In case you thought US docs had a monopoly on self-hating self-destructive anti-intellectualism:

[eye love lamp]

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In answer to your first question, I was deployed (twice) to austere regions of the world where western medical infrastructure didn't exist. To provide care to the local populace required old school physical examination, adaptability to limited medical supplies (generally what I could carry on my back), and a healthy amount of patient education.

You need to move beyond your assumptions about what is necessary to provide care. There remain large portions of the world (and this country) where medical care is not provided in large tertiary care centers. And even in our medical centers, the fact that all these "efficiencies" (as you phrase it) exist does not mean that they are necessary, or even important to the provision of care. Rather, they are "efficient" in speeding billing and protecting the legal interests of the facility, neither of which matter in caring for the sick and injured.

In other words, the existence of these things and people does not imply a need for them (and to remind you, you were the one who said all these other people were necessary, and that we're all just "cogs" implying interdependence).

OK clearly a third world country is going to be a different conversation. You can't even provide the level of care that is possible in a developed nation.

I think it's safe to assume this conversation is regarding to care provided in a developed nation. If I had to practice on my own with no help whatsoever I would probably see 25% of the patients I see currently. If every provider was plagued by this we would have an even further physician shortage in the United States. I would argue they are necessary and are important in the care for the sick and injured.

 

[Mad Jack]

So if you hire an architect, you expect them to come back and say "here's your house! you get NO say in any design modifications because I'm the architect and you have no idea what the **** you're doing! Oh and I insist you call me Architect David and not by my first name"

The point is that the relationship is not one of equality. You ask for something that fits your needs, they make it happen. You don't have the expert skill to determine what beams, support structures, materials, etc will be used to make it happen. You are, for all intents and purposes, an idiot in regard to architecture, and need the help of an expert to design your house because without them your abilities in the realm of home design would be limited to a duct-tape lined cardboard box. Patients are not our equals, they are our customers. Customers seek services from those that can do things they cannot, because that's how an advanced society with professional specialization works. In the realm of each specialist, they are the expert, whom you present to for assistance in those things that you have not devoted your life to. It's not rocket science.

Do you give your patients options? Sure. Does that mean that they are an equal part of their care? Not really. They aren't diagnosing themselves. They aren't determining the optimal medication concentrations and meds to be used. They get the final say, sure, and are in control of what parts of their care they receive, but you are the one that decides what options will be presented, and in what light that occurs.

 

[Mad Jack]

What fields can you efficiently see patients without ANY other person providing ancillary services?

The reason why we have these machine-like systems set up is so that we can see more people more efficiently. Sure, if you're in the ED you could run down and do your own chemistries and then take the patient to MRI and push the button and then go pick up the meds from pharmacy and push them but at the end of the day you might see two patients.

Psychiatry, for one 😉 Direct primary care for another.

 

[Mad Jack]

Ehh, this rubbed me a little wrong. There's absolutely a power differential in the doctor patient relationship, but it's not one of roles so much as one of information. We're vastly more educated with regard to medical information, obviously. It's our responsibility to shrink that information differential as much as possible to put the power in the hands of the patient. "based on a b c, I believe q is what's most likely going on, but it could also be r or s. For those reasons, I'm recommending x, which would involve yadayada, but we could also pursue y or z - the pros and cons to which include blah blah blah". There are limits to that, obviously. The doctor isn't obligated to prescribe a treatment they feel the risk benefit ratio doesn't play out favorably, just like an architect isn't obligated to design a building not up to code, regardless of consumer desire.

I'm not sure if your post was intended to come across this way, but it read to me as really endorsing the paternalistic model of care

That we have the knowledge is entirely the point. Yeah, you give them options, but they came to you because you're the one with the answers. You provide them with the answers, eschewing all the dumb **** they dug out of Google, and the plusses and minuses of each. Then you figure out the meds that work, you figure out the treatment plan, you figure out literally all the rest of it. The "equality" line in reference to patients as part of the medical team is entirely bull****, because they're far greater than equal in many regards (they come first in all decisions and discussions and have the ability to consent or decline anything) and far less so in many others (they lack the knowledge to appropriately understand their diseases and the management of those diseases by a long shot). It isn't some magical thing at the end of the day, it's a basic consumer exchange.

 

[Psai]

OK clearly a third world country is going to be a different conversation. You can't even provide the level of care that is possible in a developed nation.

I think it's safe to assume this conversation is regarding to care provided in a developed nation. If I had to practice on my own with no help whatsoever I would probably see 25% of the patients I see currently. If every provider was plagued by this we would have an even further physician shortage in the United States. I would argue they are necessary and are important in the care for the sick and injured.

