Healthcare response towards epidemics- throwing doctors at infected

[PL198]

Why is this the prevailing strategy? I can't think of any worse way to combat something that we aren't sure of, that could end up threatening human life as a species(obviously a very small amount of cases). It makes 0 sense to me that whenever we hear about an ebola outbreak or something stronger that we hear about doctors sitting there in danger continuing to treat patients.

There isn't that much more they can do for patients than other health-care workers. The fact is that physicians are much harder to replace that people lower down the food chain, and if we're talking a threat to human life, dynamics like this are absolutely important to recognize. If they've never experienced an illness before, I don't see how putting them in close quarters with infected patients is going to help things at all.

I understand the appeal to emotion that some will have " but physicians should do everything within their power to help people," Well here's how I look at that: you can see 1 patient and risk your life and thus the ability to help others in the future, or you could administrate the treatment of that 1 patient without having direct contact or simply wait till you can get proper equipment so you can directly treat them and not get infected and not risk being infected and having your abilities compromised.

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[DermViser]

Throwing doctors? The doctors voluntarily went there.

 

[PL198]

Throwing doctors? The doctors voluntarily went there.

I understand that and I'm not just talking about ebola, but in general. I don't understand the mentality of physicians being significant in the initial phase of preventing contagious disease. If anything I'd say they're extremely unimportant initially and then as the disease progresses, they become more important and vital.

 

[DermViser]

I understand that and I'm not just talking about ebola, but in general. I don't understand the mentality of physicians being significant in the initial phase of preventing contagious disease. If anything I'd say they're extremely unimportant initially and then as the disease progresses, they become more important and vital.

Yes, but you don't know what stage people will be when you get there. You think NPs and PAs can handle it? Really? We can't make the argument that they're unqualified one moment and that they're perfect other moments bc we find the situation icky.

 

[PL198]

Yes, but you don't know what stage people will be when you get there. You think NPs and PAs can handle it? Really? We can't make the argument that they're unqualified one moment and that they're perfect other moments bc we find the situation icky.

I don't think anyone can handle it. I'm not looking for anyone to attempt to cure the people in the initial stage, all I want are accurate symptoms, histories and to have all the highest level people figure out what is going on and what to do about it. All I need the people seeing the patients to do is abate their symptoms while my studs can figure out what we're dealing with and how we fix it. If we have something more deadly than ebola, can a physician actually directly do anything more than a nurse? Not really in my opinion as I don't see how you could if you had no idea what it was. I suspect the only argument against this is that you'd get a more accurate characterization of symptoms with physicians doing the evals.

Also by stage, I mean in terms of populations acquiring the disease(ie 1st wave, 2nd wave) not sequelae.

 

[DermViser]

I don't think anyone can handle it. I'm not looking for anyone to attempt to cure the people in the initial stage, all I want are accurate symptoms, histories and to have all the highest level people figure out what is going on and what to do about it. All I need the people seeing the patients to do is abate their symptoms while my studs can figure out what we're dealing with and how we fix it. If we have something more deadly than ebola, can a physician actually directly do anything more than a nurse? Not really in my opinion as I don't see how you could if you had no idea what it was. I suspect the only argument against this is that you'd get a more accurate characterization of symptoms with physicians doing the evals.

Also by stage, I mean in terms of populations acquiring the disease(ie 1st wave, 2nd wave) not sequelae.

The disease is irrelevant. Even if it was deadlier than Ebola, you'd still want the doctor at the top of the food chain - a physician.

 

[DokterMom]

Yes, but you don't know what stage people will be when you get there. You think NPs and PAs can handle it? Really? We can't make the argument that they're unqualified one moment and that they're perfect other moments bc we find the situation icky.

He's not arguing that they're perfect.
He's arguing that they're more disposable.
A real humanitarian, that one.

 

[PL198]

He's not arguing that they're perfect.
He's arguing that they're more disposable.
A real humanitarian, that one.

If we're talking the fate of humanity, I'm not going to rely on emotion, I'm going to be pragmatic.

The disease is irrelevant. Even if it was deadlier than Ebola, you'd still want the doctor at the top of the food chain - a physician.

