Misperceptions can lead to communication difficulties that interfere with good health care. When people are operating within their own area of expertise, they may find it hard to understand what the big picture looks like from another person’s perspective. Whether the differences lie between doctor and patient or between different health care providers, the results can be unfair judgments and missed opportunities.
Learn how this attitude can affect the way doctors interpret the results of placebo-controlled trials and how they feel about home remedies. We also discuss the pros and cons of email communication between doctors and patients, and how to choose a good doctor.
Guest: Steven R. Feldman, M.D., Ph.D., is Professor of Dermatology, Pathology & Public Health Sciences at the Wake Forest University School of Medicine, in Winston-Salem, NC. He is the founder of the DrScore.com doctor rating website and author of Compartments: How the Brightest, Best Trained, and Most Caring People Can Make Judgments That Are Completely and Utterly Wrong. His Websites are www.compartmentsbook.com and www.drscore.com.
The podcast of this program will be available the Monday after the broadcast date. Podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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  1. LG

    I thoroughly enjoyed the show. The concept of “compartmentalizing” is easily believable. (Although I think I would have used a different term).
    I like the idea of a way to rate doctors. I recently used a similar website to select a new doctor. As far as the “drscore” website – I noticed a few problems – possibly because the website mentioned is new: I checked the names of about ten (GP) doctors in my area and only two had any ratings. Those two had one rating each. Also – the advertisements were a little overboard. I think with time the website will improve and become very useful.

  2. gt

    I commend this physician. He presented material in a most professional manner and never once made a derogatory remark about other professional colleagues. He is definitely leading by example. As a professional nurse I do agree that open communication is imperative between all professionals for the best outcome for our patients.

  3. Paul G.

    Hi, I only caught 25 minutes of you broadcast because WSKG was not broadcasting due to snow. Physicians are not trained properly at all. There are no opinions with a design that was made over 40 places beyond the decimal point, ie life forms. They should be calculatable. All work should be referenced to known standards. The drug levels should be expressed in moles and plotted. Suspected problem organs, should also be imaged and measured.
    Remember, important drug interactions are not all 100% and many times the patient will complain and stop taking the meds when there is a problem. Astringents, like MOM,Maalox, were also used for painting and healing diaper rashes. Vitamins should be used first to solve patients complaints before Rx meds are tried. X-ray images should be returned and viewed in 3 dimensions instead of 2. All diagnoses should be diagnosed by quantitative measure measurements as well as subjective assessments. There are probably a whole lot more of ideas too. There’s a lot of worked to do to get them in shape to solved problems in a scientific sense. Yea, they’re all over worked too. They need Cray computer type help also. These are just some of my thoughts. pg1246 o&o Paul G.

  4. KC

    Based on what actually solved my medical problems vs. what’s been done by doctors to/for me over the past 50 years, I am proof of Dr. Feldman’s hypothesis.
    For example, fatigue/brain fog (among a raft of other problems) that has plagued me over decades was not resolved by looking for the usual suspects: diabetes, overweight, cholesterol problems, depression, sedentary life style, sleep problems, cardiac/pulmonary insufficiencies.
    What did resolve my medical issues was to increase my low D3 (more sun, D3 supplement), raise B12 from 545 (which the Dr. stated was okay) to 771, and to treat sub-clinical hypothyroidism (Hashimotos).
    What it took to figure out the vitamin deficiencies was read a lot and for me to get added tests to my lab work covering the vitamins by requesting them from the Dr. It was my idea, not theirs.
    For the hypothyroid, finally a Dr. who understands one of the clinical benefits of Synthroid for treatment of sub-clinical hypothyroid, where TSH is high, and T3/T4 are normal. One doctor told my my thyroid is normal.
    Unfortunately, in my experience, virtually doctors only see horses and never venture out to determine if they are actually zebras or even unicorns. :-) And believe me, I seen many, many doctors and spent thousands on treatment, so it’s not like I’ve been neglecting anything.
    So, for $20 of vitamins, a couple hundred dollars for a expert consult and less than $100 of medication resolved problems that have screwed up a large portion of my life and made life almost unbearable at times. Fortunately I have a great wife and family who have supported me over these many long years as I’ve struggled with unfair medical judgments and misjudgments and uncountable missed opportunities.
    What I’ve learned over the years was the difference between fatigue and tiredness. If you’re not yawning, you’re fatigued. However, you may be fatigued and tired at the same time. Don’t tell the doctor you’re tired when you’re actually fatigued. It makes a big difference in their assessment.
    Also, sometimes fatigue and other psychological/medical symptoms can be caused by supplements, even the innocuous daily vitamin. What I do is to stop all supplements/medications that are not life sustaining (check with your Dr.) to determine if my symptoms would subside. I would also go on a low fat, low salt, low carb bland diet for about a week. If I felt better I would then add back each medication/supplement one at a time (with at least 3 days in between) to figure out which one it was that caused symptoms.
    Also #2, always get copies of your lab work. I set up an Excel worksheet to track test results. Doctors don’t look at trends in your lab results. In my experience, trends are the most important part of analyzing one’s medical status. Recently I asked one of my wife’s doctors about trends in lab work and she stated that no treatment would be given until an out of range score was logged, even if the patient was reporting symptoms prior to obtaining an out of range score.
    To me, that borders on malpractice. The term to use to overcome this reticence is “therapeutic trial”. If your doctor won’t do it, find another doctor.
    Also #3, ask for a referral (second opinion) to a specialist (sooner rather than later) if your doctor can’t come up with a definitive answer or treatment. Some doctors wait too long to refer to a specialist. All the while, you suffer.
    Ask for a board certified doctor when you ask for a referral.
    Hope this helps someone.
    Good luck

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