibiotic overuse is a massive problem and the vast majority of sore throats are viral. Waiting until you had more specific bacterial symptoms to start antibiotics is very sensible.

[@supercalafra]

@@mahoganywolf8843 Not that I disagree with your premise but that's not the point. Clinical suspicion of strepA is enough to justify antibiotic usage, as if it goes untreated it can cause serious complications, and the tests are.. not 100% accurate.

[@DishwasherGremlin]

@@mahoganywolf8843 I guess it would’ve been better if I mentioned that at the time I was a frequent strep case, I had it about seven times in 10 months and I still had doctors insist that I couldn’t possibly know my own body well enough to know that I had it.

[@c0ltz450]

​@kathrynmcarthur8026 Yeah you have to always advocate for yourself. Most doctors don't know everything you know about your body. You really are your best doctor because you know yourself best. Although it would be nice if your doctor knew everything, they just can't. No disrespect to any nurses or doctors but accidents are one of the leading causes of death in hopsitals. The best people in the medical field can really do is try and treat the most common/average problems. There's just too many patients, not enough nurses/doctors to look for the very specific things at first. That's why you give your own input, be your own advocate, help the doctors by guiding them in the right direction.

[@RueJue]

Bro. So my strep always presented as a weird mix of strep and the flu. I had chronic strep as a kid, well documented. I completely had it, but the nurse we were put with was convinced that I didn't and refused to do the test. Ended up going to the ER 2 weeks later with untreated strep a a very irate ER nurse (not at us). Oh! We also got pulled over for going 4-5 mph over the speed limit (totes normal in Cali) and he Gave My Mom A Ticket. Even though I was actively puking while he was talking to her.

[@too_tired_for_this]

It’s frustrating to finally get up the strength and nerve to make an appointment, only to be told to wait and see for a few months.

[@SnowieShiba]

This, especially when it's already been weeks/months since the problem started.

[@A---ti3zz]

My doctors never take into account what I want or even listen when I do what they say and it doesn’t work. I’m not dumb but they treat me like I am. Half the time if they had listened to me from the beginning they could have spared me a lot of suffering because the issue was exactly what I thought.

[@Woodshadow]

I can understand being frustrated by you not wanting to do anything. It takes about 6 months to get into a gastroenterologist here. My mom struggled for 3 years after getting her appendix out because they screwed up and had to cut out part of her colon. Finally she got into the gastroenterologist and they helped her with her medication and she has been fine ever since.

[@alexbrubaker4030]

I was about to say; Doctors are expert references, not Gods (nor are they their patient's Parents). Offering Options, and communicating about pros and cons, is the JOB. Authority or not, you and your patient are Equals, who work together to manage their health.

[@supercalafra]

Indeed. Physicians, and many other healthcare professionals seem to forget that they are not, in fact, in charge. They work for the patient :)

[@noracrittle5492]

Totally agree, inform the patient and let them make their own healthcare decisions

[@supercalafra]

That's what the job is supposed to entail, but after a decade of training that message gets hopelessly lost. That's how we end up with a supreme court & physicians debating whether to offer treatments (i.e. abortion or gender affirming hormones, etc.). It's great they have opinions, but the patient should always be in the driver's seat.

[@teutonicsniper2502]

See, 99% of the time, I agree. But then again, antivaxxers exist...

[@supercalafra]

@@teutonicsniper2502 Ethically it’s a really tough nut to crack. In a situation where lack of vaccination has been definitively proven to cause harm to those other than the patient (i.e. polio, etc.) legislative bodies need to step in to legally mandate it. I would be careful about advocating for any sort of physically compelled medical treatment, however, and prefer financial incentives like fines instead. In the case of a parent refusing to vaccinate a minor against diseases with a significant mortality rate, that could and probably should be classified as some form of abuse or neglect. In that case I think the state should educate the minor on the benefits and risks of vaccination as well as it can for their age group, and allow them to consent or assent to receiving it.

