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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 97. This is the beginning of the thread.
Posted by Phillipa on April 9, 2006, at 0:48:45
What I don't understand is so many come here to learn about others and their experiences with meds and combos ect. But in the end it seems like everyone thinks their pdoc is like a person to look up to and does whatever he says even though you know your own body better tnan anyone. Why do you spend time here and then do anything he tells you to do. It makes no sense to me you have a mind and a brain . Oh I understand if someone is psychotic or can't maked decisions for themselves but i think the decision to take a med is up to you the patient who pays their bill. Love Phillipa
Posted by JaclinHyde on April 9, 2006, at 0:55:39
In reply to Blind Faith In A P Doc, posted by Phillipa on April 9, 2006, at 0:48:45
Well, I agree with you. I can't stand my doctor but she did give me what I needed. After 25 years on MAOI's, I know the drugs better than she does. So I told HER what I needed and to her credit she wrote the percription.
JH
Posted by Racer on April 9, 2006, at 1:34:14
In reply to Blind Faith In A P Doc, posted by Phillipa on April 9, 2006, at 0:48:45
Truly, it seems dangerous to me, to suggest that anyone here would be better at choosing drugs than a doctor would be. Yes, we can learn things, but we can't prescribe things for ourselves for some very good reasons. Heck, I don't think doctors are supposed to prescribe for themselves, either, and I think that's a good thing.
Doctors really do know more than we do, even if they're not prescribing what we would like them to. Most people here can learn things about the drugs we discuss, but very few of us here can put that knowledge into context. That's what doctors have that we don't: context. And context matters. Context can keep people alive.
It frightens me to read posts like this, because I am afraid of the potential danger for people who use this sort of message and take it as reason enough to drop their pdoc in favor of some quack who'll prescribe anything they ask for. That would be dangerous.
Frankly, Phillipa, I am surprised that a nurse would say this.
Posted by cecilia on April 9, 2006, at 3:06:15
In reply to I get frightened when I read this sort of thing, posted by Racer on April 9, 2006, at 1:34:14
Regular readers here know that MANY doctors are clueless beyond belief. They have their favorite drugs and drugs they won't prescribe under any circumstances and drugs everyone on Psychobabble has been discussing for months that they've never even heard of! Frankly, I think a lot of regular Babblers know MUCH more about psych meds than many pdocs and we ALL know more about our own bodies than they do. They see patients for 10 minutes and think they know all about them. So well I won't say that people should be doing their own prescribing I do think in some cases that would be a lot safer and more effective than blind faith in some of the doctors people have described here. In my opinion most doctors could care less if their patients get better, they just want to make money and not get sued. And have their egos massaged by the patients who happen to get better by the drugs they prescribed, like they invented the drug....Cecilia
Posted by cecilia on April 9, 2006, at 5:02:03
In reply to Re: I get frightened when I read this sort of thing, posted by cecilia on April 9, 2006, at 3:06:15
I mean, I know a lot of people will say, oh doctors must be so smart, they go through 4 years of college and 4 years of med school and 3 years of residency. For pdocs, so what. 99% of med school has nothing to do with psychological issues, even though most people with physical problems also have psychological issues, doctors generally ignore them, and residency is mostly dealing with hospitalized patients. When they get out into the real world and set up their private practices to start raking in the dough, pdocs only have to know about a few dozen meds for mostly depressed and anxious but functional patients, as long as they can write their prescriptions fast enough they'll be able to pay back their student loans and get rich. How many brains does it take to do that? All they have to do is figure out how to tell the bipolars from the unipolars, and how to keep people like me who've failed every med ever made to keep coming back (prescribe sleeping pills). (Though realistically, I'm sure most just wish the failures wouldn't come back.) I guess I haven't a clue about what these pdocs supposedly know about "context". They barely know who you are. My current pdoc is quite nice (and believe me I've had some horrible ones) but if I could write my own prescriptions I could care less if I ever saw him again. Cecilia
Posted by cecilia on April 9, 2006, at 5:32:39
In reply to Re: I get frightened when I read this sort of thing, posted by cecilia on April 9, 2006, at 3:06:15
