Ask a Doc

[muhali3]

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Alot of people are just asking silly and dumb questions. I have two very serious questions.
1.) When are you running for president of the U.S?
2.) Are you god?
You will have all of SDN votes for president.👍

You just provoked me to post this video:

[YOUTUBE]http://www.youtube.com/watch?v=svhRi_6dUfs[/YOUTUBE]

 

[OtoHNS]

I have a question myself: Do you occasionally misspell otolaryngology?

In all seriousness, great thread OtoHNS. Really informative! 👍

I'm sure I have in the past. Some pretentious folks even call our specialty otorhinolaryngology.

I do, however, deliberately mispronounce otolaryngology whenever someone asks me how to pronounce it.

 

[Doctor246853]

You just provoked me to post this video:

[YOUTUBE]svhRi_6dUfs[/YOUTUBE]

Hey I was serious about the god question.🙁

 

[OtoHNS]

You just provoked me to post this video:

[YOUTUBE]svhRi_6dUfs[/YOUTUBE]

Haha that's hilarious. What is that from? Couldn't watch it until now b/c of stupid firewall at work.

 

[MisterVeil]

It's from the 1993 movie Malice, starring Alec Baldwin, Nicole Kidman and Bill Pullman. That clip is the entire reason I watched the movie

 

[PrinceVersed]

Must. See. Movie. Looking it up on netflix now.

 

[JoshuaGuit]

Someone actually uploaded the full movie on youtube if netflix doesn't have it

 

[rhodesman]

Ok enough with the rookie questions, let's start Hardball:

I talk with peon pre-meds and medical students about this all the time but I would really like to get an attending's POV:

(Note: public health perspective). What is up with healthcare reform? What are the pros and the cons of it from your perspective. What are the biggest problems with instituting such reform in the current health care system we have now? Has the administration handled the issues of health care reform proficiently?

Next, could you take the questions above and directly address them as they would affect physicians in the future. Will Dr. Nurse cut into my pockets in the future, and will reimbursements continue to tank. How do you think health care reform will affect specialists in the future, both positively and negatively.

Oh and do Rhodes Scholars get automatic interview invites 😉

 

[Doctor246853]

You just provoked me to post this video:

[YOUTUBE]svhRi_6dUfs[/YOUTUBE]

Ok... was this a movie clip or is that really god? (serious answers only)

 

[Doctor246853]

Ok enough with the rookie questions, let's start Hardball:

I talk with peon pre-meds and medical students about this all the time but I would really like to get an attending's POV:

(Note: public health perspective). What is up with healthcare reform? What are the pros and the cons of it from your perspective. What are the biggest problems with instituting such reform in the current health care system we have now? Has the administration handled the issues of health care reform proficiently?

Next, could you take the questions above and directly address them as they would affect physicians in the future. Will Dr. Nurse cut into my pockets in the future, and will reimbursements continue to tank. How do you think health care reform will affect specialists in the future, both positively and negatively.

Oh and do Rhodes Scholars get automatic interview invites 😉

Hey?!!!🙁

 

[OtoHNS]

Ok enough with the rookie questions, let's start Hardball:

I talk with peon pre-meds and medical students about this all the time but I would really like to get an attending's POV:

(Note: public health perspective). What is up with healthcare reform? What are the pros and the cons of it from your perspective. What are the biggest problems with instituting such reform in the current health care system we have now? Has the administration handled the issues of health care reform proficiently?

Next, could you take the questions above and directly address them as they would affect physicians in the future. Will Dr. Nurse cut into my pockets in the future, and will reimbursements continue to tank. How do you think health care reform will affect specialists in the future, both positively and negatively.

Oh and do Rhodes Scholars get automatic interview invites 😉

Who let you into this thread anyway? 😉

Man, you could probably write a book or a series of books to answer these questions.

I actually did an hour talk on the health care bill at my residency’s grand rounds a couple months after the bill passed. I did this because I didn’t understand the bill and didn’t know if it would work.

After researching and giving the talk, I understood the bill a little better (but not that well) and I still don’t know if it will work. I definitely don’t think it will be as good as Obama/Democrats make it out but I also don’t think it will be as bad as Repubs/Fox News crowd say. It will definitely not be worse than the system we already have, which IMO is basically the equivalent of the Titanic steaming at full speed toward the iceberg.

