Past that I dunno how your interactions played out. We have one side of the story, and you've mostly just stated what your impression of the doctor was. Not all doctors are equal. Including their bedside manner.

People like you are the reasons why women aren't taken seriously at the doctors.

You can fuck all the way off with that. I treat every patient the same. Our job in the ER is to make sure you aren't dying. Period.

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pinkstarpompadour@reddit

You can fuck off all the way with that.

I'm just stating facts. 🤷 I just see one side of you in which you dismiss my experience. Of course I'm not going to like that. Maybe do some reflection on how you treat patients if what I said got under your skin this much.

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Ruzhy6@reddit

You're inserting emotion where there was little. I'm an ER nurse. You didn't get under my skin. We get screamed at and threatened daily.

I confirmed what the doctor said to be correct. You took offense to that.

I also said there is no reason for you to be embarrassed over any of what happened. You ignored that bit.

The symptoms involved with severe anxiety can mimic some dangerous things, and I would never advise you not to get checked out.

Patients have this weird tendency to get offended when we get results that say they are not indeed having an emergency.

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pinkstarpompadour@reddit

How weird of me to think someone telling me to fuck off had some emotion behind it.

You said the doctor was correct for berating me and insinuating that I was wasting his and everyone else's time. Fuck you for that. The fact that you agree only makes me more certain you suck at your job.

You also ignored me asking what you WOULD have me do. Tell me what to do next time something feels wrong with my body. Do I just call my doctor EVERY TIME something feels off? Do you know how stupid that sounds?

Not the person you're responding to, but my mom had a heart attack a few years ago (late 70s). Based on her timeline, she started feeling it after dinner but wrote it off as indigestion/heart burn. It wasn't until a couple hours passed and it had worsened some that she decided to go to the ER.

She didn't describe it at all as a crushing weight on her chest.

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--n-@reddit

So you did more googling and figured that the MD was wrong? Hmm..

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pinkstarpompadour@reddit

Are you fucking serious? I did not use "Dr Google" I looked up accounts from REAL WOMEN. Fuck you.

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Mental_Jello_2484@reddit

I once apologized to a doctor for using Dr Google first.

He actually said “I’m so glad you looked it up because it’s what brought you in to me. And you might not have come in otherwise. Besides, if I wasn’t a doctor it’s probably what I would have done so I can’t be mad at you”. I was very grateful for his understanding and kindness (ps it was a torn retina).

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mcclelc@reddit

This is an extremely dangerous and reckless attitude of your doctor.

In the advent of covid, there has been a rise in heart attacks for people in the 20s and 30s, people who have no risk factors (no family history, normal cholesterol, lipids levels, active lifestyle.)

Another reminder, heart attacks present differently in women and often aren't that painful, often the same level as cramps.

F that doctor, I am glad you took it seriously.

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FerengiWithCoupons@reddit

Don’t ever feel embarrassed for advocating for yourself.

You are the only person who can

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treebeard189@reddit

Palpitations/chest pain get taken very seriously. Anyone whose worked in an ER for like more than a year has a story of that healthy looking 22yo in SVT with a heart rate of 270, or someone looking totally fine with mild shoulder pain having a massive heart attack.

Now you might not get back to a room quickly but any half decent ER will have metrics and be very big on getting an EKG done within like 10 minutes of your checking in.

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KevinSommers@reddit

No vent, just observation. I was diagnosed with Atlanto-Axial Instability requiring spinal fusion surgery based on MRIs taken at the ER(through scheduled inpatient stay out of state, hospital wasn't equipped for neurovascular damage/complications so refused to operate.)

The ERs seen via 911 calls all lack inpatient neuro so treatment is never attempted. They won't provide any care that can't be administered via IV. The emergency need to transfer to a higher level of care is acknowledged(last ER did a tele-consult to get a Neurosurgeon's opinion) but they refuse to document or transfer stating embarrassment or policies against transfers. When confronted with EMTALA they claim internal policy overrules federal laws due to lack of enforcement or penalty for non-compliance.

Fortunately I've been recording much of these conversations as that's legal for me to do.

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Adamantli@reddit

So it’s stopped your breathing and caused full incapacitation while simultaneously never being mechanically ventilated?

It’s miraculous you’re alive.

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KevinSommers@reddit

The breathing issues last minutes with PulseOx dipping down to around 70%. The paralysis lasts hours-days when it happens, very inconsistent in duration and how much of my body is affected. I'm incapacitated because moving(even my head) or being upright causes blackouts and can scale into triggering the breathing events/paralysis/spasms if I try to force through. Being moved by EMS triggers the critical symptoms which is its own complication to getting care, and why they'll only transport me to an ER without authorization.

It's difficult for me to break down the constants & episodic symptoms. Being KO in the ER doesn't help.

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Mindless_Grocery3759@reddit

I'll be honest, most of what you're saying doesn't entirely make sense. It does sound like you're attempting to utilize emergency services for what isn't an emergency.

It reads as though you need transport to another state, there are private ambulance services that will do that. You can Google them, or i can dm you at least one option that I know operates across state lines.

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KevinSommers@reddit

The hospitals told me to present at other ERs, my pcp/palliative said to call 911 for it, EMS said trying to get to outpatient would be dangerous & inappropriate. It's a neck injury causing brainstem compression and progressive white matter damage. Diagnostics initially threw off doctors because CNS issues make multiple bodily systems act out, they couldn't figure out what leads to follow. My heart turned out to be a red herring.

"Why are you covered in baby oil?"

Diddy say baby oil?

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bankruptbusybee@reddit

Haha a little too much sometimes. I had chest pains last year, after just getting over the flu. Figured it was costrochondritis. I dealt with it for a few days but final went to urgent care (PCP is books for weeks) to get a steroid prescription.

On all the forms where it asked “chest pain” I had to put “in ribs! From coughing! Not a heart attack!”

I was immediately hooked up to an EKG. Fine, they’re being cautious, I won’t fault them.

When it came back normal they did another one just in case.

When that came back normal, I had to do a third one

When that one came back normal the dr said, “you’re not having a heart attack, it’s costrochondritis. bye”

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Adamantli@reddit

Or a 16 y/o who’s cyanotic and in torsades

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forever_a10ne@reddit

I once got so stressed from work that I was having severe chest pain and dizziness. My boss literally drove me to the ER. I was in and out in probably 3-4 hours, which is faster than the usual 8+ hours from my prior experiences. I had nothing wrong with me and my boss drove me back to work to continue my shift. USA!

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EmotionalTowel1@reddit

I ran into the ER as a 25 yr old man with severe chest pains, it might have been 15 mins from nurse interview to EKG.

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Yuo_cna_Raed_Tihs@reddit

Yes doctors don't just do probability calculations, they also are aware of worst case scenarios. If someone comes in with blood in their stool and they have cancer that you don't catch, you are an idiot who must have skipped med school. Even if cancer is less likely than haemorrhoids, not catching it is massively harmful and so you'll probably get the scans and scopes required.

This is still useful if you're worried about like something non lethal (like coeliac or something that's super rare that you're convinced you have). But probably not gonna make a difference in life or death situations

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SniffingDelphi@reddit

Friend of mine is now cancer-free after radiation and chemo but he *did* go to the ER twice for passing blood and was sent away without any exam or tests because it was “just hemorrhoids.” Finally got diagnosed after he was admitted for a heart attack and nurses saw the blood. Lawyer says he probably won’t win a lawsuit.

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Yuo_cna_Raed_Tihs@reddit

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SniffingDelphi@reddit

My partner went in with chest pain and shortness of breath and they routed her to urgent care for her “cold” so YMMV.

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shakeyshake1@reddit

I once went to the ER and said “I have unexplained leg pain and I’m 99% sure it’s probably not a blood clot and I have anxiety so I’m probably more worried than I should be, but I’m here on that 1% chance it could be a blood clot” and they immediately put me in a wheelchair and took me back.

I’m guessing they base triage on the symptoms stated and not on any qualifying statements the patient makes. Also I can’t help but think that maybe they take people more seriously if they downplay symptoms because it’s obvious that you don’t want to be there and wouldn’t be there unless you thought it was necessary.

I mean compared to the people who come in claiming that they have 10 out of 10 pain but they’re able to talk coherently, play on their phone, and seem too aware of how the ER system works.

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CrocodileFile@reddit

I asked once how the scale was supposed to to work and I was told that 10 is the worst pain imaginable. I said “Isn’t this a test of my imagination more than anything?” Like I can imagine being fed feet first into a wood chipper while the rest of me is on fire. So I guess this kidney stone is probably like a 3 then.

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SniffingDelphi@reddit

I try to qualify my answers. E.G. “It’s a seven, but I’ve had all eight fingers broken at once, took a blow to the face with a club, and passed a kidney stone, so my idea of 10 is pretty high.“ I have no idea if that helps, but I unless I’m dealing with an OB/GYN, I generally get the pain meds I need and I’m female. My heart goes out to you, though, u/CrocodileFile, kidney stones are awful! I would be very happy to never experience that again!

And, honestly, I don’t actually remember how much getting my nose shattered hurt - just the crunching sound.

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5park2ez@reddit

This is a common problem for neuro divergent people, and people with chronic pain. The general rule is, if you're in the ER, it's a 7 at a minimum.

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Leila-Lola@reddit

That's the subject of my favorite xkcd

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shakeyshake1@reddit

I’m with you on this one. Also I have an unusually high tolerance for pain and a very low tolerance for being uncomfortable. And it turns out that discomfort is also pain when you’re using the scale.

I mean I had major surgery and the worst part about it was that they gave me a catheter. The discomfort of the catheter was worse than the surgical pain. So I guess on the scale, I’d rate the surgical pain at a 3 and having a catheter at a 5 if discomfort is pain.

I can’t go above a 5 for pain because my imagination is too good and I can think of an entire range of things that are less painful than the wood chipper and more painful than anything I’ve ever experienced.

I could fall off a cliff, break every bone in my body, and I’d probably think:

Well this might be a 7. Actually on second thought it probably isn’t because it would be worse if I broke every bone in my body AND impaled myself on some rebar, so that might be a 7. And it would be worse than that if animals then started eating me alive so let’s call that an 8. If we add all of that to someone pouring acid on me, then maybe that’s a 9. And it could still get worse. Let’s call it a 6.

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Ruzhy6@reddit

It's relative.

For instance. Had a patient last day I worked who came in with obvious distress in pain 10/10. Gave her pain meds, and she said they helped. I asked her what her pain is at now. She said 10/10.

That is failing the scale.

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misss-parker@reddit

I went to the er with gallstones once. The pain was presenting behind my sternum, a type of chest pain if you will. I did tell them that it feels gastro in nature, but I also didn't press on it too much when they were like "CHEST PAIN?!" and just rolled with it. Got bumped to the front pretty quick.

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finfan44@reddit

Wild. I had a heart attack a few years ago, my blood pressure has been hovering around 180/90 for the last three months and my doctor doesn't give a shit. He just keeps saying, you are just anxious about coming into the hospital. I'm moving out of the US in a few months and I will be so happy to go see a doctor in another country where medical professionals care about patients.

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chillmanstr8@reddit

I was at a medical facility as a patient and walked by the nurses desk right when my chest started to hurt (like it always has) and I casually grabbed my chest and said “yikes, another heart attack.” and kept walking. All three nurses shouted “wait!/hold on!” before I was out of view, and said “you cant walk past a nurses station, complain about chest pain and then walk away— we’re getting an EKG”. And like always, it was fine.

Thank you for this. I’m literally going to the doctor tomorrow with digestive issues I’ve been dealing with for 2 years and want to get my gallbladder tested etc even though I’m 35… all my older female relatives had them out at 45-50 after YEARS of planning travel etc around not wanting to poop themselves or being uncomfortable. I’m open to it being something else but this was going to be the first thing I said… along with the fact that this impacts my ability to live my daily life.

