How conservative is EM?

[NontradCA]

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Hi all, I hope you don't mind me posting here but I wanted to ask this question. I was shadowing an EM program director who told me he didn't like my tattoo and the patients would t like it either (it's just a date on my neck, very tactfully placed). I explained to him the significance and he told me that many in EM are conservative in nature and said if he had to choose between equal candidates, this would break a tie. Despite him saying this, he seemed pretty laid back and said this kind of nonchalantly. I just figured EM may have an early retirement age so it would be younger, more laid back physicians. I know it's not good to make generalizations but what do you all think of your profession as a whole in this aspect?

 

[EMmotherhen]

As long as any tattoo is not obscene in content then it shouldn't really matter. Several of our residents have tattoos (as do some faculty). F-word, nudity, violence, etc can cost you but something as plain as a date shouldn't raise eyebrows. Sounds like this person just happens to be someone who doesn't like tattoos in general. Can it be covered with a shirt collar?

 

[NontradCA]

As long as any tattoo is not obscene in content then it shouldn't really matter. Several of our residents have tattoos (as do some faculty). F-word, nudity, violence, etc can cost you but something as plain as a date shouldn't raise eyebrows. Sounds like this person just happens to be someone who doesn't like tattoos in general. Can it be covered with a shirt collar?

With a shirt and tie, yes.

 

[xaelia]

Our hospital requires that all tattoos be covered, regardless of position or specialty. It means a few folks have to always wear long sleeves under their scrubs.

 

[SeekerOfTheTree]

I tattooed my step scores on my neck. They are the same as my bench press!

 

[NontradCA]

I tattooed my step scores on my neck. They are the same as my bench press!

That means they must have been low. Do you even study?

 

[DrMom]

Hi all, I hope you don't mind me posting here but I wanted to ask this question. I was shadowing an EM program director who told me he didn't like my tattoo and the patients would t like it either (it's just a date on my neck, very tactfully placed). I explained to him the significance and he told me that many in EM are conservative in nature and said if he had to choose between equal candidates, this would break a tie. Despite him saying this, he seemed pretty laid back and said this kind of nonchalantly. I just figured EM may have an early retirement age so it would be younger, more laid back physicians. I know it's not good to make generalizations but what do you all think of your profession as a whole in this aspect?

These are usually hospital policies, so it's not an EM-specific issue.

I have a small nose stud. It has come up once in my employment only because a nurse complained that she couldn't wear one too. My boss said he'd never even noticed that I had one and he didn't care. Hasn't come up again, but I am in violation of the hospital policy so if someone wanted to make a deal of it they could.

 

[vistaril]

Hi all, I hope you don't mind me posting here but I wanted to ask this question. I was shadowing an EM program director who told me he didn't like my tattoo and the patients would t like it either (it's just a date on my neck?

if it were somewhere other than your neck it would probably be ok, but a neck tattoo is not appropriate for a physician of any type

 

[Anonymous M4]

if it were somewhere other than your neck it would probably be ok, but a neck tattoo is not appropriate for a physician of any type

That's so arbitrary.

 

[gro2001]

if it were somewhere other than your neck it would probably be ok, but a neck tattoo is not appropriate for a physician of any type

Any type? Why can''t a radiologist or a pathologist have a neck tattoo?

 

[Akail]

That means they must have been low. Do you even study?

Ahahaha left yourself open for that one seeker 😛

 

[Arcan57]

if it were somewhere other than your neck it would probably be ok, but a neck tattoo is not appropriate for a physician of any type

That's so arbitrary.

Yeah, but I'm sure you've seen that GIF about tattoo location and actual meaning. While many EPs are socially liberal, we take care of a lot of patients who are going to look oddly on someone with a neck tattoo. You should expect to keep it covered (maybe Underarmour turtleneck, I don't recommend ties in the ED) or else develop some scripting around it (ie be prepared to explain why you have the tattoo and how it doesn't mean you're a banger or junkie, if you notice them looking at it). Facial or neck tattoos are uncommon in most social settings, and vanishingly rare in professional settings (I can't come up with any docs over 11+ hospitals in 6 states I've seen have one). So the one thing I wouldn't do is have it uncovered and not be prepared to address it in a non-confrontational, non-distracting manner. If it's meaning is something you don't feel like sharing with complete strangers, then it needs to be covered at all times while working.

