What About Clients?™

My wife is an MD. I like to refer to her as a "Minor Deity." I won't let her read this post though.

Thanks, but maybe you should let her read it.

We trust she's an exception, and could begin new blog: "What About Patients?"

Yours in the struggle,

Holden

Fortunately or unfortunately, every doctor or lawyer must also be a good businessperson. Medical school and law school exist to impart knowledge of medicine or the law, not necessarily how to deal with clients and not how to admit when we're stumped.

Yes--but lawyers have more of an excuse. MDs see patients while school is going on. Hey, what if law school was split: 3 semesters of class and 3 semesters of work as an apprentice?

That's nice and good, but you're missing the reason why doctors act this way: because their "clients" aren't the ones who pay them. They get paid (by government or insurance agencies) regardless of the quality of service.

I disagree with the sentiments posted here. I see about 22 patients a day + manage another 30-40 patients by reviewing labs, placing hospital orders, home health orders, and nursing home orders. Do you realize that probably 50% of my patients don't even work, are on disability (not for something for which I believe they are truly disabled). Probably 90% of my patients are obese and all of their health problems are related to their obesity. If I were to deal strictly with problems that actually need to be evaluated by a doctor, I'd see maybe one or two patients a week. DO you think I'm compensated for 15 minutes on the phone with a patient? I have to have my patients return for visits, because that is the only way I can bill for answering questions--and why shouldn't I bill? It's my time. I'm just as responsible for the things I say on the phone as I am for the things I say in person--so why shouldn't I be able to charge for that information? Don't be quick to make judgements until you spend a day doing my job. If you can do it nicer than me, I applaud you. My patients are appreciative of what I do for them, but I do need to charge for my time. I"m not a free laborer and I owe way too much on my student loans to work for free just yet.

You're an idiot. Really, it's pretty simple actually. The answer to all of your questions is, simply, you're an idiot.

Go chase an ambulance, fucktard.

DP/anon: Nice analysis. You must be a medical student. But do MDs see themselves as having any duties (public, private, otherwise) to patients at a care and service level--or do they get a pass? Who do you guys work for? Why shouldn't you start coming over to my place?

My wife's a doctor and I'm a lawyer. We both suck when it comes to client/patient relations. We hate them. They're too needy, too stupid, too fat, too lazy, too poor, etc. I can go on but why bother? If you have to deal with the retards that we have to deal with every day, you'd think pretty highly of yourself too, and have a bad attitude to boot. Face it, America is full of fat, dumbshits who have an entitlement mentality and are too lazy to get off their fat asses and take care of themselves. Hence, doctors loath their patients. As for lawyers, we don't respect our clients simply because they are just so ignorant about the law. They think the practice is "just like" LA Law or Boston Legal or Law and Order, and they can't understand the most simple concepts like - hey, you put your fate in the hands of 12 other dumbshits and you might lose even a "slam dunk" case sometimes.

Tom--We accidentally lost your e-mail address, and so we'll thank you this way. This was one of Holden's (Oliver's) "I can't take the mediocrity anymore" posts. But we both think that both lawyers and MDs are out to lunch on service and care issues. We both believe, however, that MDs--not lawyers, who often evolve into stone creeps and robots--should know better. MDs do seem to lack a sophistication about the world they live in, which is both entertaining and frightening. Your comment was inspired and interesting. You confirmed my notion that MDs were getting tired of adult "babies and wimps" as patients. Despite my past support of many U.S. Democratic Party ideals, I am re-thinking a few things. The longer I manage a business, the more I divide the world into two categories: producers and looters. The "down" economy has not, in my view, made people rise to the occasion or reclaim their self-respect. Still lots of type-As and doers out there, though. For a while, they almost went out of fashion. Thanks, sir. Dan

