Curious About Doctory Memory

[TastefullyBlue]

Hey,

I know doctors are obviously normal people who forget just like anyone else.. My question is how do you doctors remember say some small random muscle, or tissue you had to learn back in med school, or some reaction of the body, or something of that sort...

Basically, how do you remember to not do a certain thing when a patient presents with something something.. Do you go back to the doctor desk, and look up what symptoms meet various illnesses, or what?


Also, say your a family doctor, and someone presents with some unordinary symptoms your not use to dealing with.. While the patient is in the room waiting do you look up possible diagnosis for those symptoms? Where do you look it up at? On the computer? Where?


I hope this is in the right place.. I think a few years ago there was a place to ask current doc questions like this..

Thanks
TastefullyBlue

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[AHossain]

I've always wondered this as well. Hopefully someone can answer


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[I'm No Superman]

For the record I'm (obviously) not a doctor, but I did ask this question to my dad a few months ago. He told me that he doesn't remember much of anything except orthopedics. Why? Because he never has to deal with anything non ortho-related, just like a neurologist never has to repair compound fractures. Essentially it all comes down to "If you don't use it, you'll lose it".

 

[Drrrrrr. Celty]

Not a doctor, but it's use it or lose it, simple as that.

 

[ljpm8224]

He told me that he doesn't remember much of anything except orthopedics. Why? Because he never has to deal with anything non ortho-related, just like a neurologist never has to repair compound fractures. Essentially it all comes down to "If you don't use it, you'll lose it".

^^ ditto. my buddy who is a pedi-ortho specializing in ankles told me once over beers, "dude. if i ever had anything other than an ankle to fix, I'm screwed, because that is ALL i remember now."

 

[Kahr]

My dad quoted me a study some time ago about the hippocampus of medical students being supposedly greatly enlarged compared with most regular folk... don't know if that's true, nor have I seen the study.

I do agree with "use it or lose it".

 

[docB]

Interesting question.

In med school I was told that we would learn a lot of things that we wouldn't really remember on a conscious basis but when the relavent situation occured in practice the knowledge would be there. I have found that to be true. It's almost like a trick but it does make doctors seem to have a wider scope of knowledge than we really do. For example you my not have paid any attention to American history for years. Then someone mentions Benedict Arnold. If you knew it once you will probably be able to come up with at least a few relavent facts. Ad that to what you can go look up quickly and there you go.

A lot of what we do is really just assigning patients and problems to more recognizable groups. For example I know how to treat chest pain really well. But what do I do when I get a patient who has something more vague like tingling in the left arm that gets worse with exercise? I treat it like chest pain. I could explain whay that's appropriate but suffice it to say that it's an example of grouping an unusual complaint in with a common complaint as a method of managing the situation.

Another thing is that we play the odds a lot. Minor illnesses usually get better no matter what we do and severe illnesses get worse no matter what we do. If you have a cold and I give you the wrong treatment you will still get better even though I messed up so I look good. If I tell you your terminal disease will get worse the odds are with me.

There is also the fact that as a doctor I get to decide what happens in medical situations. If I say you are diagnosed with the flu and you're going home with 3 prescriptions that's what happens. For some reason in medicine it can seem like psychic powers. Is the doctor a genius for saying "I bet the diagnosis is X." when they get to choose what to say the diagnosis is? Not really.

 

[TastefullyBlue]

Wow! Thank you very much for the responses!
I just always thought about the memory thing.

I do wonder still further about diagnosing.. I don't know if any of you have used that WebMD tool(http://symptoms.webmd.com) where it displays a body, and some tables.. Well if your having kneck pain you select kneck, and then it asks questions to narrow it down.. I guess I assumed doctors used something like this, but more advanced linked to some authority, or something..

I'm thinking of someone presenting with symptoms of a cold, but it not being typical cold.. It being some less common 1 in 20000 person disease, or something.. How would you know that one disease was out there without having some system of the latest findings? I mean I guess you could treat it as a cold, and if they don't get better within a week, or so further examine? But what would you use/do to further examine? Is this the part where you go further in-depth searching a medical database?

 

[QuizzicalApe]

Wow! Thank you very much for the responses!
I just always thought about the memory thing.

I do wonder still further about diagnosing.. I don't know if any of you have used that WebMD tool(http://symptoms.webmd.com) where it displays a body, and some tables.. Well if your having kneck pain you select kneck, and then it asks questions to narrow it down.. I guess I assumed doctors used something like this, but more advanced linked to some authority, or something..

I'm thinking of someone presenting with symptoms of a cold, but it not being typical cold.. It being some less common 1 in 20000 person disease, or something.. How would you know that one disease was out there without having some system of the latest findings? I mean I guess you could treat it as a cold, and if they don't get better within a week, or so further examine? But what would you use/do to further examine? Is this the part where you go further in-depth searching a medical database?

Doctors do use something like that, but it starts off in their head. Even as a medical student, you'll have certain things drilled into your head when they are the most common or the most deadly. You'll know the three most common bacteria causing community acquired pneumonia because it comes up all the time.

You'll know to pay closer attention to a kid that has a hard time breathing because a retropharyngeal abscess will kill them and you need to rule that out.

Once you've exhausted, for one reason or another, the stuff that is most likely and you've ruled out the things that are most deadly, as a specialist you'll likely have an additional resource of rare conditions within your field of specialty that you can draw on. As a generalist, you can send them to a specialist or read before the next appointment, but most likely both of those things.

 

[TastefullyBlue]

Thanks for the responses.. I was always curious about that, but I can definitely see where doctors remember the most common things.. Thanks =)

 

[QuizzicalApe]

You'd also be surprised at the amount of stuff you can remember through sheer repetition through med school, residency, and practice. That's a lot of years.

 

[Morsetlis]

^^ ditto. my buddy who is a pedi-ortho specializing in ankles told me once over beers, "dude. if i ever had anything other than an ankle to fix, I'm screwed, because that is ALL i remember now."

Likewise, all medical students have forgotten about organic chemistry a long time ago, and you bet nobody remember when the Pilgrims landed on Plymouth Rock, either.

 

[Green Grass]

You'll be surprised by the number of random facts you can remember when someone's health depends on it.

 

[Valadi]

You'd also be surprised at the amount of stuff you can remember through sheer repetition through med school, residency, and practice. That's a lot of years.

Truth. Beating things into your brain is the way it goes.

FWIW, The most important thing to learn from undergrad to medical training is how to think. You need not be a neurologist, but one should reasonably be able to differentiate between pathology in the brain, spinal cord, spinal root, or peripheral nerve and proceed accordingly. Following algorithms like this greatly facilitates memorization and learning.

 

[penguindoc2012]

Ultimately, docs will remember the things they see most and the things that can kill a patient. A lot of people specialize, narrrowing the number of things they remember even more.