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Plain truth

Discussion in 'Pre-Medical Allopathic [ MD ]' started by freedomist, 05.02.12.

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  1. Instatewaiter

    Instatewaiter But...There's a troponin

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    As soon as I read your first post, I guessed you had some sort of bullsh!t chronic pain condition that other doctors saw right through. You just seem like the whinny substrate that would have one of these conditions- the fibromyalgias, the somatization disorders of the world. It seems I was right. These things aren't rare. You aren't a unique snowflake.

    It was your pain that they just didn't care about because it likely had no organic cause. You people (yeah that's right, you people) are people most normal doctors avoid at all costs. They have too much true illness to deal with, without your whinny crap getting in the way. That is one of the reasons I am going into a field that has true illness- cardiology. You can't fake an MI. Your mind can't create critical aortic stenosis. You can't whine about symptomatic a-fib or heart failure without there being some real illness.

    I'm gonna guess that is not just the doctors that ignore you and your "symptoms." Stop me if I'm getting close.
  2. SpecterGT260

    SpecterGT260 Catdoucheus

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    ^^ can I get a +/-1 from someone actually post medschool on the "my pain" comment? I gathered that shadowing ER for a year as well as a couple other sources, so it is mostly opinion... It always came out when a patient was getting denied meds. "it hurt" was the complaint, until the patient was mad and suddenly we have ownership of the pain.

    along the lines of your post, though, we had a "frequent flyer" at the ER who had delusions of parasitosis. Insisted the doc use the UV vein-finder because we would be able to see the bugs inside her that were apparently inside the baggie full of tissue paper and fuzz bunnies she brought us. The doc did it for fear of being sued by a crazy person lol. even if a case wont win it is still a hassle to deal with i guess
  3. theseeker4

    theseeker4 MS 3

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    This article was the first thing I thought of when reading the OP's comments as well.
  4. xXIDaShizIXx

    xXIDaShizIXx Clinical Psychology Psy.D. Candidate

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    Not going to lie, this thread gives me the "Everybody Dropout So I Can Get In" kind of feeling.
  5. Bro Dude

    Bro Dude Subaquatic Creel Engineer

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    Preach, bruthah! :cool:

    ...or sistah? :p
  6. SunsFun

    SunsFun VICE president

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    A gomer on SDN?
  7. freedomist

    freedomist

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    Competence + compassion = effective treatment

    So without compassion many doctors can still provide care
    But without compassion, in extremely difficult cases, compassion + competence are the determining factors for effective care
    Why can't you digest that? I am the patient, so i get to tell you what works and what doesn't
  8. SpecterGT260

    SpecterGT260 Catdoucheus

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    :bang: This is why i used the word "unable" earlier. it isnt a willingness or stubbornness... I think you genuinely believe what you say and are incapable of seeing how the two are not connected.

    Yes, competence + compassion = effective treatment.

    BUT

    competence + douchebaggary = effective treatment.

    therefore

    competence = effective treatment.

    The only thing that outward compassion adds to the experience is an increase in patient compliance and a decrease in malpractice suits. That is it. But noncompliance does not mean the treatment is ineffective, it means that the treatment wasnt followed. This is a very important distinction you will need to understand if you want to go on to medical school (although it will suffice just fine for MPH ;))

    and we have ALL been patients. You are not unique nor is your perspective somehow at an advantage.
    in fact, it puts you at a disadvantage because you cannot stay objective. you blur the lines and distinciton and walk away with a conclusion that compassion = competence. I will not ask why you cant "disgest" this,as I think it is simply beyond you - but that may be my own bias as I view subjectivity as a very large handicap
  9. freedomist

    freedomist

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    Regardless of what you guys make out of it, I will be a very compassionate and dedicated physician. I insist that compassion is crucial because it was the difference between the doctor who was able to cure my condition and all the other doctors. I believe his caring nature helped him to see something about my condition that other doctors could not see. And if as a doctor, you don t care about your patients I honestly wouldn't wanna be your patient. Yes competence alone can work, but in difficult cases it is not enough, that s the bottom line.
  10. SunsFun

