AIBU to think some doctors are really arrogant?

[forestsofthenight]

I know some are wonderful: I did have a lovely GP once but as a whole does anyone else find them horribly arrogant? Just been in hospital and without fail was spoken to like shit by doctors while the nurses were lovely. Has anyone else found doctors to be so up themselves?

The problem with the assumption of arrogance is that you have no idea of the context. Maybe they delivered the worst possible news to new parents, maybe they just spent the last two hours trying to save a young life, maybe they are an arrogant twat. Without context you just don't know.

I had a very senior role over a decade ago in a busy teaching hospital. I was on call and had been awake for 22 hours. I took a call about two (expected) deaths on a ward. My response? A sigh of relief that I could move two patients out of my (heaving) A&E department. My sigh of relief was justifiably met with criticism from the ward sister. She probably thought I was arrogant. Actually I was just bone achingly tired and emotionally wrung out.

It's all about context.

Honestly I think a lot are.

My GP isn't though and part of the reason why I stick with him. TBH and totally ageist the older doctors do seem less arrogant.

Re warm fuzzies.

This isn't what I want from a doc. I want practicality, knowledge, experience and decisiveness. I think once you find a good doctor you should try and stick with them,if possible.

I once needed a risky life saving operation. The 'arrogant' surgeon breezed onto the ward and the staff visibly recoiled in his presence.
He offered no niceties, just told me how he was going to fix it, then breezed out again.
His attitude was absolutely right. I knew at that moment I could have hope of recovery, and I had faith in his capabilities.
I didn't need tea and sympathy, I needed confidence and ability.

I don't need cuddles from a doctor. I need them to be knowledgeable, decisive and effective.

I get cuddles and sympathy from DH. I get years of training and experience from a doctor.

As in all walks of life you come across good and bad.

As a patient & hospital worker I have been privileged to have been treated and work with some lovely doctors.

Op after miscarriage doctor took my hand and very genuinely said that he was sorry that it had happened. He was so gentle and sweet.

A doctor I worked with often quoted sponge bob - I loved her.

They are just people

Now I think about it, all of my less good experiences with drs have been OOH or locums. GPs are usually great, A&E have been great when we've been with dc.

I was in hospital last night for monitoring (40+2 with higher than they would like it BP) and after monitoring, the doctor came to speak with me about my PIH and a treatment plan. I was pretty worried and upset by the whole thing and this doctor sat with DH and I, answered all of our questions, actually explained why high BP was a potential issue if baby was fine and I had no pre eclampsia symptoms and had to run out because she was bleeped mid way through and took the time to say "I will be back in about 30 minutes. Relax and think if there's anything else you want to ask" before running out to answer the bleep.

She was bloody marvellous and I trusted her and I am very very wary of obstetricians as I'm convinced they just want my baby out with no regard to my birth plan.

Some doctors, nurses, midwives, receptionists.... people can be bloody arrogant. But some can be lovely.

I get lots of time and sympathy from my doctor. My private doctor. I pay him handsomely for this time and expertise, and well worth it too.

The NHS ones are so overworked I'm surprised they even have time to snarl a hello at their patients! I'm not surprised so many young doctors are leaving the NHS to work abroad.

Hic,

1 thank you for the info about training. I get what you say about "arrogance" as a front in a time critical situation. It is very interesting.
Is it possible that the (necessary) training for time-critical situations might bleed over into situations where it is less appropriate? A poster mentioned dealing with pain syndromes. For myself, I've had similar problems with musculoskeletal issues. I imagine the skills you need there are very different...

1. Do not blame unhappy patients for low morale. Blame the politicians for not funding the system. Be clear: you damage your cause every time you criticise us for reporting what we have experienced. You should be encouraging this communication. No good comes from attempts to block it.

1. Perhaps you could think again about the comparison with other professions. I have never met an arrogant teaching assistant, even though lots of them are overqualified. It would be very hard to do the job. Perhaps in medicine people can get away with it?

