DOCTORS, STEREOPTYPE AND TRUTH

Once people have graduated from medical school and have become full doctors:

 

- they can only empathize with their patients to a very limited degree

 

- they have learned to cover their tracks. If they are not receiving a salary, they are businessmen in the business of  ‘health’care. You’re probably lucky if you’re protected by the law.

 

- the process of diagnostics is based on stereotyped patterns of thinking, both formal and informal. A ‘disease’ is what they learned to recognize as such. Only that is ‘real’.

 

- doctors are usually knowledgeable about formal diseases, but quite often things go wrong when they want to manage your ‘health’.

 

- while they appear to be professionals, they really are no better than anyone else as a person. Beneath their professional veneer that exerts an influence on their work. Power differentials can lead to abuse.

 

- once they have become full doctors, they cannot learn from their patients since that goes against point 3). Their thinking is set, and they can only learn from their colleagues. There are rare exceptions.

I'm sure I'm not the only one who believes that the healthcare model above is outdated.

 

Often, people are more knowledgeable about their bodies and their health than their doctors. Quite often, people are also more knowledgeable about what is physically wrong. Whether that's a formal disease or not.

I think that healthcare model is outdated. I'm sure many people agree.

 

THEN WHY DO WE PUT UP WITH IT ?

 

Change is coming but the medical world is resistant to change.

I would very much agree with what you have written, liberty. 

 

I agree that change is coming but I am not sure what sort of change it will be .. it could be for the better, but it might not be.  I suspect I will not live long enough to see how it all pans out. 

 

As a campaigner in the UK, I see many doctors campaigning as well as patients.  It seems many of them are very disillusioned also. 

Maybe they just want to make money and don't care about other people.

Yes, money is definitely a big factor here. I've seen my hubbys and my previous practice with numerous doctors in it practically fall apart because our internist became what is known as a hospitalist (doing only inpatient work), while others left to join other doctor groups, and several join what is known as MDVIP program. That's a program where people pay a yearly fee to see the doctor aside from insurance costs.

 

I do believe money is huge in that situation. And that's a change that is coming here in US.

 

I always question a diagnosis if only to get info about it. But I also question certain medications also like statins.

 

Sure wished I would have questioned benzos years ago, but back then, my doc didn't even seem to get the danger either. I've learned way too much since then.

 

I've also seen doctors here wonder about what I say now, and question their thinking. In other words, in my case and hubbys, I've watched their reaction when I propose a possibility, and seen them and heard them say that I could be right. Not always dogmatic at all.

Yes, I know my doctor (primary care) gets bonuses for seeing more patients. It’s a revolving door of 15 minute sessions. He doesn’t remember me and reads my chart on the way in. In fact, he said he learned everything about benzos from me. I find it ironic that I have to pay him to teach him.

It's all a dominance/compliance thing.

Sore throat? Take off you pants[intentional exaggeration].

Although, during my last physical I did argue with with my doctor, he was mad I put my johnnies on backward like a robe. 

It is more medically appropriate to sit in a chair, that who knows how many other people sat in, with my backside planted on it. 

I told him I ought to bring my own robe next time. 

I won't of course but, I may grab a piece of that waxed paper for my chair. 

I would very much agree with what you have written, liberty. 

 

I agree that change is coming but I am not sure what sort of change it will be .. it could be for the better, but it might not be.  I suspect I will not live long enough to see how it all pans out. 

 

As a campaigner in the UK, I see many doctors campaigning as well as patients.  It seems many of them are very disillusioned also.

 

Yes, I know my doctor (primary care) gets bonuses for seeing more patients. It’s a revolving door of 15 minute sessions. He doesn’t remember me and reads my chart on the way in. In fact, he said he learned everything about benzos from me. I find it ironic that I have to pay him to teach him.

 

Sadly we do teach the drs re benzos  often or so I found. 

Not sure about change happening any time soon hopefully it will. 

Sadly they treat a symptom and dont have time to isolate or deal with a cause  :'(

 

 

Well, here's something I found out this week. Oh, I changed doctors. This is a post from my blog.

