Comment by hoosier2gator

A lot of physicians have terrible bedside manner and that is going to be one of the biggest criteria a non-physician is going to use to judge how much they care.

And I don't think that's unreasonable, either. It's necessary for a physician to communicate effectively with their patient. Trust is a requirement to work effectively together. If you can't establish that, then you've failed. Encounters with doctors shouldn't feel adversarial.

The entire article is a form of engagement bait. It’s a pile of stereotypes with storytelling. Paul Graham does the same thing. Arguing about which stereotype is true or false… you’re just playing into it.

My mother is a nurse practitioner who works in an acute care clinic, and I can say that she feels horrible when she makes a mistake, learns that one of her patients’ conditions has worsened and they’ve been hospitalized, or — worst of all — when they die, even if it was expected.

My personal experience with multiple doctors, some in primary care and others in hospitals, is that they often don't care and just want to get you out of the door.

Bring up some symptoms not immediately easily attributed to something? Sorry, those are "nonspecific symptoms" and they can't help you. Maybe see a specialist, maybe not. Figure it out.

Obviously this isn't all of them, but it is definitely a decent chunk.

Let me ask you a question. What's the longest time you've spent on a single patient over the last month? What do you think that number is like for your fellow physicians?

Of course this will massively depend on your specific workplace, the ratio of doctors to patients in your vicinity, and so on. But I've seen plenty of doctors for who that statistic can't be higher than 10 minutes.

I'll freely admit I'm biased. I have a medical issue that despite visiting a good number of different doctors, none have properly diagnosed. This is despite the symptoms being visible, audible and showing up on certain scans (inflammation), so it can't be disregarded as "it's in your head". Some have made an attempt, and after that failed quickly did the equivalent of throwing their hands up and saying "I don't know", providing no further path.

Regardless of facts about how much doctors actually care, he still perceives the world as one where almost nobody does. I'm glad he expressed himself as such because I feel the same way sometime, even though I know that most people try to fill their role in society well. It's like a special kind of loneliness that grows quick. I like how he describes the development of this loneliness. Once he put on its glasses, he thinks carelessness is everywhere, even in doctors who do care, so he develops existential hopelessness of some sort.

This is a statement of privilege: find a doctor who cares and stick with them.

I'm T1 diabetic, and it took me a long time to find an endo and a PCP that care. I have long since moved away from their offices, but I still make the drive because they are worth it.

My tip on finding good providers is basically to get lucky and find a good one. Then you should ask who they recommend. They know who the bad ones are.

Doctors are at the very top of my list of people who don’t care. Not necessarily that they got into the field not wanting to care, but that in practice they quickly get to the point of caring largely about getting through their day — maybe a few select patients stir them out of their bizarrely intense waking slumber where they go from patient to patient and immediately prescribe nearly the first thing that comes to mind for nearly the first diagnosis that comes to mind. Given the volumes of patients they are expected to churn through though it’s not surprising that they become desensitized and divorced from the ramifications of shoddy work with minimal research — for many (especially nonspecialists) it’s effectively impossible to do thoughtful work for every patient. I think overwork desensitizes many/most and few actually have the time or energy to do more research or think deeply about an individual patient, but ultimately decisions which consume minimal resources from them drastically affect the lives of patients.

Healthcare professionals know this to be true. This is why when their own loved ones are the patients they have such a strong tendency to become very actively involved —- it’s not necessarily that the person attending to their loved one is incompetent, but chances are that their loved ones will similarly be just another face that occupies another physician’s mind for a few minutes.

Artificially high barriers of entry in the field may lead to massive compensations but also to a huge ratio of patients to physicians — this takes a toll.

[dead]

My primary care physician will only do video meetings or wait 6 months for in-person appointment. He does not care.