Secret Doctor Conferences...

oh, hilarity MORE THAN ensued. i nearly died laughing. so typical of this girl.

oh, generalizations and thread hijackings are part of the territory here... if i could make money off of that i wouldn't be in grad school! :lol:

 

I gotta jump in here...I believe that was the way medicine was practiced. As I resident, i had the collective experience of over 100 different doctors that I worked with. Doing a cesarean section with Dr. A was very different than doing it with Dr. B. We did rotations, two months on Labor & Delivery, then two months in Infertility, then 2 months on Gyn/Oncology etc.

Also, who would want to be stuck working with the same person for 4 years? They might not do as many hysterectomies because they are proponants of ablation. What if you get stuck with someone whose whole life is dedicated to the research of hypertension in pregnancy...where will you learn about diabetes?

 

This is a good example of misplaced blame. People routinely take lousy care of themselves for decades. Then, when the health problems that have been developing slowly for years come to a head and they're in crisis mode, the doctor or the hospital makes one mistake and it's all their fault. B*LLS**T. Read Dr. Dean Ornish's book on reversing heart disease. When people with severe arterial blockage come to him, he tells them that with a strict vegetarian diet and other changes to their lifestyle, the patient can reverse the damage without surgery. The patient almost always chooses major surgery instead. Even though quadruple by-pass does not cure the problem, improve the patient's quality of life or even extend their lives by much, they'd rather do that than take responsibility for their own conditions. They'd rather pop pills and suffer through major surgery that has a lot of risks than to just take care of themselves. Then they lay all of the responsibility on the doctor. Unbelievable. If the patient had refrained from smoking (nicotine damages the artery walls), eaten less fat and other junk, exercised regularly (even a nightly walk) and just calmed themselves down over the years, they wouldn't have the problems that the doctor now has to miraculously cure them of in a matter of a few hours. We all make mistakes. The doctor might make one in a few seconds but the patient has been making mistakes for decades and the doctor gets blamed. People have to stop looking for quick fixes and concentrate on taking responsibility for their own predicaments.

 

Testify brother! Testify!(Imagine me waving my arms in the air)

This girl I dated in college, her father had triple bypass at age 45. Because of surgery he lost about 20 pounds. Anyhow, go to there house 6 months later and he's put all his weight back on, he's eating a huge plate of fried shrimp to the point he can hardly breath he's so full. Oh, he died in the parking lot of his cardiologist 5 years later.

Guy across the street from me now, he's got a 10 year old boy, he's about 40. Had a quad bypass 2 years ago...he's heavier now, then before the surgery and they leave their kitchen shades open, you can see them eating all day long. Their son is morbidly obese. He was telling us, "I'm glad I'm cured". He'll be in a box in 10 years, if not sooner.

 

heh, don't get me started. Oops, too late. Doctors and nurses are terribly overworked. Nurses alone burn out very fast. They have to tend to a lot of patients and they put in long hours. Doctors are so overworked that they can't do research and don't have the time to give to their patients that they'd like to do. If people took good care of themselves, these medical professionals would be able to do their jobs better and live longer. Doctors have the same mortality rate of professional football players, if memory serves, because of the toll that their profession takes on their health. That's something that most people don't know. If people took good care of themselves, health care costs would be so low that companies could still afford to give it away free as a benefit. It wouldn't put medical people out of business but it would improve their quality of life and they could do what they're trained to do.

If I was a doctor, I'd be in those discussions too because at least the people who criticized me would know what the heck they're talking about and aren't walking lawsuits ready to ruin your hard-earned career for a few bucks. Medical people aren't the only ones that our society beats the crap out of but I know some of them. My doctor is a wonderful woman and I don't see her as often as I should but she still concludes with "you're healthier than most people that I see that are half your age but it doesn't excuse you from coming to see me once per year" and she smiles as she leaves. A friend of mine is a nurse who trains people to be nurses and we have great discussions about things like how lousy most people care for themselves. She knows that I don't understand every word but defines them when she can and knows that I'm actually listening to her. Most patients don't.

 

Ah. Finally an individual brave enough to tell it like it is!

Thanks to television, computers, and video games, an increasing proportion of the populaiton has become pear shaped and need to drive giant pickup trucks just so their fat nice person can fit in the seat.

In particular I've always found Ford seats - cars and especially their trucks - to be incredibly uncomfortable. Like torture devices, but I'm 6 ft, in good shape, and weigh 157 soaking wet. I suppose if I had a fat nice person, giant gut, and waddled when I walked, I'd prefer a Ford seat over my Prius seat.

