Why is the word "need" used so much?

I always hear people say, "the doctor will need to see or do ______". Personally I hate it. The doctor never needs to do anything, the correct word is "should". "It would be in your best interest for the doctor to ______" would be a much better way of phrasing things. It is my body and I choose what happens to it whether or not the doctor "needs" to do anything.

Ah, a subject close to my heart!

I had a near identical experience last week. I had to go to my employer's occupational health department for fitness for work assessment after fainting last year. Now, no matter how much I like medical stuff, when I'm a patient for real, I'm nervous as anything. Especially at Occupational Health where they don;t know you from Adam and have the power to have your employment medically terminated.

Anyway, I turned up, went to the waiting room, and got called by a nurse. The first thing she asked me to do was an eye test, which I refused. I asked her why it was necessary, after all I was there because I fainted, not because of my eyesight. She argued the doctor needed it doing. I replied that the doctor could justify it to me himself, in that case.

So back to the waiting room I went. When I saw the doctor, he apologized and said he didn't ask for it, the nurses do it as a matter of course and they didn't know why I was there.The end result being I didn't have to do the tests, but I have been instructed to sort out my stress issues around doctors. Ha ha, good luck...

To the doctor's credit, he did advise me on how to complain about the service I received; which has to be a first!

I tend to agree. Saying "the doctor needs to do...." sounds like you're a cattle at the auction getting inspected.

You three are killing me here. If you don't want the doctor to examine you then why are you going to him in the first place and wasting his time and your money? If you go to the doctor because you have a sore ankle for example, the doctor will need to look at it and palpate it. Don't give me the "it' would be in your best interest if you would....." bullshit. If you don't want him to examine you and make you better then don't bother going in the first place. The doc is going to need to look at you no matter what your chief complaint is, that's a no brainer.

And personally speaking from a nurses point of view, if I had a patient who came in with a complaint of fainting from an unknown cause sure I would do an eye exam. How do I know you didn't have a stroke, or are having slight neuro issues. There are all kinds of things you can tell from even a basic eye exam. You need to let the professionals do their jobs, especially the nurses. We are over worked and grossly underpaid so please don't give us a hard time.

If you people want to be pansied around and treated like guests then go to a hollistic doctor where they tend to cater to you inner self. Where you can sip on honey sweetened green tea in the waiting room and where you are treated to flower petals on the exam table and the smell of sugar plums in the exam room.

Mashie

I have to agree. If you don't want to be properly examined, DON'T GO.

As for you med-fetters who want to probe every orifice in the body in a play exam that has no bearing on your health, it is strange that where it does affect your health, you think you know enough to tell the real physician how to perform his evaluation. RIDICULOUS.

You guys not only know less than the tip of the iceberg when it comes to physical diagnosis, but what is more important and dangerous is that you haven't the foggiest idea what you DON'T know.

Mashie and Susie,

I've got every sympathy for the plight of nurses; my mother started her nursing training immediately after school and remained in the profession for thirty-eight years. I certainly don't want to be pansied about to either; I want to be in and out again in the shortest possible time wasting as little of their time as possible.

Why am I going to this doctor in the first place? Because I have to if I want to work again. However, he's not my doctor, he's not the first one I've see over this matter, he's not doing anything to make me better, he's only doing it so the company are covered from an insurance perspective. Most importantly, it's not me wasting my money; he's an employee just like I am and I'm not paying for his time. I'm not unfit for work, I simply fainted like any other person does.

I'm not telling the doctor how to do his job. But whatever his opinion, he's not a cardiologist, and he certainly isn't my cardiologist.(who, by the way, is an expert on syncope and gave me a clean bill of health after the necessary investigations).

The point I was trying to make was that the nurse said "the doctor needed" me to have my visual acuity checked, and hearing, and my urine drug screened, etc. He didn't. The nurse took upon herself to do them because it's their standard policy, which was unnecessary (the doctor agreed) and contributed further to both my anxiety and wasting everybody's time, neither of which is in anybody's interest.

I said this before under auscultation: Get a copy of Barbara Bates" book, Physical Examination, and learn from it.

Mashie and Susie,

Stop power tripping over power you don't have. It's incredibly unprofessional. And read someone's post in full before you respond or go off on them. Also, maybe instead of turning the discussion board into your own personal venting binge maybe write the person you're taking issue with a personal message and make sure you have ALL the information and ALL the context so there's no misunderstanding. Just a thought.

