Quote:
Originally Posted by Unregistered
May I just add that back pain is just a really bad example.
Most doctors including spine surgeons have no clue what's happening.
Traditional approach to back pain is taught by orthopaedic surgeons who are just interested in ruling out cauda equina, PID and radiculopathy, and couldn't care less unless the patient wants surgery. If you've ever worked in a spine clinic you will know what I mean.
Back pain management is multi faceted, and hence the need for guidelines to form some basis for management, along with managing the ICE of the patient.
So there is no point debating about either extremes.
OP said - guidelines only for mmed doctors, no point reading it.
another guy says - just do what the patient ones, manage ICE.
we all know the truth is somewhere in between.
know what the rules and guidelines are, and gain enough experience and clinical acumen to bend the rules when required.
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Agree with you. Obviously you are someone with experience dealing with real patients.
At the end of the day, patient autonomy trumps. As physicians we try to give our professional assessment and plan of management. Sometimes the patient agrees sometimes they dont. We are always tasked to find the "common ground". But frankly speaking if there is a total difference in opinion, it is still best to go with the decision of the patient. As long as it does no harm.
What kind of facility you practice in also heavily influences what is done which can be very different between a GP clinic, a specialist pain clinic, a spine surgeon's office, an interventional pain management specialist.
Be respectful of every doctor's situation and opinions. I find the profession is too quick to disparage other doctors.