Working with difficult doctors

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Pulmonary aneurysm? Your "ER MD" that has never heard of Fourniers or hasnt seen a thoracic aneurysm is either a) a complete ***** b) purchased a medical degree online c) isn't a qualified ER doc.

Wow.

1. The MD I referenced in my paper, no. She hadn't heard of Fournier's gangrene. I included her name in the paper I re-posted, if you like I can send you her phone number and you are welcome to call and ask her yourself. She'd Director of her ED, so be prepared for that when you call to insult her. And while you're at it, can you tell us how many cases of Fournier's gangrene that you've seen, exactly?

2. The MD who saw me in the ER a few weeks ago, he said that in his experience a pulmonary aneurysm didn't present as chest pain. No one said he had never seen one. You are welcome to call him as well. I don't know his name, he's listed as 'Emergency Room Physician' on my paperwork, but I will gladly go through the trouble to find it out if it will help you to put a cork in it.

Send me a pm and I'll be happy to give you any contact information you need. I'd seriously like you to put some money where your mouth is. Would that be enough for you? Or would you find something else to moan about?

lol where did I call people "bad doctors"? If you can't handle discussion, kindly stay out of it, or at least get your facts straight before you pipe up.

schutzhund=troll :thumbup:

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Wow.

1. The MD I referenced in my paper, no. She hadn't heard of Fournier's gangrene. I included her name in the paper I re-posted, if you like I can send you her phone number and you are welcome to call and ask her yourself. She'd Director of her ED, so be prepared for that when you call to insult her. And while you're at it, can you tell us how many cases of Fournier's gangrene that you've seen, exactly?

You aren't understanding my point. You have basically no medical knowledge. You are at studentDOCTOR.net arguing with doctors (who HAVE a lot of medical knowledge). If you are going to defend you positions or papers based on some "ER MD" than that should be a credible source. A Emergency Physician (if she really is) is a ***** if they haven't heard of Fourniers. Not a good source. End of discussion. And yes, I have personally seen Fourniers. Even if I haven't I still know it exists and have since I was a MS2. I haven't seen smallpox but I know it exists.

2. The MD who saw me in the ER a few weeks ago, he said that in his experience a pulmonary aneurysm didn't present as chest pain. No one said he had never seen one. You are welcome to call him as well. I don't know his name, he's listed as 'Emergency Room Physician' on my paperwork, but I will gladly go through the trouble to find it out if it will help you to put a cork in it.

I'm not even going to touch this one. You are you're own worst enemy. Anyone who knows anything about medicine will understand how funny this is.:laugh:

lol where did I call people "bad doctors"? If you can't handle discussion, kindly stay out of it, or at least get your facts straight before you pipe up.

Alzheimers?

http://forums.studentdoctor.net/showthread.php?t=539389&page=2

"It should be obvious to anyone who can read, but I'll say it regardless. At the rate you're going, you will make a terrible Doctor (if you even are a Resident at all). At this point, you've proven that you're not worth my time, Panda Bear."

http://forums.studentdoctor.net/showthread.php?t=554045

"I regret attempting to engage those 'Doctors' in discussion of medical matters, they plainly proved their level of ineptitude. I hope somewhere along their travels that they're able to learn how to properly read and process information."
 
Those posts I made were in response to such lovely tidbits as:

Dude, your use of "medical student" along with your post content screams "wanna-be."
and

Your paper is terrible. Sounds like it was written by fourth-grader who was copying out of books.
and

You are a community college student with a non-rigorous community college education and it shows. I wrote a dandy little paper called "Our Friend the Gopher" in second grade but I don't list it in my CV.
and

Academic writing at the undergrad and graduate level demands more than this type of elementary school writing. And you say you're almost 40?
What part of all that shows sensitivities of good Doctors? Further, some posters were barreling through on the fuel of their own imaginations without addressing what had actually been stated. What part of that don't you think would be annoying?

-----------------------------------------------------------------------------------------------------------------------------

About the matter of the information I relayed from the Doctors I spoke with about the issues of Fournier's gangrene and chest pain from pulmonary aneurysm, here it is. Basically, you keep calling me a liar, and I really don't appreciate it.

I'm not even going to touch this one. You are you're own worst enemy. Anyone who knows anything about medicine will understand how funny this is.:laugh:

No. I am not my own worst anything (and it's 'your', not "you're"). That is what I was told. Dude, do you actually think I wouldn't ask about pulmonary aneurysm while I'm lying in bed 6, being seen for chest pain?? The answer he gave me was, "not from my experience, no."

Why would you laugh at someone about an account of their ER visit? You have some serious problems, in my opinion.

