- Joined
- Oct 19, 2007
- Messages
- 1,721
- Reaction score
- 47
The last week has been extremely discouraging. I am now convinced that large tertiary care centers with multidisciplinary teams are detrimental to patient care. The fragmentation of medicine into specialties and subspecialty services that have fantastic tunnel visions, ginormous egos and megalomaniac level self-masturbation is the standard.
When you have an IM team that is managing a patient and they need help from multiple specialties who refuse to acknowledge the veracity or legitimacy of each others claims, the patient is suffering.
When you have attending who pass things on to residents who then spew it at each other, you have a 2 way game of telephone that has 0 science involved and 100% egotistical self suckage. Confidence may be a necessary trait in a doctor but its actually detrimental when you don't know what you're talking about and continue to do it anyway, from your bottom orifice.
If a patient needs an excisional biopsy to properly guide diagnosis and tx for a cutaneous t cell lymphoma you don't argue with the pathologist telling you that this is what would give him adequate sampling to do flow. You don't google papers regarding core needle biopsy sensitivity in this type of lymphoma and tell IM to piss off and ignore path and heme oncs recs. You don't drag on with this wishy washy bull**** for 2 weeks while this patient suffers and develops TEN from his lymphoma which we can't treat because we font have path. What a ****ing joke.
If you are MICU you don't refuse a TEN, septic, lymphoma patient because he isn't unstable and desating YET. Why is modern medicine (in practice) all about treating things once they become completely FUBAR as opposed to actually taking proactive steps to prevent them. Sure you can write upgrade to progressive care and pat yourself on the back for all the good it will do.
Thank god I am not an IM resident and am off service. This isn't aimed at MICu or surgery specifically but at all services who play this stupid ****ing game day after day and call it good medical care. Pathetic.
When you have an IM team that is managing a patient and they need help from multiple specialties who refuse to acknowledge the veracity or legitimacy of each others claims, the patient is suffering.
When you have attending who pass things on to residents who then spew it at each other, you have a 2 way game of telephone that has 0 science involved and 100% egotistical self suckage. Confidence may be a necessary trait in a doctor but its actually detrimental when you don't know what you're talking about and continue to do it anyway, from your bottom orifice.
If a patient needs an excisional biopsy to properly guide diagnosis and tx for a cutaneous t cell lymphoma you don't argue with the pathologist telling you that this is what would give him adequate sampling to do flow. You don't google papers regarding core needle biopsy sensitivity in this type of lymphoma and tell IM to piss off and ignore path and heme oncs recs. You don't drag on with this wishy washy bull**** for 2 weeks while this patient suffers and develops TEN from his lymphoma which we can't treat because we font have path. What a ****ing joke.
If you are MICU you don't refuse a TEN, septic, lymphoma patient because he isn't unstable and desating YET. Why is modern medicine (in practice) all about treating things once they become completely FUBAR as opposed to actually taking proactive steps to prevent them. Sure you can write upgrade to progressive care and pat yourself on the back for all the good it will do.
Thank god I am not an IM resident and am off service. This isn't aimed at MICu or surgery specifically but at all services who play this stupid ****ing game day after day and call it good medical care. Pathetic.
Last edited: