Those free medication samples may not be the best -- or safest.
If You Only Knew ...
Reader's Digest offered two dozen doctors a chance to tell it like it really is, and general practitioners, surgeons, shrinks, pediatricians, and other specialists took the challenge. Some wanted to be anonymous; some didn't care. But all of them revealed funny, frightening, and downright shocking things that can help you be a better, smarter patient.

We're Impatient

? I am utterly tired of being your mother. Every time I see you, I have to say the obligatory "You need to lose some weight." But you swear you "don't eat anything" or "the weight just doesn't come off," and the subject is dropped. Then you come in here complaining about your knees hurting, your back is killing you, your feet ache, and you can't breathe when you walk up half a flight of stairs. So I'm supposed to hold your hand and talk you into backing away from that box of Twinkies. Boy, do I get tired of repeating the stuff most patients just don't listen to.
--Cardiologist, Brooklyn, New York

I was told in school to put a patient in a gown when he isn't listening or cooperating. It casts him in a position of subservience.
--Chiropractor, Atlanta

? Thank you for bringing in a sample of your (stool, urine, etc.) from home. I'll put it in my personal collection of things that really gross me out.
--Douglas Farrago, MD, editor, Placebo Journal

? One of the things that bug me is people who leave their cell phones on. I'm running on a very tight schedule, and I want to spend as much time with patients as I possibly can. Use that time to get the information and the process you need. Please don't answer the cell.
--James Dillard, MD, pain specialist, New York City

? I wish patients would take more responsibility for their own health and stop relying on me to bail them out of their own problems.
--ER physician, Colorado Springs, Colorado

? So let me get this straight: You want a referral to three specialists, an MRI, the medication you saw on TV, and an extra hour for this visit. Gotcha. Do you want fries with that?
--Douglas Farrago, MD

? I used to have my secretary page me after I had spent five minutes in the room with a difficult or overly chatty patient. Then I'd run out, saying, "Oh, I have an emergency."
--Oncologist, Santa Cruz, California

? Many patients assume that female physicians are nurses or therapists. I can't tell you how often I've introduced myself as Dr. M. and then been called a nurse, therapist, or aide and asked to fetch coffee or perform other similar tasks. I have great respect for our nurses and other ancillary personnel and the work they do, but this doesn't seem to happen to my male colleagues.
--Physical medicine and rehabilitation doctor, Royal Oak, Michigan

? The most unsettling thing for a physician is when the patient doesn't trust you or believe you.
--Obstetrician-gynecologist, New York City

? It really bugs me when people come to the ER for fairly trivial things that could be dealt with at home.
--ER physician, Colorado Springs, Colorado

? Your doctor generally knows more than a website. I have patients with whom I spend enormous amounts of time, explaining things and coming up with a treatment strategy. Then I get e-mails a few days later, saying they were looking at this website that says something completely different and wacky, and they want to do that. To which I want to say (but I don't), "So why don't you get the website to take over your care?"
--James Dillard, MD

? I know that Reader's Digest recommends bringing in a complete list of all your symptoms, but every time you do, it only reinforces my desire to quit this profession.
--Douglas Farrago, MD

Pills, Pills, Pills
? Sometimes it's easier for a doctor to write a prescription for a medicine than to explain why the patient doesn't need it.
--Cardiologist, Bangor, Maine

? Those so-called free medication samples of the newest and most expensive drugs may not be the best or safest.
--Internist, Philadelphia

? Taking psychiatric drugs affects your insurability. If you take Prozac, it may be harder and more expensive for you to get life insurance, health insurance, or long-term-care insurance.
--Daniel Amen, MD, psychiatrist, Newport Beach, California

? Ninety-four percent of doctors take gifts from drug companies, even though research has shown that these gifts bias our clinical decision making.
--Internist, Rochester, Minnesota

Bills, Bills, Bills

? Doctors respond to market forces. If the reimbursement system is fee-for-service, that results in more services. If you build a new CT scan, someone will use it, even though having a procedure you don't need is never a good thing.
--Family physician, Washington, D.C.

