Lying Doctors

[linearb]

The thing is, in terms of dollars per hour, I don't think most doctors are even top five.

If you want to get rich, be a banker.

If you want to be merely affluent, and have a comfortable life, set your own hours, and work from the beach or a cabin in the woods... Go in to software! It's worked for me so far...

 

[awbw8]

I basically agree, but I think messaging is huge. When you say to someone who is in a state of severe anxiety over this "you'll have to learn to live with it", I think what they hear is often "the terrible feelings you feel right now are something you're now stuck with, so, deal with it". It seems like doctors need to get a lot better at saying "this is a very common problem, and it's very normal to feel distress and even panic about it. However, even for people for whom this does become a chronic issue, the vast majority of them see a significant improvement in their mood, and most people eventually reach a place where they are not bothered by the sound most of the time, and may not even be consciously aware of it. It may take you a little while to calm down, and I am sorry that this happened and that you have to deal with it, but this should in no way prevent you from having a happy and normal life".

I agree that this is a nice first thing to say and probably the best way to deliver the news, but then giving someone something tangible to do well gives someone something to do rather than just sit at home and want to die. Referring them to someone who knows more about T - a T counselor - if there were such a thing, or an individual who has T and is doing well - to make the patient feel like they're not alone and discuss potential treatments, trials, habituation and to answer questions etc. - an in-person version of what we have here.

In the beginning, I have to agree with what @MattK said, anything other than, "I can fix it" basically felt like a death sentence. The only thing that really gave me any will to live then was doing something that might help, which, as none of it was medically proven, a doctor wasn't going to know about or recommend.

It's a tough thing, but I think kindness and referrals to people who can talk about T with authority and calm would be better than nothing.

 

[LadyDi]

I agree with both @linearb and @awbw8: I think a big part of the problem is not that doctors are lying or incompetent. The reality is in most cases, there isn't a lot your basic ENT can do with tinnitus. I think the issue is many of them do a bad job of delivering the initial difficult news -- especially when their tinnitus patients are likely to be in a state of severe anxiety.

I know my ENT sure did. I got the "live with it" speech, a cold shoulder when I started panicking and asking how was I going to be able to work and survive, then told to come back in three weeks -- and then he went on vacation and was unreachable. Needless to say, he is no longer my doctor. But I did go on to find many other doctors who did their best and whose care I appreciated -- although, of course, none of them could "cure" me.

I believe if front line ENTs realize that if they don't have the time or bedside manner to give new tinnitus patients the support and patience they need, they should either delegate another doctor or nurse in their practice to do what needs to be done or go into another specialty. They also should build a solid referral list of CBT therapists, audiologists, TRT clinicians other specialists -- all whom they personally check out before making the referral.

 

[jimH]

How they deliver the bad news, that is, that they can't help you, is determined mostly by the personality of the doctor. I've experienced both extremes over the many years I've had T. From cold indifference to a display of very sincere sympathy and compassion .

The last time I went to see an ENT, because my Tinnitus was getting worse, I asked him, "Just how bad can it get?" Without saying a word, his face flushed and he broke off the eye contact and looked down at the floor. He then looked up at me with the saddest eyes and still didn't speak. There was no need to. So, I said, "Well, I'll just hope that mine never gets to be that bad." This guy REALLY DID care! You can't fake that kind of thing. That was the first time I had ever met the man. So, it wasn't like he cared about me because he knew me.

 

[Street Spirit]

How they deliver the bad news, that is, that they can't help you, is determined mostly by the personality of the doctor. I've experienced both extremes over the many years I've had T. From cold indifference to a display of very sincere sympathy and compassion .

The last time I went to see an ENT, because my Tinnitus was getting worse, I asked him, "Just how bad can it get?" Without saying a word, his face flushed and he broke off the eye contact and looked down at the floor. He then looked up at me with the saddest eyes and still didn't speak. There was no need to. So, I said, "Well, I'll just hope that mine never gets to be that bad." This guy REALLY DID care! You can't fake that kind of thing. That was the first time I had ever met the man. So, it wasn't like he cared about me because he knew me.

Wow!

