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Comment by ad_hominem | Hacker News Reader

> In this trio, I blame the doctors far more than anyone. Patients have no clue, they just want to be cured. It's the responsibility of the doctors to only prescribe what is necessary.

That's a bit naive. Many patients practically demand pills, and if you displease them all you'll take a hit on your "patient satisfaction" metrics, which in turn displeases the hospital administration as things like Medicare funding are tied to these metrics. So unfortunately, doing what's best for the patient doesn't always correspond with what's best for the doctor keeping their job.[1]

Blaming the doctor for having to make an impossible choice is not entirely fair. I think the federal government (Medicare) and hospital administrators need to reevaluate the weight they put on patient satisfaction and the pressure it puts on physicians as well as patient outcomes.

[1]: http://www.medscape.com/viewarticle/821288

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Maybe if a patient demands pills, fine, the patient has already been brainwashed and lost and you have to give them what they want or you will get a bad score.

Yet whenever I visit a doctor for some minor issue, I have never asked for antibiotics, yet Doctors ALWAYS just straight away say I'm going to prescribe you such and such antibiotics.

I always push back and say is that really necessary? And they just get all glassy eyed and spout that this is the standard course they always do, as a preventative measure. (Despite that usually these interactions are over some issue that resolves without any difficulty when I don't take their prescription).

Would it be so hard for them to just stop the bullshit when it is clear the patient has a brain and is not going to be angry with them for not "givin them their pills"?

I completely agree with this, but also think that it's important for patients who are sick to leave their doctor experience somewhat soothed.

I think that if a patient listens to explanations about how antibiotics won't help with their viral infection, but still wants something to be done, that perhaps doctors should be allowed to prescribe cheap placebos of some sort. Though this is in some ways incredibly disrespectful to the patient, perhaps if it wasn't a sugar pill and something truly soothing, like bed rest and warm soup, it may pass ethical muster.

There's a reason that unsound treatments like homeopathy gain traction. Some people just want to be cared for and told that they are in good hands and will get better faster than if they were on their own.

I like this idea. Just have a can of ready-made soup - store-bought if necessary - and just add something somewhat odd-but-good-tasting. A patient with half a brain will understand they're being fooled, but whoever seeks homeopathy wants to be fooled anyway, so that won't be an issue.

And this is why there are prescription sugar pills available. Give the patient something, but don't give in to their stupidity.

Blaming the doctor for having to make an impossible choice is not entirely fair.

?? There's no "impossible choice" here. This conversation has taken an absurd turn.

So, the doctor is not to blame for writing the script. Last I heard, patients were not required to have medical degrees.

I don't care what I, as a patient, as for, I think the doctor should base his/her response on science and training and experience. Not what I want.

>That's a bit naive. Many patients practically demand pills, and if you displease them all you'll take a hit on your "patient satisfaction" metrics

So then the blame is back at big pharma for the views they are pushing.

Why can't we blame ordinary people for being so dumb?

The masses are what they are. Big phrama is the one taking advantage of the natural state of the masses. We could blame a child for being dumb, but instead we make laws protecting children from those who would take advantage of them (banning child labor, lots of rules to protect children concerning contracts, banning predatory lending, etc.).

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