Paging Etiquette

[Surg0611]

After being paged to a pager by yet another MS3 today, I am beginning to wonder if medical students are not being educated in the ways of paging etiquette before clinical rotations start.

Am I the only one who thinks this page is terribly unprofessional?

Alex #### (pager number)
Hey ____ (my first name)!!! Gotta consult for you. Pls call. thanks!!!


No I can't call you, because you have given me none of the information I need to do so.

Some helpful paging guidelines:
1. Always leave your first AND last name, followed by MS3 or MS4.

2. NEVER page someone to a pager. It is just flat out rude and disrespectful. Give a correct number to call back and STAY THERE for at least 5 minutes. Unless you are attending, it is never acceptable to page to a pager.

3. The greeting is superfluous but if you use it, please give the recipient the respect they deserve by addressing them appropriately as Dr. the first time you are interatcting with them. This may be overly old-school, but I would suggest erring on the side of formality. Again, this comes back to professionalism. Using the first name of a resident or attending when you do not know or ever met them is fairly presumptuous.

4. Don't use exclamation points. You aren't a 14 year old girl texting her BFF. Act like a medical professional.

5. Briefly, give the information the recipient needs. For example, the patient's name, room number or MR#, what the consult is for, why you are paging.

6. Leave your pager number at the end of the page, so that the recipient can get in touch with you later if they can't call back right away.

7. Lastly, please make sure you are paging the correct person. This is especially true during off-hours. It is a little annoying to be paged at 2:30 AM and discover the page should be going to someone else.

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[Deferoxamine]

Sorry, we dumb ass third-year med students had no idea that you were so perfect back when you were a student.

 

[Surg0611]

A) Never said I was perfect as an MS3. No one is, we all make mistakes

B) Just wait until you are a resident and realize how truly annoying it is to be paged to a pager, paged to a number that doesn't exist, paged to a number then put on hold for 5 minutes while they track down who paged you, paged about patients you aren't following, etc, etc, etc.

C) I was just trying to help medical student avoid getting yelled by residents.

 

[ShyRem]

My answer may be tainted by being a non-trad, but I agree with the basic respectful nature of paging someone. You don't page someone to a pager - that's a sure way of getting into a game of phone tag. However, I didn't know about sending so much information in a page about a consult. I'd give the room #/bed# and cc/reason for consult. So if they were beyond 5-15 min for returning the page (as a third year I waited at least 20 minutes by the phone), they at least knew what chart to pull. And I made sure to make a note in the chart regarding the consult/page and pertinent information. And if the resident didn't call me back I made it a point to discuss with the patient's nurse that I had paged a consult.

But then again, I call folks ma'am and sir unless I know them very well. I must be very old-school.

 

[illegallysmooth]

I can't believe you got that ridiculous page from a medical student. I'm a unit secretary in an ED and wouldn't dream of contacting a physician in that manner.

 

[Deferoxamine]

A) Never said I was perfect as an MS3. No one is, we all make mistakes

B) Just wait until you are a resident and realize how truly annoying it is to be paged to a pager, paged to a number that doesn't exist, paged to a number then put on hold for 5 minutes while they track down who paged you, paged about patients you aren't following, etc, etc, etc.

C) I was just trying to help medical student avoid getting yelled by residents.

Understood.

However, I ALSO hate being yelled at by a fellow on the phone that I paged for a consult (to a telephone) for making 1 mistake on a 2-minute phone call (pausing for 3 seconds to look up one of the ~15 lab values he wanted on my patient), where I handled myself very diplomatically (I had a prior job before medical school with lots of time on the phone and face-to-face with patients), where as a MS3 I was in fact doing something very helpful in the care of my patient (my resident was very thankful).

Sorry, not pointing a finger at YOU, per se, but I absolutely can't stand residents and fellows who look down on anything a MS3 does, even when MS3 does it VERY well. And it really makes me wonder how THEY performed as an MS3 when their own social skills still fail miserably on the phone or in person a good 5 years later. Etiquette is a two-way street.

