Ungrateful patients?

southernIM said:

Glad to see you've joined the ranks of people that view med students as worthless piles of dung before you've even graduated.

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I'm sorry, but exactly where are you getting these words and why are you putting them in my mouth?

I don't think medical students are worthless piles of dung. I think they are trainess/apprentices who are working their asses off to become full-fledged members of a profession. At the same time, however, I recognize the challenges that being in a teaching hospital presents to patients.

Certainly there are benefits to being a teaching patient (more people thinking about your case, looking over your orders, the input from those more recently trained may include unique or cutting edge solutions) but there are drawbacks too. If I were an attending or resident and a patient refused medical student involvement, I would certainly say to the patient, "I understand that you don't want to be seen by _____. Can you tell me why?" and try to encourage the patient to reconsider.

I also think it's important to remember that as medical students, the opportunity to interact with patients is ultimately a privilege and not a right. I think it's important to recognize that at times we impose another layer of inconvenience without bringing much benefit. I would argue that I have taken more away from most patients than I have been able to give to them - and there's NOTHING wrong with that. I (and most/all other medical students) will repay this debt 100-fold. I just think that recognizing our limitations as medical students helps keep us humble in our interactions with patients, which subsequently improves those interactions.

SoCuteMD said:

I'm sorry, but exactly where are you getting these words and why are you putting them in my mouth?

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Sorry...I didn't realize my sarcastic jab was any worse than yours...

SoCuteMD said:

I'm sorry, but if they didn't teach you empathy for patients in dental school, there's very little I can do for you here. But it's fine - I'll treat my patients with empathy and caring, you treat yours with your attitude. We'll see who ends up in court for malpractice first

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People in the hospital are not exactly operating at their best.

What such encounters teach us it to be evaluative of our approach. How could you have shown up in a less stressful way to this patient? How could you have put him at ease? How could you earn his trust?

Such encounters are learning experiences. If you were his actual attending, this could have been a disaster. Your rapport with him would have to be worked out.

Actually, such a patient is a great tool for testing yourself. Evaluate the encounter, look at how you could have approached him differently, or how you could have diffused the situation.

And then the real test. Go back to him. Talk with him, see if your thought-out approach helps (plus, the patient may be in a different mood next day.) And then directly ask the patient about the other day. Explain you are a student and that it is important to you to do well and have good "people skills" or "bedside manners" or whatever the local terminology is. Putting the patient in a position of power and control will relax him and you will likely find him able to tell you why things went bad, both per patient's likely bad day, but also per how patients would like to be approached. When you get a good feel for this, you will be the star student, able to handle "difficult" patients when nobody else can.

And, of course, you also become a better clinician, thus helping your future patients. You will run into such patients, where what you learn is very valuable and utterly not related to whatever illness they may have.

SoCuteMD said:

In any case, physicians can not discharge the care of a patient without arranging continuity of care for them. They have to find another physician willing to accept the patient.

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Well, yeah, you can't just not follow-up on a patient you're caring for, you have to transfer care. It sounds like we agree on the main points here.

Sorry about the misposting. I wrote a bit of an explanation below, but feel foolish over this online mini debacle.

WilliamVon said:

That's your job *******. I'm the attending to a lot of residents and have fired 10 in the past 3 months as a result of carry around that **** attitude you are conveying right now. You are an unethical man and physician if you think it is an obligation of the patient to be polite, grateful, or anything else of that quality. THEY ARE SICK! Not clients at an accounting firm. You probably have not experienced that sensation or state of being often. However, I had cancer as a child and relate to my patients, and find trouble often with my "colleagues", perfectly. They are scared and unhappy. YOUR JOB is to take that away and fix their ailments. THAT IS ALL. You are not there to teach them manners, psychoanalyze, judge, or anything else in between. If you think it is it is time you lose your medical license.

I am sick to my core, and can feel it in my bones at this point, of people like you and American patients are sick of your type of attitude too. I represent and am seen often as a mediator because I am good and ethical doctor who care about my patients' lives. Go into something else quickly because your attitude is not welcome. You have no charity of spirit and do not belong in medicine, you ungrateful brat.

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If you have really fired 10 residents in 3 months, then man, you are one ****ty mediator and I question your ability to know who is and who is not a good resident. Also, in before the ban. Personal attacks are against the terms on this website, regardless if you are really an "attending"or a high school kid pretending to be an attending.

Anyone with half a brain knows you have to be polite and grateful to your patients. That's like kindergarten knowledge.

I also think people are kind of befuddling the issue of a patient being nice and a patient taking proper care of themselves. A LOT of patients who take ****ty care of themselves are sweethearts. Alcoholics are some of the nicest people in the hospital, I've noticed. The people who tend to be all "NO STUDENTS" are often the highly educated. The best thing to do is let it roll off your back. As a student, you have the luxury of it really not being your responsibility if your patient is being difficult.

