Comments on: http://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60236 Anonymous Fri, 10 Mar 2006 04:45:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60236 "when you order a defensive test? <br/>when you prescribe statins to a slim, active, healthy woman with LDL of 134, HDL or 80 and low triglicerides?"<br/><br/>Believe it or not, slim, healthy women have heart attacks (albeit rarely)...now let's say for the sake of argument that this slim healthy woman had a heart attack...would her lawyer look kindly upon the fact that her doctor did not prescribe a statin when the ldl was high? He would have a field day in the courtroom...which position would a physician rather be in...piss off the patient by prescribing the statin and let the patient refuse to take it and document all, or risk the other option? “when you order a defensive test?
when you prescribe statins to a slim, active, healthy woman with LDL of 134, HDL or 80 and low triglicerides?”

Believe it or not, slim, healthy women have heart attacks (albeit rarely)…now let’s say for the sake of argument that this slim healthy woman had a heart attack…would her lawyer look kindly upon the fact that her doctor did not prescribe a statin when the ldl was high? He would have a field day in the courtroom…which position would a physician rather be in…piss off the patient by prescribing the statin and let the patient refuse to take it and document all, or risk the other option?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60221 Anonymous Thu, 09 Mar 2006 18:24:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60221 <i>respect my opinion,</i><br/>when you order a defensive test? <br/>when you prescribe statins to a slim, active, healthy woman with LDL of 134, HDL or 80 and low triglicerides?<br/><br/><i>do not ask for specific medication</i><br/>Even if it is the Renova wrinkle cream? One of the few equivalent drugs the patient knows works better for him/her because of past history (e.g. one type of HRT over another like the one containing micronized progesterone vs the one containing norethindrone acetate because the latter suppresses HDL while the former has no effect? or one type of two identical estradiol patches because one is smaller)? respect my opinion,
when you order a defensive test?
when you prescribe statins to a slim, active, healthy woman with LDL of 134, HDL or 80 and low triglicerides?

do not ask for specific medication
Even if it is the Renova wrinkle cream? One of the few equivalent drugs the patient knows works better for him/her because of past history (e.g. one type of HRT over another like the one containing micronized progesterone vs the one containing norethindrone acetate because the latter suppresses HDL while the former has no effect? or one type of two identical estradiol patches because one is smaller)?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60147 Anonymous Wed, 08 Mar 2006 21:26:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60147 "Ideal patient: Doesn't feel the need to drink a 12 pack or shoot up before coming to the ED and verbally and physically assault me."<br/><br/>Exactly how long have you been loathing/fearing your patients? And if you're as miserable as you seem, why do you continue doing it? The money? “Ideal patient: Doesn’t feel the need to drink a 12 pack or shoot up before coming to the ED and verbally and physically assault me.”

Exactly how long have you been loathing/fearing your patients? And if you’re as miserable as you seem, why do you continue doing it? The money?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60146 Anonymous Wed, 08 Mar 2006 21:21:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60146 I think our population has lost sight as to what a physician, whether medical or surgical, is charged with.<br/><br/>No reasonable person would say that politness, affability, empathy, etc. are not important, but they're important for everyone, whether accountant, police, garbageman, or congressman.<br/><br/>What is the physician's job? It's to take the presentation of the patient, termed signs and symptoms, develop an appropriate differential diagnosis, appropriately test those diagnostic possibilities and develop/apply a reasonable therapeutic plan, whether medical or surgical. That's it.<br/><br/>Doctors really only do three things; measurement (blood count, weight, Cat Scan), manipulation of physiology with pharmaceuticals (chemotherapy, antibiotics, fertility enhancement), and surgery (for either diagnosis or altering anatomy (remove the appendix or tumour or deliver the baby).<br/><br/>All to be done with politeness. But don't forget the core. I think our population has lost sight as to what a physician, whether medical or surgical, is charged with.

No reasonable person would say that politness, affability, empathy, etc. are not important, but they’re important for everyone, whether accountant, police, garbageman, or congressman.

What is the physician’s job? It’s to take the presentation of the patient, termed signs and symptoms, develop an appropriate differential diagnosis, appropriately test those diagnostic possibilities and develop/apply a reasonable therapeutic plan, whether medical or surgical. That’s it.

Doctors really only do three things; measurement (blood count, weight, Cat Scan), manipulation of physiology with pharmaceuticals (chemotherapy, antibiotics, fertility enhancement), and surgery (for either diagnosis or altering anatomy (remove the appendix or tumour or deliver the baby).

All to be done with politeness. But don’t forget the core.

]]> By: SarahWhttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60138 SarahW Wed, 08 Mar 2006 20:16:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60138 Why do I get the feeling you conflate "respect" with "obey". Why do I get the feeling you conflate “respect” with “obey”.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60134 Anonymous Wed, 08 Mar 2006 19:23:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60134 If ifs and buts were candy and nuts. If you want an 'ideal doctor' you should pay that doctor his or her 'ideal fee.' <br/><br/>What about the flip side to this statment. As a doc i feel i should only have to care for 'ideal patients.' I.E. patients who take responsibility for their illnesses, pay appropriately for services rendered, respect my opinion, stay off their phones during visits, do not ask for specific medication, have a pleasant affect. <br/><br/>Wouldn't life be wonderful. one can dream i suppose If ifs and buts were candy and nuts. If you want an ‘ideal doctor’ you should pay that doctor his or her ‘ideal fee.’

What about the flip side to this statment. As a doc i feel i should only have to care for ‘ideal patients.’ I.E. patients who take responsibility for their illnesses, pay appropriately for services rendered, respect my opinion, stay off their phones during visits, do not ask for specific medication, have a pleasant affect.

Wouldn’t life be wonderful. one can dream i suppose

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60133 Anonymous Wed, 08 Mar 2006 19:17:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60133 knows defensive medicine... knows defensive medicine…

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60129 Anonymous Wed, 08 Mar 2006 18:57:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60129 What about good looking? Wouldn't that be ideal? What about good looking? Wouldn’t that be ideal?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60125 Anonymous Wed, 08 Mar 2006 18:00:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60125 What about knowledgeable? What about knowledgeable?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2006/03/seven-traits-of-ideal-doctor-confident.html#comment-60122 Anonymous Wed, 08 Mar 2006 15:37:00 +0000 http://clients.emmense.com/kevinmd/2006/03/20174.html#comment-60122 If you had read the article all the way through to the end, you would have seen that the authors of the study did address technical skill. Their conclusion was that technical skill is mentioned less often by patients because it is a harder category for patients to judge. If you had read the article all the way through to the end, you would have seen that the authors of the study did address technical skill. Their conclusion was that technical skill is mentioned less often by patients because it is a harder category for patients to judge.

]]>