 

[ANCAdoc]

Etiquette is a two-way street. The above posts by the residents are good rules to follow. I agree with Def that students can get roasted sometimes. Many reasons, some residents/fellows want clear, concise descriptions of the hospital course (which is sometimes difficult for students), others want you to do their work for them history-taking wise and so probe you with a ton of questions, and others just want a name, record number, room number, and reason for consult.

In the private world, the latter is the way it works. When I call a consult at our private hospital I generally tell the office secretary for the consulting physician the barebones info and they run with it. If I need to give the doc more info for a complete perspective, I page him directly afterward.

If as a student you think a fellow/resident is being particularly rude to you over the phone (some don't like students paging) then speak up to your attending. At our school, the admin will take it seriously.

 

[juiceman311]

Hahahaha.

So long as you're not an attending (or fellow), you are getting called by your first name. You are 12 months ahead of me in medical training, you are being called John unless you are douchey enough to correct me with "I prefer Dr. Dbag" so that everyone now officially knows you're a dbag. Do you really care about being called doctor, does it make you feel good about yourself?

Residents who were never medical students are my favorite. The only worthwhile piece of advice here was to not page to a pager, which is common sense.

 

[Droopy Snoopy]

Hahahaha.
You are 12 months ahead of me in medical training, you are being called John unless you are douchey enough to correct me with "I prefer Dr. Dbag" so that everyone now officially knows you're a dbag.

I can understand this sentiment to a degree, but don't you think it's just general courtesy? I don't call anybody by their first name unless they either invite me to or we've done kegstands together. You're Ms. ___, Professor ___, Dr. ___, just how my mama raised me.

Once you've graduated intern year you feel like you've earned the right to at least f-ing be called doctor. Those 12 months are unlike any you've ever experienced I promise you. And in general if you're calling a consult you'll be talking to a more senior resident or fellow, so the whole '12-months-ahead-of-me' doesn't really apply anyway. Calling your cards fellow Joe is a good way to get your consult done after Labor Day.

 

[Jolie South]

Sometimes, I don't know wtf people are thinking. I may not know nuanced stuff about management or have the most extensive ddx ever, but I'm damned sure going to control what I can and that means acting and looking the part.

I mean "professionalism" isn't hard. Call people Dr. X until told otherwise. Show up on time. Look the part. Communicate in a respectful, diplomatic tone. Understand that the favor you're asking isn't always the other person's #1 priority.

As far as the rest goes, we're students and do make mistakes. I didn't realize that the originating number didn't automatically show up with the page when it's a text until now. While it is important for us to know these things, not all of us will know until we do it wrong once.

 

[bigDinLV]

Hahahaha.

So long as you're not an attending (or fellow), you are getting called by your first name. You are 12 months ahead of me in medical training, you are being called John unless you are douchey enough to correct me with "I prefer Dr. Dbag" so that everyone now officially knows you're a dbag. Do you really care about being called doctor, does it make you feel good about yourself?

Residents who were never medical students are my favorite. The only worthwhile piece of advice here was to not page to a pager, which is common sense.

And being such a cool guy that you don't even have to recognize someone by their title, only their first name, could make you an equal dbag.

 

[RxnMan]

My answer may be tainted by being a non-trad, but I agree with the basic respectful nature of paging someone. You don't page someone to a pager - that's a sure way of getting into a game of phone tag. However, I didn't know about sending so much information in a page about a consult. I'd give the room #/bed# and cc/reason for consult. So if they were beyond 5-15 min for returning the page (as a third year I waited at least 20 minutes by the phone), they at least knew what chart to pull. And I made sure to make a note in the chart regarding the consult/page and pertinent information. And if the resident didn't call me back I made it a point to discuss with the patient's nurse that I had paged a consult.

But then again, I call folks ma'am and sir unless I know them very well. I must be very old-school.

