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Old 09-29-2010, 01:51 PM
 
Location: Georgia, USA
37,102 posts, read 41,226,282 times
Reputation: 45088

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miyu said:

"Many doctors are good for nothing nowadays. Given that most med schools accept many people with MCAT scores of below 32 (which is already like borderline incompetent) says a lot about how low the standards are for who they allow into medical school. Trash in, trash out. This is a problem of the inferior American school system. A lot of doctors do not think with their brains but rather, go solely by "evidence-based medicine". It is good to follow best practice guidelines, but when a patient comes in with strange or unfamiliar symptoms, then the doctors become totally, utterly useless. They aren't even clinically or scientifically interested because they have lost all their academic ability. You might as well have a nurse practitioner do all your care; at least they will refer you to some specialist. Usually specialists are a bit better since it is more competitive to get into those fields."

Um, I think you do not understand the MCAT. People do not usually take it without the expectation that they stand a chance of being accepted to medical school. The average score of everyone taking it is probably 23 to 24. The maximum score is 45, and unlike the SAT, which has a significant number of perfect scores each year, I don't think anyone has ever achieved a 45. That would mean missing only one or two questions on the whole exam. That means the pool of applicants tends to be motivated and prepared. These are not "incompetent" people. And a 32 is not a shabby score. The exam is NOT easy.

Here are the scores for 2007-09 against GPA:


http://www.aamc.org/data/facts/applicantmatriculant/table24-mcatgpagridall2007-09.pdf (broken link)

By and large, people with low GPAs and low MCAT scores did not get accepted. Those with high GPAs and high MCAT scores had high acceptance rates. It is possible to get in with a high GPA and poor performance on the MCAT and vice versa, but the numbers are small. That is the reason for recommendation letters, essays, interviews, and admission committees. The table shows us that the majority of acceptances were people with scores over 23 and GPAs over 3.00. And GPA has to be evaluated in light of the college the applicant attended. The acceptees with low GPAs or low MCATs who were accepted must have aced the interviews and really impressed the admission committee.

My son did that when he applied to college. His SATs were not the best (there was the little matter of being on chemo for leukemia when he was in high school), but he was accepted to his first choice school, an excellent small liberal arts college, and did quite well.

You also apparently do not understand the concepts of "evidence based medicine" and "best practice guidelines". Both are attempts to streamline care and reduce cost while still providing good care. Neither has anything to do with diagnostic acumen. And while doctors for the most part do not like "cookbook medicine," there is evidence to show that things like checklists (which airline pilots use every time they get in the cockpit) can help reduce medical errors.

Yes, doctors vary in their abilities. Some are better than others. Some have horrible bedside manners. But if I ever get a brain tumor, I want the person with the best technical skill to operate on me, not the one with the best bedside manner.


By the way, Internal Medicine and Family Medicine are "specialties." Choice of specialty has more to do with a doctor's answer to "what do I want to be when I grow up" than ability. And most doctors do not "despise" their patients.

miyu also wrote, " Plus I have higher powers of logic than they do so in the end they always end up doing what I say."

I think your antagonistic attitude comes through in your interaction with your doctors. If you are unwilling to listen to them, why should they bother to send you home with anything except what you demand?

There is a lot of science in medicine, but there is still a lot of art. Experience plays a big part --- the more you do it, the better you get.

If you have vague, mysterious ailments that could be symptoms of hundreds of illnesses, you are not likely to get a diagnosis with a single office consultation. The best practices/evidence based medicine/checklists might save you (and your insurance company) a fortune in the process of discovering what is going on.

And, you know what? Some symptoms end up having no satisfactory diagnosis to hang your hat on. At that point, the best your doctor can do is help you deal with the symptoms themselves.

Last edited by suzy_q2010; 09-29-2010 at 01:55 PM.. Reason: add additional thought.

 
Old 09-29-2010, 01:58 PM
 
Location: Georgia, USA
37,102 posts, read 41,226,282 times
Reputation: 45088
Quote:
Originally Posted by samston View Post
Moreover, if what you are saying is true, why so many cases of poor doctors? Why doesn't society admit that the only real reason for the medical profession is prestige?
There are prestigious professions that are a lot easier than medicine.
 