I've started these threads, maybe someone there can help with you.

http://forums.studentdoctor.net/showthread.php?t=555358

http://forums.studentdoctor.net/showthread.php?t=555357


Again,
you are welcome to call either of those Doctors yourself.
 
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i can't believe there's banter going back and forth with sunfire.
let the fire burn out.
this is a young dude who doesn't know jack with way too much time on
his hands acting completely absurd.
this discussion lends nothing to the realm of clinical fortitude, let alone medicine.
everybody,
pleeeeeeeeaaaaaase........
just don't respond.
my bandwidth is getting bogged down with
this drain-clogging crap.

and sunfire,
i'm no mastermind-knowitall,
but get a frikkin' clue.
really.

maybe you should look at your (recent) high school year book
and see how much you've (*burp*) grown. :love:
 
Wow.

1. The MD I referenced in my paper, no. She hadn't heard of Fournier's gangrene. I included her name in the paper I re-posted,

That's a real smart thing to do - post someone's real name here. If she ever finds out, you're cooked, buddy.
 
Causes of chest pain, that I can think of, could be:

MI
PE
dissected/transected aorta
endo/pericarditis
neoplasm
abscess
GERD
skeletal muscle spasm
psych-related

Crap, thought of another one. Fractured rib...and learned one more, pulmonary hypertension.

Also, BADMD stated, in regards to pain from pulmonary-region vasculature aneurysm, "As I said before, if the vessel was tearing. Aneurysms of all types are generally asymptomatic. Some abdominal aneurysms press on other structures causing pain."
 
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That's a real smart thing to do - post someone's real name here. If she ever finds out, you're cooked, buddy.

I doubt she'd care too much, but you're probably right. I edited it out. The one dude was chastising me for having the names out in the first place...I should have just left it the way it was.
 
Dude, do you actually think I wouldn't ask about pulmonary aneurysm while I'm lying in bed 6, being seen for chest pain??

Nobody say anything.
 
Right, like a "pulmonary embolism", you mean? :rolleyes: I thought it was obvious what I was saying, but I guess now at least I know the lingo a bit better. It's cool. I'll leave you guys alone for a while. Don't forget, knowledge is power.
 
Right, like a "pulmonary embolism", you mean? :rolleyes: I thought it was obvious what I was saying, but I guess now at least I know the lingo a bit better. It's cool. I'll leave you guys alone for a while. Don't forget, knowledge is power.

Don't lie.

http://forums.studentdoctor.net/showthread.php?t=555357

And for the record, nobody expects you to be a medical expert.

We are all at various levels of training, ranging from our little premeds who know nothing to our Chief Residents who know everything to our attending Surgeons who are back to knowing nothing.

There is no shame in ackowledging what you don't know. But presenting yourself as some kind of expert on topics where you are self-taught, instead of formally taught, is the surest way to reveal your own ignorance and hubris. And you're bound to get the type of responses you did here.

Good luck, see you around the forums.
 
Crap, thought of another one. Fractured rib...and learned one more, pulmonary hypertension.

Also, BADMD stated, in regards to pain from pulmonary-region vasculature aneurysm, "As I said before, if the vessel was tearing. Aneurysms of all types are generally asymptomatic. Some abdominal aneurysms press on other structures causing pain."

there are actually A LOT more causes of chest pain that you will learn about in school and on rotations( and in your professional career).
one of our cardiologists likes to pimp students with "give me 20 causes of chest pain" and then he works through each one with the student to decide if it should be in our out of the differential for that particular pt.
when you do exit orals in school they will pimp you mercilessly about any number of complaints and want to know common and uncommon presentations, a reasonable workup for each, critical lab values, diagnostic studies needed, appropriate treatments out to several different drugs to treat each condition, who needs next day f/u, who needs a referal in 2 weeks, who needs to see a surgeon tonight, etc....good times....
 
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Don't lie.

http://forums.studentdoctor.net/showthread.php?t=555357

And for the record, nobody expects you to be a medical expert.

We are all at various levels of training, ranging from our little premeds who know nothing to our Chief Residents who know everything to our attending Surgeons who are back to knowing nothing.

There is no shame in acknowledging what you don't know. But presenting yourself as some kind of expert on topics where you are self-taught, instead of formally taught, is the surest way to reveal your own ignorance and hubris. And you're bound to get the type of responses you did here.

Good luck, see you around the forums.