Huh. It must be the cro-magnon type pager system we have, but we are only able to send phone numbers. It was nice when the resident was willing to use text messaging. Then we could add in things like my name, c/c or reason for consult + PMHx, phone numbers, etc.

It never occurred to me to page to pager, though.

 

[christina30]

I can't believe you got that ridiculous page from a medical student. I'm a unit secretary in an ED and wouldn't dream of contacting a physician in that manner.

from a fellow ED unit clerk - always kept it professional, even when I started out in the ED as a 19 year old fool.

 

[cpants]

And being such a cool guy that you don't even have to recognize someone by their title, only their first name, could make you an equal dbag.

I have never been on a team or heard of a team where the med students were expected to call the residents Dr. ____ . Using the title just is not the default in the med student resident relationship. I have seen medical students call the resident "Doctor" and it comes off way douchey and ass-kissy.

 

[SouthernSurgeon]

I have never been on a team or heard of a team where the med students were expected to call the residents Dr. ____ . Using the title just is not the default in the med student resident relationship. I have seen medical students call the resident "Doctor" and it comes off way douchey and ass-kissy.

Agree. At my hospital any resident who expected the students to call him/her by Dr. _______ would be immediately labelled a d-bag. Though I definitely wouldn't send a page like that to a resident I didn't already know...

Also to the OP: You lament that the M3s haven't been taught this and have time to write out a 7 item list about paging etiquette. Take the initiative and either:
(1) Take a moment and teach this student about paging etiquette when you do the consult
or better yet
(2) Turn your list into a slightly more professional one and talk to the med student clerkship director - see if it could be given to students when they start their rotations so that they WOULD know how to page someone.

 

[Surg0611]

Agree. At my hospital any resident who expected the students to call him/her by Dr. _______ would be immediately labelled a d-bag. Though I definitely wouldn't send a page like that to a resident I didn't already know...

Also to the OP: You lament that the M3s haven't been taught this and have time to write out a 7 item list about paging etiquette. Take the initiative and either:
(1) Take a moment and teach this student about paging etiquette when you do the consult
or better yet
(2) Turn your list into a slightly more professional one and talk to the med student clerkship director - see if it could be given to students when they start their rotations so that they WOULD know how to page someone.

I would never expect a medical student to call me Dr. all the time ... I tell the students on my service or on call with me to call me by my first name. I don't however agree that it is okay for medical students to call residents by their first name when they don't know you or have ever met you. IMO, it's disrespectful and unprofessional on the medical students' part. They don't know if they are paging an intern or a PGY7 chief.

Believe me, I have done both of your suggestions above ... yet this still happens multiple times a week.

 

[bigDinLV]

I have never been on a team or heard of a team where the med students were expected to call the residents Dr. ____ . Using the title just is not the default in the med student resident relationship. I have seen medical students call the resident "Doctor" and it comes off way douchey and ass-kissy.

I'd say the default should actually be for a med student to call a resident Dr. X, until told otherwise. If a student walked up to me on the first day and said hey "D" whats going on? I'd be like who the hell are you? I tell students to call me by my frist name after I meet them.

Even resident to resident, I will call them Dr. X unless I consider myself "friends" with them, it varies from service to service though. At our hospital some of the students still call me Dr. X despite the fact I have told them to call me by my first name. I guess different programs vary just like different rotations.

 

[45408]

4. Do not put a resident/attending on hold when you are a med student. Even if that means paging 1 at a time and waiting for a call back. I've had a MS-4 doing a sub-I in the ER page me for a consult and then put me on hold. I made a point to come down and talk to his resident about it.

Really? You do realize that a sub-I might have just as much work to do as you do, right?

 

[FutureInternist]

I'd say the default should actually be for a med student to call a resident Dr. X, until told otherwise. If a student walked up to me on the first day and said hey "D" whats going on? I'd be like who the hell are you? I tell students to call me by my frist name after I meet them.

Even resident to resident, I will call them Dr. X unless I consider myself "friends" with them, it varies from service to service though. At our hospital some of the students still call me Dr. X despite the fact I have told them to call me by my first name. I guess different programs vary just like different rotations.