Fin.

To LIsten, first of all I am not power tripping. But make no mistake I am a woman of power professionally, personally, and on here. However I do not actually make it a habbit of putting myself on a mountain and looking down upon the others just so you know.

Also, I do happen to read someones entire post before I respond because as you know, I am too busy to post a reply in different parts or to "get back to it later" kind of thing.

Next, if a person doesn't want a public response, then they should not be posting on the public board. You my friend have never seen me angry or vent out of anger, and trust me when I tell you, you do not want to see or hear that side of me.

The fact of the matter is, if you seek medical advice or treatment, then go to the doctor and get taken care of. That means you do pretty much what is asked of you and you do so quickly without bitching. Because if you are kept waiting in the exam room for 40 minutes because the doctor is running late, that's going to make you mad right. Okay then so stop making him even later. When the doc or nurse asks you to do something do it so things can move along quickly.

As far as being unprofessional, not hardly. Speaking for myeslf, but any medical professional whether it be on this board or in my real life will tell you when it comes to being professional, I am probably one of the most professional nurses they have ever known. I am probably professional to a fault, and I am also a no non-sense type of nurse and person, and Listen, your post is nothing but non-sense. Just sayin...

Mashie

"You need to let the professionals do their jobs, especially the nurses. We are over worked and grossly underpaid so please don't give us a hard time."

Mashie,

I'm well aware a lot of medical professionals are overworked and underpaid. I'm equally aware they are not perfect, and I certainly don't expect them to be. They have multiple medication lists, patient histories, test results, etc. to keep in mind, not to mention it would be difficult to learn everything about a new patient after one meeting. I have only my medical information to remember, and I've had plenty of time to learn it. As someone with multiple health issues, I've been on the receiving end of many, many minor medical mistakes that caused severe, if ultimately harmless, discomfort. I don't blame the doctors and nurses - as you say, you are overworked, and people can mistakes in the best of circumstances. I blame myself, because after my initial requests for information were turned down I obediently 'did what was asked of me without bitching.' Yes, that made the doctors' and nurses' jobs easier, and I got the nice feeling of not irritating people. And each time I also got worsening symptoms or new side effects or duplicate invasive/painful exams and procedures, etc. Again, none of these things did irreparable damage to my health and all the instances were totally understandable mistakes. In the grand scheme of things, maybe the health system ran more efficiently than if I'd clogged it up with questions and complaints. From a more selfish standpoint, I would have avoided personal physical and emotional setbacks if I had been a difficult patient and insisted on an explanations rather than assuming the health care providers just knew something I didn't. Of course they knew plenty of things about medicine that I don't (otherwise I wouldn't have been paying for their services) but now my respect for the medical professions comes second to looking out for myself.

I'm lucky enough to have a solution that makes everyone happy - I've found doctors (traditional, no green tea or flower petals) whose bedside manner is compatible with my personality, and the medical professionals who have had similar reactions to the ones on this post are free of me. WIN.

To support you both, it is my thought that people, and/or their families, need to become a part of the heath care process. No, we shouldn't get in the way of the professionals per se, however, we can discern that the medication is correct, and coming to the correct patient. And, if there is a question, it should not be a problem to ask.

When it comes to asking questions, I am not shy. And, if the day comes that my questions are a nuisance for a physician, or nurse, then it's likely that I should visit another clinic or hospital facility. Tis my thought that 'I' have the ultimate responsibility for my health; so, it is incumbent that I become as knowledgeable as possible.

I've only experienced one problematical issue in a hospital; that was when a nurse was changing a dressing on a surgical site, and she was about to mop all of the bandages off of my chest. Had I not stopped her, she would have also pulled out a drainage tube.

To me, it is all about teamwork; and, I am a part of the team.

I applaud the medical professionals who take care of us. They are not underpaid for their work. For if they were, they would go to other occupations, or discern how to sell their services for the value they set for their knowledge, time, and experience.

Now, go out and make it a gr8 weekend!

Hermann

Mashie,

I was referring to your unprofessionalism solely as a moderator on this forum. Doesn't your job entail diplomacy and mediation? If a disagreement or fight breaks out you're supposed to be the one to smooth it out, not start it.