Plus another pet peeve-so many docs supplement their already hefty incomes via the drug reps. When Cymbalta 1st came out I couldn't believe how many people writing in here who had never been on ANY antidepressant before had been started by their docs on Cymbalta. I mean, where's the common sense, when new drugs come out you try them for your multiple failure patients--I'll be lining up for Emsam; but you don't risk trying a brand new drug on someone who's never tried any drug, you give them one of the tried and true ones, like Celexa or Zoloft, first. Unless you're getting paid under the table (or are just stupid). Cecilia
Posted by cecilia on April 9, 2006, at 5:35:25
In reply to More ranting about doctors, posted by cecilia on April 9, 2006, at 5:32:39
Well. as the old cliche goes, what do they call the person who graduated at the bottom of his medical school class? Doctor. Cecilia
Posted by alohashirt on April 9, 2006, at 7:44:16
In reply to Blind Faith In A P Doc, posted by Phillipa on April 9, 2006, at 0:48:45
Blind faith in anyone (doctor, mechanic, contracter, priest) is risky. There's a great book by Sheldon Kopp "If you meet the Buddha on the street, kill him." At the same time, whilst i might devour everything that's written about the seven medications commonly used to treat ADHD, I don't have the general context, experience, or experience that a doctor has and its both arrogant and foolish for me to assume that I (inevitably) know best. In addition there's an element of subjectivity and magical thinking that we can naturally carry about ourselves.
I agree with you Philippa - but at the same time I think its important to give my doc a chance to be a doc, which means disclosing information, trying out suggestions and sometimes plain old "managing upwards" or "ego stroking" to ensure I get the right treatment.
Working with a doctor is a relationship and, like all relationships, can be pain in the *ss for all parties.
> What I don't understand is so many come here to learn about others and their experiences with meds and combos ect. But in the end it seems like everyone thinks their pdoc is like a person to look up to and does whatever he says even though you know your own body better tnan anyone. Why do you spend time here and then do anything he tells you to do. It makes no sense to me you have a mind and a brain . Oh I understand if someone is psychotic or can't maked decisions for themselves but i think the decision to take a med is up to you the patient who pays their bill. Love Phillipa
Posted by Squiggles on April 9, 2006, at 8:38:10
In reply to Re: Blind Faith In A P Doc, posted by alohashirt on April 9, 2006, at 7:44:16
I agree with Alohashirt.
As for phillipa's question "why do people
come here" if they have a doctor, i think
(for me at least) there may not be enough
time for the huge amounts of posts, questions,
ranting, etc. in a dr.'s office. And the questions are not always of a clinical type. There is
a lot of debate on non-medical issues.Also, I think people may be too shy to ask many questions of a direct or embarrassing nature with their doctor. The net provides anonymity. I think it's equivalent to cognitive therapy and
psychoanalysis, and very much cheaper to boot.One more thing - I think it's emotionally important for people to trust their doctor in general. You have to ask yourself, with whom you *could* replace a doctor (with their years of training and experience)? This becomes particularly relevant when you are very sick.It is presumptuous to assume that ALL doctors are corrupt. If I went into a profession for the
money, I would choose another trade, with less
liability, hard work, and worry.Squiggles
Posted by Glydin on April 9, 2006, at 10:31:36
In reply to I get frightened when I read this sort of thing, posted by Racer on April 9, 2006, at 1:34:14
> Truly, it seems dangerous to me, to suggest that anyone here would be better at choosing drugs than a doctor would be. Yes, we can learn things, but we can't prescribe things for ourselves for some very good reasons. Heck, I don't think doctors are supposed to prescribe for themselves, either, and I think that's a good thing.
~~~ I agree.Honestly, I don’t see a lot of blind faith in pdocs on this board or other health boards. I think most folks probably come here for the “mission statement” of this board: “mutual support and education”. So, I think the results of coming here or researching in general, leads more to NOT following along blindly. I find most folk’s goal is to be more informed to better advocate for themselves. That being said, I believe blind faith in any resource isn’t a good idea whether that is a doc, a friend or an Internet board.
For me, objectivity and being able to make good judgements are clouded when I’m ill. I don’t think you have to be psychotic to NOT have the ability to make good judgements. The partnership between the doc and myself is really important for a balanced view of things and there is not a substitute for it.
