challenging the doctor you shadow?

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batista_123

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what would you have done?
the doctor that i shadow had a patient who said she felt a burning sensation in her hands when she went under the sun.
the doctor thought and thought and he prescribed a couple of lotions and said this may not fix it, we have to refer you to a dermatologist.
well all this time i was screaming in my head "vaseline, vaseline"
when i was like 10 i had the same problem and someone gave me this suggestion and i was cured immediately.
so do you challenge or do you keep your mouth shut?
 
batista_123 said:
what would you have done?
the doctor that i shadow had a patient who said she felt a burning sensation in her hands when she went under the sun.
the doctor thought and thought and he prescribed a couple of lotions and said this may not fix it, we have to refer you to a dermatologist.
well all this time i was screaming in my head "vaseline, vaseline"
when i was like 10 i had the same problem and someone gave me this suggestion and i was cured immediately.
so do you challenge or do you keep your mouth shut?
Click to expand...

you keep your mouth shut.
 
Mouth shut. Your opinion (and personal situation ) may not be correct for this person. Also, I know if I had someone (who I'm pretty much doing a favor for) challenge my authority in front of a patient, that person would not be coming back.

One option though, is to politely ask about your situation. Why might the Vaseline have helped? Was it perhaps coincidence or is there a condition where that is the norm? Phrase it as an inquiry, not a challenge, and after the patient is gone.
 
You should say something, clearly the memory of your ca. age ten anecdotal experience provides you with insight and qualifications to diagnose and prescribe that are vastly superior to those of any trained/experienced physician.
 
batista_123 said:
what would you have done?
the doctor that i shadow had a patient who said she felt a burning sensation in her hands when she went under the sun.
the doctor thought and thought and he prescribed a couple of lotions and said this may not fix it, we have to refer you to a dermatologist.
well all this time i was screaming in my head "vaseline, vaseline"
when i was like 10 i had the same problem and someone gave me this suggestion and i was cured immediately.
so do you challenge or do you keep your mouth shut?
Click to expand...

You don't say a damn word. You are there to shadow, not treat patients. So, shut the bleep up and move on with your day. Leave the medical work up to the doctor. If the doctor does not realize there is a better treatment option, that is between the patient, the doctor, and the family. It has NOTHING to do with you. You could hint at something if you were employed at the hospital, but you are just shadowing.
 
In private you could say to the doctor that the case interested you, and you would like to know what he thinks it could be. It might give you some insight into his thought process when deciding to make a referral. I would not, however, "challenge" a doc I was shadowing. You have nowhere near the medical knowledge required to make such speculations.
 
SabC said:
You should say something, clearly the memory of your ca. age ten anecdotal experience provides you with insight and qualifications to diagnose and prescribe that are vastly superior to those of any trained/experienced physician.
Click to expand...

Ha. 👍

OP, *challenging* an attending in front of a patient is never a good idea...be you a random premed, a med student, a resident, or a fellow. Heck, that's proper social etiquette regardless of your field. (The one exception to this is, of course, is if the attending is about to make a life-threatening mistake...prescribing hand lotion probably doesn't qualify.)

Even if you were certain you are right and the attending is wrong, there are more productive and professional ways to approach the situation. You can always politely ask why the attending made the choice he/she did...usually there actually is a reason and so then you can learn from it, and if there isn't a good answer or he/she had made a mistake it can seg into a professional discussion rather than some sort of adversarial argument. As a premed, this is probably best done after the patient encounter is over. Cutting down an attending in front of a patient (particularly when you are a premed and grossly underqualified) is never a good idea, and even if you were "right" it is the best way to guarantee a rapid end to your shadowing experience.
 
Don't challenge in front of a patient. Wait until the patient is gone then ask about it.

There was a patient who had a situation where she was using an herbal "remedy" and was showing all the signs of having a potentially bad reaction which can occur after you've been on it for a while. The neurologist I was shadowing was completely perplexed over her new problems. When the patient left, I went to the doctor and said "I think I know what the problem is. It's the Valerian Root." He asked me how I knew, I told him during my several years of being too scared to go to the doctor, I was trying to use herbs and I'd used it and I had a lot of the same problems. He said he didn't really know much about herbs (and would love a source to back up what I was saying, which I later provided) but that the next time she came in he would try to get her off the herb and see if that really was the cause. Let's just say, I was thanked later, the patient's "new symptoms" completely disappeared within a week or so of stopping the herb.
 