"haveyourselfamerry doctors are trained in a manner than instils them with confidence in their decisions. When you're faced with someone critically ill after major trauma, you don't want someone uncertain or indecisive running the team. You want someone who trusts themselves to work out what's going on and come up with a logical action plan to fix the (often multiple) issues - and you want them to do it in a very time pressured environment. You don't want someone who's unsure, dithering, doing nothing because they can't make a decision just looking at the patient while they bleed out.

For what it's worth, many doctors don't have that level of inner self assurance. We all second guess ourselves occasionally and everyone I know goes over scenarios over and over again with colleagues, questioning their judgement at the time. We do it after the event though, not during it. Arrogance can be a front to cover uncertainty, lack of knowledge of a particular issue, not wanting to "lose face" in front of other colleagues or patients, or fear that the doctor in question just isn't good enough. I'm sure there are patients in my past who will have formed the opinion that I am arrogant, just as there are others who think I am lovely (I have the thankyou letters in my portfolio)."

I have met many arrogant shop assistants who feel that because they work in 'designer' shops they are better than other shop assistants or their customers.
I have met arrogant chefs who try to decide how I like my food cooked and make a fuss if I don't agree.
I have met a fair number of arrogant car sales people. One lost the sale of a new Mercedes because we clearly didn't look quite rich enough.
I have met a fair number or arrogant estate agents (in days before online sites). Try asking about houses when you are pregnant and have four children in tow.
I have met some arrogant teachers - but not many.
Are doctors more arrogant? Of course not and this is such an unfair suggestion with criticism of the many because one or two have a perceived bad experience or unrealistic expectations.

I'm sure I've come across as arrogant, and I'm really not. I am less giving of myself when I'm exhausted or when I'm desperately worried about someone else.

Here's an example, I'll blur a few details although it was a million years ago now.

I was working as a junior doctor doing a gynae job. After hours there was a single Registrar covering gynae and obstetrics and SHOs covering obstetrics, acute gynae (me) and maybe a ward SHO (can't remember).

A lot of our work was early pregnancy bleeding and in the acute gynae area the mornings were set up for this with designated scan spots etc. The nurses had all been doing it forever and were generally kind and good. It was about 9 at night and a young woman turned up who was very early pregnancy with some spotting and terrified that she was losing the pregnancy. I saw her quickly and assessed her, checked her blood group, gave her written information and organised a slot for her for USS in the morning. The spotting was very minor and she didn't need to be in hospital. Unfortunately someone had told her that if she got to hospital early enough someone would stop the bleeding and save the bleeding and we all - I think gently- emphasised that this wasn't the case.

While she was still there, another woman came in - older and not pregnant - who began to haemorrhage. Very, very badly. At that time there wasn't a gynae theatre set up for emergencies at all times and the registrar was busy with baby stuff. I called for help - consultant, on call theatre staff etc and began putting in big iv lines, accessing blood products, checking bloods and clotting factors etc. She was bleeding right through the hospital bed, it was pouring all over the floor.

Meanwhile, the woman who has spotting was shouting and swearing and irate that nothing was being done for her and she "paid her taxes" and this wasn't good enough.

I actually can't remember what i said to her but I'm sure she perceived me as rude and arrogant and dismissive. On any other day I would have been much kinder but sometimes it's not possible to be everything to everybody and still do the most important part of your job.

I think the reality is that there are both arrogant and non-arrogant doctors, just as there are good and bad in any profession. However, most of us have interaction with doctors at various stages in our lives, and so there is a shared experience that is talked about in a way that doesn't apply to less society-facing careers, such as computer programmers for example.