Posted by TylerJ on April 9, 2006, at 10:56:27
In reply to I get frightened when I read this sort of thing, posted by Racer on April 9, 2006, at 1:34:14
> Truly, it seems dangerous to me, to suggest that anyone here would be better at choosing drugs than a doctor would be. Yes, we can learn things, but we can't prescribe things for ourselves for some very good reasons. Heck, I don't think doctors are supposed to prescribe for themselves, either, and I think that's a good thing.
>
> Doctors really do know more than we do, even if they're not prescribing what we would like them to. Most people here can learn things about the drugs we discuss, but very few of us here can put that knowledge into context. That's what doctors have that we don't: context. And context matters. Context can keep people alive.
>
> It frightens me to read posts like this, because I am afraid of the potential danger for people who use this sort of message and take it as reason enough to drop their pdoc in favor of some quack who'll prescribe anything they ask for. That would be dangerous.
>
> Frankly, Phillipa, I am surprised that a nurse would say this.
Just like everything else in life, there are good doctors and there are bad doctors. Although at times I disagree with my pdoc, I know he's a good doctor and I know he knows a heck of a lot more about medicine than I do.
There have been times when I wasn't doing well and I would tell him I want to try this or that and sometimes he would say okay, other times he would say no, and always give me a reason why. And everytime he has said no, months or even a year later, I would look back and say WOW, he was right, I'm so glad he said no.
A GOOD DOCTOR looks at us objectively when we are depressed and anxious etc., and we go in thinking I want relief and I want it now! We, at that time, would swallow rocks if they made us feel better. A good doc will look at what will be the best medicine for you long term, not just hand over prescriptions that will make you feel better for a week-if that's what we want, all we have to do is go to the local 7-11 and buy some beer or wine and stay drunk for a week...but when we sober up, guess what, we're worse than we were before. Sorry for rambling..I hope I made my point clear.Tyler
Posted by Phillipa on April 9, 2006, at 11:16:36
In reply to I get frightened when I read this sort of thing, posted by Racer on April 9, 2006, at 1:34:14
Don't be surprised you have no idea how many fatal mistakes nurses pick up on as the nurses are responsible for knowing what the proper and safe doses are and the pharmacy always calls if they don't agree with what a doc orders. They work long hours and mix patients up. I've seen surgical pts go psychotic cause they were on a benzo and when a patient goes to surgery the regular orders are automatically cancelled and most of the time the surgeon is only interested in his or her postop orders for antibiotica and pain meds. The one pt had been on high does os xanax for years and ended up in leather restraints until a nurse picked up the fact that the doctor had forgotten to reorder the xanax after the surgery. The nurses picked up the mistake and the med was started again . The next day the patient was back to normal and didn't remember a thing. That's why. Love Phillipa
Posted by linkadge on April 9, 2006, at 11:31:36
In reply to Re: I get frightened when I read this sort of thing » Racer, posted by Phillipa on April 9, 2006, at 11:16:36
I don't think its a matter of being "smarter" than your doctor. When you're dealing with something like a mental health issue, its not always about right and wrong, it can be a matter of what works better and what works worse.
Sure, it can set your mind at ease to think that all of the doctors decisions take place on a wavelength two steps above the average patient, but most of it is trial and error.
My doctor told me it was ok to take lithium and parnate together. When the pharmacy called him back questioning the decision, he recanted !
Thinking you're better than your doctor probably won't get you very far, but as far as do I "trust" my doctor, the answer would have to be: How could anybody fully trust their doctor? Many of these sorts of medical decisions always cary a degree of uncertainty and risk.
You've got to think for yourself. I think it is foolishly to blindly trust every decision a doctor makes for you, under the guise of "oh they know what they're doing"
Linkadge
Posted by linkadge on April 9, 2006, at 11:38:11
In reply to Blind Faith In A P Doc, posted by Phillipa on April 9, 2006, at 0:48:45
I agree with you Phillipa. Ones intuition is very strong, and to ignore it in favor of blind faith is unwise in my opinion.