Yea in the last 2 years I've met MANY, MANY doctors..I would say out of all of them...3 genuinely cared...sadly I now have a HUGE mistrust for doctors and.basically feel the need to do my own research.

I don't care much about bedside manner, (House would be my ideal doc) what I want is bloody facts and truth. If you don't know, just bloody well say so without pulling the psych card...and please if any docs read this, research meds before prescribing!!! for the love of God it takes mins!

 

[soundmachine]

Wow!

Yea in the last 2 years I've met MANY, MANY doctors..I would say out of all of them...3 genuinely cared...sadly I now have a HUGE mistrust for doctors and.basically feel the need to do my own research.

I don't care much about bedside manner, (House would be my ideal doc) what I want is bloody facts and truth. If you don't know, just bloody well say so without pulling the psych card...and please if any docs read this, research meds before prescribing!!! for the love of God it takes mins!

Absolutely. Bedside manner is nice to have. But competency, due diligence, and a good patient history is woefully lacking in many. Pharmacology is the one thing that they get very little background in. They get one course in pharmacology in med school, then the rest from drug reps. I even had to explain drug contraindications to some docs on some meds I was on. Pretty sad. Had I not done my own research, I could have had a bad reaction.

 

[soundmachine]

The thing is, in terms of dollars per hour, I don't think most doctors are even top five.

If you want to get rich, be a banker.

If you want to be merely affluent, and have a comfortable life, set your own hours, and work from the beach or a cabin in the woods... Go in to software! It's worked for me so far...

Yes, but if you don't get "rich" as a programmer...and you are not a great coder, or are old, you may be out of work. But a doctor pretty much never has to worry about job security at all. Old or incompetent. At the very worse, they can work for an insurance company denying patients health coverage for a needed procedure. They have job security the rest of us poor schmucks can only dream of. Yet, we have to pay for poor service or treatments. Or pay with our health...either way...they can continue.

In Software, you write unit tests and ensure correctness. That is lacking in medicine.

The system needs "software" to ensure better care. It is sort of out there but not uniform or complete. Feedback from patients and peers can feed into an evaluation system. Payment and bonuses should be based on this kind of system.

From an "old" C/C++ Java coder. I still have work but how long before the grey starts to kill contracts is any guess.

 

[Dr. Nagler]

I've been to my share of lousy doctors - and a couple of unethical ones as well.

I'm just curious about something ...

Let's say for argument's sake you had the best and most honest doctor in the world. Like a 2015 version of Marcus Welby, M.D. with specialty training and true expertise in ENT. And you went to this doctor with a chief complaint of SEVERE TINNITUS. Given the current state of tinnitus research would anybody here be appreciably better off? I mean, besides feeling better about your doctor.

 

[Danny Boy]

The thing is, in terms of dollars per hour, I don't think most doctors are even top five.

If you want to get rich, be a banker.

If you want to be merely affluent, and have a comfortable life, set your own hours, and work from the beach or a cabin in the woods... Go in to software! It's worked for me so far...

This might shock you.... http://www.dailymail.co.uk/news/article-2057818/The-family-doctor-earns-750-000-year.html

http://www.telegraph.co.uk/news/hea...of-GPs-paid-more-than-the-Prime-Minister.html

 

[soundmachine]

This might shock you.... http://www.dailymail.co.uk/news/article-2057818/The-family-doctor-earns-750-000-year.html

http://www.telegraph.co.uk/news/hea...of-GPs-paid-more-than-the-Prime-Minister.html

Good God..and in the UK. In the US it tops at 200K for family practice (unless it is Beverly Hills or something).

 

[Danny Boy]

Good God..and in the UK. In the US it tops at 200K for family practice (unless it is Beverly Hills or something).

Yep, the NHS is very, very blooming expensive. The NHS in England alone's budget is 95.6 billion pounds. That doesn't include, Scotland, Northern Ireland or Wales in the budget...So it's far more expensive than that 95 billon.

 

[soundmachine]

I've been to my share of lousy doctors - and a couple of unethical ones as well.

I'm just curious about something ...

