So true. And, it has been my experience, especially true with an older male doctor and a young female patient.
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I think I disagree with some here. These days, if I need to see a physician and it is of importance, I either call in advance to interview the provider or I set up a consult-only – no hands on – visit. Either one of which I make clear I want to pay for. The front desk and not the physician often pose the restriction. Many competent providers welcome a patient-centered relationship in which they are the expert consultant and you are the project director. You have to adopt a take charge approach and be prepared to run the gauntlet of the front desk person who is appalled by such impudence 
These times . . . they are a changin’
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You might not have run into those ultra-specialized doctors yet—the ones whose noses are way up in the air. I once tried to consult with a top-tier specialist in a very specific field, but it was impossible to talk to him. He was convinced he was always right and fought me on everything. I immediately switched to another doctor of the same caliber, and the experience was much better; the communication was great, and I actually got the results I was looking for.
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Sometimes apparent arrogance is camouflaged insecurity. But it is definitely a numbers game. It helps I think if you can appeal to some common background to establish a connection. To pick up a few extra bucks as a grad student, I taught in a medical school, helping students interpret and assess the implications of published medical research. As a group, they are poor at this. I try to initiate the relationship by establishing a framework for setting boundaries. So far, so good but I would be OK if it didn’t work out. It would prevent me from wasting his or her time and mine. I have no interest in working with anyone – on any subject – who will not participate in constructive dialogue.
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Can you share your framework? thanks a lot!
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I just tell them what I bring to the table and emphasize what I lack, which is deep clinical knowledge that you don’t get from reading research papers, no matter how many. I position it as a partnership and maybe a little fun of a different kind.
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I never thought much of him. He says he is a physician and treats all conditions, but then I read that he did not even complete his residency. His views on longevity science lays heavy emphasis on exercise and other regimens that is promoted by his new business.
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I wouldn’t count Peter Attia out just yet. Looking at the latest output from his team over the last few days, he seems to be coming back stronger than ever with highly viable tools for maintaining healthspan.
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Not too many slouches doing surgery at Johns Hopkins.
" Peter Attia served as a general surgery resident at Johns Hopkins Hospital for five years, where he received extensive clinical training in surgical techniques, patient management, and critical care. During this period, he was recognized with prestigious awards, including Resident of the Year and Excellence in Teaching , and focused his training on general surgery with a concentration in oncology.
While he completed the five-year residency program, sources indicate he did not finish the full residency requirements necessary to become a board-certified surgeon, leaving with two years remaining before pursuing other paths. Following his time at Johns Hopkins, he transitioned to a surgical oncology fellowship at the National Institutes of Health (NIH) to conduct research on immune-based cancer therapies."
Whatever else we may think, Attia is definitely a high achiever, take-no-prisoners type personality. Some find that off-putting. I don’t mind if the substance is behind it.
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Seems like he may be a beneficiary of the Iran war. And short American attention spans.
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This makes no sense. Gen surg is a 5 year program. You can’t complete 5 years yet leave the program 2 years prior to completion. Hopkins is a great program but completing half of a Gen Surg residency doesn’t make you a competent or even capable surgeon.
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Attila does not say he’s a surgeon, nor practice as one.
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I completely agree with this and with most patients try to make joint decisions. You guys are not typical patients though. You’d be surprised how many patients want a doctor to be like a plumber. Just fix the problem and let me know when you’re done. I will often offer up several possible actions to take for the patient to choose and the response I get is “why are you asking me, you’re the doctor”.
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LOL, there’s also the old school doctor. Back in the late 90’s I was at a dental clinic and I had been assigned a dentist who came highly recommended. I asked her to explain to me in detail her reasoning for a certain procedure. She grew impatient and somewhat offended and got snippy to the effect that she knows what she’s doing. I spat out the cotton spacers, tore off the bib, got out of the chair and left that clinic never to return. I have zero tolerance for that attitude. You still get that occasionally, but it’s driven more by time constraints somewhat understandably. During visits I try to structure my conversation with that in mind, just hitting key points without wasting any time.
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LOL this made me laugh for real. Yea I could totally see this. So much for complaining about doctors not listening to us when in fact we don’t even want them to listen LOL, boy o boy aren’t we a complicated species.
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Mine came after reading his book “Outlive”. I started taking Rapa in the fall of '24 and have now switched to Sirolimus. I have never felt better…
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In USA in most states it is illegal to practice medicine with just an MD unless you have completed your residency, or at least the first 2 years of residency.
Board certification comes after the normal residency and not all doctors complete one.
During the Residency MDs are not supposed to treat patients without the presence and supervision of an attending physician.
The first year of a residency program is often refered to as an internship. Patient mortality is significantly higher during the first six months of the residency in ERs. If you encounter an Intern in an ER during the Fall/Winter insist on the presence of the attending physician before being treated (Based on what my younger Sister told me about her Residency).
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You make a good point but it is has the color of someone younger than, say, 75. I know I am not alone in saying that at some age the less inspiring human instincts are no longer in play, even mentally. It is not so much that one learns to master them as that they quietly lose their importance such that you have difficulty imagining that they were ever important.
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Aren’t Rapa and sirolimus the same? real question btw and does it mean that you felt better after switching from Rapa to Sirolimus, or am I misreading your posting. Thanks,
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damn, I wish that were true in my case LOL. Every single instinct, desire, hate (if you like) and any human emotion there is seems exactly the same for me as it was since I became an adult or even earlier. I’m 60 and maybe from now on it is where things start changing but I can literally say Nothing in me has changed not even 5%. Physically obviously yes (even there not so much), but mentally and emotionally I’m carbon copy of myself at 45 years ago LOL. But I do get your point and for most people I assume things do change.
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