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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Dave001 on September 7, 2004, at 19:10:16
OK. Everyone has their breaking point, and I have reached mine. I am really pissed off. After wasting another $125 this afternoon on a 45 minute session, all of which was spent in a fruitless attempt to educate my 'doctor' in modern medicine so that I could obtain 'permission' (a prescription) to switch to a different combination of medications, I left the office empty-handed. "We can discuss it next time." Is there some secret, special list of docs which those of us whom already are well-educated in modern medicine can use to just pay for the damn 'script without having to qualify our rationale to someone whom in all probability isn't capable of comprehending it in the first place? I'm talking about non-scheduled substances, here.
This is outrageous and should be outright criminal that doctors are given the power to limit one's medical treatment to only those options they are familiar and comfortable with.
Posted by pseudonym on September 7, 2004, at 23:44:57
In reply to Losing time and money: ignorant doctors, posted by Dave001 on September 7, 2004, at 19:10:16
What was your game plan going in? What combination were you going from and which were you suggesting?
Posted by becksA on September 8, 2004, at 9:10:19
In reply to Re: Losing time and money: ignorant doctors, posted by pseudonym on September 7, 2004, at 23:44:57
I would just talk to him straight up. at the beginning of the appointment tell him what you want to have accomplished by the end. If he disagrees, then you shouldn't have to pay, and you can walk out then and there without writing a check.
Posted by Racer on September 8, 2004, at 13:03:39
In reply to Losing time and money: ignorant doctors, posted by Dave001 on September 7, 2004, at 19:10:16
Problem number one is that your doctor has an ego, which is probably conflicting with your ego. If he/she is also insecure at all, that's gonna be magnified.
Problem number two is that you're walking in with ideas of your own, which are in conflict with your doctor's ideas. This is probably a subset of the first problem, of course, but since you can't do an ego-ectomy on either of you, this is the problem to address.
Now, how to do that? First of all, that ego thing means that the doctor doesn't want you walking in and self-prescribing. Part of that is pure ego: he went to the time, trouble, and expense of going to medical school, so he gets to make these decisions and have his name on the prescription pad. That, a pretty diploma, and a mountain of med school loans are pretty much all he brought out of med school, so he's going to hold on to it pretty tight.
The other part, though, really is worth keeping in perspective: because he went to medical school, he's got the foundation and the context for all the information you may be picking up on the internet and in a vacuum. And no matter how thorough your research is, you're just not going to have that same level of understanding that he does. He really does know things you don't know -- even when he's being an idiot. Try to keep that in mind when you hit that conflict.
So, with all this background, how do you handle the problem? Well, diplomacy. It's sad and unfair, but at the time we are least capable of being ambassadors on our own behalf, we most need to be just that. The way to handle it is to ask for information, rather than making suggestions. For instance, the most effective I ever was with a doctor was when I first started Effexor six years ago. I knew it wasn't working, and I was in lousy shape. I also knew that adding a low dose of an SSRI was probably a pretty good bet. I cried to the doctor (because I couldn't stop crying anyway) that I just 'wished there was a way to get the bit of good that the Effexor was giving me, while still getting the good that the SSRIs had given me, without the bad from the SSRIs..." She took the bait, and suggested that we try adding a very low dose of Prozac to the Effexor, which might avoid the side effects I'd had on the SSRIs, while still providing the benefits. It worked well enough, for a while, and I didn't have to butt heads with her. Sometimes asking for information about something works better than asking for a new med outright. It allows the doctor to feel in control, and that prevents the conflict from turning into a contest about who can outstubborn whom.
Out of curiousity, what are you on and what are you asking for?
Best luck.
Posted by olysi79 on September 8, 2004, at 16:10:28
In reply to Losing time and money: ignorant doctors, posted by Dave001 on September 7, 2004, at 19:10:16
Same experience with my PDOC, she frustrated e this morning... to her all SSRIs are the same, and newwer is better.
> OK. Everyone has their breaking point, and I have reached mine. I am really pissed off. After wasting another $125 this afternoon on a 45 minute session, all of which was spent in a fruitless attempt to educate my 'doctor' in modern medicine so that I could obtain 'permission' (a prescription) to switch to a different combination of medications, I left the office empty-handed. "We can discuss it next time." Is there some secret, special list of docs which those of us whom already are well-educated in modern medicine can use to just pay for the damn 'script without having to qualify our rationale to someone whom in all probability isn't capable of comprehending it in the first place? I'm talking about non-scheduled substances, here.
