In IT, all the worst patients are doctors.
Hopefully no actual doctors answer this question though ๐
this post was submitted on 30 Aug 2024
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My first job out of college was in a hospital. When you see doctors outside of their own setting, you quickly realize that >90% of them are pretty stupid at literally everything else. I was an accountant processing travel reimbursements for business-related professional expenses (mostly vacations disguised as conferences and workshops for CMEs) and many of them just could NOT understand why they weren't allowed to claim alcohol on their travel reimbursements. Literally, the IRS will not allow it. And even if it did, state law forbids it, too. Sometimes, I got angry emails because they couldn't claim miles for taking a detour to visit a relative before going to their destination after I adjusted it as if they drove directly from work to the airport. Shit like that. I was good friends with the IT guy there and he had many similar gripes. Most of his job was arriving on-site to plug machines in because they swore up and down on the phone that the machine was plugged in.
I'm convinced the majority of doctors are just average intelligence people who spent a decade practicing and mastering a skill. That's it. Anyone can be a doctor if they can be allowed into med school and sink the time and effort into becoming one.
Doctors are min-maxers. It's just that simple.
That's how they become doctors in the first place. I teach 30 premeds per semester
Yes, that's what I implied.
What's that? My friend's dog is asking
Min maxing is a game theory strategy (mathematics). Coincidentally useful in games and other competitions. It involves a reward and working your resources to max out your winnings while minimising the opponents'. The min max approach to a genie wish that gives you a thousand dollars but someone close to you you hate a million is to not take the wish.
But I think here who you were responding to is talking about the colloquial term: doctors focused on becoming (good?) doctors in detriment of every other skill. I personally find we in the sciences often disregard social skills too far, academically and at times professionally.
Min maxing is a legit academic topic? Awesome. I learned what it is from years of being sweaty at killing internet dragons
[Wiki article](https://en.m.wikipedia.org/wiki/Minimax#:~:text=Minimax%20(sometimes%20Minmax%2C%20MM%20or,to%20maximize%20the%20minimum%20gain.) is pretty good at talking about it, yeah.
Is that some king of new trend like nft?
It's actually more like choosing the strategy with the relatively best worst-case scenario, in general. In zero-sum games it turns into what you're describing.
But either way, yeah, that's not what OP means.
But it's a specific best worst case : it's not only about how best you can do for yourself, it's for how far from you the opponent is. You prefer'd a -1 -100 option over a +2 +1 in minmaxing. While you'd take the second in a maximizing strategy, if there wasn't a third option thatd be like +3 +20. All that being your reward, opponent reward.
That's what I want to transmit to folks reading us.
Sometimes I feel like the brain has a hard limit on the amount of information it can take in, and doctors seem to hit it during their training.
It's sort of the same effect that can prevent elderly people from grasping new technology.
Personally I think your theory seems more accurate, however..
I mean, there is a hard limit on how much info your brain can take in. It's time. Every hour spent learning one thing is an hour not spent learning everything else.
Healthcare professionals as a whole, inclusive of doctors
I do not think it is appropriate to talk about any details, but something somewhat adjacent to this is that a lot of my colleagues didn't go into pediatrics because they hate dealing with parents.
And I've also read somewhere that pediatricians who says it can also destroy you mentally when seeing parents who doesn't really care about their children wellbeing.
I guess it tracks with not wanting to deal with shitty parents.
The bad parents as in "not caring" aren't the worst ones, at least for me (not a doctor, paramedic with former leadership/admin roles including in a hospital like environment)- the ones who think they care but really don't are the ones that get most of my colleagues and me far more. Because for "simply not caring" parents you can at least inform the proper authorities and at least here they are actually fairly good at dealing with them.
But there are so many "bad faith" parents out there meanwhile - intentionally withholding Information from both the healthcare providers as well as the children, withholding care, working against the best interest of their child.
Just to put themselves and their beliefs first. It's a huge crowd these days:
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The alt-righters who think that their children will get nanobot vaccines and that that modern medicine is against them anyway.
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The alternative medicine idiots who believe in homeopathy and crystals
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The religious numbnuts who think that their God gave them a prayer as universal treatment - and not modern medicine.
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The instagramers. The ones who either need their sick child as a way to gain sympathy or even money in social media, to exclude themselves from other obligations of adult life (that borders on Mรผnchhausen by proxy often). And the ones who blindly follow some influencer and their "new nutrition supplements" that helps against everything.
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The know it all's. The ones who think a quick google search can actually replace a multi year medical training and specialisation and the four buzzwords they just googled in the elevator make them the new noble price winner. There are actually two types of these people: The diagnosers and the undiagnosers. The first ones have already diagnosed themselves and will jump from hospital to hospital,from doctor to doctor until they finally find someone who gives them the diagnosis they already had in mind four years ago. The undiagnosers are always three steps ahead of you and you can always count in them to bring in another rare disease that needs to be checked out.
