Scared the hell outta me

[thechad]

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Some background information to start:
Me: First semester med student
Friend: Construction worker who "jammed" their finger

Ok, so there I was, having a few beers with some of my friends who don't go to med school on a Saturday night. We're all having a good time, talking about things past and fond memories and so on and so forth, when all of a sudden, one of our friends walks in with an injured finger.

Now, I was just thinking, "oh, man, that sucks," but then someone said, "Well, Dr. Q, whats wrong with his finger?"

Well, I quickly changed the subject by making a joke about his usage of said finger. Why? Because the question scared the hell out of me. Why? Mainly because I didn't know the answer. I thought to myself, "Maybe he ruptured a blood/lymphatic vessel leading to the edema. (Makes sense, right?) Perhaps the swelling is putting pressure on the nerve, causing pain (But wait, wouldn't it cause paresthesia instead (pins and needles)?). But I just couldn't say for sure what was wrong.

Has anyone else ever been in a situation like this? I guess it just caught me off guard, with no time to think about anything and everyone just looking at me expecting me to blurt out some sort of panacea.

Well, I don't know, what do you think?

 

[186321]

I have felt the same way you do. Except I bet I'm worse off than you are (I have no idea what the crap you just said). However, I hear its pretty normal. Furthermore, why would we pay 250 grand for knowledge we already have?

 

[Random Anesthesiologist]

I would have told my friend to go to the ER.

 

[Dirt]

Dude I have had people ask me for medical adivce that I don't know the answer to ever since I said that I "might" want to be a doctor. I would say get used to saying "I don't know" or "you should call your doctor".

 

[mjl1717]

I have felt the same way you do. Except I bet I'm worse off than you are (I have no idea what the crap you just said). However, I hear its pretty normal. Furthermore, why would we pay 250 grand for knowledge we already have?

Yea I can barely make out what he said,... Thats one of the classic questions.. "Dr. Q what what is it or Dr Q what should I do?"

If you want to sound Osler like you send him to the E.R.even if he gives a macho -man response.. And then tell him the sequence of events that will occur in the E.R. You could offer to drive him to the E.R. If you think thats something just wait until you have to answer questions during "grilling rounds"...
Its part of the ritual- come up with professional answers at any expense and dont sweat!!😱

 

[ACSurgeon]

I would have told my friend to go to the ER.

I echo that... Whenever anybody comes to me (usually a family member, sometimes joking and sometimes not) with a medical question, my answer is invariably go see a doctor. However, if they ask me to explain something a doctor told them or they read, and if it happens to be something I learned about, I don't mind explaining what I know, but starting and ending my explanation with, I don't know anything at this point, so take what I say for what it is worth.

 

[joyrunner]

Yeah, I definately agree with telling people to go see their doctor. My grandmother started asking me about an ailment in her shoulder, and I told her to go see her doctor. It turns out that she has a genetic condition that definately should have been diagnosed a long time ago. The funny thing was, I didn't suspect anything serious; I just didn't want to be responsible for telling her the wrong thing. Needless to say, now I always tell people to see their doctor, and I probably will even after I get my license if someone solicits "unofficial" advice from me.

 

[njbmd]

Just remember, dispensing medical advice with out a license is againt the law in every state in the U.S. You can always say that you are a medical student and you haven't covered that particular body part yet or remind them that the state doesn't let you practice yet. When you get your license, you can hand them your card and let them see you in office.

 

[mjl1717]

Just remember, dispensing medical advice with out a license is againt the law in every state in the U.S. You can always say that you are a medical student and you haven't covered that particular body part yet or remind them that the state doesn't let you practice yet. When you get your license, you can hand them your card and let them see you in office.

Another thing:

Some, not all may try to take advantage... Feeling free medical info is conveniant to them and you owe them..eg. professional opinion , {not what a friend told them or taco stand advice} in other words "real" answers that one spends years studying for or even asking for samples..

