Misconceptions about surgeons

[johnny_blaze]

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I don’t know about any of you but I have found that during my clinical rotations I have gotten along much better with the attending surgeons rather than the medics. Before I first started med school I was a bit intimidated by surgery because I heard that a lot of surgeons were mean to medical students and made them feel inferior . I have noticed the complete opposite. In all the surgical placements I have done I have found that the surgeons were not only friendly but also gave the best teaching. I have not had the same treatment from the physicians. I found that a lot of physicians were very arrogant and unfriendly… and some of them didn’t give me ANY teaching at all.

One cardiologist I was placed with didn’t even bother meeting us, he just stood us up and when we bleeped him he just told us that he didn’t want to meet us and that we should just learn off one of the residents. I’m currently doing paediatrics and I find that the same thing goes. I find it suppressing how some paediatricians can be so unapproachable.

All of the surgeons I’ve met were full of character and loved to joke around… I find that orthopods are by far the funniest people of all. I find it pretty bad that surgeons have such a bad wrap with the general public. I think their “arrogance” is just a misconception of confidence in their skills and abilities to make fast important decisions.

Has anyone noticed this as well or have any comments?

 

[phoenixsupra]

My experience is EXACTLY the same. I find the fleas arrogant, passive/aggressive, snotty and lazy. Surgeons I just get along fine with. They are generally competant and good humored. In general they like to call a spade, a spade and don't hide behind jargon as much as other docs.

BUT I've been looking at that issue for a while and I'm sure it comes down to an issue of character. People like their own kind. Doers vs. talkers. What's more as a surgeon your work speaks for you so it doesn't really matter if you are humorous or irreverent in the OR. The patient isn't conscious anyway. For a flea however, his talk and demeanor are the tools of his trade. If he doesn't act stogy and "doctorlike" his respect will slip away.

***disclaimer*** These are generalizations. I know of exceptions on both sides. But for me the atmosphere is the surgical world is so much more breathable. 🙂

 

[pikachu]

My experience is EXACTLY the same. I find the fleas arrogant, passive/aggressive, snotty and lazy.

Do you call medicine people arrogant, lazy, snotty, passive-aggressive fleas to their faces? Or do you just convey this in your attitude towards them? Perhaps these (mis)conceptions go some way towards explaining your bad experiences with medicine types. Obviously we all have different personalities and so we like different fields better. I just don't understand what you are trying to accomplish by bashing internists. You should respect what they do, because trust me you will be calling internists in for help on many, many surgical cases. Much the same, any internist would be stupid to disrespect surgeons. It's kind of like a colon and an anus, one needs the other to function properly (and many times, both are full of s---).

As far as the doers-vs.-talkers business, page me when you figure out how to treat diabetic ketoacidosis with a scalpel. I'll call you once I discover a medical treatment for a ruptured appendix. (See my point?)

 

[Doc 2b]

. It's kind of like a colon and an anus, one needs the other to function properly (and many times, both are full of s---).

 

[Whisker Barrel Cortex]

As a consultant who interacts with all specialties at our hospital, the most fun to interact with are the general surgeons. They generally joke around more and are usually friendly. Of course there are exceptions. Medicine people, while in the hospital, seem to be much more serious in demeanor. The funny thing is I hang out with a lot of them out of the hospital and they are not like that at all. Maybe the theory that their behavior and language is more a part of the way their patients see them is true.

 

[phoenixsupra]

I just don't understand what you are trying to accomplish by bashing internists. You should respect what they do, because trust me you will be calling internists in for help on many, many surgical cases.

A general surgeon is an internist who has completed his training. 😉 Basically general surgeons are internists who can operate. Sure, a smooth working relationship with fleas is important. It's just less pleasant. Most transplant centers are moving to using NP's instead of IM docs. Better workers, less attitude. 😉

 

[velo]

My experience has been that most surgeons are great, funny, friendly people outside of the OR. I think the stereotype comes from their personality in the OR. I was a little shocked the first time I saw a surgery and the increadably affable, easy-going surgeon I had been shadowing suddenly turned pretty curt. I had never scrubbed before so he was showing me how, and it wasn't the "try holding your hands like this" encouragment that he had given me in clinic... it was "no, what are you doing? not like that! no, wrong etc" ...similarly once we got in the OR the resident he was training wasn't getting much slack. It would never be, "try approaching that from a different angle," it was more along the lines of "no, that's wrong...not like that...do it like this, no like THIS"

Then once we got out of the OR he was nice again. I completely understand why he acts like that in the OR, he's responsible for the patient's life and can't afford to sacrifice the patient's well-being for the sake of pleasentness. I think he's a great guy, and its fantastic that he can limit the more pointed persona to the OR, but I think that's where some of the stereotype comes from.