Let's say for argument's sake you had the best and most honest doctor in the world. Like a 2015 version of Marcus Welby, M.D. with specialty training and true expertise in ENT. And you went to this doctor with a chief complaint of SEVERE TINNITUS. Given the current state of tinnitus research would anybody here be appreciably better off? I mean, besides feeling better about your doctor.

Tinnitus suffers will naturally go to an ENT. So ENTs SHOULD be better trained (even if they are surgeons) in treatment options (there are some). It is said that 10% of the US population has Tinnitus. So one would think that is not an insignificant part of their business. So being better at directing and educating patients on what they *CAN* do to survive. TRT, CBT, various drugs that might work, and even new research and where to look (besides just the ATA ...not that they even do that). ENTs are the first line of contact for most patients. Hence, it is not unreasonable that they are better trained in what I mentioned. If they take a patient's cash...do work to earn it.

 

[Danny Boy]

Tinnitus suffers will naturally go to an ENT. So ENTs SHOULD be better trained (even if they are surgeons) in treatment options (there are some). It is said that 10% of the US population has Tinnitus. So one would think that is not an insignificant part of their business. So being better at directing and educating patients on what they *CAN* do to survive. TRT, CBT, various drugs that might work, and even new research and where to look (besides just the ATA ...not that they even do that). ENTs are the first line of contact for most patients. Hence, it is not unreasonable that they are better trained in what I mentioned. If they take a patient's cash...do work to earn it.

In the UK, they get paid no matter what, so there's no accountability and that's an issue. In the UK, we need a system, where they can be held accountable and get paid based on their service.

 

[soundmachine]

In the UK, they get paid no matter what, so there's no accountability and that's an issue. In the UK, we need a system, where they can be held accountable and get paid based on their service.

Yes, a computer system that patients, patient outcomes, and peer reviews, can be feed into a scoring system. Based on the score, you get paid. Actually someday, computers will be able to replace most doctors (except surgeons until robots get a bit more adept). Most GPs can be replaced by a computer program now and more accurately for a differential diagnosis. A well trained computer (learning algorithm) and big data can be far more accurate and consistent. And they would cost almost nothing.

 

[Danny Boy]

Yes, a computer system that patients, patient outcomes, and peer reviews, can be feed into a scoring system. Based on the score, you get paid. Actually someday, computers will be able to replace most doctors (except surgeons until robots get a bit more adept). Most GPs can be replaced by a computer program now and more accurately for a differential diagnosis. A well trained computer leaning program and big data can be far more accurate and consistent. An they would cost almost nothing.

Haha...Those computers might be better than my doctor...I could get a prescription for trobalt then.

 

[PaulBe]

I don't think its about lying. I think its about not knowing, or worse, knowing how little they can really offer. My problem lies with them not knowing, yet still expecting to be paid for Specialist knowledge they refuse to acknowledge they don't have. Maybe we are buying their time, not their knowledge after all. I see your references to firing those who don't measure up, Dr. Nagler. That would be great, but the trouble with that is many of us just don't have the resources to Doctor shop, when they are all still demanding payment in full, and when so many come up short in this field. Too many Doctors lacking basic knowledge to sift through, too many specialist bills, and too little cash, or no resources to fight off the collection agencies if we dig our heels in and refuse to pay the full bill (been threatened with that one). Did I mention waiting times to get in and see someone who as it turns out doesn't know anything after all? Six weeks is normal here.

 

[MattK]

I agree with both @linearb and @awbw8: The reality is in most cases, there isn't a lot your basic ENT can do with tinnitus.

Unfortunately, there isn't a whole lot anyone can do about tinnitus if your goal is to either make it go away or have a consistent and repeatable way to lower the volume. It doesn't matter if your doctor is the more caring person in the world or the harshest doc there is. The end result will be the same: you'll leave with tinnitus.

That's the cold-hard facts. All of us, when we're depressed and anxious want to be comforted. But the good news is that tinnitus doesn't have to go away for us to no longer suffer. That unfortunately isn't something that comes easily or quickly.

 

[soundmachine]

Unfortunately, there isn't a whole lot anyone can do about tinnitus if your goal is to either make it go away or have a consistent and repeatable way to lower the volume. It doesn't matter if your doctor is the more caring person in the world or the harshest doc there is. The end result will be the same: you'll leave with tinnitus.

