Doctors can be so stupid

[undeterred]

I have a friend, he's 55, and he's been having a lot of pain in his side for the last few months. He's been getting nowhere with doctors, and getting really angry when some start asking him if he's depressed and that sort of thing.

Today he went to a new internist, who asked him about ten questions, had him move around and ordered an xray. Turns out he badly needs a hip replacement.

How can doctors not know the difference between depression and needing a hip replacement?

[BlueIris]

1. Sadly, the stupidity of your average doctor is the result of many factors.

Relax, DU MDs, I posted average. There are many excellent, attentive, caring physicians out there. I haven't met one in almost a decade, but I'm sure they exist. And relax, fellow posters who love their docs, I'm sure you have good, trustworthy health care providers.

My father (an FP) and I have talked about this a lot. He feels that the quality of medical education in the United States has been on the decline for many years, and is now starting to show in a big way. Not that it was ever that terrific, in his opinion. He also thinks that education and higher ed in the US have declined in quality as well. He and I both think that the role the insurance companies have in the medical system is appalling. There are many other reasons doctors today are, in my opinion, doing a collectively shitty job, but those are the ones my dad and I discuss most frequently. There's also the argument to be made that doctors in the United States have always been this incompetent. We're not exactly a brain trust over here, people.

Also, it's become basically impossible for doctors to be doctors first and pawns of the insurance industry second when virtually all of us (who give or get care via the private side of the US system anyway) are pawns of the insurance industry. Sadly, though, I suspect that docs like those who mistreated your friend aren't ineffectual because the insurance companies are making their lives a living hell. They're ineffectual because they don't give a shit about being effective. They're either too bitter about no longer making doctor $$$ to care what happens to their patients, or they are so disenchanted with the entire medical profession that they don't care what happens to their patients (or themselves?).

It's also possible though that with regard to the nature of his issue, your friend wasn't seeing the "right" kinds of doctors. Medicine is more highly specialized than ever. If your friend's problems were way, way outside the scope of the specialties of the providers he was being "treated" by, it's likely they simply didn't have an adequate base of knowledge to help him appropriately.

[lost-in-nj]

2. My daughter

had to go to the ER last year with pain in her chest and she could not breath...

The Dr. on duty asked her questions also.... he ordered a Cat scan and Xrays based on her answers....
She had blood clots on her lungs, he asked her if she had been on a plane in the past few weeks...
I thank God every day we got the "right " Dr. to look at her, someone else would have sent her home with a pulled muscle...
I learned that day that you have to ask questions, be pro active, and make sure they give you an answer not a pat on the back and
You'll be ok....


lost

[pitohui]

3. they think everything is depression

you think that's bad, they almost killed my mom diagnosing her with depression, she had severe blockages in her arteries and turned out to need a quadruple bypass! the first doc tried to palm her off with prozac, can you imagine? she almost died

my friend's dad did die, diagnosed w. depression, he had colon cancer, by the time they figured out "oops" it was too late

one problem is that many serious illness cause fatigue and malaise, so it's easy to say "depression" instead of looking for an underlying physical cause of the fatigue, yes, you might be tired because you're depressed, but you MIGHT be tired because you have cancer or heart disease


doctors should look for a physical cause of any serious symptom first, not assume everyone is mentally ill, esp. in your 50s and 60s, let's be honest, by that age, you already know if you're mentally ill

[LeftyMom]

4. That happened with my grandmother twice

The first time was torticollis (a neck problem which is pretty rare) and it took almost a decade to get a diagnosis. She had to go to I don't know how many shrinks because every doctor who couldn't figure out the problem thought she must be a hypochondriac or worse.

The second time was breast cancer. I have no idea why a doctor wouldn't think *cancer!* when a woman in her late 50s who smokes like a chimney, drinks like a fish and has a family history of cancer presents with rapid and dramatic unexplained weight loss, but they looked at everything from eating disorders to an aids test before they gave her a fucking mammogram, and the year or so of dicking around while she got thinner and sicker probably cost her a shot at survival.

[undeterred]

9. Just because you have depression doesn't mean you don't have

colon cancer too! People can have multiple diagnoses, and the older you get, the more likely that is.

[pitohui]

10. the man didn't have depression, his fatigue was caused by cancer

sheesh, every time you get tired it is not clinical depression, a doctor should know that

older people are actually happier with their lives and less likely to get depression than younger people, absent a physical illness

[baldguy]

5. My mom spent 8 monthes being treated for a digestive ailment.

Then the docs figured out that this woman who smoked for 40 yrs had lung cancer.

By then it was too late...

[undeterred]

7. thats inexcusable...

[undeterred]

6. I think it has a lot to do with "framing"

When I had a complete physical 2 years ago I asked why I had a chronic cough in the morning even though I don't smoke. The doctor gave me a mishmash of possible answers that led me nowhere, and two years later I'm still coughing.

Well, last month I mentioned it to my OB/Gyn, who I really didn't expect an answer from. She asked me 3 or 4 questions and told me it was probably allergies. I've started taking Claritin, and the cough is a lot better. And she was on her way out the door when she made this diagnosis of something which has been bothering me for years- like, no big deal. I realized later its kind of an obvious guess and I don't know why I didn't think of it myself- but neither did the other doctor I talked to!

[ForrestGump]

8. Very, very often are

I know many people who've found out the hard way, some very close to me. One woman died (repeatedly...in the end she survived, but the resulting medical bills almost killed her anew) as a direct result off MD incompetence. Too many examples, too depressing to even outline.

It's particularly bad in the US, where standards are not necessarily standard, the place is too darned big for thorough oversight, and -- most of all, in my opinion -- MDs are looked upon by many Americans as infallible gods. In many other countries, physicians are basically seen as technicians. They're also more open to complementary modalities of healing that may have actual merit (and not arrogantly sure that they know it all, a certainty certain only to be wrong -- I taught premed students and some of them I would not want anywhere near me even with a tongue depressor).

[caty]

11. I once went to

the doctor for a cold that was not getting better after about three weeks. After he checked me over, he was writing out a couple of prescriptions for me and then said, "And I am also going to write one for depression". I said, "What for? I'm not depressed". He then said, as he kept nodding his head, "You're depressed, aren't you." Only he didn't say this as a question. He said it as a fact. I told him not to bother and that I was not going to take something for a problem I don't have. I wonder how much these doctors get for writing prescriptions for antidepressants that their patients don't even need.

[undeterred]

12. The thing about depression is it can also be treated

by therapy alone, or by diet and exercise, or a million other ways. Depression is also a natural reaction to certain life events like breakups and loss, and some doctors feel that under these circumstances it is perfectly normal and should not be medicated at all. You really have to wonder what some of these doctors are thinking when they write scripts so easily.