Also, I was misdiagnosed with a heart condition last year. It was only after I was persistent in asking for a heart MRI that they found out that my diagnosis is actually something very different from what they originally diagnosed me with.
If you're not happy with your doctor, find a new one. We are forced by law to pay for health insurance here. I think we should therefore be entitled to some level of control when it comes to the type of healthcare we receive.
candidly, we could get used to the doctor always being on time, and the appointment always being over when scheduled to be so.
not necessary to do blood tests.I would think that blood tests are
always essential.Yes,I guess one has got to look for the right doctors.Not so easy though.
I would dare say that medical doctors here in Switzerland are a bit like human beings. Therefore, it is entirely possible to have an encounter with an unprofessional and unpleasant Swiss doctor, as also here in Switzerland there seem to be unprofessional and unpleasant Swiss people. I did encounter the same in the US, SA, BE, NL, and almost anywhere where there are human beings.
I also am curious as to how some people here on EF approach Swiss doctors. Is there any chance that there may be a language barrier? How many US doctors would be able to deal with a German-speaking patient? My guestimate is 0.001 %, and only because their parents immigrated into the US 30 years ago from Germany.
Then again, I agree that there are differences in both attitude and medical practice. Having seen at least 3 different Swiss Hospitals and one Swiss GP practice from the inside, and having talked with at least 10 Swiss Medical Doctors and another 10 German Medical Doctors working in Switzerland, I can say that most Swiss patient don't argue (too much) with their doctors. Therefore, it is not unexpected that an American patient demanding specific treatment for whatever he thinks he has, may be considered arrogant and ridiculous, and thus treated as such. Again, it does not exclude the real possibility that one runs into an unprofessional and unpleasant person. And it does not relieve any medical doctor from the responsibility to care for his patient in a professional way. I do not think it has to be pleasant though. Doctors are not there to entertain you.
I read that the OP didn't tell the Medic about the allergies and that the Medic didn't ask about it and still prescribed medication. I fully agree that both are wrong. Prescribers should ask about allergies, and patients should tell them. Both have their (different) responsibilities, which includes the sharing of relevant information.
Just my 0.02. And yes, I am a MD.
If you're not happy with your doctor, find a new one. We are forced by law to pay for health insurance here. I think we should therefore be entitled to some level of control when it comes to the type of healthcare we receive.[/QUOTE]
100% agree. Fortunately I have not had any problems with docs here. They were a little cautious with antibiotics based on my blood work, but gave some great homeopathic remedies that helped a ton. Payment was done on the spot, although we could have requested a bill for later. Fees were clearly spelled out based on time spent with doc (i.e. first 15 mins included in the base fee and then a certain amount for additional time).
Finally I think OP just likes to complain and make sweeping generalizations about CH since he's having trouble adjusting.
Just think about it. Would you be happy if every time you go to the doctor, they order a HIV test? Or a blood test for some other stigmatizing disease?
Furthermore, the results of such a test are not always conclusive. In other words, testing positive in a blood test for a certain disease does not always mean you have that disease.
If one would test for cancer markers in your blood, I am certain that some tests would turn positive. But it does not mean you have cancer.
In summary, I just want to argue that human beings are NOT like cars. Yes, you can treat a human being like a car, fixing broken legs like a flat tire, or providing a meal when the battery seems empty. But underneath there is always the human being who needs care, attention, confirmation, a proper diagnosis, and a consented treatment. I just hate to treat test results. I recommend treating the person behind it.
Anyone who knows anything about medicine will understand that one of the most difficult tasks faced by any doctor in any speciality is differential diagnosis. Sometimes, based on examination and reported symptomatology, diagnosis is straightforward, often it is not and one (or more) tests are needed to finalise the diagnosis. Unfortunately, sick humans are not like broken cars - for every 999 patients whose disease X manifests itself with the classic symptoms of A, B and C, there will be 1 patient who has disease X with symptoms C, D and Z.
The last person in a position to make an effective differential diagnosis is the patient themselves. When your chest hurts and you are sweating like a pig - it could be a cardiac event (and I believe that most people would immediately think of that diagnosis), but it could also be an oesophageal spasm, or one of a number of other diagnoses with overlapping symptomatology - hence the importance of an objective differential diagnosis.
Unlike the OP, whose approach I find incorrect, I believe that to take responsibility for your health also means informing the doctor of all medical history (allergies, previous surgeries and major illnesses) and trying to describe as fully and accurately as possible the symptomatology (e.g. instead of saying "my leg hurts", say "I have a dull pain here in my calf which appeared suddenly and which worsens with movement....").
I also think a cautious approach in prescribing antibiotics and analgesics (as practised by all the MDs I have interacted with here in German Switzerland), is the correct one.
Firstly, as pointed out by another poster, indiscriminate prescribing of antibiotics leads to widespread pathogen resistance and the rise of so-called "super bugs" like MRSA (or worse...). It is not a coincidence that countries with the highest incidence of antibiotic resistant pathogens are those countries where antibiotic use is liberal, or worse available OTC. Unfortunately, many doctors are pressured to give antibiotics. GPs (for example) often come under pressure by parents to prescribe antibiotics to children - even if not necessary (I remember being told " ear infections in children resolve in 7 days with antibiotics and 1 week without "). And sometimes MDs "give in" to such pressure by parents/patients (they are only human) - which is unfortunate.
Secondly, in regards to analgesic use, there is a phenomenon known as tolerance, whereby someone needs higher and higher doses just to obtain the same effect. By using high doses of NSAIDs or other non-narcotic analgesics for mild to moderate pain, then there is a much higher risk of serious AEs (e.g. too much paracetamol can permanently damage your liver, sometimes fatally if the paracetamol dose is VERY high).
