Follow Dr's orders or move on(?)

[joany]

From copd.net, there's an interesting article re: not following Dr's orders.  It could be a good idea to make sure we're either following dr's orders or have a reasonable justification of "why not."  I recently changed my Dr. because I WAS getting sloppy about following orders - what's the point of going to a doctor if I  know better.  "I know my body better than my doctor".  Right! This implies my communication with my doctor is poor or I'm playing guessing games with my doctor.  What a doofus!

copd.net/living/follow-doctors-orders-continued/

[gerald]

excellent article.

I have also had issues with a Doctor not keeping an mind open enough to understand why something was not working.
Unfortunately we do not have the luxury of switching doctors due to an extreme shortage of doctors.  However, I managed to got referred to specialists for all of the critical stuff and that took a lot of strain off. 

[jarca]

thank you, Joany, I can relate to several of the reasons.
Having a dr I can trust is #1.....
I live 165+ miles from specialists so now days I just can't go! 

excellent article!

[judi]

I might be the worst patient in the world. I used to be very compliant but finally had to go my own way in self defense against severe med side effects.  Its not fun or ideal and I wish I had a better pulmo but he is the only one in town so I do the best I can and he does too...sometimes.    Sometimes I think they could do better but just don't want to take the extra time it would take to precisely tailor treatment to each individual and that is probably fine for most people but if you are an 'outlier'  it can be a problem.

[gerald]

Judi, I know what you mean.  I am probably the patient from hell as well.    I had made the mistake, in the past,  of assuming the medical people knew what they were talking about. I was wrong and it cost.    I find I have to do the research and when I find something that I feel is relevant I print it out, and take it to the specialist and ask for an explanation as to how it will assist me.

I find the concern about many doctors not staying current in the COPD field which is changing constantly.   While they may not be able to stay current with the latest and greatest, it would be great if they coul dkeep current with stuff/treatments/practices etc that should stopped or tempered.

[jim]

I do the same as you Gerald.

[lavishgail]

I really need to learn how to do this there's so much I do not know that I do listen to what the doctor say even if I'm feeling bad SOB or any of the above because one day I might have a good breathing day does not mean tomorrow is going to be a better breathing day. One time she wanted to sign off on me and I had to tell her please don't sign off on me I get very sick I can't breathe I need my oxygen please don't take it away from me and she said she wouldn't but if my insurance had anything to say about it it was up to them so I do have breathing tests and things coming up soon and December but I'm telling you I get so SOB just making the bed I have to sit down I can't even breathe so I feel myself getting worse as the days go by I just have to learn how to talk to my doctors and not be so afraid to speak my mind.

[judi]

I  printed out a research paper that was relevant and my pulmo was disinterested and dismissive.   I found out he follows 'Evidence Based Medicine', 

.....Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions
about the care of individual patients. The practice of evidence based medicine means integrating individual clinical
expertise with the best available external clinical evidence from systematic research....

For this usage 'best evidence' means statistics  based on meta analysis showing what has the highest statistical probability of being wrong or of being the best treatment for the symptoms.  They are supposed to combine with their own experience and patient preferences but I think my guy uses the statistics of what should be happening and I'm out the door.  He sent me to the ER a couple of years ago and I mentioned to one of the nurses that I thought he was so wedded to his EBM that he couldn't see what was in front of his face and she said that was exactly what was wrong with him as a physician.  They don't like him either.   

I don't know if he keeps up on newest research, possibly in Critical Care which is his specialty but I have never felt he especially cared about day by day quality of life.  If I am 'stable' ie not having an exacerbation I am out the door within 10 minutes no matter what else is going on. 

I see some people who seem to have good pulmos but I think there a few others like mine, I also feel I have been injured by his treatment.  We do have to stand up for ourselves LavishGail or we fall through the cracks.  Gerald please move to Washington state and go to my pulmo so I won't be the only patient from hell he sees.    I think you would give him a good run for his money.