I think that there must be some miscommunication here. I haven't lied. I knew exactly what I meant when I stated "pulmonary aneurysm" and thought that meaning would have been obvious to others. Someone then better clarified for me, "aneurysm in a pulmonary vessel". I don't understand why you're accusing me of dishonesty. My reference to a "pulmonary embolism" a few posts up was in regards to what I presumed was your joking about my referring to a "pulmonary aneurysm" (apparently a largely unfamiliar terminology), please correct me if I misinterpreted you. If you'll notice, the similarities in wording are similar, yet "pulmonary embolism" is an accepted terminology even though it too refers to vasculature within the lung. I'm assuming that's probably because that condition is more common. It makes me wonder if there are ever dissected aneurysms in pulmonary vasculature (edited to note: there are), but I think I've asked enough questions for one day.

If I appeared to present myself as an expert on any certain subject, you have misinterpreted. It seems I have to clarify that again and again. However, no one will ever stop me from learning and if I present information that I've worked hard to gather, in an attempt to share and garner feedback and addendum, then that needs to be viewed for what it is and nothing more. If someone has a problem with anything I've written, I suggest that they go do their own work and come back and present it on their own merits. And trust me, I'll read it respectfully with understanding, and with hopeful intention of bettering my knowledge.
I know that rudeness is out there in the world, but that doesn't mean I have to stand for it on my own computer screen. Maybe you could all branch out a bit in learning more yourselves, instead of feeling the need to rule this particular section of the forum.

Most importantly, I hope that any questions that arose from the points I raised were put to rest in the threads I posted in the EM section. Thanks for the kind words tho, see you around.
 
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there are actually A LOT more causes of chest pain that you will learn about in school and on rotations( and in your professional career).
one of our cardiologists likes to pimp students with "give me 20 causes of chest pain" and then he works through each one with the student to decide if it should be in our out of the differential for that particular pt.
when you do exit orals in school they will pimp you mercilessly about any number of complaints and want to know common and uncommon presentations, a reasonable workup for each, critical lab values, diagnostic studies needed, appropriate treatments out to several different drugs to treat each condition, who needs next day f/u, who needs a referal in 2 weeks, who needs to see a surgeon tonight, etc....good times....

And while that must suck at the moment, it definitely will help reinforce the book learning and crystallize important foundational knowledge that will serve the students well in the future. "I have chest pain" is probably up there with "it hurts [motions to half of the body]" and "My head has hurt since [vague time/date]".
 
I was just wondering, do they teach anything about personality disorders in PA school?;)
 
Right, like a "pulmonary embolism", you mean? :rolleyes: I thought it was obvious what I was saying, but I guess now at least I know the lingo a bit better. It's cool. I'll leave you guys alone for a while. Don't forget, knowledge is power.

I think you're trying to be sincere and learn more. That's all well and good, but you're going about it the wrong way. It's that proverbial trying to stick a square peg in a round hole. It's honestly quite painful to watch, but so entertaining.

There's a time and place to ask questions. Challenging physicians on their knowledge of medicine is being presumptuous to say the least. This is just an anonymous website so what you say here nobody cares. But if you do this in PA school or when you work as one, you'll run into a lot of trouble. I know of one fellow med student who almost got booted out of school because he didn't know when to let things go. I know you're older, but you won't get any more slack than the 22 year old.
 
there are actually A LOT more causes of chest pain that you will learn about in school and on rotations( and in your professional career).
one of our cardiologists likes to pimp students with "give me 20 causes of chest pain" and then he works through each one with the student to decide if it should be in our out of the differential for that particular pt.
when you do exit orals in school they will pimp you mercilessly about any number of complaints and want to know common and uncommon presentations, a reasonable workup for each, critical lab values, diagnostic studies needed, appropriate treatments out to several different drugs to treat each condition, who needs next day f/u, who needs a referal in 2 weeks, who needs to see a surgeon tonight, etc....good times....

SOME... but not many PA students get training this rigorous...
So I HOPE you are NOT tryin to suggest that this is the NORM...:rolleyes:

I think that there must be some miscommunication here. I haven't lied. I knew exactly what I meant when I stated "pulmonary aneurysm" and thought that meaning would have been obvious to others. Someone then better clarified for me, "aneurysm in a pulmonary vessel". I don't understand why you're accusing me of dishonesty. My reference to a "pulmonary embolism" was in regards to what I presumed was your joking about my referring to a "pulmonary aneurysm", please correct me if I'm wrong. If you'll notice, the similarities in wording are similar, yet "pulmonary embolism" is an accepted terminology even though it too refers to vasculature within the lung. I'm assuming that's probably because that condition is more common. It makes me wonder if there are ever dissected aneurysms in pulmonary vasculature, but I think I've asked enough questions for one day.