Old 09-29-2010, 02:15 PM
 
Location: Georgia, USA
37,102 posts, read 41,226,282 times
Reputation: 45088
MaryleeII wrote:

"Also, I'm allergic to penicillin. I had an atypical reaction years ago, but a reaction is a reaction, I don't want to challenge it again when there's plenty of other antibiotics out there. But try convincing some doctors. They always ask if you have any allergies. Then when I say penicillin, they look puzzled, then ask about the reaction. They ask if I had hives or a rash. No, but I had other symptoms. Well, if I don't fit the classic pattern, such as hives,rash, they dismiss it. If it doesn't fit their little chart, they don't know what to do. I finally learned to tell them what they want to hear, oh, yes indeed, I had a rash, hives, etc, that makes them happy, now I have PCN allergy written all over my chart."

But from what you describe, you are not "allergic" to penicillin, are you? Not every "reaction" to a medication is a true allergy. By misleading doctors about what happens when you take the drug, you also eliminate the possibility of taking other similar drugs that you might not "react" to.

Would it not be better to say, "When I took penicillin, my skin turned blue. I looked like a Smurf. I would prefer not to take it again. What would you recommend instead?" This expresses your concern in a nonthreatening way, and your doctor would likely agree with your request.
Why is it so hard to be honest and up front and just describe the effect the drug had that bothers you?

There are lots of "reactions" to medicines that are not allergies in the strict medical sense of the word. For example, many people get severe nausea with codeine due to the way the drug is metabolized. It is not an allergy, but folks who "react" that way do not want to take it. Some reactions are clear indications not to take it again, but some are treatable if the offending drug turns out to be the best one for the problem.

Last edited by suzy_q2010; 09-29-2010 at 02:15 PM.. Reason: correct typo
 
Old 09-29-2010, 03:22 PM
 
Location: Wherabouts Unknown!
7,841 posts, read 18,991,883 times
Reputation: 9586
I have no reason to give up on doctors because I have rarely ever submitted to their practices. I will honestly say that they performed quite adequately to stitch up my wounds on a few occassions, but other than that I tend to shun medical practitioners. I prefer chiropractors, naturopaths, ayurvedic physicians, psychic surgeons, prayer, energy healers, etc. Along with eating good food & taking herbal formulas, getting plenty of exercise, & meditaion, I am remarkably healthy at the age of 61.

The medical profession tends to see people in one of two ways
1. They have too few chemicals in their body so they give em drugs

2. They have too many body parts so they surgically remove them.
This might be funny if it wasn't so darn close to the reality of allopathic medicine in the USA.
 
Old 09-29-2010, 04:31 PM
 
Location: Georgia, USA
37,102 posts, read 41,226,282 times
Reputation: 45088
Quote:
Originally Posted by samston View Post
Moreover, if what you are saying is true, why so many cases of poor doctors? Why doesn't society admit that the only real reason for the medical profession is prestige?
I've given this one more thought.

Why would anyone go to medical school for four years, run up over $100,000 for education debt, then work 80 or 90 hours a week for 3 or 4 years as a resident --- or more --- while earning less money than friends who graduated from college but did not go to graduate school?

Why would anyone want to be a surgeon and spend hours at all times of the day and night up to the elbows in someone's blood and guts, wondering if he'll get the needle stick that exposes him to HIV?

Why would anyone want to deliver babies, knowing the parents will sue her if that baby is less than perfect, while paying a malpractice premium of $50,000 to $100,000 per year, depending on the state where she lives?

Why would anyone want to treat patients with cancer, knowing that many will die despite his best efforts?

Why would anyone want to open a private medical practice, knowing he will have to deal with insurance companies that demand "pre-authorization" for every test, procedure, and prescription, while cutting reimbursement to the doctor and paying their own CEOs exorbitant salaries, bonuses, and stock options?

Why would a gastroenterologist* write on a colonoscopy report, "This man has a beautiful colon."?

I have to tell you, beauty is truly in the eye of the beholder, and people have to go into medicine for more than "prestige" --- or even money. Most docs do not make anything near what patients think they do. The fact is that the vast majority of doctors went into medicine because they love it and cannot envision doing anything else.

*From my father's gastroenterologist!
 
Old 09-29-2010, 06:29 PM
 
4,379 posts, read 5,381,251 times
Reputation: 1612
Quote:
Originally Posted by suzy_q2010 View Post
There are prestigious professions that are a lot easier than medicine.
i don't care, doctors are scum, end of story.
 
Old 09-29-2010, 06:31 PM
 
4,379 posts, read 5,381,251 times
Reputation: 1612
Quote:
Originally Posted by suzy_q2010 View Post
I've given this one more thought.

