What do doctors know? (warning: rant)

This is the reaction I normally got when I went to my family practioner RE:inability to lose weight, thinning hair cold all the time.... (BTW- ex-cancer patient, peri-menopausal from said treatments, I suspect a low functioning thyroid because of how I FEEL....thyroid's a 2 BUT ' in range...so it's not your thyroid...just cant be'...cause the dr said I guess...)
The medical advise I got without even a blood pressure reading was ...."EAT STIR-FRYS...chicken is your friend":bigsmile:

I do not discount what my doctor says, in his educated opinion that is going to solve my issue HOWEVER......
I am ultimately responsible for my own healthcare and well being, people need to understand that doctors are NOT supehuman and can make errors or mistakes....
I headed to the healthfood store and began to read and learn how MY body reacts to changes in diet and additions of supplements. I feel better...not at goal weight but FEEL better than I ever have....and really dont eat stir-fry's on principle....even tho I'm all about Paleo....cause it works for me.....LOL

Pretty much sums it up. Doctors are so concearned with ranges and "normal" numbers that they can't even think past that and treat the person.

As an MD, I can tell you that doctors don't want to see their patients every 10-20 minutes and would love to sit and talk with you about weight loss and exercise plans if they had the chance. The problem is that insurance companies don't pay for education in most instances, and the reimbursement rates are so low that doctors have to stack patients in order to stay afloat. This is why 'concierge' practices are becoming so popular - without the insurance company, doctors can spend an hour plus with each person and be very thorough. They hammer the patient-first model into us in medical school, but when you get into the real world it's the insurance companies that determine how you practice.
Also, doctors aren't magicians. If you come in with a set of symptoms, it could usually easily be about 10 different things. We usually start conservatively with an educated guess (I think someone mentioned this). This is why it's SO important to have a running dialogue with your physician... and to even have a primary care physician to begin with. You can talk about what's working and what's not and tailor therapy to the individual. If you keep hopping from one physician to the next, most are going to come up with the same differential and work it up in the same order, or end up with unnecessary expensive tests at the ER.
As for the nutrition side, it's true that we don't get taught in-depth about different exercise regimens and whatnot, but we do learn nutrition and know healthy and unhealthy ways to lose weight and if you're lucky, you can refer to a dietitian for specific diet plans and help with lifestyle changes and things that require a lot more time than the doctor's visit has for it.

Most doctors are idiots and only have a career because of that MD title. I've met way more crappy doctors than good ones. I typically don't trust anything they say beause each time I've had an issue I've had to argue with a doctor and eventually prove that I am right.

ahh in that case you will never have to visit one.

However, if I had the choice between you and a doctor, it would be the doctor I would choose everytime.

Just think, if you need stitches or an op, you can do it all on yourself, you need nobody's help ))

1. Not all doctors made A's in school. :laugh:

2. I have gotten some VERY questionable treatment from doctors in the past and had to move on to new ones and do a lot of research on my own. (regarding kidneys, not weight loss but mistakes happen every where every day )

3. I don't ask my OBGYN advice about weight loss because they have posters all over their walls advertising WL pills. It actually REALLY bothers me every time I see them.

Indeed.

I was having issues sleeping and my GP prescribed me an anti depressant. I am the least depressed person I know! I never took it but now whenever I'm not feeling well I tell my husband I'm going to go to Dr. X to get an anti depressant.

Your doctor may have prescribed the correct medication in this instant. Many medications labeled as anti-depressants have other uses as well as treating anxiety and depression. These include both increasing and supressing appetites, reducing seizures and helping reduce insomnia. Mirtazipine is a commonly prescribed "anti-depresant" which is very effective at helping someone sleep.

Traditional, benzodiazepine based sleeping tablets (diazepam, tamazepam etc) are now generally only used as a last resort or if there is another medical condition necessitating their use. The main reason for this is the effectiveness of benzodiazepines reduces very quickly as you become reistant to them (your tolerance increases) which means a higher dose is required often within 1-2 weeks. It is also very easy to become dependent on them after a relatively short time.
A responsible doctor will not prescribe benzodiazepines initially and if they are prescribed for persistant insomnia it will usually only be for a few days.
If a person becomes dependent on benzodiazepines (especially at higher doses) it can become dangerous to stop immediately and to do so can cause seizures and even death.

This is why a responsible doctor will often prescribe what seems a "silly" medication labeled as an anti depressant instead of a "real" sleeping tablet. It still will help but it reduces the risks to the patient.

If you are ever unsure why you have been prescribed something ask your doctor, there is normally a very valid reason.