If I appeared to present myself as an expert on any certain subject, you have misinterpreted. It seems I have to clarify that again and again. However, no one will ever stop me from learning and if I present information that I've worked hard to gather, in an attempt to share and garner feedback and addendum, then that needs to be viewed for what it is and nothing more. If someone has a problem with anything I've written, I suggest that they go do their own work and come back and present it on their own merits. And trust me, I'll read it respectfully with understanding, and with hopeful intention of bettering my knowledge.
I know that rudeness is out there in the world, but that doesn't mean I have to stand for it on my own computer screen. Maybe you could all branch out a bit in learning more yourselves, instead of feeling the need to rule this particular section of the forum.

Most importantly, I hope that any questions that arose from the points I raised were put to rest in the threads I posted in the EM section. Thanks for the kind words tho, see you around.

Dude, you don't know jack about jack. You come off here as someone who read a couple articles, took a couple classes and ended up getting the whole mess F&@kd Up...:scared:

I'm curious to know if YOU had ANY "significant" DIRECT patient care experience in a RESPONSIBLE role prior to pursuading a PA admission commitee to admit you...:confused:

As a PA-C... I'd really appreciate it if YOU would "pipe down" and not feel the need to "champion" our cause...:rolleyes:

Thanks

DocNusum, FNP, PA-C

Btw... :idea: A AMI is a AMI/ACS UNTIL it is definatively proven NOT to be a AMI/ACS...
 
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There's a time and place to ask questions. Challenging physicians on their knowledge of medicine is being presumptuous to say the least. This is just an anonymous website so what you say here nobody cares. But if you do this in PA school or when you work as one, you'll run into a lot of trouble. I know of one fellow med student who almost got booted out of school because he didn't know when to let things go. I know you're older, but you won't get any more slack than the 22 year old.

You're right about challenging people (altho I think the time and place to ask questions here was becoming overdue). I've been there already. I had a Cell teacher who wasn't changing his tests, and had knowledge of a select group who had the old copies. I reported him to the Dean. He was demoted. He gave me a C. Would I do it again? Not sure.

Then there was the time that I worked as an EMT at a retirement community. Received a complaint from medics, about a patient with chest pain whose chart hadn't been updated in 2 years. Received another complaint from the ER about a patient who I had sent from independent living. The community had no policy for med lists for those residents. The ER was all in a tizzy over needing a list. I let myself in to her residence and tried best I could to compile a list with the husband, who was senile. I have no idea what the patient's outcome was.

To make a long story short, I went up against the head nurse who had me fired a week or so later. But get this...before I was terminated, policy for independent living residents was changed to include medication lists. Would I do that again? You bet, most definitely. Maybe with a lighter touch tho, somehow?

You are right, people can be fragile things. I just like to learn and share, and get things done best I know how. I am still learning communication skills tho, sometimes seems like I'll be learning those into the everafter.
 
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I'm about ready to give up on this place as a place for sharing substantial information.

Dude...

Your... "when I was in bandcamp" scenarios are lacking... and do not pass the "substantial information" smell test...:rolleyes:

As the long time PAs here will attest to... I'm a 110% PA/NP advocate...

I look for reasons to get banned defending MY profession...
but you are "pinging" my BS meter. You sound like one of the FEW PAs that I wouldn't send patients to.

:idea: PLEASE read more and POST less...!!!

Better yet... stop wasting time reading this site and use that time to study medicine...

I'm done here...

Have a very PA day

DocNusum
 
lol This whole time I've been studying the urinary system!! Did you know that the ureters are comprised of 4 different tissue layers?

I'm sorry to hear you wouldn't want to send patients to me...hopefully they're not patients with pulmonary aneurysms :laugh:

Take care, DocNusum. I hope you find peace.
 
There's a time and place to ask questions. Challenging physicians on their knowledge of medicine is being presumptuous to say the least. This is just an anonymous website so what you say here nobody cares. But if you do this in PA school or when you work as one, you'll run into a lot of trouble. I know of one fellow med student who almost got booted out of school because he didn't know when to let things go. I know you're older, but you won't get any more slack than the 22 year old.

I agree with your point, though I would frame it like this:

Any monkey can flip through the interweb and come up with some random, rare diagnosis that most physicians have never heard of. Heck, patients do this crap all the time, especially the chronic pain patients.

Pt: "Doctor, I was wondering if you thought my low back pain could mean I have Bingham's Syndrome?"
MD: "I'm not familiar with that syndrome. Where did you hear about it?"
Pt: "Never heard of Bingham's Syndrome?! Clearly you are not a very good doctor!"

