1. They Do Too Little – Too Late Doctors often don’t BELIEVE any new information they hear until it becomes old and too late. Let’s face it, one year we hear news sensationalizing a “new discovery” and then a few years later, we’re told that the “big discovery” didn’t turn out to be so great after all. Doctors get weary of new claims, because of frequent changes in the research. The opposite can happen as well. Instead of a “new discovery” that may offer an exciting change to the status quo, doctors can be driven to stop a particular form of therapy due to speculated preliminary reports on an upcoming research release.
Because these preliminary results have not yet gone through the scrutiny that occurs after the study has been completed, it is not uncommon that the final research results do not correlate with the speculated results.
For instance, this happened when the Women’s Health Initiative was halted in 2002 and hysteria around the fear of Estrogen causing breast cancer and heart disease occurred. These were speculated results 2 years before the study had time to be carefully studied, and in 2004, confirmed in 2006 and 2007 – the backtracking that occurred to clear up the miscommunication was not reported to doctors or the public. In fact, it wasn’t the Estrogen itself that caused breast cancer and heart attacks, but instead the synthetic progesTIN in Prempro that was responsible.
But by this time, the damage had been done and the small number of doctors paying attention, didn’t know who or what to trust. We all would like to have a good bit of history behind anything that is new before we use it, or in the latter case, stop using it. For instance, I prefer not to prescribe new drugs that are introduced to the market until it has been around for at least 3 years and preferably 5 years.
By then, we have had the opportunity to hear about the most common side effects. That all sounds well and good, but it can also hold back a potentially good treatment if one is too conservative, holding back new therapy just because it’s “new”. We have to balance trusting new treatments with being too cautious in order to provide the best care for individuals. And this balance is often a difficult process.
2. They haven’t HEARD of the new information. There is so much information being thrown at everyone these days, it can be years before a doctor actually even hears about something new. In fact, research itself has identified that new information actually takes SEVENTEEN YEARS to make it down to the front-line doctors – the ones taking care of patients! In this age of technology this seems crazy! But it’s true. To worsen this situation, it takes DECADES before new information and research is even discussed in medical societies. This is especially true for research that does not originate in America. Government agencies can delay new information, delaying potentially helpful front-line treatments.
Natural treatments face ridicule and are also delayed by pharmaceutical companies as well as medical societies that prefer to keep patients within the conventional aspects of medicine. You can see how physicians are not always even aware of the latest information. Medical societies and research universities are often supported by the money of big pharma! So new information is not only held back, but also MIS-represented with a slant that supports the interests of the pharmaceutical companies, government, medical societies, and even universities whose research is supported by them. Most people know this is happening, but we feel helpless in changing it.
This is where grass root efforts may be all we have until many years pass. The best thing a doctor can have are patients who feel comfortable enough to share new information with them. I have learned many things from my patients. In fact, that is one of the main reasons I am so slow with patient care and personally see so few patients in a day. Though I may only see 5 patients… I’m spending an hour or more with each one! When they tell me something I am constantly asking more questions around their comments. I have learned a great deal practicing this way. Not only about the patients, but also information that I later use when I am talking with other patients.
I honestly believe this has expanded my knowledge base tremendously. If your doctor isn’t interested in what you have to say… you can bet that he isn’t learning from his/her patients and are limited by the new information they take in from conferences and medical journals. But the act of caring for patients is the number one opportunity to learn new things – NOT at conferences and in medical journals. Patients themselves are the one who bring the most significant and powerful lessons to doctors.
3. They don’t WANT to know the new information. If new information becomes available, even with a proven track record, such as what we know today about bioidentical hormones verses synthetic hormones, that still doesn’t guarantee your doctor will devote the time it takes to master the new information if it requires a set of new skills. Many doctors are just not prepared to tackle a whole new set of skills!
Especially if they have been practicing for years. To spend an extensive amount of time learning a new skills after already having a thriving, busy practice, is not something a doctor is going to jump for joy over unless the subject matter is something they have been following or personally interested in. As doctors obtain more experience in their practices, they find their own interests and niches which drive their focus and development of subspecialty care.
Take me for example. I found my niche among an interest I have in midlife women. Though I am a very competent physician in caring for complicated multi-system diseases, bioidentical hormones and the care of midlife women has become a strong subspecialty of mine. So along with the conditions all doctors expect to see on a regular basis, we doctors tend to gravitate toward our interests.
Therefore, when new information is available to a doctor who has no interest in the topic, they are going to be far more interested in either disregarding the new information, or simply referring the patient out to another doctor. However that doesn’t mean that even the specialist will be up to date on the newest information.
There are so many different conditions that specialists treat these days, that we are now seeing SUB-specialties – or “Specialists of specialties”. In fact, there are even sub-specialists of sub-specialists. Critical Care sub-specialists in the field of pulmonology.
Geriatrician sub-specialists in the field of internal medicine. Geriatric psychiatry sub-specialists in the field of psychiatry. Neonatologists, (infants), sub-specialists in the field of pediatrics. Retina, (part of the eye), sub-specialists in the field of ophthalmology. Hepatologists, (liver conditions) sub-specialists in the field of gastroenterology. Anti-aging sub-specialists in the fields of internal medicine and family medicine. Electrophysiologists, (strictly the electrical part of the heart) sub-specialists in cardiology. And the list goes on.
4. The topic may not INTEREST them. If a doctor is interested in a particular subject, he or she is going to focus their on-going study on the subjects that interest them and listen to patients with more intent when they are talking about a condition of THEIR particular interest. If they aren’t interested in a particular condition, it is likely they aren’t nearly as up to date as a doctor who finds the subject interesting.
In my geriatric rehab practice, I work with another doctor who is a master at caring for patients with joint replacements and musculoskeletal injuries. He’s a sports enthusiast and enjoys working with these patients because it seems like the two go hand in hand. Personally, I don’t really care about one sport over the other and certainly don’t even know what sport is going on nationally – even. I just remember that there is some football game playing sometime after the New Years and their commercials are supposed to be interesting to watch. (No exaggeration!) So, the doctor I work with takes all the broken bones, joint replacements, and trauma cases and I take all the congestive heart failure patients, pneumonia and COPD cases, and patients with multi-system failure. My gynecologist is another example.
He is not a bit interested in menopause or hormone replacement at all… and doesn’t manage any menopause symptoms. He sees himself mostly as a gynecological surgeon and has mastered De Vinci Robotic assisted surgery. Some gynecologists specialize in delivering babies and have no interest in menopause. This specialty and subspecialty is the new medicine of today. And it’s not going to go back to LESS specialty care – ever. It will only become MORE specialized. So, you see, doctors often choose what interests THEM most, and if you end up sitting across the room from a specialist who is not interested in your particular concern, you may get less than optimal care. Don’t shoot the messenger. It’s true.
5. They are simply CLOSED-MINDED individuals. That’s right. Some doctors are just closed-minded just like anyone else might be. Closed-minded individuals get an opinion on something and that’s that. This can be the worst of the 5 reasons that cause you to get stuck between a rock and a hard place because closed-minded doctors usually don’t change their tune even when they are presented with rock solid evidence. But don’t get discouraged about finding help just because one doctor poo-poos something you feel may help you.
Keep in mind each of these 5 of these things which may delay you getting the help you need and want. Stay focused on what is right for YOU and YOUR body. Keep reading and discovering all that you can find, and never stop suggesting what you have discovered to your doctors. I promise you, you WILL eventually find the right doctor to help you reach your goals!
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