[@samanthalewis3778]

I struggle...I have VA so insurance and money is not the issue...I live 30 min from town an hour from my doctor something has to be bad for me to go...example I fell a week ago and yes I lost consciousness but I was up within 10 min and moving but my shoulder arm and back hurt...it will take me a week to go in because I don't want to go if I'm just going to be told it's fine and walk it off...BTW with that example I put a slap tear on my shoulder and a tear in the bicep muscle...falling is so normal for me but pain not leaving or being worse is not

[@JennyLouRN]

As a hospital RN, The best approaches to discuss pros and cons with your patient and involve them in the decision making so the approach is agreed upon by both parties. Sometimes a follow-up visit is appropriate, and sometimes the patient would rather just pay for immediate testing. If you’re already in the hospital, get any tests done during your visit and ask for a printout of the results. It’s a pain to make multiple office, lab, & radiology visits and have multiple co-pays, wait for results, then return for readings.

[@mainstreammutant]

In my experience (as someone with a rare genetic condition that causes tumor growth) I've seen probably over 100 doctors in my life. My absolute favorite thing when I go in with a complaint or there is a small finding on one of my scans, is when the doctor presents me with options. "Well you're saying you're experiencing severe headaches. Would you prefer to rule out something serious first? Or would you like to assume they are simple sinus migraines and treat it as such for now and see if the symptoms go away? Being presented with options is really thoughtful and I appreciate that

[@JellyWaltzov]

The best question a doctor could ask me is: "These are the options and the risks. What would you like to do?" Beats telling me what's good for me without listening. I know medicine is hard to explain, but my reason for going to the doctor is the information first, treatment second. But I might be weird.

[@christinesmith3711]

I woke up one morning with central abdo pain which migrated to the rif through the day. As a dr I told myself I was just making it up so just kept on working. Was getting sore so let a colleague know who told me I had appendicitis, did not believe them so went for an US, US technician told me I had appendicitis did not believe them either but agreed to drive myself to the ED to get checked out. Surgeon told me I had appendicitis and insisted on surgery. Just wanted someone to agree with me that it was all in my head….

[@ColFlustered]

My GI dr is given 15 minutes to see patients and he never takes more than 5 minutes with me. It's annoying, but he keeps my GERD under control, so i just put up with it...

[@ShadanSomani]

Also if they have been to a doctor before with this complaint makes a difference - especially if it’s been multiple times (even if long periods between visits).

[@cataphract9132]

As a doctor myself one way that really helps me with the patients is that I explain to them my diagnosis and why I believe it to be correct and then explain the treatment course. Kinda like a small lesson on their disease. It really helps me gain their trust and put their mind at ease.

[@Asptuber]

Yes! Or even better is when the doctor "thinks aloud" - something I as a patient always try to encourage (because I know not everyone likes this). Especially in cases like these that are sufficiently vague/multi-faceted that many different pathways are equally reasonable. Sometimes 10-15 minutes of "thinking together" (I already have a reasonable layperson's knowledge of anatomy) is much better than a battery of tests.

[@fulltimeslackerii8229]

“I really think we need a CT scan to know what this is” “I don’t want it/cant afford it” So what do you say? “Then there’s nothing more I can do. Take Tylenol”?

[@TheVivi13]

there's probably a few more alternatives but if the patient denies trying anything then I mean, that's on them.

[@GhostOfJade]

In my experience. “Abdominal pain” is generalized into “you’re pregnant”

[@logan666]

Thanks for being open about this stuff!

[@itsjustme6314]

So true! I currently work in ER, we have really awesome DRs, I agree with you…..damned if you do, damned if you don’t. 🤷🏽‍♀️

[@cactustree505]

Please SPEAK UP!! Especially women. Statistically women's pain complaints are marginalized.

[@StevenPitts]

I find it incredibly frustrating when a doctor changes or doesn't decide what is the best plan for me based on what they perceive to be my reaction or feelings about what they have said. You're not a therapist. Just ask first. Don't make decisions for me, just tell me the options and then explain to me the consequences of my choices. Which is honestly something I've only ever gotten from a NP, because my doctors (and especially specialists I've seen) just tell me they don't have time for that. And so my severe diverticulitis and ulcers went undiagnosed for many years.

