Word: patients
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...hygienic shield of the sterile white coat guards them from ever having to put on the flapping gown and flimsy bracelet, climb meekly into the crisp bed and be at the mercy of the U.S. health-care system. And if somehow they did enter the hospital as a patient, physicians ought to have every advantage: an insider's knowledge, access to top specialists, built-in second opinions, no waiting, no insane bureaucratic battles and no loss of identity or dignity when you turn into the "bilateral mastectomy in Room 402." But it doesn't usually work that way. While doctors...
...education of Lisa Friedman, patient, had begun. Like any other patient--and perhaps even more so--she had to drag information out of her physicians. "They were treating me like I was knowledgeable, but they weren't listening to me." When she found out that the cancer had spread to several places in one breast, Friedman told her surgeon there was no need to preserve her breast for cosmetic reasons; she was more concerned that the cancer be entirely removed. She asked for a mastectomy--but she was told that a lumpectomy would do the job fine. "I went along...
...even if we can't prove it, we can usually "tell", and quite easily. Just like parents, pastors and policemen, physicians get pretty good at detecting lies. What's not so easy is then letting your patient know that you think he is lying. Not only is he paying you to be his advocate, but being caught in a lie is still embarrassing for most people. And remember, if they're looking for money in the first place, they can sue you too. It tests your integrity. it's often easier, often safer to "go along with...
...right, or even that simple? Pain and disability have a pernicious way of becoming true even if they start out false. My patient Eddy was in a car accident in the last several years. When he saw me soon after the accident, my examination showed he had a mild finger and knee sprain, but no bruising or swelling. All of his x-rays and MRI's were essentially normal. Eddy walked with a ridiculously fake limp and a cane, when he remembered...
...evil twin of rehabilitation - act sick-get sick - and it happens a lot. "Accentuate the negative" may be sound legal counsel, but it's the worst possible medical advice anyone could ever give. It's a pain for the doctor, and often ultimately, an even bigger pain for the patient...