my brain

on some topics they do, on some not at all. They do mostly think they know everything though.

US may be rather different to here. Here crass stupidity is too common.

NT

Not IME. My previous GP wouldn't even think of venturing outside his expertise (family medicine and drug rehab). When a problem cropped up, he looked at his job as finding the best specialist he could. Every one he referred me to has been really good and they do exactly the same (when they're out of their league, they refer me to the best).

He didn't like dealing with insurance companies (and refused to deal with government "insurance"), so went into concierge medicine (so I don't use him anymore).

Crass stupidity *is* human. The variation in their competency shouldn't be expected to be any different than those in other professions.

of them as invariably right when someone disagrees with them. My life woul d be over twice if I'd followed some of their more stupid advice.

ow everything though.

Variation in competence comes down entirely to what they can get away with. Here doctors are simply assumed to be competent, so no action is taken and they get away with all sorts of silliness. They aren't called on their bs and the bad ones in that respect are not usually weeded out. We have a bad system. The bar is set very low on this point.

NT

Nonsense. That assumes that all people are equal, which is obviously not the case.

Engineers are assumed to be competent. Auto mechanics are assumed to be competent. Lawyers are...

At the end of the day, only you can be responsible for you.

As James says, treat your doctor like an employee.

iew of them as invariably right when someone disagrees with them. My life w ould be over twice if I'd followed some of their more stupid advice.

know everything though.

n.

th.

clearly it doesn't

nd they get away with all sorts of silliness. They aren't called on their b s and the bad ones in that respect are not usually weeded out. We have a ba d system. The bar is set very low on this point.

by some people in some situations yes. That's all.

indeed.

NT

"comes down entirely to..." means that there are no other factors.

Doctors are no different.

James doesn't seem to have any employees. Does that make his advice on the subject all that reliable?

In fact a doctor is a specialist sub-contractor. You've called on them because they can be expected to know more about your problem than you do. If you have reservations about what you have been told, you are welcome to find a second opinion.

An employee would feel hurt if you did that.

fix

e view of them as invariably right when someone disagrees with them. My lif e would be over twice if I'd followed some of their more stupid advice.

hey know everything though.

is

mmon.

with.

a daft argument

n and they get away with all sorts of silliness. They aren't called on thei r bs and the bad ones in that respect are not usually weeded out. We have a bad system. The bar is set very low on this point.

half a sentence! Honestly.

NT

cause they can be expected to know more about your problem than you do.

Sometimes. Sometimes it's just to get the drugs you already know would help . More often the latter here.

ond opinion.

Or take other courses of action, like treat it yourself. Or follow a treatm ent plan that has nothing to do with anything your doc would recommend. I'v e had several successes with both those. Most people seem to put doctors on a pedestal where they really don't belong.

NT

One of the specialists I go to is well known to *not* prescribe what's wanted. He doesn't take self-diagnosis well at all. He's also considered one of the top doctors in the area.

The GP I had was also known to never prescribe schedule-2 drugs. Druggies knew he wasn't worth bothering with.

Again, they're better trained than I am. If I can't/won't take their advice, there is no point in hiring them.

I've had an issue recently that doesn't make sense. The specialist didn't make any lights go on, though I do have more information. I'm hoping a new GP will be able to shed some light (we'll see next week).

because they can be expected to know more about your problem than you do.

elp. More often the latter here.

I'd think we all know not to upset their fragile ego by presenting it as a self diagnosis and asking for the drug.

good, prescribing abuse type drugs doesn't solve things.

second opinion.

atment plan that has nothing to do with anything your doc would recommend. I've had several successes with both those. Most people seem to put doctors on a pedestal where they really don't belong.

sometimes. The tough truth is that even with little formal medical training I can frequently find out more & solve problems they don't. It's a sad com ment on the NHS.

sometimes there is, sometimes not. A high percentage of doctors here don't seem to have any sense of their own limits and insist on things that the 'p atient' has already made clear aren't an option. I've had advice ranging fr om excellent to actionable. Too many times it's just been stupid.

Doctors have helped me many times. But many times I've found the solutions lie elsewhere, I'm just grateful to know that. So many people live their li ves with serious problems they could soon solve if they took their doctor o ff their mental pedestal. Many cling to their childhood beliefs while it ki lls them.

NT

If you want his help, let him help. I have the same reaction when my boss tells me how to do my job ("here, knock yourself out!").

As I mentioned above, his second (and third) job is the director of drug rehabs. He knows druggies and can spot them a mile away.

You need to find better doctors.

If they're not going to help you, why bother asking for help? Of course, there are incompetent people in every profession. Avoid them.

I'm sure it happens. The opposite also happens.

Doctors tend to know about stuff like drug interactions. What you know helped last time might not be the best choice in your current situation.

Even a doctor who treats himself has a fool for a patient.

That might explain why your thinking doesn't work as well as it might.

What a medical education offers is years of information about what sometimes goes wrong. If you make your own under-informed choices you can make fatal or damaging mistakes, and you won't be monitoring for the things that can go wrong.

Talking to a doctor who has got the message about evidence-based medicine is informative, but it can be slightly terrifying.

em because they can be expected to know more about your problem than you do .

help. More often the latter here.

a self diagnosis and asking for the drug.

Opioids are great pain killers. Our GP in Tasmania wasn't happy that he had to jump through progressively more hoops before he could prescribe them .

Morphine kept my father comfortable through his slipped disk. When I copped a ruptured intervertebral disk in the UK thirty years later, I wasn't as l ucky.

ome to find a second opinion.

reatment plan that has nothing to do with anything your doc would recommend . I've had several successes with both those. Most people seem to put docto rs on a pedestal where they really don't belong.

ng I can frequently find out more & solve problems they don't. It's a sad c omment on the NHS.

Perhaps. Then again, your "solutions" might not be quite as nearly optimal as you like to think. "Not invented here" is about people being unreasonabl y attached to the solutions that they did invent.

t seem to have any sense of their own limits and insist on things that the 'patient' has already made clear aren't an option. I've had advice ranging from excellent to actionable. Too many times it's just been stupid.

Too many times it has just struck NT as stupid. More objective observers mi ght have come to other conclusions.

s lie elsewhere, I'm just grateful to know that. So many people live their lives with serious problems they could soon solve if they took their doctor off their mental pedestal. Many cling to their childhood beliefs while it kills them.

Putting one doctor on a mental pedestal is a bad idea. Thinking that all do ctors are identical is a much worse idea. Thinking that you know better tha n a doctor may be correct (though it won't happen often). It is very unlike ly that you will know better than everybody in even a small group of doctor s.