Hey. Parent of medically complex kid with GI symptoms and a disorder that will likely cause gallstones at some point in their future. A couple of suggestions in no particular order: 1. Straight up say, "I am concerned about gallstones because these symptoms seem consistent with what I've read: [list symptoms]. How are gallstones ruled out?" 2. Add time and severity to symptoms. So I don't say "my child is nauseous," I say "my child has been nauseous every day for the last three weeks. It's usually but not always worse in the evening. It prevents her from eating when she's hungry and drinking more than maybe 10 Oz of water a day. It's woken her up from sleep twice and she's avoiding bedtime for up to two hours past her regular time because of it." 3. Include what you have already done. For example, "to rule out constipation, we've been giving a cap of miralax every morning which she is able to drink every other day. She poops every day and it's about a 3 on the Bristol stool chart. We've been giving pepcid twice a day for the last two weeks in case it's post viral gastritis, which she's had in the past." 4. When the doctor recommends testing: "what will this rule in or out? How will the results change the treatment plan?" 5. When they recommend a change to the treatment plan: "how long should I wait to see if this works? If it doesn't work, what's the next step? And the step after that?" So you have a chance to try multiple things while you wait ANOTHER three months or whatever between appointments.

You get to the point where you can basically answer most of their questions for them during initial intake which helps make the most of short appointments. Does that help?

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Little-A@reddit

I would have to stop myself from going back to every doctor who dismissed me and shaming them.

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vulpesvulpes666@reddit

Honestly why stop yourself? Maybe some shaming is an appropriate consequence to their inaction and will raise enough noise to make change. It is shameful to believe yourself to be infallible and not listen to your patient when the stakes are so high.

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Little-A@reddit

Yeah. You put it like that and I felt a bit silly for thinking I would have to stop myself. Realistically, I have crippling anxiety and would probably make do with a pointed email with 1000 edits.

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Cauliflowwer@reddit

I wanted to do this so badly when I had PEs. I was 21, felt like I couldn't breathe and had immense pain on inhale. It was just after I had a problem with my leg that suddenly stopped. I go to urgent care, tell them I think I have a clot in my lung 'thats not possible. You're 21'. He did a chest x-ray, didn't see anything, sent me home. My resting HR at that visit was 99. The doctor rolled his eyes and told me 'if you're really that concerned, go to the emergency room, but I think you're fine' my urgent care copay was 50$ and my ER copay was 200. I couldn't even afford the urgent care copay I had to pay, so there was no way I was going to the ER if I was fine.

I spent a week feeling AWFUL. I couldn't breathe and could only take sips of breath. I had to work, which was quite physically intensive. And EVERYONE around me had an opinion about what was wrong. 'Oh it's clearly just gas' 'oh you probably just need to see a chiropractor' blah blah blah. Finally on day 7, I cough up a chuck of blood. Went to the ER. My resting heart rate is 167. They take me back, ultrasound my leg, do a CT of my lungs. The doctor told me he was shocked I was still alive and that I wouldn't have lasted much longer without intervention.

I wanted so badly to go to that urgent care doctor and tell him what an asshole he was. And show him he almost killed me. I felt like it was important for him to know his non-chalance almost cost someone their life. However, I never did - realistically I didn't know how. I only hope some doctor I saw on the day I was at the ER sent him a note or SOMETHING telling him his misdiagnosis nearly killed someone.

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Oh yeah, victim blame the sick person in the system where healthcare is arbitrarily expensive

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joennizgo@reddit

I had bilaterial PEs w/ infarct at age 20 due to an undiagnosed blood disorder and I got so, so lucky that I got a nurse who had an ischemic stroke in college. The doctors assumed I fractured a rib because I rowed daily, but the nurse is the one who called for the d-dimer on a hunch. I even had the "sudden impending doom" that was written off as anxiety. They're so awful.

On the bright side, now I get a free pass anytime I have a respiratory issue because I just say "I have a clotting disorder and a history of PEs" and suddenly I'm a priority.

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You have to be your own champion. Hospitals simply give pain meds when someone in my family complains of back pain. After the third visit, it took them shouting at the doctors to do more test because it's not "nothing".

Turns out its tumour on their spine, suddenly it's an urgent case and needed surgery now. If it's up to the doctors, they'll just brush it off and give pain meds for another few months until the patients dead.

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DJDanaK@reddit

That's hilarious, I can't even get pain meds for my crippling endo ❤️ I wish a doctor would throw pain meds at me

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KiWi0589@reddit

So I had crazy digestive issues for about a decade before I finally got a colonoscopy after trying to adjust some dietary things and getting tested for crohns, Celiac, UC, IC…. Which still gave very little info other than I had inflammation, completed a round of steroids, and after the meds were gone, symptoms returned. Doc gave me a powder/med to take daily, it did nothing after 3 months using it. Finally, my husband suggested another dietary change after having seen a documentary. I went vegetarian and within days felt so much better, I’m going in 3 years now and the only time I have belly trouble is when I get sick/stomach flu. I lost 50lbs and can finally not plan my life around where the bathroom is. Anyway, it’s worth a shot if you want to try something else before possible surgery!

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pinknoisechick@reddit

I got my gallbladder out this year. I went to my doctor to talk about the awful heartburn I'd been having, and she said it sounded like it was a problem with my gallbladder.

I told her how I'd been to doctors for 17 years with this pain happening off and on, and it seemed like if it was my gallbladder it would have gone septic by now. She told me that sometimes, especially with a megalith, it doesn't go septic, it just hurts a lot for a while and then calms down. So she sent me up for an ultrasound.

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unity-thru-absurdity@reddit

It may be worthwhile to make a small edit to your OP explaining what a risk factor is. Many laypeople could conflate risk factors and symptoms at first glance.

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Depensity@reddit

I’m sure you’re just going to say I’m being a whiny defensive doctor but…my two cents anyway.

Risk factors are a critically important part of the diagnostic process. Without taking them into account, everyone just gets tested for everything every time. Is that good medicine? Should we give up then on taking histories? Also, do you really want a system where doctors can’t trust anything their patients say and we all just assume patients are lying about their histories? Do you think that leads to better healthcare? Should every cough get a TB workup? I guess so because someone read about it on WebMD so now they’re telling me they lived in India for a year working on a TB ward 20 years ago. Let’s just cath every single person with chest pain bc they’re all going to say both their parents died of heart attacks at age 40 anyway and that may or may not even be true so let’s just do it. What’s the harm? Oops we perfed their coronary and now they’re in tamponade. Oh well…they read something on Reddit about someone whose chest pain was ignored and died of a heart attack and it was super sad so...it was all worth it in the end even though they had no coronary disease.

We have the best diagnoses.

Because of jail.

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birdenvy@reddit

I appreciate the Parks and Rec reference!

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silsune@reddit

...was it???

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wheatgrass_feetgrass@reddit

He's a goner.

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Image_Inevitable@reddit

This doesn't always work.

I suffered with toxoplasmosis for 2 months and went to the er three times. It was a mystery bc my basic bloodwork was perfect.

The second time I realized I was having textbook symptoms and stupid me....had unknowingly adopted a toxo shedding kitten 3 months prior who had in turn infected my other two cats.

I told this guy this and that I'd like to be tested because I've been exposed.

He said "Haha! You better go see an eye specialist or something then. I don't think we can run those tests." Then he walked out.

The nurse came in to discharge me and I flipped through the paperwork which said if you experience "every symptom I was experiencing" - please return.

I said, I'm currently experiencing all of these. Do you want me to leave and then come back, because I'm not signing this.

She got all flustered, said no one has ever refused to leave before and went to get the doctor again.

He waltzed in and said "You know what! I was just looking over the tests available and they do have a toxo add on we can run with your initial bloodwork."

I said "Great, thank you."

And the rest was infectious disease history.

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Negative_Way8350@reddit

"No one has ever refused to leave before."

Okay, champ.

--Actual ER nurse.

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Image_Inevitable@reddit

Maybe she was new.

-Actual (regretful) ER patient.

I'm not immunocompromised. They did all the tests and were baffled. I do believe what happened was that I contracted the norovirus from work while I had already been fighting toxo for a couple of weeks. I knew I was fighting something because my lymphnodes were painful and swollen on and off. Then I woke up one Tuesday and was convinced it was the end.

I was so sick that my period stopped for two days. My teenage son had to physically pick me up off the floor of the bathroom.

It was the kind of illness where there is a complete lack of pantless shame. I hope to never experience it again.

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fastates@reddit

They love to pull out that line to make us feel like a freak, "no one has ever," "you're the first...." Well then good, glad the world's smartening up as of now.

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MLB-LeakyLeak@reddit

The vast majority of immunocompetent patients don’t need treatment, and treatment hasn’t been shown to be beneficial.

ExtremisEleven@reddit

It’s literally not appropriate care if you have to lie to get it. You’re personally going to get a hell of a lot of people a diagnosis of malingering or munchausen and they will never be taken seriously again.

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InstructionWorth2451@reddit

Have you read some of the patient stories in this thread? We're already not being taken seriously.

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Rrroxxxannne@reddit

My doctor has been up in arms about being in control of my thyroid hormone doses/management, which was fine with me bc he’s six hours closer to me than my former endo. Until he started making tons of changes. I asked him for a referral to a new endo and this man goes “you know you need a problem for a referral. Is there a reason you need this?” and I was like hmmmmmm I don’t have a thyroid? The ongoing care and management of my thyroid cancer???

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Death_Spaghetti@reddit

Don’t. Lie. To. Your. Doctor. That is stupid.

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ethical_arsonist@reddit

This is a wonderful unethical life pro tips

It's not ethical because it undermines the system in a way that focuses resources on you. If everyone did it the world would be worse

But we're not here for ethical tips. This was golden but I hope I never need it

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AriadneThread@reddit

Exactly. This is plan C in my book. But keeping it in my back pocket.

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Reglette69869@reddit

Yeesssss. I've learned several times over in my years as a female-presenting person struggling with lifelong mental illness how important it is to be careful how you talk to doctors. If anything, I've learned the importance of omitting certain information that might give them reason to be prejudiced toward you, including psychiatric stuff or substance use. Then it's "oh, it's probably just your anxiety/grief/other thing in your head that's causing your physical symptoms. We don't need to test or treat you further" or "You're a druggie! We need to focus on that instead of diagnosing or treating the thing you're obviously trying to self-medicate for."

Less can often be more. You need your doctor to respect you in order to be safe.

Some caveats: always tell your anesthesiologist what substances you're putting in your body; they actually NEED to know. And if you're getting prescribed meds that may have interactions with whatever you're taking secretly, you're taking a risk by not disclosing as well. You have to use your judgement because unfortunately we sometimes need to convince medical professionals we are worthy of care as human beings and that, for me, has often required me to be dishonest.

I know this really sucks, and I wish it didn't suck, but I can't discount my lived experiences and neither do countless other people in similar situations.

A lil tip for my fellow menstruators in the US too: I also tend to be stubbornly forgetful when it comes to exact menstrual dates, but I always remember I'm regular. My uterus doesn't have much of a paper trail thanks to my derpiness. Again, use your best judgement according to your unique needs.

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Fcuk_Spez@reddit

Or just be an adult and tell your doctor what’s wrong. They don’t believe you? Find a new doctor

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Adamantli@reddit

So it’s stopped your breathing and caused full incapacitation while simultaneously never being mechanically ventilated?

Sure, if you come in with symptoms that resemble something sinister, I am more likely to order big expensive and more invasive testing. We physicians are always trying to balance cost and benefit, with cost being in terms of not just money, but time and health as well. I don't even want to begin to think of all the CT scans' worth of radiation I've ordered that in retrospect weren't necessary-- but it was part of the learning process and "defensive" medicine. Medications, biopsies, and other tests can be super expensive, painful, and come with their own set of risks. When we take our oath, some of us would like to believe we truly do have a responsibility to 'do no harm'.

To paraphrase this notion as "JUST the right amount and ANY more will kill you" is inflammatory language on your part and does not reflect the thoughtfulness of any other physician I have met.