And if everyone else was there and you weren't, they would see 0% of the patients you see currently. Those people help you do your job and are valuable but you are indispensible. None of those people would have those jobs without you.

 

[PikminOC]

Do you disagree with that statement?

I hate to break it to you, but everyone is important in the treatment of a patient. It depends what setting you plan on practicing (we'll use the ED for example), but the following people are needed:

Clerical staff
Security
Nurses
Phlebotomy
Lab techs
Radiology techs
Radiologists
Patient transport
IT staff
ED physician
Social workers
Administrators

....and others I missed. Everyone in that list plays an important role. You can't just dismiss their importance because you have more education under your belt. No one is knowledge shaming here, but it's time that physicians realized that they're a cog in the wheel of healthcare delivery. Healthcare doesn't work any other way.

Wrong. Cut all the bloat from medicine. Get back to basics. Doctor and patient. I can clean my bathroom myself.

 

[PikminOC]

No one is devaluing our contributions by acknowledging this is a team sport.

Team malpractice and liability too?

 

[PikminOC]

OK clearly a third world country is going to be a different conversation. You can't even provide the level of care that is possible in a developed nation.

I think it's safe to assume this conversation is regarding to care provided in a developed nation. If I had to practice on my own with no help whatsoever I would probably see 25% of the patients I see currently. If every provider was plagued by this we would have an even further physician shortage in the United States. I would argue they are necessary and are important in the care for the sick and injured.

Ever heard of direct pay practices?

 

[CherryRedDracul]

Wrong. Cut all the bloat from medicine. Get back to basics. Doctor and patient. I can clean my bathroom myself.

I've been reading more and more about micropractices, and the more I read about it, the more I like it. Bloat is inefficient and sometimes it's better to do things yourself. Rather than wait half an hour for the cleaning staff to clean up the angio suite so the next case could come in, one of the IR attendings at my hospital took matters into his own hands, got down on his own hands and knees, and cleaned the room himself (and I helped too, of course). That event has stuck with me and will likely influence how I practice in the future.

 

[username456789]

I've been reading more and more about micropractices, and the more I read about it, the more I like it. Bloat is inefficient and sometimes it's better to do things yourself. Rather than wait half an hour for the cleaning staff to clean up the angio suite so the next case could come in, one of the IR attendings at my hospital took matters into his own hands, got down on his own hands and knees, and cleaned the room himself (and I helped too, of course). That event has stuck with me and will likely influence how I practice in the future.

Well, also keep in mind that working in the "real world" is different than academics. OR turnover time seems to shrink exponentially when the powers that be realize that physicians' time is more valuable than pretty much anyone else's, and will be much more likely to ensure such a scenario that you described never has to happen.

Everything is bigger, more bloated, and less efficient in academics.

 

[PikminOC]

Well, also keep in mind that working in the "real world" is different than academics. OR turnover time seems to shrink exponentially when the powers that be realize that physicians' time is more valuable than pretty much anyone else's, and will be much more likely to ensure such a scenario that you described never has to happen.

Everything is bigger, more bloated, and less efficient in academics.

Yet these places cost so much. Dont forget facility fees! Everything is passed along to the patient..

 

[eye love lamp]

Your assumptions are incorrect. Again, this massive infrastructure we have built is designed largely for administeative purposes, not to provide better care.

Wrong. The infrastructure is to provide more care. More access, more patients. It shouldn't affect quality.

Medicine today is quite different than it was 20 years ago, and worlds different than 50 years ago. Yet we treat the same conditions, and in a multitude of cases, achieve the same general outcomes. Advances in lifespan and population health were largely unaffected by advanced imaging and surgical techniques. They are completely unaffected by electronic health records, expensive wound dressings, and the latest hospital beds that go up and down.

It seems like your real argument i that the current medical system in large referral centers would grind to a halt without all our supplementary personnel and technology. I'm not even sure I agree with that, but at least it's somewhat more reasonable than your original "everyone is a cog" argument.

Not quite my argument, but ok

You think "3rd world" scenarios are completely different, but they're not. They just require more innovation and imagination to deliver quality care. Ditto on care that occurs in rural areas and small community hospitals. You may experience this sooner than you think, with the end of residency creeping up. I hear the job market has gotten a little tough on your field.

Not according to my experience/search. I landed my dream job, and part of the reason was because of my progressive attitude of about how health care works in 2015.

The only constant in all of this is the physician. Without a physician, it all grinds to a halt. So yeah, we're special.

