V**y
发帖数: 788 | 1 【 以下文字转载自 MedicalCareer 讨论区 】
发信人: doctor1999 (doctor 1999), 信区: MedicalCareer
标 题: 美国就医经历记
发信站: BBS 未名空间站 (Wed Nov 16 17:12:02 2011, 美东)
我来美国快二十年了，也看了不少医生。我的经验是：
PMD: 一般来说水平最差。我几年前颈椎有问题，去看一个公司老美交口称赞的PMD. 我
亲戚在国内大医院做医生， 所以我对颈椎病有基本的了解，整个谈话中也显示PMD的知
识没有我丰富。 我亲戚让我问能不能开点治疗颈椎病的药。英文药名写好了，然后我
就问PMD,PMD说他不知道那些药。其实这些都不算啥。PMD吗，又不是specialist.可是
这个PMD次日打电话，叫我今后再也不要去他哪里了。他说：I am a general
practitioner, and not a supermarket where you can get one-stop medical
service. 我把他的原话告诉公司中国同事，结果他们也不去他哪里了。老美还是去，
不过他们主要是去体检。
PMD (2): 后来我又找了一个去体检。这个有cardiologist training. 我提了一下我二
十年前学习紧张的时候有过早搏。不过，很快就消失了，二十年来一直没出现过。这个
PMD听了以后如获至宝，马上要求我做彩超。我明确告知 不做。她马上威胁说即使验血
一切正常，也不会电话通知我验血结果，一定让我再来一次doctor visit. 我简直sick
,没看到过怎么贪的。当场把她fire了。
Specialist (1): 一亲戚美国检查，肺部CT出现1厘米结快。Pulmonologist建议
bronchoscopy看一下到底是什么。这个Pulmonologist自己不会操作bronchoscopy,他
practice的另一个Pulmonogist (B)会做。结果国内亲戚看了CT,说那个部位，说
bronchoscopy根本到不了。美国亲戚另找sloan kettering医生。Pulmonologist B 给
美国亲戚打电话约bronchoscopy时间，美国亲戚说家里有人在国内做医生，看了CT,认
为此部位bronchoscopy不能到。Pulmonologist B 说，不可能，我们医院有全世界最好
的设备。美国亲戚遂挂电话。几天后，Pulmonologist B 又来电话，说CT看过了，是肺
结核。美国亲戚马上告知中国医生美国 sloan kettering 医生都认为不是肺结核，并
告知请不要再来电话了。总结：不是所有的Pulmonologist都懂bronchoscopy；也不是
所有的做bronchoscopy的医生都看CT看bronchoscopy是否有意义做。
Specialist (2): 另一美国亲戚胆结石。中国医生建议保守治疗，不主张开刀。美国医
生极力建议开刀。结果更相信美国的医疗水准，开刀。结果大出血，输血。中国亲戚听
了，沉默了五分中后说，是把xx大血管弄破了。这样的医生，要是在中国出了这样低级
的医疗事故，长江三角洲别想开刀了。
总结：不是和另一个帖子抬杠，但是从我们病人的角度，在美国得到和中国同等的医疗
，实在是太难了。而且美国医生的经验实在是少的可怜。那个Pulmonologist每天工作4
小时，每周工作4天，中国医生每天工作10小时，每星期工作6天，美国医生真的有那么
多learning on the job以至会有同样甚至更高超的医术吗？我在PMD(2)的办公室待了
一个小时，跟护士在一起10分钟，等医生40分钟，跟医生在一起10分钟。在我等医生的
40分钟里，听到医生跟别人(不是其他病人)gossip长达30分钟。我亲戚在医院看门诊，
从早到晚，写处方手都写麻了。美国仪器确实很先进，可是医生行业垄断相当厉害。相
比之下，中国医生行业由于市场经济，所以医术好也不稀奇了。
令：欢迎推荐你认识的医术好的医生。限纽约地区。 |
A*******s
发帖数: 9638 | 2 哈哈， 有意思。
感觉中国人看美国医生有交流的问题。不光是语言， 而且是文化。
1. 颈椎病药物， 什么药可以治疗颈椎病？ 我觉得好像没有， 可是中医说这个药可以
有， 对了， 好像有个刺五加， 这个“可以有的药”肯定让老美犯难了， 你坚持这个
药可以有， 他只能fire你了。
2. 这个家庭医生真是少有， 20年前的病都给你瞧，这需要多少的耐心啊！ 我们的行
话叫thorough。 一般家庭医生10分钟就打发你： 你来体检， 居然让我把你20年前的
病都看了， 你以为是买一送一啊？ 结果你认为她有阴谋的榨取你的钱财， 你不会是
当年的曹操再世吧？
3. 还要我接着说吗？ |
s******v
发帖数: 477 | 3 "所以我对颈椎病有基本的了解"，can you tell me how much do you know about 颈
椎病
"整个谈话中也显示PMD的知识没有我丰富"。Tell me which part you know, but your
PMD don't know. Are you sure your knowledge is real knowledge rather than
江湖秘方
"我亲戚让我问能不能开点治疗颈椎病的药"。Again, there is no cure for 颈椎病,
but there are many ways to reduce the pain. Your doctor can not prescribe
medication for someone he has never seen. That's illegal and irresponsible. |
s*******y
发帖数: 1739 | 4 其实有些他说的还是对的,我现在跟的一个INTERNAL MEDICINE ( 60岁了)到现在摸不出
甲状腺是不是正常SIZE |
A*******s
发帖数: 9638 | 5 It can't be denied there are quacks everywhere including China and USA. But
LZ apparently distorted the stories with his limited medical knowledge.