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Numerous_Birds@reddit (OP)

I appreciate the thoughtful reply and genuinely agree with everything you've said. Except that, as I mention and as many non-physician commenters have pointed out in this tread, there are certain groups whose honesty and upfront reporting is actually not rewarded with appropriate care but instead routinely met with dismissal. This is a well-known and well-documented phenomenon especially for women. Even worse for Black women or other non-White women. This is just a true thing that happens lol. I'm not saying the silver bullet is dishonesty. This is r/UnethicalLifeProTips, not JAMA Viewpoints or Health Affairs lmao. Not quite the place to seek high-quality or generalizable advice. That being said, my point was to highlight this gap and how "gaming" physicians' clinical reasoning is a strategy that exists and actually can work in certain patients' favor. A debate of its ethics, as you're getting into, is totally reasonable here, considering the sub we're in lol. But we can't pretend that the premise is so unfair or so far off base to be irrelevant. Clearly, this resonated with a lot of people. Way more than I expected.

That all being said, you're completely right about everything you said. It's all great on paper and I believe you mean it. Indeed, for most people, being honest and just trusting your physician trusting the process will work out just fine. However, that's simply not the case for everyone. And for patients waiting 3, 6, or 18 months to see a physician, the advice to "find another doc who won't dismiss your complaints" is not really sound, much less practical (I know that's not what you're saying, but it came up often in the replies). Sometimes that's your one shot to have your shit taken care of and knowing you're not totally powerless to the specific physicians' clinical reasoning is important. Whether what someone does with that information is ethical or not is a separate discussion and one I'm interested in having, genuinely.

Also, I don't need to die on this hill but my paraphrasing is actually not off many of the physicians' commenting here which many times took such extreme stances lol. Thankfully, I also don't work among people who talk like that. But they are in here apparently. Evidently, yours is not one of those replies and I appreciate the earnest dialogue. Even if it's happening in a sub that is often intentionally facetious.

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Mundane-Bug-4962@reddit

Can we send you the bills for all the unnecessary testing?

It warrants a rectal exam first, then possibly an outpatient colonoscopy here in the US. Anyone with persistent rectal bleeding or rectal bleeding without palpable hemorrhoids gets a colonoscopy. The problem is no one has access to primary care and fewer people have access to GI. GI is overwhelmed with their current list of people who need a scope. People aren’t lying because they wouldn’t ever get a scope. People are lying to try to push their way in front of other people with real risk factors or to get admitted for a quick colonoscopy because they’re tired of doing things in order.

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Numerous_Birds@reddit (OP)

I wish I could do 6 months in the UK, I feel like I would learn so much. I agree with you, unfortunately not everyone sees it the way you do.

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molhotartaro@reddit

Every now and then I'm forced to see a new psychiatrist (because my insurance is crap) and sometimes they want to change my medication, which has been working beautifully for 8 years.

First, I arrived there with my own previous diagnosis + photos of past prescriptions, because I thought I was helping them. Boy was I wrong.

Now I show up with a tormented expression and ask for a small piece of their wisdom, while casually mentioning that my only fear is that new meds won't work and, you know ... it would be terrible if I started drinking again.

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forgivemytypos@reddit

Nope. I don't let patients play that card on me. That's extremely manipulative behavior and I do not play that game.

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molhotartaro@reddit

But why does it have to be a game? I had drinking problems for 15 years. During that period, I went through several different diagnoses and tried a plethora of meds. One beautiful day, I met a doctor who figured out the problem. I've been on the same medication for 8 years and now I don't drink anymore.

What is the purpose of making me change these meds? I can't think of anything but pride. And that makes me very angry because it's my life we're talking about. If you would really risk a patient's sobriety out of spite, then you're proving my point.

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fluffylilbee@reddit

it’s like they don’t want us to actually get any help. like why the fuck is consistency and thoroughness a BAD THING??? why the fuck do we exist to stroke their egos????? i just need pills so my brain doesn’t tell me to jump off a bridge but it’s like some fucking dog and pony show so they can feel important. good god

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customheart@reddit

Just keep pushing. They ultimately don’t like having a bunch of follow up phone calls and will relent if you have a solid reason and you are polite.

meechie900@reddit

Damn like how can a doctor miss a broken foot?! My father ended up with his leg amputated after blood clots and a discolored foot were misdiagnosed as a muscle injury and prescribed physical therapy and massage. After a few days of getting worse, saw a second doc who took one look, asked if the first doc by chance checked foot pulses.. checked for himself and surprise there were no pulses. Immediate hospitalization and multiple surgeries to try to save it without success.

Now my family trusts no doctors and second opinions always.

There are good and bad doctors out there like every profession. Just because you passed schooling and boards, being a doctor does not mean you are a compassionate human or good at your job.

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mangababe@reddit

I have no idea! He just squeezed the shit out of it and told me it was a strained muscle. No X-ray or anything. I went to urgent care a month later and half way through explaining my pain the doc was ordering an X-ray. The uc doc was beside himself when he got the X-ray back.

Im so sorry he lost his foot like that. Medical negligence is infuriating.

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No-Letterhead-649@reddit

Not the whole truth.. I don’t order every test people ask for due to insurance. If they don’t meet criteria then insurance isn’t going to pay and then they are stuck with a huge bill. If people are adamant about a test I forewarn them that insurance may not cover it and they will be responsible for the bill. They will usually balk at it and not want to do it. If they want to take that risk then I will happily order it for them 🤷🏻‍♂️

That would be reasonable too. An add on to this ULPT is that if you actually *do* have that family history, please make a point of sharing it. A lot of people don't realize how much this influences doctors' thinking.

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forgivemytypos@reddit

So seriously you think every single person that has any episode of blood in their stool needs a colonoscopy? If we extrapolate that to every single problem being the worst case scenario and over ordering all these tests we're going to further clog up the system and make it more difficult for people who are really sick to get the scans and specialists that they need and it's just going to keep driving up the insurance costs. This is not good advice. Better advice would be to find a good Doctor who listens to you and keep them. I'm a primary care PA myself and colonoscopy might not be the very first test that I order, but as long as they keep a follow up with me or if they're not responding with initial treatment options then that's still part of the algorithm. Every headache doesn't need an MRI after the first visit. Everybody stool doesn't need a colonoscopy after the first visit. Every heartburn doesn't need a CT scan after the first visit. And so on and so forth and you of all people should know this

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Tomokin@reddit

100%

We have strong autism genes in our family: the relatives who mention that when their kids start being assessed for speech delay miss out years of "wait and watch", hearing tests and "global developmental delay".

Our country starts cervical screening aged 25, my sister has been tested since age 16 due to a sensible doctor who asked her about family health conditions.

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nicholus_h2@reddit

is that sensible?

Dirigo72@reddit

I assure you, my healthcare is handled by some of the best in the world. I literally receive my care in one of the best hospitals in the world and by a physician considered a “key opinion leader” by his peers. I’ll be sure to tell him some dude on Reddit is concerned.

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nicholus_h2@reddit

do you believe that he can take things that have been scientifically disproven, and magically make them true? Can he turn water into wine? Are you a patient, or a disciple?

Watch out, one of your co-disci...I mean, co-patients is going to rat him out for some silver.

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When so many women in the family died of cervical cancer, large number of the older women have had full blown cancer and every single female past 35 has had to have treatment for abnormal cells. I'm very thankful her doctor is on the side of caution.

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nicholus_h2@reddit

scientifically, we know that cervical cancer screening in women younger than 25 has no impact on outcomes. so, is it caution? it is it theatre?

would it be more cautious if her Ob did paps every 6 months? every 3 months? how about if they did ultrasounds every year? CT scans of her pelvis every 2 years? why don't we do these things?

should we be thankful that TSA agents make you take off your belt and shoes before getting on the plane? even though it does nothing to make us any safer?

I agree.

Honestly, you shouldn't need to justify your family history that far just to get a screening that would be routine for everyone a decade later. We're not talking about an invasive course of treatment that will do significant harm if there's no reason for it; just a screening. If nothing is found, no harm done, come back in a few years.

Genetically, though, if enough people in your slightly-more-distant family have the same thing, it's very likely it was passed down through the common links. Is it exactly the same? Probably not, but it's statistically a substantial step up from these connections individually.

I don't think we have to study 2nd and 3rd degree connections directly to know that many 2nd and 3rd degree connections most likely indicates that they came from a common source — likely a first degree connection who has never been tested for the genetic marker, and lucked out on the condition it's a risk factor for.

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Dirigo72@reddit

If we want that to be used as a risk factor then we absolutely do need to study it. Medicine shouldn’t be practiced on a “makes sense to me basis”. The data has to be there for insurance to pay for preventive/screening tests and for companies to invest in treatment options.

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GalumphingWithGlee@reddit

But the genetics of this are already known. If we're confident that there's a genetic component to the risk in the first place, take the following example: if 4 of your first cousins from different parents all have a rare genetic marker, then it's a good bet it came from the common link, which is not their different parents, but their shared grandparents. So if we already know the risk impact of a grandparent, we can extrapolate a very similar risk from 4 first cousins, because they collectively represent an extremely strong likelihood that the grandparent has it.

Yes, technically, they could each have gotten that genetic marker from entirely separate sources on parts of their family trees that aren't shared, but that's statistically extraordinarily unlikely. If the marker were in 1 of every thousand people, for example, the chances of it coming to all 4 of these from unrelated sources would be roughly 1 in a trillion. Even if 1 in 100 people had this marker, it would still be a 1 in 100 million chance. So for estimation purposes, we can just assume it came from one or both of the shared grandparents, which means that whatever we've already studied about that grandparent link almost certainly also applies to the 4 cousins link.

That's not guesswork. It's solid statistics. And your insurance may say it doesn't count because nobody specifically studied people who have 4 cousins with this genetic risk factor, because they're looking for excuses, but your doctor should not. They shouldn't need to absolutely prove that you have the risk factors to give you a simple screening. If it's likely you have it, then screening is the best course of action.

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Dirigo72@reddit

I agree, screenings are important and should be more easily available. The issue (in the US) has a couple of different factors. First, if insurance doesn’t have to pay, they won’t. Not everyone can afford to pay for screenings out of pocket. Second, the healthcare system is already backed up with long wait times. There has to be a triage system and that comes from data.

People should have access to better screenings and preventative care, we will only get that if we prove that those tests are necessary.

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GalumphingWithGlee@reddit

Maybe I misinterpreted your previous comment, because I'm 100% in favor of studies that prove when tests are necessary. I just don't think the lack of such studies should be a blocking factor assuming, of course, that we're talking about low risk tests.

Whether insurance will pay for it is an entirely separate story, but the entire US insurance industry is a blight on the nation. If patients can't pay for their care, then they'll make whatever financially motivated decisions they have to make, but doctors shouldn't be taking their cues from insurance companies.

There's been articles in major newspapers recently. This shouldn't be a brand- new idea to a doctor.

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Live-learn-repeat@reddit

Well Dr., I applaud your modesty and good advice. Your profession's arrogance is not unique. Many specialists in many areas of life, discount the customer/patient(s) concern to a condescending degree.
Now, if it makes you feel any better, Dental professionals are worse!🤣

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-ImYourHuckleberry-@reddit

I do not believe you are a doctor. You post on r/stonerfood.

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Routine-Mulberry6124@reddit

OP’s post history suggests they are in fact a doctor.

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-ImYourHuckleberry-@reddit

I deleted the fraud part before you posted your comment.

I deleted it because I don’t want to sound malicious because that is not my intent.

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Routine-Mulberry6124@reddit

Unless you really think OP has been setting up this post for five years by falsely claiming to be a medical student, and then falsely claiming to find work as doctor a year ago, then you are lying in order to make them look dishonest about their background and qualifications. If that is not malicious I don’t know what is.

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-ImYourHuckleberry-@reddit

I’ll be honest. I didn’t scroll through five plus years of their comment history.

