My family also has a predisposition to weight issues. My grandmother has always had an extremely large chest which ended up causing such severe back problems it impeded her ability to exercise. I also have ended up with large breasts, and I really wish I hadn’t. I’m not obese, but I am a little heavier than I would like. I worry that I will have problems as I age due to weight issues, and I also worry about my chest causing structural problems, but when I mentioned the family predisposition to a previous healthcare provider he mentioned my concerns were merely ‘cosmetic.’

As one of my medic friends says when a patient we get several times a month with a problem that they wouldn’t have if they just complied with treatment. ‘Gee, I don’t know what’s wrong. They’ve tried nothing and nothing seems to work.’

On another note. If reading about the few patients in the medical blogs that just make us cynical and frustrated upsets you….don’t read them. For every one of those patients, there are literally hundreds of patients that we do see, and do help and for most of us there is not another job in the world we would be happier doing. And, just so you know. Even the patients that we see frequently that refuse to be compliant and are pains in our butts, we still treat them with respect. Sometimes our blogs are just our way of venting. A PA friend of mine says working in the ER is a lot like acting sometimes.

Here is the thing – you might go through your day and meet only one person who is a waste of oxygen. We see many, many more. Like the police we find ourselves regularly going to alcoholics, drug users and general abusers of the medical services. It wears you down after a while.

Consider the type of person who annoys *you* in your day job, if you work a till it might be the person who takes forever to load their shopping on the belt, if you are a teacher the parent who refuses to accept that their child’s bad behaviour is anything to do with them, or the photographers who try to take pictures of squirming children.

All these things annoy, some more than others.

But it doesn’t mean that we don’t treat those people the same as the nicest little old lady. We just snark about it a bit behind their backs – something I’m sure that we are *all* guilty of.

(Or to boil it down – us medical types are human beings as well).

And the ‘well-educated servants is I suspect what the patient thinks, not what the doctor thinks…

I bet there’s no one here who can say that, in the hurly-burly of their everyday life, they would manage to take several medications a day at exactly the right times and have everything they could possibly need on their person every time they leave the house, every single day for ten, twenty, thirty years or more. Forgetting your tablets is a bit like forgetting your keys or your purse, you know it’s important, you try to remember, but sometimes it just happens.

A teenager I know who has epilepsy has mucked up his medications badly enough for it to cause seizures and hospitalisation once in the last five years. He didn’t do it on purpose (there were a lot of life-events happening to him and his family at the time) and personally, I think one major cock-up in five years isn’t bad going. Yeah, I think he should have been treated, and treated sympathetically at that. I don’t think he should be treated like dirt just because to the doctors, he’s the N-th person they’ve seen this week to get carted in because of a medication error, rather than an individual who has made a one-off honest mistake.

Well, just because they’re ‘rational and logical’ in the mind of the patient doesn’t mean they’re rational and logical in the real world.

I have always hated that philosophy. Just because I ‘perceive’ the sky to be purple doesn’t make it so. Just because I ‘think’ I have reasons not to take my meds doesn’t mean those reasons hold water, or that other people should go along with said reasons.

I’ve thought about writing a story (and if we ever go to a single-payer system, I wouldn’t be surprised if this actually happens) wherein if you don’t have a yearly physical and other recommended screening tests, and if you don’t keep your weight down–even if this means gastic bypass–or if you smoke or take drugs or don’t take your meds correctly–you don’t get medical care. Period.

Sure, this is non-compassionate, but by crackey you get tired of dealing with idiots.

I agree with ConcernedMother that the tone of all too many medical blogs is simply dripping with condescension for those in need of medical care.

Melissa is also correct that there are reasons for ‘non-compliance’ that often seem quite rational and logical in the mind of the patient at the time.

I don’t think ‘enabling’ is the main problem in this country today. Rather it is the unchecked arrogance of some (not all) Medical Doctors who have an opinion of themselves preposterously inflated far beyond their actual value to suffering patients.

Sorry. Just my opinion.

I get real concerned when I read these medical blogs. They resonate with distain and disgust for the majority of the patients served. Most of the bloggers see a drug seeker or a PITA around every corner. If you are unhappy in your profession, then leave. There will always be people who work the system.

If we want to fix health care, we need some sort of single payer system. Have you ever looked at the websites of various insurance companies and HMOs? They have more executives than I care to see. If we had one system for payment, everyone would know what was covered and how much. There would be no need for Vice Presidents of: Sales, Marketing, Communications, Medical Operations (why does an insurance company need this? Oh yes, I forgot medical decisions re no longer between patient and doctor), Pharmacological Operations, Business Retention, etc. That is a boatload of savings right there.

As for the rest of the so-called problems with switching to a single payer system? We already have waiting lists and no choice. If your doctor doesn’t participate, you need a different one or pay cash. If your Primary Care Physician (PCP) refuses to refer you, you pay cash. The insurance companies and HMOs say that they are not stopping you, they just won’t pay for it. In most cases, that is the same thing. Hedis, JCAHO, all designed to make more work, cost more money without contributing a damn thing.

As a caregiver for 5 disabled people, I am in and out of hospitals all the time. Even top 100 hospitals. Behind the hand rubbed cherry lobby with water fountains, the plasma TVs and saltwater fish tanks in the waiting rooms, lies filth. It’s third world as you roam the corridors behind the scenes. One when my son was hospitalized, there was vomit in the room. No one could tell how long it had been there, all dried up. Someone had vomited on the TV channels listing card and then it was stuck back between the phone and the monitor on the table. Dried blood on the gurney, not ours, since we hadn’t been stuck yet. Once we got a room with carpet in it. Who puts carpet in a patient’s room?

Thanks for the rant. But, I am even more wary of my MDs now. I am very concerned that the blogging is reflective on the industry as a whole.