 

[NontradCA]

Yeah, but I'm sure you've seen that GIF about tattoo location and actual meaning. While many EPs are socially liberal, we take care of a lot of patients who are going to look oddly on someone with a neck tattoo. You should expect to keep it covered (maybe Underarmour turtleneck, I don't recommend ties in the ED) or else develop some scripting around it (ie be prepared to explain why you have the tattoo and how it doesn't mean you're a banger or junkie, if you notice them looking at it). Facial or neck tattoos are uncommon in most social settings, and vanishingly rare in professional settings (I can't come up with any docs over 11+ hospitals in 6 states I've seen have one). So the one thing I wouldn't do is have it uncovered and not be prepared to address it in a non-confrontational, non-distracting manner. If it's meaning is something you don't feel like sharing with complete strangers, then it needs to be covered at all times while working.

Makes a lot of sense. Honestly with this physician it was the only time it's come up in a professional setting. I understand how it could be a problem to some.

 

[NontradCA]

Thanks for your replies!

 

[dotcb]

Need to look professional at work. That includes absence of visible tattoos and distracting piercings. When you work in healthcare, the emphasis should be on the patient's experience, not your appearance. You don't need to make a statement with your appearance at work, other than you are clean and groomed.

Someone in our ED came to work with a large lip ring. While this does not bother me personally, I don't think it is professional appearance for the clinical environment. I kept my mouth shut.

Unfortunately, people will judge you for this kind of thing for the rest of your career. You can decide if it's worth covering with hair, collar, etc.

That said, I think EM is much more forgiving than some other fields (derm). Many of our ED staff (mostly non-MD) are heavily tatted. They cover them to varying degree and as they are able to. As a whole, our staff are pretty accepting of eccentricities, given the patients we serve.

If someone was debating getting a visible tattoo, from the standpoint of ruffling feathers in medicine, I would advise against it.

 

[The White Coat Investor]

Ahahaha left yourself open for that one seeker 😛

I wish I could bench my scores but I max out at 250. 🙂

 

[The White Coat Investor]

if it were somewhere other than your neck it would probably be ok, but a neck tattoo is not appropriate for a physician of any type

While I don't know if it's appropriate or not appropriate, it does show a lack of judgment IMHO. Someone who gets a tattoo they can't hide should they so desire isn't someone who's thinking ahead about future consequences to their career, group, hospital etc. I know of a lot of docs who wouldn't hire you because of it. Would I? I don't know. I like to think I'm open minded. But I suppose it would cause me to question your judgment. If you can't think far enough ahead to figure out the consequences of a visible tattoo, can you think ahead to figure out the consequences of interacting poorly with the chief of the medical staff or with a patient's family etc.I suggest when you interview that you keep it covered. I don't care if it's your dead grandmother's birthdate. Significance or reasoning makes no difference IMHO.

Tattoos are becoming more and more commonplace, but so is meth use. Just cause it's common doesn't mean it's okay. It isn't that EM is conservative (it isn't when compared to other specialties.) It's that medicine and the professions in general are conservative.

 

[NontradCA]

Well at least I'll have the Meth and drug seeking patient population support. By the way your post is literally the definition of conservative AD MD

 

[DocCartman]

he told me that many in EM are conservative in nature

Socially Conservative? Generally no- much less so than a lot of other specialties
Fiscally Conservative? Generally yes- but this describes the majority of docs in general

Conservative in the sense that they think Doctors shouldn't have NECK TATTOOS?!?! I mean is this where we are in 2013 that medicine has pushed so far away from the "Patriarchal, Norman Rockwell-esque..." medicine of our parents' generation that we're arguing the relative merits of neck tattoos on physicians?

I'm not even going to be one of those Docs that's like "well, I'm cool with it, but my 75-year old grandma wouldn't be..."

I wouldn't be cool with it for my grandma, myself, my spouse, or my kid.