[@amandajoslin-kk5zc]

So I had my gallbladder out about 4 months ago, and I had 100% relief for a month. Then I started having intense pain that was different but in the same general area. It was so bad that I felt like I needed to throw up. After an MRI that showed my organs were perfect and the surgical area was just fine, I continued to have that pain two weeks after, it stopped. It’s a huge relief knowing my guts are healthy. My gastroenterologist said I had PCS. It’s so crazy to me that my body would betray me like that, like, the issue is fixed, stop causing me problems!

[@laurapeterson559]

I've had the situation where my doctor called me at home (at 8am on a Sunday) and said to go to the ED for a CT immediately. I was in the car before I hung up. Personally I like CTs, the weird contrast feeling is fun and IVs always have the saline flush that tastes weird. I'd get them recreationally, I love seeing inside my body! So Doc, any time you want to order one I'm game lol

[@haleygilstrap5229]

I had pretty bad right lower belly pain that i went to my doctor about, she said it's probably constipation and take miralax for a month and come back if its worse. Now, i have a history of only going once a month. It had been that way for over 10 years, so i knew those pains and this wasnt it but i listened because yes, i hoped i was just being overly stressed. When i went back because it didnt help my pain and it was getting worse, we did an x-ray. Oh wow, yes very constipated, she said she didnt know how i wasnt dying from pain and could still eat. I explained over and over again it wasnt this, and i wanted more tests. She said no, this is the problem, come back in 2 weeks to speak about my diet. Well it was so bad a week later i went to the ER, told them the situation and i got a CT. Turned out i had an 8 inch ovarian cyst on the left side that was rubbing up against and causing organ damage on the right side. I called my doctor the next day, and they said "oh okay, but the constipation was probably making it worse". I got a new doctor. My new doctor is fantastic, and we make plans together

[@sabrinastone4104]

I mean, the silver lining with the CT scan is, you do ususally reach your deductible so for the rest of the year its all down hill...🥴

[@RueJue]

I feel like the 2 different responses might fall into fairly gendered categories, based on the experiences of friends, family, and myself.

[@rissabiagi1570]

You mean doctors shouldn’t tell their very upset patient to “not let the issue run their life” and “learn to push through” and should take the patient’s requests seriously? I need to meet these doctors…

[@candiceakers9957]

It's something you don't hear about in med schools and have to figure out when you start practicing

[@mrhomely]

I'm one of those guys that if I'm coming in to see you I'm already very concerned and I'm ready to get it looked at seriously but that's me

[@racheln2136]

Imagine being the patient and feeling both ways about both options 😱🤦‍♀️

[@solario8628]

And some patients just want their doctor to tell them what to do and don't like to be given a choice about their treatment plan.

[@Anniehastar]

This is so true, and even if we get the patient onboard with the plan, there might also be next of kin that has their own ideas about said plan!

[@ferretyluv]

The former kind of patients are women, the latter kind of patients are men.

[@HeatherBDentureDiVa]

I was 30 years old and I was getting really bad pain in my right upper abdomen and a whole bunch of other symptoms. My primary wanted to tell me that statistically I wouldn't be of age or my gallbladder to go bad and it's probably IBS. Well we'll just say a month went by and my gallbladder exploding at 24 hours to live

[@michaelsnider2484]

It seems like doctors don't want to do any tests. OFFER THE TESTS. It is up to the patient if they want one. If they want one, dont refuse them. Is the insurance companies paying doctors NOT to do tests? That is what it seems like. Way, way too many patients are not getting the testing they need. Especially women. Doctors just say "it is stress". OFFER THE TESTS.

[@supercalafra]

To expound: I wrote a paper a while ago about the ethics of prescription restrictions. If a patient wants to get a MRI, EKG, blood draw, etc. they should not need to go through a physician to get it done. There's no need.