However, I think there is a tendency for high-powered/high-paid careers to be guilty of having an overall culture of arrogance, which isn't to say that individuals are, just that the career culture encourages it. It's a well-studied and documented sociological trend and is due to quite complicated reasons. Just two of those many factors are quite revealing:

To start with, anyone involved in a career where decision making has far-reaching consequences cannot survive without a high level of confidence in their opinions. Be that doctors, nurses, magistrates, police officers, social workers (all roles that have been accused of arrogance). If you don't have confidence, you won't survive for very long as indecision is perceived as weakness and leads to challenge, unpredictable results, stress and ultimately sickness, absence and people leaving the career.

Secondly, during training and the early years in these careers, you work through your reasoning for the decisions you make - quite often out loud in the interests of transparency and accountability. This has the nice side effect of making those affected by your decisions feel involved and less talked down to. As time passes and you become more senior, there are higher expectations on you to deal with more people in a more timely fashion. The result is that social niceties disappear. The decisions which once took 10 minutes to rationalise out loud and 'translate' to the individual, are made in a split second and are so familiar to the decision maker that they have forgotten how alien it may seem to the recipient (much like when you say something as part of a conversation with someone, then have a train of thought and say something which to you makes complete sense but to the other person is a complete non-sequitur leaving them thinking WTF?).

I'm sure I've come across as arrogant.

we are human, patients are human and sometimes the interaction goes awry.

I generally get good patient and colleague feedback but can think of a few cases (out of the thousand or so I've managed this year when it went wrong). Sometimes I was tired, sometimes the parents were, often I was stuck dealing with a system failure e.g.delayed Surgery.

A lot of perceived arrogance is perhaps just expectation management. Sadly I often encounter unrealistic expectations of the NHS. Patients have a role to play by articulating to the politicians what kind of health service they want.

haveyourselfamerry

Re:3 - I have come across plenty of arrogant teachers and teaching assistants! DS1 had a very turbulent first few years of school mainly due to the arrogance of the teachers and assistants I encountered who didn't believe that a 5 year old could read, write, comprehend, do simple maths / algebra etc let alone that he had been doing it all since he was around 2.5 (we had to get ed psych involvement, put him through a battery of tests I'd rather he hadn't had the stress of and finally move schools). There was a great deal of "don't be silly, we know better than you could possibly be aware of, he's faking it/memorising words you've read to him/copying/you did this not him" in his first school and much more "he'll learn in the bottom of a bucket given the chance, let us help him with the social awkwardness of being a year 10 level in a year 2 body" in his second.

Re: 2 - in no way do I blame unhappy patients for low morale. I blame the politics that have used the nhs as a soccer ball for the last couple of decades, resulting in the current mess. However, endless drips of "doctors are all arrogant/useless/crap/" (which is what these threads often degenerate into) makes it more personal to a lot of medics, particularly overworked, overstressed and overtired ones. Patients equally shouldn't blame the doctors for poor behaviour when often again it's the system at fault. Yes people should complain about poor standards and poor treatment - but ultimately unless the system is fixed there is nothing that will change. Insulting us on a personal level ("on the whole you're all arrogant") isn't constructive, helpful or in fact true.

1. You're almost certainly right that the skill set required for rapid decision making in an acute medical setting (ED, surgery, anaesthesia, icu) doesn't translate so well into the skill set required for clinic / chronic medicine (GP although that's blurred as many GPs are faced with acute emergencies requiring rapid action, chronic pain conditions). Often a specialty requiring one skill set doesn't have as much exposure to situations requiring the other and so gets less practice.

Finally - what PoundingtheStreets said, in triplicate. Underlined, with asterisks, bold and highlighted.

Being able to cut into humans with sharp implements requires a certain level of removal from the situation. It helps a lot if you see patients as "other" from oneself. That may come across as aloofness or arrogance, true. Sociopathic tendencies are a useful tool in medicine.

Some Drs are nice some are not. Some nice Drs are just having a bad day and you've caught the rough edge of it. That happens and maybe they go home and beat themselves up about what they said did/ didn't do. Bad days are getting more frequent for those of us who work in the NHS.

