Doctors are smart, we're idiots

[Boon Doctor]

Yeah, the guy who writes his GPA out to the 15th digit to internet strangers and calls someone a bitch for 'GIVING' him a B is unhappy that people tell him he shouldn't be diagnosing anything.

Honestly, I am very angered by this post, but I won't revert to any personal attacks. I'd just like to point out to phatmonky that yes, my original post was indeed sophomoric, but you should read the entire thread before making such an imprudent reply.

Still, I encourage any curious premeds to read my blog and post comments as well. I will be updating it soon. Thank you.

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[neuroprotector]

I'm with boondoctor on this one. I think the criticism we've all put out here stopped being productive a while ago. He's been really mature about it, too. Can some mod lay this thread to rest, finally?

 

[135892]

And for posterity, from the OP's entitlement blog:



Yeah, the guy who writes his GPA out to the 15th digit to internet strangers and calls someone a bitch for 'GIVING' him a B is unhappy that people tell him he shouldn't be diagnosing anything.

HAHA, that blog is hilarious
"people think I'm a genius"- hahaha
If you truly think like this, then its no wonder why the doc got annoyed with you

 

[PeepshowJohnny]

What is the show that represents all blacks? I'd love to watch it. I once thought the Cosby Show represented all blacks, but figured since not all blacks are well-to-do OB-GYNs, maybe it was just portraying one small, fictionalized slice of life in a very diverse culture within a culture. Much like boondocks.

Very good point. I think one of the strengths of Boondocks is it tries to parody many different elements of black culture. You go all the way from "Angry young man" Huey, to his hip hop loving brother Riley, to "Basically a white guy" Tom (whose name is anything but a coincidence.) None are really spared.

 

[MattD]

<stuff>

Wasn't attacking your statement pal, I was just contributing my thoughts, which were peripherally related to what you were saying, which is why i quoted you.

My point was simply that you're probably going to grow out bacteria in a sputum culture whether there's an infection or not, but if the sputum is purulent it would indicate infection as opposed to a non-infectious process. I was then pointing out that even then you could theoretically have purulent material from the upper respiratory tract in that sample, if the patient was on the tail end of a URI. And perhaps blood cultures aren't done USUALLY, as you put it, to find a hemotologous source of infection, but infection certainly doesn't always proceed lung -> blood -> wherever. I'm sure that as you did so wonderfully on Step 1 that you've heard of hematologously seeded pneumonia. I apologize for not listing the entire Ddx for positive blood cultures. Oh wait, if you read what I actually wrote, I SAID a hemotogonous source OR spread. But that doesn't matter, I'm sure. Please don't scut me for the rest of my rotation. Although since I don't know what I'm talking about, that may be the best use for me.


I have no doubt that you're aware that you can get TB in the states. I wasn't suggesting otherwise. It was just a comment. Again, I apologize for attempting to participate in a conversation with my mental superiors. I'm sure that when I take Step 1, I will score at least 1 point less than you. May God have mercy on my soul.

 

[smq123]

Wasn't attacking your statement pal, I was just contributing my thoughts, which were peripherally related to what you were saying, which is why i quoted you.

My point was simply that you're probably going to grow out bacteria in a sputum culture whether there's an infection or not, but if the sputum is purulent it would indicate infection as opposed to a non-infectious process. I was then pointing out that even then you could theoretically have purulent material from the upper respiratory tract in that sample, if the patient was on the tail end of a URI. And perhaps blood cultures aren't done USUALLY, as you put it, to find a hemotologous source of infection, but infection certainly doesn't always proceed lung -> blood -> wherever. I'm sure that as you did so wonderfully on Step 1 that you've heard of hematologously seeded pneumonia. I apologize for not listing the entire Ddx for positive blood cultures. Oh wait, if you read what I actually wrote, I SAID a hemotogonous source OR spread. But that doesn't matter, I'm sure. Please don't scut me for the rest of my rotation. Although since I don't know what I'm talking about, that may be the best use for me.

I have no doubt that you're aware that you can get TB in the states. I wasn't suggesting otherwise. It was just a comment. Again, I apologize for attempting to participate in a conversation with my mental superiors. I'm sure that when I take Step 1, I will score at least 1 point less than you. May God have mercy on my soul.

Thanks for your blast of sarcasm. It was truly irritating.

I suggest that you go back and re-read your initial post. It certainly didn't feel like you were just "peripherally" commenting on what I said - you were directly telling me your opinion (or your professor's opinion) on the utility of sputum cultures. Advising me to "remember" that sputum cultures are often contaminated with normal flora implies that you didn't think that I already knew that or that I didn't remember that. I know, sputum cultures aren't great tests. But getting it anyway isn't the idiotic idea (or the waste of time) that you seemed to think it was.

