State of the healthcare system in America: Let's discuss why it's failing

Susan Rodriguez4 said:It's clear we see our profession through completely different lenses.
I've been working with patients every single day for 15 years, and my philosophy hasn't changed: as a doctor, my duty is to provide the diagnosis, explain the treatment options, and lay out the expected outcomes for each path. After that, the patient has every right to decide which direction they want to take.
My role is to provide the expertise; the patient makes the choice regarding their own health.
That’s how I’ve practiced for 15 years, and that’s how I’ll practice for the rest of my career.
I know plenty of colleagues who operate this way—people with massive experience and deep knowledge who stay calm, collected, and never burn out.
And their patients are thrilled...
For those of us treating actual human beings rather than just managing symptoms, seeing satisfied patients makes all the stress worth it. That's just being human.
And honestly, a smile costs absolutely nothing. Nothing at all.
I would never dream of labeling someone as "unintelligent" just because they don't grasp something outside their field of expertise. By that logic, you'd be considered "unintelligent" by a lawyer because you don't understand legal jargon... at least according to lawyers with your mindset.
Also, categorizing doctors into "grumpy experts" versus "nice amateurs" is frankly ridiculous.
Being kind is about being a decent, cultured person. It has zero correlation with clinical knowledge; it's strictly about how you carry yourself.

I couldn't agree more.

Kate Collins67 said:@ Jacob Fox6

Don't let them spin you around—stick to the conclusions you've reached on your own skin, and then maybe you'll actually be a real doctor. Anyone can talk a big game, but when you're finally standing there in the thick of it, the decision is always going to land squarely on your shoulders. Keep your eyes wide open and don't let them screw you over.
Just do the medical side of the job properly; nobody gets sanctioned for being unlikable.

P.S. If you have no clue what you're doing, at least try to be charming.

😁 You're good—but man, that didn't even make me crack a smile. 😁

Thanks for the input and the advice.😉

Up until now, I've tried my best to stay polite while staying laser-focused on actually getting the work done that's expected of me, but honestly... once I've put in enough years and seniority, I truly think I won't give a damn if someone thinks I was unfriendly, which is usually just how patients describe arrogance... as long as I do my job right and meet my own standards, my conscience is clear and I feel good about myself, and I really don't care if one patient gossips about me, because eventually you'll run into one other person who cares more about whether you're a high-quality doctor and if you're actually good at your job rather than worrying about being bubbly, and even if there's only one of those people out of a hundred, I'll be happy.😉

I realized a long time ago that in medicine you can't afford to be subjective or overly sensitive like a little flower... you're gonna have better days and worse days, but as long as you don't lose sight of that ultimate goal, you know, where everything clicks into place and reminds you why you're doing this in the first place!😉 Even though I'm sure sooner or later there will be moments where I ask myself "why am I even doing this?", I'm a natural optimist so I'm sure I'll find a way to push through it...😁

Susan Rodriguez4 👍, luckily I know plenty of people just like you 🙂

The best experts I’ve ever met are usually just down-to-earth, kind people. They don't deal with those massive ego complexes where they feel the need to act superior just to prove they belong. Plus, a true pro can take even the most tangled diagnosis or complicated treatment plan and explain it so anyone can actually grasp it—whether you're an entry-level assistant or a specialist. It's honestly pretty tacky to try and hide your own lack of knowledge behind a wall of medical jargon...

I know there are all sorts of personalities out there, but that’s never an excuse for someone to lose their humanity.

Jacob Fox6 said:I'm with you on that. But let's be real, some things are just way easier to explain than others... If someone has a fracture, but it's complicated or open and stuff, it gets so much harder to walk them through why they need surgery, or antibiotics, or why they might have trouble walking later on... Some things are simple, some aren't, but if you can simplify something without losing the actual point, then you definitely should... But try explaining a brain tumor that completely changes someone's personality! From what I've seen so far, the issue isn't usually that doctors don't tell patients what's wrong—honestly, I haven't met a single doctor who hasn't told a patient their diagnosis unless the patient couldn't understand it—it's more that people suddenly want to know every single tiny detail right away. I honestly find it hard to believe anyone expects a doctor to give them a full lecture on their medication... that's just "too much"🙄... And if they get a diagnosis but have no idea what comes next, that's not on the doctor, it's on the healthcare system and how weirdly it splits up responsibilities between specialists and primary care docs, where nobody is allowed to step outside their own lane...