>
> This is outrageous and should be outright criminal that doctors are given the power to limit one's medical treatment to only those options they are familiar and comfortable with.
Posted by PhoenixGirl on September 8, 2004, at 17:03:44
In reply to Losing time and money: ignorant doctors, posted by Dave001 on September 7, 2004, at 19:10:16
Gotta shop around for a doctor. I had to go through several before I found a good match for me. It sucks, but it was worth the trouble.
Posted by HappyGirl on September 8, 2004, at 17:51:55
In reply to You've got two problems here » Dave001, posted by Racer on September 8, 2004, at 13:03:39
Hi Racer:
I totally agree with you,... from pdoc. med. school to rx meds.
H.G.
Posted by Dave001 on September 9, 2004, at 20:53:54
In reply to You've got two problems here » Dave001, posted by Racer on September 8, 2004, at 13:03:39
>
> The other part, though, really is worth keeping in perspective: because he went to medical school, he's got the foundation and the context for all the information you may be picking up on the internet and in a vacuum. And no matter how thorough your research is, you're just not going to have that same level of understanding that he does. He really does know things you don't knowThat's a pretty bold assumption, considering I never revealed the sources or level of my education. For all you know, I could *be* an M.D. (though that would say more about my financial upbringing than it would academic...). I most certainly didn't learn anything in a *vacuum*. Also, my doctor doesn't have a Mensa level IQ, and IQ is the main determinant of the rate at which one can learn and assimilate new information.
Posted by alesta on September 9, 2004, at 21:29:57
In reply to Re: You've got two problems here, posted by Dave001 on September 9, 2004, at 20:53:54
hi, dave,
sorry to hear of your problems..some of these doctors really are ridiculous..your anger makes perfect sense..
i was going to babblemail you, but i see you're not set up..if you email me i can give you some quick info that might be helpful, i'm not sure....my addy is enchantedmystic0@aol.com. or you can babblemail me if you get set up...if you like..
amy:)
Posted by Racer on September 9, 2004, at 22:04:26
In reply to Re: You've got two problems here, posted by Dave001 on September 9, 2004, at 20:53:54
You're right, and I'm sorry. Let me see if I can kinda clarify what I meant, and see if that eliminates the offense where none was meant.
Going through medical school will give your doctor a specific, formal structure to what he learns, which is unlikely to be possible without that educational foundation. Yes, we can all do research, and we can all assimilate information to a lesser or greater degree, but the structure of medical school education really does make a difference.
(That said, the ego thing has been more of a problem in my own experience.)
As for what the difference is likely to mean in practical terms, that's just about humans being complex organisms, and any drug is likely to affect more than one system within our bodies. In theory, the whole business about pdocs going through the same basic training as any other MD means that they're more likely to be aware of some of those somatic effects.
Meanwhile, I have a lot of sympathy and empathy for your situation -- and can only add that it would likely be much worse if you were a woman. Best luck.
Posted by alesta on September 10, 2004, at 16:23:21
In reply to Re: Losing time and money: ignorant doctors, posted by becksA on September 8, 2004, at 9:10:19
hi, dave,:)
i just wanted to add something to my previous post to you. your doctor's "we'll talk about it next time" statement serves no purpose. if he doesn't think the med combo is a good idea, then he should discuss the reasons why to you, rather than wasting your time and money..i just wanted to say that, as i thought it might help you to know that i understand...:)amy:)
Posted by Phamos818 on September 11, 2004, at 3:14:40
In reply to Clarification » Dave001, posted by Racer on September 9, 2004, at 22:04:26
i appreciate the fact that doctors have gone to med school and i haven't, but i've seen doctors before that just don't keep up with the more recent pharmaceutical options. it's very awkward, coming in to a doctor's office feeling like you have to tell your own doctor about a drug that could work for you.
the psychiatrist who diagnosed me as bipolar refused to use any mood stabilizers except lithium and depakote until lamictal got approved -- she just wouldn't prescribe off-label.
i have another friend who has tried to present ideas about drugs to her doctor only to be told she was just manic and should be quiet like a good little girl.
there ARE bad doctors out there who don't respect that their patients are intelligent people who should have some say in their care. i'm not saying we should be able to go in and tell them what to prescribe for us. but having looked something up on the internet shouldn't make us bad patients. doctors and patients need to work together more and get over the ego crap that you talked about.
This is the end of the thread.
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