I can't help but feel like many of the complaints on here about doctors being terrible are directed at the wrong people. Maybe it's the system that is terrible, and the doctors are just doing the best they can within the confines of how they are forced to work?

Okay... so I'll be the first to tell you that the M.D. or Ph.D. behind your name is not magic. It does not make you a god. It does not make you infallible. But good heavens. I keep seeing people post about something their doctor suggested and then a whole bunch of people who are NOT DOCTORS come in and tell that person, 'oh, doctors aren't experts in nutrition, you should ignore their advice' or 'only you can decide what's right for your body' or whatever.

<-- snip! -->

HOWEVER... the flippant attitude that some people have about doctors (and scientists) is crazy. Odds are, your general practitioner is going to know a heck of a lot more about the human body than an accountant or computer scientist or even a biochemist or pharmacologist/neuroscientist (like me) on MFP.

Please don't dismiss your doctors' advice on a whim or on the council of an MFPer. Read, study, learn what you need to know so that you can be a good consumer. Push for the care you need... but don't be foolish. Don't ignore medical advice unless you've got a good reason to believe your doctor is wrong.

I do get on my high horse, and I'm sure there are probably many who are sick of hearing me say this. To them, I apologize in advance. Because I'm going to say it again.

A person I love very much was kept on a VLCD (very low calorie diet) of 500 cals per day, all liquid, and expected to push a stationary bike routine 30 min. a day. By a doctor. No, sorry - by a TEAM of doctors in a program touted as "medically supervised weight loss" - people who used their professional reputation to bring in the clients. Ok, morbidly obese people may need that for a time. Like, a month. Maybe two. Three? That's pushing it.

But for a year?

And the worst thing is - they didn't even do what the program is supposed to do. They said they would "reset the eating habits" and replace it with new ones. Well, NOT. All they taught my loved one is - you have to starve and work out beyond endurance in order to lose weight.

Are all doctors that unconscionable? Probably not. But I will continue to shout it from the rooftops. Over and over and over again.

Question your physician! Make sure they know enough to not damage your metabolism. Find people with similar conditions as yours and ask how they got better. Read. Learn. Do not take anybody's word for anything. Then make up your own mind, try what you believe will work, and give it time to work.

if that doesn't work, rinse... repeat.

Doctors are not always right, and sometimes - they're deadly wrong.

1. Not all doctors made A's in school. :laugh:

2. I have gotten some VERY questionable treatment from doctors in the past and had to move on to new ones and do a lot of research on my own. (regarding kidneys, not weight loss but mistakes happen every where every day )

3. I don't ask my OBGYN advice about weight loss because they have posters all over their walls advertising WL pills. It actually REALLY bothers me every time I see them.

This is true...but they graduated. Which means that after 4 years of undergrad, they got into med school (which 50% of applicants dont do), they passed every systems exam (about 10 of them), 3 sets of board exams, passed all of their rotations and subsequent exams, and then had to match into a specialty. And let me reassure you, they don't just pass people for the hell of it.

That said, in every profession there are people who either don't keep up on their reading or are just crappy people. I wouldn't write off every doctor if you have a bad experience, but don't hesitate to move on if you feel like you're not getting great care...for whatever reason.
Also, WL pills in an OB/gyn office?! That would piss me off too. Although, while ob/gyn's are technically primary care, I wouldn't go to them for weight loss advice.

I have a huge problem with modern medicine, specifically because quite simply it's a business. A business has a job to make money, and as such is biased. Aside from the conspiracy on the modern medicinal society which you can get enough bullroar about by using google, I would also have to point to the statistics of how many doctors make mistakes, and the fact that a nurse working a normal shift will make an error in 1/4 of her decisions.

Also while your doctor is given tons and tons of classes, they don't do a bit of good if they don't know everything about YOUR body. Every time a doctor prescribes something to you it's based on best guess. Yes they take into account what you look like when you walk through the door, your description of the symptoms etc. However in the end it really is just a quick calculation of something that matches around those symptoms.

The only way to really be sure of anything is to research yourself, know your entire body, and really understand the concept of a drug and what it's made to accomplish. That or get a family doctor who should know pretty much everything about you after 5-10 years of seeing him on a regular basis including yearly physicals.

That all being said, at least a doctors guess is an EDUCATED one. So unless you truly have taken the time to educate yourself on your body and health, and how it all functions, you should definitely take your doctors advice. You may not like the advice, but it is a thousand times better than your best guess, and DEFINITELY a million times better than some random person posting online who hasn't even SEEN you in order to understand what symptoms you have that you don't even know about. Doctors are trained to take everything into account about you from the second you walk in the door, they see subtle things that you likely don't have a clue about.