 

 

 

I went for my annual today. The good news was while I was waiting in the room I looked at papers on the wall. There is this one paper that caught my eye: It was about benzos. It was an informed consent letter the patient has to read and sign. It talked about the dangers of this class of this class of drugs and how withdrawal abruptly can result in bad things. It also reserved the right for any pharmacist to call the doctor to make sure the script is accurate and it must be put in a nationwide database so no doctor shopping. It also reserved the right to test the patient and if no benzos are found there will be no more scripts and the doctor will refuse to see that patient for further benzo treatment It also said the prescribing doctor has the right to share this information with other doctors. Progress!

Well, here's something I found out this week. Oh, I changed doctors. This is a post from my blog.

 

 

 

I went for my annual today. The good news was while I was waiting in the room I looked at papers on the wall. There is this one paper that caught my eye: It was about benzos. It was an informed consent letter the patient has to read and sign. It talked about the dangers of this class of this class of drugs and how withdrawal abruptly can result in bad things. It also reserved the right for any pharmacist to call the doctor to make sure the script is accurate and it must be put in a nationwide database so no doctor shopping. It also reserved the right to test the patient and if no benzos are found there will be no more scripts and the doctor will refuse to see that patient for further benzo treatment It also said the prescribing doctor has the right to share this information with other doctors. Progress!

Hi Benzogirl,

 

This not a critique of your post. These are only observations. The questions herein are all rhetorical to direct contemplation.

 

I do seem to see a change with the establishment regarding that notice. It is very good to keep people from getting a script and then selling the pills.

 

Yet, the lack of reciprocity is glaringly apparent. What about the patients who have been on these pills compliantly, been dutiful to making appointments, been honest and above board? Is there a data base of patients that can log a request to cite their concern about being on these benzos and be matched with doctors that will assist in sensible tapering support. Does it link to pharmacists who will fill custom scripts to aid in the tapering process, taking all the backroom measuring, cutting, and prepped dosing, so that patients aren't carrying the entire load of recovery that the system put patients on in the first place?

 

From the written notice, people are only being told they are the ones responsible for all the problems, with subsequent punitive consequences of abuse/misuse. That is not a socially equitable contract for true patients desiring least harm management when exercising their right to self determination on desisting from a particular course of treatment.

Respectfully,

Eutychus

 

Liberty,

 

I read your posts with interest. Clearly you’ve had some terrible experiences with doctors and I am very sorry for this.

 

I have worked in healthcare in the UK a long time. I personally know several different types of doctors, both physicians and surgeons.  I have worked with patients extensively.  My point of view is that there are good apples and bad apples in every profession.  I have come across many superb doctors, who devote their lives to medicine and truly see it as a vocation. Also, I have seen those who are clearly in the profession for financial reward and their own ego.  To view everyone the same, is, I feel, somewhat a sweeping statement.  But you are of course entitled to your opinion.

 

We still have so much to learn about the human body, particularly the brain, and I believe many doctors would agree that many specialities are under-researched with few effective treatment tools.  Unfortunately healthcare is a political football and will always be attractive to unscrupulous private enterprise.  This is something I don’t see changing in a very long time.  Certainly in the UK we go through many cycles flipping between new management systems and old, and no real progress is ever made. We seem to substitute one problem for another.

 

The current litigious environment in the UK is doing nobody any favours because it makes doctors naturally more defensive. Yes, doctors should be accountable for their actions and decisions, but very often these are carried out in increasingly stressful working environments under ridiculous targets and restrictive guidelines, set by people in ivory tower offices who have no clue what the job actually involves.  Who would want to perform surgery on a patient in theatre with equipment missing or temporary agency staff assisting who do not know the surgical procedure? I have seen this happen many times. Who would want to see 30 - 40 patients in a day with 10 minutes each to establish a diagnosis and treatment plan? Many patients these days present with multiple complex problems, both physical and mental, and doctors are increasingly expected to deal with serious social problems as well, since that infrastructure is now chronically underfunded and nonexistent in many areas.