[@m136dalie]

​@@supercalafra This is wrong for a few reasons: 1. Healthcare resources are limited, if MRIs were given out to the highest bidder it would drive up the price & increase wait times for people who need it the most. 2. Tests always need to be interpreted in a clinical context. You cannot interpret a test without a proper history. Patients bypassing clinicians to order their own tests would make almost impossible to interpret. 3. Incidental findings and false positives happen all the time. Without clinical correlation patients can be given an incorrect diagnosis leading to unnecessary anxiety and further healthcare waste on unnecessary testing. I'm a doctor myself but I would never consider getting a head MRI without consulting a neurologist first. I simply do not have the knowledge to correctly interpret the findings and make an accurate diagnosis from that investigation.

[@supercalafra]

@@m136dalie Wrong in your opinion*. This is exactly my point. Physicians have *opinions*, and they can be right, wrong, or both. MRIs are already given out to the highest bidder, it was a social commentary running joke in Scrubs, in fact. Patients are not stupid, and can indeed determine for themselves how the data should be regarded, with about 15 minutes of research. Your position is similar to why Apple fights against consumers having the right to repair their devices. I am against both positions and find them facially fatally flawed.

[@m136dalie]

@@supercalafra I am a doctor who studied at medical school for 5 years. I am telling you that I do not have the knowledge to adequately interpret an MRI scan with equivocal findings. Yet you're telling me the average person can do that with a 15 minute google search? What a joke. You have no clue what you're talking about.

[@m136dalie]

@@supercalafra Let's take a different test where cost isn't really an issue: the electrocardiogram ECG. Let's say you have had on & off chest pain and decide to get an ECG done without consulting a doctor. At the time of doing the test you have no chest pain. There's a bunch of squiggly lines and the machine reports "Sinus rhythm, inferior Q waves, ST elevation in inferior leads consider infarct" What do you do? I'm hoping you answer this correctly because apparently it only takes 15 minutes on google to know how to interpret investigations.

[@underyourbreath331]

Yeahhh.. speaking of the cost though, I basically never go to the doctor unless I feel there’s something that might really be wrong. Healthcare is WAY too expensive just to pop in and check things out. If I’m in your office it’s because I’ve already waited and it’s still impacting my life. I want a scan. I want a test. I want SOMETHING! Otherwise I don’t know why I should bother paying anything at all.

[@cmdrtianyilin8107]

I see. Western doctors need to learn a thing or 2 from Bangladeshi doctors. If there's a patient with abdominal pain, most Bangladeshi doctors will inject strong Esomeprazole to see if it's just acid. Also, an Esomeprazole injection in Bangladeshi private hospitals costs something like $1-$3 max and in public hospitals, it's free. And CT? It's less than $100 and in public, it's not more than $50.

[@emilyweathers8977]

I had a doctor tell me "just take some miralax, you'll be fine" when I was having severe constipation and abdominal pain for MONTHS, without even SUGGESTING doing any kinds of scans or follow-ups, so I did. Years later (and through tons of pain, time spent in the bathroom or sleeping from exhaustion), I come to find out I had pelvic floor dysfunction, easily treatable with some physical therapy! All it took was one doctor listening to me in order for me to actually get me the help I needed.

[@GoombaTheCat]

And doing a proper history. Pretty sick of being told to bring in a single complaint only to be diagnosed immediately with some form of "you need to fix your" response without any further questions. It's all well and good if some patients want to hear, "You're fine," but if it's not the case, then saying so is actively doing harm. I have abdominal pain. 1) it's probably fine, let's monitor vs 2) For how long? Have you had this happen in the past? Have you had any weight loss? Has your diet changed? How has it changed? Have you had changed in your bowel movements? Menstrual fluid? Menstrual cycle? Does it worsen with specific food? Is it less in the morning? Let's monitor really shouldn't be the response to someone who was affected enough by pain to arrive at the doctor's office. That's the difference between seeing someone as a CLIENT rather than a patient.

