[BigRedBeta]

I didn't like the fact that some of the providers (not just MD's but also NP's and PA's) I was with made changes to medications when the patient was experiencing some improvement (but not total) after only 4 weeks - even if they were handling the side effects okay (though they had some) and had room to go up on doses. Several times the provider literally said, "I think we're doing okay, but we might get better results if we switch it up". When you throw in the amount of time to taper off the meds, start the new one, wait the appropriate 4-6 weeks to see a response, adjust the dose from there, it's nearly a 2 month process.

The most egregious moment was when a woman came in saying, quote "I feel great, I can't remember the last time I felt this good, I'm not having any side effects at all", and the NP then spent the rest of the appointment telling this woman what they'd do if she did start having side effects. He seriously went over the side effect profile of Drug A (which she was on), told her they'd go to Drug B, went over the side effects of that med, went on to explain that Drug C was in a different class, went over the side effects of that pill, and ended up on Drug D and the possibility that at that point they might have to reconsider her diagnosis because she'd be refractory to treatment at that point. It was seriously like he looked at his watch, saw that only two minutes had been spent finding out that she was doing great and decided that he needed to fill the remaining 18 minutes of the visit talking about something. The thing is that this was at the County Health Dept, and this woman wasn't extremely high functioning before her illness, so I know she left absolutely confused about the single side effect she was supposed to be watching for in regards to the drug she was on.

As for the PhD's...most of the animosity I've seen between MD's and PhD's is in the basic bench sciences - PhD's think MD's are a bunch of frauds who claim to love science but either aren't smart enough or aren't passionate enough about it to do it the way it deserves while the MD's think the PhD's are a bunch of anti-social losers who are way to carried away about the theory and not enough about the application or what goes on in the clinical setting which is where patients actually get better...