I'm glad that you were aware that I knew that (very rarely) people can get TB in the US. So why did you feel the need to "point out" that people CAN get TB in the US? Honestly, go back and re-read how you worded your post. You come off sounding like someone fresh out of microbio lecture forcing your knowledge on other people who, incidentally, already knew this information. You're not teaching me anything new, so don't act like you are. And the point about Step 1 was merely that, hey, I already learned this, so your condescendingly worded post was not needed.

 

[MattD]

Thanks for your blast of sarcasm. It was truly irritating.

I suggest that you go back and re-read your initial post. It certainly didn't feel like you were just "peripherally" commenting on what I said - you were directly telling me your opinion (or your professor's opinion) on the utility of sputum cultures. Advising me to "remember" that sputum cultures are often contaminated with normal flora implies that you didn't think that I already knew that or that I didn't remember that. I know, sputum cultures aren't great tests. But getting it anyway isn't the idiotic idea (or the waste of time) that you seemed to think it was.

I'm glad that you were aware that I knew that (very rarely) people can get TB in the US. So why did you feel the need to "point out" that people CAN get TB in the US? Honestly, go back and re-read how you worded your post. You come off sounding like someone fresh out of microbio lecture forcing your knowledge on other people who, incidentally, already knew this information. You're not teaching me anything new, so don't act like you are. And the point about Step 1 was merely that, hey, I already learned this, so your condescendingly worded post was not needed.

Like I said, I was responding to the topic you were talking about. Wasn't trying to 'educate' you. Way to belittle me there by the implication that I'm a parrot of my professors. It makes you sound smart because I learned from books and teachers whereas I guess you... did experiments to discover the information on your own? I'm sure you had professors in school as well, so your point is rather silly. Again, I wasn't speaking 'at' you, I was attempting to add a point to the conversation. Sure it's basic knowledge for us, but lots of other people read these threads, maybe they'd be interested. If i've said something factually inaccurate, please inform me, for my own benefit as well as that of other readers. If you're just ill that you feel like someone may have been trying to preach to you about something you already know, well, sorry. I'm sure we'll both live.

As far as my commenting on TB in the U.S., you ask why i felt the need to mention something that I 'knew you already knew.' Well, for one, again, the conversation isn't all about you. It was meant as an expansion of the discussion. But since you ask the question, gee, we all know when you go overseas you could get TB, so why do YOU feel the need to 'point out' that? It's rhetorical. I know why you mentioned it. You were pointing out that overseas travel is a risk factor for TB, which should increase your index of suspicion for that disease. Well, I was simply pointing out that you should maintain an index of suspicion for TB even in people who haven't traveled overseas, as it's still a possible diagnosis. Not that YOU should do so, like I think you're dumb, but that 'you' in the general 'people reading this thread' should do so.

I wasn't 'acting' like I was teaching you anything in the first post, you chose to read it that way and to become offended at my impudence. I wasn't being condescending. It was just a discussion. Now I WAS (obviously) being sarcastic and condescending in the second post, in response to what I perceived to be you speaking down to me as if I had an IQ of 40 and that I shouldn't dare to say anything that might be considered a disagreement with you. As if I were your little scutmonkey on the wards. Well, I'm not. And I hope you're a little less belittling when you speak to people in person. Sure you have more experience in medicine than me. What, 1 year? Or is it 2? I tell you what. I'll speak to you respectfully if you do the same with me. Deal? Truce?

Please excuse the crappy grammar. It's late, and I don't care

 

[axlaxl1]

So I've been working with Docs, PAs, NPs, and Nurses everyday for the past 6 months (I'm a medic deployed overseas), and needless to say, MD's are brilliant...NPs are too actually. But, I am beginning to hate the pretentiousness that most of the doctors I work with have. I understand that they have gone through 12+ years of education and training since HS, but they don't have to make the rest of us feel like idiots. I understand that medicine is hierarchal and moreso in the Army, but do they really think that I can't diagnose a patient with pneumonia if the patient has a fever, cough, purulent sputum, 13 WBC, and obvious infiltrate on the chest Xray? I mean c'mon, most of medicine is algorithmic, especially the diagnostic process. Why should I have to pussyfoot around semantics when I chart a patient because I "sound too much like [I'm] diagnosing them." Why even teach me this crap if I can't apply it? Why recommend that I take an ACLS (Advance Cardiac Life Support) class if I can't actually do any of it? It seems so hypocritical. They KNOW that I'm premed and smart and eager, but it just feels like they're trying to hinder me instead of help me.

