Yes mate, it is my experience that is the problem. I would look at the research on organisational behaviour within hospitals, this is a problem with doctors everywhere and has measurable impact on people's health.
And I am fairly happy with the idea that this is particularly true in the UK because my sample is not small. Your response to this is odd in itself. Why do you think I would be convinced by what you say? Why tell me you are a doctor (I can tell you: without the appeal to authority, there is no argument)? Literally, in the post you have replied to I have said...doctors in the UK tell you straight away...it took you ten words. How little self-awareness do you have? It is comical that you actually wrote that and, presumably, had some thought that it was a good idea to say any of that (again, the only reason to think that is because you think your arguments don't require justification).
And great...you have wasted your life writing a paragraph explaining to yourself why you are a doctor but are choosing not to help someone who is sick. The significance of this to me, let alone some who is sick, is zero...again, lack of self-awareness...why write this at all? I am sure it is a nice thing that helps your self-image...you failed to prove its consequence in the real world (i.e. you skilfully explained what is but left out why it should be).
To highlight two points again. The issue with OP and my relative is that doctors are often actively attempting to prevent further care. No-one denies that psychological therapy is helpful for chronic pain. The issue is that, for most people, it isn't going to solve anything...but it is presented as the cure even when alternatives exist. Even suggesting that people could be lying or that it is psychosomatic is wrong-headed. If that is the case, then that is another condition (lying isn't a medical condition, you don't adjust medicine conditional on the probability that someone is lying). Again, there is an obsession with people lying that is truly unhealthy here and quite contrary to practice outside the UK (indeed, my experience within the UK has been, as you have just done, that almost every doctor will start talking about the possibility of lying completely unprompted when these particularly conditions are mentioned...random?).
The other issue is that this has profoundly stunted research in the UK. It is not particularly hard to find ample research on these issues. You are saying that psychological therapy is a treatment...well, read the research. Is there a known biological pathology? No. But there are possibilities (and none of those possibilities suggest the current treatment will have a significant effect...CBT, in the case of people with psychological conditions, is only effective 20-30% of the time). And is it appropriate for the "policy" to be in cases when there is no known pathology that psychological therapy (or, presumably, a lie detector test) be the only course of action? No. That isn't logical (and, again, it is why there are people who are helping people who you have actively chosen to abandon). Somewhat amazing that you go onto criticise the US system for "overdiagnosis"...so no diagnosis is better than overdiagnosis? Again...you are a doctor, right? You are just saying: I would prefer to do no work at all than hard work. Feeble, and unbelievably arrogant (it is feeble to justify doing no work, it takes arrogance to criticise others for doing work).
Truly, I hope this will help you. Stop. Think it through. Think whether what you wrote helps yourself more than other people.
Btw, it is often very clear in these cases (and in life, generally) when someone is or is not lying because lying usually requires motivation (I have never come across someone who was obsessed with other people "lying" for anything other than self-interested reasons). Most people who have these conditions have their lives destroyed...to suggest that someone is motivated to destroy their own life is just stupid. To suggest that this must be the case to cover up your own personal failings (competence, lack of sympathy, ending up in a job that requires sympathy when you only possess avarice, etc.) is something far worse.
EDIT: just to add actual info, because we are actually talking around some of the issues here...the UK uses the Oxford criteria for ME/CFS, this is a measure that was designed by psychiatrists, and has been shown to be a statistically significant treatment in samples selected using that criteria...one issue...all these studies have massive selection bias (some of these therapies wouldn't actually be possible for people with CFS/ME to undertake, imo) and the Oxford criteria wildly overstates incidence of ME/CFS (compared to Fukuda). The Lancet, a UK medical journal, continues to publish guidance that this is a psychological condition (again, not what is said above, that there are no biological pathologies...the Lancet is saying this can be cured by psychological therapy) despite the NIH (and others) showing that this is likely not the case (and suggesting that it is actually damaging research funding to suggest it is a mental condition).
Many doctors believe what you say and dismiss patients as psychosomatic if they can't find anything obvious. Sometimes they refer them to psychiatrists or insinuate they are drug seeking. It's a disgrace. This treatment from health "professionals" almost drove me to suicide.
Actually my own research got me into a path of finding out I have a rare disease and I had to pay private consultants to help with diagnosis. Only then and a threat of lawsuit got the doctors treat me seriously and I actually got help.
