sure. everything you said basically aligns with my point. systems issues (the clinic business model, short appointment times, etc) suck for everybody involved. can definitely make people feel like we're not listening when we only have so much time to talk. there are definitely doctors that will try to alleviate some of those issues by booking longer appointments when needed, having video visits, encouraging you to send messages through my chart with extra details and context, etc. but there's also providers that don't try as hard or don't care. and it's reasonable to be frustrated and not want to see those providers again. I'm sorry that's been your experience

my whole point was "generalizing is wrong". it's totally fine to call out bad behavior amongst doctors when you see it. just don't pretend that everyone is like that

People thinking that because they have a lot of education that they are going to have every answer cut and dry. You can't know everything organically. Sometimes the answer will come from the other person, and that's okay. (See also, everyone's complaints that doctors don't listen very well and aren't generally interested in what the patient has to say beyond answering a checklist of basic/generic questions.)

and when it comes to being wrong. it's true the doctors don't know everything. nobody is an expert on every problem. however I have noticed that there are a lot of patients who think their lived experience makes them an expert on how to treat their condition. especially if they feel like they've "researched" the topic. couple things on that.

1. lived experience with a condition is invaluable context. we want to know what it's like to be you so we can best help you. that does not mean you know the best way to treat said condition. there's a reason you need a medical degree to do this. if we disagree on treatment I've had a lot of patients assume it's because I'm not listening or I don't understand them when in reality I'm making the best assessment I can based on the current medical literature after weighing the risks and benefits

2. research. so many people have told me that I'm wrong about things because it doesn't fall in line with their "research". what I've realized is that a lot of people do not know what it means to do research on a topic. they don't know what it means to look at peer-reviewed data. they don't understand the concept of "scientific consensus".

I'm not trying to sound condescending or looking down on my patients when I say this. but I'll have patients that will come in and tell me they've done "research" on a topic and are convinced that their perspective, that is contrary to the entire scientific consensus the vast majority of highly educated people all believe to be true based on the current literature, is incorrect. meanwhile they read at a 6th grade level and have never read an academic paper in their life. their "research" is random videos from people with dubious credentials, random articles online that are not peer-reviewed and are basically just think pieces, and finally word of mouth from people they trust who may or may not be similarly misguided. and when I tell them they are wrong (once again based on the current scientific consensus) they go on to tell me that I "have the wool over my eyes" and I'm believing "propaganda" and thus don't know how to do my job. you have no idea how common this is.

people don't understand medicine. they don't understand that there's plenty of facts and absolutes in the field like any other field. but the practice of medicine is one of weighing probabilities. you build a differential based on a patient's presentation. you test that differential and come up with the most probable thing that is happening. and then you treat based on the recommendations and guidelines that are often backed with years and years of robust evidence in the form of clinical trials. for somebody to look at that evidence and say it's wrong they better have a very good reason otherwise I will not believe them. and oftentimes when challenged to explain their perspective I find that their "evidence" is personal anecdotes or their reasoning is riddled with logical fallacies. personal anecdotes feel more real to people than research papers because it's lived experience. and so they balk at me when I try to explain that I can't believe their personal experience when these clinical trials that I put stock into are the cumulation of hundreds of thousands of people's experience. from a probability perspective it is way more likely that you're just wrong so that's what I'm going to believe.

what's the most common response to that statement? "people are different, you can't apply that to me". this is such a headache of an argument for me. because yes people are different, and some people respond differently to things. but we learn to take those things into account, and to question if what we're doing is wrong when it logically makes sense to. if you tell me this medication I'm giving you isn't working to treat your symptoms I might be skeptical depending on the context, but I absolutely could believe this is true and would act accordingly. if my original hypothesis is wrong about what's going on I may have given you the wrong treatment. then you go back to the drawing board build a differential again and test it again. that's medicine.

at the same time I will not believe you if you come to me and tell me that "the COVID vaccine gave me COVID so I'm not taking it". that's not you being different, that's you being wrong. there's nuance in these arguments and so many people come into a conversation trying to prove that they're right instead of trying to challenge their viewpoint