EM Doc mocks patient

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Gorne

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Gallows humor...
 
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I think this is an opportune time to remind everyone that every patient we evaluate (and whoever is in the room with them) has the ability to burn you to the ground with their cell phone. There’s a huge disconnect between the lay public and what we know in medicine. Be respectful. Treat everyone well. Just do the best you can. Cheers.
 
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Sadly I see this happen all the time. Most of the time I get the sense its a provider trying to sound funny to his/her colleagues and seem "cool/hip" by being edgy. Don't be edgy/witty around patients. Just treat them seriously and you can show off exhuberant wordplay at he bar with your buddies afterward where you won't get in trouble
 
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It’s most interesting to read the differences and similarities in replies to this instance across the EM, Psych, and Med School forums.
 
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It’s way more fun to just sit there and smile at terrible patients and watch them charge out of the department because they can’t get a rise out of you.

:D
 
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Dealing with difficult patients is an art... And this was not the way to handle it. The feelings in the EM forum are similar... Just walk away for a second and collect yourself. Be frank with the patient about your evaluation, your thoughts on the case, etc. If they don't like the eval that's ok, they don't have to submit to testing and likewise can't force you to perform tests or give meds. Engage them in decision making, but ultimately you're the doc.

This is unfortunate. The interaction was ugly.
And to the above posters.... Spot on.
Always assume you're on camera. ALWAYS.
 
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A good rule is that whatever pre-conceived notions you have about the patient, personal biases, etc. - maybe they have a diagnosis of panic attacks, maybe they are morbidly obese, or have fibromyalgia, don't blame yourself for your bias, but acknowledge it at the door, and then leave it there and go in and take and evaluate the complaint seriously.
 
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The problem with this article is that so much is left out. 100% agree that the physician acted irresponsibly. However, the fact is the article is most likely purposefully omitting information. I honestly feel that to some extent most providers have snapped or acted irresponsibly and were simply fortunate to not have been caught on camera. Articles like this always have the agenda to make the physician look inhumane. Of course they would never mention details of how awful her shift was, or that said patient repeatedly was verbally abusive with the health care providers or said patient has historically had a drug seeking behavior. Of course not, its perfect/sad patient vs abusive provider. So many details could alleviate the public opinion of what was going on.
Like all have said, best to just tuck in your tail and get through the day. Never know when you're being filmed. I don't trust anybody. I once was ambulating a patient whose family (not really involved in care) insisted I get physical therapy to which I insisted I've been helping her to the bathroom all day. Patient family secretly takes out her phone and films me ambulating their mother just hoping she takes a fall and gets that early retirement. I caught her filming me multiple times while I ambulated her mother.
 
The problem with this article is that so much is left out. 100% agree that the physician acted irresponsibly. However, the fact is the article is most likely purposefully omitting information. I honestly feel that to some extent most providers have snapped or acted irresponsibly and were simply fortunate to not have been caught on camera. Articles like this always have the agenda to make the physician look inhumane. Of course they would never mention details of how awful her shift was, or that said patient repeatedly was verbally abusive with the health care providers or said patient has historically had a drug seeking behavior. Of course not, its perfect/sad patient vs abusive provider. So many details could alleviate the public opinion of what was going on.
Like all have said, best to just tuck in your tail and get through the day. Never know when you're being filmed. I don't trust anybody. I once was ambulating a patient whose family (not really involved in care) insisted I get physical therapy to which I insisted I've been helping her to the bathroom all day. Patient family secretly takes out her phone and films me ambulating their mother just hoping she takes a fall and gets that early retirement. I caught her filming me multiple times while I ambulated her mother.
That the patient left with pain medication is perhaps the most interesting part of this case for me. The pain one experiences from anxiety attacks is not the sort that requires medication, which makes me wonder the reasoning on the part of the doctor
 
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In this thread: posters who don't deal with bull**** from otherwise healthy psych and personality disorder patients daily
 
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In this thread: posters who don't deal with bull**** from otherwise healthy psych and personality disorder patients daily
I mean, I specifically signed up for that sort of patients and this really isn't even in the ballpark of the best way to go about dealing with them. Being a competent physician includes the skill of properly handling challenging patients, which were probably the most useful skills I mastered in my six years of health care experience prior to medical school. Worse still, by poorly approaching such patients, you're putting yourself at real risk should they have an actual issue (the fallout of which I've seen play out several times over the years, often with sky-high payouts due to indefensible workups).

