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Old 09-29-2010, 11:25 PM
 
Location: state of procrastination
3,487 posts, read 6,536,585 times
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"Treat the patient, not the lab result." I hear this from a lot of the better doctors.

 
Old 09-29-2010, 11:37 PM
 
9,967 posts, read 16,577,996 times
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Quote:
Originally Posted by suzy_q2010 View Post
Now see, that wasn't hard was it? Next question: were you on Prednisone when you took the penicillin? That could have modified the response and blocked the hives.

Yep, I was on prednisone when I took the penicillin, I think it probably blocked the hives. But I tell doctors all that, and they just look confused, hm....I don't fit all the criteria for an allergy, so, I must not be allergic to it. Therefore, its ok to take it again. Their little idiot chart tells them its ok! Think for themselves? never..........
 
Old 09-29-2010, 11:46 PM
 
Location: state of procrastination
3,487 posts, read 6,536,585 times
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Suzyq: I've heard the correlation between success and verbal scores and I think they are partly true. I do know people who have gotten 7 Verbal, 14 Bio, 14 Phys who went on to do very well. It would be interesting to see what results Mount Sinai obtains from their program. I do feel that the science being tested on the MCATs is fairly basic and most humanities majors should be able to do well if they took the prerequisite courses.

Certainly not even 10% of the doctors are truly incompetent ... but a lot are burned out, cut corners, jaded, no longer keeping up with the newest information, or no longer interested in what their patients have to say. Insurance companies are definitely at fault. It is a sad state of the profession which leads to suboptimal practice. One of the best FP guys I've seen always runs about 2-3 hours late by the end of the day because he is thorough.

It is far from hopeless, but time will tell... it certainly seems like the board exams get easier and easier to pass every year.
 
Old 09-29-2010, 11:56 PM
 
10,452 posts, read 10,970,621 times
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Quote:
Originally Posted by miyu View Post
One of the best FP guys I've seen always runs about 2-3 hours late by the end of the day because he is thorough.
i had an eye doctor like this. the wait was long but it was worth it.
 
Old 09-30-2010, 03:33 AM
PYT
 
122 posts, read 261,647 times
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Quote:
Originally Posted by miyu View Post
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).
Most people who get in with lowers score are what you call URM students. Schools will usually put in cut offs at around 28+ before they even consider a student and they only give leeway to those who have URM status, such as african-americans, hispanics and native americans. If you look at schools such Howard, Meharry and University of Puerto Rico (and there are many similar schools as well), they accept mainly URM students and have significantly lower average statistics. All schools aim to accept certain # of URM students and they skew the statistics heavily.

If you take a look at this link:
http://www.aamc.org/data/facts/applicantmatriculant/table19-mcatpgaraceeth09-web.pdf (broken link)
You see that the average mcat of matriculants from puerto ricans are 23.7, african americans - 26.1, Mexican Americans - 28. They constitute roughly 1,800 out of 18,000 applicants (nearly 10%).

You take a look at the average mcat scores of asians (which is 32) and caucasians (31.3). You see how the scores are actually where you'd expect to be.

So no, your average medical applicant is never going to make it in with a 26 or even a 27.

The average MCAT score is around a 30.8 (taking into consideration URM matriculants) when 80% of the matriculant averaging between 31-32+. Usually, it is uncommon for anyone below a 29 to get into medical school who isn't URM. (Please note that I have nothing against students who are URM. Nor do I doubt their abilities to become great physicians or plan to debate affirmative action on this thread.)


I must also take offense to your claim that a 32 is borderline incompetent. Anyone admissions officer would vouch that a 32 is a very solid score and requires a great deal of hard work and intelligence to get. The MCAT is not easy at all and your claims makes me raise an eyebrow.

Why do you think a 32 is such an abysmal score? Have you taken the MCAT and have done fabulous? The MCAT is commonly regarded in academic circles as one of the more challenging graduate admissions test too.

In the following graph, it shows that a 32 is roughly in the 15th percentile. Keep in mind, these are high-achieving pre-med students. Not your average high school SAT test takers.

http://www.aamc.org/students/mcat/admissionsadvisors/examstatistics/scaledscores/combined07.pdf (broken link)

So I don't catch you at all, how is that borderline incompetent? You make it seem like anyone with a 32 is a horrid student who just parties all day and night. In reality, most people I knew who had 32s were exceptional students, coming from elite universities with great academic records.

