41 Doctors Won't Tell You (Part II)

The Darker Side

• It saddens me that my lifelong enjoyment and enthusiasm for medicine has all but died. I have watched reimbursement shrink, while overhead has more than doubled. I've been forced to take on more patients. I work 12- to 14-hour days and come in on weekends. It's still the most amazing job in the world, but I am exhausted all the time.
--Vance Harris, MD, family physician, Redding, California

• In many ways, doctors are held to an unrealistic standard. We are never, ever allowed to make a mistake. I don't know anybody who can live that way.
--James Dillard, MD

• Not a day goes by when I don't think about the potential for being sued. It makes me give patients a lot of unnecessary tests that are potentially harmful, just so I don't miss an injury or problem that comes back to haunt me in the form of a lawsuit.
--ER physician, Colorado Springs, Colorado

• Doctors often make patients wait while they listen to sales pitches from drug reps.
--Cardiologist, Bangor, Maine

• It's pretty common for doctors to talk about their patients and make judgments, particularly about their appearance.
--Family physician, Washington, D.C.

• Everyone thinks all doctors know one another. But when we refer you to specialists, we often have no idea who those people are. Generally, we only know that they accept your insurance plan.
--Pediatrician, Hartsdale, New York

• In most branches of medicine, we deal more commonly with old people. So we become much more enthusiastic when a young person comes along. We have more in common with and are more attracted to him or her. Doctors have a limited amount of time, so the younger and more attractive you are, the more likely you are to get more of our time.
--Family physician, Washington, D.C.

• Plan for a time when the bulk of your medical care will come from less committed doctors willing to work for much lower wages. Plan for a very impersonal and rushed visit during which the true nature of your problems will probably never be addressed and issues just under the surface will never be uncovered.
--Vance Harris, MD

• At least a third of what doctors decide is fairly arbitrary.
--Heart surgeon, New York City

• Doctors are only interested in whether they are inconvenienced -- most don't care if you have to wait for them.
--Family physician, Washington, D.C.

The Sensitive Side

• When a parent asks me what the cause of her child's fever could be, I just say it's probably a virus. If I told the truth and ran through the long list of all the other possible causes, including cancer, you'd never stop crying. It's just too overwhelming.
--Pediatrician, Hartsdale, New York

• Most of us haven't been to see our own physicians in five years.
--Physical medicine specialist, Royal Oak, Michigan

• When a doctor tells you to lose 15 to 20 pounds, what he really means is you need to lose 50.
--Tamara Merritt, DO, family physician, Brewster, Washington

• If a sick patient comes to me with a really sad story and asks for a discount, I take care of him or her for no charge.
--Surgeon, Dallas/Fort Worth

• Though we don't cry in front of you, we sometimes do cry about your situation at home.
--Pediatrician, Chicago

IJN Privatization

Last week Malaysian Government again attempted doing another inane verdict. They have announced a plot to privatize Institut Jantung Negara which is one of the established in dealing heart cure for the past decade not only for Malaysian but popularized to few other adjacent countries’ citizens as well. Regarding to this matter, I totally nod to what Tun Dr. Mahathir has uttered in his recent blog posting.

He has always been for privatization. In fact privatization started during his time. People know all about the Government companies, departments and functions which were privatized. Some were successful, some were not. About the weigh inside, I don't think people know about privatization proposals which had been rebuffed as he does. He knows about them because the proposals perhaps were studied carefully before they were rejected. There were reasons of course but there was no necessity to make public the rejections or the reasons.

With regard to the Institut Jantung Negara, I must say he has a personal attachment to it. I don't think I need to explain why. The IJN is really the institution that is physically closest to his heart.

IJN is a unique institution. It started as a Government department but the Government felt that it was unfair to put the staff on Government pay scheme. So it was corporatized. As a corporate body it has been successful in giving the people good service. It is one institution that has not been subjected to criticisms and vilifications by the press or the public as most other institutions have been. We often hear of its many "firsts" and we are proud of them.

“The doctors and nurses are very well trained and efficient. During the 50 days I was hospitalized there I never heard them complain about their salary or how they have been treated. They seem to me to be a happy lot. They are not mercenary, thinking only of their pay. I think they love their work; they love to see their patients recover and go back to normal, especially their transplant patients.”-Tun Dr. Mahathir

Maybe he is biased because he owes his life to IJN. But I think as a corporatized institution the IJN has done extremely well.

If it is going to give the same service to civil servants and pensioners the Government will have to pay out the same amount of money after privatization. How does the Government gain? Besides if the poor are going to be charged the same low fees and charges how does Sime Darby make money? Or will the Government continue to subsidies an ever growing bill for treatment of the poor? If so why is there a need to privities? How does Sime Darby, a business entity make money when 80 per cent of the patients are poor?

Some of the major surgeries performed there are so costly that the IJN lost money on them. Will Sime Darby shoulder these losses?

From more I think it is just a simple another iniquitous, not smart and oppressive to rakyat move of the government. And again ought to be ask how are they playing the role theory of taking care of people welfare and reliance? Again they failed.

There are far too many questions about this privatization which need to be answered. Some I think cannot be answered.

“ I seldom oppose privatization but this is one instant when I feel privatization is the wrong thing to do.”

Tun Dr. Mahathir

Leave this institution as it is. It is our pride and it is doing a good job as it is.

The Barisan Nasional Government is not too popular today. Why do something that may give the opposition another issue to belabor the Government.

41 Doctors Won't Tell You (Part I)

If You Only Knew ...

Reader's Digest offered two dozen doctors a chance to tell it like it really is, and general practitioners, surgeons, shrinks, pediatricians, and other specialists took the challenge. Some wanted to be anonymous; some didn't care. But all of them revealed funny, frightening, and downright shocking things that can help you be a better, smarter patient.

We're Impatient

• I am utterly tired of being your mother. Every time I see you, I have to say the obligatory "You need to lose some weight." But you swear you "don't eat anything" or "the weight just doesn't come off," and the subject is dropped. Then you come in here complaining about your knees hurting, your back is killing you, your feet ache, and you can't breathe when you walk up half a flight of stairs. So I'm supposed to hold your hand and talk you into backing away from that box of Twinkies. Boy, do I get tired of repeating the stuff most patients just don't listen to.
--Cardiologis, Brooklyn, New York

• I was told in school to put a patient in a gown when he isn't listening or cooperating. It casts him in a position of subservience.
--Chiropractor, Atlanta

• Thank you for bringing in a sample of your (stool, urine, etc.) from home. I'll put it in my personal collection of things that really gross me out.
--Douglas Farrago, MD, editor, Placebo Journal

• One of the things that bug me is people who leave their cell phones on. I'm running on a very tight schedule, and I want to spend as much time with patients as I possibly can. Use that time to get the information and the process you need. Please don't answer the cell.
--James Dillard, MD, pain specialist, New York City

• I wish patients would take more responsibility for their own health and stop relying on me to bail them out of their own problems.
--ER physician, Colorado Springs, Colorado

• So let me get this straight: You want a referral to three specialists, an MRI, the medication you saw on TV, and an extra hour for this visit. Gotcha. Do you want fries with that?
--Douglas Farrago, MD

• I used to have my secretary page me after I had spent five minutes in the room with a difficult or overly chatty patient. Then I'd run out, saying, "Oh, I have an emergency."
--Oncologist, Santa Cruz, California

• Many patients assume that female physicians are nurses or therapists. I can't tell you how often I've introduced myself as Dr. M. and then been called a nurse, therapist, or aide and asked to fetch coffee or perform other similar tasks. I have great respect for our nurses and other ancillary personnel and the work they do, but this doesn't seem to happen to my male colleagues.
--Physical medicine and rehabilitation doctor, Royal Oak, Michigan

• The most unsettling thing for a physician is when the patient doesn't trust you or believe you.
--Obstetrician-gynecologist, New York City

• It really bugs me when people come to the ER for fairly trivial things that could be dealt with at home.
--ER physician, Colorado Springs, Colorado

• Your doctor generally knows more than a website. I have patients with whom I spend enormous amounts of time, explaining things and coming up with a treatment strategy. Then I get e-mails a few days later, saying they were looking at this website that says something completely different and wacky, and they want to do that. To which I want to say (but I don't), "So why don't you get the website to take over your care?"
--James Dillard, MD

• I know that Reader's Digest recommends bringing in a complete list of all your symptoms, but every time you do, it only reinforces my desire to quit this profession.
--Douglas Farrago, MD

Pills, Pills, Pills

• Sometimes it's easier for a doctor to write a prescription for a medicine than to explain why the patient doesn't need it.
--Cardiologist, Bangor, Maine

• Those so-called free medication samples of the newest and most expensive drugs may not be the best or safest.
--Internis, Philadelphia

• Taking psychiatric drugs affects your insurability. If you take Prozac, it may be harder and more expensive for you to get life insurance, health insurance, or long-term-care insurance.
--Daniel Amen, M, psychiatrist, Newport Beach, California

• Ninety-four percent of doctors take gifts from drug companies, even though research has shown that these gifts bias our clinical decision making.
--Internis, Rochester, Minnesota

Bills, Bills, Bills

• Doctors respond to market forces. If the reimbursement system is fee-for-service, that results in more services. If you build a new CT scan, someone will use it, even though having a procedure you don't need is never a good thing.
--Family physician, Washington, D.C.

• I really do know why you're bringing your husband and three kids, all of whom are also sick, with you today. No, they are not getting free care.
--Douglas Farrago, MD

• Doctors get paid each time they visit their patients in the hospital, so if you're there for seven days rather than five, they can bill for seven visits. The hospital often gets paid only for the diagnosis code, whether you're in there for two days or ten.
--Evan S. Levine, MD

• Twenty years ago, when I started my practice, my ear, nose, and throat procedures financially supported my facial plastic surgery practice. Today, my cosmetic practice is the only thing that allows me to continue to do ear, nose, and throat procedures, which barely cover my overhead.
--Ear, nose, throat, and facial plastic surgeon, Dallas/Fort Worth

Free Advice

• Avoid Friday afternoon surgery. The day after surgery is when most problems happen. If the next day is Saturday, you're flying by yourself without a safety net, because the units are understaffed and ERs are overwhelmed because doctors' offices are closed.
--Heart surgeon, New York City

• In many hospitals, the length of the white coat is related to the length of training. Medical students wear the shortest coats.
--Pediatrician, Baltimore

• Often the biggest names, the department chairmen, are not the best clinicians, because they spend most of their time being administrators. They no longer primarily focus on taking care of patients.
--Heart surgeon, New York City

Eid Adha

Assalamualaikum wbt to all family and muslim friends..
Wish you all in blessings and bath of pureness in this Eid Adha. I have been long abroad and this is my 7th Eid Adha without my family. First I had was in Langkawi during my matriculation, oh what an eve without family it was adventurous and kinda kooky, you know what i mean. The festival just went so lame at first. I thought it was a last one never expected in the following years it turn out so way different. For the past six years I had long enough experiences and acquaintance celebration of any eve with different kind of people all around the world here in Ukraine. They gave me tremendous savor indeed. I should be grateful of that. Oh really really I feel my life is so nifty...
''Eid Adha and Selamat Hari Raya Qurban...''

This Blog

Hey...
This is my first post for this blog. Me currently completing my final year in a medical university. This blog is my 3rd blog, expecting some differences from previous one.I hope this blog will give me a new exaltation to share with people outside there some of know ledges and stuffs which capturing to me. Items here might be from my own thoughts, experiences, extracted from online book, magazine, and perhaps they will be from friends.