? I really do know why you're bringing your husband and three kids, all of whom are also sick, with you today. No, they are not getting free care.
--Douglas Farrago, MD

? Doctors get paid each time they visit their patients in the hospital, so if you're there for seven days rather than five, they can bill for seven visits. The hospital often gets paid only for the diagnosis code, whether you're in there for two days or ten.
--Evan S. Levine, MD

? Twenty years ago, when I started my practice, my ear, nose, and throat procedures financially supported my facial plastic surgery practice. Today, my cosmetic practice is the only thing that allows me to continue to do ear, nose, and throat procedures, which barely cover my overhead.
--Ear, nose, throat, and facial plastic surgeon, Dallas/Fort Worth

Free Advice

? Avoid Friday afternoon surgery. The day after surgery is when most problems happen. If the next day is Saturday, you're flying by yourself without a safety net, because the units are understaffed and ERs are overwhelmed because doctors' offices are closed.
--Heart surgeon, New York City

? In many hospitals, the length of the white coat is related to the length of training. Medical students wear the shortest coats.
--Pediatrician, Baltimore

? Often the biggest names, the department chairmen, are not the best clinicians, because they spend most of their time being administrators. They no longer primarily focus on taking care of patients.
--Heart surgeon, New York City

The Darker Side

? It saddens me that my lifelong enjoyment and enthusiasm for medicine has all but died. I have watched reimbursement shrink, while overhead has more than doubled. I've been forced to take on more patients. I work 12- to 14-hour days and come in on weekends. It's still the most amazing job in the world, but I am exhausted all the time.
--Vance Harris, MD, family physician, Redding, California

? In many ways, doctors are held to an unrealistic standard. We are never, ever allowed to make a mistake. I don't know anybody who can live that way.
--James Dillard, MD

? Not a day goes by when I don't think about the potential for being sued. It makes me give patients a lot of unnecessary tests that are potentially harmful, just so I don't miss an injury or problem that comes back to haunt me in the form of a lawsuit.
--ER physician, Colorado Springs, Colorado

? Doctors often make patients wait while they listen to sales pitches from drug reps.
--Cardiologist, Bangor, Maine

? It's pretty common for doctors to talk about their patients and make judgments, particularly about their appearance.
--Family physician, Washington, D.C.

? Everyone thinks all doctors know one another. But when we refer you to specialists, we often have no idea who those people are. Generally, we only know that they accept your insurance plan.
--Pediatrician, Hartsdale, New York

? In most branches of medicine, we deal more commonly with old people. So we become much more enthusiastic when a young person comes along. We have more in common with and are more attracted to him or her. Doctors have a limited amount of time, so the younger and more attractive you are, the more likely you are to get more of our time.
--Family physician, Washington, D.C.

? Plan for a time when the bulk of your medical care will come from less committed doctors willing to work for much lower wages. Plan for a very impersonal and rushed visit during which the true nature of your problems will probably never be addressed and issues just under the surface will never be uncovered.
--Vance Harris, MD

? At least a third of what doctors decide is fairly arbitrary.
--Heart surgeon, New York City

? Doctors are only interested in whether they are inconvenienced -- most don't care if you have to wait for them.
--Family physician, Washington, D.C.

The Sensitive Side

? When a parent asks me what the cause of her child's fever could be, I just say it's probably a virus. If I told the truth and ran through the long list of all the other possible causes, including cancer, you'd never stop crying. It's just too overwhelming.
--Pediatrician, Hartsdale, New York

? Most of us haven't been to see our own physicians in five years.
--Physical medicine specialist, Royal Oak, Michigan

? When a doctor tells you to lose 15 to 20 pounds, what he really means is you need to lose 50.
--Tamara Merritt, DO, family physician, Brewster, Washington

? If a sick patient comes to me with a really sad story and asks for a discount, I take care of him or her for no charge.
--Surgeon, Dallas/Fort Worth

? Though we don't cry in front of you, we sometimes do cry about your situation at home.
--Pediatrician, Chicago

Shocking Stats
60% of doctors don't follow hand-washing guidelines.
Source: CDC Morbidity and Mortality Weekly Report

96% of doctors agree they should report impaired or incompetent colleagues or those who make serious mistakes, but ...