    SunsFun VICE president

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    Have you considered pursuing naturopathic medicine? You'll fit right in man.
  11. VisionaryTics

    VisionaryTics Señor Member

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    Oh, man, medicine is gonna eat you alive.
  12. freedomist

    freedomist

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    whatever and again like all the bad doctors your superficial judgment makes you think you know what I need hahahahahaha that s my point, you don't know what I need until you care so much to dig that deep :)
  13. SpecterGT260

    SpecterGT260 Catdoucheus

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    how does one dig deep here? your argument now is "whateva! you don' know me!" as a retort to any inference into your situation, followed by a "well if you knew me then you'd know!" :confused: In your circular progression it doesnt matter how much anyone cares. The only thing that matters is how much YOU perceive them to care in that you will only divulge necessary information if the doctor has passed your subjective test.

    This is still not supporting your argument in any way.
  14. VisionaryTics

    VisionaryTics Señor Member

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  15. freedomist

    freedomist

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    One cannot dig deep here so one doesn't tell me what i need :)
  16. freedomist

    freedomist

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    l
  17. Morsetlis

    Morsetlis SGU MS-4

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    Stop the fighting!

    Won't somebody think of the children?
  18. Instatewaiter

    Instatewaiter But...There's a troponin

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    What no response to my post? Or did I hit the nail on the head...

    To respond to this you are just plain wrong. In difficult cases, competence is what determines effective care. Compassion is what gives the patient that warm and fuzzy feeling inside. The fact that you haven't grasped that these are different concepts is the entire reason for this thread.
  19. SpecterGT260

    SpecterGT260 Catdoucheus

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    hmmm.... I am trying to put this into perspective for you.... the bolded part is just false. Nobody is saying compassion is a bad thing. But just because it is good and even if it helps, this does not make it a requirement.


    Outcome X requires components A and B.

    Component Y can increase the effectiveness of component B.

    Therefore Component Y is necessary for outcome X. This is false. Under no circumstances will a lack of "component Y" ever result in failure of outcome X as defined here.

    Your error is in assuming that compassion affects the physician. It does not. It affects the patient in terms of mood and willingness to follow directions. Thats great and there are uses for it. However if the "situation" is more difficult, you cant just "care" at it harder and expect a different outcome.
  20. VisionaryTics

    VisionaryTics Señor Member

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    SpecterGT, I don't know why you always let yourself get dragged down to their level.
  21. freedomist

    freedomist

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    Alright so I have been faking and whining about the same condition my entire life :laugh: And if my condition were fake, howcome it was finally cured ? thanks to a real physician not the common physician :laugh: ? dude there is doctor and doctor, that MD/DO is not the end, meditate on that and please reply ASAP
  22. SpecterGT260

    SpecterGT260 Catdoucheus

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    debate is therapeutic when dealing with endless pages of notes :p
    however "their level" in this sense would mean arbitrarily generating a point of view and adhering to it at all costs. Simple engagement is not "sinking" by any means
  23. SpecterGT260

    SpecterGT260 Catdoucheus

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    what?
  24. surfactant

    surfactant Al Herpin

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    i hate when people have experienced one thing or the other and make an overwhelming generalization. if your doc is a real ******* just switch to another one. you arent assigned a doc and forced to stick with them.


    ALSO
    1) docs are underpaided for their skill set and hours they work
    2) docs dont get the same respect as they use to many patients will argue that WebMD said they had this or that
    3) docs dont have the same freedom to practice med as they use to
  25. freedomist

    freedomist

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    Compassion affects the outcome of the treatment and hey I agree with you that compassion is not required, but it a plus and can make a difference in many difficult cases. Just like extra credit, extra credit can help but cannot hurt, yes many students make it without extra credit, but if the exam is extremely hard, here comes the benefit of extra credit. Simple analogy with my condition.
  26. dbeast

    dbeast Neurorectal surgeon

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    Couldn't bear to see this get buried on the first page... SunsFun, you crack me up. :D
  27. surfactant

    surfactant Al Herpin

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    they censored my post
  28. VisionaryTics

    VisionaryTics Señor Member

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    Come on, just tell us. What was it? Maybe give us some symptoms. See if we have enough COMPASSION/PASSION/COM to diagnose it.
  29. TheVillain

    TheVillain

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    OP, why can't you understand that compassion does NOT necessarily equal a great doctor.

