There have been a few news articles recently about healthcare, and for most comments were left by the reading public. If those comments are an indication of the general public’s opinion of doctors, it’s frightening. Go to any online newspaper, find any medically related article, and you’ll see it there … all doctors are arrogant, they don’t care about the patients, all doctors are totally under the sway of pharmaceutical companies, they just try to churn as many patients through as possible to earn as much as possible, no doctor can even admit when they’re wrong.
A large proportion of people seem to think that doctors are simply idiots. That doctors don’t know how diagnose simple and common maladies. That years of university training and experience working is no match for a quick Google search. That they know what illness they have from checking the symptoms online, and present to the doctor to request a prescription for what they believe to be the right treatment. No thought is given to alternative diagnoses, and they are often quite annoyed when the doctor won’t just give them the script but insists on examining them to make their own diagnosis. It reminds me a bit of the story I read about Prince William when he was doing charity work building houses in South America. He was apparently convinced he had leukaemia. What he really had was a run-of-the-mill generic virus. Another thing is the medical information that intermittently becomes available through the popular media. People with little to know medical background assume they can grok it the same way people with medical training can. Take antidepressants, for example. I know a lot of people who think they’re useless and dangerous, and that doctors who prescribe them are simply puppets of the big pharmas. These people were ecstatic when a study came out a few years ago which was reported in the media, ANTIDEPRESSANTS DON’T HELP!! I saw people who had been anti-antidepressants gloating on their blogs about this, with one going so far as to say that therefore any doctor who prescribed them was being willfully negligent in order to get some free merchandise from the big pharmas. What was interesting was to actually READ the paper in question. It said that antidepressants weren’t effective with mild depression (something that is well known anyway), but the study only covered the first 4-6 weeks of treatment. You know, the same as the general lag period for antidepressants to become effective. Which doctors are well aware of. But these laypeople still believe that this study proves what they already knew, and therefore doctors are ignorant. They don’t want the facts pointed out to them. And of course, completely ignoring the fact that not all doctors automatically give antidepressants to people who present claiming to be depressed.
Despite believing doctors are idiots, these same patients still attend with ridiculous expectations. Everything should be cured (there is nothing that has to be managed). Every ailment can be fixed with the right pill (no other modifications in the patient’s life need to be done). And if the pill didn’t work, it’s because the stupid doctor gave them the wrong one. They expect miracles from modern medicine (how many people still go to the doctor with “the flu” without the primary reason being a medical certificate for work?) but have no respect for the practitioners.
Bulk-billing is another matter of contention. I have often heard complaints about how few doctors still bulk-bill and how unfair that is. First, I want to explain how bulk-billing works. Basically the government decided how much a doctor’s time was worth, then decided doctors should get 75% of this. That’s what bulk-billing is. What’s worse, although the amount may have been fair when introduced in the 1980s, remuuneration rates haven’t kept up with the CPI. And in the greatest irony, studies have found that patients have more respect for advice when they have to pay their own money to see the doctor. People try to justify the income of doctors by saying “well, I paid $X, they see Y patients per hour, so they are making $Z per year, greedy bastards!” It doesn’t work like that. Doctors only receive a percentage of the payment for each consult. Add in a few no-shows (that’s right, if the patient doesn’t show up the doctor doesn’t get paid), and all the unpaid time spent on administrative tasks, and suddenly it’s not so great, is it? But nobody wants to think in those terms, so it just comes back to doctors earning lots of money and being greedy.
This is not to say that a doctor’s income isn’t good. But damn, a doctor works for it. Do you know how ridiculous some of the malpractice laws are? If you see a doctor who recommends that you have a test or see a specialist, and you choose not to, and suffer as a result (for example if the doctor is worried about a cancer, and by not undertake the further testing or specialist review and as such the cancer becomes terminal) you can successfully sue the referring doctor for negligence. No, I am not kidding. A grown responsible adult can choose not to look after their own health after being given the appropriate referrals, and it’s still the doctor’s fault if they suffer as a result. That’s just an example of what doctors live with every day.
It’s really a no-win situation for medicos.