[@TinaNewtonArt]

Just saying... Sir, I'm broke so if I'm coming to the doctor it's been bugging me for awhile. So perhaps run the tests and don't dismiss me by calling it fine or we'll watch it for a few months, no I've already done that, that's how I ended up here. Lol 😂 moral of the story. Ask them how long it's been ongoing. TW I think it's hilarious back a few years ago I went to the doctor's quite a few times complaining about nausea and vomiting and they were like, "are you sure you're not pregnant, it's probably hormones or acid reflux" a few months later I'm puking up blood. Fun right. I had 7 bleeding ulcers at 23. 😂 Another time I went to the ER and told them I had the flu. Took them 6 hours and unnecessary CT scans, pregnancy tests etc. they finally decided to take blood and found out I had been infected by deadly strain of the flu (somewhere like a 61 percent mortality rate), and my kidneys were shutting down. Renal failure was really painful. I mean they could have listened to me hours before my kidneys shut down. But they were convinced it was my gallbladder or some type of pregnancy. I have plenty of other stories of doctors just flat out not listening to me. It's great 👍 like women's exams that take tissue samples, like they're using a hole punch on me and they're trying to tell me oh it's just going to pinch a little, no numbing no local anesthetic straight up went for it. Lol I wish doctors/physician assistants had better bedside manners and communication skills. (Mainly listening skills).

[@violetheise4717]

I've had some neuropathy in my right hand for four years. It's really annoying having my hand tingle, hurt, and be numb for four years. I had another nerve test done and the neurologist essentially shrugged because he couldn't see anything wrong with the nerves themselves. When I went to a different doctor (same system, different specialty), he actually took the three minutes to explain that "even though the nerve test didn't show us what it is, it showed us things which is isn't." Which is significantly more than the neurologist said. Doctors, PLEASE just take the couple of minutes to explain and discuss.

[@wholeNwon]

I find many of these videos entertaining but, clearly, this one was not intended for amusement. So, I skimmed through the comments and read pretty much what I expected. I'll add my own approach. I'm a cardiologist, certified by 3 boards. When I see my own physicians and surgeons (all board-certified specialists and subspecialists) for both diagnostics and therapeutics, I ask them what I should do, not what the various options are. I usually know all that. I want their best advice and that's what I do. Simple.

[@jenniferellsworth1226]

Ug. Okay. Here is what I feel you may be missing here...your patient actually doesn't feel good. So much so that they have stopped their life to come see you. Ask yourself this, are you in your best mood when you don't feel well? Of course not. Your humility in service will go a long way. As a person with life long intestinal pathology, remember, my gut does not absorb nutrients properly. Malnourished people rarely feel good. ❤❤❤ We are doing our best to be on our best behavior so you will help us. Then our good behavior causes the doc to think we don't need anything done. Some of us don't know how to communicate effectively with you.😢

[@pennymitchell8523]

Constipation.....as an Oncology RN....our biggest problem. As many patients are on long acting meds ie MS Contin/ Oxycontin if they become constipated cannot absorb meds. So 2 problems. In Australia we then put them on SC analgesia and sort out constipation. Good education

[@Uhlbelk]

Lots of different approaches. The shock and awe; you dump a bunch of different causes and workups on the patient and hope they get overwhelmed and defer to your "expertise" on what to do. This doesn't have to be bad, you can do it respectfully and compassionately. Or you can sympathize, paint both you and the patient as victims of a system that forces you to worth through the problem in a specific way, and minimize the difficulties and maximize the benefits of doing it this way. Or if you have a smart and reasonable patient, you can be straight forward. LOL.

[@Hi_Im_Akward]

When i was having mystery gut pain i was blown off a lot and frustrated with the amount of money i spend on appointments that resulted in nothing being done. I was missing work because of my pain. Having a straight forward conversation about options would have changed how I felt. There were definitely situations unrelated to abdominal pain where i was pressured into getting a scan and it cost a fortune. Current doctor actually has time during my appointment to talk (40 minutes vs old clinic which was 15 minutes) and she will happily explain things, cost vs benefits, refer me to a specialist, explain the options AND admit when she doesn't know something. It's refreshing and i feel like my doctor is talking to me as a person instead of as some task they are rushing to complete and check off before they get to the next task.

