>>>another MD

The anonymous who replied you is not me. I always sign off properly. He/she is probably just one more individual who saw right through your BS.

In your latest outpouring of rubbish, you write:

ZZ gripes that patients demand ridiculous things and complains about their ignorance, then says that OF COURSE he is willing to sit down and explain his ‘decisions’ about the appropriate course of action if only patients would ask — without realizing that a patient who says “How about a CT” or even “I want a CT” is in fact trying to engage on the subject of what to do.

You are simply lying through your teeth. I guess the reason you’re such a disagreeable person is that it’s not easy to understand why some people lie like that…

It must now be the fifth or sixth time that I’ve pointed out that no good doctor discourages honest questions from his patients.

What is being objected to is ABUSE and THREATS, whether direct or implied.

If you can’t see the difference between,

Say doc, I’m concerned about (disease X), and wonder what you might think of (investigation Y)? Could you explain why you’re recommending Z?

and,

Look, damnit. I don’t care about what you think. I know what I want, and I’m ordering you to get me a CT, ultrasound, bone scan and MRI. How dare you?! “How do you justify calling this practicing good medicine?” You “pompous jackass!” You’re a threat to all patients!! “Heaven save us from doctors like you”!!! If you don’t order everything that I demand, make no mistake, I’ll sue you!

you’re a lost cause.

The difference between the two is that in the first the patient maintains perfect autonomy while also giving being considerate and respectful of others. It’s a meaningful dr-pt relationship. In the second, typified by clowns like you, the “pt” views the doctor as a vending machine for tests and procedures. This would be fine if she also took complete responsibility for all the damage her stupid decisions would cause, but of course that is never the case.

ZZ

Pity about the flame war. I’ll have to wait a bit for the discussion I had hoped to see, eh? Just as well; I have homework I’m supposed to be doing.

I’ve noticed that part of the responses here, eg critcizing patients for ‘demanding’ a CT when you think it is contraindicated, don’t take into account that the patient’s knowledge of the possibilities and outcomes IS limited, and so they ARE trying to engage you in a discussion of what else can be done. ZZ gripes that patients demand ridiculous things and complains about their ignorance, then says that OF COURSE he is willing to sit down and explain his ‘decisions’ about the appropriate course of action if only patients would ask — without realizing that a patient who says “How about a CT” or even “I want a CT” is in fact trying to engage on the subject of what to do.

This is appropriate behavior, for the patient to seek invovlement in his/her own care and health care decisions, and it is important to recognize that a stressed and ill patient may not present with what ZZ deems sufficient deference. If Dr ZZ says “Take two aspirin and call me next week if you’re not well” but the patient feels much worse and knows that something awful is indeed at work within his/her body, then is the most productive question “Is there anything else?”, or “How about a CT, or an Xray, or some blood tests?” Rather than get offended when a patient tries to engage and call him ‘clueless’ and ‘not your place’, look at it as an imperfect effort to be active in one’s own health care, then go throught the possible tests and procedures and explain why the recommendations [not decisions] are made.

This is simply common sense. We’ve had two family members die from arguable medical neglect — an elderly woman with an intestinal blockage and a middle aged man with meningitis, both of whom were seen multiple times by doctors and admitted to hospital, then discharged to die. This is wrong, and attitudes like those ZZ exhibits are the problem, not the answer.

You are offensive and unpersuasive. I have no trouble believing you have negative relationships with doctors. In fact, it would not surprise me that you had difficulty with most people from whom you might have to seek professional advice, so confused you seem to be between your knowledge and your negative opinions. Anyone who tells you what you don’t want to hear must be doing so out of “physician’s money.power/ego-lust”. That has to be limiting.