Having a neck tattoo doesn't mean you can't be a brilliant physician. Neither does showing up in a dirty, wrinkled white coat, not shaving for 3 days, or not brushing your teeth. There's a reason we bow to social norms, and that is because we want to make good first impressions.

I'm certainly not alone in this sentiment, and I live in a large urban area on the West Coast.

 

[Hamhock]

By the way your post is literally the definition of conservative AD MD

I suspect it will not be the tat that causes you problems...

I think you just ended honest replies.

HH

 

[NontradCA]

I suspect it will not be the tat that causes you problems...

I think you just ended honest replies.

HH

Actually the point was to get them, which seems to be working.

 

[Tiger26]

Agree with pretty much everything said above. Medicine, and especially emergency medicine, is built on establishing relationships and rapport with patients. In our business, we have to do that within seconds to minutes, however.

You may be the next Osler, DeBakey, or whatever brilliant physician, but a neck tattoo is clearly outside the social norm.

Although no one will tell you to you face that they won't hire you, if given the choice between two candidates (even if not academically equal), there are many groups (or residencies) that simply won't hire you.

 

[NontradCA]

Agree with pretty much everything said above. Medicine, and especially emergency medicine, is built on establishing relationships and rapport with patients. In our business, we have to do that within seconds to minutes, however.

You may be the next Osler, DeBakey, or whatever brilliant physician, but a neck tattoo is clearly outside the social norm.

Although no one will tell you to you face that they won't hire you, if given the choice between two candidates (even if not academically equal), there are many groups (or residencies) that simply won't hire you.

Gotcha. So get tattoo removed prior to rotations or face a large uphill battle for entire career.

 

[nlax30]

Or start working on a turtleneck scrub top....

 

[Tiger26]

Gotcha. So get tattoo removed prior to rotations or face a large uphill battle for entire career.

It all depends on what's important to you. In all honesty, I couldn't care less about it as a patient or colleague, however, it depends on whether you think the hassle it will entail is worth the meaning it has for you.

 

[discharged]

Why they be trippin'?.. Oh wait, common sense..

 

[JacobMcCandles]

As ActiveDuty pointed out, it's more of a display of your lack of judgement than anything. It doesn't mean you can't be a great physician but you're putting unnecessary obstacles in front of you.

 

[la gringa]

ED physicians? conservative?

you will find EP's of nearly any ethnic background, religion, and color. american and foreign-born. MD and DO. a good mix of women. haven't met a transgender, but plenty of gay/lesbian/bisexual. many EM groups allow domestic partner benefits.... conservative how??

imho tattoos that are visible when in normal work clothing are not in good TASTE... and i don't think that has anything to do w/ whether one is conservative or liberal.

 

[NontradCA]

ED physicians? conservative?

you will find EP's of nearly any ethnic background, religion, and color. american and foreign-born. MD and DO. a good mix of women. haven't met a transgender, but plenty of gay/lesbian/bisexual. many EM groups allow domestic partner benefits.... conservative how??

imho tattoos that are visible when in normal work clothing are not in good TASTE... and i don't think that has anything to do w/ whether one is conservative or liberal.

I agree with you. Except the fact that it is conservative.

 

[discharged]

BTW, there is an article on this.

http://www.do-online.org/TheDO/?p=86631

 

[NontradCA]

BTW, there is an article on this.

http://www.do-online.org/TheDO/?p=86631

Interesting article. I'm really interested in how tattoos specifically alters patient encounters (for some reason I don't trust that Bowtie n=1 analogy). I tend to think gender and race have similar effects. Most likely body composition as well. Thanks for the link.

 

[The White Coat Investor]

BTW, there is an article on this.

http://www.do-online.org/TheDO/?p=86631

A few lessons to learn from the article:

But Amanda J. Hersh, OMS III, who describes herself as “very heavily tattooed,” didn’t let the naysayers squelch her dream of becoming a physician. She not only was accepted into her first-choice med school, the Rocky Vista University College of Osteopathic Medicine (RVUCOM) in Parker, Colo., but also is in the top 10% of her class and has been voted Student DO of the Year by students and faculty.

