A typical family doctor’s appointment is scheduled every 15 min where I am (except for annual checkups). This includes the time between patients for any necessary paperwork. So, not much you can do for people with rare symptoms in that setting. This is where MetaMed can help, since they spend 100 to 1000 times more time than that on each case and are looking specifically for edge cases and individualized treatment.
I agree that fifteen minutes minus paperwork is shockingly short. Still, there are doctors who do reasonably well at paying attention.
Most of my information is from the fat acceptance community, where there are a great many stories about doctors who just tell fat patients to lose weight*, regardless of symptoms. The typical stories seem to be either “I had to go to three or four doctors to find one who would listen” or “I must be lucky, I have a great doctor”. I can’t derive a strong opinion about the proportion of attentive doctors from this, though I wouldn’t be surprised to find that it’s under half.
*I’ve also seen a few stories from unusually thin people who were simply told to gain weight, and one from a man who (as far as I could tell) was lean and muscular, but was told to lose weight by a doctor who literally only looked at his BMI.
A fat friendly professional does not necessarily avoid mentioning a client’s weight, but he or she avoids making an issue of it, avoids lectures and humiliation, and respects the client’s wishes with regard to weight discussions.
If a client asks not to be weighed, the request is acknowledged without complaint and taken into account automatically on future visits. (Note: there are a few cases where weighing is necessary, for example, when administering certain medications, chemotherapy, or anesthesia.)
If weight sometimes contributes to a problem, the professional may mention this, but also considers other diagnoses and recommends tests to determine the actual diagnosis if appropriate. If weight loss is a recommended treatment for a problem, the fat friendly professional may mention this, but at minimum will also recommend and prescribe other treatments. A fat friendly professional accepts a client’s wish not to use weight loss as a treatment.
Ideally, the professional’s office has available armless chairs, large blood pressure cuffs, large examination gowns, and other equipment suitable for fat people. If not, the office acknowledges the importance of such items when told.
Some fat friendly professionals believe that fat is not unhealthy. Others may believe that fat is unhealthy, but may acknowledge that weight loss doesn’t work or is dangerous and/or that the client has a right to direct his or her own treatment.
Sure- but if you have some rare symptom, any decent family doctor should say “go see a specialist” and refer you. You certainly aren’t going to contact metamed every time you get sick, and for chronic conditions, a specialist (with journal and up-to-date access) is going to be the managing physician. Anything other than routine sniffles, vaccinations and check-ups and you probably have exceeded your family doctor’s expertise.
The big problem for misdiagnosis at the family-med level are the hordes of relatively rare diseases with common symptoms, but this is a very hard problem to solve. Having spent some time dealing with this as a statistical problem, even if you have a rare cluster of common symptoms, its usually the case that you are more likely to have a rare presentation of a common disease than it is that you have a rare disease.
A typical family doctor’s appointment is scheduled every 15 min where I am (except for annual checkups). This includes the time between patients for any necessary paperwork. So, not much you can do for people with rare symptoms in that setting. This is where MetaMed can help, since they spend 100 to 1000 times more time than that on each case and are looking specifically for edge cases and individualized treatment.
I agree that fifteen minutes minus paperwork is shockingly short. Still, there are doctors who do reasonably well at paying attention.
Most of my information is from the fat acceptance community, where there are a great many stories about doctors who just tell fat patients to lose weight*, regardless of symptoms. The typical stories seem to be either “I had to go to three or four doctors to find one who would listen” or “I must be lucky, I have a great doctor”. I can’t derive a strong opinion about the proportion of attentive doctors from this, though I wouldn’t be surprised to find that it’s under half.
*I’ve also seen a few stories from unusually thin people who were simply told to gain weight, and one from a man who (as far as I could tell) was lean and muscular, but was told to lose weight by a doctor who literally only looked at his BMI.
International list of fat-friendly medical professionals
Sure- but if you have some rare symptom, any decent family doctor should say “go see a specialist” and refer you. You certainly aren’t going to contact metamed every time you get sick, and for chronic conditions, a specialist (with journal and up-to-date access) is going to be the managing physician. Anything other than routine sniffles, vaccinations and check-ups and you probably have exceeded your family doctor’s expertise.
The big problem for misdiagnosis at the family-med level are the hordes of relatively rare diseases with common symptoms, but this is a very hard problem to solve. Having spent some time dealing with this as a statistical problem, even if you have a rare cluster of common symptoms, its usually the case that you are more likely to have a rare presentation of a common disease than it is that you have a rare disease.
I think MetaMed is intended to supplement the treatment advice you’d otherwise receive from specialists.