See, the thing is, the US will literally go bankrupt in like 20 years if something isn’t done to control health care costs. I know people freak out about deficits and stuff now, but we’re talking astronomically higher deficits in 20-30 years if this problem isn’t controlled.

I would love to see the new health care law work as it’s supposed to, but I’m not overly optimistic. There are too many roadblocks and conflicting interests. Patients (even if dirt poor and homeless) expect everything to be done for their ailment immediately. Doctors want to get paid like it’s 1985 and do as many procedures as possible to increase their income. Insurance companies want to skim billions of dollars off the top in profits and deny care whenever possible. Politicians want to get reelected and pander to the lowest common denominator of society to do so. Obviously there are exceptions to all these examples (except the insurance companies...). Overall, the system is jacked.

I’ve always been pretty liberal and I do think everyone is entitled to a basic level of health care. BTW, we have already had this for many years via the EMTALA law, it’s just very inefficient and wasteful. I also would prefer if the US didn’t go bankrupt. The new law in theory would help with both problems. We’ll have to see what it does in real life.

Bottom line: this stuff is complicated. Really really complicated. It is much more complicated than Obama or Fox News make it out to be. IMO, it is too complicated for any person to predict what will happen (especially since a lot of the cost-saving measures in the bill are still to be determined).

I don’t know how much it will affect doc’s salaries in the long run. I’d imagine they will continue to stay level or go down a bit more. I think there is a breaking point where large numbers of physicians would quit or go on strike, which would be catastrophic. This is why I don’t think we will suddenly see a drastic drop in salaries. Honestly, though, doctor’s salaries are a drop in the bucket compared to the other problems in the system.

So what's the take-home message of all this? Well it's obvious: OBAMA WANTS TO KILL YOUR GRANDMA!!!!!!

 

[PrinceVersed]

I know you said you thought you'd do IM when you started but after all you have seen and done, what field (other than the one you are in now) would you choose to do and why?

Also, what do you think are the best and worse fields in medicine. It can be based on any criteria. I'm not too picky.

 

[OtoHNS]

I know you said you thought you'd do IM when you started but after all you have seen and done, what field (other than the one you are in now) would you choose to do and why?

Also, what do you think are the best and worse fields in medicine. It can be based on any criteria. I'm not too picky.

Hard to say. I would probably say radiology (esp neuroradiology) or maybe opthalmology (though I really don't know that much about what they do to be honest).

Making a best/worst list is so subjective, it really is different for every person.

I think it makes the most sense to group specialties into medical, surgical, and other.

Medical specialties: Int Medicine and it's many subspecialties, Pediatrics and subspecialties, Family Med, Neurology. Tend to manage more chronic conditions, lots of mental masturbation over differential diagnoses and lab values etc, more emphasis on treating conditions with medicines than procedures in general.

Surgical specialties: Gen surg and subspecialties, ortho, ENT, urology, ophtho, neurosurg. Tend to manage more acute and short-term conditions. Too busy operating to spend inordinate time thinking about diagnoses, etc. Emphasis is on surgical management of problems in general.

Other specialties: Radiology, anesthesia, pathology, PM+R, Rad Onc, Psych. These are a varied bunch but don't really fit into the other 2 categories.

The only way you're going to know what's best for you is to do your M3 rotations and see what the various fields are like. Usually people can figure out pretty quick if they are more of a medical type or surgical type. those who are neither tend to do rads/anesthesia/path/etc.

 

[BushidoBrown]

Oto, can you tell me a little bit more about your experience with having a social life during medical school? Did you go out-of-state or stay in state? Were you happy with where you were socially? Do you still keep in touch with any of the friends you made during college and medical school? How was your love/sex life during the entire time?

 

[Ischemic]

Why are there so many questions about pulling tail in this thread? I mean, unless you're celibate you can pull tail. Even truck drivers can pull tail, albeit nasty ones, but still tail nonetheless.

 

[OtoHNS]

Why are there so many questions about pulling tail in this thread? I mean, unless you're celibate you can pull tail. Even truck drivers can pull tail, albeit nasty ones, but still tail nonetheless.

