If you are seeing this then you are in the wrong blog. Come to my new blog called Doctor.
If you are seeing this then you are in the wrong blog. Come to my new blog called Doctor.
I can be found in my new home. Welcome to Doctor.
Was that me, dressed up in a dark suit doing my best not to look intimidated?
chekc out the COTV at Ravenwood's Universe
I find it troubling that almost all the fourth year graduating students in our affiliated medical school have no intention of entering primary care, or for that matter, internal medicine. What’s more alarming is the reason that they most often cite: “I found out I really hate to deal with patients/people”.
I am contemplating getting rid of haloscan and going back to good old blogger comments. I just have to figure out how to un-install.
Over the last three years I’ve developed a not so healthy case of generalized anxiety. It’s official; there are too many ways to die. Six million may be just a small exaggeration, but the point being: I know way too many of them now.
Its moments like these that made me want to become a doctor in the first place. The strange thing about all this is how these rare moments happen whenever I’m doing my ER rotations. Strange, because I find I am able to spend very little time with patients, much less than I would as an internist, and yet there are these little sparkles of light. Maybe this is what draws emergency physicians to their specialty. Although, I’m betting it’s the fact that they get to intubate.
Go check out the best medical writing of the week.
This week's Grand rounds are at the Examining Room. Charles has been doing so many carnivals you'd think he put a picture of a ferris wheel somewhere on the page.
Two days into my rotation as ER chief. That means that every patient who walks/is wheeled into the Emergency Room has to be seen by me first and then I hand it out to a junior resident.
Tomorrow I start ER chief. That's right, you guessed it, that means there's going to be a lot of ER bitching going on really soon. So while I get worked up why don't you go enjoy this week's Grand Rounds.
Recently, I wrote a post about being names in a lawsuit which was brought forth by a patient I had cared for in the past. The patient had a bad outcome and felt that this was due to the medical care he/she recieved or did not recieve. I've written similar posts about others before and usually what happens is that a med-mal discussion begins to brew in the comment section. It did this time as well and I put an end to it early, honestly, because I'm tired of hearing about it and arguing about it.
So why am I writing this post? Well, I've observed that the readers who are drawn to medical blogs are either people in the field or patients who have chronic disease and do a lot of research on the web about their own disease. These readers like to pick physician's brains or are interested in hearing something that validates their pre-concieved notion about their prognosis or other concerns. Of course, there are the occasional readers who are just interested in medicine as a field. But I digress.
Whenever one of these posts gets written, and this discussion begins, there is always one or two comments from readers who are truly convinced that their physician made a mistake, or missed something or just plain didn't know. This time the reader goes by the name "Bluedude". As they say "if you live in a glass house don't throw stones" so I will be happy to address him as "Bluedude".
This is not the first time I recieved this kind of response. I believe that Bluedude really is upset by what he believes are "physicians covering up for each other". I do understand how the situation can appear to be as such but please allow me to offer some counter-arguments you may have not given any consideration to. The reason I am going to do this here is because if I were the one being confronted by this family memberI would probably not point this out, in fear of being misunderstood, further worsening the situation and infuriating the complaint or because it would simply take wayyyyyy too much time and the person with whom I am having the discussion does not have the approprate background knowledge to begin to understand the full ramificaions of what I am saying. Especially when they are angry and more closed minded. I believe this phenomenon occurs because on television decisions seem much more straightforward. X-rays always tell the truth. CAT scans are perfect, an MRI, undeniable! If only things were that simple in REAL LIFE medicine. Please don't forget that television shows are aimed at the general public and have to be extremely simplified. A shame, since the general public gets most of their impressions about medicine from a very simplistic version.
"My father died very suddenly, and it was revealed that his doctor, also personal friend, missed the spot on his lung on the xray. We are not a litigious family and people do make mistakes. But what infuriates me is the way each doctor consistently stood up for each other, and my dad's friend kept reassuring my mom that there was no way he could've been diagnosed by the xray. Everytime he said that, it made me angrier and angrier. If doctors make a mistake, which they will, since they're only human, please don't lie to my face. Also, we asked the oncologist, and he just kept stating he didn't have a chance to review it. Be honest, be remorseful; show that you care about this patient, at this time. There would be less law suits if doctors didn't circle the wagons so readily."
I'm thankful my residency is over in 7 months. I'm thankful I'm no longer a second year or an intern. I'm thankful my residency is almost over. I'm thankful for a wonderful healthy girl and a loving wife. I'm thankful my residency is over in 7 months. I'm thankful for a beautiful world full of beautiful sights and gorgious women. I'm thankful my residency is over in 7 months. I'm thankful I'm a third year resident. I'm thankful that interns do my scut work. I'm thankful for not doing one guaiac exam myself this year, not one. I'm thankful my residency is over in 7 months.
Or Shall I say "We are getting sued".
I've been thinking about money lately. I think the reason is simple: I love money! There I said it. Finally, it's such a relief, I'm out of the closet.