It seems like its just an insecurity thing. As long as there's a huge banner at the door that says "thank you God for physicians" everyone in this thread would be happy.

 

[eye love lamp]

And if everyone else was there and you weren't, they would see 0% of the patients you see currently. Those people help you do your job and are valuable but you are indispensible. None of those people would have those jobs without you.

So the physician is the biggest cog? Is that better?

 

[eye love lamp]

Wrong. Cut all the bloat from medicine. Get back to basics. Doctor and patient. I can clean my bathroom myself.

This works if you don't need any technology in your office. Unfortunately I need a lot of $$ for equipment to do mine.

 

[username456789]

It seems like its just an insecurity thing.

See, this is exactly the kind of BS that medical schools have indoctrinated our students with.

On no planet and in no universe should someone be viewed as "insecure" for wanting to maintain their designated (and "earned") title in their profession.

Yeesh.

 

[PikminOC]

This works if you don't need any technology in your office. Unfortunately I need a lot of $$ for equipment to do mine.

Equipment not necessarily tons of bloated staff..look around you...cut the bloat..

 

[eye love lamp]

See, this is exactly the kind of BS that medical schools have indoctrinated our students with.

On no planet and in no universe should someone be viewed as "insecure" for wanting to maintain their designated (and "earned") title in their profession.

Yeesh.

Who needs a title though? Doesn't the respect that comes from the fact that the patients are coming to you for help in their time of need count? Or the fact that nurses abide by your orders? Or physical therapy comes and rehabs your patient and gives you rec's where to discharge? Or social work comes along and helps arrange discharge? Or the nurse who calls your patient post discharge to see how they're doing?

I don't understand why the title is so damn important. Physicians have plenty of respect in the day to day world. I don't see why going on a first name basis with everyone diminishes that.

 

[PikminOC]

So the physician is the biggest cog? Is that better?

Team malpractice and liability? That is how much part of the team you are..

eye Lu, what kind of physician are you?

 

[PikminOC]

Who needs a title though? Doesn't the respect that comes from the fact that the patients are coming to you for help in their time of need count? Or the fact that nurses abide by your orders? Or physical therapy comes and rehabs your patient and gives you rec's where to discharge? Or social work comes along and helps arrange discharge? Or the nurse who calls your patient post discharge to see how they're doing?

I don't understand why the title is so damn important. Physicians have plenty of respect in the day to day world. I don't see why going on a first name basis with everyone diminishes that.

If everyone is equal on the team, why would they listen to the physician more, first name or not?

 

[username456789]

Who needs a title though? Doesn't the respect that comes from the fact that the patients are coming to you for help in their time of need count? Or the fact that nurses abide by your orders? Or physical therapy comes and rehabs your patient and gives you rec's where to discharge? Or social work comes along and helps arrange discharge? Or the nurse who calls your patient post discharge to see how they're doing?

I don't understand why the title is so damn important. Physicians have plenty of respect in the day to day world. I don't see why going on a first name basis with everyone diminishes that.

It is my opinion that the more "established" these things are, the more ridiculous and patronizing it is to force the whole "How do you do, fellow kids?" thing.

It almost comes off as more insulting. When I was an intern and didn't quite feel comfortable yet in the role of physician, I often countered "Hi Dr. ______" with "oh please, call me Firstname." Then I quickly realized how silly, forced, and unnecessary this seemed. I know it seems cool to think "yeah, those patients totally identified with me because I'm John, not 'Doctor Smith'" now, but this novelty will likely wear off.

Or, maybe not. Maybe you'll keep introducing yourself by your first name, and your patients will be fine with it. I don't know. But I do know that in my department, which arguably is the friendliest and most personable Dermatology department in the nation, we still introduce ourselves as "Doctor _____" because that is our role and it's silly to pretend otherwise.

 

[username456789]

eye Lu, what kind of physician are you?

Pretty sure he/she is in ophtho.

 

[PikminOC]

A physician? So eye lu, who on your team is equal to you? The janitor?

 

[Psai]

Pretty sure he/she is in ophtho.

SouthernIM is a surgeon though

 

[username456789]

SouthernIM is a surgeon though

True, but I think he/she stated ophtho on an earlier thread. Or maybe I'm just imagining it due to the name.

 

[eye love lamp]

If everyone is equal on the team, why would they listen to the physician more, first name or not?

A physician? So eye lu, who on your team is equal to you? The janitor?

I did say everyone is important to deliver healthcare, but that doesn't mean the janitor and I have equal say in what the diagnosis/treatment of a patient is.