I believe it is important to know why anyone is doing anything to me. I was in an emergency room with severe type of food poisoning. While being pumped w/fluids because I was dehydrated from throwing up a nurse came & was rolling my bed toward the elevator. I asked her where she was taking me & she replied, "up to surgery." I told her I wasn't supposed to have surgery and she said, "aren't you having your leg removed?" !!!!!! NO, I'm not. The nurse stopped and looked at the clipboard on the end of the bed and to keep it short turns out I knew her and worked w/her hubby. She apologized profusely and parked me back in the ER.

Thus, I feel it is very important to know what is going on with my body, with what anyone is doing to me, and why they believe I need it done. Of course, I ask nicely but firmly. If a person can't tell me why, then they don't "need" to do anything to me. To blindly trust in a medical situation seems foolish to me. *unless of course it involves medical play* 😉

One time several years ago I went to an Urgent Care for a sports physical. The female NP had done all the basics and finally looked at me and said "I'm gonna need to examine your testicles now." Her facial expression seemed to tell me that she knew I probably wasn't too excited about it but that it was a necessary part of the exam, almost as if it was company policy and beyond her control.

The word isn't used with me. I am simply told what to do or what will be done to me. For example, nurses never tell me that I "need" an injection. They just tell me to pull down my pants and bend over, occasionally preceded by "I'm going to give you a shot".

I have to say that Mashie and I were responding as ordinary members posting here, not moderators. We have personal opinions, too. The fact that we are moderators had no bearing on what Mashie or I had to say.

As far as the poster who had a fainting spell is concerned, FAINTING ISN'T NORMAL. The cause could be as benign as postural hypotension, but it is a sign something is wrong somewhere and the company physician is responsible for making sure nothing happens to you that could cause you or someone else to sue the company.

One thing that I have always found confusing is that sometimes after a medical error is discovered, the provider wants to know why I didn't try harder to point out the mistake (answer: because the first time I said something the response was "we're medical professionals and we know what we're doing, so let us do our jobs" and I took them at their word); other times when I ask someone to double check or explain something I'm confused about and they find there was an error, the response is "I'm glad you said something!" Since I'm NOT the one with extensive medical knowledge I obviously don't know for sure that something's wrong - sometimes I've asked and my concern was unfounded - so how can I tell when I should keep my mouth shut and when I should be difficult?

I also wanted to say to the health care professionals on the board, when I'm purchasing health services I believe the only things I'm entitled to are medical competency and anything specified in legal/ethical rules. I'm not entitled to a good (for me) bedside manner or way of interacting. And a lot of the time that leads to situations where a provider performed his or her medical duties perfectly, which I appreciate, but interact in a way that leaves me distraught. I don't think it's out of line for me to feel upset about that, but I don't expect the person to change because of it. I think there's a lot to be said for the "if you don't like it you can leave" approach (assuming one has access to other options). Because I REALLY don't enjoy being the bad patient, but it's also in my best interests to stay emotionally stable.

One thing I give to everyone upon their admission is their own copy of their "bill of rights." Every facility has them and are required by law to hand you a copy and to make you sign a form stating that you understand what your rights are. They also give you a copy of them to take home. Try there first. We are more than happy to answer any questions that you may ask as long as you ask them in a decent and appropriate manner and/or setting. Attacking us will get you no place but the back of the line.

Mashie

... when I\'m purchasing health services

This is a basic concept that many people seem to have nowadays, especially in the US it seems. Never once have I ever heard anyone in the country I live in or in neighboring countries talk about 'purchasing health services' ... one goes to a doctor or a clinic to consult a medical professional in order to rectify a health/medical problem, to get well.

By bringing marketplace values and concepts and modes of thought into the medical field so that patients think in this manner, is begging for attitude problems. As soon as people start seeing themselves as paying customers, their mental approach to others changes. Cooperation becomes less important, acting as a demanding and all deserving customer becomes more so. If people start coming to doctors with such an attitude, then it is no wonder that there are often differing opinions on how to go about medical things.

This is not to wave away mistakes and mix-ups or even incompetence. But if people persist in thinking in marketplace terms about medical matters, they will get themselves into a blind and often be very unsatisfied, simply by the nature in which they approach the situation.