Recently, Misha (sorry no address) wrote a response to one of my posts:
I thought "Heck, I spend half my day day-dreaming anyways so why not actually write down what I would love to do. So here it is, a list of what the 'little me' would really enjoy doing and then things I promise to actually do: (Some of these will get me in trouble)
"madman--you sound depressed. I think you need a diversion. How about a post of things you promise to do for your inner child.....Kind of a "to do" list. Not important achievement kinds of things....crazy things...fun things....things you have never done. You are clever....I trust you can come up with some good ones"
Over at Charles. And...He placed me first, I love you Aiden!
I feel so badly pouncing on this when really it's so much more ideal for the blogs of my emergency physician friends. the Annals of emergency Medicine October 2005 issue published an Article titled "The Next Generation of Emergency Medicine Reality Television". It's possibly the funniest thing I've ever seen in a Bona Fide medical Journal (if you consider EM medicine???). Props to Jeffrey Freeman who wrote the piece. Truly Mad my friend, I love it. Please excuse me for publishing it here. I have no money, really, I promise, none. Forgive the EM joke, that's mine, figures right?
As any emergency physician knows, it is normal to ride through the hallways of the hospital doing CPR atop the chest of a dying patient while shouting out orders to nurses at the top of their lungs—at least on television. And, while miracles occur in emergency departments (EDs) every day (such as a specialist coming in to see a patient), they are not always sufficiently dramatic for prime time. Like it or not, the American public learns more about emergency medicine from the television than from their personal experiences. ER has just finished 10 seasons; Trauma: Life in the ER has finished 7. Since it's only a matter of time before these shows fade from the airways, a replacement will soon be necessary. In this era of reality television, something that will grab the public attention and let them feel the true grit of today's ED is needed.
The following are reality television proposals for the next generation of emergency medicine viewers:
The Resident—A powerful and omniscient residency director starts with 12 emergency residents and each week fires one resident and gets all the remaining residents to work the extra shifts vacated. The last resident working gets hired to a large contract management group, but not as a partner.
Joe Emergentologist—Ten patients compete for the attention of Dr. Joe, the only physician working in a small rural ED. Each hour, Joe transfers off 1 patient to an alternate facility. Imagine the patient's surprise when it's finally revealed that Dr. Joe is only a moonlighting first-year dermatology resident, with no experience in any ED. Will the last patient standing still accept the loving care that Dr. Joe offers when they find out the truth?
Waiting Room Survivor—Twelve patients are stranded in an isolated, barren waiting room, and triage is closed. Who will survive? Without water or food, they have only their wits and the will to survive. Each week a patient is voted out of the waiting room. As they form tribes and win challenges, they struggle for the ultimate goal: any available treatment room.
ER Jeopardy—In this game show variant, 3 emergency physician contestants try to guess a patient's diagnosis, but the answer to every question is another question. Categories of answers include such puzzlers as: “What Language Is That?,” “Nominal Aphasia,” “Geriatric Confusion,” “In2bated,” and “Toxic Delirium.” Losers get sued, and the winner gets no actual cash or prize, but does get to come back for another shift and the satisfaction of a job well done.
The Mole—A high-volume ED, and one of the staff is sabotaging patient care. The Mole changes lab results, erases orders, and gives wrong doses; each week another abbreviation is cut from the list of accepted abbreviations. Can the emergency physician find the Mole before another patient calls their attorney? Sponsored by the Institute of Medicine.
Patient Extreme Makeover—A team of top-notch support services: social worker, physical therapy, occupational therapy, and dental hygienist, take a frequent ED visitor each week and work their wonders. Consultants are called in for bariatric surgery and laser tattoo removal; clothing is donated from the local thrift store. The patients return after their complete makeover with a new chief complaint, and the ED staff can't recognize them until they ask for Dilaudid…
The New Price Is Right—Forty-five million uninsured audience members are invited to the television studio ED waiting room, where 4 contestants are chosen to possibly win some medical care. To win, they've got to guess the price of industry-sponsored drugs and medical procedures. Those who guess closest are invited to a final showcase, where they try and guess the complete cost of their medical treatment before succumbing to their disorder. “Come on down!”
The Simple, Poor Life—Two consultant physicians, both from fabulously wealthy subspecialties, are sent to live and work in an ED for a month. Each week they are given a different job, from unit clerk through transport and housekeeping. Can they get through one last shift without getting their clothes dirty? A laugh a minute…
Who Wants To Be a Millionaire?—Two physician CEOs compete for an ED contract, trying to underbid and underpay their employee emergency physicians without going over the contract price. Three lifelines are given: “Noncompete clause,” “Restricted access to billing information,” and “Call a Friend.” Winner gets a million dollars and retires early from medicine.
American Idle—Each week, 12 patients wait hours for lab and radiograph reports while their medical conditions deteriorate and inpatient beds are unavailable. Radiologists and audience members can text message their vote for favorite patient to be admitted.
And finally, Fear Factor—This could be the ultimate ED program. It's apparent that the potential for an endless series of reality-based episodes of pain, terror, and inedible food is available. Just like a career working shifts in any ED.
Note 1: If anyone wants to consider hiring an emergency physician as television producer, please contact the author immediately.
Note 2: JCAHO has reviewed this article and would like to remind emergency physicians who shout out orders while performing CPR while riding stretchers down hallways, that for verbal orders, please verify the order by having the person receiving the order “read-back” the complete order. Thank you.