We also (obviously) get wildly different paychecks. Another factor that shows more respect to physicians.

 

[eye love lamp]

GWDS is right, I am ophtho

 

[eye love lamp]

It is my opinion that the more "established" these things are, the more ridiculous and patronizing it is to force the whole "How do you do, fellow kids?" thing.



It almost comes off as more insulting. When I was an intern and didn't quite feel comfortable yet in the role of physician, I often countered "Hi Dr. ______" with "oh please, call me Firstname." Then I quickly realized how silly, forced, and unnecessary this seemed. I know it seems cool to think "yeah, those patients totally identified with me because I'm John, not 'Doctor Smith'" now, but this novelty will likely wear off.

Or, maybe not. Maybe you'll keep introducing yourself by your first name, and your patients will be fine with it. I don't know. But I do know that in my department, which arguably is the friendliest and most personable Dermatology department in the nation, we still introduce ourselves as "Doctor _____" because that is our role and it's silly to pretend otherwise.

We can agree to disagree. I've been doing it for four years, there's no novelty. Unless it's a staff member, I don't correct patients and ask them to address me by first name. I always introduce myself by first name though. Some patients get my first name and call me Dr John. A rare few have outright asked me for my last name and go for Dr Doe. I've never encountered a problem yet.

These people let me cut into their eyeballs. I'm not pretending to act otherwise than a physician.

 

[PikminOC]

We can agree to disagree. I've been doing it for four years, there's no novelty. Unless it's a staff member, I don't correct patients and ask them to address me by first name. I always introduce myself by first name though. Some patients get my first name and call me Dr John. A rare few have outright asked me for my last name and go for Dr Doe. I've never encountered a problem yet.

These people let me cut into their eyeballs. I'm not pretending to act otherwise than a physician.

It may have to do with where you work then. In a hospital setting the patients are confused on who is seeing them.
What works in your practice may not work in other practices or places.

 

[charmiedermie]

She's from Florida.

Maybe this is from their joke Christmas issue?

No, @GuyWhoDoesStuff is correct: http://www.fau.edu/honors/faculty/faculty_ashleykennedy.php. she has written similar articles on the topic on her CV. She is American though, not British. I'm willing to bet she has all her students address her as "Doctor" or "Professor". Why should a teacher-student relationship be deferential?

 

[PikminOC]

We can agree to disagree. I've been doing it for four years, there's no novelty. Unless it's a staff member, I don't correct patients and ask them to address me by first name. I always introduce myself by first name though. Some patients get my first name and call me Dr John. A rare few have outright asked me for my last name and go for Dr Doe. I've never encountered a problem yet.

These people let me cut into their eyeballs. I'm not pretending to act otherwise than a physician.

just BC u don't pretend to be anything other than a physician doesn't mean others dont pretend to be physicians..

once again, we make more BC of our education and liability...why are you arguing with that? If I go work at a law firm as a receptionist, I would expect to be paid as a receptionist not a lawyer..

 

[PikminOC]

r u angry BC u r an eye dentist and I'm a head shrinker?

or r u an optometrist?

 

[Tenk]

The reason why ER doctors introduce ourselves as Dr. X is because the patient has 5 different strangers in their room at the same time asking them questions and they need to know who the doctor is.

If you don't, the patients sometimes complain, "Well I never even saw the doctor!" (Sometimes they do this anyways).

The person who wrote this article is just ignorant.

 

[PikminOC]

See, this is exactly the kind of BS that medical schools have indoctrinated our students with.

On no planet and in no universe should someone be viewed as "insecure" for wanting to maintain their designated (and "earned") title in their profession.

Yeesh.

You should see what midlevel school is indoctrinated with...

 

[PikminOC]

I dont call any of my physicians by their first name nor do I have them call me Dr when I'm their patient.

 

[Terry Toma]

I, for one, insist that physicians refer to themselves as premeds while they are in my presence in order to ensure that I never feel like an unequal partner. Nothing is more comforting than feeling like the person who is about to cut me open and take out a body part is a regular guy who's no better than me.

 

[Lord Humongus]

Enough talk darn it! When are we going to start chopping down them tall poppies? I've got my machete nice sharp and ready.

You didn't build that bro!

 

[Shams al Deen]

I'm really offended that everyone is referring to the author as 'she'. Just because the author's name is Ashley doesn't mean the author identifies as female. Use 'they', please.

 

[LetItSnow]

Fair warning. I ranted. It was a super long weekend on ER.

.
.
.