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Numerous_Birds@reddit (OP)

Not that it matters but: (1) marijuana has [kind of miraculously, really], never been reliably linked to lung cancer, (2) it helps a lot of people especially cancer patients, (3) its harm comes from use beyond moderation, (4) I'm a very infrequent user lol I just like r/stonerfood because it's usually posts of humble but cozy food people are at home enjoying and that makes me happy.

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-ImYourHuckleberry-@reddit

No doubt it eases pain, kind of how many of these prescription medicines help with one health issue but have a myriad of side effects.

While further research is needed, researchers know that marijuana smoke contains many of the same harmful chemicals and compounds found in tobacco smoke and therefore may be associated with an increased risk of developing lung cancer.
For people with cancer, cannabis is being studied for its possible benefits in helping to manage certain side effects of cancer and its treatment. But cannabis can be harmful in certain situations, forms, and doses.
No doubt.
I don’t judge you. I just would hope my doctor made better choices for themselves for the benefit of their patients. Just like I would avoid obese doctors, I would avoid those that use illicit substances for recreation.

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Rimkantas@reddit

You don't have to smoke marijuana. THC is not the only beneficial cannabinoid.
You can say that anything is harmful in certain situations, forms, and doses. The dose (and sometimes the route of administration) makes the poison. Treating cancer and practicing medicine as a whole is almost entirely about acceptable risk—chemo is a poison that will hopefully kill the cancer before it kills you. Radiation kills everything, but it is aimed only at the tumor. And so on, and on, and on.

It is also about ensuring quality of life. Many people eschew treatment in order to enjoy the time they have left, even if they could otherwise live longer. As their disease advances some may choose to undergo palliative chemo, which is the administration of chemotherapy to manage symptoms of their cancer, not cure it.

Marijuana is a drop in the bucket as far as risk when you have cancer. Sure—it may do "harm" in some tiny way, but who cares when it can help so much? And even if it doesn't have any of the typical "tangible" benefits like helping with nausea, pain, etc., if it does even the smallest thing to make someone feel better then they should have the choice.

How does using marijuana outside of work hours in moderation have any effect on how good doctors are at their job? As people that spend so long learning about and seeing the consequences of diseases, they have significantly more ability than you to make an educated choice about what they should and shouldn't consume (unless you're a doctor).

Marijuana is legal recreationally in 24 states, medically in 40, and decriminalized in countless other cities and municipalities. So why do you clutch your pearls at the idea of your doctor using it? Do you want your doctor to not drink, smoke, or ride a motorcycle? All of those are much worse or more risky for your health. Do you also want your doctor to not consume food dyes, red meat, or benadryl for more than 5 days in a row? Doctors should not, and cannot, be a complete paragon of health. As humans, we all take calculated risks. Shouldn't the ability to realize they're taking calculated risks matter more than the fact that they do?

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NorthRoseGold@reddit

The absolute insanity it takes to question a doctor about medical research lol.

Stfu and gtfo

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-ImYourHuckleberry-@reddit

About smoking weed ? Are you serious?

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Routine-Mulberry6124@reddit

Well if you can spare the twenty seconds needed to do that, maybe just shut the fuck up next time.

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-ImYourHuckleberry-@reddit

Twenty seconds? You’re on crack… Twenty seconds is what got me through the most recent 186 days.

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Routine-Mulberry6124@reddit

LeAvE mE aLoOoNE.. waaaahhh waaahh

You’re a fucking liar. OP has made maybe 30 posts, and unless you are a complete fucking idiot it is not difficult to scroll thru and see they were in medical school. Seems like the least someone could do before explicitly accusing someone of fraud, and are still claiming they are not in fact a doctor. You lying fucking slime ball.

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Numerous_Birds@reddit (OP)

I respect the skepticism but the boring truth is I just like thinking about anything but work when I’m at home on Reddit lol. But I really am a doctor.

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You have failed to communicate.

“What brought you into today?”

When what you really meant is "What symptoms are you feeling that brought you in today?

“my MRI says I have this thing [cites something 90% of the population has]”

You can say "In order of treat you, I need to know what symptoms you are feeling".

Yes it can be very inconvenient. I do have access through MyChart because all of my current and past providers now use Epic. But it would be wonderful if we had one unified medical record system. I don’t know any doctor that doesn’t want that.

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sowinglavender@reddit

the only thing that's ever worked for me was aggressive documentation wrapped up in as much politeness as possible (because somehow, as op admits, managing the ego of the person from whom i'm seeking medical care is my responsibility).

"okay. i just need you to sign this piece of paper saying i've reported my symptoms to you three times over six months and you've declined further testing, treatment, or referral."

"um, i'm obviously not doing that."

"didn't think you would but you always try the knob before you pick the lock." (snaps a selfie with him in the background)

"(enormous sigh) i guess i can order a test."

(by which of course he means actually rule out [condition] instead of just deciding in his head that you don't have it.)

So to all those who actually want to have a productive discussion with your physician without involving risk management (which is likely what the above poster is going to run into, also likely to get kicked out by every clinic around them eventually), just tell me what you think is going on and I'll do my best to fix it, I can't promise I have all the answers but at the very least I'll do everything that doesn't compromise your safety and refer you for a second opinion if I can't figure it out. Trying to corner me into ordering a bunch of things that doesn't fix anything and at worst results in dangerous procedures where the risks greatly exceed the benefits.

These are just ER experiences but everything I've ever had wrong with me was repeatedly waved off by doctors. I don't know if it is specific to me or how I communicate but if I ever went to a hcp for a serious issue and they managed to diagnose it correctly without me having to fight with them for months or years - I would be absolutely shocked.

I don't know what magical thing I had to say to the ER docs to have them take my emergency appropriate concerns seriously but next time if I think my leg is broken I sure as hell am going to tell them I break bones all the time if that's what gets me an X-ray when I need one.

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Rough_Dream_2457@reddit

I relate to this too much.

I visited the hospital in SVT. My resting heart rate was 180+ for several hours. Doctor went on and on about how it was anxiety and prescribed me Xanax. I had to use a wheelchair to get back to my car after discharge because I couldn’t stand up without passing out. Afterwards, the symptoms persisted. My O2 started dropping into the 80s. Turns out I have a cardiac disorder.

Few months later, my dad takes me to the emergency room because he thinks I’m having seizures. I don’t remember anything from that night, but I do know that a doctor, again, stated it was just anxiety. Had to wait months to see a specialist after my visit, and developed brain damage due to my now diagnosed epilepsy.

I have spent the past four years in debilitating hip and knee pain. I’ve discussed it with an immunologist, two rheumatologists, and several PCPs. For YEARS, I begged for x-rays. They’d do the same blood tests over and over, which always came back fine. I was told my pain was psychosomatic/fibromyalgia. Recently, I saw a nurse practitioner at my rheumatologist’s office. She heard my symptoms and asked what my last imaging results showed. Blanched when she heard I hadn’t had imaging and immediately ordered an MRI. Well, I am twenty years old and have fucking osteoarthritis!

This is a joke, right?

They exist to clear a queue. Well, ER drs do, not sure about this poster making this obvious joke.

The faster they can push you back out the doors. Anything that won't kill you in the next few minutes is "go tell your primary care". Ofc primary care only says "well if it gets worse, go to the ER".

The only time I ever got treated was because of OPs advice, or more aggressive enhancements. Only then did they start doing more than a blood test, only then did they start actually finding things.

No one is checking your charts. What a joke. I have a decade of medical history in there and literally every "doctor" who stumbles thru the door only knows things about me than I tell them that session. This is doubly so for psych - at least sometimes I'll watch a body doctor skim my record during my appt when they realize I've got more than they can easily dismiss going on. I've never seen a psych doctor reference or check a single fucking thing. And heaven forbid you got something done in a different building than the one you're at - then they literally have nothing, even after the ROIs over and over.

I mean, sure, RFK may start hunting autists for sport and Ins companies will gladly sift thru your records and even invent things to cut you.. but your doctor does not give the tinest of fucks. They have grossly overbooked to milk the most cash for their day and they couldn't give a tiny damn about any single patient.

The only reason this trick works is they don't wanna get sued later. Barely. Because even that minuscule amount of accountability has been stripped from us. The new trick, especially for anyone without fancy private ins, or in any marginalized group, is to simply ignore the patient and say they have some non-issue. Any guts is heartburn, any skull pains just a headache, any neck/ spine pain is pain-seeking. If they don't ever diagnose you, then they don't have a standard of care to follow, so you can go die at home and they are in the clear, blaming the dead for not "presenting" correctly.

Tldr: Nuremberg the doctors , and follow OPs advice till then

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mezotesidees@reddit

First, do no harm.

There is a reason this was posted in unethical LPT. There are real harms from downstream effects of unnecessary testing and treatment. OP is harming people with this post but apparently disagreeing means we have an ego problem.

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skeinshortofashawl@reddit

For good drs, yes.

But then there are others where if you act the least bit knowledgeable they will shut you down.

I was having bouts of a resting heart rate in the 130s with shortness of breath. Figured maybe I should see a doctor about it. Made the mistake of mentioning it happened at work one time and I threw on a pulse ox because, I dunno, I doubted my ability to count.

“Oh, you think you might have xyz condition? Why is that?”

Then we can have a discussion about whether that’s likely or not, what the risks and benefits are of pursuing that diagnostic workup, and engage in shared decision making. You can get what you want and also be educated on whether it’s necessary or potentially harmful. IMO this is a better strategy for all parties involved. YMMV.

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SniffingDelphi@reddit

No, being honest is “not hard,” but neither is listening to and *believing* your patients, just to be equally condescending. What makes you think we haven’t already *tried* honesty and gotten no where? You know your peers and yourself - do you truly believe you’re *all* so perfect? Signed, one of those manipulative patients who was told my crippling fibromyalgia was all in my head.

How about just getting over your ego?

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tc7665@reddit

i was diagnosed with lupus by my pulmonologist, and the rheumatologist he sent me to said i don’t have it and refused to treat me. i still have the butterfly rash, i practically die in heat, its bad, and, i continue to have pleurisy.

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runonandonandonanon@reddit

The number of psych assessments where you're like "I have this condition because I have all the symptoms" and they're like "I'll be judge of that. Here is a diagnostic test where it asks if you have these symptoms. Complete it and I will peform arcane analysis on it to divine the truth of your condition!"

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ComfortableParsley83@reddit

If it’s as simple as blood tests, there’s obviously not that much risk with this approach. However, mix in some health anxiety with the internet, and suddenly you’re exposing a person to a shit ton of radiation or procedures. I do agree that it’s unfortunate that patients feel the need to resort to this strategy, but perhaps it’d be better for these types of patients to find a different doctor or type of doctor (eg functional medicine) where they feel they are better heard.

As a doctor I love the stupid shit you guys make up in your heads about doctors and medicine. I just don’t know where the confidence despite being so wrong comes from

There’s a lot to unpack here, but put simply, everyone is worried about something. It is impossible to meet that demand without completely overwhelming the system more than it already it is. And lying? That's a great way to get misdiagnosed, mistreated, and possible complications you risk by getting worked up and treated.

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G_roundC_offee@reddit

I don’t trust doctors. Period. Egotistical narcissists that apparently get off on other peoples suffering

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apothecarynow@reddit

A huge word of caution: even if you're exaggerating or lying about these red flags / symptoms in order to get some tests fucking yourself for future ability with regards to life insurance / disability insurance. The symptoms / family history will be documented in the medical chart and will be reviewed if you apply for those in the future. Doesn't matter if it's not true. Matters if it's documented.

In the USA: The 21st Century Cures Act & "Information Blocking" Final Rule from 2021 made it illegal for most providers and health IT vendors to block patients from accessing their electronic health information.

You can't see every little communication that's like internal but any real published note for reimbursement or documentation in the health record is basically visible now.

A lot of Health systems had to pivot very quickly. Most health systems that use Epic are accessible MyChart.

That being said as you mentioned things are sticky- as soon as it's mentioned in a problem list or a family history it gets pulled into hundreds of notes moving forward.

Therefore, I would recommend after every doctor's visit you login to the portal that your health system has given you and you review any and all health information. If it's not accurate, make that correction immediately because as you pointed out it will stick around even if the initial error was corrected.

