Lest the students out there get disillusioned, it is probably a good idea to be upfront about the reality of being a doctor:
Maybe it’s not always this bad, but in the ER there is a real ring of truth to this.
From the marvelous Saturday Morning Breakfast Cereal
*This blog post was originally published at Movin' Meat*
A hard thing about being an ER doctor is that I know a little, sometimes very little, about a lot of things. When I am faced with a particular condition, I often need to call the specialist for that organ, who knows way way more about it than I ever will, and they all think I’m an idiot because I don’t know as much about their organ as they do. There’s a huge asymmetry of knowledge, and it can create some tension and conflict.
I’m OK with it, because I can ignore their condescension and I am secure with what I do know, and its limits. But sometimes I get perplexing instructions from the specialists. The emergency medicine dogma can be overbroad and a little hidebound and what the specialists will do in the real world often radically diverges from what the Emergency Medicine textbooks say to do. It’s often an interesting learning opportunity for me, especially when it’s a condition I don’t encounter that much. But I also have to work to maintain a flexible and open-minded attitude when I call a consultant and my side of the conversation consists of “Really? I didn’t know you did that for this…” You need to know and trust your colleagues in other specialties, and know when to call BS on them and push to do something else, which is really hard to do when you are talking to someone who is so much more of an expert than you are.
So I saw this guy recently, an urban hipster who was perhaps a bit too old to be riding his longboard on the hilly streets of our fair town. He didn’t seem to be too good at it, judging by the collection of crusted abrasions and aging ecchymoses he was sporting. He had been falling a lot recently — we only get about a month of sun here, so I guess he was making the most of the summer weather practicing his new hobby. He had a variety of complaints from Read more »
*This blog post was originally published at Movin' Meat*
Howard Dean wrote an op-ed defending the use of foreign international medical graduates:
Today, young physicians with degrees from international medical schools face skepticism from some in the American medical community. That strikes me as misinformed thinking, given the large number of international medical school graduates practicing in the United States, alongside American medical school graduates, and given that the American medical system depends on them to fill the growing doctor shortage.
The federal Health Resources and Services Administration predicts there will be a shortage of approximately 55,000 physicians in the United States by 2020. We simply can’t build the capacity to meet our growing needs for skilled physicians — especially given budgetary constraints on schools receiving government subsidies. Even if the new medical schools now in the planning stages all come to pass, they won’t turn out enough primary care physicians to meet urgent needs in urban and rural communities.
I actually don’t have a lot to say about the IMG thing, I have worked with and hired many IMG’s and their skill and quality vary as much as US graduates. But this whole argument seems to miss the central point regarding the projected physician shortage. The supply of new medical graduates is not the choke point, under the current state of affairs. The choke point is the number of residency training slots. Read more »
*This blog post was originally published at Movin' Meat*
A 24-year-old Cincinnati father died from a tooth infection this week because he couldn’t afford his medication, offering a sobering reminder of the importance of oral health and the number of people without access to dental or health care.
According to NBC affiliate WLWT, Kyle Willis’ wisdom tooth started hurting two weeks ago. When dentists told him it needed to be pulled, he decided to forgo the procedure, because he was unemployed and had no health insurance.
When his face started swelling and his head began to ache, Willis went to the emergency room, where he received prescriptions for antibiotics and pain medications. Willis couldn’t afford both, so he chose the pain medications.
The tooth infection spread, causing his brain to swell. He died Tuesday.
It can’t be denied that his poor decision-making was the proximate cause of this guy’s death (and many times I’ve gotten the maddening call from the pharmacy, “Doctor, the patient only wants the narcotics”). The underlying cause, however, was the fact that he was uninsured. Read more »
*This blog post was originally published at Movin' Meat*
Darryl Cunningham has a lovely detailed explication of the state of chiropractic “medicine,” in a multipanel cartoon format!
Worth clicking through to see the whole thing.
*This blog post was originally published at Movin' Meat*
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