Docs would still be at the top, just I don't feel they need to have the immediate contact with the patients.

 

[DermViser]

Docs would still be at the top, just I don't feel they need to have the immediate contact with the patients.

And what would they be doing? Sitting on lawn chairs?

 

[PL198]

And what would they be doing? Sitting on lawn chairs?

advising the people in the field!

 

[DermViser]

advising the people in the field!

This isn't some swanky hospital in the United States.

 

[PL198]

This isn't some swanky hospital in the United States.

ok you're right but I'm talking theoretical!

 

[DermViser]

ok you're right but I'm talking theoretical!

Yes, they'll just stand there doing this:

 

[Psai]

son if you have an ebola patient, you have a duty to that patient
it's not just your job, it's your responsibility to take care of them
i'm the farthest thing from an premed idealist but i think this is what we're supposed to do

 

[DermViser]

son if you have an ebola patient, you have a duty to that patient
it's not just your job, it's your responsibility to take care of them
i'm the farthest thing from an premed idealist but i think this is what we're supposed to do

He'll be 23 when he graduates from medical school, currently an MS-2. The "duty to patient"/responsibility thing hasn't hit him quite yet.

 

[DokterMom]

He'll be 23 when he graduates from medical school, currently an MS-2. The "duty to patient"/responsibility thing hasn't hit him quite yet.

That explains a lot.

 

[PL198]

son if you have an ebola patient, you have a duty to that patient
it's not just your job, it's your responsibility to take care of them
i'm the farthest thing from an premed idealist but i think this is what we're supposed to do

well first I'd say my duty to a patient is no more than the duty of a chef to their customers.
However if you're going to make the duty argument, I could easily say that jeopardizing my life = a loss of care for patients in the long run, rather than a gain of one, so I don't see that as a valid point.

 

[DermViser]

That explains a lot.

Yes. Although quite expected when one graduates from med school when most traditional premeds are entering medical school.

well first I'd say my duty to a patient is no more than the duty of a chef to their customers.
However if you're going to make the duty argument, I could easily say that jeopardizing my life = a loss of care for patients in the long run, rather than a gain of one, so I don't see that as a valid point.

Wow, MS-3 is going to hit you like a ton of bricks if you think medicine is analgous to a chef and his customers. I could totally see you as the med student on surgery refusing to help the resident with placing a central line on a patient who has HIV/Hep C. You seem to have a view of medicine from a very egocentric angle.

 

[DermViser]

He's not arguing that they're perfect.
He's arguing that they're more disposable.
A real humanitarian, that one.

Yeah, I don't think he'll be getting the Arnold P. Gold Humanism in Medicine Award anytime soon.

 

[Lawgiver]

Lol to say the least

 

[DermViser]

He's not arguing that they're perfect.
He's arguing that they're more disposable.
A real humanitarian, that one.

He better hope to God he gets into Radiology - the clinical specialties will destroy him. He'll be putting his life in danger quite a bit in those specialties.

 

[DermViser]

Especially in derm!

(Sorry couldn't resist )

I meant more in the MS-3 required clerkships - Surgery, IM, maybe OB-Gyn

 

[TooMuchResearch]

Yes. Although quite expected when one graduates from med school when most traditional premeds are entering medical school.

Wow, MS-3 is going to hit you like a ton of bricks if you think medicine is analgous to a chef and his customers. I could totally see you as the med student on surgery refusing to help the resident with placing a central line on a patient who has HIV/Hep C. You seem to have a view of medicine from a very egocentric angle.

Most of my actively bleeding patients lately have had Hep C. Of course, I am working a lot of nights in the ED...

OP, the doctors go into the hot zones because we have the knowledge and experience to diagnose and treat. In general, other members of the treatment team do not. If you send someone else who collects suboptimal data, your treatment will be suboptimal.

 

[mcloaf]

well first I'd say my duty to a patient is no more than the duty of a chef to their customers.

If I worked with you I'd be really uncomfortable with you being responsible for patients.

 

[IlDestriero]

Cheaper to round them up and let them die in death camps.
The survivors get released after the quarantine period.
That looks bad on the news, probably better to try to help.