By the way, doctors probably may hate you for calling up and making these corrections but they should be accurate.

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fastates@reddit

NAD. Also, if a doctor writes something inappropriate in your chart, contact patient services or whichever dept. and I sist it be removed. I did that once with a real jackass of a doctor. Also, don't joke. Just don't. Play it totally straight, because anything you do say CAN AND WILL be used against you.

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Material_Strawberry@reddit

Might be worth bringing a witness or using a recorded video call during the visit (since you don't always have the best memory and want to ensure you understand everything correctly) so that there is someone present when you inform the provider of the accurate information so that any future complications or problems caused by the improper documentation in your medical history as a result of the error if it persists are traceable to an insured provider documented as having been informed of the error on the medical record and being advised of it at that date and time.

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Hanging_Thread@reddit

Somehow my mom had the diagnosis of Parkinson's added to her chart, despite having no symptoms and no testing done for it. We couldn't get it off the chart, and as her cognitive decline got worse she couldn't advocate for herself well (she did have Alzheimer's).

Several times she was seen in the hospital for unrelated issues and started on Parkinson's meds without talking to the family. We BEGGED to have the diagnosis removed but no one would.

Then right before she went into a hospice facility, she also got an MRSA diagnosis added, despite NO cultures being done for anything, and no recurrent infections. The hospice put her in contact isolation, which initially prevented us from freely spending time with her, bringing in food, letting her wear her own clothes, etc. I finally marched down to the DON office and demanded they look through her chart for evidence of the cultures that would have led to the diagnosis. She finally agreed there were none, and removed the precautions. Turns out the EMTs who transported her from the hospital to the facility thought someone had said she had MRSA so they added it to their problem list and it got transcribed and became permanent.

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CuragaMD@reddit

It took months to take off that I had a c section. I have no idea how that ended up in my chart. They kept asking me if I was sure. Uh yes, I am sure. It got put into a chart and it metastasized into a million charts.

Hilariously I am a physician.

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AdamsAtwoodOrwell@reddit

I've seen absolutely crazy stuff on my kid's chart just because my MIL mentioned something offhand during an appointment.

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shakeyshake1@reddit

Someone put that I was a cigar smoker in my chart and it took like 5 or 10 years for the hospital system to get it out of their system after I told them every single time that it was not correct.

I mean everyone believed me that it wasn’t true. There aren’t too many women in their 30s who are habitual cigar smokers. It would’ve been much more annoying if it were something that was plausible.

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dollyvile@reddit

But that is a problem for the US with for profit medical insurance and not elsewhere where it would only mean that you get tested somewhat more often.

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1speedbike@reddit

My SO is an underwriter, and you are 100% correct. They comb through everything in your medical records. If you exaggerate symptoms or conditions, you're either going to get much worse coverage or pay a much larger premium. They may even completely deny your application for coverage or postpone it for several years, telling you you may be eligible in the future. If you lie to the insurance company or they find inconsistencies in your medical records, you will at best be denied coverage, at worst be blacklisted for good.

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apothecarynow@reddit

Tocilizumab?

True. Inaccurate medical records can cause a lot of downstream consequences. Hopefully that got sorted out for you.

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physihoe@reddit

Its worth noting that this is primarily for Americans and other places with insurance based healthcare. In Australia, the UK and most of Europe having a risk factor on file will not cost you any more money.

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Another thing I would add is that if you are nearly 100% that you have an illness and they make you fill a test, try to exagerate a little bit.

My experience with sleep apnea: I was super sure I had it. Friends told me that it seemed like I stopped breathing. The doctor made me fill a test. Do you fall sleep when taking with others? In a car? I'm an anxious person, i can be super tired and be awake all the time. So they said I didnt get the points to considerate testing. I insisted, in another place I put higher number in the situations of the test, they made me the test and... Surprise, surprise! I do have sleep apnea!

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ilovekittensandpuppy@reddit

Am a doctor. We do this to get our own colonoscopies early.

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Numerous_Birds@reddit (OP)

You’re not the first person to tell me this lol

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mikehocalate@reddit

This is not only unethical, it is stupid and dangerous.

You’re trying to manipulate the doctor - a professional whose job it is to consider all possible diagnoses (including rare ones) into considering more likely the diagnosis you, a non-professional, are worried about. You’re risking inappropriate testing (potentially harmful and unnecessary testing) by misleading the doctor. Instead of playing these games it’s much more effective to just say, “do you think it could be colon cancer?”

You say to avoid lying about symptoms but suggest lying about family history as if that’s not as bad. That can be just as bad.

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fastates@reddit

Spoken like someone who's had clear sailing his entire life through all medical systems.

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mikehocalate@reddit

No, sounds like someone who understands how dangerous it is to mislead your doctor into getting tests that are most likely unnecessary. OP is right that doctors think about probabilities, but that is not just how likely a diagnosis is, it’s also how likely a test is to cause harm. So if a diagnosis is highly unlikely, and the test might cause harm, they may not recommend the test.

Taking OP’s example: imagine the doctor is thinking hemorrhoids and nothing suggests colon cancer so they decide the risks of colonoscopy outweigh the likelihood the patient has cancer but the patient lies and says they have a family history of colon cancer. Now the risk increases they order the test and the patient gets a colon perforation during the procedure. If all the patient had was hemorrhoids, the doctor just caused significant harm by ordering an unnecessary test.

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Wavydaby@reddit

You can also state that you want it written in your chart that they refuse to test for xyz.

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robdalky@reddit

This is shit advice.

Determining if rectal bleeding is hemorrhoidal in origin is not rocket science. I can do an exam and know whether it is or not. And if it is not, we do further investigation. The suggestion that you make up history to try and get the doctor to work up colon cancer instead suggests to me that the person suggesting this doesn’t know how to diagnose hemorrhoids.

Making up risk factors may deliberately mislead your doctor into ordering unnecessary tests, which come with the risk of complications and false positives.

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TheArcticFox444@reddit

ULPT: If you need a doctor to take you seriously, make up a risk factor

My problem is PCP and EBP. That combo missed cardiac arrest, heart failure and sphenoid sinus infection from MERSA...all in one year!

If you have been diagnosed with something unusual for your sex, age, etc., talk, ask questions, and listen to the specialist who diagnosed and treated you.

You may find yourself having to inform a PCP about your problem because they know little or nothing about it. And, believe me, that's scary!

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WoodpeckerSure2739@reddit

I like to ask them what their differential diagnosis was and why they ruled it out.

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Ambitious_Balance319@reddit

The best thing I've ever done to get taken seriously is go to a small, low volume clinic that I guess they were bored enough to actually look into stuff.

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Dr_Dubs@reddit

I am also a doctor and disagree. There are certainly bad doctors but my job is to help the whole person. In the age of the internet most patients come in thinking they know what they already have. Most of the time they are wrong because they don't know what they don't know. However, I often ask if there is something in particular that they are worried about. It is helpful to actually tell your doctor what you are worried about. Most doctors understand that the patient in front of them is human and will get the answers necessary to help that person.

SnooCrickets3338@reddit

I can't believe OP is a doctor telling people to lie about family/social history

More dangerous tests will be ordered.
These fake risk factors can be picked up by insurance, potentially increasing your premiums.
If your family comes to a follow up appointment and the Lie is uncovered your rapport and trust is forfeit.

Please don't listen to this "doctor". This guy is an idiot.

Truth means something.

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mezotesidees@reddit

OP forgot the first rule of medicine: do no harm

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marymap@reddit

I always say a friend of mine is a doctor and he thinks I might have X. The imaginary doctor friend is always a dude.

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greedy_algorithm@reddit

I do something similar but I'll say "my friend who is a chiropractor/NP/RN/med student/etc said that I shouldn't worry."

The key is choosing a credential that is below them.. that's how I finally got the MRI I needed

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bigsillygoose1@reddit

Yo this is brilliant

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rick157@reddit

This is terrible advice (Am an ED NP (filling similar role as resident or PA) in one of the busiest ED’s in the country).

Your example of blood in the stool and differential diagnosis of hemorrhoids of colon cancer doesn’t hold water, all of this can be determined with a physical exam and then a follow-up with GI. You’ve completely neglected to mention any kind of information gathering that goes on, even something as simple as “How much blood? In what quality? What color? Clots or flow? How often? What’s your diet like? Ect.”

I’m skeptical of your claim that you’re an MD.

No one makes a diagnosis without data to support it, and I don’t know what field you claim to be in, other than “I’m a doctor, trust me bro”, but this is not how it works. You will not get a colonoscopy in the ED if you are claiming blood in stool and family history of colorectal cancer; the ED is not equipped for that, it’s just not what we do. It requires several different departments coming together to make this happen, which is why it’s scheduled, and which is why not everyone receives a colonoscopy at the drop of a hat, it’s a large assembling of resources and disciplines for what appears to be a standard procedure.

If we get a 24-year old with no cardiac history patient presenting with chest pain, it still requires a thorough physical exam and assessment, blood work, chest imaging, and an EKG is one of the first things that will be performed, of course, but it’s about risk stratification. What are the chances that a 24-year old without any cardiac history, without any symptoms is having a cardiac issue? Pretty low. Not zero, but low. If that EKG looks good, chest xray is clear, and cardiac enzymes are low or zero, we can safely rule out a cardiac issue, because EVERYTHING leaves a fingerprint.

If a patient is reporting exacerbation of heart failure, there will be signs you can’t just “make up”, like fluid retention, decreased activity tolerance, crackles in the lungs, etc. You can’t just claim these things, there are always signs and symptoms.

Medicine is transitioning to a 3.0 type environment which is a good thing…maybe a bad thing for me, but if it gets people healthier in general I’m for it.

Enough of the idea tho that doctors are here to only keep you sick or to gatekeep or that we get kickback from insurances. We just trying to live y’all too and with midlevel providers creep and continuous criticism about the bs that was created from old medicine narratives, don’t be surprised if there are less and less docs training in general

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burtmacklin15@reddit

The AMA is still over-limiting med school admissions to ensure that doctors will always be in demand and paid very, very well.

You may not have an ego, but with that nonsense still going on, there are many who will.

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mezotesidees@reddit

Where have you seen the AMA pushing for limits to med schools? Last I heard they were trying to increase residency funding.

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fastates@reddit

Literally no one is surprised. There's a shortage of Veterinarians also. ? No surprise.

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MLB-LeakyLeak@reddit

I’m less empathetic at this point.

You want me to CT your kid? Well the risk of a management changing finding is 0% with a p of <0.001 and the risk of cancer is 1%.

Ok, your choice.

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funny_3nough@reddit

This is helpful advice for patients but also speaks to an opportunity for the medical community in the current AI-is-coming-for-all-our-jobs environment.

The tendency for doctors to play probabilities and sometimes miss unlikely but critical edge cases is one of the drivers for AI to come in and replace doctors as there is clearly room for improvement.

Medical practitioners continuing to operate as per the status quo will be the first to be replaced.

Those willing to constantly improve and adapt are clearly helping not only patients but themselves.

If you allow ego to influence your decisions, and your ego is based on the success you had yesterday under yesterday’s conditions - you are setting yourself up for failure when tomorrow’s conditions have changed.

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trianglesquarebox@reddit

i am a medical student and from what I have seen so far, I agree with this sentiment. things get overlook a lot and unfortunately it's the patient who suffers

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nicholus_h2@reddit

well, often times the diagnostic pathway is the way it is because risks are being balanced against benefits. the risk of a colonoscopy in a person with actual elevated risk of CRC may be outweighed by the benefit. the risk in somebody who has lied about their history might not be.

most people, of course, don't want the massively simpler DRE to confirm the diagnosis because, well...

One thing I do is put my true symptoms in a different order if I want the doc to check something specific. For example, I get migraines. I might have extreme head pain and light sensitivity, and if I lead with that, we will talk about my migraines. If (and I’m making this example up), I also have a stiff neck and I’m concerned about meningitis, I might say severe headache, stiff neck,and then light sensitivity. All hypothetically true symptoms, just in a different order to take the conversation a different place.

