Most useful physician during the apocalypse?

[Matthew9Thirtyfive]

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....yes. Obviously. 😛 My initial goal with med was to do ID so I shadowed the hell out of ID docs.

Someone posted on here the other day saying that neurosurgery was a fellowship of general surgery, so you never know.

They are still most comfortable with the specialization, as opposed to someone in IM who does more all encompassing roles or does more actual procedural medicine.

I've seen plenty of subspecialists who practice a mix of their specialty and general medicine. Even if you just practice ID, I doubt you'd forget so much that you couldn't competently practice general medicine for the majority of what's going to be seen.

Personally, I think an EM doc with a toxicology or wilderness medicine fellowship would be the most helpful.

My point was if you want the researchy/knowledgable ID dude, just get a scientist.

Yeah but they're not useful outside the lab. An ID doc can still treat basic stuff and could probably fumble their way through basic procedures in a pinch. A scientist isn't doing any of that.

 

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EM doctors will provide the only real benefit. Chronic conditions will be a first world problem, that will no longer exist.

IME, EM docs often don't know a LOT of things though- they don't have good breadth.

Still think an excellent GP might be best bet overall.

 

[Matthew9Thirtyfive]

IME, EM docs often don't know a LOT of things though- they don't have good breadth.

Still think an excellent GP might be best bet overall.

An internship training GP is better than a board certified EM doc? Are you high?

 

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Someone posted on here the other day saying that neurosurgery was a fellowship of general surgery, so you never know.



I've seen plenty of subspecialists who practice a mix of their specialty and general medicine. Even if you just practice ID, I doubt you'd forget so much that you couldn't competently practice general medicine for the majority of what's going to be seen.

Personally, I think an EM doc with a toxicology or wilderness medicine fellowship would be the most helpful.



Yeah but they're not useful outside the lab. An ID doc can still treat basic stuff and could probably fumble their way through basic procedures in a pinch. A scientist isn't doing any of that.

EM with wilderness maybe yeah. Wish people with better understanding of most needed procedures would chime in. 😛

I think you'd want not a super specialized person because you want someone who knows how to do XYZ things very well, quickly, and deeply enough that they can forgo using hospital equiptment/environment. And doubt that subspecialists are gonna do that well.

Scientists are definitely useful in the field. 😛 Get a field ID scientist you will be golden.

Their role isn't to be the doctor anyway. You get a doctor and ALSO a scientist. 😛 I guarantee the scientist will be a better scientist than the physician, esp an EM doc.

 

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An internship training GP is better than a board certified EM doc? Are you high?

Sigh.

I'm thinking like this: you will run into MANY problems besides just emergencies and trauma in the end of times. You will need someone, ideally, who could be the jack of all trades.

Again, I think it would be impossible to pick well and that a small team of physicians would be best.

 

[Med Ed]

What specialty of physician would you pick if you could only have one in your zombie/[insert your fav apocalypse] survivor community?

Dentist.

 

[libertyyne]

Sigh.

I'm thinking like this: you will run into MANY problems besides just emergencies and trauma in the end of times. You will need someone, ideally, who could be the jack of all trades.

Again, I think it would be impossible to pick well and that a small team of physicians would be best.

A majority of medical need will be small trauma, setting bones, rudimentary amputations, ABX, emergent c-sections, dehydration, malnutrition . GPs would not really be comfortable with a lot of that off the bat, that's not to say they couldn't do that after a few years. EM is all you need to keep someone alive till they either recover or die due to their underlying condition. Managing diabetes, or prescribing statins will not be a priority untill there is stability again. Imho.

 

[Matthew9Thirtyfive]

EM with wilderness maybe yeah. Wish people with better understanding of most needed procedures would chime in. 😛

I'm not sure anyone has been in a zombie apocalypse here, but even the CDC has speculated about it lol. Regardless, you'll need someone to treat a variety of traumas (GSW/penetrating trauma from fighting over food or in zombie fights, orthopedic injuries, bite wounds, etc), infectious GI stuff from utilities going down (no running water, electricity, etc means sanitation will go down, food safety will decline, etc), as well as the general stuff that regularly hits people.