I'm not the OP lol, I'm just telling you that some people are off the rails delusional and it's not about withholding information at that point. Do you think that little children should be told 100% factual medical information regardless of circumstances? Do you think an elderly patient with dementia should still be trusted with their own medical decisions?
There are not easy answers to these questions sure, and one might be philosophically opposed to the withholding information route, but as far as pure patient outcomes there are absolutely situations where a lie is helpful. The placebo effect is a big one btw. Pretty sure telling a patient with social anxiety that they suck at socializing is not the right play 100% of the time.
And if doctors are worried, the first step should be doing actual tests to see if people are experiencing pain. Not making some judgement based on their cynical bias whether someone is lying or being truthful.
It is amazing how much of the medical community states they believe in science, yet they seem entirely disconnected from it at times.
edit:
I always get beat up on the internet when I make comments like this. Not sure why I keep doing it. Slow learner. In this case, I meant that it is a shame medical professionals tell folks that their issues are going to be with them for perpetuity, as in a lot of cases the medical professional is reinforcing a narrative of helplessness.
I think that needs to be weighed against the fact that it seems unlikely 1) everyone would lie and 2) they would lie regarding a health issue that has killed people, meaning they have a strong interest in doctors having accurate information so it doesn't kill them too
But it sounds like you are taking it personally. The doctors are embedded in a system and they act they way they do because their environment teaches them to, not because it is a personal attack against you.
Doctors often deal with difficult people, and it takes care to avoid one being stereotyped: boxed into a label that doesn't help one. You don't want to be labelled: drug-seeker, hypochondriac, batshit crazy, or conceited know-it-all, etc.
Use the doctors, listen to them, and treat them as people trying to help you; if you want to get treatment from them.
I have seen it from a doctor's point of view (I have seen the patient stereotypes), and I think that the majority of us would act the same way as the doctors if we were put in their situation.
I believe you completely need to be in charge of your own health solutions, and it is a good idea to explore safe variations of a variety of treatments - science works if you can be suitably objective with your measurements. But one variation you should properly trial is whatever the doctor says to.
If it is a mental issue, then perhaps:
1. Get multiple videos of yourself interacting. Humans usually suck at self awareness when it comes to the psyche.
2. If you can find someone else with the same label that has it "worse" (as per a neutral third party), then try and watch how they act and often disown/deny/distort their world. Or watch videos online and see the weird and wonderful shit our brains do to us!!!
I wish you good luck finding a solution that helps you.
>1. You pay to see a doctor. You weren't forced to. You chose to.
Yes, that they couldn't help me is not the problem. The problem is that they behaved unprofessionally and mocked me.
>2. You tell them you read about your condition on the internet. Even though the majority of the health information on the internet is utter garbage.
>3. You then get offended when they tell you to not trust what is on the internet. Although again they are 100% spot on here.
- I am 100% OK with a doctor disagreeing with me. A few of the doctors I've met I respect immensely - even though I disagree with them - simply because they were respectful in their disagreement of what I had to say and had an adult answer for me that didn't involve mockery.
- They did not tell me not to trust what is on the Internet. They mocked me and gave up trying to treat me. They became aggressive. And they still wanted to get paid even after deciding I wasn't worthy enough for them to try!
I am an expert in my field, yet I don't dare imagine what would happen if I mocked a client who asked a "stupid" question! And even if there were no consequence, I'd never do it. Why is this somehow OK in medicine?
>4. You are confused why they are dismissive of you. When you chose to see them, paid money for their expert advice and then wanted to dismiss it in favour of your expert advice. Except that your expert advice = 5 mins of Google and theirs = 20 years of schooling.
I did not dismiss their advice. I took it, for decades. You underestimate the hubris of some of these people - they mocked me even if I took their advice, simply for reporting what happened to me.
>I really do feel really sorry for GPs to have to go through this 100x a day.
Oh those poor snowflakes, having to speak to non-expert clients without mocking them!
There exists no other industry where the expert can be so ineffective, yet at the same time aggressively mock the client outright, even deciding not to do the work because the client is not to his/her liking, while still getting paid.
You have an unhealthy relationship to medicine if you refuse to even read the advice of other people. I've been treated by hundreds of medical professionals and worked with dozens and I can assure you they do not hold any secret undying truth about human health. Modern medicine is primitive and brutal, we are fumbling buffoons when it comes to the human body and its ills, especially in the realm of mental health. If you don't believe me watch an orthopedic surgeon do his work (if you can stomach the electric saws and the hammers).