46% of them admit to having turned a blind eye at least once.
Source: Annals of Internal Medicine

94% of doctors have accepted some kind of freebie from a drug company.
Source: New England Journal of Medicine

44% of doctors admit they're overweight.
Source: Nutrition & Food Science; Minnesota Medicine

58% would give adolescents contraceptives without parental consent.
Source: New England Journal of Medicine

Anatomy of a Doctor's Bill

Just how much of the $100 your doctor charges for taking 30 minutes to investigate your stomach pain goes into his pocket? After paying the bills, he gets less than half. The breakdown, according to Robert Lowes, senior editor at Medical Economics:

$3.50 for malpractice insurance

$3.50 for equipment, repairs, and maintenance

$6 for supplies, including gowns, tongue depressors, and copy paper

$7 for rent and utilities

$11 for office expenses, such as telephones, accounting fees, advertising, medical journals, licenses, and taxes

$28 for secretary, office manager, and medical assistant salaries and benefits

$41 Amount that goes into the doctor's paycheck

Over the course of a year, that adds up to $155,000, the annual salary of the average family physician. That number rose just 3.3% between 2002 and 2006, while expenses increased nearly 25% over the same period.

那些免费药方可能不是最好的甚至可能不是最安全可靠的。

若果你只知道….

读者文摘为24位医生提供了一个平台来讲述事情的真相，而且包括一般的实习医生、外科医生、精神科医生、儿科医生以及其他专科医师也接受这个挑战性的邀约。这些人当中有的希望匿名参加，有的则不在乎。但是，他们所有的人都爆料出一些或有趣、或令人害怕或令人相当震惊的事情，由此可以让我们参考有助于让我们做个更好更聪明的病人。

我们不能忍受

我们已经极度厌倦做你们病人的“老妈”了，每次我只要见到你就不得不说那些戒条“你该减肥了”，可是你却赌咒发誓说你“没吃什么东西”或“自己的体重就是减不下来”，因此就这个减肥计划就没能成功。然后你到我这里抱怨你的膝盖受伤了，你的背疼死了，你牙疼，还有就是才走了一半的楼梯就喘不过气来。因此这时我就要像往常一样抬起你的手并且说服你远离那个”box of Twinkies”。孩子，我真的厌烦了重复那些大部分病人都不屑听的话。

——心脏病医生 布鲁克林，来自纽约

在学校我就被告知当病人不遵医嘱或不与医生合作就让他穿上医生的外衣，这样可以让病人处于医生的从属地位。——按摩师，亚特兰蒂。

多谢你从家里给我们带来的医学检样（粪便,尿液等），我将会把检样放在我一堆的检样品中，可是那真的会让我恶心地要吐。

—道格拉斯 佛拉格 医学博士，编辑，《普雷瑟波周刊》

其中一件事情最令我恼火的是有些病人一直用手机呼叫我。我每天都要赶着一些紧凑的诊疗工作日程，我想将时间尽可能地放在照料病人方面。希望这些病人利用我出诊的这段时间多找些适合自己病情的信息和治疗程序，请不要总是打我电话。

——詹姆斯 迪拉德 医学博士，疼痛专科医师，来自纽约城

我希望病人们可以更多些地对自己的健康负责，而不是依靠我们医生来摆脱他们自己的病情。——急诊内科医生，科罗拉多 斯普瑞斯，来自科罗拉多

因此我得出这样一个结论：你想将一份病例？送交三位专科医师，一位磁共振成像，你在电视上看到的一种药物，以及额外一小时去看医生。难倒你了, 你想跟薯条一起吃?