Like, I get the frustration, we're only human and it can be difficult to deal with. But we are held to a higher standard with regard to our actions, and expected to be better than the average individual were they to deal with similar.
 
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In this thread: posters who don't deal with bull**** from otherwise healthy psych and personality disorder patients daily

A MS-III on their first rotation would've handled the situation better than she did. Seeing BS on a daily basis is called experience which leads to competent handling of formerly difficult situations. That doc failed.
 
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Doc did not act professionally. End of story.

Not the BS med school/residency/hospital admin definition of “professional” but real professionalism: impartial, detached, objective, exercise of rational judgment. Sarcastic mocking, cursing and yelling have no place in a patient interaction.*

The crazy thing is many EM docs act like patients like that kid are such inconveniences when they know damn well from rotations and residency that at least 1/3 of patients in the ED are “psych” patients. This is what they signed up for with full informed consent in exchange for high hourly rate, less hours worked, zero follow up, lack of prior auths and so on.

* I occasionally mock addicts in a gentle, “Come on, bro” manner to confront their denial defense, but that is an objective, calculated move. If a patient swings at me I will def be yelling and cursing.
 
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Yes, that doctor exercised poor judgment. Repeatedly.

That being said, anyone who hasn't at least finished 1 year of residency is no position to judge here.
 
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Yes, that doctor exercised poor judgment. Repeatedly.

That being said, anyone who hasn't at least finished 1 year of residency is no position to judge here.
Actually, the administrators who fired her probably weren’t doctors and they were obviously in a position to judge. The 3 million viewers? All of them are judging. So take heed people.
 
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Yes, that doctor exercised poor judgment. Repeatedly.

That being said, anyone who hasn't at least finished 1 year of residency is no position to judge here.

I have sympathy for the stress she must face every day. I’ve only spent a few hours in the ED during IM rotations, and left frustrated and exhausted.

I hope she’s able to find a position more suitable for her skills. She’s probably not an evil person. :/ Just weak in an area that can contribute to awful patient care.

Hard to believe she practiced for 31 years.
 
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Actually, the administrators who fired her probably weren’t doctors and they were obviously in a position to judge. The 3 million viewers? All of them are judging. So take heed people.

I don't disagree with you that she's being judged. I'm also not condoning the behavior at all.

Mobile videophones at every corner... good luck everyone!
 
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Yes, that doctor exercised poor judgment. Repeatedly.

That being said, anyone who hasn't at least finished 1 year of residency is no position to judge here.
Wrong. Anyone with eyes and ears has a right to an opinion and to level judgement about this, no matter what level of training they have. They may not have eminent justification to pretend to be salty, jaded, world-weary or whatever, but anyone can see this interaction and assess, most likely correctly.

You don't get to tell people what they can think or say or feel about this, savvy?
 
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I don't disagree with you that she's being judged. I'm also not condoning the behavior at all.

Mobile videophones at every corner... good luck everyone!
Um yes. That’s the world we live in. And if you can’t afford to be a ****ty person ie: A list celebrity, Sports team owner, Fortune 500 ceo, President, then you should probably act professional in public if you want to keep your livelihood.
 
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Hard to believe she practiced for 31 years.

Easy to believe. Sad to see that no one saw her sliding into the person that would eventually lose the ability to maintain professionalism and do something about it.

There's no mechanism for preventing and remediating burnout built into high stress job functions in the civ world.

At least in the military if you stay in for more than the minimum amount of time, you go somewhere new and do something just different enough to keep it interesting every 2-3 years.
 
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i love how all these keyboard warriors are pissed at the doctor who goes in day in day out dealing with these fools.
 
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I watched this and think ZDogg’s take was pretty on point. Humans are pattern formers and she’s seen the drug-seeker numerous times and black people have seen real racism to the point where both have likely developed equally unfair preconceived notions of the other. Also, as Zdogg points out, its not even typically the black man/women, but typically a white middle aged male that gets that caricature so I don’t think the issue’s race. That being said, her actions demonstrate the utmost lack of professionalism as defined above by another poster and this is what translatesd to terrible optics that the media latches onto.
 