Due to the cost escalation to care for self-inflicted health problems (Obesity, heart disease, narcotics, lung cancer, etc etc) it's only a matter of time before Medicare and HMO's outright refuse to pay to treat self-inflicted health problems.

 

To give a different perspective as a family doc. Don't know what field Ralphh (post #60 of this thread) is in but in my group I am cosidered a 0.9 FTE physician. The FTE hours are only the "scheduled" face-to-face time in the office (28 hours), not the inevitable work-ins, and running behind due to complex problems being booked by entry level front office workers (not really thier fault). It also doesn't count Call, OB back up call, (I am only one of three in my group that still delivers babies), hospital rounds, nursing home rounds and yes, paperwork. In actuality it adds up to 50-80 hours a week. All for something that runs just 6 figures some years and other years doesn't quite make it.

Could I think of doing anything else at this point. Nope. I love what I do. Spend the time my patients need (for the most part). Will even put up with the chronic pain patients (if they will follow strict guidelines). The only thing that I regret is that I haven't had enough time with my wife and family. Family Practice and Pediatrics are the lowest paid specialties in American Medicine but the most fun because of the variety. And where I practice I get to the full scope of my specialty
(By some estimates, ie those of the American Board of Family Practice (?bias??) 85% of all visits walk into any physician office in the US can be appropriately handled by an Board Certified Family physician).

 

why are chronic pain patients so difficult to deal with? prescription narcotics?

 

Now you have done it. You are dead meat and the sharks are circling. I don't want to watch this. I think that we need a balance because both genders bring something to the table. I see all female groups with problems as I did in the old days when it was all males. Different problems. My opinion we do best in mixed groups and Ob/Gyn becoming a largely female is going to turn around and bite us in the future. More of the women should be going in to Urology, Orthopedics, and other more male dominated specialties.

 

Actually when I wrote this sentence I started with the phrase 'drug seeking'. The art with this category is to sort out the legitimate pain from 'just' drug seeking. There is no true objective test of pain. It is solely what the patient reports. Under current JCAHO standards pain is considered "The Fifth Vital Sign" along with Temp. Blood Pressure, etc.
If you don't treat pain it is considered malpractice. If you are supporting a drug dependency it is a felony.


P.S. I am with those who 'know' that the American Health System is broken. Just hasn't caught up with us yet. Robert LeBow a doc who established a free health clinic in our valley wrote a book on this subject just before he died.

PPS. I sometime refer to my DEA license a my "legal drug dealer license"

 

Lanky, very strong, and not pear shaped or with a fat nice person. Just the way I like myself. If this warm spell continues, I may even be able to go jogging again, that would be very nice. The treadmill in the condo exercise room doesn't cut it.

 

Well, when it's 0 F or colder, snow on the ground, you really don't have much choice. A few around here try to jog even at -20 but I really don't see how they do it.

Like most people, I don't breath very well when the air is very cold and dry, especially if I try to breath through my mouth instead of my nose. Severe pain at least, maybe health problems at worst.

The exercise room at my condo is a good compromise and I use it in winter. In summer I never touch it.

At least out at the hobby farm I can do something that is work and also exercise: split wood. I never do it in summer, but it's a great way to keep your muscles strong in winter.

 

Five minutes? That's just getting warmed up ... I'm usualy good for 45-50 minutes before I get that ache in my shoulders.

Nope, no fireplace, at least not a "real" fireplace. I have a Regency airtight fireplace conversion in the living room at the hobby farm, and a Regency airtight box stove in the basement.

I'd never have a "real" fireplace again: too dirty and inefficient. The Regency airtight one really blasts the heat, you can still see the glowing wood through the glass doors, and the cat can cuddle up to it without catching fire.

Don't laugh, it happens. Cats are known to get too close to a heat source.

 

That's the victim mentality. 'I can't help myself because there's a McDonalds and Burger King on every corner. It's not my fault.' Sounds as if you haven't seen the documentary Supersize Me. There are lots of healthy choices that taste pretty darned good, you just have to understand more about nutrition and that it's not as difficult as it seems to ignore the fast food restaurants. Panerra Bread, Applebees, Red Robin, these are all good places to eat and even though they have stuff that's not that good for you, they also have a lot of things that are very healthful. Actually, if you want to read something that's really helpful in understanding nutrition and what you reall need in your diet, buy the book Becoming Vegan. You don't need to be or want to become vegan. It's written by four or five nutritionists and while I'm not vegan, it's helped me in making nondairy, nonmeat choices when I need to, which are usually made at breakfast and dinner. Lunch, I get a salad with chicken or salmon. It's much easier to eat healthy food than you may be willing to acknowledge yet. Saying that it's just too hard to change is a lame excuse. I know because I used to say it myself B)