On Tue, 04 Feb 2014 09:05:49 -0500, Peter wrote in


On 2/4/2014 8:39 AM, CRNG wrote:
On Mon, 03 Feb 2014 21:39:43 -0500, Peter wrote
in

Yes, medicine is still very much an art as well as a science.
Accurately predicting any individual patient's clinical course,
especially in the case of chronic illness, is usually impossible.

IMO one cause for misunderstanding is the medical profession's
(perhaps unconscious) cultivation of a public aura of infallibly;
I.e. the "..doctor knows best.." aura. I'm guessing that medical
pros are taught early to project a mystique of confidence and
certainty so as to reassure the patient and family that all is under
control. And that is certainly worthwhile. But I do believe it leads
to disappointment when reality sets in.


Much less a factor these days than in the past.

Yes, I should have mentioned that I do see less of it than fifty years
ago.

More a factor recently
is the pressure placed on physicians by their patients to conform to
their "requests" which are often couched more in terms of threats. They
see an ad on TV or in a magazine, or in a blog, and they want that same
Rx.

Glad you mentioned that. IMO the "big pharma" move into public
advertising was one of the worst things to happen to medical care
vis-a-vis development of unrealistic patient expectations. I seem to
recall reading somewhere that big pharma mounted a successful lobbying
effort with the Feds to make that happen, but I don't know if that is
accurate.

The threat, sometimes overt, sometimes implied is that without
getting what they want, they'll (a) leave your practice and bad mouth
you to all their friends and family, (b) find a lawyer who agrees to
file a trumped up lawsuit against you, (c) file a complaint with your
State's board of discipline and/or licensing office, or (d) a
combination of some or all of the above. It's usually faster and easier
to placate the patient and just given them the Rx. So the motivation is
usually not greed, it's intimidation!

I'll bet that does a lot to take the satisfaction out of medical
practice.
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