    By now with countless replies, simple analogies, and brute logic, you should succumb to the truth, plain truth that you are incorrect. I sense that through your erroneous logic and beliefs you feel that you are somehow special, unique, and thus should be accepted over the-less-compassionate individuals (the rest of us according to you).

    Let me give you another example. Let's assume hypothetically that one-hundred years from now technology begins to effectively take over various tasks that were previously done by homo sapiens, i.e Doctors. Lets assume that these robot doctors have a 99.99% success rate, are able to run through billions of treatment plans per second depending on the problem, and are also 80% faster than human Doctors. Over a period of ten years these robot doctors are tested, experimented, and found to be superior in every aspect to its human counterpart. As more of these robots are being produced, the human doctors begin to lose their jobs and are outsourced. Some human doctors such as yourself would probably cling to "But I am, like, a million time more compassionate than that lifeless machine!" But no one heeds your pleas. If this ever happens you should understand that patients would always choose the robot-doctor over the human one, who, as compassionate as one might be, is sub-par.

    I know this is extremely cheesy:p but I am trying to strike a point here and get it through your skull, that just because you had your own subjective experience with some rare disease, it does not account for the majority of us. Hopefully this clears things up a bit.:xf:
  30. SpecterGT260

    SpecterGT260 Catdoucheus

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    I am literally going to aneurysm.... the logical progression there is in fallacy. being a "plus" does not mean that it will "make the difference". You just keep missing the point.... we keep going around in circles and at the end of every cycle you just go "yes, oh and it also will make the difference!.... LIVES!"

    :rolleyes: Im done. It was fun and hopefully some idealistic pre-med lurkers learned something. Have fun getting your MPH and sorry about the 2013 medschool application cycle :(
  31. SpecterGT260

    SpecterGT260 Catdoucheus

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    while it is probably not ok to goad someone to revealing medical history :laugh: I agree.

    if his case actually was dependent on compassion then the key piece missing from the puzzle is what the illness was.
  32. Instatewaiter

    Instatewaiter But...There's a troponin

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    Guess what, when you treat depression the chronic pain gets better. It doesn't make the person any less whiny. It doesn't make the pain any more organic. It proves it was all in the person's head.

    If you let us know what your "condition" was that they treated I could better answer your first question. The fact that you are avoiding it makes me believe we may be on the right track.

    Also is this supposed to be a question: "Thanks to the real physician not the common physician?" I can't tell.

    Finally, I would medidate on, "dude there is doctor and doctor, that MD/DO is not the end"
    if it were a coherent thought. Please retool it and come back.
  33. SDN9876

    SDN9876 adorablest koala ever

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    Wait a second. Fuel in the tank of a car is very very very important and similarly engineers are the bedrock of society. They are the pillars that hold our buildings up. They are the foundations of our streets. They are the domes of our homes. They are the everest of human successes.

    How dare you reduce them to "other things". I am apalled, mystified, and also disturbed by your reduction.

    We need to rise together and praise engineers who are our leaders and our fathers in this community we call the world.

    No, keep going, that sounds almost exactly right.:)

    GREAT link thanks, definitely adding that to my read list.
    You think it's a trick? Probably her plan to get into MPH school and try to sabotage engineers at the bridges and trains to somehow show the power of the public health person over the engineer. I still dont why people picking on engineers. They're so crucial!