 

[phoenixsupra]

My experience has been that most surgeons are great, funny, friendly people outside of the OR. I think the stereotype comes from their personality in the OR. I was a little shocked the first time I saw a surgery and the increadably affable, easy-going surgeon I had been shadowing suddenly turned pretty curt. I had never scrubbed before so he was showing me how, and it wasn't the "try holding your hands like this" encouragment that he had given me in clinic... it was "no, what are you doing? not like that! no, wrong etc" ...similarly once we got in the OR the resident he was training wasn't getting much slack. It would never be, "try approaching that from a different angle," it was more along the lines of "no, that's wrong...not like that...do it like this, no like THIS"

Then once we got out of the OR he was nice again. I completely understand why he acts like that in the OR, he's responsible for the patient's life and can't afford to sacrifice the patient's well-being for the sake of pleasentness. I think he's a great guy, and its fantastic that he can limit the more pointed persona to the OR, but I think that's where some of the stereotype comes from.

Ha ha. I totally agree. I've been doing craftwork all my life. The fact is that the parts of our brains that process language and the parts for three dimensional space relations are very seperate. A complex question or statement can really take your attention away from where you need it. It's the same way with car mechanics, carpentry or anything like that. Really, it's hard to concentrate on doing the job and being articulate at the same time. I understand that from my own experience so I haven't had any problems understanding what's going on in the OR and why people are acting and talking like you say. It's probably not easy to see that if you don't have any experience with craftwork.

Sure there are lots of IM docs that I like but in general I find them much stuffier than surgeons.

 

[fang]

The fact is that the parts of our brains that process language and the parts for three dimensional space relations are very seperate. A complex question or statement can really take your attention away from where you need it.

I think everyone has a different ability to "multi-task"... I get absorbed in what I'm doing if it's some manual task and can't concentrate on that plus a conversation at the same time, but I know other people who do it just fine.

 

[phoenixsupra]

I think everyone has a different ability to "multi-task"... I get absorbed in what I'm doing if it's some manual task and can't concentrate on that plus a conversation at the same time, but I know other people who do it just fine.

Yeah, that's true. Some of us multi-task better than others. And surgeons generally are fine keeping conversation going....most of the time. Until the op gets to the difficult part or something goes wrong. Then all attention goes to the task and the talking gets well a lot less complex. Knowing when to talk to a craftsman at work and when to shut up is something you learn from doing craftwork yourself.

Also, a thing I like about surgery is that you can learn it by watching and keep the talk mostly for entertainment. You can also anticipate what the surgeons going to do cuz you can see what he's doing. If you're not much of a visually oriented person you may have a hard time with the lack of spoken instructions and you may find the frustration with that to be unreasonable. I think we all fall somewhere on a spectrum between being visual learners on one end and auditory learners at the other extreme. Surgeons and IM docs, I think generally are on opposite ends of this scale. Each has the opposite learning style of the other and so both find the instruction of the other unhelpful at best.

BTW I think many of the animosities in medschool and medicine come from a profound missunderstanding of different learning styles. 😉

 

[Paws]

I have a friend who spent a few years working on a trading floor of a NY investment bank. He is the sweetest, most mild mannered guy. Very funny and down to earth. But, get him on a trading floor and he was a tiger. I think surgery is very similar. When you have millions of dollars (or more) at stake and you're on the phone to whoever, surrounded by about 500 other people at their turret phones and the stuff is flying all around you, you have to be cool under pressure and yet also able to think and act very quickly - knowing the intensity of your decisions. I loved his friends, same personality.

And today, I love the surgeons I meet. Same personality. So easy to be straight with. That harshness under pressure never really phased me or I don't take it personally. 'It's just business, nothing personal,' my friend would always say. 'Got to get the business done.'

