Hello, Crown Wearer —
The doctor’s burden of knowing a lot, including just how much I don’t know, is a heavy one. I do think that many patients (at least, the non-naive ones who have been sick a few times) understand that doctors are “just really edjimacated humans” — but all too often, patients grace/curse me with a level of expectation that I feel inadequate to attain.
I think part of this expectation comes from the way doctors are portrayed in pop culture. Don’t get me wrong, I LOVE watching Dr. House (or Dr. Green, or any other Dr. Television) display insane levels of eidetic memory and intuitive knack about anything even vaguely medical — but it sure sets a high “standard” for real life doctors.
I often feel as if a patient expects me to have an instant understanding and perfect recall of anything medical, no matter how uncommon it is in my general practice — not just a vague “Um, yes, I remember a professor mentioned that extremely-rare genetic disease once, and I could probably find more info on it within 5 minutes, after a couple of Google searches”, but rather a “Ah yes, good old Aarskog Syndrome, well that certainly would explain why Little Billy’s belly button sticks out more than his testicles do.”
As for “relying on my judgment more readily" — well, yes and no. I think the Golden Era, when the majority of people believed in the "trustworthy and expert physician", is over. This is paradoxical, given the ease of information-sharing in modern times. After all, I can now access a lot more knowledge more quickly than doctors could 20 years ago (thanks, Internet!) — but on the other hand, if I or any of my colleagues screw up, that knowledge becomes widespread very quickly (oh, THANKS, Internet), therefore tarnishing the overall “trustworthiness” of doctors more than in past decades.
Partly because of this trend, I actually feel like I spend most of my time trying to PROVE my “trustworthiness” to my patients. I have to spend extra time explaining why antibiotics probably won’t make these cold symptoms go away any quicker, even though “that’s what their regular doctors always gives them.” I have to cajole and almost beg diabetic females with shortness of breath to go to the ER for a “MI rule-out” when they come in certain that it’s “just anemia or something.” My years of schooling, residency, and practice don’t carry much weight, for many patients — they gleefully trump my advice on vaccines, fever management, antibiotic usage, cholesterol screening, colonoscopies, and risks of smoking (cigarettes in my real-life clinic, marijuana on Tumblr) with the all-powerful mantra of today’s self-educated patient: "Well, I read on the internet…"
So, in short: the general public’s perceptions of doctors comes in three flavors — overly trusting, woefully mistrusting, and (still, happily, a few) willing to work together as a team to figure out what is best, not just for that patient’s disease/diagnosis, but for THAT PATIENT. All three scenarios carry their own burdens and stresses for us physicians, but we learn to deal with most of them (and then we complain about the rest of them at the end of the day). :)