DomAviator
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quote:
ORIGINAL: philosophy
quote:
ORIGINAL: SinLee
If you know the diseases, disorders, issues, whatever that you have, and you know that that drug is a possible solution, when you ask your doctor about it from a educated standpoint, they will listen. And yes, there are people like me that will go look up medication for their own issues.
.......just out of curiosity, does the ability to use google, access to television advertising and a reasonable grasp of basic biology equal the years a medical doctor has to put in in order to be able to practise madicine?
From an outside pov, advertising for medical drugs on tv is bizarre in the extreme. From that outside pov it seems that US culture puts commerce above health.
For the most part, the practice of medicine is not what most think it is - nor are the years of schooling actually necessary and most doctors forget most of what they learn or never use it again. Probably the best way to fix the health care crisis would be create a new category of practicioner and to have most medicine practiced by persons other than doctors... Aside from the odd cases involving differential diagnosis between exotic tropical diseases or some bizzare neuropathy, practically everything done in medicine is done via a cookbook recipie.
For example, in the event of a cardiac arrest everyone - whether a doctor, a paramedic, a critical care nurse, etc will follow the same exact ACLS protocol. If the person is in asystole "flatline" it is continue cpr, intubate, IV - preferably 2, confirm asystole in more than one ECG lead, look for underlying cause (hypoxia, hypothermia, drug overdose etc and treat for that) transcutaneous pacing if available, 1mg epinephrine IV push every 3-5 minutes, 1mg Atropine IV push every 3 -5 minutes, consider bicarb 1mEQ/kg with a down time of 15 min or more. If the underlying cause is treated, and you reach .04 mg kg on the atropine with no conversion, try a last push of 2-5 mg of epi and then call it and note the time of death. Similar "recipies" exist for every other problem. You dont need 12 years of school to do that - every paramedic in my volunteer fire dept, including myself, learned it in a single weekend ACLS class.
Less dramatic things than cardiac arrest are treated similarly. Kid has ear pain and tugs at ears, otoscope shows a reflection on the typanic membrane, prescribe the pink shit (Amoxicillin). Person has nasty cut - wash out, infiltrate with lidocaine to numb, debride dead / damaged tissue, suture up, cover with clean dressing, prescibe broad spectrum antibiotic, give tetnus booster.
For the most part very little of what doctors do requires any great skill or training. In fact, for most routine things I would rather be treated by a paramedic or a nurse as they know more than most doctors do. If only I had a dollar for every time I have had to correct a doctor over the radio when he gave an incorrect order (shock asystole, use the wrong epinephine - the 1:1000 instead of the 1:10,000 etc) or seen a doctor do something utterly retarded in the emergency room - like start an IV in an artery instead of a vein. (hint - if you withdraw the needle and blood squirts 6 feet out of the cathether instead of slowly oozing, then it aint a vein.) or had to have a cop pull a helpful bystander physician off of our patient before he hurt them further. (Nice tracheotomy Dr. Dermatologist - I would have tried the Heimleich Maneuver, if that didnt work then I would have used a laryngoscope and mc gill forceps to visualize and remove the object, and if that didnt work I would have done a needle cricothrotomy with a 14ga IV needle, and if that didnt work then I would have done transtracheal jet insulfation but hey what the fuck you had a steak knife handy so nice work on the throat slitting Doc!) Honestly, if I was ever in a serious accident and heard someone say "Im a doctor" I would start crawling away! I would claw my way to freedom dragging myself by the fingernails if need be. LOL
Despite the mystique and aura they like to create around themselves, most doctors actually know very little outside their own area of expertise. (and less than your average boyscout when it comes to emergency care). Therefore I think SinLee is absolutely correct to be an informed consumer and to ask about and for specific medications. I personally want what I tell him to give me, not what he needs to write one more scrip for to get the cruise to Jamacia. I dont want his fancy $38 "Z Pak" of Zithromyocin because I know my body and I know that $3 worth of amoxicillin or penecillin will knock out that bronchitis and have me right as rain in two days with fewer side effects. I would NEVER take a drug I didnt know and havent read up on because I have no faith in doctors.
I have told this story privately to a few people here - but Ill tell it publically now. I recently called a foreign doctor a variety of slurs and stormed out of an emergency room in a rage and called the state health dept . Why? Because he asked the date of my last menstural cycle. I couldnt believe it and actually made him repeat the question twice. If he can not tell that the 6' 4" tall, 230 pound extremely masculine patient named Kevin with the baritone voice and a moustache sitting on the table in front of him is male, or if he lacks the biological knowledge that men do not menstrate, then I certainly wouldnt ingest any potions he may prescribe. Just because someone is a doctor doesnt mean they aren't an idiot, so its in a persons interest to be an informed consumer.
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