And always Dr. X in front of patients & nurses...partly because they hardly know our first names as it is

 

[NYRN]

It surprises me how in this day and age people have no idea what constitutes professional behavior. Even though some of the attendings/residents are my close friends, I NEVER call them by their first names in front of patients.

Keep in mind too, that in many hospitals, pages are recorded by some system, especially if you use alpha paging through a computer. If they decided to audit the pages, they could see whatever you are writing. I know my hospital does record them because there have been disputes about whether the MD was in fact paged or if they actually weren't.

 

[cpants]

I'd say the default should actually be for a med student to call a resident Dr. X, until told otherwise. If a student walked up to me on the first day and said hey "D" whats going on? I'd be like who the hell are you? I tell students to call me by my frist name after I meet them.

Even resident to resident, I will call them Dr. X unless I consider myself "friends" with them, it varies from service to service though. At our hospital some of the students still call me Dr. X despite the fact I have told them to call me by my first name. I guess different programs vary just like different rotations.

Obviously it would be rude to walk up and say "Yo D what's going on?". It usually goes something like "Excuse me, are you the resident for team A? My name is Cpants and I'm the 3rd year med student for your team." Then you say, "Oh hi, I'm D." We go from there.

 

[cpants]

And always Dr. X in front of patients & nurses...partly because they hardly know our first names as it is

Always "Doctor" in front of patients. In front of nurses, who cares?

 

[45408]

Yes, I do. The hiearchy exists for a reason. i have as much or more work than my attending, but I wouldn't dare put them on hold when I page them. It's an understanding of the way things work.

How exactly were you improving patient care or helping a student's education by telling on him to his resident? For all you know, his attending walked into the room right when you called, so the hierarchy superseded you.

 

[smq123]

After being paged to a pager by yet another MS3 today, I am beginning to wonder if medical students are not being educated in the ways of paging etiquette before clinical rotations start.

You know what? They probably aren't!

At our MS3 orientation, we were given lectures with chirpy titles like "How to avoid burnout!" "Dealing with dying patients" and "Delivering bad news."

Then they released out onto the wards without telling us how the d*mn paging system even WORKED.

To be honest, some of the blame may lay on the residents. The first time I called in a consult was after my intern said, "Hey, call GI for a consult." That was it. I'd never really heard anyone call in a consult before, I'd never been told how to do it, and so it was probably little wonder that it was a crappy, terrible consult request. It would have been nice if my intern had coached me on how to call in a consult first, but, well....<shrug>.

Agree. At my hospital any resident who expected the students to call him/her by Dr. _______ would be immediately labelled a d-bag.

True, but I have definitely seen some med students who confuse sending a text page and texting a friend on a cell phone. While you might text your roommate like that ("Hey, Mike!!! I got some beer!!! Come over!!!), under no circumstances should you text someone like that at work.

 

[Jolie South]

True, but I have definitely seen some med students who confuse sending a text page and texting a friend on a cell phone. While you might text your roommate like that ("Hey, Mike!!! I got some beer!!! Come over!!!), under no circumstances should you text someone like that at work.

I always err on the side of being too formal. It never hurts to call a resident "Dr. X." I've also never had a resident insist on me calling them "Dr. X." Usually, they'll introduce themselves as "firstname," but I don't go there if they haven't.

 

[MattD]

I occasionally page my residents to the local strip club. Is this unprofessional? Cuz it sure is funny.

 

[Surg0611]

How exactly were you improving patient care or helping a student's education by telling on him to his resident? For all you know, his attending walked into the room right when you called, so the hierarchy superseded you.

Because a student that puts a consultant on hold obviously needs education in how the medicine hierarchy works and the best person to do that is the resident overseeing him/her. I'm sorry but even if you are the hardest working sub-i on earth, the resident's time is still more valuable than yours.

And because arrogant MS3's turn into arrogant MS4s that turn into arrogant residents who future medical students will hate.

