I read this letter a couple of days ago (and browsed some of the comments) and it's been lurking around my brain since.
I had to laugh at his suggestion to avoid ED's after my own experiences. I now add General Surgeons to the list of people to avoid. When I was about to go under anesthesia last Oct for an emergency appendectomy I jokingly said to the anethestist "Can you get him to fix my knee while I'm under" His swift and contemptuous reply was "You don't want a general surgeon working on your knee!" This isn't the reason GS's are on my list - that's for the way he completely mishandled managing my autoimmune condition and put my life at risk.
There is a quote I learned as a child which I now apply to dealing with the medical profession " Diplomacy is the art of letting others have your way" (unless I'm in a crisis state - then all bets are off and survival instinct kicks in). It may sound like a very self-serving quote but when you are fighting a chronic illness you don't also need the stress of fighting a disfunctional medical system. It's something I try to keep in mind when I plan how and what I need to say to resolve whatever issue needs taking care of. Does it work? Most of the time yes - but there are definitely those doctors who, for whatever reason; arrogance, greed, incompetence, negligence, all the planning in the world won't get the necessary results. These doctors will only get to see me once.
That being said there is an onus on the patient to manage their interaction with medical professionals so as to not waste resources.