We in the US never used to think of "purchasing health services". Most healthcare was covered by insurance and most insurance companies were Mutuals, which meant that they were owned by the policyholders. Then, in 1974, the "Employees Retirement Income Security Act" (more commonly known as ERISA) was passed and insurance companies found that they could exert greater control over what was covered (and make more money as shareholder owned companies) because the act essentially gave them immunity from lawsuits. As a result, medical care has become a commercial commodity as the insurance companies control what they will reimburse and cover and the physician-patient relationship has become, in a word, a threesome. When you reimburse for specific services, physicians have an incentive to employ those services and when you have to see so many patients / day, physicians are encouraged to limit their interactions with their patients. This system benefits neither the physician nor the patient. The only beneficiaries are the insurance companies' executives and their shareholders.

Sorry, I've only started using the phrase "purchasing health services" because I've gotten "you're hiring us to do a job" from so many health professionals. I don't like either phrase. Also, I'm in health services research and translating everything into jargon is a bad habit - again, sorry! I guess a better way of putting my point would be that I think it is fair to expect medical competency and ethical behavior from someone who is trained and paid to provide health care, but that these fair expectations do not include good bedside manner (or the outpatient equivalent - is there a better phrase?). That's the provider's personal choice. I've come to think the issue is that health professionals and patients don't always have the same goals. As it's been pointed out in many places on the site, health professionals see patients as bodies with problems to solve and don't any kind of emotional thrill from the experience. And they have a lot of patients besides me to attend to. I respect that. But I don't see myself that way and I AM emotionally impacted by the experience. My responsibility is looking out for myself. The two perspectives don't always align.

As for the patient bill of rights, I'll be totally blunt - I know this isn't the way it's supposed to be done, but I'm self-centered and if I'm really concerned about something I'm not going to see if a mistake is made and then lodge a complaint in the "decent and appropriate manner and/or setting." I'm going to protect myself - like I said, it's selfish and I won't try to justify it, but there it is. I've been told plenty of times that noncompliance will earn me delayed or poorer care. There are times I'm ok with that, because sometimes the effects of even a mistake that wouldn't cause major medical harm are worse for me than whatever the nurses dish out.

Ironically, the difficult encounters I've had with doctors and nurses over the years (before I developed my aforementioned selfish outlook) played a big role in the interests that brought me to this site. So...thanks?

Sjaney,

As both a nurse and a patient, I agree with you 100 percent. I see both sides of this coin. It is very easy for me to sit here and say that a patient can't be selfish and has to realize that I have many many, way too many patients. But when I am the patient, I want to think I am the only patient too. It's human nature and your feelings are quite justified.

Mashie

Sorry, I\'ve only started using the phrase "purchasing health services" because I\'ve gotten "you\'re hiring us to do a job" from so many health professionals. I don\'t like either phrase. Also, I\'m in health services research and translating everything into jargon is a bad habit - again, sorry!

There's nothing to be sorry about. It was just a general observation and when everyone starts to use the same phrasing, there is usually little you can do to avoid adopting the same manner of speaking. It's mainly an observation that is indicative of how societies tend to think about some very basic premises that affect everyone's lives.

And I wouldn't really consider it medical jargon. It seems to me that it is a corporate/monetary mindset that is permeating virtually everything and so many aspects of life. It's insidious and once it becomes a habit to think in this manner, it becomes hard to escape the mindset that virtually everything in life has to do with a marketplace/profit economy.

Mashie,

I think this is what gets to me - I expect medical professionals to be good at medicine but not to be super attentive, nice, or even really look out for me beyond the scope of their job. But I don't understand why they would expect me not to look out for myself beyond the scope of their job!

Sure, I'm not going to waste their time with requests for pillows or PRNs or answers I can find myself, and I trust them to adequately treat whatever medical issues brought me there. But I've seen firsthand how easy it is for people to make minor and totally understandable mistakes, and those minor mistakes often have a major impact on me. And my focus is not the specific medical problems they are treating, it's the whole of my well-being and quality of life long after I leave.

So, of course, I have different priorities, and if I'm concerned about something, then that takes precedence over making the doctors' and nurses' jobs easier by doing what I'm told. Just like if they have patients with more urgent medical needs that will take precedence over making my life easier by doing what I'm asking.