What makes us physicians is not our knowledge of disease, but the recognition of patterns of health and disease. We understand (or, to be more accurate, are in the process of learning to understand) the process by which medical problems are evaluated, diagnosed, and treated. We simultaneously consider not only what things could be, but also what they are likely to be. This process understanding is taught in formal settings, both classroom and clinical, and simply cannot be replicated by independent reading of medical texts.

And Sunfire, that's exactly what's going on here. You obviously have read a lot of medical texts. Hell, they're probably the same ones I have sitting on my shelf. But your knowledge is piecemeal, acquired through rote memorization with the benefit of context. It doesn't matter how many articles you cite, because your problem is not lack of sources, it's lack of formal education.

You're learning the words of our language and their meaning, but you don't understand the grammatical rules. You don't understand the process, so you sound ridiculous to us (Pulmonary Aneurysm? Seriously, that's really really funny). But at the same time, you don't understand that you don't understand the process, so you're confused about why everyone is laughing, since you're using the same jargon, citing the same journals, and using the same technical words as the other posters here.

Listen, I'm not going to continue pounding on you anymore after this. Someday, if you manage to get through PA school and actually practice for a couple years, you're going to look back on your posts here and be like, "I thought my chest pain could be a Pulmonary Aneurysm? Oh man, what was I thinking? I sounded so dumb."

But until then, you should probably avoid posting on medical topics.
 
I agree with your point, though I would frame it like this:

Any monkey can flip through the interweb and come up with some random, rare diagnosis that most physicians have never heard of. Heck, patients do this crap all the time, especially the chronic pain patients.

Pt: "Doctor, I was wondering if you thought my low back pain could mean I have Bingham's Syndrome?"
MD: "I'm not familiar with that syndrome. Where did you hear about it?"
Pt: "Never heard of Bingham's Syndrome?! Clearly you are not a very good doctor!"

What makes us physicians is not our knowledge of disease, but the recognition of patterns of health and disease. We understand (or, to be more accurate, are in the process of learning to understand) the process by which medical problems are evaluated, diagnosed, and treated. We simultaneously consider not only what things could be, but also what they are likely to be. This process understanding is taught in formal settings, both classroom and clinical, and simply cannot be replicated by independent reading of medical texts.

And Sunfire, that's exactly what's going on here. You obviously have read a lot of medical texts. Hell, they're probably the same ones I have sitting on my shelf. But your knowledge is piecemeal, acquired through rote memorization with the benefit of context. It doesn't matter how many articles you cite, because your problem is not lack of sources, it's lack of formal education.

You're learning the words of our language and their meaning, but you don't understand the grammatical rules. You don't understand the process, so you sound ridiculous to us (Pulmonary Aneurysm? Seriously, that's really really funny). But at the same time, you don't understand that you don't understand the process, so you're confused about why everyone is laughing, since you're using the same jargon, citing the same journals, and using the same technical words as the other posters here.

Listen, I'm not going to continue pounding on you anymore after this. Someday, if you manage to get through PA school and actually practice for a couple years, you're going to look back on your posts here and be like, "I thought my chest pain could be a Pulmonary Aneurysm? Oh man, what was I thinking? I sounded so dumb."

But until then, you should probably avoid posting on medical topics.

Please read.

http://ats.ctsnetjournals.org/cgi/content/full/59/2/528

http://rheumatology.oxfordjournals.o...full/42/8/1022

http://www.ncbi.nlm.nih.gov/pubmed/9591533

http://www.circ.ahajournals.org/cgi/...ll/112/15/e263

http://dpi.radiology.uiowa.edu/nlm/a...se2/case2.html

http://www.ncbi.nlm.nih.gov/pubmed/3387622

http://cat.inist.fr/?aModele=afficheN&cpsidt=16835823

http://www.jpgmonline.com/article.as...aulast=Lakhkar

http://linkinghub.elsevier.com/retri...54611199907503

http://www.medhelp.org/forums/cardio...ges/31612.html

You're the one who sounds ridiculous to me.
 

You are absolutely illustrating Tired's point. How?

You used pubmed and Google and posted a sloppy list of links.

All of the links - except the last one - which is asking for medical advice, are 'case reports' of pulmonary aneurysm. If you had any idea what a case report means, you'd immediately understand why these links reinforce the idea that you have no clue what you're talking about. Since you don't know, I'll tell you.

Case reports are reports of rare occurences or features of a disease. You proudly throw up all these links, but they reinforce the fact that you have no idea what is common and uncommon in medicine. We know what's common in medicine, and pulmonary aneurysm is a zebra.

