Please feel free to ignore this rant.
There is a mantra in med school P=MD that has always bothered. I hate settling for mediocrity. It drives me insane when I hear people say that they don't have to try anymore since they're going into family practice medicine. That's bullshit. Everyone involved in a patient's care is critically important. As I review more and more patient notes to evaluate their histories, the more I realize that there are a lot of dangerous doctors out there. There's the family practice doc that discontinues a type 1 diabetic's insulin and places him on metformin because it's a "better" drug and wonders why the patient's A1c has skyrocketed or the patient came into the ER in DKA. I mean, shit. This is bread and butter stuff people. Learn your shit. If you don't get it, you have no business assuming responsibility for the health of patients.
The worst is a doc who's notes I see over and over as part of my research project. He sees elevated PSA in patients in their early 50s. They're 4 or 5. He just sits on them as they rise to 7, then 10 a few years later. He'll decide to biopsy when the PSA is 24. Of course, the biopsy comes back with raging prostate cancer and the patient is put on palliative care because he has metastatic disease. If the patient is 70 with multiple co-morbidities, I understand. Guys who are healthy in their early 50s need to know if they have cancer and it can be cured early on. It's just wrong. Or the guy who has bladder cancer, and has it removed. Then he gets lost to follow up in the notes because the doctor forgot to look over his notes from the previous session. I mean, come on guys. Document all the shit that you do. Review it. Take initiative and responsibility over the health and safety of your patients. It's our moral responsibility. At the very least, it's what we get paid to do. Please for the love of God, take the extra minute.
-bender is venting
hey bender,
ReplyDeleteyeah, the mediocrity makes me angry (and scares me when i think about people i care seeing doctors whose level of practice i don't know about.) but,when you look around our class, you can easily see some of the people that will become doctors like that. that makes me wonder about dr. f's speech in our first year: are we also not responsible. are we being mediocre by turning a blind eye to fellow classmates who lie and fake their way through rotations, who are just by default complete users? i don't know. sometimes i think i'm too idealistic. othertimes i think it's not my business - who am i to say someone is mediocre. but mostly, i think i'm not doing enough.