 

[footcloud]

I think you misunderstood their question. What if the student was on the phone with the RESIDENT and then a CONSULTANT walks into the room and starts talking to the student? Should the student go "Mr. Consultant, you have to wait, I'm talking to a resident right now"? They'll have to put someone on hold, right? I suppose the urgency of the situation obviously, but most people generally don't talk to people who are obviously speaking on a phone if what they have to say isn't that important.

 

[bigDinLV]

Obviously it would be rude to walk up and say "Yo D what's going on?". It usually goes something like "Excuse me, are you the resident for team A? My name is Cpants and I'm the 3rd year med student for your team." Then you say, "Oh hi, I'm D." We go from there.

Yes, that is how it usually goes.

I'm pretty laid back, I even tell patients my first name on occasion and I don't really care what they call me.

Just the guy that said if you're a resident you're getting called by your first name because you're only 12 months ahead of me.. That guys seems like he/she has the potential to be a tool.

 

[cpants]

Because a student that puts a consultant on hold obviously needs education in how the medicine hierarchy works and the best person to do that is the resident overseeing him/her. I'm sorry but even if you are the hardest working sub-i on earth, the resident's time is still more valuable than yours.

And because arrogant MS3's turn into arrogant MS4s that turn into arrogant residents who future medical students will hate.

I'm confused. Are you the same person as Wagy?

Seriously, tattling to a student's resident about being put on hold is about the least professional, most babyish thing I've ever heard. What do you expect the kid's resident to do to him? Put him in time out? Slam him in the eval? Oh no, that's right, you want him to educate him on how he should be kissing your ass as a resident/consultant/person higher up in the hierarchy. Dude, it's attitudes like yours which give medicine a bad name as a profession.

If you have a problem with a student's behavior, address it yourself. If being put on hold damages your ego, then hang up. If they want the consult, they will call back.

 

[Surg0611]

Oh no, that's right, you want him to educate him on how he should be kissing your ass as a resident/consultant/person higher up in the hierarchy. Dude, it's attitudes like yours which give medicine a bad name as a profession.

I disagree. The hierarchy exists for a reason. We all know it sucks to be a medical student and be at the bottom of that hierarchy. You get shat on for no reason sometimes. But the residents/fellows/attendings "higher up" do actually deserve your respsect because they work harder and have WAY more responsibility that you do.

In my opinion, it is attitudes like yours that are giving medicine a bad name. The attitude that medicine is one big fuzzy, let's hold hands, everyone is equal playground. Take some pride in your career and act like a professional.

 

[christina30]

I disagree. The hierarchy exists for a reason. We all know it sucks to be a medical student and be at the bottom of that hierarchy. You get shat on for no reason sometimes. But the residents/fellows/attendings "higher up" do actually deserve your respsect because they work harder and have WAY more responsibility that you do.

In my opinion, it is attitudes like yours that are giving medicine a bad name. The attitude that medicine is one big fuzzy, let's hold hands, everyone is equal playground. Take some pride in your career and act like a professional.

Being professional doesn't mean tattling on one another. If you're so much higher up in the so-called hierarchy, shouldn't you be handling this lowly medical student yourself?

 

[45408]

Because a student that puts a consultant on hold obviously needs education in how the medicine hierarchy works and the best person to do that is the resident overseeing him/her. I'm sorry but even if you are the hardest working sub-i on earth, the resident's time is still more valuable than yours.

And because arrogant MS3's turn into arrogant MS4s that turn into arrogant residents who future medical students will hate.

I said that you have no idea why he put him on hold - maybe it was because the attending (whose time is still more valuable than the resident's) just walked in and wanted to talk to the sub-I.

I disagree. The hierarchy exists for a reason. We all know it sucks to be a medical student and be at the bottom of that hierarchy. You get shat on for no reason sometimes. But the residents/fellows/attendings "higher up" do actually deserve your respsect because they work harder and have WAY more responsibility that you do.