> I went away to the UK. I brought my medical records from America, but my British neurologist did not read my records or perform examinations. [...] My GP read the note and informed me: He would not prescribe me painkillers. He would not send me for a second opinion from a neurologist, or treatment from any other specialist.
"Bad faith" is a vague term. Is not reading medical records evidence of bad faith? I don't know. But I'd sure feel dismissed if a doctor who hadn't read my records concluded without examination that the root cause of my problem was psychological and my GP refused to allow me to seek a second opinion.
I think you may be confusing the American diagnoses (which were of the "we don't know the underlying cause" variety - fibromyalgia, idiopathic neuropathy) with the UK diagnoses (which I'd paraphrase as "you don't have a non-psychological problem and we won't allow a second opinion").
Yes, possibly misunderstanding or perhaps I did not communicate clearly enough. My position is not extreme and speaks of the relative minority of medics who suffer from medical arrogance.
> to state that the patient does a better job diagnosing himself than the doctor does
This is not what I stated. I stated that listening to and trusting the patient helps arrive at a diagnosis more reliably than only doing tests. Sometimes it can even help arrive at a diagnosis more reliably than doing tests (for example, fungal infections can be seen or felt by patients more reliably than their cultures grow in the lab, and most doctors diagnose without a culture test).
> Medical diagnoses are made using a variety of sources of information, including of course symptoms!
Yes, but too often the diagnoses are made following algorithms or guidelines that don't suit many patients. A doctor is often required to follow the algorithms (and perhaps for a good reason), but should also know when they are not applicable to an individual patient.
My position is not extreme, although it's not mainstream either. There is a large body of research talking about medical arrogance specifically manifesting as doctors ignoring the patients. Likewise, many people in the field (at least in some regions like the UK) have experience dealing with colleagues who swear by algorithms (or worse — their own ideas) and are skeptical of patients who don't fit within them. This seems to be much less common in other regions. My family works in the medical field in Central Europe where, in my opinion, very few medics have issues with medical arrogance. I cannot comment on the US where I assume a good number of readers of this text are from, although academic literature indicates it's a global problem.
I don’t doubt everything you’re saying, and that unscrupulous physicians are genuinely taking advantage of their patients. However, as someone with a family member who was recently diagnosed with a (largely untreatable) autoimmune disease, I want to explain why patients become so desperate that they’re willing to try anything. The basic problem here is that anyone who goes online and reads about their condition (eg PTLDS) will find ample scientific evidence that there’s a real condition there — however, a huge majority of medical practitioners aren’t as caught up on the research as their desperate patients, and will often express skepticism that the condition even exists. (Note that this is different from acknowledging the condition is real and being unable to offer a treatment.) This destroys credibility in the conservative medical establishment, and makes it much easier for charlatans to make inroads, simply by acting like they believe the patient. My point here is that a little empathy can go a long way to protecting patients from this outcome.
Parent article is low quality rant with little substance. Exactly the same claims can be made of pain medications (ranging from opiates to paracetamol) but we don't get anti-analgesia rants similar to this anti-psychology stuff.
I don't think membership of BACP is important - I'd far rather get therapy from the NHS. The BACP register is accredited by Department of Health, so has some credibility. BACP accreditation means practitioners meet some minimal levels of competence, experience, and safety. (And some people lie about their registration, so that's a useful sign that they're probably not the right person to get therapy from.)
That's an interesting point, and it seems correct. You need to consider the context and background to get an idea whether someone doesn't know better or actively tells the truth.
That's often hard for me with a lot of the "out there" medical advice, where it's not immediately obvious to me that they're just scams where the person goes home to laugh at the fools giving them money, but rather themselves believe in whatever theory they're advocating. I don't think it becomes an opinion (it's still a statement claiming to be factual), but it's not a lie, and certainly not blatant, though some of it is absurd (but again not to everyone, obviously).
Right, and it also prevents positive outcomes. People chronically lie to their doctors about their actual lifestyle behavior and then are surprised that the Dr. didn't catch all the warning signs for some disease.
You are saying the response had low quality but don't cite what about it is wrong. If anything, I find this response to my comment as lacking quality.
The author is lying. I stand by the statement that he is lying. He is presenting an imaginary situation where doctors ignore solutions that demonstrate results. That simply isn't the case. If the results were there, it would be done. And it is done.