What it boils down to is you mistakenly refered to 'pulmonary embolus' which is more commonly known, as 'pulmonary aneurysm', which is rare. Then you got called on it, rather than admit you had no clue, you backpedaled and found this condition that's so rare that most people haven't heard of it, and made like that's what you meant all the time.

It's so friggin obvious to the rest of us that that's why we're all on you, mang.
 
What it boils down to is you mistakenly refered to 'pulmonary embolus' which is more commonly known, as 'pulmonary aneurysm', which is rare. Then you got called on it, rather than admit you had no clue, you backpedaled and found this condition that's so rare that most people haven't heard of it, and made like that's what you meant all the time.

This is incorrect. Where did I say or infer that an embolus is the same as aneurysm?? What are you talking about. This is becoming more and more confusing as it plays on. It seems that some of you just want to argue, truly. You're pent up from your days work, or something, I don't know. Some advice...goto the gym, and please read thoroughly before you comment.

Who teaches you all your levels of comprehension, honestly! Take off your white robes, loosen my noose, and calm down a little. What I did was post in response to everyone laughing and saying that there was no such thing as a pulmonary aneurysm! Guess what! There is! And my common logic told me that there would be, which is probably why I used the words in the first place! But it seems that people don't like being taught through someone who's a PA-S! Guess what! I don't care! What's most important to me is that I learned of a condition, no matter how insignificant that condition might seem. And hopefully helped to educate anyone who might come across it someday, including myself. It's pretty sad when one of you buckaroos isn't mature enough to stand up and say, 'wow, cool', or rather, not 'cool' (I wouldn't call an aneurysm 'cool'), but 'cool to have that information'. You act as if I should apologize for sharing it!

Further, I never said it was common in medicine. Do you understand. Let me say that again. I never said it was common in medicine. Will you please stop putting words in my mouth and thoughts in my head that weren't there?

You know what man? If those links are so repulsive to you, just don't read them. Alright? Just. Don't. Read. Them. I actually found them interesting, certainly enough to avoid disrespecting the authors who went to the trouble to write and publish them.
 
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Now, more than ever, I understand the need for more people to drink Ayahuascha:laugh:
 


SOME... but not many PA students get training this rigorous...
So I HOPE you are NOT tryin to suggest that this is the NORM...:rolleyes:

all of my students do...:)
many of the newer ms level programs don't teach like this but I'm sure they still do this at my alma mater as well as most of the older programs out there....
 
OMG. Sunfire, for all thats holy quit screwing it up for the rest of us PA students. You really are making us look bad:(:(:(.
 
It seems that some of you just want to argue, truly. You're pent up from your days work, or something, I don't know. Some advice...goto the gym, and please read thoroughly before you comment.

Take a good deep look in a mirror, because this fits you perfectly.
 
finally i think it has stopped....i did just feel like i wasted the last 20 minutes of my life reading through these posts...but was it worth it? yep
 
lol This whole time I've been studying the urinary system!! Did you know that the ureters are comprised of 4 different tissue layers?

I'm sorry to hear you wouldn't want to send patients to me...hopefully they're not patients with pulmonary aneurysms :laugh:

Take care, DocNusum. I hope you find peace.

Well, reading your posts are pretty entertaining Sunfire-- I'll give you that. I guess what irritates everyone is that you really seem to lack humility, present yourself as an expert in topics after doing a community college paper or reading a couple of paragraphs in a textbook, and you don't have a clue when to back down or when you're wrong, which is really dangerous. You just don't know your place on the totem poll, which is really, really low because you're a student.

As a PA student, you're in or around the position of a med student, which means you know absolutely nothing about anything and so when an intern, resident, or attending tells you something, you nod and shut the hell up because they know a heck of a lot more than you and you don't question their knowledge. If you don't understand what they're talking about, then ask for clarification, but you don't act like you're a greater authority on the subject because you're not. If you think they're wrong, then look it up using the appropriate resource (i.e. not google) and make a mental note of the appropriate standard of care.

But if there's one thing I've learned in my very limited exposure to medicine, it's that the textbooks aren't always right, and good physicians know when to deviate from them.

The faster you learn that you don't have a clue about anything and that you're a piece of crap that needs to shut up like the rest of us until you learn enough to actually be useful to patients, the better off you'll be.

Oh yeah, and when you do get to the wards, don't bring in your community college papers on trauma or anything else you may have written because it's going to make you look foolish. Don't talk about all of your extensive health experience previous to your PA school because no one cares about that either and you're just wasting everyone's time, and all anyone care's about is going home on time. And don't bring in any other research papers or any other crap that you think the team will be "interested" in reading, because no one is interested in reading it. It's annoying behavior and you should try to nip it in the bud now before it's even more out of control. This advice may seem harsh, but believe me, it's for your own good.
 
finally i think it has stopped....i did just feel like i wasted the last 20 minutes of my life reading through these posts...but was it worth it? yep

ME TOO... I litterally cyber-stalked this guy to see what else he was ranting about. I'm actually really really surprised at how extremenice everyone is being to him (actually explaining what he was wrong with, etc).