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i love how all these keyboard warriors are pissed at the doctor who goes in day in day out dealing with these fools.

Well at least you're amused.
 
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In this thread: posters who don't deal with bull**** from otherwise healthy psych and personality disorder patients daily

It's really not surprising. Look elsewhere and see the vastly different responses to this. Medical school nowadays is full of soft doughy liberals, most of which haven't had to work a day in their life with the general public yet.
 
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Um yes. That’s the world we live in. And if you can’t afford to be a ****ty person ie: A list celebrity, Sports team owner, Fortune 500 ceo, President, then you should probably act professional in public if you want to keep your livelihood.

You can quit with the junior varsity level sassmouth. I'm not impressed.

I gave you the benefit of the doubt here. Have fun with your rude awakening as a PGY-2 when you're no longer able to sit through your medical school lectures posting snarky replies on a message board in between reading First Aid and regurgitating the newest manufactured outrage story all over your Facebook wall, and instead are on consecutive hour #28 on your feet with no sleep and maybe 1 meal, and let's see how flawless your personal interactions are with a stressed out family after a code.
 
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You can quit with the junior varsity level sassmouth. I'm not impressed.

I gave you the benefit of the doubt here. Have fun with your rude awakening as a PGY-2 when you're no longer able to sit through your medical school lectures posting snarky replies on a message board, and instead are on consecutive hour #28 on your feet with no sleep and maybe 1 meal, and let's see how flawless your personal interactions are with a stressed out family after a code.
Kek.

tenor.gif
 
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Yeah Doc didn't act professionally but I am getting sick of these outrage stories that cause people to lose their livelihoods with videos that are cut together and edited. If people are gonna call for someone's job, release the entire interaction, or at least whatever this person recorded.
 
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Medical school nowadays is full of soft doughy liberals, most of which haven't had to work a day in their life with the general public yet.

It's been that way.

I watched my entire medical school class have an aneurysm every time "evil" McCain tried to challenge Obama. 10 years later, these said people all had Facebook aneurysms with "Trump is so mean, sadface OMG brain cancer so horrible." After awhile, their contradictory reactions actually become quite entertaining.
 
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It's been that way.

I watched my entire medical school class have an aneurysm every time "evil" McCain tried to challenge Obama. 10 years later, these said people all had Facebook aneurysms with "Trump is so mean, sadface OMG brain cancer so horrible." After awhile, their contradictory reactions actually become quite entertaining.

Yeah I think this thread just ended. Feel free to close.
 
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Oh man. I just brought my popcorn. And it is true. Until you’ve been thoroughly in the suck of residency, most have no idea how truly frustrating medicine is. I went to some really dark places towards the end of PGY3. Really dark places.
 
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It's been that way.

I watched my entire medical school class have an aneurysm every time "evil" McCain tried to challenge Obama. 10 years later, these said people all had Facebook aneurysms with "Trump is so mean, sadface OMG brain cancer so horrible." After awhile, their contradictory reactions actually become quite entertaining.
Yes everyone else is triggered. Not you, who turns internet threads on medicine into your own political agenda. I bet you’re that bro that has been banned 3 times.
 
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You can quit with the junior varsity level sassmouth. I'm not impressed.

I gave you the benefit of the doubt here. Have fun with your rude awakening as a PGY-2 when you're no longer able to sit through your medical school lectures posting snarky replies on a message board in between reading First Aid and regurgitating the newest manufactured outrage story all over your Facebook wall, and instead are on consecutive hour #28 on your feet with no sleep and maybe 1 meal, and let's see how flawless your personal interactions are with a stressed out family after a code.

Most of us are barely letting out a yawn.
Get over yourself.

It's been that way.

I watched my entire medical school class have an aneurysm every time "evil" McCain tried to challenge Obama. 10 years later, these said people all had Facebook aneurysms with "Trump is so mean, sadface OMG brain cancer so horrible." After awhile, their contradictory reactions actually become quite entertaining.

Super stoked to see how many times you get sued of your career. Karma is a cold, cold mistress.
 