You also make the assertion that board exams are getting easier as well. Why do you think that as well?



There are issues with the medical field, however, I don't think the academic strength of students in medicine are one of them. They are the brightest students (academically) our colleges have to offer. Like you said, I also believe the majority of our doctors are quite competent.

I think the problem lies else where. One of the main problems is that doctors simply don't fully listen or are bad at management. I think this can be attributed to decreasing amount of time doctors spend with each patient. With reimbursement dropping per patient, doctors are filling in more and more patients and spending less time with each person in order to maintain their income. As a result, physicians become rushed and try to move quickly from one patient to another, not doing an effective job. Whether a physician's pay is justified or not, this issue must be addressed in some way. Yes, there are some greedy doctors but I don't think harpooning a whole field as soul-less monsters would be correct either. There must be balance to this process. In addition, if you want to attract the best and brightest into one of the toughest fields out there, you can't pay them peanuts. Otherwise, that student with a 4.0 gpa and 38 MCAT won't think its worth it to sacrifice his social and family life for a career that requires so much of them. Maybe a different form of payment such as combining capitation with fee-for-service and rewarding improved outcomes would serve to be more effective.

Another problem is that physicians must spend more of their day dealing with paperwork. Every minute spent on paperwork is another minute taken away from the patient (this ties in directly to the listening problem I stated above). Often times doctors spend their weekends, catching up on paperwork and arguing with insurance over payment issues. Think about how much of that time could be spent with patients? We must somehow streamline the insurance process and make it easier so that doctors can spend more time simply doing medicine.

In addition, lawsuits and medical litigations also cause doctors to perform defensive medicine. For example: As a person in this thread said earlier. The eye doctor sent her to the ER when she didn't really need to. Perhaps, her eye doctor was doing that in order to make sure there would be no potential legal problems. Unneeded tests and procedures are done simply because the risk/cost of a lawsuit is just too high. Defensive medicine costs the system an abhorrent amount of money and leads to unnecessary hassles and even complications. This is another issue that must be addressed. We must somehow be able to prevent poor physicians from practicing, while at the same time, still making sure that doctors aren't constantly scared about a lawsuit behind their back.

However, maybe you were onto something. There might be a problem with the admissions system. But it isn't because the students aren't intelligent, maybe they aren't well rounded enough. Perhaps, medical school admissions should take a more holistic approach to admitting students and not only focus simply on grades and scores (and you, on the admissions committee, of all people should know how GPA and MCAT is king). Being book smart is important but that's not all there is to being a doctor. They should try to attract solid students who demonstrate strong interpersonal communications skills, altruism and leadership/management skills. Students who demonstrate a passion for medicine. These qualities may serve the public better than simply the ability to get an A+ on a test versus an A.

I think we can go further than simply blaming the intellect of medical students. There has to be something else wrong, whether it is the insurance/ health management policies, the medical school education system itself or other various problems such as over specialization.

Check out this interesting article: Dr. Dennis Gottfried: Too Many Doctors, But Too Few Primary Care Ones
I had another article on JAMA but couldn't find it.


Personally, I don't think doctors aren't good for nothing.

My parent's doctor saved both of my parent's lives from late-staged cancer. Yes, I've met my fair share of lousy doctors, however, I owe all of those good doctors everything.

Last edited by PYT; 09-30-2010 at 03:52 AM..
 
Old 09-30-2010, 08:11 AM
 
Location: Between Philadelphia and Allentown, PA
5,077 posts, read 13,342,195 times
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Quote:
Originally Posted by stan4 View Post
Anyone tired of annoying patients who run to the doctor for every little thing without considering whether or not it's a waste of time for everyone? You think it just wastes your time and your money? Watch the insurance company or (especially) the government slash the reimbursement once they figure out you never needed to be there in the first place.

Seriously, this right here is why you need a good, permanent medical home with a GP. Get a GP, they know you, you know them, they work you in quickly, and they can decide whether or not you need to be shuffled off from one specialist to another.


I work in the medical industry FOR doctors... I HAD to post a response to yours (lol).