I also might say something a little self depreciating like, “I know better than to trust Dr. Google, but now I need you to help me rule out what I read.”

Sad state when you even have to game your doctor and can't be straightforward. Too bad you can't order monthly ego draining on physicians.

I was married to a physician for over 30 years. It was impossible to be right in the relationship

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OlDirtyJesus@reddit

Idk man. If the more test the doc gives us the more money the hospital makes then there must be a reason my doctor is not having me tested for everything he can right? I assume that’s because there are risks with the tests.

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N64GoldeneyeN64@reddit

This is terrible advice. Family and personal risk factors play a huge role in deciding testing and monitoring. Saying you have a family history of brain aneurysm bleeds or brain cancer almost guarentee’s a head CT when you go to an ER. If you go frequently enough, you’re gonna give yourself doses of radiation that can cause cancer. Youre gonna get more cardiac testing if you have a family history of early heart disease. Thats going to take away appointments and time from patients who actually have those problems!

the next doctor told me that it was a "fad diagnosis" and that I should "stop making shit up for attention"

next doctor (a woman) actually listened and tested me. heartrate went near 200 when I stood up. she said it was clear I had it and said the other doctors I had seen were quack jerks. so yeah, sometimes you have to lead them into thinking they are just SO smart and know SO much about your body otherwise they'll call you an attention seeking overweight liar. that's with me DIRECTLY telling them every symptom and declaring that I believe they line up with POTS.

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Numerous_Birds@reddit (OP)

This. In fact, I didn’t intend to say it but this is exactly why I wrote this post. So many women have their issues ignored or treatments delayed because the doctor genuinely believes it’s more likely to be anxiety or just completely made up. You have more power in the interaction than you think!

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sylphrena83@reddit

Seriously. My daughter’s heart condition was missed for years because it was probably hormones/anxiety they said (she ended up needing surgery when a doctor that wasn’t full of himself actually listened). They missed a life threatening illness in another child until my other kid’s doctor noticed it during an unrelated appointment (we had brought this up with multiple docs and ER and all ignored us). They almost missed my follicular thyroid cancer because they were sure I was just eating too much and getting old and kept putting me on antidepressants. I have nearly zero trust left in most doctors now.

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AriGetInTheJar@reddit

dude anxiety was such a common one too I totally forgot "your heartrate is pretty elevated but you're probably just anxious since you're at the doctor"

yuh no buddy. any anxiety I have is about the fact that you're about to completely ignore the fact that I can't stand up without blacking out and act like I need a diet

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xsmp@reddit

Considering your wordcount, you add exactly nothing to the conversation, your anecdotal evidence not withstanding. I cannot speak to terrible doctors or individual circumstances. What exactly about my gender disqualifies me from speaking to the point of being specific with your doctor instead of being nebulous and hoping for the best?

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fastates@reddit

Every last woman on Reddit Earth is reading this & cheering her. You just are obtuse, & deliberately so.

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Clevererer@reddit

Some facts for your consideration:

We spend far more on women's healthcare than men's.
We've made far more progress improving women's health than men's health. Look at diseases morbidity rates for any disease you can name: Women have made more progress than men.
Women are living longer healthier lives than men and this gap has been growing for nearly a century. Yes, women naturally live longer, but even factoring that in, it's still clear that modern medicine is benefitting women far more than men.

Only a dishonest person wouldn't agree that women are by far the biggest beneficiaries of our healthcare system.

That said, yes, it's frustrating when your concerns aren't taken seriously. It's almost as frustrating as constantly being told that the system is, still, somehow, against all data and facts, unfair to the group it most benefits.

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silentstone7@reddit

Do we spend more on women's health because of reproduction? Women not dying in childbirth seems to support all your points, statistically.

If you removed pregnancy from the equation, how would those stats change?

I don't think women are saying the system is unfair toward women, fullstop. Rather, I think it's more that a woman is more likely to have specific self reported symptoms dismissed as weight, anxiety, hysteria.

If a man and a woman both show up with a cut, they will both get stitches. The issue is that sometimes the man may get more pain medication because the woman may not be believed. The medicine isn't biased, but some providers can be.

A lot of minority people or people with rare conditions get ignore by doctors. Dentists refuse to believe that their "good drug" don't work well on me, and I bite down when something hurts. A lot of people in my family are anesthesia resistant in a sort of strange way. The assorted members of my family that are odd don't really get knocked out by drugs. Instead, we lose the ability to care. My grandpa was aware enough during an open heart surgery to insert a pace maker to feel them cutting into him and make a nurse scream by sticking out his tongue. He just didn't really care or feel pain. He was just aware. It is and was always a struggle to get doctors to believe him. It is worse for me as an autistic man. I can't convince doctors that their drugs don't last as long and I can go from just fine to biting down in pain with little to no notice because i dont get numb, i just stop caring after a certain point. Instead, I just get told the practice has good drugs, and after an incident, I just get passed to another practice.

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ClairLestrange@reddit

Do you/your relatives have red hair by any chance? There are some really interesting studies linking red hair with a resistance to anesthesia

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JustLookingForMayhem@reddit

Brown. Which really doesn't help the argument.

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AriGetInTheJar@reddit

YES WITH THE AUTISM I've been told that I'm too calm or too researched and I'm clearly medication seeking

Part of the problem as a woman is that butting your head up against a system that minimizes the significance of the symptoms you report and repeatedly routes you to ineffective treatments leads to giving up on getting your problem treated at all, leading to more suffering and complications down the road.

I had a tricky left hip for much of my adult life which got much, much, worse during and after pregnancy. I rarely slept more than 90 minutes at a time because of the pain, and I often felt that I was at risk of falling down because of sudden bolts of pain and weakness in my left leg when I moved.

Time and time again, doctors would send me for PT and/or prescribe me high doses of NSAIDs, steroids, or even opiate stuff like Vicodin. None of it was helpful.

I broke down in tears at one of the visits when yet another doctor wanted me to do physical therapy. She then suggested group therapy for parents of kids with disabilities, attributing my anguish to my son’s autism. I mean, what the hell? After that humiliating encounter, I decided that no doctor was going to take me seriously, so I avoided talking about it for years.

When I finally mentioned it again to a new doctor, she sent me for x-rays. End result? Referral for a hip replacement tout de suite. Yay for the happy ending, but if I had been taken seriously much earlier, I wouldn’t have spent years in such excruciating pain that lifting my left foot off the ground even a little bit made me feel like I was going to pass out.

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AriGetInTheJar@reddit

THIS THIS THIS

eventually you get so fucking tired of being treated like you're making shit up and being "treated" improperly that you just give up

then it snowballs into so many other problems and if they had just listened the first time none of it would've happened

Pat_G_Rilley_IV@reddit

I forgot what they are already...

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DuffleCrack@reddit

Bingo

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Rakhered@reddit

Tbh I don't really want to diagnosis coach because that could get hairy, just lurk r/ADHD for a bit and you'll get a good idea

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fletters@reddit

I don’t think that’s what OP is describing, though? They’re suggesting that you start the discussion with “my [parent or sibling] has [disorder/condition],” which raises the index of suspicion and might cause a doctor to run a test they might not consider otherwise.

Running through a checklist of symptoms you memorized in advance is a different thing, and seems much more likely to backfire.

(ADHD is highly heritable, btw! And speaking from experience, the right meds can be life changing.)

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WRXminion@reddit

I had to do this exact thing. I was complaining to my doctor about stomach issues, not feeling like I had gone after going, having bloody stools every once in a while and had been reading about an increase in colon cancer in younger people. So I asked to go see gastro, he said I'm too young for that and not to worry about it.

I went to a friend's party and he had made some reaper / pyramid pepper infused tequila. I used to love spicy food, but due to the stomach issues I had to cut back. But wanted to try his tequila. It was a mistake along with all the high fat foods we had been eating.

I had diarrhea for like three days and caused a hemorrhoid from going so much, and had blood from popping it while whipping. I called my doctor up and told him I had been shitting liquid blood for three days straight and was worried I had a fissure or something. When he asked how much blood I said how much I had been going which was a pint or more but couldn't tell how much blood. He got me an appointment with a gastro like the next day.

Most doctors know fuck all about celiac.

https://celiac.org/about-celiac-disease/screening-and-diagnosis/diagnosis/

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ziostraccette@reddit

Oh 100% your liver would be better

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OptimismNeeded@reddit

How long does it take for Mets to develop from the colon to the liver?

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Mental-Temporary2890@reddit

Yeah sure that might help if the rheumatologist and nephrologist i saw actually cared and would diagnose anything. Now I'm walking around with ulcers on my gangrene toes as a 34 or old woman being told by any doctor or nurse or anything that I need to see rheumatology as soon as possible so I dont lose my toes, but the one I saw laughed me out of her office. So this doesn't work. Nice try.

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ExtremisEleven@reddit

Lying to your doctor is how you get unnecessary medical procedures with very real risks.

If you want to die from an infection that occurred from a biopsy you didn’t actually need, feel free to lie to your doctor about your risk factors.

Doctors can recommend extra tests if there is cause. This might be useful for people with serious issues however could abused by somebody with health anxiety.

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Bitter_Cry_625@reddit

I’m a doctor. This is stupid. Just tell me what you’re concerned about and we’ll test for it. Play games and lie to me and you’re getting fired as my patient.

Hope this helps more than this shitty advice.

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Classic_Oven_756@reddit

This is honestly so pathetic. I understand the post and I get that it is well meaning and you want to help people actually receive medical attention… but this is so insanely tone deaf. This behaviour has been so wide spread and well known that you’re really just saying the quiet part out loud. We know. We live in this reality. We watch our loved ones suffer and die… while also suffering ourselves. Time for the doctors to actually do some self reflection and inner work. Go hold your colleagues accountable or something. We’re sick of being handed solutions that require us to have to constantly cater to and walk around on eggshells to protect the egos of sad fragile men. Stop expecting us to do all the work for you because change and account are hard.

Your post or comment was removed for violating rule 1: Tips must be unethical, tips that are ethical will be removed.

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neverendum@reddit

There needs to be a term for this kind of manipulation, I find it very effective. Similarly, I have to deal with government wonks who come to check stuff before giving a license etc. It always works for me to give them a nice easy 'find' and they're happy. They feel like they've done their job and it's always something that's an easy fix for me.

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Dog1234cat@reddit

Sometimes this trick goes sideways. https://youtu.be/BNlyZSvsNjw?si=n1mjXfYjqeLiWk2F

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kittehcat@reddit

You: doctors are narcissists who won’t take you for your word if you suspect a cause for your symptoms Also you: trust me I’m a doctor

Sure, Jan

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YaIlneedscience@reddit

On top of this, say that it has “compromised your quality of life” and if they refuse to do a specific test that really should be done to rule something out and is fairly simple and within their office’s ability to do, ask them to document their refusal, and ask for a copy of your records from the visit.

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Also a doctor. This is a TERRIBLE idea. The OP's suggestion to about one's family history so that someone can get pushed into an invasive test that they likely don't need is just insane.

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SkisaurusRex@reddit

Wow wow wow

This is so refreshing to hear coming from a doctor. I’ve thought so many of these things over the years.

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ArbitraryMeritocracy@reddit

That's wild, I told a doctor my mother had cervical cancer and she refused to give me a pap smear and then she molested me.

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Heavy_Hall_8249@reddit

Genuine question: What is the difference between “make up a risk factor” and lying?

That said, I agree with the spirit of the post— patients not taken seriously because of probabilistic diagnosing taken too far.

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Mobile-Buy-4000@reddit

This is how you add more money to medical waste for unnecessary testing

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boostedjoose@reddit

found the ceo of medicare

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OutrageousAd9576@reddit

This is more than unethical it is downright stupid. Are you really a doctor?

Thanks for this ULPT

My symptoms had major negative consequences for my life several times.