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We don't know the full interaction because we only got moments but mocking anyone who is sub-resident in this forum doesn't justify the behavior we were shown in the video. He very well could have been her hundreth ****ty patient of the shift but you don't yank on a patient, you don't curse at a patient. If you can't control yourself, you need to leave the room and figure it out. "He did it first" is unacceptable.
 
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The issue isn't so much the sarcasm & disrespect from the physician. We get it, you're over-worked, you deal with **** patients all day, you have the right to your sarcasm/patronism/pessimism/whatever you want to call it. The audacity to do it in front of the patient, patient's father, and with a phone in your face is something else. How dumb/blind/arrogant are you? ****'s embarrassing.
 
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This is one of those things which are almost plausible when you're actually there, but looks horrible when viewed in isolation outside of context lol.
 
In our profession, we are essentially "glorified customer service".

If I taught my university chemistry courses like this, I'd be fired.

If I acted like this in virtually any profession, I'd be fired.

Yes, physicians deal with stress, but that doesn't mean you should fly off the handle.
 
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I hope this doctor's repercussions are not too severe. As said already, the holier than thou crew on here are mostly made up of premeds and med students who still have a rose tinted (delusional?) view of how most patient interactions will be.

Anxiety attacks do not cause a patient to go "in and out of consciousness." And klonopin is not the only, or best, treatment for anxiety.
 
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I hope this doctor's repercussions are not too severe. As said already, the holier than thou crew on here are mostly made up of premeds and med students who still have a rose tinted (delusional?) view of how most patient interactions will be.

Anxiety attacks do not cause a patient to go "in and out of consciousness." And klonopin is not the only, or best, treatment for anxiety.
I’m about to be an intern who was shot at by a patient and I would never act like this at the hospital. You also won’t find instances of me prescribing **** to my buddies or whatever this physician got busted for. But you don’t have to be a physician to not be a ****ty person. Premeds, med students and laymen can all treat people with respect.
 
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I hope this doctor's repercussions are not too severe.

Even in 2018, not everyone has to get fired.

Some good old fashioned political re-education camps a.k.a HR-directed anger management courses could be just the ticket to a bright tomorrow. Some folk just need to be recalibrated when they go off book. Adjust the headspace and timing and send 'em back to the fleet. The new-era zero-defect mentality has never actually been that productive in the long run. It's just the easiest path for the organization.
 
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High Yield:
* I never defended the actions of the physician. See above.
* I did not mock sub-residents for being sub-residents.

Yes everyone else is triggered. Not you, who turns internet threads on medicine into your own political agenda. I bet you’re that bro that has been banned 3 times.

Super stoked to see how many times you get sued of your career. Karma is a cold, cold mistress.

I still don't know what "triggered" means, and I don't really care.

My own political agenda? I am registered as non-affiliated and both parties have plenty of work to do. I'm tame, and my comment was even tamer.

Ban? Sue? Bad karma? After my innocuous replies? Doesn't bode well for you folks in this career if you're that thin-skinned. I should've known you'd automatically latch onto the "brain cancer" without reading the full sentence or even identifying the context in which it was used. No one was picking on the senator's brain cancer. I hope your medical school curriculum included a course on logic. Best of luck, I think you're both going to need it.
 
High Yield:
* I never defended the actions of the physician. See above.
* I did not mock sub-residents for being sub-residents.





I still don't know what "triggered" means, and I don't really care.

My own political agenda? I am registered as non-affiliated and both parties have plenty of work to do. I'm tame, and my comment was even tamer.

Ban? Sue? Bad karma? After my innocuous replies? Doesn't bode well for you folks in this career if you're that thin-skinned. I should've known you'd automatically latch onto the "brain cancer" without reading the full sentence or even identifying the context in which it was used. No one was picking on the senator's brain cancer. I hope your medical school curriculum included a course on logic. Best of luck, I think you're both going to need it.
Your posts are so cringe.
 
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I still don't know what "triggered" means, and I don't really care.

Triggered is the new word for "got your panties in a bunch." But instead saying P!$$ off and walking away, when someone is triggered, they scream in your face and accuse you of being a fascist because you voted for Trump.
 
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Political discussions stray far off the topic of the thread. Please keep things on topic.

(If not because derailing threads is a terms of service violation, then at least to give me some place free of political b.s.)
 
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