Anyone else have negative experiences working with doctors? Sometimes I wonder why I even want to be one of these people.

Here is the deal, truth is you're not a doctor yet so get over it. Gray's anatomy, perfect example. (laughing hysterically) I was watching this guy who was an intern, the one Doc Gray had to watch, the old man, and he was giving silly diagnoses that in the end could have killed a patient. DAMNED writers strike, can we get a new episode??? GEEZ MA protein. OK, with that said the point is this. You may know a lot but if it's not your job to diagnose then it's not your job. Play your role and keep it moving. What if you were wrong, what if it was something else, something else you haven't seen or were trained for but as you said the doctor with his/her 12 plus years of schooling simply was?

You'll understand when it is you dealing with a bright eyed youngin who wants to look important but in reality, isn't. Take care kiddo and good luck to you.

 

[Bacchus]

Ax, 4 - 5 new episodes are being filmed for April/May. **I saw this info on TVGuide when checking listings**

 

[8744]

So I've been working with Docs, PAs, NPs, and Nurses everyday for the past 6 months (I'm a medic deployed overseas), and needless to say, MD's are brilliant...NPs are too actually. But, I am beginning to hate the pretentiousness that most of the doctors I work with have. I understand that they have gone through 12+ years of education and training since HS, but they don't have to make the rest of us feel like idiots. I understand that medicine is hierarchal and moreso in the Army, but do they really think that I can't diagnose a patient with pneumonia if the patient has a fever, cough, purulent sputum, 13 WBC, and obvious infiltrate on the chest Xray? I mean c'mon, most of medicine is algorithmic, especially the diagnostic process. Why should I have to pussyfoot around semantics when I chart a patient because I "sound too much like [I'm] diagnosing them." Why even teach me this crap if I can't apply it? Why recommend that I take an ACLS (Advance Cardiac Life Support) class if I can't actually do any of it? It seems so hypocritical. They KNOW that I'm premed and smart and eager, but it just feels like they're trying to hinder me instead of help me.

Anyone else have negative experiences working with doctors? Sometimes I wonder why I even want to be one of these people.

Well, you see, you are a victim of the "A Little Knowledge is a Dangerous Thing" syndrome. You know a tiny bit about medicine, just enough to put you above the average person, but not enough to really appreciate what you don't know and you get irate because somebody else is pointing out your very real limitation.

As for most of medicine being algorithmic, laying down my usual reminder that I am not the biggest booster of the medical profession, this is what people who don't know anything about medicine except the algorithms typically say. Medicine is actually a good deal less algorithmic than most jobs and there are many, many nuances and variations in every patient that will confound your algorithms. In fact, it's the rare patient that fits into the so-called check boxes and it is the lazy doctor who treats the form, not the patient.

If you ever get through medical training you are going to look back and laugh that you ever thought there was nothing to it. You diagnosed pneumonia. Well la-dee-****ing-la. Quick, tell me four or five other things that your patient could have that are not the check box bacterial pneumonia, things that are not uncommon, but present with almost the same clinical picture and how you'd handle those. What if he didn't have an infiltrate, could he still have pneumonia? Afebrile? No sputum?

What?

 

[LikeClockWork]

Well, you see, you are a victim of the "A Little Knowledge is a Dangerous Thing" syndrome. You know a tiny bit about medicine, just enough to put you above the average person, but not enough to really appreciate what you don't know and you get irate because somebody else is pointing out your very real limitation.

As for most of medicine being algorithmic, laying down my usual reminder that I am not the biggest booster of the medical profession, this is what people who don't know anything about medicine except the algorithms typically say. Medicine is actually a good deal less algorithmic than most jobs and there are many, many nuances and variations in every patient that will confound your algorithms. In fact, it's the rare patient that fits into the so-called check boxes and it is the lazy doctor who treats the form, not the patient.

If you ever get through medical training you are going to look back and laugh that you ever thought there was nothing to it. You diagnosed pneumonia. Well la-dee-****ing-la. Quick, tell me four or five other things that your patient could have that are not the check box bacterial pneumonia, things that are not uncommon, but present with almost the same clinical picture and how you'd handle those. What if he didn't have an infiltrate, could he still have pneumonia? Afebrile? No sputum?

What?

Just came across this and thought it deserved a bump. I feel like there are more than a few people in the hospital I work at who suffer from this.