It's like these people learned a subset of their field and then just refuse to ever learn anything new.
It's completely obvious that the doctor isn't going to really read the paper (he's too busy). You just present a paper and suddenly the doctor will trust you more. Literally it's deference to Authority being employed by the doctor here; nothing going on with rationality or logic.
Don't present a single logical argument to the doctor. If that argument, however logical, goes against traditional medical knowledge you will be dismissed. The key is to forget about logic and use an authoritative approach.
I'm betting the actual contents of those research papers don't even matter. You can print out a completely bogus study, just make sure it looks legit.
There has to be some degree of verification regardless of how complex the world is. At the very least he should read the paper. Because not doing so is hypocritical. Doctors treat patients as dimwitted idiots but suddenly the patient is smart because he has a paper? No, you can't make that judgement unless you read the paper.
What the mother did here was more rational and logical then every doctor in the department of UCLA. Think on that, then think about the amount of money UCLA charges patients and whether or not this sort of incompetency justifies this high level of monetary compensation.
I would say all people are irrational and biased. The issue is Doctors in general think they're better than everyone. They dismiss the fact that the biases and crazy ideas that effect all of humanity could effect them as well.
He also went through and dismissed most of the more worrying possibilities, which set my mind at ease, and narrowed it down to a more likely condition.
So basically, I threw in a bunch of options and most of them were wrong. Thankfully I didn't walk in convinced that any one of them was absolutely the cause, but I imagine some patients do, and it can be a pain for the doctor.
B) Just like IT Support, doctors abilities are distributed on a bell curve. We all hope that the curve is leaning to the right, but I think the jury is still out on that one.
Think of it this way; in Europe it is far easier to become a doctor then in the US due to significantly less stringent requirements. However in Europe and other 1st world countries treatment and other quantitative measures on quality of medical care beat the US by a far margin.
It shows that the "unpleasantness" is pushing something to the right of the bell curve. However it is clearly not pushing "effective medical diagnosis and treatment" to the right of the curve as Europe is beating us on that front with far less stringent requirements.
[1] It's supposed to be legally limited to 80, but ask around and it's obvious that even that limit isn't properly enforced.
The big problem is that 2 is true.
In fact, education and medical systems are different enough between Europe and the US that saying one is harder is very subjective. For instance, american specialists are really hyperspecialized. They often excel at what they do, and are completely ignorant of other fields. Europeans often have a much broader medical knowledge. They are also far less aggressive. All in all, I much prefer Europe.
Either way if you're saying the "hardness" is the same, the conclusion still stands. "Hardness" is not the metric that is making European quality of care better than the US because both countries have the same "hardness".
What makes you think that they are filtering for good physicians? Or even filtering for those who are capable of becoming doctors?
Here in South Africa, post-1994, universities adopted a very aggressive affirmative action policy to correct imbalances of the past. While med-schools had previously been based purely on merit, post-1994 introduced quotas for each of the major race groups.
This meant that a disadvantaged-background student with a C average would often be picked over an advantaged student with an A average.
The result was still doctors who graduated, and then went on to practice. The restriction by med-schools everywhere is not because only high-performing students will survive it, it's a purely artificial restriction.
After all, if C average students pass, why not simply increase the intake?
It sucks, but as with any human system, the majority has priority, minorities have to wait for their turn (and/or actively fight for it).
Have a weird condition? Sorry, but most of the time you'll be out of luck. And there isn't really anything planned in our healthcare systems to help you. And frankly, people coming into my practice wielding science papers often understand neither what they read, nor that they are asking for an impossible thing. The best I could do if your claim seems realistic is to refer you to a specialist in the matter, but never ever would I act solely on the basis of research papers. And that's because I am a researcher myself, so I know how unreliable that is.
I think you're right that most doctors don't do research, but doctors publish papers all the time. if I look at a surgery journal I'll see articles by surgeons. my doctor isn't like, in the lab running tissue assays, but he'll try experimental things when no clear-cut treatment exists, see if they succeed or fail, and adjust his practice accordingly.
also, dismissing people with "weird conditions" as "out of luck" is a pretty crappy thing to do. I can understand not having enough time or background to handle those cases, but I sure hope you're referring those people to someone who can rather than giving up on your patients because you can't be bothered.
What people don't understand is that modern medicine is not centered around the practitioners but around precise guidelines that are both medically and legally binding. When I say that you're out of luck, it's not to spite anyone. If a competent clinician specialist examined a case and sees no way out, going to the big fish professor will not benefit you otherwise than maybe entering a study, because from a reasonable clinical pov there are really many conditions for which we can only offer support.
So sometimes, no one "can". But clinicians are not expected to use creative thinking, and that's the very best medical evolution since the past century. It's the job of researchers to read science papers and formulate the guidelines to be transmitted to clinicians. You REALLY should not be doing that all by yourself as a practitioner.