The Cellar - Mental Health and discrimination

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- - Mental Health and discrimination (http://cellar.org/showthread.php?t=29300)

Quote:

Originally Posted by xoxoxoBruce (Post 873456)

They're a little smarter maybe, better educated for sure, larger egos from what I've seen, but still human, with all the warts and flaws, not gods.

It's a high pressure job and if they suspect someone of making it tougher, I wouldn't be surprised to see them go into defense mode.

Doctors rely heavily on interpersonal communication, especially during the initial workup on a patient. The most important part of the physical examination is the patient History. If anyone ever asks "What are the three most important parts of the physical examination?", the answer is History, History, History ... like Location, Location, Location in real estate it's that important. Anything that interferes with the doctor being able to get information, especially reliable information (not erroneous information or even disinformation), from a patient is an unwelcome game changer for the doctor who bases treatment plans on that information. The doctor's oath to "First do no harm" can become a longshot with serious consequences all around if even unintentional harm is done.

Quote:

Originally Posted by orthodoc

I suppose I'll die with a scornful look on my face, then.

Present company excepted, of course. ;) It's not always directed at the patients--I've found more often than not the doctors are being scornful towards each other behind their backs. I can't even count the number of times a doctor has looked at a previous doctor's orders/diagnosis/etc. and expressed bafflement or open disapproval at the decisions made. Very few of them will acknowledge how much guesswork they're all doing; it's always the other guy who's an idiot.

Quote:

Originally Posted by orthodoc (Post 873476)

:facepalm: I suppose I'll die with a scornful look on my face, then.

Yes, bipolar meds make things more complicated. However, it's been my experience, having raised children with mental health disorders, that nurses are more prone to labeling and stigmatizing.

It helps to give people insight into the fundamental difference between the way doctors and nurses think. A nurse deals mostly with the science of medicine. Every time a nurse learns something new, a nurse thinks that's one less thing they don't know and that they're one step closer to being the consummate nurse. A ramification of that is they can believe they know best how to categorize and deal with patients. A doctor deals with the science of medicine and additionally with the art of medicine to a greater degree than nurses. When a doctor learns something new, it opens the doctor's mind to two new questions the doctor hadn't considered before. Doctors are humbled by that experience despite their significant accomplishment in becoming doctors and it tempers their egos enough that they are less likely to develop tunnel vision regarding their patients. This difference between doctors and nurses is why the idea of nurses going to medical school has not been enthusiastically received. Nurses not only have to learn new things, they have to learn a new way to think.

Quote:

Originally Posted by sexobon

When a doctor learns something new, it opens the doctors mind to two new questions the doctor hadn't considered before. Doctors are humbled by that experience despite their significant accomplishment in becoming doctors and it tempers their egos enough that they are less likely to develop tunnel vision regarding their patients.

Bull...

...Shit.

This might be one of the funniest things you've ever written, sexobon.

Ignorance is bliss, you haven't WORKED with enough doctors AND nurses newbie.

It's very cute how you take the thing I was saying ('doctors are not open to new ideas') and act as if it had anything to do with what you were saying ('doctors think better than nurses.') Shit, for all I know nurses ARE even worse than doctors in that area. Not what I was talking about.

Quote:

Originally Posted by Clodfobble (Post 873506)

It's very cute how you take the thing I was saying ('doctors are not open to new ideas') and act as if it had anything to do with what you were saying ('doctors think better than nurses.') ...

Cute is as cute does.

If you had cut the quote off here:

Quote:

Originally Posted by sexobon (Post 873497)

... When a doctor learns something new, it opens the doctor's mind to two new questions the doctor hadn't considered before. ....

I would have got this:

Quote:

Originally Posted by Clodfobble (Post 873506)

... the thing I was saying ('doctors are not open to new ideas') ...

This,

Quote:

Originally Posted by sexobon (Post 873497)

...Doctors are humbled by that experience despite their significant accomplishment in becoming doctors and it tempers their egos enough that they are less likely to develop tunnel vision regarding their patients. .......

... WAS contrasting doctors and nurses (i.e ... they are less likely [than nurses] to develop ...). I took your response to be addressing both.

Sorry I couldn't read your mind. Well, actually I can; but, then I'd have to bill you!

Quote:

Originally Posted by Clodfobble (Post 873498)

Bull...

...Shit.

This might be one of the funniest things you've ever written, sexobon.

Seconded, big time. :thumb:

I'll use this thread to introduce a somewhat different current topic... Obamacare and mental health.

There is an "experiment" going on in North Carolina that is being watched by many...
Today, the NY Times has an article that serves to introduce one of the new ideas to the public.

http://www.nytimes.com/2013/12/26/he...it_th_20131226

NY Times
JULIE CRESWELL
December 25, 2013
E.R. Costs for Mentally Ill Soar, and Hospitals Seek Better Way

Quote:

<snip>
While there is evidence that other types of health care costs might be declining slightly,
the cost of emergency room care for the mentally ill shows no sign of ebbing. <snip>
Nationally, more than 6.4 million visits to emergency rooms in 2010,
or about 5 percent of total visits, involved patients whose primary diagnosis
was a mental health condition or substance abuse.

For decades, North Carolina resisted the broad mental health reforms.
But in 2000, state lawmakers moved to overhaul the state’s mental health system,
closing state facilities and pushing counseling and outpatient programs to local communities.<snip>

Uninsured patients rarely receive individual therapy, only group sessions.
And it can take up to three months to see a psychiatrist.

The head of Wake County Emergency Medical Services, Dr. Myers was also among
a handful of paramedics in the county who are trying to expand the role of first responders.
<snip>
Shortly thereafter, a group of Wake County paramedics began to be trained to perform
mental health exams on patients in the field who are judged not to be in need of emergency medical care.

By asking a series of questions, the paramedics are then able to evaluate a patient’s mental condition.
While giving a patient the option of going to a local emergency room if they prefer, they also offer the choice
of being taken to another facility that might be better suited to provide the kind of care they need.

Last year, more than half of the 450 patients identified with
mental illness asked to go somewhere other than the emergency room.
<snip>

The importance here is that most laws, rules, and traditions,
have been to require transportation to hospital ER's only.
Obamacare may be the mechanism to change the system
into something more efficient and appropriate to the individual patient.

I skirt the issue by referring to my anti=depressants as "performance enhancing drugs" Much less stigma attached to those.

:D

I might be wrong, I frequently am, but, I don't think the word 'efficient' will ever be associated with ObamaCare.

"Some have noted that ObamaCare is an efficient time waster."

Just spitballin' some ideas around.