    That would be perfect for her.

    absolutely, but i don't think she'll ever get to clinical medicine. She'll end up MPH or a PA or MD and work only part time. She will never have a full time practice that she runs. Impossible. She would be eaten immediately.
  34. SpecterGT260

    SpecterGT260 Catdoucheus

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    oh.... my bad
  35. SDN9876

    SDN9876 adorablest koala ever

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    Compassion is important because it helps to exaggerate the placebo affect. The placebo effect is great in treating patients, especially when it comes to psychologically related problems such as pain for example.

    I hate to agree with freedomist on that but she is right about that. Compassion is important, but her reasoning is FALSE.

    Compassion for someone doesn't make a difficult illness easier to solve, in fact it can hinder progress because compassion is emotion and emotion can fog the practicality of the diagnostic procedure. This is why you shouldn't treat yourself, your close loved ones.

    When too much compassion is involved, you cannot make the same practical decisions that you would for a non-loved one.

    This is why I had asked you if you slept with your doctor, freedomist. I wasn't kidding, I wasn't joshing you. It was a serious question. You chose to ignore it.

    You chose to ignore my request for a full apology.


    For those who disagree with placebo affect, just look at the recent findings that antidepressants work no better than placebo for majority of average psychiatric problems! That's crazy.

    Don't ever underestimate the power of consoling someone, and being compassionate. It is important. If the patient feels better, they can get better! We cannot reduce that to "oh it doesn't matter" It does matter.

    BUT it is absolutely false to think that it helps to "dig deeper" and "more difficult cases" NO. NO. NO.
  36. vayntraubinator

    vayntraubinator

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    ohmy gosh :cry: this made me :'( please apologize! the emotion...
  37. tiedyeddog

    tiedyeddog

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    You've always been one of my favorite posters on SDN.... Here is why. Strong work. :thumbup:

    P.S., why are people still feeding Freedomist? Guy can't even spit out linear progression of thought or structured english sentences that even slightly resemble cohesive logic, I think he's choking on his self-righteousness.
  38. SpecterGT260

    SpecterGT260 Catdoucheus

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    http://*********************/instances/400x/19930361.jpg
  39. Perrotfish

    Perrotfish Has an MD in Horribleness

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    I normally like your posts, but I have to disagree with this one. The attitude that parasthesias, chronic pain disorders, and iritable bowel syndromes are 'all in a the person's head' goes against the current body of medical evidience (I've never understood how people can call Irritable bowel 'all in your head' when it clearly affects the volume of your stool) and also is the excuse that physicians use to avoid treating these extremely treatable problems.

    The funny thing is that medical treatment of chronic pain disorders is often much more rewarding that the treatment of the majority of 'organic' medical conditions in terms of giving a patient years of funcitonal, productive life. Give your IBS a TCA, your chronic pain an SSRI or a fentanyl patch, or throw some neurontin at those pins and needles and you will very often get an essentially housebound patient back to work for years. I just saw a patient with persistent parasthesias who was functional on a stable dose of neurontin for 15 years with no complaints. How many MIs get years of functional life from our treatment?
  40. Instatewaiter

    Instatewaiter But...There's a troponin

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    I don't include IBS or *many* of the functional GI syndromes in this group because just as you point out, there is something objective to point to (however, I have to say, cyclic vomiting patients do seem to be very, very similar to the prototypical fibromyalgia patient). Some chronic pain is real. Sure, especially when it has a root cause- like a previous gunshot wount to the abdomen or true peripheral neuropathy. Some chronic pain however is not. Paresthesias are not the things I am talking about either.

