Who do you think you are?

Skepticism is everywhere. What isn't usually considered is that while skepticism can be healthy, this can be proportionally unhealthy to those that may be struggling. Especially when a person finds themselves depleted of reasonable QoL (quality of life), trying vigilantly to restore it.

This posts' title, how do you interpret it? Who do you think you are? Common dude? Expert? Fan? Lover? Antagonist? Developer? Thinker? Conqueror? Leader? A million ways to dice this potent philosophical question.

"Shit takes time. Shit takes effort." -Samuel Jackson

A person who must endure a long and arduous,  purposeful venture,  develops knowledge and more importantly experience, that separates the amateurs from the experts. That's mainly why Doctors are revered as quintessential experts - "They went to medical school!". A feat of dedicated tenacity for sure.

But once you get past the superficial exterior of the "expert", what is there? An intellectual warehouse of meticulously labeled crates of information? What's the delivery method - just-in-time multi-faceted coordination, or perhaps the truck driver must find, collect, and load individual packages himself, deliver, aquire, deliver.. methodically, linearly, and uniformly. It seems medical students are steered towards the latter as they learn about Liability. The result is that while the system operates within the mechanical precision of expectation, the ability to correlate and evolve is entirely sacrificed.

There's further digression. Those that take shortcuts. Those that subvert or circumvent the process of having a system, or developing that warehouse's material products. Those that instead head to the nearest supply store for a comparable or perceptually viable clone. "See son, this Thwar action figure is just like Thor! Can't tell the difference right? Go play!" Lesse how Capt. Merika saves this day. Sigh.

These types of people are not just disappointments, they're dangerous. Time Magazine reported the current 3rd leading cause of death is now "Physicians errors". There's an additional trickle-down effect. Those that base their own knowledge and biases, having a far inferior background, on these Medical Posers and Professional Parents, to dispense their interpretation of medical justice upon the sick and hurt. These types are even more dangerous to the mental health of individuals needing care.

I've termed these drive-by Googlers and armchair Doctors to be "Nonologists". People that troll their medical beliefs with fanatic and religious assertion. They're usually quite thick-headed, bringing dismay to those lacking which appeases the Nonologists. "Proof" is their currency.

Sometimes it becomes necessary to deal with this misguided mindset.

Here's some tips on how to produce the manufactured product perceived to be "Proof", if one finds themselves under the duress of a contemptuous person:

- Letterhead. This automatically instills security (even if false), giving appearance that some deity corporation or entity Approves This Message.  
 - Executive summary. If it can't be presented in a 14 second interaction at a drive-through window, you lost 'em.
 - Act like an employee. Nonologists are like bosses who feel it's your fault, or it's going to be your fault. Bossman is ready to fire you. 90 seconds is all you have to support your summary.
 - Documentation probably won't save you. In fact, the only good documentation, once aesthetics have been approved, is documentation that you can drop one fingertip down on one statement, and it is that tidbit alone which will (to the inquisitor) lead the "Proof".

Nonologists are more like Orcs than Trolls. They wander about, pissing about their turf, preying on the weak, brutishly dealing with anyone that opposes their way of life, jovial amongst themselves though perpetually skirmishing among each other in pointless king-of-the-hill disagreements. Pathetic, learned behavior.

If you can't beat 'em, know' em.

Nonologists. Ha!

       

The Physician's Assistant

I've noticed a common trend, probably in place for some time. Putting P.A.'s (physicians assistants) at the front line of clinical work to sort through the bulk of patients. There are advantages and disadvantages to this situation. Also, in many or even most cases, for the purposes of this writing, RN-C's (Registered Nurse, Certified), are effectively interchangeable with PA's in terms of quality, demeanor, and purpose that I discuss below.

PA's make on average half the amount of a physician. From a business perspective, the clinic can bill the usual amounts, and make double the profit (generally speaking). Patients are relatively unaware that their "doctor" is a PA, or just accept the illusion of a PA as their "doctor". Their schooling and background differs, though the rules, liabilities, and expectations remain essentially the same.

In my personal experience, I've found working with PA's is a more enjoyable, personable encounter. They seem to vest more of themselves into bothersome issues. They also do not seem as pressured, or rushed (though always very busy). The perception they appear to convey is that they are patient-oriented, not profit-focused. Facial expressions used by most physicians can be described as smug, disdain, or contempt. PA's I find to be warm, caring, attentive, and focused.

The rigid box of reputation and liability physicians are subject to also applies to PA's. However, they seem more graceful when operating within the imposed limits. They are perhaps not as flexible to venture into the fuzzy grey out-of-the-box area that an experienced, seasoned physician may walk. Conversely, PA's seem to consider the concept of How We Can, vs Why We Can't, as physicians seem to get stuck in, exploring options that are akin to "smelling the roses", versus "being chased by a rolling boulder". Outrun or get-out-of-the-way. Amazing what taking a moment to breath does in terms of quality.

The applied quality of How We Can appears to be highly determined by a patients' presentation and tenacity. PA's will likely take a more conservative approach, initially offering mild solutions, OTC recommendations, and sensible advice, before kicking into high gear to get the job done right. Most physicians, on the other hand, require a great deal of verbal convincing, going through unnecessary Rx's and treatments, ping-pong referrals, and anecdotal evidence before reluctantly advancing moderate treatment plans. Where physicians seem to need a firetruck's worth of alarms and crisis to provide advanced care, PA's can put some grease into those squeaky physician gears.

Overall, I find PA's to be a friendlier, more capable resource than most physicians. Reduced pressure makes a lot of difference.