I am going to shadow a neurosurgeon this break and I am totally looking forward to it - 👍

 

[johnny_blaze]

My experience has been that most surgeons are great, funny, friendly people outside of the OR. I think the stereotype comes from their personality in the OR. I was a little shocked the first time I saw a surgery and the increadably affable, easy-going surgeon I had been shadowing suddenly turned pretty curt. I had never scrubbed before so he was showing me how, and it wasn't the "try holding your hands like this" encouragment that he had given me in clinic... it was "no, what are you doing? not like that! no, wrong etc" ...similarly once we got in the OR the resident he was training wasn't getting much slack. It would never be, "try approaching that from a different angle," it was more along the lines of "no, that's wrong...not like that...do it like this, no like THIS"

Then once we got out of the OR he was nice again. I completely understand why he acts like that in the OR, he's responsible for the patient's life and can't afford to sacrifice the patient's well-being for the sake of pleasentness. I think he's a great guy, and its fantastic that he can limit the more pointed persona to the OR, but I think that's where some of the stereotype comes from.

I have noticed this as well but only with a few surgeons. Most of the surgeons I’ve met were quite friendly in the OR and still loved to crack jokes. I have met some with weird “rules” in the OR, I think the most common one is complete and utter pin drop silence while he/she operates. I’ve only encountered this once but it’s totally understandable, as some people need silence to concentrate. I recently did a research placement with head and neck surgeons. These guys were doing 8-10 hour long radical neck dissections with microvascular surgery (something you think would require concentration) and flap reconstruction and were making jokes all the way through it… they even got into a bit of an argument because of me*

*Btw, if you ever want to see two surgeons argue about really pointless stuff while they operate (this is quite funny to watch) ask a maxfacs and an ENT surgeon which specialty is better to pursue if you wanna be a head and neck oncologist. They will revert to the old medic vs dentistry thingy. Insults such as “snot and ear wax doctor” and “jaw breaker” will be passed around by people who are supposed to be professionals

 

[Sharn Penndroen]

A lot of what has been said here are gross generalizations, and as someone pointed out, your view may be tainted by what you like and your expectations of what they should be like. I've met both nice and rude surgeons and internists. Simply put, doctors are human. It's silly to try to place personality labels on entire groups of people based on their chosen profession. Probably the "nicest" people I've met here have been family physicians and pediatricans. But does that mean that I should assume that all of them are the nicest? No. I saw one of the surgeons I met in the hall the other day and said hey to him. He looked me right in the eyes and said nothing back and kept walking. Am I to assume that he did this because he is super arrogant and that all other surgeons are that way? No. Come one people. This attempt to blanket everyone in a given specialty breeds the kind of professional prejudice that we need to try to get away from. There are plenty of sick people for all of us to work on. A little professional respect and team work never hurt anyone...

 

[sacrament]

A general surgeon is an internist who has completed his training. 😉 Basically general surgeons are internists who can operate.

The fact that this is over-the-top arrogant wouldn't bother me so much if it was even remotely true. Surgeons trying to manage complicated medical issues without help from IM has led to a lot of patient misery in this world.

 

[phoenixsupra]

The fact that this is over-the-top arrogant wouldn't bother me so much if it was even remotely true. Surgeons trying to manage complicated medical issues without help from IM has led to a lot of patient misery in this world.

Yes, IM docs or NP's are helpful for managing electrolytes and minor stuff. That's why on services like renal transplant the renal IM team are there to give their two cents. But they can't make any orders... only recomendations. After six months the surgeons sign off the patient is transferred over to to the flea team to manage the basic stuff.

But this thread is about character, not skill or niche. And I still say the surgeons are way more fun to be around. 😉

 

[sacrament]

Yes, IM docs or NP's are helpful for managing electrolytes and minor stuff. That's why on services like renal transplant the renal IM team are there to give their two cents. But they can't make any orders... only recomendations. After six months the surgeons sign off the patient is transferred over to to the flea team to manage the basic stuff.

But this thread is about character, not skill or niche. And I still say the surgeons are way more fun to be around. 😉

Do they use more laughing smilies than the IM docs?

I'm somewhat interested in surgery as a career, but I'm not interested in participating in the ego whack-off that most surgeons like to instill in their community.