——道格拉斯 佛拉格，医学博士

以前只要我在诊室遇到一个难缠或是非常能说的病人并且跟他呆在一起达5分钟，我就让我的秘书用扩音器叫我，然后我就立刻出去并说一声：“哦，我有个急诊。”

——肿瘤学家, 桑塔 克鲁兹，来自加州

许多病人都觉得女性内科医生就是护士或是治疗医师。我无法告诉你我多少次向别人介绍自己是M.博士，可是下一刻又被叫做某某护士或是医师或是某某助手，还让我去帮他们取咖啡或是帮忙做其他类似的打杂工作。我绝对尊重我们医院的护士和其他助理医护人员以及他们的工作，可是这种称呼上的误会似乎从未发生在我的男同事身上。

——理疗医学和康复医生，罗伊尔 奥克，来自密切根

对于内科医生来说令他最不安的事情是病人不再相信和信任你的时候。——妇产科医生，来自纽约城

我真的很烦有些人，分明可以在家处理的小病小恙就来挂急诊。

——急诊内科医生，科罗拉多 斯普瑞斯，来自科罗拉多

你的医生懂的东西比网上的医学知识的要多，我跟些个治疗了好长时间的病人解释他的病情并且提出治疗方案。然后我在几天后收到他们的电子邮件，上面说他们在网上看到了他们病情的相关治疗方法，说我说的与那些方法相比有个别的完全不同并且很怪异，他们想试试网上的治疗方法。我想说的是（当我没说出来）：“那么你们干嘛不直接从网上查找保持健康的方法呢？”——詹姆斯 迪拉德 医学博士

我知道读者文摘建议带来一份完整的病症清单，可每次你这样做，只会让我很想以后结束医生的职业生涯。——道格拉斯 佛拉格 医学博士

药片，药片，药片。有时比起解释为何病人不需要某种药片来，医生写个药方则更方便。

——心脏病医生，班歌，来自缅因州

那些所谓的最新出的也是最昂贵的药品的免费试用品可能不是最好、最安全的。

—— 费城

使用神经性药物会影响你的保险。如果你使用百忧解，那么对你来说要得到人寿保险、健康保险或长期护理保险，就会更添难度而且买这些保险也更昂贵。

——丹尼尔 阿门 医学博士 精神科医生， 新港海滩，加州

94%的医生都得到过制药公司的礼物，尽管相关调查显示这些礼物都是对我们做出的冷静客观决定的偏见。——内科医生 罗彻斯特 来自明州

账单，账单，账单

医生也对市场压力做出回应。如果补助系统是免费提供服务因而引出更多的服务，如果你建立一个新的CT扫描仪诊疗室，那么有人就会使用它，尽管你不需要这个程序不会是一件好事。——家庭医生，华盛顿特区

我真的很了解为什么你今天带着你生病的丈夫和三个孩子一起来就诊。不，他们都没有得到免费护理。——道格拉斯 佛拉格 医学博士

每次医生在医院会诊他们的病人都会得到报酬，因此如果你住院7天而不是5天，医生们会出7个会诊单。意愿常常根据诊疗条码来计算改收的报酬，如论你住院2天或10天。

——伊万 S. 莱文，医学博士

20年前，我开始了我的实习，耳鼻喉科行诊的实习程序让我的面部整形手术的实习有了经济支柱。现在我的整容实习是唯一可以让我继续进行耳鼻喉科行医的支持，也仅仅够我的医疗经费。——耳鼻喉集整容手术医生，道拉斯/福特沃斯

免费建议/好心建议

避免周五做手术，手术后的这一天正是问题多发之日，如果第二天是周六，那么你就要无安全保障地忙乱了，因为医院科室人手不足，而且急诊室超负荷，因为医生办公室大门紧闭。

——心脏手术医生，纽约城

在许多医院，医生们穿得白大褂的长度跟他们接受培训的长度挂钩，学医的学生穿的白大褂最短。—— 儿科医生，来自巴尔的摩

通常最出名的医院科室主任并不是最优秀的医生，因为他们工作的首要重点不再是护理病人，而是将绝大部分时间都用在怎样做好一个管理者这件事上了。——心脏手术，来自纽约城

更黑暗的一面

让我伤心地是我一生习医的乐趣和热情都已经被淹没了，我眼看着补助金萎缩，而医疗经费双倍以上地上涨，而我要负担更多的病人，我日日要工作12-14小时并且常常在周末都要到医院来加班。世上仍然有做不完的大量工作，当我一直都很厌烦。