“During my interviews and when I first started at Rocky Vista, I covered up my tattoos because I thought there would be a stigma,” says Hersh, a Colorado native. “Then I thought, let’s throw caution to the wind and just be myself. I have never had any negative feedback on the campus. This is part of who I am.”

1) She was smart enough to hide it to get accepted. That reflects good judgment.

2) Her first choice school was Rocky Vista Osteopathic med school. Now, I'm sure you're aware of Rocky Vista's outstanding reputation, but I'll be honest, this is the first time I've ever heard of it. Hmm....it's only 8 hours away from me and I still haven't heard of it. Looks like their first graduating class was....this year. Interesting.

You make your bed, then you lie in it. It seems to me it's hard enough to get into med school, residency, and a good job without throwing up completely unnecessary obstacles. But if it's worth it to you, well, knock yourself out. I did things that were a lot harder than hiding a tattoo (heck, removing a tattoo) to get into medical school.

 

[NontradCA]

A few lessons to learn from the article:



1) She was smart enough to hide it to get accepted. That reflects good judgment.

2) Her first choice school was Rocky Vista Osteopathic med school. Now, I'm sure you're aware of Rocky Vista's outstanding reputation, but I'll be honest, this is the first time I've ever heard of it. Hmm....it's only 8 hours away from me and I still haven't heard of it. Looks like their first graduating class was....this year. Interesting.

You make your bed, then you lie in it. It seems to me it's hard enough to get into med school, residency, and a good job without throwing up completely unnecessary obstacles. But if it's worth it to you, well, knock yourself out. I did things that were a lot harder than hiding a tattoo (heck, removing a tattoo) to get into medical school.

What I got from the article is that these people (student and physician) altered their appearance to fit their self interest. The student felt she would take the hit eventually. I'm more interested in how it really effects patient outcomes. Maybe some of you can pitch in on that. Like I said, patients will also judge on other characteristics as well. I wonder why that physician does wear a Bowtie? I have some theories. He speaks about complaints but what's the disposition of the patient?

 

[vistaril]

That's so arbitrary.

so is needing to wear clothing to cover up your private parts and not your elbow.......the point is that some things are acceptable and some arent. A small tattoo on the inside of ones ankle or even on the inside of ones wrist(if very small and something like letters) is different than a tattoo on ones neck or face......in much the same way that a ring in someones ear is different than a ring in someones lip.

 

[deleted109597]

So, Rocky Vista isn't what I would call the best school out there. I'm sure there are worse, but it has a reputation for being a diploma mill that farms all their students out for clinicals.

Even so, the fact that she's in a picture with the tat showing doesn't mean much.
Even people with tattoos know that there are places to show them and places not to. Just like coloring your hair magenta or whatever.

"One physician remarked, ‘You have way too many tattoos. It makes you look stupid,' " Hersh recalls.

My son went to see a DO PM&R Specialist who appeared behind the reception desk dressed in scrubs with tattoos showing down his arms, as my son was checking in. My son was appalled, telling the doc that he didn't look at all professional, cancelled his appointment and walked out of the office.

You know what I did to express myself before medical school? I protested against the Vietnam War and marched on Washington for equal rights for blacks (I am an old white fart). And what does your generation do? Get "tats" customize your iphones and pierce your labias. Give me a break.
Go ahead and whine. It won't do a goddaman thing. I won't hire you and I won't refer to you if I see something I and my patients see as unprofessional.

Not everyone has to be an individual snowflake.

 

[JacobMcCandles]

What I got from the article is that these people (student and physician) altered their appearance to fit their self interest. The student felt she would take the hit eventually. I'm more interested in how it really effects patient outcomes. Maybe some of you can pitch in on that. Like I said, patients will also judge on other characteristics as well. I wonder why that physician does wear a Bowtie? I have some theories. He speaks about complaints but what's the disposition of the patient?

As far as actual patient outcomes, your practice of medicine is going to be the predictor of that (and assuming he trusts you and listens to your advice). As far as how patients perceive you (this could also reflect in your Press Ganey scores), that's going to bode on your interaction with them. A lot of the interaction is based on the first impression. If you polled the entire nation on whether they got a positive or negative first impression from somebody with a visible neck tattoo, I'd feel confident in saying the majority would view that as a negative.

