The doctors we criticize


#41

I have met a great many doctors in my life. That makes it very easy to compare and contrast. When I had pneumonia and almost died, my immunologist saved my life. And I told him I was grateful. He said something about religion.

I loved my family doctor when I was a child. I remember him giving out suckers to his patients right as they were leaving.

I had an allergist doctor stop what he was doing and coach me to eat five tiny micro meals throughout the day to treat my diabetes. I liked him for the kind attention and good advice he gave me.

I talked one time with one dorky looking fellow right out of med school. I shared with him that I had steroid induced diabetes. He twisted his face and sneered at me. I just avoided him next time. He was smart enough to pass the med school tests, but had unpleasant, untreated marketing problems.

In a hospital one time, when my lung collapsed, one hospitalist doctor called another doctor a “thoracic bozo”. That was not very friendly nor professional. It may also have been true.

About six in the morning, right before surgery, one surgeon told me that he needed a stiff drink to steady his hands in order to do my surgery. I could not tell if that were a joke or if he were serious. The surgery went well. Right after the surgery, he moved to North Carolina. I have no complaints, really, but that was a strange comment, right before surgery.

I like my gastro-interologist. He plays loud rock music in the operating room when he does colonoscopies.

My primary now is a good chap and friendly, but when my heart issue became too complicated, he asked me to go back and see my cardiologist for anything around my heart. I go to several specialists and just bring back the results to my primary. My chart is pretty thick, but I am still alive and I’m grateful.


#42

Good morning Gary,

There are many white coats who are very, very good. Unfortunatrly, there are lots who were never top of their class on almost any level!

As a type 1 diabetic, many of us have far more intimate experience with our disease than those who unfortunately we encounter in negative D situations.

Rarely met a nurse I did not trust… doctors, not so much. But got lots of decent experiences, but the bad ones they stick out big time.

Pleased to hear you met one of the many good ones


#43

Doctors are no different than auto mechanics, gardeners, lawyers or computer programmers. They have their own bell curve, like any occupation. There are great ones, awful ones, and the great majority somewhere in between. The only policy that makes sense is:

  • Reject the awful ones

  • Hang on to the good ones for dear life

  • Remember that they’re human and cut them the same slack you’d want for yourself

  • The other side of that coin—hold them to the same standard of responsibility you expect of others (including yourself)


#44

Q: What do you call a former medical student that graduated last in his class?

A: Doctor.


#45

And you probably remember that Custer graduated at the bottom of his class.


#46

And didn’t Robert E. Lee graduate at the top of his?


#47

Second, actually. And (later) was Commandant of the Academy. The guy who graduated ahead of him resigned within a year, so had no real Army career.


#48

Ok - you’d know from personal experience! :laughing:
But I did say “at the top” - -as someone who always finished second in my classes, that counts! :smile:


#49

I studied very hard to get great theory grades and worked very hard to get great clinical grades. Just because someone has top of the class grades doesn’t mean they can translate into practice. I’ve known a lot of very smart people but they couldn’t apply the knowledge. This doesn’t just include doctors, nurses but can include engineers, lawyers, and other professions. Top of the class doesn’t necessary mean the best there are other factors. Most boards require book knowledge to pass.


#50

So very very true. I’ve worked with heavily credentialed and degreed people who I wouldn’t trust to drive a car in traffic, and quite a few uncredentialed people who were the very best at what they did. And I’m not talking about blue-collar occupations, either.


#51

Amen. I had a very good friend that was top of the class but one day she wanted me to check a drug she was mixing which was standard practice where we worked. she had a 1 gram vial of medication which we mix with 10 ml of normal saline so she mixed it with 20 ml of normal saline because she wanted 2 grams of medication and she had a diffcult time understand you can not make 2 gm of medication by adding more saline to a 1 gm vial. That why we double check with another nurse.


#52

Wow. Just . . . wow.


#53

No but she struck upon how some businesses increase their profits. same amount of active ingredient in a larger volume, the public will never know.


#54

People are frustrated, I think, with the system, not with individuals. Individuals work within a system. It doesn’t hurt to push on the restraints of the system. Individuals should not get their feelings hurt because of complaints against the system (although I know that they do, and that is sad). https://www.youtube.com/watch?v=xaU7wvtO_ZI


#55

But people do get hurt, medical professional are part of the system. I agree push against the system but please leave the good doctors out of it. They are at times a victim of the system as much as we are.


#56

It’s remarkable. Everyone but everyone, including the people who work in it, agree that the system is broken, but the will and consensus required to fix it just don’t seem to exist. SMH.


#57

Professionals choose to work within a profession and accept those professional standards as a condition of employment. The freedom/choice/responsibility to push the system in a different direction fall squarely of the people who don’t choose to be there - patients. That’s the power dynamic. It is what it is.


#58

That sounds eminently reasonable but it’s naïve. Often those professionals make that choice not realizing what they’re letting themselves in for . . . and by the time they do, it’s too late; they’ve invested years and fortunes in training to do one thing. Many have told me that in almost exactly those words.

In addition, that reasoning is a slippery slope. If one chooses to support a system by actively serving it (and getting paid to do so), one owns a piece of the responsibility. There’s a line from an old Tom Lehrer song about Wernher Von Braun that says it exactly:

“Once ze rockets are up, who cares vhere zey come down? Zat’s not my department,” says Wernher Von Braun.

“That’s not my job” isn’t an excuse when you know and admit that you are supporting something that’s wrong. Sure, it’s the patients’ responsiblity. That’s because it’s everybody’s responsibility. If you’re sitting on the sidelines, you’re not part of the solution. You know the rest.


#59

Warning, blanket statements, etc. This doesn’t apply to all of course (but I’ll happily point this at the endo I had in the ER at diagnosis - what an arrogant arse).

Personally, I would greatly appreciate if the medical industry looked to the airline industry for methods on how to improve safety after problems.

Pilots are amazing at integrating the knowledge that others have learned from incidents into their processes and so fewer and fewer planes crash each year.

I guess it helps they have skin in the game, but I also suspect that their education doesn’t indoctrinate them into thinking their poop don’t smell, so they’re actually able to learn from others.


#60

That’s a good parallel. People are sometimes disconcerted to hear pilots discuss accidents at length and in depth, picking them apart detail by detail. It’s not done out of some morbid fascination; it’s done to make sure mistakes don’t get repeated. As the old saying goes, “Learn from the mistakes of others; you can’t possibly live long enough to make them all yourself.” Almost every major advance in air safety—and there have been almost too many to count—came about because something unforeseen happened and steps were taken to try and make sure that thing never had a chance to happen again. As a matter of fact, it’s a good policy to follow in any line of endeavor.