I am a lawyer and frequent reader of this blog. My husband and father are both doctors. That being said, this post infuriates me. As an attorney, you pay for three years of school and once you leave, can pay off most of your debt with a few phone calls that you can bill out at $250/hr. Doctors today don't have that luxury. On top of 4 years of medical school, MDs have to then attend an average of 3-6 years of residency, where they get paid less then minimum wage and working all kinds of crazy hours. Then once they get out, they may be paid $5 for every $1000 that they bill to the insurance company for taking care of YOUR ass. Even still, half of their salary typically goes to paying their malpractice insurance to protect them against patient’s frivolous lawsuits. Unlike us, they don’t get paid for every minute they spend on the phone with you; hell, they don’t even get paid for seeing you half the time. Moreover, I highly doubt that your pre-med friends were “dumber then a box of rocks.” Do you know how difficult it is to get into medical school? Or worse, how difficult it is to get into a residency program? Any idiot can get into law school; you take the LSAT which gages nothing about actual intellectual knowledge and is not dependent on anything you have ever learned in any school ever. Medical school on the other hand requires students to take numerous courses that are very rigorous (and do well on them), in addition to taking the MCAT which is an 8-plus hour exam. Medical schools also interview each and every applicant to make sure that they are not a complete moron despite their excellent MCAT scores, unlike law schools who let anyone in who meets their threshold LSAT requirement. Then, MDs have to pass at least three rounds of medical boards in order to become licensed, whereas we attorneys only take the one Bar exam (which is again, dependent on nothing we ever learned in law school ever). So next time your doctor doesn’t give you the smile you feel you deserve, go add up your billable hours and suck on them.

Disgusted: Let me jump in because I believe even more strongly than Holden does that MDs and lawyers both are becoming increasingly shallow, numb and "hardly there".

But your points are well-taken, persuasive. I get what you're saying. And I've heard it. But I don't think that either profession gets a "pass" on care/service duties or being a complete human because (1) these professions, done right, are very hard or that (2) the people we serve are often a pain in the ass. Both being doctor and lawyering are supposed to be very hard; if the "people" part of it gets to us day in and out, you need to try another line of work. You can't divorce the skills from the patient and client care part.

And in college I really did think that the vast majority of pre-meds were missing an important chip or two. (It was Duke, so there was scads of them--and I knew lots of people.) The one exception, maybe ironically, was future shrinks. Psychiatrists perch on the fringe of the medical profession--and they can be very strange creatures. But at least everything is "there", if even in a disassembled and loopy way. I am NOT a fan of therapy. In fact, I think it's a crock. But shrinks at least do seem to "draw on everything" about themselves, and also draw from the world around them, to do their jobs. That tells me that it's possible for MDs--and lawyers, for that matter--to become more roundly and fully educated humans. If they can't or won't, they'll evolve into dreaded household appliances, cranky and self-absorbed equipment that can talk.

The common "sin" to both groups? Maybe it's not using everything you've been given--all aspects of yourself good and bad, emotional, intellectual, gut instincts, etc.--to be a professional. Keeps you from ever being "smart"--or anything that remotely passes for a complete human. Most lawyers strike me as pretty mediocre, uncomplicated, simple and harmless. But MDs? With so many of them, there's just not much going on AT ALL, and not much "soul". I wonder if the medical school education and process--the difficulty of getting in, and going--keeps a lot of physicians from ever being truly "smart", complete and, hey, happy, and therefore better at their jobs. And, sure, there's a few lawyers like that, too.

a doc here, stumbled following a ralph steadman search.

post has a bit more truth than many would care to admit, although i disagree with parts as well. then again, while i finished in the lower half of my med school class, a few years later i was catching and correcting the errors of my 'smarter' classmates. i wasn't a pre-med, until after i had earned my degree (in exercise physiology, of all things). i was a bit higher on the common sense scale than my peers, imho. ie--i exited the stock market 100% in august '07. not from being smart, but from listening to smart people, and ignoring the liars.

in any event, doctors are for the most part sheep. and we are indeed servants, but not to the public. we are servants of the insurance companies. how else to explain the drastic increase in number of patients we see per day (mislabled 'productivity') while having our income decrease, in most cases absolutely, in all cases adjusted for inflation. unless you bought shares in the big health insurance companies.

we as a profession are failing in providing good health care. but we have failed ourselves much worse in the process, handing over control of our system to the insurance industry w/o a peep. only way it will get worse is as the government further inserts themselves. as the public and the docs go after one another, ignoring the real power.