What kind of BS is this? Treating people with respect is one thing. Treating them as 'equals' is another.

I mean, I'm in animal medicine, so I don't know what kind of hell you people have to deal with. But I am not "equal" to my personal doctor. He went to med school to learn how to treat people. He did a residency. He did god knows what to get where he's at and build the expertise he has. I do defer (as in, treat with deference) to him for my care. Am I a helpless lackey in the process? Of course not. I weigh his opinion and, if necessary, I go get another educated one. And ultimately I make the decisions. But his opinion carries most of the weight because .... we're not equal. If we were, I wouldn't need him.

He does have to be respectful to me or I'll tell him to go to hell and I'll find a physician that can act like a decent human being. But we're not equals in the process of delivering medicine to me.

Same with my clients. They aren't my equals. They bring their pets to my ER because their pet is sick and they don't have the capability to manage the problem. Thus, we're not equals. If we were, they wouldn't need me. They deserve respect as human beings, but there's no reason for me to give up my 'title' of doctor just to bring myself down to their level of knowledge. I went to vet school. They didn't.

Screw that article. I hope it was intended as a joke.

Ehh, this rubbed me a little wrong. There's absolutely a power differential in the doctor patient relationship, but it's not one of roles so much as one of information.

Totally disagree - both as a doctor and a patient. There is a HUGE role difference. My role is to take a history, evaluate the patient based on PE, make a diagnostic recommendation, make a therapeutic recommendation, and then implement therapy if in hospital. None of those are roles the client can assume. They sure as heck can't come back into my operatory and perform a surgical procedure. Their role is to give me information and then accept or reject my recommendations. I don't see even a slight overlap.

As a human patient, I feel the same way. My role is to present myself to my physician, be as honest as I can in describing what's going on, and then make a decision (hopefully an informed decision if my doctor has done his job) about accepting or declining his recommendation. That's my role. His role is ....... everything else.

Why does it rub people the wrong way to simply say "Yeah. The doctor is superior to me in the delivery of health care"???

I mean, hell, that's their JOB. Of COURSE the doctor is superior to the client/patient in that context. I HOPE my doctor is superior to me in the medical process - if he isn't, man, I'm in trouble. It doesn't make them a more valuable human being. Or a better human being. Or anything like that. It doesn't make them superior to the client in any or every other way. And presumably the client/patient is superior to the doctor in some ways, too, based on their own personal area of excellence/expertise.

Hmph.

I've noticed this ... leveling of the relationship ... in human medicine as a client/patient. My wife busted her knee. We saw a few different doctors for opinions .. and then left one we liked to find another purely for geographical convenience for post-sx rehab ... so we saw, yanno, a bunch. I was struck by how frickin ambivalent each and every one of them was. They'd come in, go over the whole "how did you bust up your knee" thing, talk about the possibilities - do nothing, scope only, fix the acl this way, fix the acl that way, etc. - and then they'd kinda sit back and say "so.............. what do you want to do?" So of course my wife turns to me and says "you're a doctor, what should I do?" To which I have to say "I'm a DVM, not an MD. I don't have the faintest clue what the literature says about human knees. Ask your doctor." Who then says "Well, it's kinda up to you."

Great.

I mean, I appreciate being given at least a little control of the driver's seat. I certainly don't want to be marched around and told what to do with no say in the matter. But at the same time, I sure wish her doctors had been a lot more assertive in saying "this is what's wrong. this is what the latest evidence says gives you the best long-term prognosis considering your goals for use of your knee. this is what I recommend." Most of them wouldn't even go so far as to RECOMMEND something - they'd just say "these are the things we can do" and leave it at that.

Man up/Woman up/Physician up! Make some recommendations, physicians! Human medicine is failing clients because it's NOT offering them leadership, not because the relationship hasn't been leveled enough so that everyone is "equal partners". You people went to school and did residencies and whatever else to become experts. Don't diminish that because of some academic nonsense about how people want to be treated as 'equals'. They don't. They want to be treated with respect. Completely different.

(Except, of course, for those Dr. Google people who come in telling you what's wrong, what diagnostics they'd like, and what treatment they've already settled on even without the diagnostic information. Those people can go take a hike. I assume you have them in human medicine, too.)

<grump out>

 

[FindMeOnTheLinks]

Fair warning. I ranted. It was a super long weekend on ER.

.
.
.

What kind of BS is this? Treating people with respect is one thing. Treating them as 'equals' is another.