In my opinion, it is attitudes like yours that are giving medicine a bad name. The attitude that medicine is one big fuzzy, let's hold hands, everyone is equal playground. Take some pride in your career and act like a professional.

So why not take it up with the student, rather than tattling on him to his resident?

Now you really sound like one of those formerly arrogant M3s.

 

[cpants]

I disagree. The hierarchy exists for a reason. We all know it sucks to be a medical student and be at the bottom of that hierarchy. You get shat on for no reason sometimes. But the residents/fellows/attendings "higher up" do actually deserve your respsect because they work harder and have WAY more responsibility that you do.

In my opinion, it is attitudes like yours that are giving medicine a bad name. The attitude that medicine is one big fuzzy, let's hold hands, everyone is equal playground. Take some pride in your career and act like a professional.

Who said anything about holding hands and being fuzzy? I said you shouldn't be a baby and throw a tantrum when someone doesn't stroke your ego enough. Putting a resident on hold IS NOT UNPROFESSIONAL. You don't seem to grasp the concept of professionalism. You may have felt annoyed, disrespected, inconvenienced, but honestly, that could not possibly have been the student's intent. You are the one who took it to an unprofessional level, when, like a third grader, you went and tattled to the student's resident. How embarrassing.

 

[VA Hopeful Dr]

I disagree. The hierarchy exists for a reason. We all know it sucks to be a medical student and be at the bottom of that hierarchy. You get shat on for no reason sometimes. But the residents/fellows/attendings "higher up" do actually deserve your respsect because they work harder and have WAY more responsibility that you do.

In my opinion, it is attitudes like yours that are giving medicine a bad name. The attitude that medicine is one big fuzzy, let's hold hands, everyone is equal playground. Take some pride in your career and act like a professional.

You're missing the point. If you have a problem with a medical student, you go and confront the student yourself. If whatever behavior is pissing you off continues after you try and correct it, then consider going to their resident.

 

[ShyRem]

Maybe i'm just waaaaaaaay too old-fashioned here, but as an MS3 on the phone to a resident when someone higher up the food chain comes along in person to see you why not say "oh, gee, hang on a minute - Dr Consult just stepped in to see me" or "Dr Attending needs me for a minute - hang on". That's how I was brought up. Then again, I was taught to introduce myself when I called someone (again, a nicety that seems to be lacking in today's society).

wouldn't that be respectful to all parties involved and not get in the juvenile "but what if" argument we see here?

 

[McLovin]

I can understand this sentiment to a degree, but don't you think it's just general courtesy? I don't call anybody by their first name unless they either invite me to or we've done kegstands together. You're Ms. ___, Professor ___, Dr. ___, just how my mama raised me.

Once you've graduated intern year you feel like you've earned the right to at least f-ing be called doctor. Those 12 months are unlike any you've ever experienced I promise you. And in general if you're calling a consult you'll be talking to a more senior resident or fellow, so the whole '12-months-ahead-of-me' doesn't really apply anyway. Calling your cards fellow Joe is a good way to get your consult done after Labor Day.

I will add there is something to be said for professionalism. If i'm contacting an MD I don't know -- intern or attending -- over the phone, i'll introduce myself as "Dr." and address them as "Dr."

If I'm face to face, its a little easier to be colloquial and i'm more apt to say "hey, I'm the pulm fellow, or you Joe the intern who placed the consult".

Just my two cents.

 

[Surg0611]

You're missing the point. If you have a problem with a medical student, you go and confront the student yourself. If whatever behavior is pissing you off continues after you try and correct it, then consider going to their resident.

To clarify, I was never in the above situation. I was just commenting on it. In general, I agree that as a resident if you have a problem with a medical student you should address it yourself, instead of "tattling". Which would probably take the form of "hey for the future, you may want to avoid putting consultants on hold". I wouldn't rip an MS3 for a tiny issue like that.

It all comes back to where you stand on the issue of medical student's respect for residents. There seem to be 2 camps: the old school hierarchy and the more informal one. A lot it has to do with where you go to medical school and the culture there.