WilliamVon said:

That's your job *******. I'm the attending to a lot of residents and have fired 10 in the past 3 months as a result of carry around that **** attitude you are conveying right now. You are an unethical man and physician if you think it is an obligation of the patient to be polite, grateful, or anything else of that quality. THEY ARE SICK! Not clients at an accounting firm. You probably have not experienced that sensation or state of being often. However, I had cancer as a child and relate to my patients, and find trouble often with my "colleagues", perfectly. They are scared and unhappy. YOUR JOB is to take that away and fix their ailments. THAT IS ALL. You are not there to teach them manners, psychoanalyze, judge, or anything else in between. If you think it is it is time you lose your medical license.

I am sick to my core, and can feel it in my bones at this point, of people like you and American patients are sick of your type of attitude too. I represent and am seen often as a mediator because I am good and ethical doctor who care about my patients' lives. Go into something else quickly because your attitude is not welcome. You have no charity of spirit and do not belong in medicine, you ungrateful brat.

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You do realize you are replying, with significant anger, to a 3 year-old thread, right?

WilliamVon said:

That's your job *******. I'm the attending to a lot of residents and have fired 10 in the past 3 months as a result of carry around that **** attitude you are conveying right now. You are an unethical man and physician if you think it is an obligation of the patient to be polite, grateful, or anything else of that quality. THEY ARE SICK! Not clients at an accounting firm. You probably have not experienced that sensation or state of being often. However, I had cancer as a child and relate to my patients, and find trouble often with my "colleagues", perfectly. They are scared and unhappy. YOUR JOB is to take that away and fix their ailments. THAT IS ALL. You are not there to teach them manners, psychoanalyze, judge, or anything else in between. If you think it is it is time you lose your medical license.

I am sick to my core, and can feel it in my bones at this point, of people like you and American patients are sick of your type of attitude too. I represent and am seen often as a mediator because I am good and ethical doctor who care about my patients' lives. Go into something else quickly because your attitude is not welcome. You have no charity of spirit and do not belong in medicine, you ungrateful brat.

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Haha, I can already tell your patients hate you.

Can't say I'd blame them either. You mad.

GuyWhoDoesStuff said:

Haha, I can already tell your patients hate you.

Can't say I'd blame them either. You mad.

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I doubt that person has any patients as he is only playing a doctor on this thread.

I have just come to realize that this thread that I posted to had been artificially joined to another thread in the adjacent browser tab due to the Firefox autopager extension that is installed on my browser. It appeared, because of the extension, to have been one long thread that seemed at the time to be hosting a conversation which started off with a news article about Hsiu-Ying Tseng. Sorry for the comment. It was done quickly and because of the pagination together of the two different webpages made the first comment on this thread look like a reply to the news article. As I said, I did it quickly and didn't bother to take the time to pay mind to the disconnect in points that I now see is evident between the conjoined version of the pages.

I will now take down my comment. My apologies to the member who posted the question. I took your question out of context and placed it somewhere else, and as a result thought you were asking a question in spite of the news articles about the internist who killed 3 of her patients.

There are people who are sick and scared and are prone to outbursts due to the many doctors and medical students who go in and out of their room, examine them and then leave without explaining much of anything. These are people who have the misfortune of being lumped in with the actual *******s by jaded medical personnel

THEN there are the patients who bitch and moan about everything, who ask me 30 minutes worth of roundabout questions or tell me their soup is too cold or who have a perfectly good pair of legs and ambulate fine but prefer to piss and **** on their beds. If I could pour gasoline on these patients and light them on fire and use their ashes to fertilize my plants I would love to do it.

thepoopologist said:

THEN there are the patients who bitch and moan about everything, who ask me 30 minutes worth of roundabout questions or tell me their soup is too cold or who have a perfectly good pair of legs and ambulate fine but prefer to piss and **** on their beds. If I could pour gasoline on these patients and light them on fire and use their ashes to fertilize my plants I would love to do it.

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Don't go into psych.

Or geriatrics.

Or IM

Or...well you get the idea.

thepoopologist said:

There are people who are sick and scared and are prone to outbursts due to the many doctors and medical students who go in and out of their room, examine them and then leave without explaining much of anything. These are people who have the misfortune of being lumped in with the actual *******s by jaded medical personnel

THEN there are the patients who bitch and moan about everything, who ask me 30 minutes worth of roundabout questions or tell me their soup is too cold or who have a perfectly good pair of legs and ambulate fine but prefer to piss and **** on their beds. If I could pour gasoline on these patients and light them on fire and use their ashes to fertilize my plants I would love to do it.

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I understand that this is largely hyperbole, but jesus christ that makes you come off as a real psychopath.

TheProwler said:

Don't look now, but he's establishing quite the trend:

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The vindictive is strong with that one, haha.

I think everyone has had instances where a resident or attending has been a giant jerk to the medical students or been swayed heavily by flattery and less by competence. Almost everyone has been through that. The important thing is learning that it's NOT a good thing. The only way to change the culture of medicine is by providing an example for the next generation (though there are definitely people who thrive off of being like that, but you can't change an inherent sociopath).

Your comment was a little over the top. When I shadowed ob/gyn's there patients also needed space and would yell out. The doctor would just ignore it and continue with his/her work. Plus sick people tend to be grumpy. So I wouldn't take it personally.

I like watching old episodes of Scrubs, and I recently saw one where JD broke into a patient's house to get thanked for saving his life. He was then attacked by ostriches.

Ostriches are funny.