Wow OP, who do you think you are? You have no clue what your talking about or whether the condition you had was the same as the patient - or perhaps the lotion perscribed has similar effects to vaseline

..either way..ru crazy? you being a premed who knowns next to nothing about medicine challenging and attending physician with 10+ years of experience......even entertaining this thought is absurd...geez
 
:laugh:
batista_123 said:
what would you have done?
the doctor that i shadow had a patient who said she felt a burning sensation in her hands when she went under the sun.
the doctor thought and thought and he prescribed a couple of lotions and said this may not fix it, we have to refer you to a dermatologist.
well all this time i was screaming in my head "vaseline, vaseline"
when i was like 10 i had the same problem and someone gave me this suggestion and i was cured immediately.
so do you challenge or do you keep your mouth shut?
Click to expand...

:laugh::laugh::laugh:

as if you, based on your minute experience with your condition, can give a differential diagnosis. I hope you realize there are many diseases, conditions, neuropathies, etc.. that can manifest in the same manner as your issue. Do yourself a favor by not putting your foot in your mouth.

Simply sit back, learn from your experience, and maybe if possible ask how he concluded what he concluded and chose that specific course of treatment.

PLEASE don't be the annoying pre-med (and I am NOT saying you already are)!
 
i'm going to preemptively answer OP's next question and say that you should NOT write about this in your PS
 
su... I don't even say anything to patients/docs unless I have 110% certainty about the topic, like the sky is blue and such.
 
I mean if the doctor said well you have a paper cut, sorry but we have to cut off your head. Then you might want to go- "Wow sounds cool, but really won't that kill her"..
 
I agree with most people here-- don't "call out" the doctor. If the opportunity arises during conversation and you're able to very casually mention how you had a similar incident that was alleviated by vaseline, then so be it. However, I doubt that would accomplish anything really.
 
wow. even i think that these reactions were harsh.












but well deserved. =)
 
Yea...what everyone else has said...

I did have ONE doctor ask my advice on something when I was in there with him. It had to do with training stuff and I have my CSCS. That was only after he asked and I still felt weird being put on the spot.
 
Usually you don't say a thing- but when you leave the exam room you might say something along the lines of, "do you think vasoline might have helped?"

I had this happen in undergrad with a patient with a rash that was hot and the doctor wasn't sure what it was from- I later thought it could be fungal based on a case I saw with a friend, the doctor went ahead and ordered some labs for it and even told the patient that I had suggested it. Since I was only with him one day not sure the result of those labs.
 
batista_123 said:
what would you have done?
the doctor that i shadow had a patient who said she felt a burning sensation in her hands when she went under the sun.
the doctor thought and thought and he prescribed a couple of lotions and said this may not fix it, we have to refer you to a dermatologist.
well all this time i was screaming in my head "vaseline, vaseline"
when i was like 10 i had the same problem and someone gave me this suggestion and i was cured immediately.
so do you challenge or do you keep your mouth shut?
Click to expand...

never be afraid to challenge other people's logic, but do so respectfully. ask the doc afterwards, definitely DO NOT call him out in front of a patient.
 
Off topic a bit I know, but..

One of the doctors I shadow asks me questions all the time. She is not looking for advice though. Whenever there was a patient that didn't want a pre-med student in the room, I was told to look something up and read all I can about it. I would then be drilled about the topic when she got back during paperwork / typing.

This was actually a pretty cool experience, much more than I was expecting when I asked to shadow. I sometimes ask questions about a case after the patient has left, but I agree with the crowd here that you shouldn't challenge the doctor's opinion (especially in front of the patient or co-workers). You could ask how or why they decided upon a treatment plan, and the chances are very high that the attending will be correct. This could show that you are interested and want to learn while remaining respectful.
 
Last edited:
If you are smart about it and ask as some above posters have said after the patient is gone and from a curiosity standpoint, then potentially the doctor will be impressed by your interest....but definitely don't mention it in the appt.
 
justdoit31 said:
Usually you don't say a thing- but when you leave the exam room you might say something along the lines of, "do you think vasoline might have helped?"

I had this happen in undergrad with a patient with a rash that was hot and the doctor wasn't sure what it was from- I later thought it could be fungal based on a case I saw with a friend, the doctor went ahead and ordered some labs for it and even told the patient that I had suggested it. Since I was only with him one day not sure the result of those labs.
Click to expand...