[@customconsult3045]

Being a Dr. is tricky… because medicine has been co-opted by Big Business. Healthcare is driven by shareholder return & algorithms. Increasingly both patients & providers are treated interchangeable generic widgets. Whether (& when) testing gets done is often dictated by insurance companies. What’s needed is a total paradigm change that returns control of healthcare to medical providers & their patients.

[@heidic527]

Being included as a partner in my own healthcare, since it requires my compliance anyway, is all the difference in the world. Some doctors still have the old school "being a doctor makes me an authority figure" attitude, and that automatically breaks the trust for me. I'm paying for your expertise, that doesn't make you an authority. Thanks for understanding that.

[@DeeLite220]

Or there are people like me who use e-visits until finally I’m told “Look, You need to be examined, get in here!” And then I get the CT scans and blood tests and 4 different prescriptions 😂🤣.

[@drsuessl]

Sometimes it feels like a few of my doctors want to run things THEIR WAY, and don’t like it when I have questions. It is MY BODY.

[@ixo666]

I'd wager it even does change outcome - maybe not on this single case but if you feel treated wrongfully overall by doctors one's behavior when encountering further/other health problems. Also placebo effect is a thing so yeah, just ask the patient "well, what would you like me to do that makes you feel safe and properly treated?"

[@katakimikusan]

If you see me in the ER or at the doctors then I have had enough of the pain and it won’t go away on it’s own. The most frustrating thing is when my stomach hurts (I am am talking chest buster trying to burst through the stomach pain) and the doctor finds out that I have celiac disease they just look at me and tell me to stick to my diet, and when I say that I do stick to it 100% but I can’t help that my school don’t give a shit about it. They just look at me and say welp just stick to eating gluten free. Not picking up on that I am keeping my diet but my school doesn’t care much about it and I most likely have ingested gluten thanks to my school and now I can have stomach problem that if fixed in time won’t evolve to be a bigger issue, or simply my stomach pain might not have anything to do with my celiac disease at all. But the doctors are kinda just using it as a scapegoat instead of actually trying to find the reason for my pain. But no I MUST simply not keep my diet I don’t trust doctors and I trust them less and less every time I go and see one, last time I had a doctor saying that I didn’t have a damage on my hearing nerve just because he didn’t think so, not caring that the top ear doctor in my country came down to my city to give me a proper hearing test that took 30min-1h. When he just gave me a poorly ear exam that took 1-2 minutes at most, he didn’t help me at all with my extrem pain in my ear that won’t go away after a month. And he also didn’t believe when we told him that nose spray’s doesn’t work because I have to small of nasal passages

[@aiedle007]

My mother said she had abdominal pain in the lower right quadrant of her abdomen. She asked me because I am studying for a medical degree where the appendix was because she said she was thinking of going to the hospital but wasn't sure. I told her to go because it's either nothing and they will send you home, or it's something. Turns out it was appendicitis, and now she is recovering from a laproscopic appendectomy. They said it could clear with antibiotics, but that it might come back. She chose the surgery.

[@adrigon]

This is why I almost died. "You're just fat, it's gas. Eat less food." Uh, no, I was septic from a necrotic appendix by the time anyone would run a test on me 3 months later

[@emilyk5003]

I wonder if this would be different outside of the US, I assume Australians typically would be more upset with wait and see. Mainly because we view specialist as a last resort and imaging (if ordered by said specialist and not a GP) would be free. But maybe this is common everywhere. There are old men who hate being told to do anything about their health everywhere in the world.