I think you'd want not a super specialized person because you want someone who knows how to do XYZ things very well, quickly, and deeply enough that they can forgo using hospital equiptment/environment. And doubt that subspecialists are gonna do that well.

Yeah, my point was just that in a pinch, an ID doc can still practice general medicine.

Scientists are definitely useful in the field. 😛 Get a field ID scientist you will be golden.

Their role isn't to be the doctor anyway. You get a doctor and ALSO a scientist. 😛 I guarantee the scientist will be a better scientist than the physician, esp an EM doc.

I'd rather keep them locked up in the CDC so they can find a vaccine and/or cure.

 

[Matthew9Thirtyfive]

Sigh.

I'm thinking like this: you will run into MANY problems besides just emergencies and trauma in the end of times. You will need someone, ideally, who could be the jack of all trades.

Again, I think it would be impossible to pick well and that a small team of physicians would be best.

Do you have any experience with EM? Much of what they treat is primary care stuff. They specialize in emergency medicine, but there is not an EM doc in this country who is not comfortable treating the majority of the bread and butter acute complaints of general medicine.

An internship-trained GP might be able to treat the common horses that waltz into an urgent care clinic or something, but they are not going to be comfortable doing emergency sections, appies, complex lac repairs, fluid resuscitation, anything that requires ATLS or possibly even ACLS, etc.

In the apocalypse, almost every complaint is going to be acute for a while. Once things calm down and people start having chronic problems again, you might want an internist. So maybe the double boarded EM/IM guy is your best bet. But if I had to pick one specialty, I'd still pick EM. You have to make it past the acute stage to get to the chronic stage, and I'd rather have an EM doc or a trauma surgeon handling that than an IM or GP.

 

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Do you have any experience with EM? Much of what they treat is primary care stuff. They specialize in emergency medicine, but there is not an EM doc in this country who is not comfortable treating the majority of the bread and butter acute complaints of general medicine.

An internship-trained GP might be able to treat the common horses that waltz into an urgent care clinic or something, but they are not going to be comfortable doing emergency sections, appies, complex lac repairs, fluid resuscitation, anything that requires ATLS or possibly even ACLS, etc.

In the apocalypse, almost every complaint is going to be acute for a while. Once things calm down and people start having chronic problems again, you might want an internist. So maybe the double boarded EM/IM guy is your best bet. But if I had to pick one specialty, I'd still pick EM. You have to make it past the acute stage to get to the chronic stage, and I'd rather have an EM doc or a trauma surgeon handling that than an IM or GP.

Yeah, most of my clin vol was in a very poor, underprivileged ED. It was a lot more interesting than normal because we got actual trauma from guns/fights, awful accidents, overdoses etc.

The residents really hated EM and I got a pretty good sense of the problems in the field.

Their comfortabilities were often admittedly just what they had to do. But that was my just experience.

I think the double boarded guy might be best too.

 

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I'd rather keep them locked up in the CDC so they can find a vaccine and/or cure.

In the apoc., might be best to have a mobile scientist for awhile who is trained in the field/lab. Because communication systems may be off for awhile, so sticking together might be best. Micro lab work is surprisingly easy to do well outside the lab if you know what youre doing.

 

[Matthew9Thirtyfive]

Yeah, most of my clin vol was in a very poor, underprivileged ED. It was a lot more interesting than normal because we got actual trauma from guns/fights, awful accidents, overdoses etc.

The residents really hated EM and I got a pretty good sense of the problems in the field.

Their comfortabilities were often admittedly just what they had to do. But that was my just experience.

I think the double boarded guy might be best too.

Yeah, the majority of EM docs are not dealing with that stuff every day. Some are, most are not. Many EDs see a large portion of primary care stuff, just at 2am vice normal business hours. However, they are also able to take care of the disasters. That's why I think they'd be the best if getting a doubled boarded doc isn't an option.

Definitely want that EM/IM or even better, EM/FM (not sure if that exists).

In the apoc., might be best to have a mobile scientist for awhile who is trained in the field/lab. Because communication systems may be off for awhile, so sticking together might be best. Micro lab work is surprisingly easy to do well outside the lab if you know what youre doing.

Rock on.