Doctors often just say things becuase they think that (in the medical community) this is what is acceptable, and expected of them. Doctors feel pressured to make decisions, and to get people well. They will downplay side effects in order to get you to take medications. One doctor told me that effexor does not cause sexual side effects or any insomnia. Now how can I trust that doctor when he tells me that the drug isn't going to fry my brain?
It is not totally uncommon for some psychiatrists to end up leaving their practice because they don't really feel "right" about the sorts of decisions they are being pressured to make.
Linkadge
Posted by Phillipa on April 9, 2006, at 11:53:13
In reply to Re: I get frightened when I read this sort of thing » Racer, posted by Phillipa on April 9, 2006, at 11:16:36
Oh and nurses carry their own malpractice insurance cause a hospital only backs up the docs. Nurses are replaceable. And I never suggested that we should prescribe for ourselves just research any med you may be prescribed and use the same pharmacy as they will pick up on meds that are not compatible together. And the ER doc I just saw said that pdocs are not choosing that profession anymore. And please if anyone knows of a pdoc that schedules an appointment for more than l0minutes as mine are schduled for l0 minutes only . I bring notes and questions written down with me but they are thrown in the waste basket by the pdoc. And I have to talk to his nurse he never talks to the patients on the telehone I asked why to his nurse . Her reply oh he doesnt talk to patients he doesn't have time even at the appointments the appointments must be once a month or the insurance company won't pay him. Love Phillipa ps do you have a pdoc that talks to you and please give me their name in the Charlotte NC area if you know of one there . Thanks
Posted by Phillipa on April 9, 2006, at 11:55:21
In reply to Re: I get frightened when I read this sort of thing » Racer, posted by TylerJ on April 9, 2006, at 10:56:27
Tyler where is your doc? I want one like him. Love Phillipa
Posted by Squiggles on April 9, 2006, at 12:20:13
In reply to Re: I get frightened when I read this sort of thing » TylerJ, posted by Phillipa on April 9, 2006, at 11:55:21
> Tyler where is your doc? I want one like him. Love Phillipa
Just for bedside manner, i wouldn't mind
the style of Eric LostBoyinNC, but the fact
that he is a racist and possibly a net KOOK
just makes him an attractive writer with
insight into people's insecurities.Squiggles
Posted by Racer on April 9, 2006, at 12:30:55
In reply to Re: Blind Faith In A P Doc, posted by alohashirt on April 9, 2006, at 7:44:16
Posted by Maximus on April 9, 2006, at 13:02:34
In reply to I get frightened when I read this sort of thing, posted by Racer on April 9, 2006, at 1:34:14
> Frankly, Phillipa, I am surprised that a nurse would say this.
Hi,
I'm 100% with Racer on this one. I will add that "sometimes" there are some positives debates here but most of the time that does not fly high. Moreover to my knowledge there is no "active" psychiatrists here. So yes i have been reading for 15 years or more on mental illness (neurotransmitters, neuroanatomy, name it...) but that does not give me in any way the clinical expertise of a psychiatrist.
Did i mention that a lot of us, here on psycho-babble, are treatment resistant and can not represent the majority of people with that type of illness.
So, BLIND FAITH in a pdoc? I would say no. BUT it is really better to work WITH the psychiatrist, to question him and may be "suggest" to him an alternative. That is a whole different than taking our own advices and playing the doctor. What i discourage a lot.
Philippa, with all due respect, that was a very very bad suggestion and statement to make.
Posted by Phillipa on April 9, 2006, at 13:03:09
In reply to Re: Blind Faith In A P Doc, posted by alohashirt on April 9, 2006, at 7:44:16
Well maybe if my pdoc had listened to me earlier I wouldn't be going to a neurosurgeon tomorrow. My symptoms led me to the ER and then the a full cardiac workup and a referral to a neurologist and then the neurosurgeon. Seems after MRI's ordered by the neurologist that my cervial spine is narrowed and can create paralysis if in a car wreck. but when i told the pdoc about my sytoms he wasn't interested and said that's not my specialty it must be anxiety. Hence I do not have respect for the ones I now know. And the last study I read said psychiatrists have the highest rate of suicide among doctors. So is it because they do or do not take meds? A pdoc i worked with committed suicide and the other pdocs he worked with didn't recognize it. Oh they felt bad but by then it was too late. Love Phillipa
Posted by gardenergirl on April 9, 2006, at 13:14:03
In reply to Re: Blind Faith In A P Doc, posted by Phillipa on April 9, 2006, at 13:03:09
> Seems after MRI's ordered by the neurologist that my cervial spine is narrowed and can create paralysis if in a car wreck. but when i told the pdoc about my sytoms he wasn't interested and said that's not my specialty it must be anxiety.