That's the cold-hard facts. All of us, when we're depressed and anxious want to be comforted. But the good news is that tinnitus doesn't have to go away for us to no longer suffer. That unfortunately isn't something that comes easily or quickly.

I agree. This thread should not be "lying doctors" but "paying doctors".

 

[Danny Boy]

I agree. This thread should not be "lying doctors" but "paying doctors".

I think tinnitus talk should become a resource for any doctor or ent interested in the field of tinnitus. If only more doctor would come on here and contribute and aid us to aid them and vice-vera. In my opinion tinnitus talk should become a resource for the NHS for tinnitus. Is there any way, we could put this motion in to action?

 

[soundmachine]

The ATA (for the US) should also have a link to this site and work with folks here too.

 

[soundmachine]

I think tinnitus talk should become a resource for any doctor or ent interested in the field of tinnitus. If only more doctor would come on here and contribute and aid us to aid them and vice-vera. In my opinion tinnitus talk should become a resource for the NHS for tinnitus. Is there any way, we could put this motion in to action?

I wish we could also get more research scientists to join. Or have a weekly blog on this site by scientists. That would give more credibility to the site and bring in more health professionals that want to learn.

 

[Danny Boy]

I wish we could also get more research scientists to join. Or have a weekly blog on this site by scientists. That would give more credibility to the site and bring in more health professionals that want to learn.

Well, if any of the leading talents of this website reads this, I am hopeful that will lead up on this. Maybe we should have a newsletter every month on the website? With potential treatments being discussed and top tips and other stuff like that. Oh, it would be great. And we could have meets, like tinnitus meets, gatherings...The ideas are endless.

 

[soundmachine]

Well, if any of the leading talents of this website reads this, I am hopeful that will lead up on this. Maybe we should have a newsletter every month on the website? With potential treatments being discussed and top tips and other stuff like that. Oh, it would be great. And we could have meets, like tinnitus meets, gatherings...The ideas are endless.

They have the doctor's corner but what I could suggest is the Researcher's Corner. Maybe Markku could bring that in. And meetups too (like meetup.com) but better.

 

[Danny Boy]

They have the doctor's corner but what I could suggest is the Researcher's Corner. Maybe Markku could bring that in. And meetups too (like meetup.com) but better.

Yeah, that would be awesome...Although, we have only over 7000 members, which is shocking considering the trobalt thread has nearly 200,000 views. I think we need more members then this site can become more powerful. Never heard of meetups.com before.

 

[Dr. Nagler]

In response to my question in Post #38, @soundmachine posted:

Tinnitus suffers will naturally go to an ENT. So ENTs SHOULD be better trained (even if they are surgeons) in treatment options (there are some). It is said that 10% of the US population has Tinnitus. So one would think that is not an insignificant part of their business. So being better at directing and educating patients on what they *CAN* do to survive. TRT, CBT, various drugs that might work, and even new research and where to look (besides just the ATA ...not that they even do that). ENTs are the first line of contact for most patients. Hence, it is not unreasonable that they are better trained in what I mentioned. If they take a patient's cash...do work to earn it.​

Perhaps I should have worded my question better. Sorry. I'll clarify ...

Let us assume that every single ENT is not just better trained, but optimally trained. And let us further assume that they are all honest as well as polite. Even then - under those absolutely ideal circumstances - given the current state of tinnitus research, would anybody here be appreciably better off than you are as it is? I mean, besides feeling better about your doctor, that is.

 

[soundmachine]

In response to my question in Post #38, @soundmachine posted:

Tinnitus suffers will naturally go to an ENT. So ENTs SHOULD be better trained (even if they are surgeons) in treatment options (there are some). It is said that 10% of the US population has Tinnitus. So one would think that is not an insignificant part of their business. So being better at directing and educating patients on what they *CAN* do to survive. TRT, CBT, various drugs that might work, and even new research and where to look (besides just the ATA ...not that they even do that). ENTs are the first line of contact for most patients. Hence, it is not unreasonable that they are better trained in what I mentioned. If they take a patient's cash...do work to earn it.​

Perhaps I should have worded my question better. Sorry. I'll clarify ...

