Not long ago I read a blog entry that referred to doctors (general practitioners) habitually greeting their patients with "And what can I do for you today?" while at the same time reaching for the prescription pad.
I began to wonder how such stereotypes originate, and how they persist in people's perception when common experience has to be that this sort of cameo is anything but commonplace in the real world. Perhaps it never was. Or maybe it is a creation of medical "soaps". I wouldn't know - I never watch them.
Doctors are not quite the fools that this image might suggest that they are. For the notion that they can help at all in a fair proportion of cases presenting to them is a false one. "Help" implies an intervention of some sort or another, and this is usually unwise unless one knows exactly what the issue is that one is dealing with, and with a clear objective in mind. What doctors really do of course is to try to make sense with the patient just what is going on that caused the patient to come (so best to start along the lines of "so please tell me what it is you have come to see me about today"). They will try to identify reasons why the situation has arisen or might have arisen, to suggest what might be the outcome if left to itself, and finally to consider what, if any means might be utilised to modify the outcome. This last is the "help" if you like. And the wise doctor who sticks by the aphorism "first do no harm" will be circumspect on the subject of, say, ordering tests and, yes, putting pen to the prescription.
"Advice" is another two edged sword in the doctors repertoire of interventions. It should not be given incautiously, particularly if it is the "if I were you" sort of advice. Because the doctor is not the patient. Only the patient can decide, in the end, how to address their problem. The best a doctor can do is to put the patient in a position to make the choice that is best suited to her or him out of perhaps several choices (for example: to take medicine/not to take medicine; to embark on a series of tests/adopt a "wait and watch" approach).
Those situations where a reason (diagnosis) can be established unequivocally may indeed have limited or no choices of management for a safe and effective outcome are actually not that common. But your everyday coughs, colds, backache, piles, anxiety states and sadness will by and large get better by themselves - and so the patient must be given the option of allowing a natural recovery to occur in its own time. All of them, of course, are amenable to interventions that may be more or less effective. And all interventions have the potential to cause adverse effects, a few of which may leave the patient worse of than he was. Or dead.