As with anything, any advice someone gives you should be taken with a grain of salt. Something like your health you should definitely research and fully understand so that you can make an educated decision at any given time. Otherwise you leave yourself at the mercy of others, either your friend who thinks they're a know it all, a random man in a white coat (who you have no idea how well he did in med school), or the internet (good people and trolls a like.).

Many valid points here!

I'm not saying all doctors are bad - but seriously - most doctors offices book appointments every 10 minutes, sometimes 20. How much can your doctor really cover in that short of a time?

a) not to burst your bubble here, but just about everything is a business. And yes, businesses are in the business to make money, but that doesn't mean they're out to screw you over. A lot of people do like to help people and find what's right for them

b) That's why you go to the same doctor consistently. I have had my share of health problems in the past and since they know my history and my body is makes it much easier. They have also put in the time and effort to figure out what the problem was and how I can go about controlling the source.

Damn people for trying to make money! Oh wait, I guess that means me too b/c i like money

Thank you. So many MFPers think they read a study and it makes them Drs or experts.

Okay... so I'll be the first to tell you that the M.D. or Ph.D. behind your name is not magic. It does not make you a god. It does not make you infallible. But good heavens. I keep seeing people post about something their doctor suggested and then a whole bunch of people who are NOT DOCTORS come in and tell that person, 'oh, doctors aren't experts in nutrition, you should ignore their advice' or 'only you can decide what's right for your body' or whatever.

It makes me grouchy. (Unless you're ignoring Dr. Oz. HE makes me grouchy and I'd rather you ignore him, but that's another rant...)

Because... here's the deal. Maybe doctors don't have the classes upon classes upon classes about diet and nutrition that a dietitian has, BUT they do have classes upon classes upon classes about how the human body works.

The human body is incredibly complicated and it's pretty tough to learn everything there is to know about the human body. That's why there are specialists. A general practitioner could never learn it all. And so, yes, doctors aren't going to have all the answer and it is always a good idea to question the information they give you and it's always a good idea to ask for a referral to a specialist if you think it would be helpful.

HOWEVER... the flippant attitude that some people have about doctors (and scientists) is crazy. Odds are, your general practitioner is going to know a heck of a lot more about the human body than an accountant or computer scientist or even a biochemist or pharmacologist/neuroscientist (like me) on MFP.

Please don't dismiss your doctors' advice on a whim or on the council of an MFPer. Read, study, learn what you need to know so that you can be a good consumer. Push for the care you need... but don't be foolish. Don't ignore medical advice unless you've got a good reason to believe your doctor is wrong.

I don't even ignore my doctors' advice... I DO make them explain their rational to me and if I disagree, I'll tell them I disagree and I'll tell them why... but in the end, I follow their advice.

Now of course if they're suggesting Paleo, feel free to label them a quack and move on**.

















**I'M KIDDING! I'm kidding. Paleo works for some people and some doctors will recommend it because they've seen good results. I'm just biased against Paleo.

Most doctors are idiots and only have a career because of that MD title. I've met way more crappy doctors than good ones. I typically don't trust anything they say beause each time I've had an issue I've had to argue with a doctor and eventually prove that I am right.

ahh in that case you will never have to visit one.

However, if I had the choice between you and a doctor, it would be the doctor I would choose everytime.

Just think, if you need stitches or an op, you can do it all on yourself, you need nobody's help ))

We're not talking some routine stuff like stitches, or I need a perscription filled. I'm talking about major issues that get missed because they don't listen and are more interested in either pushing you out the door or just are smug. There ARE great doctors out there, but so many more sub-par ones it's mind boggling.

Perfect example is years ago I had developed kidney stones after living in Arizona for a while. I attributed this to the unusually hard water there, which I hadn't started filtering yet. The pain got horrible and I couldn't even stand erect at all without holding on to something for support. Went to a doctor after researching symptoms and told her what I thought it might be. Here's the basic rundown of how that conversation went:

"I'm not sure but I think it may be a kidney stone. Can you test for that, or maybe something else is wrong?" (I then explain symptoms I'm having)
"Oh, I see we have an armchair physician *laughs*. At your age there is NO WAY that you have something like a kidney stone. You probably injured your back.
"But the pain is travelling around my sides like something is moving."
"Lots of stuff can do that."
"Like what? I'm open to other theories."
"Well I can tell you it's not a kidney stone for sure. Go home and take some ibuprofin."
"Doc, I can't stand, can't do my job, it's unbearable. Can we at least test for it?"
"No."
"Why?"
"Because I'm pretty sure that's not the issue, you'd probably see blood in the urine."
"I ALREADY told you that I did see slight traces of blood yesterday."
"Meh, probably not enough to worry about..."
"Ok, seriously, my insurance will pay for the test, can we just do it so that I have piece of mind."
"No."
"What do you mean 'No', pretty sure my helth is my own call here?"
"Fine...whatever, I guess you're the doctor now. Just to let you know you're wasting your time..."

