Patient Case

[PADPM]

I believe several important points are being missed. I never attempted to make this a pissing match, but when there are inaccurate responses, I feel as if I must intervene.

This "doctor" asked a question and when a vaild answer or answers were given, his response was simply "no". When I questioned whether his answer was really a "primary disease" he didn't respond at first, and then said his use of the word primary was taken out of context.

He then contradicted himself stating that my response couldn't be correct since the fictitious patient didn't have a subungual lesion, even though he forgot that his OWN answer was "subungual ulceration".

When questioned, he simply decided to answer with childish responses and insults, rather than address the question(s). And finally, when he made claims of EBM to support his views, Kidsfeet did what anyone would do.....he asked for the studies to support the EBM claim, and of course instead of burying Kidsfeet with those studies, his response was that Kidsfeet wasn't smart enough to find those studies.

So the attempt wasn't to turn anything into a pissing match. The attempt was to make sure accurate information is being written. Any shmo can come on this site claiming to be a well trained MD and asking for differential diagnoses, etc., but if the answers or diagnoses or opinions that doctor is stating is in fact not accurate, I feel that it's important to challenge that information. My hope was that by challenging a medical "colleague", I would receive enlightening answers, not childish knee jerk reactions.

I have NO problem with an intelligent discussion to understand the rational behind someone's thought process. And if you read my posts, that's exactly what I attempted to do, but this doctor decided to deflect my questions and respond with childish insults.

I also find it disturbingly curious as to why this supposed "MD", who claims to be an internist with a fellowship in endocrinology would dedicate ALL but one of his posts on SDN to the podiatric forum. Doesn't anyone else find that just a little odd?

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[347932]

Podiatry students: see what I mean? Citations required actually means Kidsfeet forgot his clinical sciences and wants me to spoon-feed, be baby-sit, and review for him what he simply does not know from the clinical thread here. You podiatry students are clearly smarter than Kidsfeet and PADPM. If they both post otherwise, they are insulting all of you. At least you students can look up the EBM yourself and not be spoon-fed because of lack of clinical knowledge prowess and the independence to self learn.

Rather for Kidsfeet and PADPM, take the easy short cut and simply say "cite the EBM (so I do not waste my time doing it myself because I am lazy)" and use reverse psychology tactics. I mean, why are you pod students wasting your time on this Podiatry SDN? Leave like I am. You won't regret it. You are way too smart for this place, a place only for smart-ASSES.

Clearly you are smarter than all of us. I can't seem to find any literature that supports your claims of DM, HL/R and Onychauxis leading to the skin cancers you suggest as a primary potential diagnosis. Where is that darn study??

 

[347932]

Here's a thought for all the students as clearly I'm such an a-hole.

Someone tells you there is plenty of data out there to support his claims, but then doesn't produce any when asked and gets defensive when his EBM claim is challenged. If YOU present the data, YOU better be prepared to back it up. The onus is on YOU, not the audience to "look it up".

That's why all the people you see lecturing at respected conference add the actual citation to what they are speaking about on each slide. If they don't, please feel free to challenge them about where their information comes from. ESPECIALLY if they are saying there is "a lot of data out there", but then don't cite ANY.

Hopefully those of you in residency are learning to critically analyze the journals you are reading and presenting at journal clubs. Pissing match because we are expecting to know where the information comes from, or because the claimant refuses to produce any? You decide.

Who is the a-hole??? ME, obviously!

 

[Dr Hurly MD]

I believe several important points are being missed. I never attempted to make this a pissing match, but when there are inaccurate responses, I feel as if I must intervene.

This "doctor" asked a question and when a vaild answer or answers were given, his response was simply "no". When I questioned whether his answer was really a "primary disease" he didn't respond at first, and then said his use of the word primary was taken out of context.

He then contradicted himself stating that my response couldn't be correct since the fictitious patient didn't have a subungual lesion, even though he forgot that his OWN answer was "subungual ulceration".

When questioned, he simply decided to answer with childish responses and insults, rather than address the question(s). And finally, when he made claims of EBM to support his views, Kidsfeet did what anyone would do.....he asked for the studies to support the EBM claim, and of course instead of burying Kidsfeet with those studies, his response was that Kidsfeet wasn't smart enough to find those studies.

So the attempt wasn't to turn anything into a pissing match. The attempt was to make sure accurate information is being written. Any shmo can come on this site claiming to be a well trained MD and asking for differential diagnoses, etc., but if the answers or diagnoses or opinions that doctor is stating is in fact not accurate, I feel that it's important to challenge that information. My hope was that by challenging a medical "colleague", I would receive enlightening answers, not childish knee jerk reactions.

I have NO problem with an intelligent discussion to understand the rational behind someone's thought process. And if you read my posts, that's exactly what I attempted to do, but this doctor decided to deflect my questions and respond with childish insults.

I also find it disturbingly curious as to why this supposed "MD", who claims to be an internist with a fellowship in endocrinology would dedicate ALL but one of his posts on SDN to the podiatric forum. Doesn't anyone else find that just a little odd?

You are an imbecile to insult me and insinuate I am a quack. I refer diabetics to you podiatrists for diabetic foot care and to opthalmologists for retinopathy prophylaxis. And diabetes is my realm: internal medicine and endocrinology. What is so and/or a little odd therefore? Apples and oranges and semantics like PADPM's posts in this thread makes me feel like this

http://www.youtube.com/watch?v=ElC2XUyNHRU

 

[347932]

You are an imbecile to insult me and insinuate I am a quack. I refer diabetics to you podiatrists for diabetic foot care and to opthalmologists for retinopathy prophylaxis. And diabetes is my realm: internal medicine and endocrinology. What is so and/or a little odd therefore? Apples and oranges and semantics like PADPM's posts in this thread makes me feel like this

http://www.youtube.com/watch?v=ElC2XUyNHRU

I thought you left??

Where IS that data??

 

[347932]

I love the word "imbecile". It makes you seem like you have such panache and a European flair when you insult someone using that word.

I picture Peter Sellars as Inspecteur Cleussau in the original Pink Panther movie and his boss screaming "Imbecile!!!" at him in a Parisian accent. That's brilliant!

Btw, who is the imbecile? Someone claiming to know something they don't and actually arguing about a fabrication, or the one pointing out that the "fact" is in fact a fabrication, and asking for proof as such. Hmmm???

 

[PADPM]

You are an imbecile to insult me and insinuate I am a quack. I refer diabetics to you podiatrists for diabetic foot care and to opthalmologists for retinopathy prophylaxis. And diabetes is my realm: internal medicine and endocrinology. What is so and/or a little odd therefore? Apples and oranges and semantics like PADPM's posts in this thread makes me feel like this

http://www.youtube.com/watch?v=ElC2XUyNHRU

Feeling a little defensive??? I've called you NO names, but YOU have been slinging insults this entire thread. You call me Batman or Robin, an imbecile and a host of other insults.

However, I have not resorted to the childish, defensive behavior you have. When/where did I insinuate you're a "quack". If somehow you've extrapolated that from me simply questioning your comments, you've got some issues.