 

I was discussing mental health with a physician the other day and he raised a very salient point. If a chronically depressed or anxious patient presents who is at real risk of suicide and the physician is well aware of the pitfalls of benzos and SSRIs, what options does he offer and how does he counsel the patient about those options? Does he go ahead and give a complete picture to the patient who them might decline the medication on the basis of fear or is his objective to do what he can to prevent the patient taking their own life?  I ask this, because the answer is not as clear as you might think. There are guidelines to follow, but when suicide tragically occurs and the patient has seen a doctor, you can bet the doctor is seriously scrutinised and in some cases hauled over the coals because family or relatives are ALWAYS looking for someone to blame.

 

We are not a society these days who accepts responsibility for ourselves.  We like to complain, blame and sue. We eat junk, don’t exercise enough, don’t sleep enough and live lifestyles of excess and entitlement.  We are nothing like our grandparents. Not everyone is like this of course, but many are.  Sometimes social factors are a big part of this, but sometimes not. We want a quick fix.  We don’t want to hear that something will take a long time to heal.  We need to be back at work or looking after our families.  Is this the doctor’s fault? No. But the expectation is put firmly at the doctor’s feet.  I have seen this many many times. 

 

Because we’ve had such terrible experiences with psychotropic medication we feel so passionately about it, but in many cases it has saved people’s lives.  It saved mine. I don’t pretend to condone it, and I do agree that the pharmaceutical industry is not truthful and does hugely exploit mental health problems for financial gain.  But I view this medication in the same way as chemotherapy.  It’s brutal, destructive, the side effects are life-changing and it should be outmoded by now, but it’s not. - Because there is still so little understanding of what we are up against - nature.  More advanced treatments are still in their experimental stages or are out of financial reach for many patients.

 

Any person who becomes seriously ill can face what we might view as barbaric treatment.  Some are lucky and can avoid the worst and heal in time on their own. Others not. As much as I hate what benzos and ADs are doing to me right now, I know I would have not endured last year but for the intervention.

 

Do I blame my doctors? No. Did they tell me the whole story about what might be in store for me? No. I knew just enough to realise I was making a pact with the devil, but I felt I had no choice and time was running out.

 

Ultimately throughout world healthcare it’s the systems that are flawed and the treatments stagnant in many areas.  We have a choice: take what IS on offer or refuse and go for other alternatives.  A doctor has a duty to inform, but when the SYSTEM only allows so much time, and with the threat of legal action and complaints at every turn, it is surprising that anyone actually chooses to be a doctor these days!

 

I hope I haven’t offended anyone with my thoughts. I just wanted to add something to the discussion.

 

Best wishes to everyone.

 

Mrs B

X

 

 

 

 

 

 

Well, here's something I found out this week. Oh, I changed doctors. This is a post from my blog.

 

 

 

I went for my annual today. The good news was while I was waiting in the room I looked at papers on the wall. There is this one paper that caught my eye: It was about benzos. It was an informed consent letter the patient has to read and sign. It talked about the dangers of this class of this class of drugs and how withdrawal abruptly can result in bad things. It also reserved the right for any pharmacist to call the doctor to make sure the script is accurate and it must be put in a nationwide database so no doctor shopping. It also reserved the right to test the patient and if no benzos are found there will be no more scripts and the doctor will refuse to see that patient for further benzo treatment It also said the prescribing doctor has the right to share this information with other doctors. Progress!

Hi Benzogirl,

 

This not a critique of your post. These are only observations. The questions herein are all rhetorical to direct contemplation.

 

I do seem to see a change with the establishment regarding that notice. It is very good to keep people from getting a script and then selling the pills.

 

Yet, the lack of reciprocity is glaringly apparent. What about the patients who have been on these pills compliantly, been dutiful to making appointments, been honest and above board? Is there a data base of patients that can log a request to cite their concern about being on these benzos and be matched with doctors that will assist in sensible tapering support. Does it link to pharmacists who will fill custom scripts to aid in the tapering process, taking all the backroom measuring, cutting, and prepped dosing, so that patients aren't carrying the entire load of recovery that the system put patients on in the first place?

 

From the written notice, people are only being told they are the ones responsible for all the problems, with subsequent punitive consequences of abuse/misuse. That is not a socially equitable contract for true patients desiring least harm management when exercising their right to self determination on desisting from a particular course of treatment.