Yeaaaah...but, that scenario is vastly different than piping up with,

"I had that same thing when I was ten. someone told me use the vaselines and I was cured immediately!"

A statement in which each word brims with fail so magnificent it defies accurate quantification.
 
Only read the first post, but if you're truly an idiot if you said something. Your undergrad education doesn't trump the physician's training. It would be one thing if you were also a physician, but the physician gets ultimate deference in this case.
 
only a pre-med on SDN could be arrogant enough to entertain the thought of challenging a physician on a medical opinion
 
Don't say it, but if you do end up getting the uncontrollable urge, then don't ask later for an LOR 😉 .
 
Ignore them OP, they're all just jealous that they don't have the gunner instincts to take down an MD like you do. I say challenge - it's common knowledge that if you win in a head to head battle of diagnosing with a doc you get to usurp their degree. Good luck
 
Web MD said:
Ignore them OP, they're all just jealous that they don't have the gunner instincts to take down an MD like you do. I say challenge - it's common knowledge that if you win in a head to head battle of diagnosing with a doc you get to usurp their degree. Good luck
Click to expand...
:laugh::laugh::laugh:
 
Ive been in a situation where I knew the answer to something that the doctor did not simply from personal experience. It involved a motorcycle rider and helmets and how she had ear pain an I casually mentioned that I was a rider too and the wind can get through a fullface helmet and hurt the ears. Turns out that was the problem and the doctor said "hey, you learn something new everyday" and thanked me.

Obviously dont make it confrontational but if you know something from casual knowledge, you can let the doctor know afterwards or when they step out of the office as a friendly idea. "Hey do you think it could be this" and they'll usually explain why you are a ***** for asking that or use it in the dx. I got this before, I asked if you'd ever use NO for treatment of something (forgot what) and I got a laugh from the Dr. along with an explanation.

I guess it all depends on the Dr, but its def. good to ask questions in a friendly way even if it is just to gain insight into their thought process.
 
Yea but samurai was adding input about riding helmets, and not skin meds. The doctor referred the patient to a specialist. Just because you thought they needed some plain old vaseline, what if it was something more serious and the doctor ended up giving them vaseline because some pre-med used it once before.

Anyway, vaseline is just like a moisture and skin pretectant. They could have any number of derm problems which usually may be worsened by the sun (not that I know enough anyway and wouldn't say anything).

Are you paying your malpractice premiums lately?
 
anfleisch said:
what if it was something more serious and the doctor ended up giving them vaseline because some pre-med used it once before
Click to expand...


What hypothetical doctor would hypothetically scrap their diagnoses/treatment plan based on the hypothetical advice of an undergrad? I'd love to know what world some of you guys live in...
 
Are you serious?? If I was the attending and some arrogant little pre-med challenged my decisions I would smack him and kick his ass straight out of my office. Keep your damn mouth shut.
 
I'm going to go with all the people that said ask respectfully AFTER leaving the patient.

I'd say the fly on the wall analogy of shadowing applies 100% while you're with a patient (unless you're directly asked something). However, once you and the doc are alone, you should be asking as many questions as you can. If you're wondering about something the doctor did and you don't ask at all, you're wasting your experience shadowing. You're there to learn about the process, and you won't learn as much if you don't ask anything. However, like the others said don't "challenge" the doc. Just politely ask, "Would vaseline have worked? Why/why not? What's the difference between vaseline and other ointments? What made you decide to refer the patient to a specialist?". Obviously not all at once. In my experience, docs love to show off their knowledge.
 
OP, don't listen to these idiots. They have no basis to their claims, plus they're all going to be bad doctors anyway. You should DEFINITELY tell that attending what's what because you're premed ... PREMED!! Nothing more awesome in the world. Furthermore, I'm going to use anecdotal evidence because that's the strongest type of evidence there is out there. I challenged my attending over something just as silly as you while shadowing when I was a premed ... and guess what? I owned that fool. I became renown throughout the hospital and could bag nurses by just snapping my fingers. So, OP. Go handle some business.
 
The most I've done along those lines is very rarely the ER doctors I used to scribe for would forget a piece of history.. There was once a patient presenting with a history of G6PD who had casually muttered something about eating beans off handedly. The doctor missed it and I reminded him of what the patient said (linking favism with G6PD). Needless to say, I felt like a badass for the rest of the day.
 
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