    With regard to how many MIs get years of funcational life from our treatments: the vast majority of them which is why Cath and CABG are such fabulous modalities. A patient comes in with a STEMI on death's door, gets stented and walks out a few days later. Maybe in 1970 what you are saying would be true but now-adays people do pretty damn well unless they wait too long to get revascularized or they have incomplete revascularization.
  41. dbeast

    dbeast Neurorectal surgeon

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    What are your thoughts on complex regional pain syndrome? And would you feel like a jerk if you wrote that patient off as a crybaby and missed the window in which sympathetic blockers work? We watched a video in class of a real patient who I initially thought of as fibromyalgia or just drug seeking... he ended up getting his leg amputated from chronic infections years later :(

    PS- not trying to be a call out, I'm genuinely curious... As someone interested in EM, I'll be running into a ton of drug seekers, and I'll take all the advice I can get.
  42. KnuxNole

    KnuxNole Sweets Addict

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    HOW DOES IT MAKE A DIFFERENCE?

    Give some examples...

    Cause the one resident who suspected a somatization disorder sounds pretty legit. What did YOU have that compassion was needed?

    Rare disorders don't need compassion to be found, if you think so, name some!
  43. circulus vitios

    circulus vitios

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    My pre-med ideals!!!!
  44. KnuxNole

    KnuxNole Sweets Addict

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    Oh right, this topic is in the pre-allo board :smuggrin:

    Err....forget what I said!

    Guys, you need to love each and every patient like your own flesh and blood

    You need to spend AT LEAST 1 hour talking to your patients, asking about their dreams, motvations, life goals, favorite hookup story, what makes them smile and cry. Forget about the paging nurses and dictations and progress notes, THIS COMES FIRST.

    :D
  45. Perrotfish

    Perrotfish Has an MD in Horribleness

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    Compassion is a motivator to put more time and effort into a patient. To chase down abnormal symptoms, to research your own patient rather than lazily condemning them to half a dozen consultants, to try to sort through the tangled webs of their social work and often incomprehensible medication regimines. Its not the only possible motivation, of couse, but its one possible reason to make sure your job is done well rather than jut done. Lets be honest: there are a lot of very unmotivaed physicians out there (especially once they're done with residency) and having something that pushes you to go the extra mile will make you better than a lot of your colleagues.
  46. SpecterGT260

    SpecterGT260 Catdoucheus

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    personal pride in one's work will be a much stronger motivating factor. How many drug addicted babies do you have to see before compassion wanes and intrinsic motivation takes precedence? That example may be as over worked as the "LIVES" BS from earlier, but the point is that compassion is fragile.
  47. tiedyeddog

    tiedyeddog

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    I am going to have to differ with you on this. In my mind compassion and how well you do your job are not always so intertwined.

    I think showing outward compassion and empathy with your patients is a great thing and makes the patients feel better about your relationship. However, you don't need to ask your patient how his mood and emotions have changed since the MVA to dx a broken femur....

    My point is motivated =/= compassionate, the two aren't 100% inclusive. Maybe the fear of being sued motivates a person or fear of destroying your reputation to make sure a diagnoses is correct instead of this gushing altruistic ideal premeds tend to have towards patients.

    If we always relied on compassion to motivate ourselves to treat our patients we would do ****ty jobs on the patients no one likes, which I won't expand on but I am sure you can think of some superstars you've seen. In those cases, you can't always run on compassion and perhaps run on the ideal of just being a professional.
    Last edited: 05.03.12
  48. Perrotfish

    Perrotfish Has an MD in Horribleness

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    For me the pride in my work has always been linked to compassion. I'm not weeping over the babies or anything, but I want to do the job well because I want the patient to get better and stay better for at least awhile. I've never understood that attitude, probably most concentrated in the ER, that takes a professional pride in fixing a patient that everyone is cynically certain is going to break himself again as soon as he leaves the trauma bay. I don't see how anyone can be motivated to fix that patient in the first place.
    Last edited: 05.03.12
  49. KnuxNole

    KnuxNole Sweets Addict

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    Oh I hope I didn't mean to say that compassion is useless at all. Since yes, compassion is a positive thing to have as a physician!

    the thing which made me :rolleyes: at the OP how she throws around the word compassion. I'm guessing someone was watching too much Patch Adams and was mad when the doctors in real life weren't like that...
  50. KnuxNole

    KnuxNole Sweets Addict

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    I HIGHLY disagree with this btw.
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