Fast forward 45min and the results are back:

"So, it looks like the test came back with not insignificant blood in the urine and proteins that my indicate a stone"


Basically long story short, I had a CT scan and DID have stones after arguing with the first doc about it. I began to get more skeptical as time went on, and I've found the pattern repeated often with many doctors. Needless to say I'm pretty skeptical about most advice and research it on my own. I am confident that a lay person can become more of an expert in very specialized areas than some GPs.

If you are not going to seriously consider and be open to YOUR doctors advice (considering he is trained) then don't bother going.

It's not about not being open to doctors advice, it's when they don't listen to the symptoms at all when you are seeking help. Perhaps you've always been healthy (me too) and haven't had to deal with it much, but I've dealt with some horrible doctors with my wife who has always had one issue or another (some minor and others pretty major).

Indeed.

I was having issues sleeping and my GP prescribed me an anti depressant. I am the least depressed person I know! I never took it but now whenever I'm not feeling well I tell my husband I'm going to go to Dr. X to get an anti depressant.

Your doctor may have prescribed the correct medication in this instant. Many medications labeled as anti-depressants have other uses as well as treating anxiety and depression. These include both increasing and supressing appetites, reducing seizures and helping reduce insomnia. Mirtazipine is a commonly prescribed "anti-depresant" which is very effective at helping someone sleep.

I'm sure there are plenty of instances where a medication is developed for one purpose and is appropriated for another. My mother fell off of a ladder, suffered nerve damage (among other things,) and has stabbing burning pain in her hand that may not go away for the rest of her life. She was prescribed neurontin (gabapentin) for nerve pain. Neurontin was developed to treat seizures and is an anticonvulsant. In fact, health insurance does not cover neurontin prescriptions for treating neuropathic pain, even though it is almost exclusively used for this very reason and and rarely prescribed for its original purpose. I am certainly glad she didn't dismiss her doctor as a quack because he prescribed an anticonvulsant, since it is the only medication that has helped her deal with her pain.

Although it's great and pc to say "everyone is different, so you can't tell me what is right for MY body," human bodies do have basic similarities. By the time physicians finish their residency, they have dedicated a large percentage of their adult life to understanding the human body. They may not be complete expert in every aspect of how the body (or how YOUR body) works, but they sure as heck know more about what will work for YOU than your average MFP poster, who more often than not will give you advice on what has worked for THEM.

Most doctors are idiots and only have a career because of that MD title. I've met way more crappy doctors than good ones. I typically don't trust anything they say beause each time I've had an issue I've had to argue with a doctor and eventually prove that I am right.

This is precisely the kind of attitude that people bring in that interferes with their own care. I routinely see this with families of a patient in the ICU, and while they think the suspicion and defensive stance is helpful, it actually prevents us from doing our jobs effectively. The job being: saving your family member's life.

Some times suspicion is warranted. Sometimes doctors make horrible calls and should be questioned. It's the smug attitude of so many people that work in healthcare that gets in the way. I'm not saying that there aren't difficult patients, of course there are, but many times doctors are just as bad.

For my wife I question every single decision made by a doctor and ask them directly to not only understand, but also because she's had so many f**k ups performed on her it's mind boggling:

"Removal" of bartholin cyst in a doctors office by literally popping it like a pimple (!!!)

Same cyst reoccurs and she goes to a different doc that just cuts it open and packs with gauze. No local numbing and yells at her when she crys. Can't even walk when he's done and she's left to hobble to the car... She later gets an infection and has to be treated wtih antibiotics

Same cyst reoccurs and she is sent to a surgeon. Surgeon removes it, but does not stitch it up properly. 2 months later she still has a weeping wound that won't heal

Goes to a doctor for the wound and they chemically cauterize it, but not before literally burning every where in the bikini area. The doctor told her the burning was "normal" and she'd be fine in a few hours. She had to see a different doctor to treat the 2nd degree chemical burns.

During her delivery of our son the doctor botched her epidural after sticking her 14 (NOT an exaggeration) times. It never did work right and he injected air into the spinal column. He yelled at her for being uncooperative (which she wasn't being). Afterwards she had the sensation of electrical shocks running up and down her leg for 3 months.

