In my experience, almost every single doctor will not only talk down to patients who know something, they will also put them in the "crackpot hypochondriac" bucket. Further, most of those I've seen are not even scientists: sure, they have all the knowledge of a good medical training and can deal with common and emergency situations exceptionally well. But anything more than that and it's time for rampant lack of logic and stock recommendations that have already failed to work.
Further, most of those I've seen are not even scientists:
I've been disappointed by this realization a couple of times. Finally, it dawned on me. Doctors aren't scientists. They're not supposed to be. They are technicians. They look in a service manual, pick a likely problem, and do the hotfix. If its not in the manual (or the part they have memorized), they're done.
Medical research and medical practice are two entirely different animals.
Of course doctors aren't scientists, but comparing them to a "technician" is a horrible analogy. Doctors go through intense schooling and have a very deep understanding of all parts of the body. Your analogy fits more closely to a nurse, someone with very basic symptom/problem repertoire - not a dr. who knows what and WHY things are happening.
I've also never heard of a doctor being "done" - when have you encountered this? They may not be able to diagnose you immediately but they do research in other resources to help diagnose.
I agree with noonespecial about the technician statement, but sense that you regard that as an insult. Every good technician I know has an great understanding about the "item" they work on. I have a lot of respect for good technicians of all stripes. Doctors don't build new people, they repair, maintain, treat, and fix them.
As to a doctor being "done". Yeah, I have heard that in government provided (USA) health care settings. It happens, and it gets much worse the later in the budget year your are ("Don't get sick after June").
Sure doctors "fix things" but that's an oversimplification of their jobs. It's like saying rocket scientists are like construction workers because they "build things". There is a vast difference in the knowledge/schooling required. I didn't think the simple analogy as a doctor/technician as an insult as much as the description of their duties (1. Look in manual, 2. Hotfix, 3. If not there, done) - this is insulting whether describing technicians or doctors.
And no, doctors aren't "done" when the problem isn't in the manual. You're referring to something completely different, "I don't have money or healthcare and expect you to work for free". Maybe they're like technicians after all.
I guess I don't believe a definition of a real technician is simply someone who looks in a manual to fix thing. I believe technicians of all stripes need knowledge and a good feel to fix things. I think your definition of technician is limited and does disservice to a wide variety of professions.
"I don't have money or healthcare and expect you to work for free" - no, the USA was paid in land via treaty, so the bill was paid.
Good point, but it can only be said of certified auto mechanics. I don't know the percentage of auto-mechanics that are certified and tested to know "why" but I'm guessing it's less than doctors (100%).
Either way, it's a pointless argument comparing the systems and schooling required to understand automobiles vs. the human body.
Both of my parents are physicians (pathologists). What you're saying isn't true at all -- they do diagnostic medicine all the time. This is in every way scientific. At the moment they're both doing research, but previously my mother was in private practice.
The further up the specialization ladder you travel, the more scientist-like the doctors become until you reach the pinnacle where doctors at research hospitals are doing ground-breaking treatments and publishing the results.
The gulf between the average MD doing GP and this pinnacle is huge. Much larger than most people suspect.
I don't understand what you're trying to say. First, the average MD isn't a PCP with generalist training. In fact, a lot of PCPs now are IM specialists. In fact, when talking about PCPs, there are many cases when no generalists come into the equation at all -- kids should see pediatricians as their PCP.
> In my experience, almost every single doctor will not only talk down to patients who know something, they will also put them in the "crackpot hypochondriac" bucket.
In fairness, that's generally the appropriate approach. Given the choice between "crackpot hypochondriac" and "disease most doctors won't see in a lifetime of practice", the former is far more common.
Yeah, so as it turns out, speaking in generalities is useless. Let's talk about the specific condition so those of us with a medical background can talk about the degree of difficulty of diagnosis and treatment. Saying "being dismissive is bad" is just universally true.
In a perfect world, perhaps. Here in the States, though, there's already a shortage of general practitioners.
Expecting them to spend significant extra time with all the hypochondriacs is simply not practical. Doing so would be a detriment to every patient in the system.
But for "disease most doctors won't see in a lifetime of practice" it generally is appropriate (or at least some form of dismissal is appropriate), since the patient is generally wrong.
NB: "generally" in this case means approx 99.9% of the time.
Well, no offense but anecdotal evidence does not a large dataset make. I personally have the opposite experience. Since my parents are physicians I've grown up in and around hospitals all my life and met probably hundreds of physicians. In talking with them and talking with my parents about them I've found maybe two dozen that are either unscientific or incompetent. I completely agree that ~20% is way too high, but insulting all doctors based on your knowledge of maybe 3 or 4 of them is like saying all computer scientists are unscientific (although many are) just because you had a ten minute chat with three or four bottom-level PHP programmers.
Oh, I thought it was clear I was simply presenting this as counter-anecdotal evidence (although my anecdotal data set is probably an order of magnitude higher than the ops). I was arguing more for the null hypothesis than "physicians are definitely scientific."
