Non-Nephrologist Doctors' Knowledge of Kidney Disease

[pelagia]

You can always ask a doc "what would you do if it was your husband/wife/mom?"

[Romona]

I respect a doctor that looks at me and tells me they don't know an answer. As long as they point me in the right direction. My family doctor will tell me to call transplant if she is unsure of anything. My nephrologist is wonderful too, if he doesn't know he'll work to find out. As am so fortunate and blessed to have the great doctors I have now. It wasn't the case in 2005, I was terrified. When I was sent to Pittsburgh I thought I was a goner. Around here being sent there was a last resort. I am not saying the hospitals around here aren't good, I just don't think it is a good choice for me.

[Roadrunner]

Our trouble comes with medications. 
We have the diabetic doctor, cardiologist, nephrologist, internist, urologist all prescribing medication.  We have also moved so most of these doctors are new.  No one wants to change medications that someone else prescribed, but they will add new ones.  We have finally gotten our nephrologist to look at his medications and try to eliminate some.  She is also working with our cardiologist but now the cardiologist says, "she is taking care of your medications and watching you" .  He has backed off on monitoring the medication.  Now he just does testing and send his reports to her.

[stauffenberg]

On the one hand there are clinicians who react with terror when they see a renal patient come into the room, with the result that they won't make a move without the nephrologist, which means that visiting them is a pure waste of time, since ultimately the nephrologist is forced to do all the work, even for issues he initially sent you to the GP to handle because he felt they were too routine to justify wasting his 'precious specialist' time.

On the other hand there are the 'bull-in-a-china-shop' doctors, who know far less than their patients and nonetheless persist in wreaking havoc with the patient's life by prescribing all sorts of inappropriate or ignorantly dosed medications, at the same time as they wave off any protest as sheer patient ignorance compared to their own omniscient stupidity.

Then there are the 'blame-the-patient' doctors, whose first and last response to every failure of a prescribed treatment is to accuse the patient of not following their instructions, since there is no way their own genius or that of the Medical Establishment can be in the least bit imperfect.  These characters only went into medicine because all the student places at the Police Academy were full that year.

The most ubiquitous sub-species is the doctor who subscribes to the motto that when medicine comes in the door common sense should fly out the window.  The main impact of the technical knowledge this type of character has is to drive out of his consciousness all ability to think logically.  A paradigmatic example of this sort are the doctors who insisted that, prior to my transplant, I undergo a 12-hour fast to determine my fasting blood sugar level "just to get a baseline."  I reminded them that as a type 1 diabetic I always had to take a basic dose of long-acting insulin to cover background metabolic processes, whether I was eating or not, so that I always had some insulin acting 24/7.  This meant that I could give them any "baseline" value for a fasting blood sugar they wanted, depending on how high or low I set the background dose.  They wouldn't be measuring anything real about my physiology, but only something entirely arbitrary and artificial, i.e., how far I had drawn the plunger down the barrel of the syringe.  "Oh," they said, "that's the first time a diabetic patient ever mentioned that." And to think, 40% of transplant patients are diabetic!

[del]

We have been in "kidney college" for 11 years!!  We always ask questions, question the reason for changes, do research. When hubby was in center he actually told the nurses things they didn't know lots of times!!!  One neph he had was constantly pushing transplant. Started to get on hubby's nerves one day hubby had had enough. He told him that when he was ready to have a transplant he would let him know and not to ask him again

[lruffner]

I am fortunate to have just started going to a new PCP that actually has a clue of what is going on in the human body. Not only being an MD, he has a Master's in physiology, so he gets most of it. He does thorough research on any and all drugs before prescribing them to me. He is faculty for the Univeristy of Kentucky and teaches physiology for them, so he has full use of their online pharmacology and medical databases. If anything is questionable, he will ask me to contact the tranpslant hosptial to get the drug approved, because he sincerely doesn't want to do anything to hurt me.

I have been through all of the rest of them...know it all's, you know nothing's, it's your fault's, etc. Hopefully I am done with all of those idiots. 

[okarol]

We saw Jenna's transplant surgeon last week. I asked him about the idea of reducing or eliminating immunosuppressants and where research is heading. He gave me a 3 part answer and when he was done I said, "Well, that's good, you've confirmed everything I have been able to learn about the subject." And his reply was "Oh good! Then I have passed the test?" He is bright and good natured and takes so much time with us, I am always pleased when we leave Scripps Hospital, knowing Jenna's is probably getting the best care she can.