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

Posted on 7/21/19 at 11:20 am to
Posted by jcaz
Laffy
Member since Aug 2014
19452 posts
Posted on 7/21/19 at 11:20 am to
I’d say general practice docs, yes.
They check your vitals and talk to you then recommend tests and/or a specialist.

They are well educated and more than capable but their particular specialization doesn’t make it seem like they are.
Posted by GEAUXT
Member since Nov 2007
30617 posts
Posted on 7/21/19 at 11:26 am to
quote:

Tests are relied on today. Bloodwork and radiology of all types.


This is a product of having to practice defensive medicine. Still no substitute for a solid history and physical though.
Posted by WaydownSouth
Stratton Oakmont
Member since Nov 2018
11341 posts
Posted on 7/21/19 at 11:44 am to
quote:

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


Out here in the West, you can visit your pharmacist and he can prescribe birth control
Posted by Kraut Dawg
Member since Sep 2012
4811 posts
Posted on 7/21/19 at 11:47 am to
This post was edited on 11/8/20 at 5:33 am
Posted by JudgeHolden
Gila River
Member since Jan 2008
18566 posts
Posted on 7/21/19 at 12:04 pm to
quote:

possess up-to-date medical knowledge that far beyond what they were taught in medical school


Well, I think I can diagnose your problem right now. You have acute hypochondriasis.

My docs are pretty up to date.
Posted by Tigerbait357
Member since Jun 2011
71180 posts
Posted on 7/21/19 at 12:23 pm to
quote:

Most Dr's seem to take the approach "This guy isn't gonna die, so let's prescribe something to get him the frick out."




I don't know what doctors you go to but pretty much all the ones I have worked with and through residency are far from this.
This post was edited on 7/21/19 at 12:24 pm
Posted by HoustonGumbeauxGuy
Member since Jul 2011
33742 posts
Posted on 7/21/19 at 12:23 pm to
Teledoc is a fricking joke

Posted by Norbert
Member since Oct 2018
3761 posts
Posted on 7/21/19 at 2:49 pm to
Lolz.

Pretty stunning combination of arrogance and ignorance, but I guess that's not too rare in the OT. Paint with a broad brush don't ya, considering how many types of doctors there are - from surgeons to rheumatologists to oncologists to radiologists to pathologists, etc.? I guess they're all just gate keepers, and you could simply diagnose and treat yourself if it weren't for those pesky laws.

And all of this is based on your experience with maybe three doctors working up one benign disease process that has overlapping symptoms with dozens of disorders?

El. Oh. El.

Posted by TigerStripes06
SWLA
Member since Sep 2006
30032 posts
Posted on 7/21/19 at 2:51 pm to
quote:

but having to educate the doctor on these things doesn't make me feel very confidence in their ability to diagnose and just makes me look at them as a tool to get tested for suspected illness or to receive a prescription for a certain medication.



The irony of this statement. You think extremely highly of yourself, but in reality you are a moron.
Posted by dgnx6
Member since Feb 2006
91598 posts
Posted on 7/21/19 at 2:55 pm to
I haven't had this experience, but reminds me of a car salesman. I knew more about the car and options I wanted than the guy trying to sell the fricking car. Give me the fricking commission for doing my own research on your vehicle.
Posted by Gus007
TN
Member since Jul 2018
14937 posts
Posted on 7/21/19 at 3:17 pm to
It sounds as if you have been talking to my brother in law and his son. Neither are MDs but they act like it. Maybe you are one of them.
Web MD is good to educate you on what questions to ask, IMO.
My PSA was changing and I noticed some other symptoms that I researched. Then I made an appointment with the Urologist. Prostate Cancer! Had a procedure two years ago. So far looking good.

My Urologist and Radiologist are not "Gatekeepers", they are life savers or at least life and quality of life extenders.
Posted by Gus007
TN
Member since Jul 2018
14937 posts
Posted on 7/21/19 at 3:45 pm to
quote:

I suffer from the same... Yea most ENT or GP don't know anything about this condition... Hell, the medical community in general doesn't yet have good data or understanding on this condition so you can't really blame the doctors... email me if you want to discuss in more detail ramlsu at gmail



I've suffered from similar problems since I was a child. I've had three surgeries to remove polyps since I was forty.
I turned 76 last August. There is a picture on facebook of me jumping rope on my 76th birthday so I'm in pretty good health, but suffer from symptoms similar to the OP. Last Fall I awoke dizzy, couldn't walk, and threw up. MY wife is an RN. We thought possible stroke or Heart Attack. Called the ambulance and went to emergency room. They did an MRI on my head. Dr said brain is excellent and clean for a man my age.
Still no answer to the cause.
Since then I have visited a Pulmonologist. Lungs excellent.
ENT-MRI of my Sinus, Ear test, and a test for vertigo.
Everything is fine.
On the way home I self diagnosed my self.

