- Joined
- Apr 22, 2003
- Messages
- 28
- Reaction score
- 0
I am not in internal medicine--I am a Surgical resident
Imagine yourself being called to a code. You get there on the oncology floor to find out that no one has addressed code status on a person with metastatic cancer, cachexia, and essentially no possibility to make it out of the hospital.
Or...
Imagine that you are the surgeon being consulted for placement of a port on a patient with colon cancer metastatic to both lobes of the liver. As the consultant, you start to get the feeling that this person, despite being seen by the oncologist and being admitted to his/her service, has never been told that he/she will die of her disease, or if so, that the median survival is 6 months.
I am a bit of an instigator (sp?). Actually, most of the IM people that I deal with are much better at obtaining code status than the surgeons are. However, I have found that the oncologist are absolutely the worst at establishing the nature of peoples' diseases to them. Why must the consultant for the port be the ones that "break the news" to them that the patient will die soon of their disease? Why is there a breakdown in the system for the people that should me the most atuned to this issue?
I have a few answers:
Do you know why they put nails in coffins? To keep oncologists out!
Joking aside, I think that there is a disconnect between what is done and what should be done. I depend upon the oncologists and truly respect the medicine that they practice. I am glad that they are there, as they will cure many of my patients with microscopic metastatic disease. However, in my institution, they do a rotten job of fully establishing the gravity of prognoses with the patients.
Is it money? They get paid a lot to continue chemo or XRT on patients that won't benefit significantly. I have very recently had a rad-onc doc fill me with a line indicating her magical beams would help cure local and metastatic disease.
I guess I just wonder where reality goes when one begins fellowship in onc.
Imagine yourself being called to a code. You get there on the oncology floor to find out that no one has addressed code status on a person with metastatic cancer, cachexia, and essentially no possibility to make it out of the hospital.
Or...
Imagine that you are the surgeon being consulted for placement of a port on a patient with colon cancer metastatic to both lobes of the liver. As the consultant, you start to get the feeling that this person, despite being seen by the oncologist and being admitted to his/her service, has never been told that he/she will die of her disease, or if so, that the median survival is 6 months.
I am a bit of an instigator (sp?). Actually, most of the IM people that I deal with are much better at obtaining code status than the surgeons are. However, I have found that the oncologist are absolutely the worst at establishing the nature of peoples' diseases to them. Why must the consultant for the port be the ones that "break the news" to them that the patient will die soon of their disease? Why is there a breakdown in the system for the people that should me the most atuned to this issue?
I have a few answers:
Do you know why they put nails in coffins? To keep oncologists out!
Joking aside, I think that there is a disconnect between what is done and what should be done. I depend upon the oncologists and truly respect the medicine that they practice. I am glad that they are there, as they will cure many of my patients with microscopic metastatic disease. However, in my institution, they do a rotten job of fully establishing the gravity of prognoses with the patients.
Is it money? They get paid a lot to continue chemo or XRT on patients that won't benefit significantly. I have very recently had a rad-onc doc fill me with a line indicating her magical beams would help cure local and metastatic disease.
I guess I just wonder where reality goes when one begins fellowship in onc.