【在 s*******y 的大作中提到】
: 其实有些他说的还是对的,我现在跟的一个INTERNAL MEDICINE ( 60岁了)到现在摸不出
: 甲状腺是不是正常SIZE
|
s**********t
发帖数: 217 | 6 First of all, Bronchoscope training is part of pulmonary training. You would
not be certified as a pulmonologist if you have failed your bronchoscope
training. Every pulmonologist is capable to do bronchoscope except he/she
chooses not doing it. There is difference between can do it and do not do it
.
Second, I do not know the details, per your story, your relative looks like
having a peripheral lung nodule which regular bronch may not reach. From
this point the doctor in China is correct. But, here is US. A new technique
: CT-guided navigation system using ultrathin bronchoscope can reach almost
all the peripheral lung nodules. The doctor in china may not know that.
By the way, pleas let your relative know, a lung nodule of 1 cm need to be
followed. |
A*******s
发帖数: 9638 | 7 I would not believe this story. A pulmonologist would never tell the
patient a TB diagnosis only based on a 1 cm nodule on CT without additional
tests.
would
it
like
technique
【在 s**********t 的大作中提到】
: First of all, Bronchoscope training is part of pulmonary training. You would
: not be certified as a pulmonologist if you have failed your bronchoscope
: training. Every pulmonologist is capable to do bronchoscope except he/she
: chooses not doing it. There is difference between can do it and do not do it
: .
: Second, I do not know the details, per your story, your relative looks like
: having a peripheral lung nodule which regular bronch may not reach. From
: this point the doctor in China is correct. But, here is US. A new technique
: : CT-guided navigation system using ultrathin bronchoscope can reach almost
: all the peripheral lung nodules. The doctor in china may not know that.
|
L****n
发帖数: 12932 | 8 This is one of those worst kind of patient u can imagine, whose THINK they
know, and yet they really don't. And you can't really communicate because
they are not only so poor in communicating skill, but also hard wired with
perjury.
additional
【在 A*******s 的大作中提到】
: I would not believe this story. A pulmonologist would never tell the
: patient a TB diagnosis only based on a 1 cm nodule on CT without additional
: tests.
:
: would
: it
: like
: technique
|
A*******s
发帖数: 9638 | 9 The patients I would not see if I have choices are. 1. Nurses, 2. Doctors, 3
. Patients who do not speak English or Chinese. 4. Chinese who knows it all,
like this guy.
【在 L****n 的大作中提到】
: This is one of those worst kind of patient u can imagine, whose THINK they
: know, and yet they really don't. And you can't really communicate because
: they are not only so poor in communicating skill, but also hard wired with
: perjury.
:
: additional
|
N*G
发帖数: 217 | 10 Good point. I know I am the worst pt of my PMD :)
3
all,
【在 A*******s 的大作中提到】
: The patients I would not see if I have choices are. 1. Nurses, 2. Doctors, 3
: . Patients who do not speak English or Chinese. 4. Chinese who knows it all,
: like this guy.
|
s**********t
发帖数: 217 | 11 I have one who has two binders, one has notes from all the specialists, the
other one has all updated information from the internet which he had
researched the night before the appointment.
I have another one even knows stem cell transplant for anoxic encephylopathy
study done in China. |
P********A
发帖数: 101 | 12 考完试了来灌水：
其实美国和中国都有好医生，也都不乏庸医。见过手术不怎么地的美国医生，但几个月
前刚刚轮转了memorial sloan kettering cancer center，几乎可以这么讲，每个医生
手术都很漂亮，或者是开放手术，或者是机器人／腹腔镜手术，各有专攻。称专家肯定
当之无愧，也都很平易近人。
而且，我个人觉得，美国医生对defencive medicine 很敏感，不愿意开非自己专业而
且自己不熟悉的药物，以免惹上麻烦。 |
A*******s
发帖数: 9638 | 13 I am not surprised and I bet their American Collegues are glad to see these
things.
the
encephylopathy
【在 s**********t 的大作中提到】
: I have one who has two binders, one has notes from all the specialists, the
: other one has all updated information from the internet which he had
: researched the night before the appointment.
: I have another one even knows stem cell transplant for anoxic encephylopathy
: study done in China.
|