 

[fang]

Yes, IM docs or NP's are helpful for managing electrolytes and minor stuff. That's why on services like renal transplant the renal IM team are there to give their two cents. But they can't make any orders... only recomendations. After six months the surgeons sign off the patient is transferred over to to the flea team to manage the basic stuff.

riiiight. I'm guessing that you're joking, hence all the laughing heads. Even the most egotistical surgeons recognize the limits to their knowlege (if they're good), and hand things off accordingly. Of course, if it's a surgical problem and there's nothing complicated, there's no reason to consult.

Also, it's strange that you equate visual learning, spacial skills, and surgury... I've never thought of it as spacially challenging, but maybe it is when you're actually doing the work. When I hear spacial skills, I think multivariate calculus or something.

 

[phoenixsupra]

riiiight. I'm guessing that you're joking, hence all the laughing heads. Even the most egotistical surgeons recognize the limits to their knowlege (if they're good), and hand things off accordingly. Of course, if it's a surgical problem and there's nothing complicated, there's no reason to consult.

Also, it's strange that you equate visual learning, spacial skills, and surgury... I've never thought of it as spacially challenging, but maybe it is when you're actually doing the work. When I hear spacial skills, I think multivariate calculus or something.

Yes, I'm joking. I'm glad the emoticons got that across. 🙂 About the spacial skills, I think you're spot on. 😉

 

[phoenixsupra]

Do they use more laughing smilies than the IM docs?

I'm somewhat interested in surgery as a career, but I'm not interested in participating in the ego whack-off that most surgeons like to instill in their community.

Yes. more laughing smiley emoticons. Maybe. Ha ha
Glad you're interested in surgery as a career. Me too. I'm not a big fan of ego whack-off either. Try not to get focused too much on "most surgeons". You'll miss out on a lot of great ones if you do. 😉

 

[johnny_blaze]

But this thread is about character, not skill or niche. And I still say the surgeons are way more fun to be around. 😉

I detect a bit of a doc bashing trend occurring in this forum 🙁. I just want to clarify that I didn’t start this forum to bash physicians and promote surgeons. I was just stating that from the few doctors I’ve met, I find the surgeons better to be around and thus, I learn better from them as compared to physicians. I’m not making any generalizations about anyone, its just something I’ve noticed from the docs I’ve worked with, and it seems that phoenixsupra has the same feelings towards this as I do 👍

 

[phoenixsupra]

Yeah. My flea swating is very much tongue in cheek. I do respect them in general and there are MANY that I like and can learn from. But I do find the surgery atmosphere easier to take. And oddly enough I've learned more IM from Gen surgeons than from IM docs. I know that's just because of my learning style. In medschool in general we hear much more about how surgeons appear from the IM and medical scientist point of view. I'm just trying ot explain my point of view. This is less and issue of "fact" than of perspective. Pleas take my "doc bashing" with a hugh pinch of salt. That's the way I've learned to take the surgeon bashing that is everywhere in the medical world. Just so you know, I try to get along with and be respectful to everyone I work with regardless of specialty or rank. 🙂

I'm very glad to find that there are others out there who are at least thinking about this issue.

 

[Smurfette]

Interesting.

At my school, all transplant patients (even the ones years post-op) are on the transplant surgery service. Rarely on my surgery rotations was IM ever consulted--the surgeons here very much believe in taking care of all their patients medical needs while in the hospital.

 

[phoenixsupra]

Interesting.

At my school, all transplant patients (even the ones years post-op) are on the transplant surgery service. Rarely on my surgery rotations was IM ever consulted--the surgeons here very much believe in taking care of all their patients medical needs while in the hospital.

That's the way it is with Liver here. But heart and kidney have a weird situation. On RT there are two teams IM and GS. They attend all the conferences together and both round on the patients. But ALL executive control is in the hands of the surgical team untill they flip flop six months down the line. Anyway the IM and GS directors cant stand each other and bicker like school children every time they're anywhere near each other. I'm reminded of them every time this issue arises. I think they need some sort of counseling session where some sort of professional mediates while they learn to understand each others perspective.

Yeah, I beat up on fleas from time to time but it's all tongue in cheek. The fact is that these two guys I speak of are really making both their lives way tougher than they need be. I've been much struck by their spectacle and it has motivated me strongly to try and avoid a similar situation in my own career. That's how I started thinking about all this. I get along with both of those attendings BTW. 😉