Tbh, I added "missed all lectures, can't wake up" etc to my messages last time. But I guess I gotta add up drama next time I am dismissed(Scandinavia, they are too chill to care). E.g. could have said "I missed an job interview and am jobless"

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Fit_Back_2353@reddit

“Lie to your doctor to potentially get unnecessary test raising your anxiety, out of care healthcare cost, and overcrowd a already overcrowded medical system with BS by lying” - you should give up your medical license if you are telling patients to lie to there doctors. Any doctor worth there salt would do a rectal exam on someone presenting with hemroids and if nothing what there would go to more invasive testing, you are a pos and giving bad advice

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Ruzhy6@reddit

What exactly are you a doctor of?

This is incredibly stupid advice.

You're advising patients to basically Google diagnose themselves and then add in fictional information to an actual doctor trying to diagnose them.

Your little edit at the end does not save your post either. Like people will listen at that point after you just told them to get what they want, they should lie to their doctor.

For anyone listening

The real LPT? Be honest and share your concerns with your doctor. If they refuse, request documentation that they refused requested testing.

Probabilities go out the window when it comes to liability.

Yeah just don’t do this it’s not how doctors think

-a doctor

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dudsmm@reddit

Also, the Dr needs to convince the insurance company to cover the procedure. For colonoscopy under 40, it is often not given unless the Dr. fights for it. And more data, like higher risk factors, is important.

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Intelligent-Guard267@reddit

With all due respect this seems like bad advice.

I was in my 30s and had blood in my stool and decided that I had ulcerative colitis based on my urgency, stool consistency, and blood. Called doctor, had appointment, discussed symptoms, at conclusion of my discussion I said ‘I believe I have UC’. The doctor concurred and scheduled follow up labs/colonoscopy.

In your edit: “please DO NOT lie” All your post is about lying to a Doctor. (Just this is going to get a lot of unnecessary tests and treatments that is not needed, lots of lost money and could be dangerous to patients)

Greetings to you from another doctor

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SeattleTrashPanda@reddit

Bring up the relative but also when they ignore you, ask them what their differential diagnosis is for eliminating your concern. Whatever they say, tell them you want it notated your medical records.

Doctors would rather run a couple exclusionary tests than write down anything they might be accountable for later.

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RUStupidOrSarcastic@reddit

That’s literally already being done by the doctors for every single patient in the ER, but alright.

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SeattleTrashPanda@reddit

In the ER maybe, but as someone with a chronic illness absolutely not with every GP, PCP, and specialists. Those fucking notes were the only way most of the doctors I’ve ever seen took me seriously, my condition and my symptoms seriously. One ounce of possibly accountability and all of a sudden doors and tests magically became medically necessary.

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Dear_Gas9959@reddit

I love this. My tip is to quote diagnostic criteria. This works great for psych. I don’t say what I’m experiencing in my own words, I say some of the medical jargon I know they’ll recognize from the DSM. This usually results in them taking me seriously.

Do you believe in evidence based medicine?

lan60000@reddit

OP is a doctor, but cannot fathom why doctors are getting inpatient with their patients, which is due to excessive lying or adding too much information because they searched up WebMD or Mayo clinic and immediately assumed they have cancer. This is part of why doctors stop taking people seriously because of the excessive ignorance being presented by the patients. Also doesn't help when a patient goes in and somehow expects a instant miracle to be performed, and when their expectations aren't met, these people leave low Google reviews out of spite. Stop giving medical professionals more reason to believe people are idiots and they'll not treat you as one.

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brisbanehome@reddit

It’s remarkable how naive OP’s assumption is, that most patients know what a reasonable differential looks like before seeing their PCP, and can therefore strategically lie to get the “right” tests ordered. Just from this thread, it’s obvious the average person has no clue how to frame a differential appropriately. I pity those encountering patients that read this post demanding unnecessary investigations because “my family has MS” or “my uncle had brain cancer” or “my brother had an MI at 30” etc etc etc.

Over-investigation carries real risks, and it’s concerning that some doctors still don’t seem to grasp that. I suppose I shouldn’t be surprised, I do work with a few morons like this.

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lan60000@reddit

There's a line a doctor said that I could never get out of my head, and it revolved around the idea of full body MRI's. The line basically went as follows:

Full body MRI's are often not recommended for routine check-ups not only because the procedure is usually extremely expensive, but there will be so many "abnormalities" being shown that doctors wouldn't be able to focus on what's ailing the patient the most.

Ohh how about this if I want to get a once in a decade full panel: https://my.functionhealth.com/

Will probably cost 10x that much if I do through Labcorp

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scapholunate@reddit

gif

MFW I’m in Clijic and some mofo has a “strong family history of low testosterone, ADHD, and intractable pain that only responds to opioids”

This was not the thread I needed to see after another interminable day in primary care. Good luck, everybody.

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ExtremisEleven@reddit

Right? Like cool, you clearly obviously lied to me, insulted my intelligence by thinking I wouldn’t be able to tell and now I have every reason to think you’re just full of shit because what else are you lying about. Absolutely nothing about the workup is going to change because these things were already on my radar and now I hate the fact that I have to be in the room with you…

Congratulations?

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parkexplorer@reddit

Ugh why is the patriarchy so exhausting

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plaesma@reddit

this is how nurses communicate with doctors, obviously don’t make stuff up but we quickly learn to word things in a way that doesn’t hurt MD egos to get what we want

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StBernardMississippi@reddit

“I wasn’t concerned, but I mentioned it to my uncle who’s a insert specialist here in insert another state here and he thought it could be insert thing you’re trying to get tested for here”

Also works well.

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Xandara2@reddit

This works twice, the third time you cry wolf you'll be left to get eaten.

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AztecGodofFire@reddit

My mom was a nurse and she said never tell a doctor what you think it is because out of pride they'll insist on diagnosing something else.

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ExtremisEleven@reddit

I’m an ER doctor and I always ask what people think it is so I can address their concern, but go off I guess?

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kex@reddit

Just tell them you are having trouble with being productive at work and they will give you anything.

That's all this society cares about anymore.

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ExtremisEleven@reddit

So this works because it puts it into a context that everyone understands. If something impacts your ability to do the things you enjoy, your work or your activities of daily living, that is very useful information. It tells us about the severity. A lot of complex complaints get brushed off because we aren’t able to clearly communicate to what degree they’re bothering us.

For example, people commonly complain of fatigue. I’m fatigued all the damn time, but I’m still able to do what I need to do to function. The workup for that is maybe a few blood tests and some lifestyle counseling (like putting my phone down right now so I can sleep). But if I’m so tired I am missing work which is not like me, I’m falling asleep at inappropriate times I probably need a bigger battery of blood tests, a sleep study and maybe a visit with a psychiatrist to see if I’m depressed.

Doctors are human too, sometimes they just need to hear things in a different way to make the symptoms understandable for them. So please, for the love of god, include the things that your symptoms limit you from doing and don’t lie about your risk factors.

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nerdinmathandlaw@reddit

I learned that ten years ago when I got into a squat where some people had scabies. Part of the education about those little fuckers was to tell the doctor that you are a) homeless or b) working closely with homeless people or in refugee camps. Otherwise they would think it's a soy allergy even with the most typical scabies rashes.

Same for STI tests: In Germany, the Public Health Office (Gesundheitsamt) will test you for free, but they will only test you for everything instead of the most common few things only if you say that you or your regular partner is a sex worker.

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DnDGamerGuy@reddit

This is extremely dangerous to your health. You’re essentially attempting to lead a doctor to the answer you want.

Which..you do not have a medical degree. So you don’t know if you have that illness either.

You could potentially end up paying hundreds/thousands on tests you don’t need or causing doctors to come to the wrong conclusions about your health which may alter their differentials.

For example—your issue could actually be an entirely different serious problem.

But because you muddied the waters with a bunch of false information you never get properly diagnosed. Possibly leading to your death.

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Intrepid-Plant-2734@reddit

This is 💯 true, and makes me completely furious (though I absolutely appreciate the OP and his or her self awareness in posting).

From a family of doctors, and science background with medical issues. I have an advanced degree in another field. I’ve been forced to diagnose illnesses of my family and my own, and even with objective evidence, have been dismissed by doctors until I either have a (not relevant specialist) physician relative with me, or find one I can walk through it who can then believe they “figured it out on their own.”

They dismiss lived experience as being factually inaccurate.

This is why I’m helping and funding the builders that replace doctors.

They are too full of bias to diagnose properly or understand appropriate treatment.

American medicine is full of students who are risk-averse, ego-ridden teacher’s pets, taking the safest possible route to perceived success and prestige. They are extremely rule-bound, and believe anything outside those rules to either be nonexistent or bad.

They cannot conceive of worlds outside their own experience. If it does not seem so to them, it must not be. Think horses, not zebras, right?

It never occurs to them there are dozens of other common four legged animals, from cows to dogs.

No. The choices are only horses or zebra. That’s how this works. Doctors consider only horses or zebras, so don’t come in here suggesting it might be a cow or a dog or a pig - nope. None of those exist.

They know nothing about patients or patient care.

AI also doesn’t care about patients, either, but it has lower error rates, and can be created with reduced bias and no arrogance.

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Royal-Pistonian@reddit

How worried should you REALLY be I mean it’s just a little blood in stool for a couple years. N happens almost all the time I mean what’s the worst that’ll happen

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ReverseMillionaire@reddit

I had to exaggerate pain to get an MRI

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BakedBrie26@reddit

Counter-point: how a doctor responds to suggestions is telling and the good ones DO in fact hear you out and make sure patients feel like they have a voice in the process.

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LaForge_80@reddit

This is so sad.

I am an engineer. I work to improve processing and efficiency at a factory. One thing that helps me considerably is when operators tell me a problem and tell me what they think would correct it.

I work to improve processing for multiple production lines. I spend time at my desk researching and time at the lines testing, talking, and learning. The people that know the lines best are those that run the line and/or that repair them directly.

How arrogant would I be if requests for improvement had to be by suggestion, instead needing to be tricked into thinking these ideas were my ideas.

I'm humbled every day by learning something new. Maybe I know some things they don't. I'm certain other people know things that I don't know.

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Taziira@reddit

It sucks but I think of doctors visits like interviews.

Practice what you’re going to say. Write down important points so you don’t forget them. Approach it like you’re trying to convince them of something - whether it’s a test or diagnosis or whatever.

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Steve_Dobbs_69@reddit

I don't trust my patients.

Source: I'm a doctor

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brad_sausages@reddit

Unfortunately, using family history doesn’t always work. Nearly every female on my maternal side was diagnosed with hashimotos, which I told my (former) dr. My tsh indicated hypothyroid and I had a myriad of symptoms indicating Hashimotos but she refused to run further tests or even medicate the hypothyroid. It wasn’t until I paid out the ass for a weight loss specialist that didn’t take insurance that I got diagnosed and she was horrified that the gp had just brushed off my lab results.

What HAS worked for me in other instances was “my psychiatrist would like to looking into the possibility of —“. Instant appointment with my current gp and referrals to specialists, even though I had brought the condition up in prior appointments and had been tracking/logging my symptoms for over a year. But now another physician is concerned so it’s worth looking into.

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Zalophusdvm@reddit

This is dumb.

It’s not wrong. But, as you point out at the end you shouldn’t make up symptoms, prior tests etc….you really shouldn’t be making up key details of history either. And…while the example you gave is a potentially ok line to cross…the average person has NO IDEA how to find that line.

Not to mention most people are bad at running their own differential so the average person is just as likely to accidentally send the doctor off in the wrong path as they are to help them along the right way.

This works great if you have at minimum some basic medical knowledge, then you’ll be able to pick out the correct key phrases to hit hard or add to your story that tip the doctor in a correct direction WITHOUT lying but rather preventing your own case in a way that you know the doctor will hear the way you want.