Respectfully,

Eutychus

 

Informed consent is just that. The doctor has an obligation to talk about the dangers of benzos and the patient checks off each one to say they understand it. It’s for patients new to benzos. Yes it does protect the doctors but should also help the patient make their own decisions whether to take them or not. Had I been given this, I would have never taken them. So I think it’s progress.

Mrs Badger,

 

'The current litigious environment in the UK' we don't have anything here. Doctors are mostly above the law. GPs make so many medical mistakes, and what's the evidence that one can get as a patient ? The GP held the medical records, and part of it only became available during the 'procedure'.

 

I wish so much that doctors were subject to real scrutiny. Medical treatment without informed consent (not just the benzo) is such a horrible thing. He managed to mess up my health in other ways and to obstruct my withdrawal from the clonazepam when it was still relatively uncomplicated. Crazy justifications and denials.

I never took meds to speak of before my accident.. I was given no information on any of them.. The nurses just fed them to me saying I needed them... Then when there were problems there still was no info or real help... Shame on them...  I have seen my good Dr get slowly brainwashed by the system that feeds her kids... Everyone, including Drs have choices about who they are, -where their morals lay...

First do no harm...

 

Informed consent says to me that Drs need to be forced to do whats right..

-an offhand comment that -these meds can cause problems... is not a reasonable effort Imo...

 

To say Drs are too busy is like saying its ok for a truck driver to run over kids if he is running late...

 

Sorry, -cranky morning..

 

Hi Cantfly, i'm having a cranky time atm too so i thought i'd put in my ten cents worth! You are so right, a dr's first duty above everything else is to First Do No Harm, they can't get their rego/licence without swearing this oath, it underpins their practice which is supposed to be evidence based. There is masses of scholarly evidence since the 1950s that benzos cause harm. To say they are too busy, the system is not working etc etc is a bit like the SS officers saying they were "only following orders". Not a defence at all. It is a dr's job to keep up to date with current medical research. If they don't know the effects of their prescriptions then they should not be prescribing them, that's their duty of care. Psychiatrists think they sit on the right hand of god the father and in fact hold great power in the social system and therefore have an even greater duty to be continually updating their knowledge.

 

All the drs that i have seen (bar one) have victim blamed me for my symptoms. Comments include "You must be very sensitve", "I've never come across this (BWD) before", "That small dose wouldn't hurt  a sparrow", "BWD only last 6 weeks, you have a return of anxiety" (I was prescribed for muscle spasm, never had anxiety til BWD), "It's not that bad, just tough it out" (had a stroke 5 days later), "I'm not interested in your symptoms, it's not BWD" (never been sick before), I could go on and on but these statements are not only a gross violation of their duty of care but constitute medical negligence. There are too many reports of similar on this forum and others for this to be a "guilty few". World wide there seems to be an epidemic of negligence and worse, a denial of it which results in blaming the patient.

 

I have been to medical centres where there are signs saying that the drs do not prescribe benzos and drugs of addiction, however i know for a fact that these prescriptions walk out the door every day in the hands of vulnerable patients ready to wreak havoc on their lives. When they return with an escalation of symptoms (due to the poison itself) they are given more evil stuff and end up polydrugged due to the drs lack of knowledge. The dr then causes more damage by informing the patient that they now need these poisons as they have a permanent illness and so the cycle perpetuates.

 

The anger i feel at all of this goes way beyond the scope of this forum. Whilst we are in hell the drs that opened the gates sit in their ivory towers and go about their daily lives, they go on holidays, they are able to work, they are able to function. I am at a loss to know how on earth they can be made accountable for their poor and negligent practice, both pre and post benzo prescribing. Many times i have been told by drs that there is no "cure" for BWD. The "cure" is very simple - don't prescribe them except in a one off emergency situation for severe seizures in ER. Here in Australia we have a govt body called The Health Care Complaints Commission (HCCC) which all registered health practitioners are terrified of. They are a powerful patient advocacy body with the legal powers to prosecute drs before a Tribunal and administer sanctions against their practice. It seems to me that if those of us in Oz report the negligence of the drs that inappropriately prescribed this poison to us there may be a chance of some change.

 

Anyways, that's my rant for today, thankyou Mrs Badger for your opinion but I for one do not hold it.