I guess it's just that I've experienced too many health care glitches that delayed hospital discharges, recoveries, and returning to MY job, that I can't always see what the value of being a good patient is. I should also say that none of this makes me less grateful for all the medical care I have received...just more cautious and less compliant.

Anyway, truce?

Agracier,

No, it's too silly for medical jargon - it's American public health/policy/whatever jargon (at least where I've worked). I blame the same people who want patients to be referred to as 'consumers.' I'm waiting for term 'sick' to become politically incorrect 😃

Sjaney,

lol, you call a truce but I am not at all arguing with you. On many levels I agree with you. We all wish things to be better for all parties involved. Personally speaking, I wish my patient ratio was a quarter of what it is. I wish I would be able to sit down with my patients and really get to know them, hear them, listen to them. One day perhaps, maybe in the future God willing.

Mashie

I agree.

Having said that, if the doctor is to do a proper job of diagnosis or treatment they may need some kind of compliance.

Still, People use that term too much. I especially dislike folks telling me that I *need* to so something for their benefit, and not mine.

My mother used to tell me that I *needed* some kind of laxative, oral or rectal. I believe that she was right. But I also *liked* them. It was the most personal attention. The enemas caused such intense feelings, in my tummy and bottom. Upon expulsion, the discomfort was so great that I cried, but I *still* wanted enemas more often. She stopped when I was about six.

I started giving them to myself when I was eight years old. On that first occasion, I was in my bedroom, with a bulb syringe and a medical book, and the babysitter walked in. She was shocked, and her mother made her stop babysitting for such a nasty little boy as she felt I must be, hehe.

If the doctor needed to do the tests to diagnose any problem, that is fine. But in the beginning of this topic, if I am understanding the posts, the nurse was doing test(s) that were not asked for by the doctor. To me that says, do not need. As a patient I have the right to ask questions so that with all of the medical professionals one sees for a problem there might not be an error.

I have had over 15 surgeries and have a tremendous health history with multiple hospitalizations. I have always questioned why tests or procedures were being done. I have had many healthcare professional make mistakes on me, one biggie that caused me to have a second surgery and four-day hospitalization, coming out with MRSA staph infection and then developed a blood clot, which I "diagnosed" on my own while recovering at home and feeling an odd ache in my calf. I called the doc (different than the surgical doc) and said what I thought it was and she sent me for ultrasound and, yes, I did indeed have a blood clot.

I try to have my sister (an R.N.) present when I will be drugged from surgeries in the hospital and she will speak up when they are doing something incorrectly, such as attempting to take vitals on my right arm, when it is in my chart and written on the board above my bed, No Vitals on Right Side.

I have also worked in medical offices for nine years and got to know many physicians on a personal level and know that they are humans, not gods. And I don't hold them up on pedestals, but I also show respect, until they give me a reason not to.

Ohhh, I could go on and on with medical mistakes. So I, too, would question the eye exam as tjc indicated. I understood that he had to attend the exam because it was a workers' comp issue, but that doesn't mean he can't question why something is being done.

So I guess I am one of those pain in the ass patients!

The answer to the original post is a much simpler matter of semantics than the long winded debate that I stopped reading seven replies ago. You have to think about the word 'need' and the context in which it is used. If the doctor, or whoever, is to make a proper diagnosis/treatment/assessment, or whatever, there are certain things that will, in fact, need to be done. That's life, just the way the cookie crumbles, the ball bounces, and all the other cliches people use.

So, once you've accepted the fact that in order for one thing to happen something prior needs to happen, the next question is this: Is what I'm being told what needs to happen, or is the person telling me this wrong? The word 'need' is not to say that you have no choice in the matter; things may need to happen, but ultimately you have the choice of whether they do happen or not.

Now, the next thing to address is the word 'should'. If a nurse said to you, "The doctor should _________." you have to wonder why the doctor should do that. The answer? The doctor should ________, because ________ is needed for a proper treatment/diagnosis/assessment.

By insisting on using the word 'should', you are creating an illusion of control that is completely superfluous, because no one has tried to take control over your own body away from you. You control your own healthcare, but there is also a common sense assumption that you have chosen to exercise that control by seeing a doctor, and that you will allow yourself to be treated as the doctor deems suitable.

Miss Petal, you ARE one of those pain in the ass patients, and I believe MM has something for that, lol. And if he doesn't, I can make sure he does. Hehehe

Mashie