For the average person: if you’re concerned about something don’t lie to your doctor. Instead TELL THEM YOU’RE concerned about something. Tell them you’d like to be tested for your concern. If they say no: Ask them to explain IN DETAIL, why they won’t do a test or follow up on your concern if they refuse. If they are dismissive or don’t answer to your satisfaction, TELL THEM YOU FIND THEIR ANSWER UNSATISFACTORY AND THAT YOU’RE STILL CONCERNED. Don’t tell them they’re wrong, don’t tell them what to think (like this guy said, lots hate that) but DO keep asking questions.

Ask them what the harm of testing for something is vs the harm of the thing you’re worried about. They work on probability and trying to reduce harm…that question will get them thinking that maybe if you’re gonna be pushy…it’d a better CYA move to just order the damn test.

If you find your doctor to still be dismissive and flippant, get a new one.

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DFW_diego@reddit

gif

Worst case scenario : the doctor might stick his fingers up your ass!

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Aware-Top-2106@reddit

As a fellow doctor, this is a terrible fucking idea and a great way to get exposed to a ton of tests that are not indicated, may be costly, slow down the healthcare system for other people, and which may potentially put you at risk of harm.

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cringepigeon@reddit

Haha luckily I didn’t need to lie about my mom dying from colon cancer in her thirties 🥲

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Thefriendlyfaceplant@reddit

This is brilliant.

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I agree it’s 1000% more necessary for different groups of people, btw! Big fan of your comment!!

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Rough_Dream_2457@reddit

I’m unbelievably jealous. I can’t imagine the kind of life I would have lived if my doctors had properly treated me (or believed me at all).

I might have been too invasive into their job, but I was very polite (less so, once they talked me off) and concerned about my state. I had that ring growing on me already for a week or two. And I took my state very seriously. I am in no means a hypochondriac. But that case was quite obvious and I needed a prescription.

I should have used less knowledge and only explaining what symptoms I have, possibly not using their scientific terms. I do know that some people tend to use Dr. Google and annoy doctors. But some people actually know what they are talking about. When it comes to someone's safety, a patient's case should be considered as possibly being true.

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dckill97@reddit

Could you not get any desired tests done on your own?

Here in India, I can schedule tests through an app, and a phlebotomist will come to my home to collect blood or urine samples.

Then I get the test results by email or WhatsApp.

As a doctor myself - just one point to add.

As you said - haemorrhoids in your example are more likely than cancer - so most healthy 30 year olds who try this should be ready to have a colonoscopy (uncomfortable) and have any and every little polyp removed and biopsied (which can cause bleeding and has a small risk of complications), to eventually be told it's nothing/just haemorrhoids, etc. you'll also wait weeks between the colonoscopy and the biopsy results (anxiety inducing).

Yeah eventually you'll likely get piece of mind but it'll be a journey to get there, with some small risks attached. Just something to consider.

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seasav29@reddit

Yup!!! This!!!!

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Significant_Lab_5177@reddit

fucking doctors man, they need to more fucking humble,

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It’s so much less work to order tests than to explain why they’re not indicated.

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RageTheFlowerThrower@reddit

And this advice will totally fuck you over when you apply for a life or health insurance policy.

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broke_velvet_clown@reddit

Thanks doc. Also I guess I have been graced to have good docs, granted they're ex military and own their own practices, so we get along fantastically. I'm the one asking them if I have to be worried about "x" and I hear back "already tested for it, your fine" ok cool but I have an uncle who.."nope, checked that too". I was concerned about my blood pressure being high one time and my doc was absolutely flabbergasted because it was healthy, but I'm used to it being 5-10 points lower e.g. 110/70 and I get back "yeah well, you're getting older, shit breaks down". 10 of 10 stars doc, see you in 3 months.

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C_Wags@reddit

As someone who also completed an internal medicine residency, this is such a disingenuous characterization of how we take a history and assemble a differential.

Using your specific example, if a young patient comes in with new blood in their stool, we do not simply assume it’s hemorrhoids based on age and probability. We’d ask specifically about the volume and presentation of the blood (mixed with stool? Blood on the toilet paper? Filling the bowl? Painful bleeding or painless bleeding?). We’d ask a targeted ROS looking for things like weight loss, change in bowel pattern or stool consistency/caliber. We’d ask specifically if there was a family history of colon cancer. And we’d perform a digital rectal exam. Any PGY-2 would know how to take this history.

Then, we’d synthesize this information to determine if a diagnostic colonoscopy is indicated, and worth the risk of the procedure, which includes perforation as well as potential complications relating to anesthesia.

(You know all of this. This is for the benefit of anyone reading these comments.)

My situation was a PT, so not a Doctor, but he did sleep on a proper diagnosis like a holiday inn bed. I learned a valuable lesson right before college about letting dismissive medical professionals override what my body appears to be telling me.

Foolishly played 1 season of lacrosse for my horrendous HS team. Got hit from behind, fell directly on my shoulder and proceeded to have persistent shoulder and neck pain for weeks that started to affect my neck mobility and literally innocuous things like laying down to sleep.

Went to a PT who's practice treated the local MLS team and other local Pro Teams and he quickly diagnosed muscle trauma in my shoulder and put me in PT sessions. After a month of muscle work that in fairness, got a ton of mobility back, I saw zero improvement on the pain. Pain that clearly wasn't from a muscle strain because even though it was chronic, it was also sharp, and like no other muscle injury I'd ever had before.

I voiced this to him and asked if it could be something else, specifically if it could be bone or nerve related. He shut me down in such a curt and condescending tone that I still remember the feeling of being speechless at how thinly veiled his borderline disdain was at even having to respond to me, and how obvious it was that he just saw me as a collosal moron.

Sage advice! I'm able to convince multiple doctors to catheter me on a weekly, and at times even a daily basis

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iloveihoppancakes@reddit

While yes i do agree,

When my wife was sick i worked tirelessly on chatgpt to get every single symptom tracked and charted for myself. Once it got to the point where she finally agreed to go to the doctor, i printed out everything i had tracked, along with suggested tests and possible diagnosis.

MNP_cats@reddit

I only got a crohns diagnosis after learning and mentioning that MSH3 cancer runs in my family and that my estranged close relative had just died from it. I got a bunch of testing done real fast after that! (Including genetic, I am a carrier of MSH3)

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nap4lm69@reddit

My dad (64) was just diagnosed with prostate cancer. I know it's pretty much every dude in the world dies with some stage of prostate cancer, but his was bad enough to need surgery and all.

Man, I just scheduled an appt with an RN and the office called me back to ask me if I could reschedule to an earlier time. I asked what was available and they said pretty much any time since she had a very open schedule.

I scheduled it for my lunch break and headed out there. She saw me for all of 5 mins and left. No follow-up questions, very casual and nonchalant, added her notes and left.

Seriously, I think I'm overselling 5 minutes, it really felt like less.

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Aruaz821@reddit

Jesus, this makes me so thankful for my doctor. She’s completely open minded and is very willing to take direction from me.

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Harvest827@reddit

My doctor's dismissal of my desire to talk about treatment options is the reason why I only see his PA now. She listens, she engages, she acts. And when it gets out of her scope, she actually directs me to other professionals in the field. I haven't seen him in 6 years.

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SoMass@reddit

With this said. Please keep in mind health insurance and life insurance insurability.

They will 100% use information like this to straight up deny or have higher prices. Use OP’s advice wisely, don’t be a hypochondriac. It’s good advice if used properly for real concerns you have.

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GibbsMalinowski@reddit

Make up risk factors, but don’t lie……how about patients say what they want and we find ways to get it if needed.

I cut to the chase, male patient has this little thing as I’m walking out of the room done with the visit after he’s not interested in any preventative/screening/labs he wants to just mention before I go

You want viagra?

Yeah how did you know.

Ask, don’t list demands and making up risk factors is lying.

Also all meds have side effects and all procedures involve risk so careful what you ask for you might end up dead sooner than you think from a medical error

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xxvcd@reddit

Saying that something runs in the family makes it more likely to gets tests, too

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benicebekindhavefun@reddit

Saying that something runs in the family makes it more likely to gets tests

Someone didn't read OP's post apparently:

casually add in that a first degree relative (parent or sibling) got diagnosed with colon cancer just a little above your current age.

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vodkawhatever@reddit

Thanks Doc.

Lol except let’s say that you lie and say that your mom had colon cancer at 40 and you’re 30. And now after the colonoscopy, even if it was completely fine, the GI doctor is going to say every 5 years you need a colonoscopy instead of the normal 10. If you lie about the number of people in your family with cancer, your PCP may want to send you to a geneticist to look for genetic syndromes that are associated with multiple cancers. Point is, sometimes it is difficult to know what to lie about.

Definitely less risky than lying about symptoms, though.

Source: also a doctor.

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1fastRNhemi@reddit

Best to make the docs feel like they thought of it themselves.

Can confirm, am nurse.

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Glum_Improvement7283@reddit

You're a doctor but talked about what dx is most likely vs. a differential dx?

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Semi_Flaccid_Penis@reddit

What about if I want to go out on disability? Would I come right out and ask? Is there a better way to go about it?

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pines6103@reddit

In my opinion, this only serves the patients' peace of mind and potentially subjects them to unnecessary and potentially harmful tests. After all, all medical procedures have risks.

It may not reduce the time for correct diagnosis.

I will not be following this advice.

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Ilovepottedmeat@reddit

Well this tip will apply very well to discussions with my wife. Give her the bait to make it her idea and it is golden. Give it as my idea and it gets shut down. Well what was that about a doctor?

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burner118373@reddit

I have deep bone pain that wakes me at night. That a big deal?

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diagonali@reddit

And here I thought we were dealing with rational qualified objective scientifically trained experts.... Turns out they're just.... Humans like the rest of us.

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bandwarmelection@reddit

this reminds me one time i said to my doctor i have alan turing with other men and he immediately assumed i was risk for aids

edit: sorry, i meant alan turing but autocorrect changed it to alan turing

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ReliefAltruistic6488@reddit

Even your edit doesn’t make sense…

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SuspiciousStress1@reddit

Oh, I had one doc that was so hellbent on finding a unicorn he missed my MS 🤣

Then had the next who decided it wasnt MS & when he didnt like the results of my EMG, he pushed the probe 2-3" into my skin so the results would be "normal" 🤣

Took me 8y to be properly diagnosed(not all their fault, I have PPMS, so the "normal" brain MRI was useless).

So while your tips are good, they dont work with all docs 🤷‍♀️ sometimes you just have to find a new doc that will take you seriously!!

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CptMuffinator@reddit

Source: I'm a doctor

I'm skeptical given you think hemorrhoids are going to have similar tones of red for bloody stool given blood in the colon itself will have the water content absorbed resulting in a darker tone.

Hemorrhoids or anal fissures will have bright red blood because the colon isn't able to absorb the water in the blood.

Frequency of the blood is also a significant factor, a few days points towards harmless causes.

Source: I take fat shits that cause regular bloody stool and have talked with my doctors in-depth to ease my own concerns. Bonus I got finger banged to rule out prostate cancer.

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adventurous-yorkie@reddit

Omg, no shit, women do this to men all the time.

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Empty_Netterberg@reddit

This is awful advice.

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Paolito14@reddit

I’m a doctor and goddamnit this is such stupid advice.

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docktardocktar@reddit

I have to disagree, I would rather someone’s tells me the history, without lying, and then tells me what they’re worried about.

I hear what you’re saying, and I agree some colleagues are incredibly confident despite poor diagnostic (and interpersonal) skills but it’s not helpful to add incorrect information to the mix.

Genuine question: Do you think the average person has the biomedical knowledge to accurately identify key risk factors, select on those which would not skew the diagnosis massively, and weave them into a history in a convincing and replicable way.

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SwimmerDad@reddit

I did exactly this earlier this year.

Spent the last 6 years being told I had anxiety/depression driving my reoccurring sickness because I was an athlete and looked healthy. Turns out Ive had misdiagnosed Cystic Fibrosis my whole life.

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Watch_The_Expanse@reddit

I, a man, am going to lead with that my ovaries hurt. Jk

MemeMasterJason@reddit

Ahhh have sinned against yewww

Whatta maroon.