[@minoraavem922]

I got so much abdominal paun that I can't have social life and my boss is pissed as well. Doctor did a ct scan. Nothing came up and the doc was like "Eh, nothing else we can do. Guess you gotta live with that" Thats my problem with doctos. They either try nothing or only one thing and they're done. They don't care about the individual its just another patient

[@AmyThePuddytat]

The second type of patient is just an idiot though. If they want reassurance that everything will be OK, they can go to their mum. The purpose of seeing a Dr is to battle through medical gatekeeping to get access to tests, medications and surgeries to fix your health problems. If a Dr says they want to “monitor” (i.e. ignore) a health problem, I never raise it again, because they've already made it clear they intend to shut the gate on that one. If I get to the point where I make an appointment, it's because I've _already_ monitored a condition or symptom that is not resolving and made the decision to come in to finally deal with it.

[@OWK000]

A naturopathic doctor would sit down with the patient for a hour and ask questions. You can tell a lot if you know if/how people are stressing, eating bad food, may have recently developed allergies from a vaccine, etc. and make a plan of action based on that. Doctors don't have time.

[@surreal-wanderer]

Looove that attitude. I experience a lot of chronic health symptoms on a regular basis, if I've come to the doctor specifically with something happening it's because it's new or different and interfering with my life, I wanna know that it's not something more dangerous than what I've already got going on

[@Hellnogizmo]

I really appreciate feeling like I was heard, and that I have a say in my own medical care. Emotionally.. I might need a couple of days to process everything, but I learned the hard way.. that knowing is better.

[@carolinecardwell2163]

Have you ever had a patient present with bleeding or rectal sx and completely refuse physical exam? How do you handle difficult patients like thay? Do you try to explain why it's necessary to do an internal exam or just immediately schedule them for scope under anesthesia ?

[@gamesglitch5946]

I once had to get driven to two different hospitals because they thought i had appendicitis and the first hospital didn't have the right equipment so i had to get transferred to a bigger one where they did an scan of my stomach and abdomen and found out i was full of shit, My appendix was fine i was just actually packed to the brim with shit,

[@tanithetiger]

Lol I'm still mad about the time I came in with abdn pain, nausea, and back pain and the urgent care doc made me go to the ER. I just wanted a return to work slip signed 😭 oh also it turned out to be period cramps. No one ever asked when my last period was, just if there was a possibility I was pregnant

[@Emily-hd9sm]

But then you ask some patients "so what do you prefer" and they'll be offended you asked, like "well I don't know aren't you the doctor, aren't you supposed to know what to do???" Um yes but the test is multiple choice sir

[@PerpetualAbidance]

What an indictment of our system of medicine. “I could order a test that would tell us what’s wrong with you but instead go home and die, or if you don’t die, come back when it will be really expensive to treat you.”

[@friskyunicorn21]

It is sad that as someone with chronic health problems, I can quickly and easily say that I don’t trust many doctors. Medicine is so fragmented and you are so easily passed off from specialist to specialist because no one tends to care or try enough to properly diagnose people. My last 3 doctors appointments that I went in for with acute problems - literally got the most pathetic assessments you can imagine. Having high BP and palpitations and not even listening to heart sounds and having to ask the doc to take a manual BP since the machines are often inaccurate. Having severe abdominal pain, nah lets not ascultate bowel sounds or palpate at all. It is just pathetic. As a nursing student I can easily say that I perform better assessments than most doctors, and this needs to change!!Doctors need to start viewing patients as a whole person instead of soley focusing on acute problems. Ive been brushed off by docs in the past and literally could have died if I would have listened to just that first opinion. Docs please stop being lazy and listen and assess your patients please

[@edwardcornell1263]

Well my mom could not wait back in 2019. She was forced into the ER and they did the tests on the spot, where as the doctor wanted to wait a month. Lets just say everyone was not happy about the doctors decision to wait. If the test was ordered the next day, chances would have been greater she could have survived cancer. But she she was pushed to wait the mass grew too large to operate.