Look, nobody is asking you to give them a PhD-level lecture; they are asking for options. If you have a patient with an open fracture (since we're talking about that), it's your job as the doctor to say: "You can go into surgery; here are the recovery odds, here are the potential issues, and here are the possible complications." If you don't lay out those chances, risks, and complications, then the patient feels like the path you suggested is the *only* path. They expect a cure because they think they had no choice. If they don't get better, they'll come after you with everything they've got.
And the idea that patients wanting to know everything is somehow shameful? Give me a break. When I take my car to a mechanic, I want to know exactly what he did to it, so imagine when it comes to my own body! It is their right to know!!!!!! I will say it a million times if I have to.
Thank God we have the internet and patient advocacy groups nowadays. All you really need to do is point the patient toward where and how they can research the condition they're dealing with. That's really not that hard.

Jason Howard9 said:It isn't about the bacteria. That gesture actually means, "I feel for you; you only have a month left to live." 😁

😁

My bad, I totally misread that. 😁

But honestly... what else is a person supposed to do? 🤷 A little touch on the arm is just a formal way to show some empathy, and honestly, I think it's pretty reasonable and decent, especially since the doctor is basically a stranger to the patient... family is there for everything else. 🤷

Kate Collins67 said:Look, I never said that being polite means you're clueless—or that being rude means you're an expert. All I’m saying is, if I’m forced to choose between a friendly person who has no idea what they’re doing and a blunt person who actually knows their stuff? I’ll take the expert every single time.
The real point here is that actual competence matters way more than how much a provider smiles at a patient—even if everyone here keeps trying to frame it differently. Being personable is a nice little bonus, sure, but let’s be real: if the medical knowledge isn't there, all the charm and friendliness in the world isn't going to do a damn thing for a patient in trouble.

Now, you might be able to judge how much your colleagues actually know...
But your "average" patient? They can't do that..
Especially not after their very first meeting with a grumpy specialist..
In the beginning, people are always going to trust the person who treats them with respect and empathy, really listens to them, and walks them through the diagnosis and treatment plan clearly..

Look, obviously expertise is the most important thing...
We can all agree on that..
It's just that patients view the whole situation from their own perspective..☕

Susan Rodriguez4 said:Look, nobody is asking you to give them a PhD-level lecture; they are asking for options. If you have a patient with an open fracture (since we're talking about that), it's your job as the doctor to say: "You can go into surgery; here are the recovery odds, here are the potential issues, and here are the possible complications." If you don't lay out those chances, risks, and complications, then the patient feels like the path you suggested is the *only* path. They expect a cure because they think they had no choice. If they don't get better, they'll come after you with everything they've got.
And the idea that patients wanting to know everything is somehow shameful? Give me a break. When I take my car to a mechanic, I want to know exactly what he did to it, so imagine when it comes to my own body! It is their right to know!!!!!! I will say it a million times if I have to.
Thank God we have the internet and patient advocacy groups nowadays. All you really need to do is point the patient toward where and how they can research the condition they're dealing with. That's really not that hard.

I am 100% with you on this.

People act like it's a crime to ask about chemical compositions or how a drug actually works. I honestly don't know what kind of examples people are bringing up, because even if I sound like I just landed from outer space, every single doctor I know explains things exactly like you just described, and that's exactly how we're taught in med school too...🤷 (well, except for my primary care doctor—but she's retiring this December anyway)

Kate Collins67 said:I'm curious about that woman you mentioned during the hallway scene—did she actually write down a formal diagnosis on the discharge papers or some kind of medical report? Because if she didn't, I'm really struggling to wrap my head around the point you're trying to make here.

I don’t have that info. All I know is they sat there for three months waiting for any kind of update regarding their kid—other than just being told he had cancer and was basically a walking target. After that whole incident, I believe the parents were actually demanding a different doctor altogether. Honestly, I have no idea how the whole thing wrapped up. When you have a physician who can't manage to put together a coherent sentence in ninety days—even with the parents constantly demanding consultations and an advocacy group having to step in to mediate—you aren't looking at a professional. You're looking at a total joke of a human being.
I’m almost afraid to even ask how that whole situation with my colleagues at the fireplace ended up.