——万斯 哈瑞士，医学博士，家庭医生，来自加州莱丁

在许多情况下，医生都被限制在一个不切实际的标准上，我们不能也不允许犯错，可我知道没有人可以这样不犯错地生活。——詹姆斯 迪拉德 医学博士

我不考虑被起诉的潜在危机，那样只会让我对病人实施许多没必要的病理测试，这些测试都对他们有潜在的危害，正是如此我没有遇到过反馈到我的且会让我官司缠身的这样的伤害或困扰。——急诊医生，科罗拉多泉，科罗拉多

医生常常会因为聆听药品代理人员的推销而让病人等待——Cardiologist 班泽 缅因州

医生跟病人探讨病情并下结论这样的事情再普通不过了，特别是病人的表面症状。

——家庭医生，华盛顿特区

每个人都认为医生应该彼此之间都了解，但是但我们对一个医生提起你时，往往都不知道你是何方神圣。一般来说，我们只知道他们乐意接受你的推荐的保险计划。

——儿科医生，哈慈德尔，纽约

大部分医疗部门都常常护理一些老人，因此当有年轻人陪同时我们会展现更多的热情。我们跟年轻人有许多共同之处而且更容易被年轻的他或她吸引。医生的时间有限，因此你越年轻越有吸引力，你们年轻人更有可能从我们有限的时间里得到更多的信息。

——家庭医生 华盛顿特区

做一次计划，你的主要医疗保健由一个愿意被支付低薪水而又不负责任的医生；你的问题实质有可能永远不被重视并且问题隐藏在表面下永远不会被揭露，这时来个冷漠而又紧急的会诊。——万斯 哈瑞斯 医学博士

医生下的病症结论有至少1/3是很武断的。——心脏病手术医生，纽约城

唯一让医生感兴趣的事情是他们是否被打扰，他们大都不在乎作为病人的你要等待他们。

——家庭医生，华盛顿特区

令人生气的一面：

如果一位父亲或母亲问我是什么原因导致他/她的孩子感冒，我只会说很可能是病毒。如果我说出真相并且罗列出一长串其他可能的原因，包括可能原因是癌，那么你就永远不会停止哭叫，那太让人绝望了。——儿科医生，哈慈德尔，纽约

我们这些做医生的大部分人在5年内都没见过自己的家庭医生。——体育医学专家，罗伊尔 奥克，来自密歇根

如果一个医生告诉你要减肥15-20磅，那么他的本意是你需要减轻体重50磅。

——塔玛拉 麦瑞特，DO，家庭医生，来自华盛顿的不鲁斯特

如果一个病人来我这里就诊诉说着一个悲惨至极的故事并要求医疗折扣时，我会免费为他或她进行医疗护理——手术医师，道拉斯/福特 沃斯

虽然我们不在你们病人面前哭，可是我们一定会因为你们在家里的处境而哭。

——儿科医生，芝加哥

令人震惊的事情：

60%的医生不按照洗手规程来。资料来源：《CDC发病率和死亡率周报》

96%的医生同意通报那些容易出医疗事故且能力不够的同事，但是46%的人至少要对这样的医生视而不见/放水一次。

来源：《内部医药资料》

94%的医生接受过药品公司的某些赠品。来源：《新英格兰医药杂志》

44%的医生承认他们体重超重了。来源：《营养和食品科学》；《明州医药》

58%的医生没有青少年的父母同意的清空下给他们避孕物品。来源：《新英格兰医药杂志》

医生的手术账单

30分钟胃痛检查，医生收取的$100的费用中有多少落入他的口袋？付过诊费后，医生得不到一半。这个爆料的来源根据是来自《医药经济》的高级编辑罗伯特 罗斯：

$3.5是营私舞弊的保险费

3.5是器材维修和维护的费用

6是相关的医院供给费用，包括医生服、压舌板和复印纸。

7是租金和水电费

11是办公费用，如电话费、报账费、广告费、医药周刊费、许可证费和缴税

28是给秘书/助理，办公室主任和医疗助手的费用和利润

41就是医生的薪资部分

一年的时间一个普通家庭医生的年薪就追加了155000，，而且这个数字在2002-2006年间上扬了3.3%，而在同一时期医疗费用上涨了近25%。