Um, Phillipa. Maybe I'm misunderstanding what you told your pdoc. But cervical narrowing would not be related at all to a pdoc's speciality, so I think his response makes sense.
> Hence I do not have respect for the ones I now know. And the last study I read said psychiatrists have the highest rate of suicide among doctors. So is it because they do or do not take meds?
I don't think that it's quite that simple, but that's for another discussion.
About your original post, though. You asked why do people come here if they are going to listen to their pdocs. Well, I come here as well as use other resources in order to be an informed consumer of health care services. I think it's the patient's responsibility to the best of their ability to have some knowledge about treatment in order to make an informed decision.
And as others have said, physicians do indeed know a heck of a lot more about how the body works and how medications can interact with the body and other substances than I certainly do. I don't expect my doctors to know everything about everything off the top of their heads, but I do expect them to consult references and to be thoughtful about treatment decisions.
I would not take it upon myself to know that taking Drug A might increase Drug B's blood levels, and thus might mean I need to lower drug B. I would expect my doctor to work with me on this based on my report of what I know...how I feel, and his/her knowledge of medicine.
It's a team effort, not a competition of who knows more or who knows best.
gg
Posted by gardenergirl on April 9, 2006, at 13:25:20
In reply to Re: I get frightened when I read this sort of thin » Phillipa, posted by Squiggles on April 9, 2006, at 12:20:13
> but the fact that he is ... and possibly a net KOOK
Please don't post anything that could lead others to feel accused or put down. If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civilFollow-ups regarding these issues, as well as replies to the above post, should be directed to Admin and should of course themselves be civil.
Regards,
gg acting as deputy for Dr. Bob
Posted by Anna5 on April 9, 2006, at 13:30:17
In reply to Blind Faith In A P Doc, posted by Phillipa on April 9, 2006, at 0:48:45
> What I don't understand is so many come here to learn about others and their experiences with meds and combos ect. But in the end it seems like everyone thinks their pdoc is like a person to look up to and does whatever he says even though you know your own body better tnan anyone. Why do you spend time here and then do anything he tells you to do. It makes no sense to me you have a mind and a brain . Oh I understand if someone is psychotic or can't maked decisions for themselves but i think the decision to take a med is up to you the patient who pays their bill. Love Phillipa
-I think a person needs to learn about the medication inorder to make a informed decision on a medication. I have have said no to a couple of medications the pdoc suggested. You can always ask if there is any other alternatives.
People come on this site to gather information and also for support. By having more knowlege a person is able to make a more informed decision.
Posted by JaclinHyde on April 9, 2006, at 13:32:58
In reply to Re: I get frightened when I read this sort of thing » Racer, posted by TylerJ on April 9, 2006, at 10:56:27
The problem is too when one hand doesn't talk to the other. Bringing up Tyler (hope you don't mind Ty) for instance he has high blood pressure and was prescribed his med for that from one doctorr while another gave him Parnate. They don't interact per se but they do affect each other. I think doctors you treat you should work like a team to help you get the best quality of life that you can.
JH
Posted by Squiggles on April 9, 2006, at 14:01:49
In reply to Please be civil » Squiggles, posted by gardenergirl on April 9, 2006, at 13:25:20
> > but the fact that he is ... and possibly a net KOOK
>
> Please don't post anything that could lead others to feel accused or put down. If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
> http://www.dr-bob.org/babble/faq.html#civil
>
> Follow-ups regarding these issues, as well as replies to the above post, should be directed to Admin and should of course themselves be civil.
>
> Regards,
> gg acting as deputy for Dr. Bob
>I only said that because Dr. Bob
kept kicking him out when he posted
racist remarks here. Rather consistent
i should think;Squiggles
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