Crazy, absolutely crazy. I have to get back to my studying now.
 
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You're the one who sounds ridiculous to me.

<sigh> Yes yes. I'm the ridiculous one.

As others have said: it's normal to run into an a**hole now and then, but when you're having run-ins with 6-7 a**holes every day, they're probably not the problem.
 
You just don't seem to get it... do you...????:rolleyes:
This is like watching a slow motion car wreck. I know how its going to turn out but I can't stop watching. To the OP PM me with your program name so I can send the PD a case of Rolaids.

Again to the OP if you really are going to be a PA student in the next two years you will find out how much you don't know (stage 1). Then when you graduate you will find out how much you really don't know (stage 2). After doing this for a while you will understand that you know some things (stage 3). Most of the people here trying to give you advice are at stage 3. You haven't even arrived at stage 1 yet. You should listen to them.

David Carpenter, PA-C
 
Amazing. I never stated that I know more than anyone, not even anyone here. Where do people get off speaking and thinking for me, and telling me to stop saying and thinking things...that I've never said or thought? I'll be the first one to admit that there's so much I don't know! Seems like I'm the only one around here, who will admit that!

Here's what my AbPsych book states as 'Fantasy':

'Person imagines events as a means of satisfying unacceptable, anxiety-producing desires that would otherwise go unfulfilled.'

It's the only explanation for what I've just read in those responses.

silas2642, I consider you infinitely more dangerous for your presumptuousness, although most of your advice is generally really solid for anyone. Am I ever sorry I posted that paper in the first place. I actually thought someone here might just be interested in reading it. Wow. Was I wrong! :laugh:

Excellent sophistry, I must say, and in group form it's even more astounding.
 
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Take a good deep look in a mirror, because this fits you perfectly.

When I'm not needing to defend myself against things that I never said, thoughts that I never thought, misquotes and misleads, you be sure and let me know. Then I'll agree with you.
 
I've been reprimanded for using wording that referenced to the KKK. I'd like to submit a formal apology to anyone who could have been offended by my statement, I was speaking more of lynch mob mentality in general and in no way meant to convey racist overtones.:(
 
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If we can't reference the clan, who's going to uphold our wimmins' honor?
 

As a PA student, you're in or around the position of a med student, which means you know absolutely nothing about anything and so when an intern, resident, or attending tells you something, you nod and shut the hell up because they know a heck of a lot more than you and you don't question their knowledge.
If you don't understand what they're talking about, then ask for clarification, but you don't act like you're a greater authority on the subject because you're not. If you think they're wrong, then look it up using the appropriate resource (i.e. not google) and make a mental note of the appropriate standard of care.
This says more about your attitudes than anything else. PubMed is just as accessible to a student as anybody else. Books happen to be a primary source of information. What makes you think an e.g pediatrics professor knows more about e.g neurology than me? Or sports physiology?

Ridiculous.

Knowledge is knowledge. If you have it, you have it no matter what your rank. Whether people will lend an ear, is a completely different story.
 
This says more about your attitudes than anything else. PubMed is just as accessible to a student as anybody else. Books happen to be a primary source of information. What makes you think an e.g pediatrics professor knows more about e.g neurology than me? Or sports physiology?

Ridiculous.

Knowledge is knowledge. If you have it, you have it no matter what your rank. Whether people will lend an ear, is a completely different story.

As a 4th year med student, I'm actually inclined to agree w/silas. I'm astounded every day when my interpretation of an article in Pubmed is trash because I dont have sufficient clinical background to take the information in context.

Im' not saying agree w/everything an attending says, but I do feel that a good margin of listening and looking up should be done prior to just doubting. Most attendings I've worked with know what they're talking about far more than I ever could from just reading books.

Just my opinion.
 
You are absolutely illustrating Tired's point. How?

You used pubmed and Google and posted a sloppy list of links.

All of the links - except the last one - which is asking for medical advice, are 'case reports' of pulmonary aneurysm. If you had any idea what a case report means, you'd immediately understand why these links reinforce the idea that you have no clue what you're talking about. Since you don't know, I'll tell you.

Case reports are reports of rare occurences or features of a disease. You proudly throw up all these links, but they reinforce the fact that you have no idea what is common and uncommon in medicine. We know what's common in medicine, and pulmonary aneurysm is a zebra.

