@freemo abuse is a big issue. Less now than 40 years ago but changing medical culture takes time. To the consternation of some senior clinicians (‘they aren’t learning anything useful like we did”) our medical students now spend time training with actor patients. A start but only that and one problem is how we select for entry into medicine. - empathy is well down the list.

@DaveFernig seem to have the same problem from older doctors. In fact might be worse from the older generation.

@freemo of course one cannot judge individuals from the average, but indeed empathy considerably lower the older they are, as the older ones had no training in this, so either it was a quality and skill they alfeady had or not. Also the culture of selection for entry and of training meant (and still does to an extent) that empathy was judged to be a ‘weakness’ - so a good deal of macho culture unfortunately.

@DaveFernig While that seems accurate im not sure how much of it is training vs the system. The change has been too short term (particularly worse the last few years) for it to be a training issue.

As best I can understand the issue comes about from the FDA and the legal system which has caused them to be unable to treat and act out of fear of law suits. Plus rules out of the FDA seem to strongly discourage prescription drugs.

@freemo I cannot speak for the US, other than from the stats (worst system among the rich countries) but in the UK there has been a welcome change though still a long way to go.

@DaveFernig The issues I am describing are fairly limited to the US.

I have been treated in many european and other non-US countries. While the specific form of abuse I describe here is certainly somewhat unique to the USA I can say with confidence all of the medical infrastructure in europe and much of the world is just as bad, just bad in very drastically different ways. But most of those problems are outside the scope of this post.