On Being a ‘Falling-Down’ Physician–Part 1

The New York Times has said it, so it must be true. In today’s Sunday Styles section it refers to lawyers and doctors as being ‘falling-down’ professions.
On one hand I cannot deny that there is much truth to this statement.
Physician morale is extremely low–for a variety of reasons. This is Part 1 of a series.

We battle a changing image among the public who arm themselves with Internet information and info-mercial misinformation.  They are quick to challenge our opinions, which is OK because it allows us to defend our decisions and therapies. What becomes a source of frustrations, however, is the cold hard fact that our patients do not totally understand all the ramifications of what they read and hear.  This is not a condescending statement. No matter how intelligent, how well read and how rational they may be, they did not put in the years of study and even more, the clinical experience of physicians.

Is that a surprising response from a meta-physician? It should not be.I consider myself to be extremely open-minded when it comes to my patient’s perspective. When given the opportunity I will openly work with them on any alternative, herbal or energetic therapy that seems reasonable and safe.

What is frustrating to me is when a patient will insist that they are right about a medical condition when it is clear to me that they have misunderstood or misinterpreted some basic concept or finding.

I have found this type of patient/doctor interaction to becoming more frequent. It saddens and frightens me because I feel that patients will be ultimately impeding their own healing.

An outstanding example was the young, intelligent woman who believed that her gall stones could be completely and adequately treated without surgery. She had utilized a rather archaic method of ‘flushing’ out the gall bladder with various oils administered orally.

What was particularly frustrating to me was the fact that she had already suffered several complications of gall stones disease:  jaundice and acute pancreatitis.  I tried to explain to her the enormous risks, life-threatening in fact, of delaying surgical removal of her gall bladder.

At any moment a gall stones could cause ascending cholangitis, sepsis and  shock. Likewise, her next attack of gall stone pancreatitis had potential for enormous morbidity.

She adamantly refused to see a surgeon and left the practice.  I only hope she is alive and well.  But I was incredibly frustrated by her stubborn refusal to accept real science. 

More to follow from the ‘Falling-Down’ Physician.

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