 

[NontradCA]

As far as actual patient outcomes, your practice of medicine is going to be the predictor of that (and assuming he trusts you and listens to your advice). As far as how patients perceive you (this could also reflect in your Press Ganey scores), that's going to bode on your interaction with them. A lot of the interaction is based on the first impression. If you polled the entire nation on whether they got a positive or negative first impression from somebody with a visible neck tattoo, I'd feel confident in saying the majority would view that as a negative.

That'd be a useless poll. It would be better if the patient actually had a physician with a tattoo and then poll them; and even then not "first impression" but first visit to see said physician. I'm betting if you asked people how they viewed their first impression of black people it would be negative.

 

[Tiger26]

What I got from the article is that these people (student and physician) altered their appearance to fit their self interest. The student felt she would take the hit eventually. I'm more interested in how it really effects patient outcomes. Maybe some of you can pitch in on that. Like I said, patients will also judge on other characteristics as well. I wonder why that physician does wear a Bowtie? I have some theories. He speaks about complaints but what's the disposition of the patient?

The secret to modern medicine is that it doesn't really matter how good you are, how much knowledge you know, how well you can perform a procedure, but instead how much others like you.

People generally don't get sued because they're bad doctors--they get sued because of a bad outcome (real or imagined, preventable or unpreventable, unrelated to care or not) + a bad interaction between the patient and doctor.

Issues with communication, empathy, arrogance, friendliness, etc will be the reason you get or don't get complaints in your career, lawsuits, bad patient satisfaction scores, etc . . .

The dirty little secret is that what we do only really matters for a small percentage of the patients who seek our care. The rest will either get better, stay the same, or die regardless of what we do or don't do medically.

 

[NontradCA]

The secret to modern medicine is that it doesn't really matter how good you are, how much knowledge you know, how well you can perform a procedure, but instead how much others like you.

People generally don't get sued because they're bad doctors--they get sued because of a bad outcome (real or imagined, preventable or unpreventable, unrelated to care or not) + a bad interaction between the patient and doctor.

Issues with communication, empathy, arrogance, friendliness, etc will be the reason you get or don't get complaints in your career, lawsuits, bad patient satisfaction scores, etc . . .

The dirty little secret is that what we do only really matters for a small percentage of the patients who seek our care. The rest will either get better, stay the same, or die regardless of what we do or don't do medically.

So...self interest then. You can't make that statement and then say its best for the patient. In relating that to tattoos I don't see what the issue is if that person communicates well with others. I'm not trying to argue with you all, it is what it is. Was just trying to find out what it is. Thanks for the discussion.

 

[JacobMcCandles]

You've gotten several honest and straightforward answers albeit not the answers you were (most likely) hoping for. Being conservative or liberal has nothing to do with your question. It's strictly professionalism. A neck tattoo isn't usually something that is thought of as professional. Granted, EM is probably one of the least professional appearance specialties, but being groomed, clean, and relatively free from an obvious lack of judgement deficits will still be required from you by your employers. You can still make it work but it's going to require effort you wouldn't have had to put in otherwise.

 

[DB2013EM]

Agree with everything.

General rule I give to friends and give to myself....

"Don't expect everyone to be non-judgmental. "

 

[Tiger26]

So...self interest then. You can't make that statement and then say its best for the patient. In relating that to tattoos I don't see what the issue is if that person communicates well with others. I'm not trying to argue with you all, it is what it is. Was just trying to find out what it is. Thanks for the discussion.

No, I'm just saying that probably 98% of our patients are in some pre-destined pattern with fate in which their course has already been set no matter what we do or don't do. In the other 2%, our skillset can tip their disease processes down one track or another.

People are judged to be good doctors based on outcomes that are frequently not clinically based: patients per hour, Press Gainey scores (patient satisfaction), number of complaints, relationships with ancillary and professional staff, other survey evaluations.

When you have a neck tattoo (or any other deviation from the norm--i.e. someone who minimizes everything, someone who's arrogant, someone who smells like body odor, someone with pizza on their scrubs, etc), those markers tend to reflect negatively and you're seen as a bad physician, even if you're excellent clinically.