I mean, I'm in animal medicine, so I don't know what kind of hell you people have to deal with. But I am not "equal" to my personal doctor. He went to med school to learn how to treat people. He did a residency. He did god knows what to get where he's at and build the expertise he has. I do defer (as in, treat with deference) to him for my care. Am I a helpless lackey in the process? Of course not. I weigh his opinion and, if necessary, I go get another educated one. And ultimate I make the decisions. But his opinion carries most of the weight because .... we're not equal. If we were, I wouldn't need him.

He does have to be respectful to me or I'll tell him to go to hell and I'll find a physician that can act like a decent human being. But we're not equals in the process of delivering medicine to me.

Same with my clients. They aren't my equals. They bring their pets to my ER because their pet is sick and they don't have the capability to manage the problem. Thus, we're not equals. If we were, they wouldn't need me. They deserve respect as human beings, but there's no reason for me to give up my 'title' of doctor just to bring myself down to their level of knowledge. I went to vet school. They didn't.

Screw that article. I hope it was intended as a joke.



Totally disagree - both as a doctor and a patient. There is a HUGE role difference. My role is to take a history, evaluate the patient based on PE, make a diagnostic recommendation, make a therapeutic recommendation, and then implement therapy if in hospital. None of those are roles the client can assume. They sure as heck can't come back into my operatory and perform a surgical procedure. Their role is to give me information and then accept or reject my recommendations. I don't see even a slight overlap.

As a human patient, I feel the same way. My role is to present myself to my physician, be as honest as I can in describing what's going on, and then make a decision (hopefully an informed decision if my doctor has done his job) about accepting or declining his recommendation. That's my role. His role is ....... everything else.

Why does it rub people the wrong way to simply say "Yeah. The doctor is superior to me in the delivery of health care"???

I mean, hell, that's their JOB. Of COURSE the doctor is superior to the client/patient in that context. I HOPE my doctor is superior to me in the medical process - if he isn't, man, I'm in trouble. It doesn't make them a more valuable human being. Or a better human being. Or anything like that. It doesn't make them superior to the client in any or every other way. And presumably the client/patient is superior to the doctor in some ways, too, based on their own personal area of excellence/expertise.

Hmph.

I've noticed this ... leveling of the relationship ... in human medicine as a client/patient. My wife busted her knee. We saw a few different doctors for opinions .. and then left one we liked to find another purely for geographical convenience for post-sx rehab ... so we saw, yanno, a bunch. I was struck by how frickin ambivalent each and every one of them was. They'd come in, go over the whole "how did you bust up your knee" thing, talk about the possibilities - do nothing, scope only, fix the acl this way, fix the acl that way, etc. - and then they'd kinda sit back and say "so.............. what do you want to do?" So of course my wife turns to me and says "you're a doctor, what should I do?" To which I have to say "I'm a DVM, not an MD. I don't have the faintest clue what the literature says about human knees. Ask your doctor." Who then says "Well, it's kinda up to you."

Great.

I mean, I appreciate being given at least a little control of the driver's seat. I certainly don't want to be marched around and told what to do with no say in the matter. But at the same time, I sure wish her doctors had been a lot more assertive in saying "this is what's wrong. this is what the latest evidence says gives you the best long-term prognosis considering your goals for use of your knee. this is what I recommend." Most of them wouldn't even go so far as to RECOMMEND something - they'd just say "these are the things we can do" and leave it at that.

Man up/Woman up/Physician up! Make some recommendations, physicians! Human medicine is failing clients because it's NOT offering them some leadership, not because the relationship hasn't been leveled enough so that everyone is "equal partners". You people went to school and did residencies and whatever else to become experts. Don't diminish that because of some academic nonsense about how people want to be treated as 'equals'. They don't. They want to be treated with respect. Completely different.

(Except, of course, for those Dr. Google people who come in telling you what's wrong, what diagnostics they'd like, and what treatment they've already settled on even without the diagnostic information. Those people can go take a hike. I assume you have them in human medicine, too.)

<grump out>

This post is the GOAT

 

[LetItSnow]

We can agree to disagree. I've been doing it for four years, there's no novelty. Unless it's a staff member, I don't correct patients and ask them to address me by first name. I always introduce myself by first name though. Some patients get my first name and call me Dr John. A rare few have outright asked me for my last name and go for Dr Doe. I've never encountered a problem yet.

In spite of my rant above, I agree with this. It's not about an ego thing. I don't give a crap what my clients call me. "Billy Bob". "Dr. Billy Bob." "Dr. Jankowitz." It's all fine by me. They can call me "hey you" for all I care. Totally not an ego thing.