[@jennifernorthcutt6462]

I wish I had a doctor like you. Out of the 10 or so I have seen after my Achalasia diagnosis only maybe 2 of them believed I actually have it. It makes no sense that they seem to think my medical file false. It is a horrible illness that no one would make up. I have even been told my symptoms are all mental. It would be nice to get actual health care without the side of gaslighting. Your patients are so lucky.

[@TekoHarris]

How about left side abdominal pain and you can’t eat at all for a year have lost 130 pounds and can’t use the restroom without a laxative at all and your belly button is purple I’ve been left to live like this with no help in the USA and they swear they can’t see anything on ct but you can feel a huge lump on my side with your hand.

[@bradpennartz]

I think you just have to judge your patient's mindset as best you can. I'm the kind of guy that if I come in to your office, it's because I don't think it will go away or can be solved by over the counter treatments.

[@solitarelee6200]

My pcp does both. She tells me both options, explains fully her thoughts and logic, and then asks me what I want to do. I have good health insurance and anxiety so its normally tests 😂

[@hannah-lk3oc]

I’m genuinely curious, what is the ratio of patients that would rather hear “you’re fine there’s nothing to worry about” to those that get upset that you didn’t do anything? Maybe I’m just around a lot of people with chronic illness but most people I talk to share the opinion that a doctor not requesting tests and telling you everything is fine is very frustrating

[@katkameo6413]

Because we have to pay a co-pay for the privilege to be with you. You don't ask about lifestyle or what you eat or bowel movements you barely ask anything I need to know nothing about the history of the person.

[@Mokaluvable]

I love this because I feel like I know my body and my situation best and I should be included in figuring out this decisions. Of course the doc will know more than me medically, but it really should be a collaboration

[@samanthabenavides4319]

I had abdominal pain for a year after radiation treatment for rectal cancer. Ended up with a perforated colon, abscesses and went septic. Literally dying for help. Two years now and still have severe abdominal pain

[@samanthadelahunt3698]

What i dont get is needing another CT scan when ive already had 4 this year that showed the same things and my symptoms are the exact same as all those other times. Use the previous ones. But also i had to find out from a completely unrelated specialist that everything was pointing to fatty liver disease, but my GI wouldnt diagnose me because i was 85 lbs and he thought you had to be obese to get that.

[@jessica.Blue777]

As someone who's been waiting for a doctor to actually listen to me for nearly 10 years now I beg to differ. I've been flat out told to deal with it, that the suspected endometriosis that caused my sister to get a full hysterectomy just doesn't exist 🤯 I'd rather do the tests

[@mtavel01]

Or you could be the zebra patient like me that needs fibroscans and regular scoping to make sure your liver isnt deciding to play games after a bout of pancreatitis. 🦓🦓🦓🦓

[@melaniev4390]

I think most people have been in pain a while at home before they come in. By the time they go to the doctor they're ready to have something done about it. I'm at the doctor's office for abdominal pain, Either the abdominal. pain is severe, or its milder pain that i've been having for a long time already.

[@SWilla00946]

i was told the other day by a rheumatologist that i should stop with constant dr visits and just let things be. Ive got a ton of symptoms with things clearly getting worse over the years but my blood work is ambiguous. Idk how i feel about that. Im not diagnosed with anything yet

[@BeingMe-t6m]

So if I’m getting this correct if I complain more they will find more wrong with me? Or address the issues I’m trying to address.

[@shannonsaunders6336]

I'm Canadian so I don't have to worry about the bill, but it took me 2 years to get a family doc, and then 1 month to see them with my pain, and then 6 months or more to see the GI. So by the time I've seen the GI I am ready to move on the issue and not be pushed off because of the constant delays.

[@lorrainesmith3082]

If there was no such thing as insurances and all medical diagnostics and tests were free, your answer and the pts attitude would be VERY different 😔

[@faffy515]

Thank you for your concern and empathy! I don't feel this from my doctors. I mostly feel condescendence.

[@ryuzakilawlight]

Also the way they react - being hella frustrated they won't get the help they desperately want - is a dead giveaway that it's serious and you need to start checking immediately