@quasinfinity
Today I learned: I've been confusing doctors by refusing pain killers with "I have a high pain tolerance, ibuprofen will be fine"
@suemilkbone4868
Wow, i didn't realize how stacked the cards are against patients until I saw this video. Because of doctor-patient biases, patients become angry and frustrated leading doctors to document in the patient's EMR that they are "difficult and noncompliant" thus leading to future biases. It is a neverending cycle stacked against the patient.
@tonym6920
You have to be an advocate for your own health, in other words, educate yourself in the available treatments for issues you are facing, procedures (the benefits and risks), medications (side-effects) how the organs function as it relates to you. Knowledge is power. It’s really comforting to talk to a doctor and understand what he or she is talking about and being able to meaningfully contribute to the conversation - and ultimately to your own care. It might be beneficial that such a checklist as you mentioned be provided when an appointment is made as a preparation for your visit.
@jws3925
This topic is very interesting and, in some aspect, enlightening. I have had physicians who actually want to dialog with me and, whether true or not, appear to actually want to be a medical "detective." Lately I moved to Florida and have found an epidemic of physicians who come into the exam room obviously hurried and frazzled. At first I thought I just got an overloaded doctor who, for whatever reason, did not have time for much dialog, if any. Mostly I will describe them as test reactive only doctors. No actual "art" of medicine required. They either have test results or order tests and then just prescribe a medication based upon these tests. If one makes another appointment (weeks wait time) and tell the doctor the symptoms are not better they either up the dosage of said medication or prescribe another similar one. This observation has been experienced from my general practitioner (which is a NP because no one sees a doctor as a GP here), urologist, orthopedist and cardiologist. Health care stinks in my opinion in Florida. It is interesting that the "blame" in many cases for a communication difficulties seems to lie with the patient according to this video. Don't say this or that or your doctor may think you have a narcotic drug problem! I have actually said to my previous Orthopedic surgeon in MI that I had a high pain tolerance to try and convey; "listen I don't go to the doctor for every ache and pain so when I do come in I have a serious issue." Instead he may be thinking all I want are narcotics??! I am sick (no pun intended) of receiving poor, sometimes rude care from my south Florida physicians. I though switching docs would solve the issue so I got a new GP------same. I dropped my first urologist and waited months to get into to see one highly recommended------same. In fact this new urologist was sent all my records from not only from my previous Florida urologist but also my Mi urologist. These records included bladder cancer, kidney stones and prostate issues. He walks into the room and says; " why are you here today?" I proceed to tell him I have some urological issues that need monitoring and recently moved to the area from MI. He asks: "like what?" I said that I dropped off my records that outlined it all. His response: " why don't you just tell me, I don't have time to read all that." Is it any wonder we go to the internet to try and diagnose ourselves and plot what an effective treatment might be based on that information? The doctors don't seem all that interested. I get the impression all they want to know is what medication to you want and, if it is not a narcotic, they will write or call in the order and bingo, they can go to the next room.
@HatoriCrazy
You just answered a question that has kept me from seeing a doctor for years. I've had menstrual cramps that (now that I've given birth unmedicated twice) I know are as bad as labor pains for the past seventeen years. I've learned to live with them and become very good at dealing with pain. I've avoided hospitals because doctors always just pushed drugs at me and never took my concerns seriously, all because I said I have a high pain tolerance... I can't say that this makes me trust doctors, but it'll help with my next ER visit.
@davidstanford4885
I have been in 10 major auto accidents. Several back surgeries plus elbow rebuild in 80s and metal in left shoulder. I've heard all the excuses used to keep from prescribing pain meds,even when I wasn't looking for it
@damdamfino
I saw a doctor once say that if a patient says they only had 1 drink, they assume they had 3. If doctors think patients are ALWAYS lying, this just seem like it will give nothing but awful results. When there’s a bomb threat, we always treat it as if it were real, despite how many were fake before. When someone threatens suicide, it’s better to treat them as if they mean it, than to think they’re just lying. IMHO, if someone is lying for opiates, then that’s on THEM. It was their actions that made the doctor think they needed it. Why do the doctors have to be judge jury and executioner on who they think is lying or not?
@liliherndz5792
Well Informed patient is KEY on all possible options in the decision making process and creating a plan of action for restoring health with medical professional Great guiding insight 👨🏼⚕️
@theenglandguy
Using a number higher than 10 on the 1-10 pain scale is literally indication of unreliability in patients. It can indicate a patient either does not understand the scale, does not want or feel the need to comply to the scale's parameters, or shows the patient minimizes the importance of the questions asked by the provider, among other things - all indications of initial unreliability (which can mean confused/needing more explanation, or can mean malicious intent.) While it does not mean the provider should withhold specific care or dismiss a patient based on such answer, it does indicate unreliability, just like a patient giving unrelated answers to other OPQRST/anamnesis questions.
@pragyasingh2297
This is an excellent topic! I'm so glad that we're having these kinds of conversations. Thank you!