Yeah, you premeds are an awfully randy bunch.

You can have whatever kind of social life you want in medical school. Don't worry about it.

 

[BushidoBrown]

Why are there so many questions about pulling tail in this thread? I mean, unless you're celibate you can pull tail. Even truck drivers can pull tail, albeit nasty ones, but still tail nonetheless.

Because asking one question at the end of a series of questions concerning the overarching aspect of social life in medical school automatically makes me a sex hound, right?

Yeah, you premeds are an awfully randy bunch.

You can have whatever kind of social life you want in medical school. Don't worry about it.

I'm asking about the social life from your own personal experience; most of what I read on here is either second- and third-hand information or gross generalities on the subject.

 

[Ischemic]

Because asking one question at the end of a series of questions concerning the overarching aspect of social life in medical school automatically makes me a sex hound, right?



I'm asking about the social life from your own personal experience; most of what I read on here is either second- and third-hand information or gross generalities on the subject.

Hey, why don't you read the rest of the thread in which 4-5 people keep asking about how many girls a doc pulls in every night. Your post just happens to be one more addition to a trend I'm commenting on. Was I attacking you? Did I mention you by name? Maybe I hit a subconscious of you trying to prey on little girls or something? I hear reading comprehension is tested on the MCATs, might wanna work on it before you take that test.

 

[BigRedder]

Because asking one question at the end of a series of questions concerning the overarching aspect of social life in medical school automatically makes me a sex hound, right?

Not just a sex hound, a neurotic sex hound.

 

[AutumnChild]

Oto, can you tell me a little bit more about your experience with having a social life during medical school? Did you go out-of-state or stay in state? Were you happy with where you were socially? Do you still keep in touch with any of the friends you made during college and medical school? How was your love/sex life during the entire time?

I was reading your post and your questions were fine until I got to the last one, where I thought, really? You're going to ask him about his sex life? It's a question that throws you back a bit. Maybe you should've phrased it differently.

 

[carbear02]

Hard to say. I would probably say radiology (esp neuroradiology) or maybe opthalmology (though I really don't know that much about what they do to be honest).

Making a best/worst list is so subjective, it really is different for every person.

I think it makes the most sense to group specialties into medical, surgical, and other.

Medical specialties: Int Medicine and it's many subspecialties, Pediatrics and subspecialties, Family Med, Neurology. Tend to manage more chronic conditions, lots of mental masturbation over differential diagnoses and lab values etc, more emphasis on treating conditions with medicines than procedures in general.

Surgical specialties: Gen surg and subspecialties, ortho, ENT, urology, ophtho, neurosurg. Tend to manage more acute and short-term conditions. Too busy operating to spend inordinate time thinking about diagnoses, etc. Emphasis is on surgical management of problems in general.

Other specialties: Radiology, anesthesia, pathology, PM+R, Rad Onc, Psych. These are a varied bunch but don't really fit into the other 2 categories.

The only way you're going to know what's best for you is to do your M3 rotations and see what the various fields are like. Usually people can figure out pretty quick if they are more of a medical type or surgical type. those who are neither tend to do rads/anesthesia/path/etc.

are there stereotypes about which type of person falls into which bucket? like anesthesiologists tend to be quiet people, etc etc? whats the stereotype for ENT?

 

[OtoHNS]

I'm asking about the social life from your own personal experience; most of what I read on here is either second- and third-hand information or gross generalities on the subject.

I had a perfectly normal social life including going out, doing fun stuff, having girlfriends, etc. You will have plenty of time outside of school and clinical time. If you pursue a difficult residency, i.e. gen surg/neurosurg, your free time will be more limited but it will still be there. I knew plenty of general surgery residents who still had time to go out and have fun on a regular basis.

 

[OtoHNS]

are there stereotypes about which type of person falls into which bucket? like anesthesiologists tend to be quiet people, etc etc? whats the stereotype for ENT?

Stereotype for ENT is nice/laid back with a touch of nerdiness.

As far as subspecialists:

Otologists (subspecialists in ears) more nerdy than average ENT.