Kate Collins67 said:Look, I didn't say anything specific, but she basically framed it as if simply slapping a diagnosis on someone and starting treatment is enough to make a doctor "likable" to the patient. So my question is simple: was the diagnosis for this kid actually written down or wasn't it?
If it was, then I don't get why she's getting so worked up about it. If it wasn't, then I don't get why she isn't—I mean, it's standard practice to include a diagnosis in a medical report, isn't it? At least in my experience, whether it's a working diagnosis or a final one, you don't just leave it blank.

I posted that specific scenario to illustrate exactly what poor doctor-patient communication looks like. As for whether they actually missed the diagnosis or not, I’m staying out of it—that’s a technical medical question for the experts. My issue is purely about professional conduct. If you fail to pin down something that was flagged as an emergency—say, a case involving internal bleeding—you don't just dig your heels in. You consult with your colleagues at your hospital or reach out to specialists at other major institutions like the Mayo Clinic. Instead, you let your ego take the wheel and lash out at parents just because they had the nerve to question you in a hallway at the hospital.

Kate Collins67 said:Look, if we were talking about moving into private healthcare, I’d have plenty of reasons to laugh, and the patient would have plenty of reasons to cry. But since we’re stuck in this socialized model, our relationships are just built that way.🙂

I’m not actually talking about private healthcare here. It’s just a fact that some people working in the public system walk around with a permanent scowl on their faces, acting like they can't stand you. But then, when they work privately, suddenly they’re all smiles, friendly, and willing to actually explain a diagnosis. I mean, a little smile and a couple of sentences shouldn't cost that much! I totally get that you guys are overworked and drowning in patients, but personally, I wouldn't let myself be that rude to people, regardless of how the system works or what the conditions are like. And I’m not just talking about doctors—this goes for the rest of the staff, too.

swiftbear86 said:Now, you might be able to judge how much your colleagues actually know...
But your "average" patient? They can't do that..
Especially not after their very first meeting with a grumpy specialist..
In the beginning, people are always going to trust the person who treats them with respect and empathy, really listens to them, and walks them through the diagnosis and treatment plan clearly..

Look, obviously expertise is the most important thing...
We can all agree on that..
It's just that patients view the whole situation from their own perspective..☕

I mean, this whole thing just doesn't add up at all... judging a doctor's actual medical expertise based on whether they happen to be having a good day or if they're just in a bad mood is totally baseless... like, seriously, that is just straight-up nonsense...🙄🤣☕

It’s pretty clear your GP isn't the only one seeing this, given how many people felt the need to start this thread...😁

Susan Rodriguez4 said:Look, nobody is asking you to give them a PhD-level lecture; they are asking for options. If you have a patient with an open fracture (since we're talking about that), it's your job as the doctor to say: "You can go into surgery; here are the recovery odds, here are the potential issues, and here are the possible complications." If you don't lay out those chances, risks, and complications, then the patient feels like the path you suggested is the *only* path. They expect a cure because they think they had no choice. If they don't get better, they'll come after you with everything they've got.
And the idea that patients wanting to know everything is somehow shameful? Give me a break. When I take my car to a mechanic, I want to know exactly what he did to it, so imagine when it comes to my own body! It is their right to know!!!!!! I will say it a million times if I have to.
Thank God we have the internet and patient advocacy groups nowadays. All you really need to do is point the patient toward where and how they can research the condition they're dealing with. That's really not that hard.

Giving a patient a choice... based on what exactly? Heaven forbid I have to pick which wire to cross in an electrical circuit when someone's life is hanging in the balance—and let's be honest, wiring isn't exactly my specialty.

What you're describing is just modern medicine—or more accurately, "alibi medicine." It's a convenient way to shift all the responsibility onto the patient's shoulders because, hey, it makes your job easier, right? But honestly, it surprises me that you—someone who claims to actually care about patient outcomes—would advocate for such a cowardly approach to medicine.

Kate Collins67 said:Since we’re already going down this rabbit hole about rights versus responsibilities, what do you think about Article 69 of the Constitution:
....
Every individual is obligated, within the scope of their authority and activities, to devote special care to the protection of human health, nature, and the human environment.

By that logic—if we’re being literal—it’s a patient's duty to quit smoking, it’s their duty to stay sober, it’s their duty to lose weight, and so on and so forth...

