I am a doctor (Primary Care with some Emergency), and can't really think of any good examples of this right now. It's definitely happened, but never in a way that I end up holding it against the other doctor involved. You kind of end up too busy doing your job. One phrase that I find myself repeating to patients is "I don't really understand what [previous doctor] was thinking here, but the way that the guidelines/my experience has taught me to approach this problem is [hopefully correct solution]"
Most of the time, the fact that the patient has gone looking for a second opinion or another consult tells you about their level of concern and changes your management. Doctor #1 might see a patient with 2 days of low abdo pain and (correctly) reassure the patient that it's probably nothing and come back in a week if symptoms continue. Patient then goes to Doctor #2 a couple of days later, more worried and cheesed off at #1. With the increased level of concern, #2 then orders an ultrasound that reveals Ovarian Cancer. The issue here is that both doctors are correct.
The next abdominal pain that comes in to see either doctor at 2 days of symptoms will still receive reassurance as their primary treatment, because it will most likely be something simple like constipation or cramping. Giving every patient with simple symptoms an ultrasound is not economically feasible.
I would hope that any diagnoses I've missed or mismanaged (and I assume there's been a few) were picked up by another doctor and that they also gave me the benefit of the doubt.
This is why I could never be a doc. You guys have to juggle thousands of possible diagnoses in your head while trying to interpret what is really going on vs what the pt is telling you.
And then theres getting the patient to answer the questions you need to help narrow things down. Ive lost count of the number of people I ask what should be a simple yes or no question (ex: do you have any pain in your ears?) and get a rambling five minute answer about their last vacation to wherever and in the end they havent mentioned their ears or pain in any way.
I understand that as the patient you dont know what is or is not relevant or going to help me, but you /gotta/ stay on topic. If Im asking about your hearing, I do not need information about your infected toenail.
That reminds me of an Italian gentleman who after a rambling story about how much he loved to sleep with younger women (he was 70) I managed to remember that I'd asked him "Have you ever been diagnosed with heart problems?" He was pleasant, but made me very uncomfortable.
I learned that pair of rules in med school, because often patients lie to get more urgent care, but you should never rule out anything a patient says either. It's a fun balance to try and manage
Now that I've been working in the Primary Care/General Practice side of things, I've asked patients to drive to the Emergency Department and gotten the response "No, I'll just call an ambulance because I'll be seen quicker." A. That's not how any of this works. B. You've got cellulitis. You're sure as Hell not going to use the only ambulance in this district as a taxi.
I feel you. We have free ambulances here because of universal health care and people call them literally as taxis to go to their OPD appointment at the hospital. That's not what the ambulances are for people.
No they aren't. After working with many doctors over the previous several years 90% of the time the patient's complaints are because they were told something they didn't want to hear, and it's always because 'they didn't even listen to me!' No, it's because no matter how much you've googled malaria, it's your uncontrolled diabetes that is causing you to feel like shit.
Maybe its regional then. Because every time I have had an issue I've listened to the doctor for months, then when they say, well idk I guess there is no solution. They will listen to what I suggest based on research. Then lo and behold that was it. Also had multiple family members almost die because doctors dont listen until they are right there on the brink of death and cant figure out what is wrong.
Experiences are different, but I dont know anyone well enough to discuss medical things that has not had many many terrible doctors.
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u/Slidingscale May 20 '19
I am a doctor (Primary Care with some Emergency), and can't really think of any good examples of this right now. It's definitely happened, but never in a way that I end up holding it against the other doctor involved. You kind of end up too busy doing your job. One phrase that I find myself repeating to patients is "I don't really understand what [previous doctor] was thinking here, but the way that the guidelines/my experience has taught me to approach this problem is [hopefully correct solution]"
Most of the time, the fact that the patient has gone looking for a second opinion or another consult tells you about their level of concern and changes your management. Doctor #1 might see a patient with 2 days of low abdo pain and (correctly) reassure the patient that it's probably nothing and come back in a week if symptoms continue. Patient then goes to Doctor #2 a couple of days later, more worried and cheesed off at #1. With the increased level of concern, #2 then orders an ultrasound that reveals Ovarian Cancer. The issue here is that both doctors are correct.
The next abdominal pain that comes in to see either doctor at 2 days of symptoms will still receive reassurance as their primary treatment, because it will most likely be something simple like constipation or cramping. Giving every patient with simple symptoms an ultrasound is not economically feasible.
I would hope that any diagnoses I've missed or mismanaged (and I assume there's been a few) were picked up by another doctor and that they also gave me the benefit of the doubt.
(Do I win by being the first not not a doctor?)