I just think it's stupid to try and pretend we're "equals" in the process. We are equally valuable. We deserve mutual respect. But my clients are not equal to me in the delivery of medicine. Period.

 

[Roxas]

I'm really offended that everyone is referring to the author as 'she'. Just because the author's name is Ashley doesn't mean the author identifies as female. Use 'they', please.

The truly sad thing is someone could have posted this and been completely serious

 

[PikminOC]

Don't offend others:
refer to them as zheveryone.

 

[The Knife & Gun Club]

It really upsets me that this woman is a biomedical science professor at FAU college of medicine. In fact it's down right insulting that the students should be taught by someone with such an obviously limited grasp of science and medicine. I've actually been trying to decide between FAU and another school for a while and I've gotta say this makes the choice a little easier

 

[Plastikos]

Who needs a title though? Doesn't the respect that comes from the fact that the patients are coming to you for help in their time of need count? Or the fact that nurses abide by your orders? Or physical therapy comes and rehabs your patient and gives you rec's where to discharge? Or social work comes along and helps arrange discharge? Or the nurse who calls your patient post discharge to see how they're doing?

I don't understand why the title is so damn important. Physicians have plenty of respect in the day to day world. I don't see why going on a first name basis with everyone diminishes that.

You seem incapable of seeing whats obvious because of what can only be assumed to be a desire to not appear to be some desire to appear ego/patient neutral and somehow a better person. Its a load of crap. The title is important so people know who you are, and thus know what to expect etc...Try any of this nameless equal doctor stuff in the real world and you will receive loads of unprofessional, too familiar and incompetent reviews. Its basic human nature, they may somewhat resent you're the doctor, but again they expect it and actually want to be sure who you are and that you are accepting and confident in that. Act like one of the guys and they will unconsciously assume youre just as dumb as their buddies and question you even more. That doesnt mean you have to be an ass, and the constant black/white extremes are so wrong its hard to take you seriously. On the whole, more people will be happy if you assume your correct role, you cannot please everyone and shouldnt try. Is their some other field where we fight hard to act as if we cant acknowledge their position or it somehow makes interaction more difficult? This engineered issue is without merit completely. Just be nice and personable and almost anything will work, if youre an ass it doesnt matter how you do it, people wont like you. I dont care what patients call me, but it seems they prefer to call me Dr. P, it makes them comfortable, so thats what happens. Not everyone is as enlightened as you hope them to be.

The medical infrastructure is for billing and liability purposes only. You have clearly a very biased view. Having worked academics, VA, third world countries and now 100% cash private practice you just have no idea how things can be done since you refuse to think about it. Dont confuse convenience for necessity. Just because you have to purchase things doesnt make the way you know it the only way, that just means you're uncomfortable with a certain way of financing your practice, and thats a separate issue.

Physicians do not have tons of respect in the day to day world, we are being commoditized and cannibalized by altruistic movements that have no understanding of unintended consequences or behavioral psychology. Most doctors arent even good at standing up for themselves and are willing to help others take them down to appear "nice", hence the trajectory of the profession for a couple decades. If you dont stand up for yourself there are people everywhere willing to cut in on all sides. Its naive to see things so black/white and not for underlying motives of all involved, aka money.

 

[qwerty89]

You seem incapable of seeing whats obvious because of what can only be assumed to be a desire to not appear to be some desire to appear ego/patient neutral and somehow a better person. Its a load of crap. The title is important so people know who you are, and thus know what to expect etc...Try any of this nameless equal doctor stuff in the real world and you will receive loads of unprofessional and incompetent reviews. Its basic human nature, they may somewhat resent you're the doctor, but again they expect it and actually want to be sure who you are and that you are accepting and confident in that. Act like one of the guys and they will unconsciously assume youre just as dumb as their buddies and question you even more. That doesnt mean you have to be an ass, and the constant black/white extremes are so wrong its hard to take you seriously. On the whole, more people will be happy if you assume your correct role, you cannot please everyone and shouldnt try. Is their some other field where we fight hard to act as if we cant acknowledge their position or it somehow makes interaction more difficult? This engineered issue is without merit completely. Just be nice and personable and almost anything will work, if youre an ass it doesnt matter how you do it, people wont like you. I dont care what patients call me, but it seems they prefer to call me Dr. P, it makes them comfortable, so thats what happens. Not everyone is as enlightened as you hope them to be.

The medical infrastructure is for billing and liability purposes only. You have clearly a very biased view. Having worked academics, VA, third world countries and now 100% cash private practice you just have no idea how things can be done since you refuse to think about it. Dont confuse convenience for necessity. Just because you have to purchase things doesnt make the way you know it the only way, that just means you're uncomfortable with a certain way of financing your practice, and thats a separate issue.

