melloworca6 said:I don't think Joe Smith was actually talking about young doctors when he brought up that whole business with the books. 😳 It’s standard practice to stick to the manual at first—follow the rules, do everything by the book. But eventually, you have to stop leaning on the text. At some point, you need to trust your own intuition and what you actually know rather than just reciting what you read.
It didn't specifically call out young doctors, just "good" ones. But let’s be real: a junior physician who sticks strictly to the textbook can be an excellent doctor. Experience isn't everything.
I’ll share an example from my own experience—nothing too detailed, mind you. I don't want anyone identifying exactly what happened.
An experienced doctor missed a single physical change because he didn't think it was necessary to perform a full head-to-toe exam—the kind you see emphasized in every medical textbook. The mark wasn't symptomatic. It didn't trigger any alarms for the patient, so it simply went unmentioned.
Coincidence, I suppose. I went in for a routine follow-up, only to be met by a young, green doctor who seemed more interested in following the textbook than listening to the patient. She insisted on a full head-to-toe physical, strictly by the book. It felt unnecessary. I was there for one specific, clearly defined issue—not a complete overhaul. Sometimes, sticking too closely to the manual means you miss the point entirely.
It turns out that by strictly following the manual, the doctor actually saved the patient's life. The secondary issue turned out to be far more critical than the initial diagnosis.
And most importantly, that wasn't even within her field of expertise.
Sure, you could list a thousand other instances where blindly following the manual or sticking strictly to the guidelines backfires. But, I’ll say this: it isn't always a disaster, either.
I see this stuff daily on my thyroid labs, and honestly, I’m baffled by some endocrinologists. We all know the textbook line: if your TSH is under 10, don't bother treating it. They tell you the standard range is 0.4 to 4.0, and that's where they stop. So, I walk in, tell them I feel like garbage—that I'm sleeping 14 hours a day, my hair is falling out in clumps, my heart is racing, and I'm gaining weight out of thin air despite watching everything I eat—and what do I get? A doctor who just shrugs and says, "The guidelines say we don't treat anything under 10." It’s like they can only function if it’s written in a manual somewhere.
Is that doctor actually any good? Personally, I’m not buying it. He doesn't listen to his patients; he just dismisses anything that isn't written in a textbook. It’s like he’s following a script blindly without looking up from the page. Take therapy for thyroid issues, for instance. You have someone on Euthyrox whose TSH is sitting around 1. They tell their endocrinologist they feel terrible—showing clear signs of hyperthyroidism—but instead of adjusting the dosage, the doctor just convinces them everything is fine. Or better yet, they claim the patient is just being anxious and hand out a sedative, or tell them to simply "get it together."
That example isn't quite hitting the mark. The core issue here is that medical science evolves. Some doctors simply fail to keep pace with those advancements, choosing to stick to outdated methods rather than staying current with modern findings.
Regarding vaccinations, I’ve already noted that there isn't a single, universal stance. It’s not a one-size-fits-all situation. You have to look at each case individually. The key here is to avoid following a rigid template; instead, decisions should be made on a case-by-case basis.
That’s exactly what the guidelines state. Whenever you see the phrase "individualized approach required," it's a clear signal that one size doesn't fit all. It means two different patients might require two different paths. That isn't a flaw; it's the protocol.