6 months later she hurts her lower back exercising. She's diagnosed with a bulging disc. She's put on heavy pain killers and told it will fix itself. When it doesn't she's given steroids, which cause her to gain weight and put even more stress on the disc. She's then told she needs disc injections to reduce the inflammation. When that doesn't work they tell her that her only option (at 31 years old!) is a discectomy and a spinal fusion at those vertabrea. I switched her to a low carb anti inflammatory diet and she was pain free in less than a month.

After being unable to loose a significant amount of weight after diet and exercise, and exhibiting over 75 different hypothyroid symptoms she gets a thyroid test. It comes back normal. We ask to see a specialist just in case they can test for a wider array of issues, we are told that she can't because her tests are normal. I fight for a referral and get one.

She goes to the endo and he won't listen to her at all and says her symptoms are nothing more than being fat and lazy, and that she should really think about cutting her calorie intake back to 600 or less a day and exercise an hour or more a day. Refuses to do any tests at all...


Long story short, going against doctors advice we've nearly cured her back issues with diet, looked for a 2nd opinion on thyroid and was diagnosed with hypothyroid and insulin resistance, as well as adrenal fatigue and gluten intolerance. She's getting better all the time. There are more minor events in there as well, such as doctors mixing perscription meds that have horrible side effects together, etc.

Point being, do not blindly trust your doctor.....

Most doctors are idiots and only have a career because of that MD title. I've met way more crappy doctors than good ones. I typically don't trust anything they say beause each time I've had an issue I've had to argue with a doctor and eventually prove that I am right.

This is precisely the kind of attitude that people bring in that interferes with their own care. I routinely see this with families of a patient in the ICU, and while they think the suspicion and defensive stance is helpful, it actually prevents us from doing our jobs effectively. The job being: saving your family member's life.

Some times suspicion is warranted. Sometimes doctors make horrible calls and should be questioned. It's the smug attitude of so many people that work in healthcare that gets in the way. I'm not saying that there aren't difficult patients, of course there are, but many times doctors are just as bad.

For my wife I question every single decision made by a doctor and ask them directly to not only understand, but also because she's had so many f**k ups performed on her it's mind boggling:

"Removal" of bartholin cyst in a doctors office by literally popping it like a pimple (!!!)

Same cyst reoccurs and she goes to a different doc that just cuts it open and packs with gauze. No local numbing and yells at her when she crys. Can't even walk when he's done and she's left to hobble to the car... She later gets an infection and has to be treated wtih antibiotics

Same cyst reoccurs and she is sent to a surgeon. Surgeon removes it, but does not stitch it up properly. 2 months later she still has a weeping wound that won't heal

Goes to a doctor for the wound and they chemically cauterize it, but not before literally burning every where in the bikini area. The doctor told her the burning was "normal" and she'd be fine in a few hours. She had to see a different doctor to treat the 2nd degree chemical burns.

During her delivery of our son the doctor botched her epidural after sticking her 14 (NOT an exaggeration) times. It never did work right and he injected air into the spinal column. He yelled at her for being uncooperative (which she wasn't being). Afterwards she had the sensation of electrical shocks running up and down her leg for 3 months.

6 months later she hurts her lower back exercising. She's diagnosed with a bulging disc. She's put on heavy pain killers and told it will fix itself. When it doesn't she's given steroids, which cause her to gain weight and put even more stress on the disc. She's then told she needs disc injections to reduce the inflammation. When that doesn't work they tell her that her only option (at 31 years old!) is a discectomy and a spinal fusion at those vertabrea. I switched her to a low carb anti inflammatory diet and she was pain free in less than a month.

After being unable to loose a significant amount of weight after diet and exercise, and exhibiting over 75 different hypothyroid symptoms she gets a thyroid test. It comes back normal. We ask to see a specialist just in case they can test for a wider array of issues, we are told that she can't because her tests are normal. I fight for a referral and get one.

She goes to the endo and he won't listen to her at all and says her symptoms are nothing more than being fat and lazy, and that she should really think about cutting her calorie intake back to 600 or less a day and exercise an hour or more a day. Refuses to do any tests at all...


Long story short, going against doctors advice we've nearly cured her back issues with diet, looked for a 2nd opinion on thyroid and was diagnosed with hypothyroid and insulin resistance, as well as adrenal fatigue and gluten intolerance. She's getting better all the time. There are more minor events in there as well, such as doctors mixing perscription meds that have horrible side effects together, etc.

Point being, do not blindly trust your doctor.....

alrighty then :huh: