Re: Choosing a doctor


"Nick Cramer" <n_cramerSPAM@xxxxxxxxxxx> wrote in message
news:20080702034104.613$7b@xxxxxxxxxxxxxxxxx
Peter Bowditch <myfirstname@xxxxxxxxxxx> wrote:
First the good news.

I ran out of metformin tablets at my place in a small country town
where I spend two or thee days a week, so I went to the doctor for a
prescription. (I had never been there before, so I took the empty box
with me to show that I had been taking the stuff.)

The doctor is a very old-fashioned country GP who doesn't have a
computer (or even a fax). The regular doc was away and the locum was
of a vintage which suggested that he might have been a contemporary of
Pasteur. Now we all know how family practice doctors don't know
anything about diabetes and testing, so this looked like a situation
where I might even have to explain what Type 2 diabetes is.

Not so. I was very impressed with his question about testing. He
didn't ask "Do you test yourself?", he asked "What was your BG this
morning?". I don't remember saying anything that might have
distinguished me from the haven't-a-clue majority who don't test.
Perhaps he assumed that anyone who took the trouble to go to a strange
doctor for some pills might also be the sort of person who would keep
track of how the pills were working.

Now the bad news.
[Arrrgh!]

Great news for you, Peter. Some of those old country docs are pretty
sharp.
Glad you found one!

In my experience as a medical technologist, most of the old country docs
were the best doctors. Why? When they learned medicine, they did not have
9 million medical tests to make the diagnosis for them. They had to
*listen* to their patients, pay attention, and make a diagnosis from what
the patient said and what they could observe. To do these things, they had
to *care*. I worked for an old country doc, and he could almost always nail
a diagnosis without any help from testing. If he ordered a test it was to
*confirm* a suspected diagnosis, not to *make* the diagnosis for him.

I noticed that the newbie docs tended to be less able to communicate with
patients, because they didn't rely on the information provided by the
patient to make the diagnosis. They used a scattergun approach--noted the
basic symptoms, not taking the time to tease out the details, then ordered
every test under the sun in order to make the diagnosis. I know it seems
that basing medical decisions on the science of the testing would seem to
provide better diagnoses and care, but it doesn't. You have doctors as
healers of patients versus doctors as researchers on lab rats. (At least
that's how some of the newbie doctors make me feel.)
--
Best regards,
Michelle C., T2
diet & exercise
BMI 21.5


.

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