It's interesting to see those noting Drs know better than the patients not long after there was a thread about a Mum being dismissed and called paranoid with a very unwell baby.

Of course they make mistakes, of course they work bloody hard and it is often a thankless task. Of course they have to be emotionally detached to an extent when working in ED type situations. If they weren't they'd turn into nervous wrecks within weeks.

But in my experience, I don't think it's helpful to give patients a ticking off who've suffered bad experiences with the odd genuinely arrogant docs just as I dont think it's helpful to assume that all docs will be arrogant because of that one experience.

The Dr who left me to deteriorate when I was on HDU, didn't do it out of choice, they were literally overrun. 2 docs manning the fort all night is going to cause problems not of their making. Thankfully I got moved hospitals that day and was treated very quickly when they spotted signs of sepsis which, in the morning, due to the frankly knackering night the Doc had had when he did get chance to check up on me, put it down to a virus.

The doctor that dismissed me later on in the year despite my HDU/ITU history, and being brought in by concerned paramedics and being visibly unwell and on nebs at the time they came to see me. Not to mention the nurse looking after me expressing their concern. That wasn't down to cuts and staffing issues, that was complacency / arrogance. It happens.

Did I complain about the former? No. Did I complain about the former given I got rushed back in in an emergency situation again? Too damn right I did. I made it clear when complaining i had no qualms with the care from the nursing staff or the doctors I'd seen prior to this one, and that I understand they're under immense pressure but by raising the issue, maybe next time said doc will think twice before dismissing a patient like me and might end up saving their life.

I've had poor experiences with restaurant staff and numerous other occupations too. Are they also "up themselves"?

What a load of tripe. Good and bad in every profession.

I was in A&E with Dd who was linked up to heart monitors when they brought in 3 people with police escorts. One of the patients was being a right pain in the arse about not wanting to be in the bay next to one of the others. The dr ripped strips off him over his behaviour and he shut up. Dr then swanned into dd's bay and couldn't have been nicer to Dd!

I do think some are overworked that they do get short tempered and they do have to work with some patients who really push them to the edge and they are human.

I often find the higher up they are the worse they can be with attitude. I watched a consultant visit another patient in my ward and was dumbstruck at her lack of bedside manner with a lady in her 80's.

I have nothing but praise for the NHS which, due to a lifelong chronic disease and years of infertility, I have been accessing since birth.

As well as that I have had operations, births, accidents, my son had a serious accident which almost cost him his life, and, more recently my elderly MIL has had to access lots of services.

I have never felt short changed by the NHS, by nurses, by GPs, by surgeons or anyone else I have come into contact with over the years.

I think it's about managing your own expectations of them. Yes the surgeon or gp might be a bit brusque on occasion, or the appointment might be running late, or the dr has "swanned off" before I've had time to process what h/she said properly. But these things are minor compared to what the alternative would be without the NHS.

When people are stretched to their limits with all the budget cuts etc and they still have to deal with their own personal story at the same time it's not surprising that occasionally they aren't as kind as they could have been.

I think that unless it's a case of neglect or harm then we should just be very grateful that they are available to us in the first place.

I was in A&E with Dd who was linked up to heart monitors when they brought in 3 people with police escorts. One of the patients was being a right pain in the arse about not wanting to be in the bay next to one of the others. The dr ripped strips off him over his behaviour and he shut up. Dr then swanned into dd's bay and couldn't have been nicer to Dd!

Sounds like our A&E on a daily basis Groovee (used to work there as a cleaner in my younger years).

nokidshere I've been in hospital several times this year. Not once has a patient had chance to tell their personal story even if they wanted too. Doctors have a quick consultation and off to the next patient, as they have to be. I did watch a doctor stay and comfort a very frightened young lady who'd just been told she'd got sepsis in the middle of the night though.

Away every time I have been in A&E there is a prisoner or a police escort.

Yep Groovee I was in resus in the summer. Police guard in the bed opposite me there too.