Bottom line: I think a good doctor-patient relationship in Switzerland IS very much achievable - with involvement and understanding on both sides. But one also has to understand the rationale behind the cautious approach with medication.
do help to work out what one doesn't have.Especially if one has great pain and doesn't have any idea what could be causing it.Again,just my opinion.I am no expert..it's just personal experience. I am always prepared to pay,as long as the treatment helps me.
Even with opiates it's not clearly understood if and how tolerance is developed. In many users, myself included, medium-term morphine (for example) use does not generate any noticeable tolerance effect. It's been suggested that the tolerance observed in long-term use for chronic disease-related pain might be more to do with pain levels increasing
over time than an actual reduction in efficacy of the drugs. (But to be clear, most medical opinion does accept opioid tolerance as the norm, and I'm not trying to argue otherwise).
They took the time to take a detailed, thorough medical history and ordered all the tests they thought necessary; I'm not a doctor, but their examination seemed extensive -- on par with what I've experienced in the US, probably a bit more extensive than in the UK.
Sure, there are good and bad doctors. But I think the ones here generally provide a good level of patient care, and I'd happily put myself in their hands when I'm unwell.
Best
Fine points of scientific and medical research aside, it must be noted that excessive use of the non-opioids can damage the liver or kidneys. Bottom line: analgesics (of whatever sort) should be used sparingly.
Whatever the method, it is certainly NOT objective. We learn the lists of possible diagnoses by heart, learn to use the appropriate investigations to be able eliminate most of them (aka differentiating, hence "differential diagnosis"), and hopefully also the most serious of them, and then come to a final diagnosis with one or two alternative diagnoses in the back of our minds.
Still, it is usually the FIRST diagnosis that comes to our mind when seeing the patient, that turns out to be the final diagnosis. Feverish young adult patient, vomited several times, lying in fetal position with abdominal pain on the bed, more pain when taking the hand from the stomach (rebound tenderness), no appendectomy in history? Most likely appendicitis, maybe even with peritonitis. I don't need a blood test for that, although it will be done, and infection will be confirmed.
That first diagnosis is heavily based on experience. Having seen 20 patients with similar symptoms that turned out to have appendicitis, makes anybody believe that the 21st will have the same.
Still, you are partially right, the differential diagnosis is kind of objective (because we learned it from our text books, and add our experience on top of it), and we certainly use kind of objective investigations to confirm or deny the list of possible diagnoses. To state that patients can not do this because they are subjective would be incorrect. And what about medical doctors suffering the symptoms? When I was in the hospital as a patient, my brain did not stop working, and I came to exactly the same diff diagnoses as all the professionals around me.
I failed to mention that on my last visit to hospital there was a language barrier as well. I started speaking in my intermediate High German to be able to explain reasons for my visit to emergency ward. However it wasn't working to extent that I would know all the important medical words to describe what medications I had taken before and the whole history behind. The nurse who received me she quickly pointed me to the doctor who spoke perfect English. In fact two more medical staff saw me that day who made sure they understood it all right. We had nearly 45min interview with all written down and checked meticulously. I think I was helped by about five people in total using mixture of High German and English. Obviously, they reacted much better when I could explain something in German but overall impression was good. To cut long story short, I was asked about allergies and etc, had my urine and blood tests done, prescribed proper antibiotics and asked to come for control next week. Overall pleasant experience and very caring staff who treated me indifferently to any other local patient for that matter. Btw, my attitude was nonpretentious and without assumption they would have to speak my language.
Certainly many can, but I think there's a fine line between accurate self assessment and guesswork for the layman (but I think this also depends on the disease, I've noticed - for example - many breast cancer patients are incredibly well informed about themselves and their disease)
True, but I've found that when you are "in the business" (so to speak) being in hospital can be VERY scary 'cos you know exactly what it could mean when (for example) a tech reads the ECG and then calls a doctor over.... or the nurse says "the doctor has ordered a new pill for you..."
Although knowledgeable, I avoid self diagnosis because I always think worst case scenario... (even when I'm 99% certain it's another bout of seasonal bronchitis...). I don't forget the old saying that " a doctor who treats himself has a fool for a patient ". Whether or not that is true....... Thank goodness I just do research...
I rarely take pain killers. But sometimes if it's a bad month I need them. Since I don't take them I don't need a lot. So off I went to get some 100mg aspirin so I could keep the dose to a minimum without having to cut the pills
up into little pieces. Nope. Can't buy low dose aspirin without a script! Sigh.
Aspirin is my favorite. Please don't make me change! I don't use that much really. I promise!
Then again, one could argue that there's not reall much point in takng the lower dose. At the level you're using it the chances of any adverse reaction are very low indeed, and the difference between a single 100mg or 200mg dose is likely to be negligible.
Heh. Not any time soon as far as I'm aware.
But Ibuprofen is a very similar molecule and is generally preferred by doctors, as it's got a somewhat better anti-inflammatory effect, so is better for much inflammation-related chronic pain, and also has a much better tolerance wrt gastric irritation.
Also, they act like the patient knows nothing about drugs. "you've been taking ibuprofen? I'll write you a prescription for something much stronger" (hands me a prescription for Paracetamol.)
Now, I have no problem with Paracetamol, it's what I wanted in the first place, but really? You just swapped an NSAID for a general analgesic... Do you honestly think I don't know what Paracetamol is? They're equivalent drugs for the most part.
I wondered if I should to mention to the doctor that if I wanted a psychosomatic boost, I'd go to France and get 10mg tablets of codeine directly from the pharmacist.