re: In the modern era is a doctor nothing more than a gatekeeper for medication?

No, doctors aren't just medication gatekeepers. But, like any profession, some are better than others. That fact is compounded by the nature of medicine. You may think you have a firm grasp on their diagnostic methods, but the truth is that unless you went to med school, you probably don't have a clue. So, as a result, you're obligated to take a leap of faith and (in most cases) defer to their opinion. That's not to say you won't have some befuddling moments ...

I had a high PSA that prompted a digital exam. The urologist found a nodule and ordered a biopsy. The morning of the biopsy my blood pressure was though the roof (can you blame me?) and upon further examination, I was in A-Fib. So the biopsy got scrapped until I got cleared by cardiology.

Eleven days later, I meet with a cardiologist. Never laid a hand on me. Cleared me for surgery and ordered an EKG almost as an afterthought. Still in A-Fib ...

That was May 23rd. Apparently, Cardiology and Urology don't communicate well and the biopsy never got rescheduled. I'm now spending a month in FL and feel much better!

That sucks. Sorry you're not getting the care you deserve. I've heard of other people with the same problem. I think they were eventually diagnosed with something called FDIS. Maybe ask your GP about that?

Yes and no. First, no amount of web md and mommy forum reading will make you understand your illness better than even the dumbest Caribbean medical school grad.

However, you are correct in the sense that there’s no reason to need a permission slip from a doctor for most of what you currently have to go to the doctor for.

For example, birth control should be sold next to the gum and chap stick by the cash registers as far as I’m concerned.

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You may think you're educating them on things, but you actually aren't.

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Calling bullshite on this stupidity.

I was bitten by bed bugs in a hotel and had 45-50 large welts on my arms. I knew EXACTLY what it was because I had caught two of them in the room the morning before. The doctor told me it was scabies. I explained how it was clearly not scabies (and didn't even resemble scabies), and then she told me that scabies and bed bugs were the same thing (They aren't. Scabies are invisible mites that burrow under your skin and lay eggs causing a rash. Bed bugs are very visible little blood suckers like ticks that leave welts when they bite). I laughed at her.

I had flown in on a Friday evening and had gone to a doc-in-a-box on that Saturday morning.

Not all doctors are well informed doctors. Some of them are legitimate dumbasses.

Frankly you have a a constellation of symptoms that encompasses a wide range of potential etiologies. (Reflux/LPR, aural fullness, tinnitus).

It's natural to want to find a diagnosis that you can attribute all of the symptoms to and package it in a neat a box. And if LPR is that box then great, but I would caution being so driven to do that and consider that you may very well have 3 separate diagnoses, and that treatment of these may either be different or may be largely ineffective(i.e. tinnitus).

If you're truly interested in determining if you have true LPR(if you aren't satisfied with lifestyle modifications/PPI). You may want to consider seeing a laryngologist at an academic center who can get you set up to perform impendance testing and see if you are actually having non acidic reflux that is contributing to your problem.

I have multiple doctors and my general practitioner is essentially a gate keeper but also an identifier. The thought it you will have a relationship with your doctor where they know your medical history. They can then use that to find the issue bothering you and correct it or send it to someone else. They are essentially the screener to see if there is a big issue and solve the minor ones.

My orthopedic surgeon has done very little prescribing medicine for me. He gave me pain pills after my surgery and an anti-biotic when I had a small infection. The other stuff he did to my leg, I would not be able to google or do on my own.

To answer your question, no because there are lots of different doctors and they do different things. Would you want the plumber doing your electrical?

Been a nurse a while now.

From the days of early HMOs where the ER triage nurse had to call your GP before seeing you. If your GP could see you, they denied your visit and you saw your MD. UNHEARD of today. To now where every call to several GPs is handled by office staff who say “go to the ER”.

Much of it is simple perception. The loss of the hands on physical exam. Tests are relied on today. Bloodwork and radiology of all types. A physical exam is becoming window dressing now.

Also, the push to stop over prescribing antibiotics has been going on for years and still pisses people off. Add to that the tap being turned off for pain meds, and costs all going up? People are pissed.

A good physician will always be a wealth of knowledge, but as mentioned they are becoming tied up by red tape and regulation. It’s to the point now that I question who the hell would put themselves through med school to stop at a GP? Kill yourself for $250,000? That’s not chump change, but considering hours put in? Why? Also family docs are business owners. Some of them probably had ZERO desire to ever do that.

I’m sitting in a free standing ER all day. I can answer your questions. Lol. In between patients and The Open.

Just because you don't have the willpower to stop eating doesn't mean a doctor should have to come to your house and make you exercise. Just take your insulin like a good little piggie and be happy we live in a time where you may actually live long enough to see your child graduate middle school.

100% gateways to meds. Doctors are quick to send someone to a machine to diagnose Bc 1) they make more money off of it through costs and billing insurance companies and 2.) they can’t diagnose ailments on their own merit. Doctors today learn more on how to justify billing insurance over actually learning how to treat their patients- it’s disgusting.

I'm pretty sure the doctors who did my transplant surgery, which I'd be dead without, were more than gatekerpers for medication.