The thing is, you all seem to have a massive list of obligations, yet you barely bother to fulfill any of them—but suddenly, you become incredibly vocal the second someone mentions your "rights."

You're absolutely right. The only difference is that while everyone is responsible for their own life, you're being paid to be responsible for theirs, too. You need to have that level of awareness baked in by age 18 if you're even considering medical school. For me, that realization was the exact thing that made me hesitate when I was looking at medicine as a career path.

swiftbear86 said:It’s pretty clear your GP isn't the only one seeing this, given how many people felt the need to start this thread...😁

No way😁, because they're way too busy trying to look important in all those medical journals...🙄😁

Angela Wright said:I don’t have that info. All I know is they sat there for three months waiting for any kind of update regarding their kid—other than just being told he had cancer and was basically a walking target. After that whole incident, I believe the parents were actually demanding a different doctor altogether. Honestly, I have no idea how the whole thing wrapped up. When you have a physician who can't manage to put together a coherent sentence in ninety days—even with the parents constantly demanding consultations and an advocacy group having to step in to mediate—you aren't looking at a professional. You're looking at a total joke of a human being.
I’m almost afraid to even ask how that whole situation with my colleagues at the fireplace ended up.

I posted that specific scenario to illustrate exactly what poor doctor-patient communication looks like. As for whether they actually missed the diagnosis or not, I’m staying out of it—that’s a technical medical question for the experts. My issue is purely about professional conduct. If you fail to pin down something that was flagged as an emergency—say, a case involving internal bleeding—you don't just dig your heels in. You consult with your colleagues at your hospital or reach out to specialists at other major institutions like the Mayo Clinic. Instead, you let your ego take the wheel and lash out at parents just because they had the nerve to question you in a hallway at the hospital.

And look, if that’s what they actually told them, then honestly, there isn't much else to add. You could maybe rephrase it to sound even more brutal, but that's really it.

Jacob Fox6 said:I mean, this whole thing just doesn't add up at all... judging a doctor's actual medical expertise based on whether they happen to be having a good day or if they're just in a bad mood is totally baseless... like, seriously, that is just straight-up nonsense...🙄🤣☕

Once you've put in as many years on the job as I have, you'll see my point..🙄
Since you're still a student, like you mentioned, you've got a lot of catching up to do regarding both your profession and how to actually deal with people..😍
And I'm not talking about a doctor just having an off day here; I'm talking about a consistent pattern of how they treat their patients..👍

Jacob Fox6 said:I mean, this whole thing just doesn't add up at all... judging a doctor's actual medical expertise based on whether they happen to be having a good day or if they're just in a bad mood is totally baseless... like, seriously, that is just straight-up nonsense...🙄🤣☕

There’s no such thing as a "bad day."
Basic professionalism dictates that anyone working with people should stay smiling and polite.
I would never let a stranger—a patient—see that I'm having a rough time or feeling grumpy. Even if I were screaming on the inside.
Plus, you're giving people way too little credit. Not everyone without a medical degree is clueless.
People can tell pretty quickly if you're actually a competent doctor or not.
swiftbear86 was only talking about first impressions.

Susan Rodriguez4 said:There’s no such thing as a "bad day."
Basic professionalism dictates that anyone working with people should stay smiling and polite.
I would never let a stranger—a patient—see that I'm having a rough time or feeling grumpy. Even if I were screaming on the inside.
Plus, you're giving people way too little credit. Not everyone without a medical degree is clueless.
People can tell pretty quickly if you're actually a competent doctor or not.
swiftbear86 was only talking about first impressions.

If you ask me, I think you’re actually giving them far too much credit.

As for that second point—nobody even brought that up.

Angela Wright said:You're absolutely right. The only difference is that while everyone is responsible for their own life, you're being paid to be responsible for theirs, too. You need to have that level of awareness baked in by age 18 if you're even considering medical school. For me, that realization was the exact thing that made me hesitate when I was looking at medicine as a career path.

As for me? Medicine was never even on my radar as a choice—it just sort of... happened. By pure accident, really.

Bob gets exactly what’s going on here...👍
There's just no room for arrogance in the healthcare system..
Even the most brilliant specialist can still be someone who greets you with a smile🙂🙂🙂
And actually stays accessible to their patients👍