Great Chief Resident Sayings

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Today I was in clinic and I had a pt with bilateral ear pain. The chief resident came in the room to check on me and she examined the pts ear after I had. The pts TMs looked different to me and appeared that there was bubbles behind them. We then left the room and the chief resident says, "lets google some images and compare them. The pts TM's look weird." After looking she asks our attending to come and look, and the attending looks at the pt and states she has air bubbles and probably serous OM. We all then leave the pts room and the chief looks at me and states, "I knew the whole time what the patient had. I was just trying to make you think of a DDX. I knew it was serous OM after looking in the pts ear."
I almost fell over. If that is what she thought then why ask our attending to come and look and, why google the images? This actually made me lose some respect for our chief resident.
They always tell us that if you dont know something just say, "I dont know." I would have respected her so much more if she just admitted that she didnt know what it was and that she just learned something.

Originally Posted by ruger3030

Today I was in clinic and I had a pt with bilateral ear pain. The chief resident came in the room to check on me and she examined the pts ear after I had. The pts TMs looked different to me and appeared that there was bubbles behind them. We then left the room and the chief resident says, "lets google some images and compare them. The pts TM's look weird." After looking she asks our attending to come and look, and the attending looks at the pt and states she has air bubbles and probably serous OM. We all then leave the pts room and the chief looks at me and states, "I knew the whole time what the patient had. I was just trying to make you think of a DDX. I knew it was serous OM after looking in the pts ear."
I almost fell over. If that is what she thought then why ask our attending to come and look and, why google the images? This actually made me lose some respect for our chief resident.
They always tell us that if you dont know something just say, "I dont know." I would have respected her so much more if she just admitted that she didnt know what it was and that she just learned something.

Are you a med student or intern?

Well, you can "know" something and still want a second set of more experienced eyes to look at it. This probably reflects more on your chiefs confidence level than knowledge base. You don't really know if she's been burned by overcalling things like this in the past by this attending, or if this attending has previously expressed that he wants to be in the loop on positive findings, and may just be treading lightly. Most of the time your actions need to be calculated to "treat" the attending, not the patient. Best to walk a mile in someone's shoes before judging them -- by sheer experience any senior resident will still know more than you. And it's very hard to get novices "involved" in patient care, so sometimes trying to get them to help figure something out (even if you already know the answer) is of value.

Fragile egos.

A 1st year IM, Peds, or FM resident would be able to diagnose serous otitis media. I diagnosed it as an M3.