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Jay and Barb: Jay I pretty much agree with you here. I think one of the most important things a physician needs to know is what he or she doesn't know and have the humility to admit it(at the proper time with the proper patients) That must be balanced with the need of some patients to see their physicians as all-knowing ( They perceive an admission of lack of knowledge as incompetence.) The tricky thing is that when your patients regard a doctor as a God that the physician use that in the best interests of the patient and not accept that attribution as being the patient's excellent judgment. This is probably the only incidence where it does a physician harm to believe his patient As you mention Jay, some tact on the part of the patient is necessary. We doctors, contrary to popular opinion (and sometimes our own,) are human. We respond defensively to what we perceive as an attack. In dealing with an MD or anyone else for that matter you can get a lot further if you don't challenge her/him directly but present the information that you have as "I heard or read that... happens in PD patients or ... is a new treatment. What have you heard and what do you think?" Remember that if he/she is aware of the information they are probably in a better position to evaluate the information than a layman, given a broad experience with neurological disease especially (hopefully) PD. I am in the unique position of being both a physician and a PWP. In both roles a mutual respect is necessary for optimum care. A patient should not allow a physician to totally discount his/her feelings and opinions. That does not mean that the MD should always agree with the Patient- but he needs to respect where the patient is coming from. He should listen and then present to you his position and why he recommends the particular course. He is your consultant toward your health care. You are hiring him because he has more knowledge and experience with neurological disorders than you do. He deserves a thorough consideration of his recommendation but if you feel he is wrong then get another opinion. You have the last word (in most cases). Charlie Jay A. Henkelman wrote: > > BARB MALLUT WROTE: > > >I go to Kaiser Woodland Hills (L.A. suburb) and am not pleased with the neuro, > >tho have nothing but positive Kaiser experiences otherwise. The neuro > >probably isn't a bad doctor for general neurological services, but he ISN'T a > >movement disorder specialist, and THAT was readily apparent when we met for > >the first time last month. As my general PD knowledge became obvious to him > >he adopted an authoritarian attitude. He left no doubt that HE was the > >expert and _ I _ was the patient! (I got the feeling the word "ignorant" > >should have preceded the word "patient!") <rueful smile> That said, at least > >he HAD heard of Mirapex and several of the other new PD drugs. > > It would be no surprise to me if this physician "marks his territory" when > no one is around! First and foremost, we as patients deserve and should > demand to be treated with respect and dignity. The exchange of info. > between an informed > patient and his/her physician can only be a plus if approached constructively. > Assuming that (Barb) didn't openly challenge this individual in some way, > he does not deserve to have her as his patient. His time would be best > spent down the hall on the "couch" for a few reflective hours. > > Jay > > *-*-*-*-*-*-*-*-*-*-*-* > Jay A. Henkelman 47/7 > Portland, Oregon > [log in to unmask] > *-*-*-*-*-*-*-*-*-*-*-* -- CHARLES T. MEYER, M.D. Middleton, WI [log in to unmask]