Let us assume that every single ENT is not just better trained, but optimally trained. And let us further assume that they are all honest as well as polite. Even then - under those absolutely ideal circumstances - given the current state of tinnitus research, would anybody here be appreciably better off than you are as it is? I mean, besides feeling better about your doctor, that is.

Perhaps yes. There are treatments (as you go on with TRT for example) and there are some drugs (off label) that seem to work for some folks. So I think there could be some better help....even if they are a "surgeon", they are the first line of contact (other than a family doc).

 

[Dr. Nagler]

Perhaps yes. There are treatments (as you go on with TRT for example) and there are some drugs (off label) that seem to work for some folks. So I think there could be some better help....even if they are a "surgeon", they are the first line of contact (other than a family doc).

TRT, CBT, TAT, PTM, whatever. I am talking about the folks on this board who are bitching about their doctors in this thread. I don't know of any of them who are doing TRT, CBT, or any of that stuff. Whether they heard about it from their (optimally well-informed) doctors or whether they heard about on this board ... the fact is that they aren't doing it. So in the final analysis, what difference does it make how well-informed, honest, and polite those doctors might be? You are still not going to be appreciable better.

The reason, in my opinion, is that given the current state of tinnitus research, the answers do not lie in a doctor's office. Rather, the answers lie deep within ourselves. The challenge then for each of us - and it can be a formidable challenge at that - is to find the answers that lie within us. And bitching about the inadequacies of the medical profession, considerable though those inadequacies might be, is not going to bring anybody one microtonic flickering closer to his or her answers.

 

[Danny Boy]

TRT, CBT, TAT, PTM, whatever. I am talking about the folks on this board who are bitching about their doctors in this thread. I don't know of any of them who are doing TRT, CBT, or any of that stuff. Whether they heard about it from their (optimally well-informed) doctors or whether they heard about on this board ... the fact is that they aren't doing it. So in the final analysis, what difference does it make how well-informed, honest, and polite those doctors might be? You are still not going to be appreciable better.

And the reason, in my opinion, is that given the current state of tinnitus research, the answers do not lie in a doctor's office. The answers lie deep within ourselves.

And you seem to forget about the people who TRT can't help...What do they do? Just die? Off-label treatments like trobalt are valuable for people on the verge of suicide. I personally wouldn't have lasted long, without these off label treatments. I've had to rely on contacts I've made to help me get trobalt. Why should I have to do this? I'm spending loads of money on trobalt, because doctors don't want to give me drugs off label as that don't want to accept responsibility.

I've be told to "just live with it", as you do. Even if I wanted to do TRT, my audiologist hasn't spoken to me in months, just gave me a white noise generator and said go on amitriptyline. Useful eh? The WNG didn't work on me, as I had reactive tinnitus, so it would just compete with the white noise, of course the reactive tinnitus is gone now thanks to keppra. But what if I didn't know about keppra, what would I have done? How would I cope? Do you know what hyperacusis, reactive tinnitus and super loud tinnitus does to person Dr. Nagler? It nearly kills a person. I wouldn't want anyone else in my position.

I'm not saying take keppra, take trobalt. What I am saying what do we do for the people TRT can't work for? It seems hopeless, fruitless...But in all honesty, what do you expect them to do?

 

[Dr. Nagler]

Even if I wanted to do TRT, my audiologist hasn't spoken to me in months ...

Really? Why won't your audiologist speak to you?

 

[Danny Boy]

Why won't your audiologist speak to you?

Well, I think she gave up. I spoke to her a few months back, this was before I took keppra and because my tinnitus was reactive she ran out of ideas and just told me to go on amitriptyline. After that, I haven't heard from her. So, this is why I gave up and tried to find my own solutions, as they didn't seem to have any for me. I would've loved mild tinnitus had TRT or whatever and said I've got this but I've got to live with this. Trust me, before trobalt I told myself I had to change my reaction, but the whole world was so loud and the tinnitus was just so loud that death seemed much better...Couldn't sleep without drugs. It was louder than anything. Could even hear it over the headphones I had on with mozart playing. So, so loud. I hope I never go back to that hell ever again. I just don't want people to suffer like that, it's unfair.