 

[NontradCA]

No, I'm just saying that probably 98% of our patients are in some pre-destined pattern with fate in which their course has already been set no matter what we do or don't do. In the other 2%, our skillset can tip their disease processes down one track or another.

People are judged to be good doctors based on outcomes that are frequently not clinically based: patients per hour, Press Gainey scores (patient satisfaction), number of complaints, relationships with ancillary and professional staff, other survey evaluations.

When you have a neck tattoo (or any other deviation from the norm--i.e. someone who minimizes everything, someone who's arrogant, someone who smells like body odor, someone with pizza on their scrubs, etc), those markers tend to reflect negatively and you're seen as a bad physician, even if you're excellent clinically.

Well in that case, I guess my boyish good looks and charm will serve me well. 😎

 

[Anonymous M4]

Why they be trippin'?.. Oh wait, common sense..

While your command of Ebonics is impressive, your post demonstrates exactly why (many) black people hate (the kind of) white people (who try to use cultural appropriation and mocking to humorous ends). To your point though, "Common sense" that visible tattoos are inappropriate is a modern Eurocentric principle. Ask a Maori.

Anyway I don't think a lot of people realize how offensive posts like this are *drops Afro pick and exits*

 

[NontradCA]

While your command of Ebonics is impressive, your post demonstrates exactly why (many) black people hate (the kind of) white people (who try to use cultural appropriation and mocking to humorous ends). To your point though, "Common sense" that visible tattoos are inappropriate is a modern Eurocentric principle. Ask a Maori.

Anyway I don't think a lot of people realize how offensive posts like this are *drops Afro pick and exits*

You shouldn't bring the tattoo into that, as he will fall back on the tattoo argument rather than address his very inappropriate-doesn't know it's racist-and trying to be witty-yet failed comment. But, I see this thread is going nowhere fast (wasn't my intention). Thanks Obama.

 

[Anonymous M4]

Enh it was more for my own benefit than really trying to educate... You know black people, always hypersensitive lol

 

[NontradCA]

Enh it was more for my own benefit than really trying to educate... You know black people, always hypersensitive lol

Tsk tsk. Well on the bright side people don't judge on skin color anymore, or anything merit based ;just tattoos. Just make sure you wear a Bowtie.

 

[Siggy]

so is needing to wear clothing to cover up your private parts and not your elbow.......the point is that some things are acceptable and some arent. A small tattoo on the inside of ones ankle or even on the inside of ones wrist(if very small and something like letters) is different than a tattoo on ones neck or face......in much the same way that a ring in someones ear is different than a ring in someones lip.

To be fair, neck tattoos fall into the "I actually cost taxes... you know, with the prison and all."

 

[The White Coat Investor]

Tsk tsk. Well on the bright side people don't judge on skin color anymore, or anything merit based ;just tattoos. Just make sure you wear a Bowtie.

It's not some tat discrimination thing. I'd feel the same way about a facial piercing, 20 ear piercings, a mohawk, pink hair etc. Every year I see the nurses dress up for Halloween and I think, I should dress up. Then I realize I would have a very hard time explaining to some parents that I did everything I could to save their drowned 3 year old while wearing a Dr. Seuss hat or some other costume. So I come to work on Halloween wearing the same old clean blue scrubs, nametag, and a stethoscope. Judgment. Professionalism. Kind of important.

It's not like I can't run a darn good code while wearing a Dr. Seuss hat. It wouldn't affect the patient outcome one bit. But it still isn't the right thing to do.

 

[EctopicFetus]

Patient outcomes have no correlation with tattoos. However, if the CEO of the system I worked for came down and met you and saw the "187" tattoo on your neck it probably wouldn't reflect well on you, me for hiring you, or our group.

That's the rub. Those c-level dudes they re-up the contracts. We want them on your side. Outwardly they are conservative old white guys and therefore it would make me uneasy.

On another note in residency we had an Ed pharmacist and the guy was one of the most brilliant guys I EVER met. He was tattooed from the neck down. I didn't think less of him cause he was amazing.

It's not just the patients. It's the real bosses who matter. The guys who decide who work in the Ed and I'm not talking about the medical directors.