Why am I even writing this. This will turn so, so ugly.
By way of stating my bias, I am the child of a specialist. I have two siblings who have ventured into radiography. I have multiple friends who have completed, or are completing their medical degrees. I'm also a psoriatic arthritic, have an anxiety disorder and am overweight. All of this information together means only that I spend a lot of time with doctors and have far too much inadvertent medical knowledge. It also means that I see first hand how distressing, exhausting and traumatic it is to study and practice medicine, and the toll it takes on your mental and physical health and your family life. Which is why it infuriates me to keep encountering folk who believe that because they spent half an hour on WebMD they are more qualified to know whats medically best for them than the doctor who has spent X years studying and XX years wading through emergency rooms, being spat at, screamed at, physically attacked, bled on, vomited on and still slogging onward.
The concept of Big Pharma has the power to instantly raise my hackles, and after some consideration I've decided that the people who use that term don't entirely grasp what it means. Pharmaceutical companies are companies, first and foremost. They have employees who they have to look after, an output they need to maintain and shareholders they need to keep happy, and they need more of all of these all the time in order to stay afloat.
Medicine (let's say the Australian Medical Association, in this example) is in the opposite corner. They are, more often than not, the hurdle who the company have to get past in order to maintain a relationship with the patient. For the most part, the AMA and the company are at loggerheads. They frustrate and irritate each other, while also needing each other. The company sends out freebies, stationery, occasional snazzy stress balls shaped like a spleen (I've seen those, they're great fun), sometimes even dinners and conferences, in the hope that this or that doctor will walk away with a more favorable impression of that company.
Except it doesn't work. Because doctors are cynics.
And you would be too, if you were constantly in a loop of trying to care for people who don't care for themselves. Or adversely, trying to give proper medical care to people who dearly want the help, but can't afford it or for some reason are denied it. What an exhausting, horrible carousel of emotions.
The Company in question plays to the rules for the most part. They advertise, yes, but only in medical literature and not really in any way that makes sense to the common layperson. There is no facade of appealing to the patient whatsoever. Similarly, the AMA closely monitors Company behavior to ensure that nothing breaches medical ethics. Yes, the Company manufactures and sells medicines, and isn't it dreadful that people who can't afford them can't get them. But they are not a charity, and they have thousands of people, rents, bills and accreditations to pay. It falls to the government to take that final step and make the medicines accessible to you and me (PBS scheme). The Company was never meant to deal directly with the patient. Never, ever, ever.
I've had my current GP since I was a babby, and he still works monday to friday in the same office he was in when I was three. He starts at 8.30 and is usually still there at 8 at night, even though the last appointment is 6pm. This is partially because he's always behind schedule - he'll always squeeze in patients who are panicking about something or other - but also because for every patient he sees there are referrals, follow ups, blood test and Xray forms, calls to various people to talk about test results. And almost none of it can be deferred to someone else, because he needs to sign off on it all. And then there's volumes upon volumes of medical literature he needs to keep tabs on to make sure he's up to date with everything that's happening elsewhere.
And sure, at the end of the day (evening) he gets into a cute little black Porsche and drives home to his family. And it must be nice to have such a lovely car, and assumedly lovely house, but they are not a package deal that comes with your degree. They come after decades upon decades of work, terrible pay, no sleep and deteriorating personal relationships. That Porsche is running on blood and sweat, and is ultimately a pretty sorry consolation prize for what is lost in the push towards becoming a Doctor.
And all of it can be taken away if one person decides that you have been negligent. For example, a skin cancer that was benign six months ago is now malignant. Never mind that the doctor stressed to you that you had to come back three months ago to get it checked, it's malignant now, which means it's the doctors fault, I'm calling my lawyer, I'm going to A Current Affair, etc. There is very little in the way of protection for doctors who are called out as being negligent, mostly because the unspoken belief is that it doesn't matter if this person gets sued - they can afford it, they're a Doctor. And ultimately it's the doctors word against the patients, since due to medical ethics no one else was privy to their appointment.
I'm definitely not saying that there are no negligent doctors, because I'm sure there are. But they definitely are not the norm. Every doctor you meet has gone through hell and back in order to get to a place where they can help people and support their families, and they aren't going to be swayed because Big Pharma sent them some themed stationery. If they withhold information from you (which I completely support), it's because it'd alarm you without the multiple years of medical training to contextualize it. So yes, it's a trust thing. I've been very lucky with the doctors I've fallen into the hands of, enough to hulk out when someone huffs about how they aren't immunizing their children because they don't think it does anything, and it's just a profiteering racket. I'm not going to go into the AVN here, because I need to think about my blood pressure. Suffice to say if you choose not to immunize your children then businesses, schools and other parents have the right to specifically exclude your child. You aren't just hurting them, you are hurting the herd immunity which will make other children sick. It's not about You and Your Beliefs. It's about science, and the relatively decent odds that thousands of scientifically and medically trained minds carrying out years upon years of trials and testing probably know better than you do.
So in summary - your doctor has nothing to gain from prescribing medication or referring you elsewhere, save the piece of mind of a job well done. If you and your doctor don't get on like a house on fire, then go elsewhere, because that trust level is vital to this working. If your GP comes at you with a scalpel and a canister of liquid nitrogen, you gotta believe that they have your best interests at heart. Which they do, because caring for other people is what they've given up a normal, happy life for.