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peepeehands
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So many young people in the USA put doctor visits as an outsized point of discussion and source of anxiety. When my gf gets a sore throat or knee pain, she books an appt and surprise surprise the doctor has absolutely nothing to do except bill her and recommend advil
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Arrested development is tight
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You know that feeling when you're sitting in a meeting regarding a subject that could've been handled over the phone or through email? That's what being a primary care/family med doc must be like 24/7
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Family medicine is awful, though not specifically for that reason. I have a friend who's doing it and it's craziness.
1. As you sort of point out, patients don't take your recommendations very seriously so you repeatedly remind them to take their allergy meds or stop smoking or whatever but they just ignore you.
2. You cover every field, and obviously cannot do all of them so 90% of your job is referring people to specialists, which is absolute paperwork heck.
3. Patients are generally shitty to FM more than any other field because FM usually can't directly fix their issue and/or the patients don't listen to anything FM tells them (see 1 and 2)
IDK why my friend it doing it, but he's also a hardcore powerlifter so I assume he's just a masochist and that's why.
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Honestly it's probably better to have buff dudes in fm/pc since patients are less likely to give them shit lol
re:#1 though, I think that's a problem with most if not all fields that deal with patients managing chronic or recurring issues
for example this former neurosurgeon discusses how he became disillusioned with the field after it became apparent that procedures to alleviate chronic nerve-related pain were often ineffective because of or less impactful than lifestyle changes, but people sought out a miracle cure regardless
obviously I wouldn't go as far as the people in that video's comments who completely decry modern medicine, since it's obvious that interventions are effective for treating acute conditions, but lots of seemingly idiopathic/"""multifactorial""" symptoms are probably the result of lacking a healthy lifestyle
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This is a problem across many fields but it's especially pronounced in FM since FM is generally the field suggesting such long-standing treatment regiments with lifestyle changes or "minor" medication.
For contrast, I'm in cancer (research though, I'm in academia not medicine) and patients don't tend to skip their chemo because they just think they don't need it.
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Yeah, cancer's sort of in between since it can be acute (and therefore treated as such with excision) but also has lifestyle risk factors
and there are obviously cases in which lifestyle factors can significantly impact recovery or rates of reoccurrence - apparently something like 30% of smokers who get diagnosed with lung cancer persist in smoking even after receiving a diagnosis (https://pubmed.ncbi.nlm.nih.gov/15596667/)
Obviously not saying this to dismiss FM since they're the first line who have to try to convince people to alter their lifestyle, but there's always gonna be a certain subset for whom there is literally no possible wake-up call for change
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People are often not going to do lifestyle changes. A ton of cancer diet/exercise studies fail due to retention. 30% actually surprises me with how low it is -- I would assume the majority would be like "well I already got lung cancer, so..."
The difference is that FM is usually, as you say, the first line, and also therefore the most consistent line. They'll be the ones telling them to alter their lifestyle over and over until they do develop something acute, and then they have to transfer them to a specialist, who the patient will usually appreciate for helping with the acute issues more than they appreciated the FM for trying to prevent them.
I guess what typing this out makes me realize is that people really don't respect preventative health at all because its effects are longer-term, even though they're often more powerful (though not in cancer...cancer is actually notoriously random despite one's best efforts to avoid lifestyle risk factors).
Anyways, on the point of the intimidating FM doctor, I don't think anyone's gonna give my buddy shit lmao. Dude's a 6'2 Chinese-American guy built like a extra-wide refrigerator. He was up there as a powerlifter in his weight class too when we were in undergrad, not state champ but usually second-best. Guy measured his bench progress in hundreds. Was part of my gym buddy group when I was in in undergrad, we'd all hit the gym before morning biochemistry, good times.
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lol my friends used to go before our 9AM organic chem lecture too. I remember during midterm week we tried to do this r-slurred cramming method where we timed rests based on a certain number of flash cards. miss those guys
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Lol sounds like a similar vibe. I remember after our Biochem final all eight of us went to the gym and worked out for like 3 hours, then we all hit a nice KBBQ place and got all-you-can-eat. The servers were cracking up at the amount of food we put away, I think we ordered like fifteen platters in total.
Yeah, it's crazy to think it was so long ago now, guy in FM just got married, seems like ages ago I saw them. Sad that we all moved to different parts of the country, but we all just were doing what was best for our post-grad education...that's how it goes.
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That's what I was saying with the whole covid panic. If you're under 70, the treatment is literally "rest and hydration".
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