What Doctors Won’t Tell You

Looks at the factors that determine what doctors are able to say or not to say to you when you consult with them.

Erasmus : Doctors are people with personalities. So, depending on the Enneagram type of the individual doctor, your interactions and experience will differ.

Kinkajou : So, what sort of problems do you think people may run into when relating to doctors:
Dr Xxxxx : Political Correctness. One friend of mine was censured by the medical board for telling a paedophile that he should not abuse children. You can imagine how careful he would now be in saying just about anything which could be objected to. Doctors in Australia are perhaps not allowed to ask questions about sexuality, even though it may be relevant to the consultation/problem at hand. Doctors are perhaps not allowed to mention race (Chinese/Caucasian/Negroid/Aboriginal), even though it may be relevant to the consultation/problem at hand. Doctors need to be careful about discussing the legalities of things that patients may be doing, even though it may be relevant to the consultation/problem at hand.

Politically Correct Doctor

 

The easiest and safest thing to do - is not to say anything at all. If the person doesn’t know about it, they cannot complain about.

So, there are many things that doctors will not mention that may be controversial, even if they are of benefit to you.  You probably will never learn what you are not being told.

Dr Xxxxx : On Saying No.
Another friend of mine was censured by the medical board for refusing to provide a certificate that he did not feel he was justified in providing, (requiring him to not being truthful to issue it). So, his new strategy was to always say yes. Yes I’m happy to do this for you, but I need – this information – I need you to see the specialist – I need this information from hospital clinic – I need you to obtain information from your previous doctors.

This gets people out of the doctor’s consultation room and can get the patient permanently refused access to the doctor if the doctor notifies the clinic’s booking system.  It creates difficulties and delays for the patient in search of their certificate/paperwork. You probably will never realise that you have received a “No”.

Erasmus : Doctors who are Enneagram “sixes” can be described as a distrustful, slightly paranoid, suspicious people whose orientation is to work “around” your problem and not to give you what you want unless they are absolutely comfortable with doing so. You will see explanations, excuses and all sorts of evasive manoeuvring to get around the issue.

The Enneagram “one” Doctor is a perfectionist who is always right. They can be quite narrow-minded and obstinate in their pursuit of what they regard is the perfect outcome. And heaven forbid if you’re doing something a little bit “underhand”. They can be very intolerant and insulted by any such activity. The belief system is that they are always right and that they know best. They generally only see one path through a problem to a solution. They are not the sort of people who develop multiple management scenarios.  it’s just their personality.

Perfect Doctor Enneagram "One"

Dr Xxxxx : . It may well be a bit of Paill Spectrum as well.

Kinkajou : True!
Dr Xxxxx : Paill Spectrum gives you – concrete thinking with reduction of laterality of thinking, (a loss of the ability to think of multiple solutions scenarios), poor memory, poor judgement, poor cognition and a loss of sequencing ability. Doctors are just as susceptible to this condition as anybody else. The only difference being that with a higher education and hopefully intelligence to start with, it takes longer to go downhill.
Erasmus : Enneagram “eight” doctors are a unique scenario. This personality type could well take you under its wing and protect you as much as any human can through any crisis. If they decide they are not sympathetic with you, they can abandon you just as easily.
Dr Xxxxx : In medical consultations, Enneagram “eights” have a definite energy. And Enneagram “eight” will Paill spectrum would create some very bad behaviour indeed. Worst case scenario is the affected doctor looks at you for one second and knows everything that is wrong with you.  And people like this, because the doctor has instantly worked out their problem, when no one else could. The reality is this doctor has not worked it out either. They just have made quick strong decisions, not to be argued with.

But let’s face it, a well-informed and intelligent doctor can well often make the correct diagnosis at a single glance. Often the diagnostic process is a very rapid process. Quite likely, 80% of the time doctors you will get it right - first time.

Dr Axxxx :Medicare in Australia (the public health medication program) loves this type of doctor. They see lots of people quickly and cheaply, diagnose most of them adequately and save a fortune for the system.
Dr Xxxxx : I remember once talking to a friend about the Medicare (Australian public health insurance) system’s failings. I said that if you just give the doctors 15 minutes to work through a problem instead of 7 to 8 minutes, you get an improved diagnostic rate of up to 95% in most medical consultations.

My friend replied – just think about it. For $6 billion you can get things 95% right, whereas for $3 billion you can get things 80% right. And for those people in whom you do not get the right diagnosis the first time around, if they go back to the doctor you can probably get it right on the second consultation for a cost of ¼ of a billion. What do you think the system would like – a bill of $ 3.25 Billion or $6 billion.

Doctors Work Against the Clock

 

Goo : A cynical comment on the financial aspects of a publicly available universal health insurance system

Erasmus : Next. Let’s talk about Time Constraints. There is only so much that you can do in the average doctor’s consultation time. If you bring three problems to a 10-minute consultation each problem gets three minutes of attention each. So, if you really want things to be worked through intensively and properly, you need to allow the doctor time to do it. Doctors who do still try to give significant amounts of time to people, end up being swamped, burnt out and broke. These doctors become saturated with patients, and have a lower capacity than the average doctor to deal with their patient load.

Many people look at the medical consultation situation and think that the fees are high. The reality is that each consultation needs to pay for these three basic items.
1. Infrastructure: Staff and admin,
2. Accessory business costs like insurance, repairs, rent and finally
3. wages.

And then there is a need to provide a salary for the doctor. The only way this structure works is to sell a large number of consultations, at small-time fragments which although they seem expensive, are within the realms of what many average people are able to afford. A friend I know who was seeing 40 patients a day (bulk billed) was amazed that someone could set up a Sleep Apnoea clinic providing machinery to sleep apnoea patients and earn sufficient money to keep the business rolling over. My friend was having problems making adequate profits seeing 40 people per day. The Sleep apnoea clinic was seeing 2-3 people per day.

Kinkajou : It is when you see issues like these that you can see the constraints which bind doctors’ activities. They will often do what they have to do just to get by. There are financial and time constraints on everything the doctor can do for you. And they will not be telling this to you. It takes far too long to explain.

Erasmus : Let’s talk about Low Empathy doctors.
Enneagram self pres is the classical personality type of low empathy. People with this personality type are capable of empathy, but the personality generally creates a distance between the person and empathic behaviour. If you want to get warm fuzzies and feelings from your medical carer – maybe this is not the doctor to go to.

Empathic Doctor

There is nothing wrong with these doctors. Its just how they look at life. In fact, this behaviour may well be a big bonus for patients. These doctors are far more likely to tell you the bad news: All of it. Not to hide away the bits that they know  you won’t like to hear. You get all the facts.

The medical profession as a helping profession. Most people are committed to working hard to try to give you the best outcome. But doctors cannot change their personality. Doctors cannot change their degree of Paill Spectrum brain damage. Doctors are still people. And people make mistakes and get things wrong.

Generally, most effective relationships are partnerships and you get as much out of it as you put into it. Most doctors will look after you well – if you are committed to the relationship.