I have to be completely honest here. I've been working for large practice doctors for over 8 years and this is completely true. Doctors detest the patients that come in for every single itch, burn, ache, twitch, etc... you name it, and the same repeat patients come in.

So much so in fact that we (doctors and staff) have knicknames for some patients. Cruel and unjust? maybe but it's true. There are some patients that want something to be wrong with them so badly that they have talked themselves out being healthy.

You should only go to the doctor if you really need to. You should only take medication when you really need to. If you are overweight and all of a suddent have high blood pressure. Yes, this is serious, yes you could possibly die from a heart attack IF you don't lose weight. Staying on the medication the rest of your life isn't the cure.

If people just used common sense (which is clearly missing these days) they would be able to rule out most aches and pains, most odd things that are going on with their health, etc...

Doctors do love being doctors but when patients who constantly come in who truly do not have legitimate health issues, then yes, they are going to get huffy. They are going to be impatient, the staff is going to be impatient and borderline rude. Yes, because it's people who abuse the system who take up valuable time from other patients who have legitimate health problems.

If you go to your doctor and aren't happy, then get a second opinion. If that doctor finds nothing and sends you to a specialist and they find nothing - just stop there. Doctors go to medical school for 7 years, they have to go through rounds at hospitals, they have TONS of experience before they even get their first "job". At some point you have to trust your doctor and if you don't, you get a new doctor or a second opinion.
 
Old 09-30-2010, 08:36 AM
 
Location: Wherabouts Unknown!
7,771 posts, read 17,230,289 times
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andreaspercheron wrote:
If you go to your doctor and aren't happy, then get a second opinion.
Good advice, but this can be costly moneywise.
 
Old 09-30-2010, 08:48 AM
 
Location: In a house
13,253 posts, read 37,879,151 times
Reputation: 20198
I disagree with andreaspercheron's opinion that you should only go to the doctor when you need to.

You should go to the doctor yearly, AND when you need to. Preventative medicine, such as getting annual checkups, periodic screenings, blood tests, and the like, are part of maintenence. If you're healthy, preventative medicine can help you stay that way. If you're not healthy, preventative medicine can point out where improvement might be needed.

If you wait until you "need" to go to the doctor, in some cases, it might already be too late.
 
Old 09-30-2010, 09:50 AM
 
10,452 posts, read 10,970,621 times
Reputation: 12543
Quote:
Originally Posted by samston View Post
Prestige. Nothing more, nothing less.
How does anything I just said have anything to do with prestige?

You can have your opinion, but what I don't understand is how you seem to believe that you know the motivations of every doctor, and that their motivations are all the same. How do you know why your doctors went into their profession? If they have messed up or haven't treated you well, there could be a million reasons behind it. How can you speak for another person, let alone a whole group of people?

Saying all doctors are in it for the prestige is as absurd as saying all U.S. residents live here for the climate. Not only does the climate vary in the U.S., the people vary in their desires and intentions. Likewise, each doctor's situation and motivations are unique. Neither you nor I can possibly know each doctor's reason for going into medicine.
 
Old 09-30-2010, 11:22 AM
 
Location: In a house
13,253 posts, read 37,879,151 times
Reputation: 20198
Quote:
Originally Posted by samston View Post
i can present a number of sources:

- Culture
- human nature
- human psychology

All point towards doctors entering the profession for their own ends.
Ah, so now they're not entering it for power, they're entering it for their own ends. Well, isn't that why everyone does everything?

My own end = a clean house. Therefore, I will enter into the activity of cleaning my house. And then I will achieve my end desire.

One doctor's own end: eradicating the disease that killed his father. Therefore, he enters the medical profession, in the hopes of researching and helping to find a cure for that cancer. And then, he will achieve his end desire.

Another doctor's own end: to rebel against his dad, who wanted him to become a lawyer.

Another doctor's own end: prestige.

Another doctor's own end: to finally place a local doctor into the rural area in which he grew up, that hasn't had a local doctor for the past 20 years.

Another doctor's own end: the means to live in Hollywood and become <insert famous person's name here> personal plastic surgeon.

See? People enter things for all kinds of reasons. And those reasons are always "their own end."

Thank you for proving your original statement wrong, again.
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