The author isn't asking for doctors to suggest people talk out their problems with religious figures, he's advocating for religion instead of scientifically backed care. I don't care how many articles he publish in some non-peer reviewed junk source like Psychology Today.
"Even doctors will pickup on one thing you say and draw conclusions from that and dismiss everything else."
This pattern seems really common, and is what scares me about the future in general. The 'experts' concentrate on the stuff they understand / are best to the detriment of where the actual focus needs to be. In a lot of cases, this is despite the insistence of the supposed non-expert who is the one suffering as a result.
Some of the worst cases are as a child, where you get in trouble twice. First for wasting adults time because you didn't tell them properly, and then again for pointing out that you did.
And I am fairly happy with the idea that this is particularly true in the UK because my sample is not small. Your response to this is odd in itself. Why do you think I would be convinced by what you say? Why tell me you are a doctor (I can tell you: without the appeal to authority, there is no argument)? Literally, in the post you have replied to I have said...doctors in the UK tell you straight away...it took you ten words. How little self-awareness do you have? It is comical that you actually wrote that and, presumably, had some thought that it was a good idea to say any of that (again, the only reason to think that is because you think your arguments don't require justification).
And great...you have wasted your life writing a paragraph explaining to yourself why you are a doctor but are choosing not to help someone who is sick. The significance of this to me, let alone some who is sick, is zero...again, lack of self-awareness...why write this at all? I am sure it is a nice thing that helps your self-image...you failed to prove its consequence in the real world (i.e. you skilfully explained what is but left out why it should be).
To highlight two points again. The issue with OP and my relative is that doctors are often actively attempting to prevent further care. No-one denies that psychological therapy is helpful for chronic pain. The issue is that, for most people, it isn't going to solve anything...but it is presented as the cure even when alternatives exist. Even suggesting that people could be lying or that it is psychosomatic is wrong-headed. If that is the case, then that is another condition (lying isn't a medical condition, you don't adjust medicine conditional on the probability that someone is lying). Again, there is an obsession with people lying that is truly unhealthy here and quite contrary to practice outside the UK (indeed, my experience within the UK has been, as you have just done, that almost every doctor will start talking about the possibility of lying completely unprompted when these particularly conditions are mentioned...random?).
The other issue is that this has profoundly stunted research in the UK. It is not particularly hard to find ample research on these issues. You are saying that psychological therapy is a treatment...well, read the research. Is there a known biological pathology? No. But there are possibilities (and none of those possibilities suggest the current treatment will have a significant effect...CBT, in the case of people with psychological conditions, is only effective 20-30% of the time). And is it appropriate for the "policy" to be in cases when there is no known pathology that psychological therapy (or, presumably, a lie detector test) be the only course of action? No. That isn't logical (and, again, it is why there are people who are helping people who you have actively chosen to abandon). Somewhat amazing that you go onto criticise the US system for "overdiagnosis"...so no diagnosis is better than overdiagnosis? Again...you are a doctor, right? You are just saying: I would prefer to do no work at all than hard work. Feeble, and unbelievably arrogant (it is feeble to justify doing no work, it takes arrogance to criticise others for doing work).
Truly, I hope this will help you. Stop. Think it through. Think whether what you wrote helps yourself more than other people.
Btw, it is often very clear in these cases (and in life, generally) when someone is or is not lying because lying usually requires motivation (I have never come across someone who was obsessed with other people "lying" for anything other than self-interested reasons). Most people who have these conditions have their lives destroyed...to suggest that someone is motivated to destroy their own life is just stupid. To suggest that this must be the case to cover up your own personal failings (competence, lack of sympathy, ending up in a job that requires sympathy when you only possess avarice, etc.) is something far worse.
EDIT: just to add actual info, because we are actually talking around some of the issues here...the UK uses the Oxford criteria for ME/CFS, this is a measure that was designed by psychiatrists, and has been shown to be a statistically significant treatment in samples selected using that criteria...one issue...all these studies have massive selection bias (some of these therapies wouldn't actually be possible for people with CFS/ME to undertake, imo) and the Oxford criteria wildly overstates incidence of ME/CFS (compared to Fukuda). The Lancet, a UK medical journal, continues to publish guidance that this is a psychological condition (again, not what is said above, that there are no biological pathologies...the Lancet is saying this can be cured by psychological therapy) despite the NIH (and others) showing that this is likely not the case (and suggesting that it is actually damaging research funding to suggest it is a mental condition).
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