I'm a Hypochondriac! ;)

Somethings are very difficult to diagnose. I've tried Allegra D. It stopped up the wrong end, its constipating but but didn't stop the head problem. Tylenol Sinus seems to help as much or more than anything else I've tried but it has long term side effects as well.
Posted by TigerOnThe Hill
Springhill, LA
Member since Sep 2008
7631 posts
Posted on 7/21/19 at 8:13 pm to
For anyone who's interested in the physician's perspective, read this interesting essay.
Posted by LSUERDOC
Member since Jul 2013
2608 posts
Posted on 7/22/19 at 12:06 am to
quote:

I guess I'm hoping I'm wrong or that he can just address the sinus symptoms, dizziness, ears ringing, etc.


Vestibular neuronitis or Meniere's Disease. Unrelated to your GERD.
Posted by LSUtwolves
Member since Jun 2016
1111 posts
Posted on 7/22/19 at 12:07 am to
LPR is just GERD that gets to your pharynx. You aren't special and you aren't an enigma. GERD isn't related to your sinuses, either.

You are the worst kind of patient. Doctor shop on and on, hoping that one will tell you what you want to hear.

If you are dizzy and have ringing in your ears, you likely have inner/middle ear problems or obstructed eustachian tubes. It is so fricking unlikely to be related to your fancy name for GERD.

Lastly before you ask, GERD isn't related to your fibromyalgia or IBS either.

Posted by BulldogXero
Member since Oct 2011
10379 posts
Posted on 7/22/19 at 12:38 am to
quote:

LPR is just GERD that gets to your pharynx. You aren't special and you aren't an enigma. GERD isn't related to your sinuses, either. You are the worst kind of patient. Doctor shop on and on, hoping that one will tell you what you want to hear. If you are dizzy and have ringing in your ears, you likely have inner/middle ear problems or obstructed eustachian tubes. It is so fricking unlikely to be related to your fancy name for GERD.


I wrote this post feeling particularly despondent, but I never felt special. LPR is pretty common. Common enough that virtually every GI, GP, and ENT should know about it. The problem is that they don't. The GI dr and the gp flat out denied that GERD can cause anything but heartburn and esophagitis.

I've never doctor shopped. The first doctor I saw for this was a GI because GB surgery was the last medical issue I had prior to experiencing these problems. I did go to two GIs but that was primarily because I was not happy with the office staff of the first GI (needing to reschedule my appointments without telling me until I got to their office, etc). I started going to a local GP who referred me to an ENT.


According to the ENT, I do have obstructed Eustachian tubes. Actually, I got diagnosed with that by my GP back in September who gave me a prescription for Allegra D. The ENT said I should take steroid nasal spray instead. Can't say it has done anything for my ears though. I had a VNG as well that came back without anything abnormal.

When I told him I was first diagnosed with Eustachian tube dysfunction back in September of 2018, he really didn't comment at all. Eustachian tube dysfunction isn't going to last 10 months without something continually aggravating them. It's in the literature that LPR is seen in a lot of patients with recurring Eustachian tube dysfunction, so again, I feel like LPR is the root cause of the majority of if not all of my issues.

That's what's so infuriating about this. I've read through enough journal articles and talked to enough real people who experience these issues every day to know that there is a link there, yet I can get virtually no guidance from supposed medical professionals (at least in the local area) on how I can find any relief.
This post was edited on 7/22/19 at 12:42 am
Posted by LSUERDOC
Member since Jul 2013
2608 posts
Posted on 7/22/19 at 1:08 am to
quote:

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


Which one? First Choice? My wife is an ER nurse in one there. She mostly watches Netflix and sees an occasional patient. Sweet gig, but she has heard they area closing her shop and a few others.

Oh, and your comments are spot on...
Posted by LSUEnvy
Hou via Lake Chas
Member since May 2011
12690 posts
Posted on 7/22/19 at 1:13 am to
Google search a symptom. Good luck with that...
Posted by LSUERDOC
Member since Jul 2013
2608 posts
Posted on 7/22/19 at 1:17 am to
quote:

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.


Such bullshite. We order tests to rule in or out our differential...which is STANDARD OF CARE. Guess what happens when we do not practice standard of care? We get sued. We have to practice how the insurance company and the patient want us to...and yes, it is disgusting.
Want to reduce healthcare costs and improve care? Give emergency physicians sovereign immunity and modify EMTALA laws.
Posted by mailman
Houston
Member since Jul 2009
6143 posts
Posted on 7/22/19 at 1:22 am to
quote:

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


I'll give you a pass this time. Its ok for ppl to come OT to flesh their thoughts out but this is type of dumb shite that will frick you up in life. If you said this to me, i would never take your dumbass seriously. I dont think you understand the work it takes to get into med school, this isn't pipeline type shite dawg
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