People can belong to multiple of these categories. And parents are especially bad at it - I get it, it's your child - but after working in healthcare on 4 continents for 20 years now it feels like these people spin faster and faster down their rabbit holes today.
Just to give you a few examples(not all directly from me,some from colleagues I know):
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The mother who replaced the "Chemo" for her deadly sick child with saline in an unobserved moment. The twist: It wasn't even a chemotherapy drug,it was an immunoglobulin, 10k per session. Kid nearly died as a result and will be disabled for life.
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Parents who withhold cancer care for their daughter, daughter suffers immensely and dies. They thought prayer would be enough.
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A mother faking vacation certificate so her kid could attend kindergarden. A few months later the kid showed measles symptoms in the kindergarden and was sent home. The mother faked a doctor's certificate that the kid was well and non-contagious so the kid could attend an event there. The event was also attended by other parents and the younger siblings. Multiple kids still too young to vaccinate got infected and one kid died.
And a few more recent ones:
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Parents brought their lawyer to the ED when they attended it for a broken arm.
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Parents demand a hymen-repair surgery at 4am on a Sunday for their 17 year old daughter.
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Parent told me the 6 year old kid with diarrhoea and fatigue (at 2am at night) surely had pellagra. Dumbfounded I asked how much corn or sorghum they eat. None,the children don't like either.
I asked how much corn or sorghum they eat. None,the children don't like either.
Isn't niacin found in meat and fish? What do corn and sorghum have to do with it?
Pellagra usually comes from eating a high corn/sorghum diet without proper nixtamaliziation (I really hope I spelt that correctly), the alkalisation of the food before cooking. While some chronic digestive diseases, alcoholism and a few other causes can also lead to it, malnutrition is the main cause and neither of these causes come upon an otherwise healthy looking child overnight. While I might not rule out that someone is idiotic enough to feed their kid only corn and sorghum it is rather unlikely and diarrhoea is one of the rather late symptoms.
(I transferred a five year old with major liver and some cerebral damage after the parents kept the poor kiddo on a "barley, corn, yeast, self produced apple juice and full grain" only diet for a year....one can imagine what that leads to)
The antivax parents are the most annoying ignorant people on God's earth.
I have family members who are doctors and they generally agree that the worst patients are physically/verbally abusive ones. Apart from that, they complain a lot about patients who don't follow their advice and then get angry when they don't get better.
donโt follow their advice and then get angry when they donโt get better.
This was my father. The son of a bitch (said with love) sawed off a cast because it itched too much.
That must be really frustrating.
Don't they complain about hypochondriacs?
Lookup the phrase โSwamps of Degobahโ
People usually see doctors when something has gone very wrong with their life. It's scary when your body backs you into a corner, and fear makes people act stupid and angry. I would hope they could be given a little bit of slack.
Not a doctor, but my worst pt was this disabled guy who was 'confused' and restrained to his bed. I did an echocardiogram on him and he masturbated the entire time.
I won't get into specific patients (I'm not a doctor but work in health care) the worst patients in general is an older person with untreated borderline personality disorder. They call screaming their heads off that the medication they've been on forever is giving them side effects, and it's just that they have this void within them that you can never pour enough attention into. They're obnoxious, demanding, and treat people in an ignorant fashion as if you are a servant at their disposal, and if you don't answer them right away they start threatening suicide. The younger ones with BPD are largely at least somewhat aware and are calmer and just sad and tearful, but the total dysregulation of the older ones is a hell of a thing to see.
I work in healthcare. My best patient is the guy who punched the rudest doctor in the face. If that rude doctor were in this thread, I bet heโd pick that guy.
Ethically horrible thing to ask. I hope no one answers.
There's a 0% chance doctors don't talk shit with each other about patients, just like in every other service profession. They literally talk shit about patients on charts sometimes.
The unethical thing would be if they revealed protected information in the process.
My sister doesn't talk specifically about patients by name, but she'll say things about what she told someone to do that they didn't, and the consequence was exactly what she told them. Stuff like that.
Yeah. Same as a medical paper right? "A 37-year old male patient with a history of chloracne" or whatever.
My dad is a doctor. I grew up around him and his partners.
They donโt. Outside of work, they donโt talk shop and want to do anything else. Usually golf.
I wonโt say never, but work is very stressful, so they do their best to leave it behind.
Interesting. I'm going to need to hear from more people if I'm going to buy that's standard, though.
There's established medical acronyms like "Funny Looking Kid" or "Get Out Of My ER". The stress thing depends heavily on specialty once out of residency, and a stressful job can actually mean more story time once they're done with a patient - just ask a paramedic.
I also had a good friend who was a paramedic until recently, and those are some gossipy bitches, lol. That guy would never shut up about work