Physicians do not have tons of respect in the day to day world, we are being commoditized and cannibalized by altruistic movements that have no understanding of unintended consequences or behavioral psychology. Most doctors arent even good at standing up for themselves and are willing to help others take them down to appear "nice", hence the trajectory of the profession for a couple decades. If you dont stand up for yourself there are people everywhere willing to cut in on all sides. Its naive to see things so black/white and not for underlying motives of all involved, aka money.

So much this.

 

[Dr. Janitor]

But you wouldn't be able to do your job without these people. Unless you wanted to pitch a tent on the side of the road and offer medical care to people who drive by.

 

[eye love lamp]

You seem incapable of seeing whats obvious because of what can only be assumed to be a desire to not appear to be some desire to appear ego/patient neutral and somehow a better person. Its a load of crap. The title is important so people know who you are, and thus know what to expect etc...Try any of this nameless equal doctor stuff in the real world and you will receive loads of unprofessional, too familiar and incompetent reviews. Its basic human nature, they may somewhat resent you're the doctor, but again they expect it and actually want to be sure who you are and that you are accepting and confident in that. Act like one of the guys and they will unconsciously assume youre just as dumb as their buddies and question you even more.

Hasn't happened yet?

That doesnt mean you have to be an ass, and the constant black/white extremes are so wrong its hard to take you seriously. On the whole, more people will be happy if you assume your correct role, you cannot please everyone and shouldnt try. Is their some other field where we fight hard to act as if we cant acknowledge their position or it somehow makes interaction more difficult? This engineered issue is without merit completely. Just be nice and personable and almost anything will work, if youre an ass it doesnt matter how you do it, people wont like you. I dont care what patients call me, but it seems they prefer to call me Dr. P, it makes them comfortable, so thats what happens. Not everyone is as enlightened as you hope them to be.

I don't understand what the issue is that I choose to introduce myself by first name? I'm not fighting for anything.

The medical infrastructure is for billing and liability purposes only. You have clearly a very biased view. Having worked academics, VA, third world countries and now 100% cash private practice you just have no idea how things can be done since you refuse to think about it. Dont confuse convenience for necessity. Just because you have to purchase things doesnt make the way you know it the only way, that just means you're uncomfortable with a certain way of financing your practice, and thats a separate issue.

Everyone keeps chirping this notion that they could do their job without anyone's assistance. They know the medicine and they can make it happen on their own. This might be true for family medicine or psych (where you can go to a third world country or do a micropractice and push some vaccines and pills), but how would this work out for neurosurgery?

You're a neurointerventional radiologist and you need to treat a patient with an aneurysm. You're going to do this on your own with a micropractice? In a third world country? No administration to buy machines/equipment? No nurses? None of those unnecessary people who are just there to serve billing and liability purposes? This makes no sense to me.

The physicians in this thread have an over-inflated ego, sorry. Unless you're running a low-tech gig you need people to help you do your job.

Physicians do not have tons of respect in the day to day world, we are being commoditized and cannibalized by altruistic movements that have no understanding of unintended consequences or behavioral psychology. Most doctors arent even good at standing up for themselves and are willing to help others take them down to appear "nice", hence the trajectory of the profession for a couple decades. If you dont stand up for yourself there are people everywhere willing to cut in on all sides. Its naive to see things so black/white and not for underlying motives of all involved, aka money.

Day to day world? What are you looking for? The old days where you get free haircuts because you walk in and say you're a doctor?

 

[eye love lamp]

So much this.

Where am I right now, Reddit?

 

[FistLength]

I'm really offended that everyone is referring to the author as 'she'. Just because the author's name is Ashley doesn't mean the author identifies as female. Use 'they', please.

We had a gay physician come to our school and he talked to us about gender issues in medicine. All goes well, good lecture, charismatic guy. Then he mentions gender identity is something society places on us. Ok me thinks. Then he mentions that we should not issue gender at birth because it causes parents to force gender on children through buying gender specific dolls/toys

 

[TBV]

We had a gay physician come to our school and he talked to us about gender issues in medicine. All goes well, good lecture, charismatic guy. Then he mentions gender identity is something society places on us. Ok me thinks. Then he mentions that we should not issue gender at birth because it causes parents to force gender on children through buying gender specific dolls/toys

Oh hey let me introduce you to my offspring! Its name is Jordan and it plays ballet-football.