What it boils down to is you mistakenly refered to 'pulmonary embolus' which is more commonly known, as 'pulmonary aneurysm', which is rare. Then you got called on it, rather than admit you had no clue, you backpedaled and found this condition that's so rare that most people haven't heard of it, and made like that's what you meant all the time.

It's so friggin obvious to the rest of us that that's why we're all on you, mang.

This is true.....And very obvious!!!
 
Wow, everyone calm down. I'm not a medical doctor (obviously), but I would think a doctor would admit a patient if they come into the ER after a certain (because of certain disease risks) age range to rule out all possible causes of the chest pain. Can a minor heart attack not show up on tests? If this is the case, there is a possiblity of scare tissue damage.

What exactly is the whole arguement in this thread about? Is a pre-pa student trying to say that they know all forms of possible chest pain and when it is appropriate to admit a patient?

I worked in a hospital for a little over three years and I came across a couple of PA's who were given the freedom to see the patient first if the MD was busy and couldn't see the patient right away (after being admitted to a floor), but I know for a fact that these PA's are well trusted by the MD's. Some form of independence of a PA doesn't come without being trusted by their supervisors.

How do you deal with difficult doctors? Well, the first thing you do is take a look at yourself. Is the way that you are communicating elevating the communication problem?
 
As a 4th year med student, I'm actually inclined to agree w/silas. I'm astounded every day when my interpretation of an article in Pubmed is trash because I dont have sufficient clinical background to take the information in context.

Im' not saying agree w/everything an attending says, but I do feel that a good margin of listening and looking up should be done prior to just doubting. Most attendings I've worked with know what they're talking about far more than I ever could from just reading books.

Just my opinion.

Yes. It takes time to know when a study in PubMed is junk or to know how to properly interpreate the finding (you need background knoweldge and training to really understand the significance of a study).

I work with the medical literature for one of my jobs. I read all sorts of medcial journal articles.....some of them are very hard to understand without a background as an MD).
 
This is true.....And very obvious!!!

That is most definitely not true. I never referred to pulmonary aneurysm as pulmonary embolism. Please read carefully before you comment, and certainly before you make accusations. And please refrain from quoting out of context! It's the whole story or nothing, KNC, you don't get to pick and choose simply in order to try and make someone look bad. If you'd care to accuse me of anything, I'd appreciate full disclosure of your supporting facts.

football rules, this thread was originally about working with difficult Doctors, until an immature troll-post was made which linked to a post containing a paper I thought that some would enjoy reading (they didn't). It has since gone off on an insane tangent, one part of which involved discussion of chest pain. I never professed to be any type of expert on chest pain, I was simply trying to engage in medical discussion (apparently not always a good thing here), part of which involved my own recent experience of being seen in the ER for chest pain. And I guess since I haven't started my PA program yet, you could call me pre-PA-S.

If you guys can pull it back on-topic, more power to you.
 
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That is most definitely not true. I never referred to pulmonary aneurysm as pulmonary embolism. Please read carefully before you comment, and certainly before you make accusations. And please refrain from quoting out of context! It's the whole story or nothing, KNC, you don't get to pick and choose simply in order to try and make someone look bad. If you'd care to accuse me of anything, I'd appreciate full disclosure of your supporting facts.

football rules, this thread was originally about working with difficult Doctors, until an immature troll-post was made which linked to a post containing a paper I thought that some would enjoy reading (they didn't). It has since gone off on an insane tangent, one part of which involved discussion of chest pain. I never professed to be any type of expert on chest pain, I was simply trying to engage in medical discussion (apparently not always a good thing here), part of which involved my own recent experience of being seen in the ER for chest pain. And I guess since I haven't started my PA program yet, you could call me pre-PA-S.

If you guys can pull it back on-topic, more power to you.

This section of SDN is not the proper place to talk about management of diseases and the like. There are better places to do such a thing.

I have an interest in genetics. I enjoy talking about genetic conditions. So I visit blogs that clinical geneticists publish to talk about the medical aspects of stuff.

Your visit to the ER for chest pain won't be the same reason as the next person or the person before to visit with chest pain. Just take what the doctors tell you and what you learned about your time in the ER and read the literature to learn more. Reading the literature and having active discussions with ER doctors and cardiologists (not on SDN) would be the best way to learn more.

I've talked to clinical geneticists in person before and I knew a couple of things they didn't (when I was shadowing) know. But I knew they were the doctor and I wasn't. So I just took in what I learned from them and what I already knew and further developed my knoweldge base that will come in handy once I get into graduate school and get my job at some clinic in the future.
 
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