Head and neck cancer surgeons closer to typical surgeon stereotypes.

Cosmetic facial plastics: well, you know that stereotype...

Like all stereotypes, there is a bit of truth to these but many exceptions.

 

[OtoHNS]

Bump.

 

[carbear02]

any study / time management tips to share for MS1 and 2?

also - what is your opinion on PBL vs systems based vs traditional curriculums? what would you look for in a med school?

 

[PrinceVersed]

What, if any, is the common trait between the "best" doctors that you have worked with/know?

Did you have a defining moment where you did something or something happened and you thought "wow! I AM a doctor!"?

 

[OtoHNS]

any study / time management tips to share for MS1 and 2?

also - what is your opinion on PBL vs systems based vs traditional curriculums? what would you look for in a med school?

It's been a long time, I don't really have any specific tips except make sure you have a life outside of studying and classes.

As far as 1st 2 years curriculum, in my opinion it's completely irrelevant. The most important thing in picking a medical school to attend is cost- go to the least expensive school (probably instate public school).

If you really have to consider the curriculum, focus on the 3rd year clinical training. Good = multiple training hospitals, especially VA or county hospitals. Med students tend to have a little more autonomy and get to do more stuff at these types of hospitals.

 

[OtoHNS]

What, if any, is the common trait between the "best" doctors that you have worked with/know?

Did you have a defining moment where you did something or something happened and you thought "wow! I AM a doctor!"?

Traits of good doctors: good communication skills, empathy, work ethic, honesty, the right balance between confidence and humility.

I don't really remember anything specific for your 2nd question. I do remember being really psyched during my first week on the wards as a M3, even though I wasn't really a doctor yet. I'm only just recently an attending with no oversight- it's pretty cool but also a change in responsibility. Most of what I've seen so far has been pretty straightforward, though...

 

[2341o7]

What kind of (if any) bureaucratic obstacles do you face as a physician? i.e. external influences such as the prospect of lawsuits, pharmaceutical companies, administration. Are there cases where you were feel hindered in your ability to care?

 

[OtoHNS]

What kind of (if any) bureaucratic obstacles do you face as a physician? i.e. external influences such as the prospect of lawsuits, pharmaceutical companies, administration. Are there cases where you were feel hindered in your ability to care?

There are definitely plenty of different bureaucracies which make my life less enjoyable. Since I'm a new physician, this system is all I've ever known, so I don't think it bothers me as much as an older doc.

Hospital administrators don't necessarily hinder my ability to care for the patient, but they definitely do force everyone to comply with one-size-fits-all safety rules which in some situations can lack common sense.

I frequently have to change a prescribed medication to an alternative which is covered by the patient's insurance. Almost always, the alternative medication is an equivalent to the original med, so this doesn't really harm the patient, it's just an inconvenience. Sometimes insurance companies will cause trouble about paying for a certain scan or test- a lot of the time this can be resolved by talking to a doc who works for the company on the phone, but not always.

As far as lawsuits, the key to avoiding them is to be liked by your patients. I try to be likeable by listening to the patient, explaining what I want to do for them, and spending an extra few minutes with them when necessary. There's a lot of pressure these days to see more and more patients, and for a lot of docs, it's easier to order an unnecessary CT scan or lab than it is to spend an extra 5 minutes explaining the plan to a patient.

 

[Geekchick921]

This thread needs one. I always want to respond to old posts. >.>

Yeah, that person got shot, actually many years earlier. The bullet was really lodged in the mastoid but you could see it through the ear canal. You'd be amazed at how many people get shot in the head and don't die. Our skulls are amazing structures. I wouldn't recommend trying it at home though...

This entire answer, not just the last line, is hilarious to me, especially, "You'd be amazed how many people get shot in the head and don't die."

Does this once and for all, unequivocally, prove that guys make better surgeons than girls? 😉

WTFever, man, I could pwn your ass.

No it just means girls need to start playing some more COD:MW2.

The hubster likes that one... I'm not a big fan of FPS games. I like RPGs (especially the one in your avatar, good sir), mostly. My main in my MMO is a beast in PVP, even though I didn't build her for it.

As a gamer I approve of this message.

As a female gamer, so do I. 👍