@ramironin2042
Great video, patient education shouldn't be limited to only their health, but also how doctors perform clinical reasoning and make decisions. For example, in my experience most patients ignore that diagnostic testing and reasoning are statistical in nature, and therefore uncertainty is always present. This contributes to something all of us have seen: a doctor chooses not to perform certain tests because they deem a diagnostic as unlikely, or a treatment as not beneficial, and another doctor might perform them either because (1) they don't think it likely either, but do it nonetheless to satisfy patient demands, or (2) they consider the diagnostic likely and end up being correct. In this scenario de first doctor is thought of as negligent by the patient and the second one as a "hero", even if they didn't even consider the diagnosis in the first place. In the opposite side of the spectrum, a doctor might perform a test, invasive procedure or start a treatment, but a second doctor wouldn't have done it because they considered that the risks outweigh the benefits. If the patient is harmed by said procedure/treatment, then the first doctor is deemed as negligent and the second one as the responsible one. Example: patient with epigastric pain which is non-specific in its clinical characteristics. First doctor chooses a conservative approach and an empiric treatment, second doctor orders an endoscopy and the patient is harmed by a procedure complication and ends up in ICU, and the study wasn't helpful in diagnosis. Similar patient same doctors, but the endoscopy goes well and uncovers a peptic ulcer. The second doctor gets praise while the first is judged, even if the second doctor, as the first one, wasn't sure about the endoscopy but did it regardless and owes his correct diagnosis to luck!!! This situation could be avoided if we as physicians explained to patients how we actually make decisions and what information we use to do so, and how probabilities, based on either published research or clinician gestalt, influence this process. If patients understood that we are never 100% sure that something will be helpful or not (either in diagnosis or treatments), they wouldn't think less of a physician when they are wrong or, if they are unsure about starting a specific treatment or performing a specific test/procedure. In my experience communication gaps and biases between parties are almost always the main culprit of adverse outcomes in patient-care.
@bookaufman9643
About 20 years ago I was having back problems and my doctors in the pain clinic insisted that I could take all the oxycontin in the world because it wasn't addictive. A year later they called me an addict because I went through withdrawals when they cut me off. How did that communication cycle go? I have a fatal mitochondrial myopathy so I see doctors a lot now but I never fully trust them and it seems like doctors never fully trust their patients.
@CNP-rn3gd
My experience with physicians in the last 5 years is that they are too busy to deal with you and you should only mention one symptom and then keep quiet so they can fill in the EMR. Don't offer any opinions or they get mad (after you have taken time off, driven to the office, found parking and then waited in the office and the exam room). In short, it's not worth the effort to go visit a doctor anymore.
@franzpattison
I recently went through an operation where they tried to give me 2 mg of hydromorphone and I kept saying that extremely resistant to pain medication such that it usually takes me at least 3x-4x the normal amount to have an effect, and even then it doesn't really reduce the pain, merely assists me to refocus my attention so it's not unbearable. (This is true, not drug-seeking BS; hydromorphone is actually a very unpleasant drug to me because of how confused it makes me, which I even told them.) Eventually I was able to convince the nurses, thank God. I understand that sometimes people are disingenuous in order to "score" but it makes it much harder for people such as myself who sincerely are resistant to painkillers.
@NormalPersonCommenting
Funny, because I've said "I have a high pain tolerance" but what I was trying to communicate was the lack of a desire for more intense pharmaceuticals Like, yeah, my hip is broken, but I'm not in surgery anymore. Just bring me a chicken sandwich and get out of the way of the TV; Star Trek's on!
@SatumainenOlento
I caused changes on bones of my fingers by working through pain during 5 years. So I worked pretty hard to get them to that stage in such a short time. The changes are clearly seen in ultrasound. I conclude that I might have a little higher pain tolerance than average. I will be silent like a mouse about this fact when a doctor is around.
@mistylee717
If there is one thing I would change about how many or likely most physicians communicate, it would be explaining the fallibility of initial diagnoses. Example: hubby had pain with urination and slightly discolored urine. I accompanied him to his doc appmt. They did a urinalysis and the doc said, “you have a UTI”. Prescribed antibiotics and left. I told hubby that the doctor does not know if it’s a uti or not. A basic urinalysis showed presence of WBC. But if he had blood in his urine (which I suspected) that would explain the presence of WBC. He did, in fact have a large kidney stone. What his doctor should have said? “It appears you have a UTI. I’m going to prescribe some antibiotics. If it doesn’t improve in _____, call my office.” Very often physicians and nurses ask me where in the medical field I work. Because I do have a greater than average understanding of medical jargon. I just say, “I’m a professional patient”. I have had multiple health problems my entire life. I have a heck of a lot of experience with physicians. I even almost married an internist. I’ve often thought I should write a book about the serious communication problems between doctors and their patients.
@SatumainenOlento
GREAT SUBJECT!!! Thank you so much Hank and Dr. Strong!!!
@Mr_3raqi
"Complaining of x" doesn't mean the doctor has heard enough of you or doesn't want to listen to you, it's a medical term meaning the main symptom of this person is x
@StrongMed