It is just my personal opinion that medical student should err on the side of formality when dealing with residents and give them the small amount of respect they deserve.

 

[VA Hopeful Dr]

To clarify, I was never in the above situation. I was just commenting on it. In general, I agree that as a resident if you have a problem with a medical student you should address it yourself, instead of "tattling". Which would probably take the form of "hey for the future, you may want to avoid putting consultants on hold". I wouldn't rip an MS3 for a tiny issue like that.

It all comes back to where you stand on the issue of medical student's respect for residents. There seem to be 2 camps: the old school hierarchy and the more informal one. A lot it has to do with where you go to medical school and the culture there.

It is just my personal opinion that medical student should err on the side of formality when dealing with residents and give them the small amount of respect they deserve.

OK, I see where you're coming from and I completely agree with what you've said.

 

[footcloud]

What if a nurse interrupts you when you're on the phone with a resident/consultant? Do you tell them to wait because they're "down in the hierarchy"? Yea yea you could tell them nicely and because you're speaking to whomever, but if people are impatient and going to get pissed about being put on hold, they're gonna get pissed no matter what you say/do.

Technically, you're still the lowest no matter what and you're probably going to piss off someone either way. Sure, might be a better idea not to piss off resident/consultant since they're evaluating you, but the nurse could make your life miserable too....lose-lose situation.

 

[Smurfette]

Nurses will generally wait while you are on the phone for you to finish your conversation. Usually all it takes is a gesture acknowledging you saw her for her to calmly wait until you're done to talk to you. Rarely can something not wait for a 2 minute phone call to end.

I usually don't mind being asked if I can hold for a minute. That in itself I do not find rude or unprofessional; it's the content (words, tone, etc.) of what is said that may be rude or unprofessional.

Actually, if a student does something wrong or inappropriate, depending on what they did, it *may* be appropriate to let someone from their team to know about it. Not as a tattletale, but so the student can be explained the proper way to do something or because it may be important (i.e. you don't want a complete jerk in your residency program, so certain behaviors are important to be aware of). I once had a GU sub-i start bossing me around in the OR, ordering me where to stand, etc. (I'm a chief). I told him-politely-that I knew what I was doing, and that I was the surgery chief. He then continued to be an obnoxious tool (even anesthesia commented on it). So I told the GU resident (who I've known for years) about it. His response "yeah, we know he's a tool". But they also appreciated knowing that he acted like a jerk to people in other specialties while being a total suck up to the GU guys.

But really, if you don't know how to call a consult, why don't you ask? The first time I ever called a consult, I asked beforehand what I was supposed to say and what they may ask me, so I was prepared.

 

[jdh71]

In the academic world we give out WAY to much information to "beg" our consultants to come see our patients and give an opinion. Just so you know, in the private sector, you ask for the consult, give the patient's name, location, and reason for the consult - that's it - none of this whole story from admit to consult nonsense we tend to do these days in academic centers.

 

[Aphasic]

Generally when calling in a consult I DON'T give my name or title. I go with, "Hey I'm with the -- team, and we need a consult for Mr. X in room 666 for ..." Why? Because I'm awkward, and I stutter, and pause, and you're annoyed with me before I even started talking. If I give my name, you'll know it was me, if I give my title (or lack thereof), you'll take forever to return my page. But hey, I'm a MS3 I've been on this service for 2 days, my resident/attending told me to page, so I'm paging, they're grading us, not you. Cut me some slack, I'm a MS3, you used to be one too.

I generally call residents Dr. X the first couple times, if you insist on being called Dr. X, I'll call you Dr. X (but i'll think Dr. D-bag), especially if you're an intern.

 

[45408]

In the academic world we give out WAY to much information to "beg" our consultants to come see our patients and give an opinion. Just so you know, in the private sector, you ask for the consult, give the patient's name, location, and reason for the consult - that's it - none of this whole story from admit to consult nonsense we tend to do these days in academic centers.