I mean sometimes we can help.. But in general its probably best to send someone thru our lowly rated healthcare system..{ we are not in the top 10 in health care..}😴

 

[FutureInternist]

I always remind them that "A little knowledge is a dangerous thing" 😀

 

[DocPsychosis]

Just remember, dispensing medical advice with out a license is againt the law in every state in the U.S. You can always say that you are a medical student and you haven't covered that particular body part yet or remind them that the state doesn't let you practice yet. When you get your license, you can hand them your card and let them see you in office.

I'm not sure I buy this without either 1) a source, or 2) some qualification. Sure, it's illegal to be paid for medical advice without a license, or to pose as a medical professional giving sound advice. But I hardly think making suggestions based on a year or two of medical school (or even years of life experience) is against the law, so long as it's taken for what it is. If (hypothetically) I ask my mom what to take for a fever and she suggests one thing or another, are they going to cart her away in chains? Of course not.

 

[bcat85]

So this has already started for me like a year ago.. when I was a junior in college! What am I supposed to say? I've taken a few biology classes and shadowed a doctor. I tell them "it's probably nothing bad, but go to the doctor if you are worried about it." as any intelligent human being would..

 

[DoctorPardi]

I'm not sure I buy this without either 1) a source, or 2) some qualification. Sure, it's illegal to be paid for medical advice without a license, or to pose as a medical professional giving sound advice. But I hardly think making suggestions based on a year or two of medical school (or even years of life experience) is against the law, so long as it's taken for what it is. If (hypothetically) I ask my mom what to take for a fever and she suggests one thing or another, are they going to cart her away in chains? Of course not.

Have you read the book Better by Atul Gawande? He talks about malpractice and malpractice insurance at one point in the book. He tells a story about being a first year medical student and how a woman accidentily tripped over his foot and fell. She injured herself in some way and feeling sorry for her on the spot he gave her his name and number and said "If I can help let me know, or at least let me know how you're doing" (or something to this effect). She later sued him after she found out he was a medical student and tried to claim he improperly "treated" her somehow. He got the case thrown out but it cost him $15,000 dollars in attorney fees and other costs and it took 2 or 3 years to get it thrown out.

So while giving your friend some advice may not even be truly against the law it can certainly cost you money to prove you didn't do something illegal. The only thing you can truly do is say, "you need to see a doctor". This might be a little over zealous and your friend isn't likely to sue you, but still you should consider all possibilities.

I am starting medical school this Fall and I have had relatives and friends asking me for advice for years. I don't know why they do it, because clearly as a premed you couldn't know any real "medical advice", but they do. I've always told them to go see a doctor if they are worried about something.

 

[kirschwasser37]

I always reply to these questions (which I've gotten since high school ) with, "Give me 10 years or so, and I'll get back to you."

 

[mjl1717]

I'm not sure I buy this without either 1) a source, or 2) some qualification. Sure, it's illegal to be paid for medical advice without a license, or to pose as a medical professional giving sound advice. But I hardly think making suggestions based on a year or two of medical school (or even years of life experience) is against the law, so long as it's taken for what it is. If (hypothetically) I ask my mom what to take for a fever and she suggests one thing or another, are they going to cart her away in chains? Of course not.

I was thinking that also... That paragraph in so many words is not a "slam dunk"..🙄
But its always better to err on the side of caution!

 

[Haemulon]

Have you read the book Better by Atul Gawande? He talks about malpractice and malpractice insurance at one point in the book. He tells a story about being a first year medical student and how a woman accidentily tripped over his foot and fell. She injured herself in some way and feeling sorry for her on the spot he gave her his name and number and said "If I can help let me know, or at least let me know how you're doing" (or something to this effect). She later sued him after she found out he was a medical student and tried to claim he improperly "treated" her somehow. He got the case thrown out but it cost him $15,000 dollars in attorney fees and other costs and it took 2 or 3 years to get it thrown out.

So while giving your friend some advice may not even be truly against the law it can certainly cost you money to prove you didn't do something illegal. The only thing you can truly do is say, "you need to see a doctor". This might be a little over zealous and your friend isn't likely to sue you, but still you should consider all possibilities.