Why would anyone go to medical school for four years, run up over $100,000 for education debt, then work 80 or 90 hours a week for 3 or 4 years as a resident --- or more --- while earning less money than friends who graduated from college but did not go to graduate school?

Why would anyone want to be a surgeon and spend hours at all times of the day and night up to the elbows in someone's blood and guts, wondering if he'll get the needle stick that exposes him to HIV?

Why would anyone want to deliver babies, knowing the parents will sue her if that baby is less than perfect, while paying a malpractice premium of $50,000 to $100,000 per year, depending on the state where she lives?

Why would anyone want to treat patients with cancer, knowing that many will die despite his best efforts?

Why would anyone want to open a private medical practice, knowing he will have to deal with insurance companies that demand "pre-authorization" for every test, procedure, and prescription, while cutting reimbursement to the doctor and paying their own CEOs exorbitant salaries, bonuses, and stock options?

Why would a gastroenterologist* write on a colonoscopy report, "This man has a beautiful colon."?

I have to tell you, beauty is truly in the eye of the beholder, and people have to go into medicine for more than "prestige" --- or even money. Most docs do not make anything near what patients think they do. The fact is that the vast majority of doctors went into medicine because they love it and cannot envision doing anything else.

*From my father's gastroenterologist!
I think you're making empty and vacuous defences of your (ostensible) profession. I think that doctors only do enter it due to the vocation's prestige. nothing more, nothing less. Such is life anyhow, it's basic human psychology, so in that sense I won't fault them.
 
Old 09-29-2010, 06:44 PM
 
Location: Georgia, USA
37,102 posts, read 41,226,282 times
Reputation: 45088
Quote:
Originally Posted by samston View Post
I think you're making empty and vacuous defences of your (ostensible) profession. I think that doctors only do enter it due to the vocation's prestige. nothing more, nothing less. Such is life anyhow, it's basic human psychology, so in that sense I won't fault them.
You are entitled to your opinion. The problem is that you cannot know why a single person became a doctor, much less all of them.

Edited to add: please do not go to the ER if you have a broken leg. Wouldn't want that scum doctor to have to fix it for you.
 
Old 09-29-2010, 06:46 PM
 
Location: Los Angeles area
14,016 posts, read 20,898,193 times
Reputation: 32530
Default Irrational hatred

Quote:
Originally Posted by samston View Post
i don't care, doctors are scum, end of story.
Actually, that would be the beginning, not the end, of an interesting story - the story of how you came to the point of forming such an idiotic, over-generalized conclusion. You have posted more than once about the prestige of the medical profession, as if that is a tremendous sore point with you. Do you have basic insecurities and a feeling of lack or prestige yourself that you would begrudge an entire profession its prestige? Did some doctor once cause you very deep humiliation which gave rise to such irrational hatred? What is your job or profession? Suppose you are a plumber, and suppose I said, "Plumbers are scum, end of story"? That wouldn't make a bit of sense, and neither does your statement. Do you hate any other large group of people, or just doctors? There is a lot more to this story. (Just for the record, I am not a doctor nor did I ever work in the health field in any capacity).
 
Old 09-29-2010, 06:56 PM
 
10,113 posts, read 19,394,180 times
Reputation: 17444
Would it not be better to say, "When I took penicillin, my skin turned blue. I looked like a Smurf. I would prefer not to take it again. What would you recommend instead?" This expresses your concern in a nonthreatening way, and your doctor would likely agree with your request. Why is it so hard to be honest and up front and just describe the effect the drug had that bothers you?

Because when I did tell doctors the reaction I had to penicillin, they discounted it, mainly because it didn't fit their little checklist.

I've had 2 relatives with similar reactions to penicillin. Why should I risk taking it again when there's so many other antibiotics out there?

And yes, in my opinion, I'm allergic to penicillin. Why bother to ask me my allergies, then dispute them? Do I have to prove it over and over, or why can't they just take my word for it? I've had docotrs literally insist I could "probably take penicillin again with no consequences" simply because it didn't fit into their little checklist. Hey, it threatens me to be told I'm about to be given a drug I've had problems in the past, regardless of whether you call it an allergy, reaction, or whatever.

The point I was trying to make is not whether I'm allergic to penicillin, but how doctors just can't function outside the box. If it doesn't fit their little checklist, they're lost.



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