I think it's a bit service dependent. I just finished nephrology consults, and honestly, the story usually didn't help. We usually looked at the MAR, the past medical history, the labs, the vitals, and the I&Os, and we had our history. other times, it's a bit more important to find out the "We did this, then this, then that, then this, and here's our problem now..."

 

[jdh71]

I think it's a bit service dependent. I just finished nephrology consults, and honestly, the story usually didn't help. We usually looked at the MAR, the past medical history, the labs, the vitals, and the I&Os, and we had our history. other times, it's a bit more important to find out the "We did this, then this, then that, then this, and here's our problem now..."

I generally do like to feed my consultants something, simply because I attempt to play nice with others, but by this time of year some of the surgery interns like to flex their nuts, and I just ask them for their name, they give it, then I tell them I'm documenting that we think the patient needs a surgical eval for X, and that I have contacted him. I then tell him he has three choices come see the consult, some write a note why he doesn't think he need to see the consult, or wait until my attending asks his attending why they didn't see the patient. I then hang up. I'm not in the mood to argue with consultants, and I promise I am the LAST guy in the hospital that you should complain to about being busy - outside of path and the rad onc guys, we're all ****ing busy, so let's just get the work done. I don't bother people unless I think I need their help, and since I don't cut, it's often helpful to talk to someone who does.

 

[Substance]

One of the many reminders of why I hate inpatient medicine.

 

[footcloud]

All this is making me really fear third year. =S

 

[ZagDoc]

All this is making me really fear third year. =S

Eh, you learn by screwing up. That's how everyone learns how to navigate clinical medicine.

I screwed up one of my first few consult pages. The fellow nicely corrected me by saying "next time you may want to do _____". That's how it works most of the time during third year. You feel briefly embarrassed, internalize the experience, and learn from it.

 

[juiceman311]

I would never expect a medical student to call me Dr. all the time ... I tell the students on my service or on call with me to call me by my first name. I don't however agree that it is okay for medical students to call residents by their first name when they don't know you or have ever met you. IMO, it's disrespectful and unprofessional on the medical students' part. They don't know if they are paging an intern or a PGY7 chief.

Believe me, I have done both of your suggestions above ... yet this still happens multiple times a week.

Our text paging system has the resident's name and their PGY status, so, we do know.

And the 2 PGY6's that I've worked with have been two of the most laid back dudes ever (neurosurgery) and they'd probably knee me in the balls if I addressed them as doctor. A neurosurgery attending here goes by his first name with the entire hospital staff.

I don't understand, it's like you guys have never been medical students before, you skipped college and medical school and became God's gift to medicine by default and in the process lost your first name. You disrespect medical students to jerk your ego off but I am sure you are quick to make the student fill out all the discharge paperwork and to fill out med rec sheets before they can go off to lunch at 2pm. Lighten up. Yes, the page you got was unprofessional, but not because your first name was used. I can't imagine a time an explanation point is ever needed in a text page, but who gives a crap. Someone's not as miserable as you.

 

[juiceman311]

I disagree. The hierarchy exists for a reason. We all know it sucks to be a medical student and be at the bottom of that hierarchy. You get shat on for no reason sometimes. But the residents/fellows/attendings "higher up" do actually deserve your respsect because they work harder and have WAY more responsibility that you do.

In my opinion, it is attitudes like yours that are giving medicine a bad name. The attitude that medicine is one big fuzzy, let's hold hands, everyone is equal playground. Take some pride in your career and act like a professional.

Excuse you, I am not going to stick my nose in your bumhole and give you a prostate massage because you are 3 years older than me.

Attitudes of being more laid back and working as a team and not being dbaggy give medicine a bad name? I could have sworn it was the residents that are d1cks to their students but have a nose full of the brown stuff when the attending walks in. Attitudes like yours are the ONLY thing that suck about M3 and M4, otherwise, the clinical years are pretty fun and educational. I simply avoid the jerk residents.