I am starting medical school this Fall and I have had relatives and friends asking me for advice for years. I don't know why they do it, because clearly as a premed you couldn't know any real "medical advice", but they do. I've always told them to go see a doctor if they are worried about something.

Ok, you do make a point. But it seems like the "being sued" or "thrown in jail" argument for discussing medical things with family and friends is really stretching things beyond common sense. It would be silly, for instance, to argue that med students can't give much of the same common sense advice that any Joe Smoe in a bar could give. After all, it is not practicing medicine without a license if one never claims or gives the impression of being a medical provider. Plus, Good Samaritan laws exist in most states that legally protects well intentioned individuals that come to the aid of their fellow citizens in need. Performing CPR and using an AED if necessary comes to mind. Telling someone to rinse their eyes with water when they splash some chemical in them or perhaps to stop drop and roll if they catch on fire are other common sense things. See what i mean?

That being said, it is a wise person that refrains from speaking beyond their knowledge and authority. I try to say as little as possible about medical stuff outside of school, since after all I don't really know anything all that usefull yet anyway. Therefore any statement like: "You know, if it is something concerning to you, you should probably bring it up with your physician." is almost always appropriate, and is still my favorite "out".

Of course though, if I practice taking bp's on my Mom, Dad, wife, friends, etc ... and someone keeps coming out with moderate or severe hypertension ... I am inclined to inform them and encourage a doctor visit. Same with any other abnormal finding or complaint that gets brought up or I come across. Wouldn't hurt to mention that melanoma-looking lesion on a family member's neck as something that needs to be checked out as well right?

Funny thing though, one of my wife's friends called a few weeks ago and asked my wife to get advice from me on how she should treat her burned finger. I sat dumbfounded on the couch as I realized that with all of the heavy subjects ranging from anatomy to physiology and neuroscience I had crammed in my head, even with me knowing the histology of the skin and being able to talk about the molecular architecture of things like basal lamina and tight junctions, I was drawing a complete and total blank on even the most fundamental concepts of first aid. Naturally, even if I could remember, the appropriate resonse would probably be something like "if you have any question about this being a significant burn, you should get it checked out by a doctor". In actuality, I think I shouted out something funny like "I don't know, we don't do fingers until next year". But it was quite eye-opening to me none-the-less. Yep, for all my fancy book learning, I still don't know squat.

 

[Tiger26]

Some background information to start:
Me: First semester med student
Friend: Construction worker who "jammed" their finger

Ok, so there I was, having a few beers with some of my friends who don't go to med school on a Saturday night. We're all having a good time, talking about things past and fond memories and so on and so forth, when all of a sudden, one of our friends walks in with an injured finger.

Now, I was just thinking, "oh, man, that sucks," but then someone said, "Well, Dr. Q, whats wrong with his finger?"

Well, I quickly changed the subject by making a joke about his usage of said finger. Why? Because the question scared the hell out of me. Why? Mainly because I didn't know the answer. I thought to myself, "Maybe he ruptured a blood/lymphatic vessel leading to the edema. (Makes sense, right?) Perhaps the swelling is putting pressure on the nerve, causing pain (But wait, wouldn't it cause paresthesia instead (pins and needles)?). But I just couldn't say for sure what was wrong.

Has anyone else ever been in a situation like this? I guess it just caught me off guard, with no time to think about anything and everyone just looking at me expecting me to blurt out some sort of panacea.

Well, I don't know, what do you think?

Also, just keep in mind that you're a 1ST YEAR MEDICAL STUDENT--you know pretty much nothing relevant to clinical medicine at this point (not trying to be mean, just realistic). Hell, I'm a 3rd year and I feel like I only know slight more than nothing right now. Like others said, tell him to go to the ER if it's that big of a deal

 

[thechad]

Funny thing though, one of my wife's friends called a few weeks ago and asked my wife to get advice from me on how she should treat her burned finger. I sat dumbfounded on the couch as I realized that with all of the heavy subjects ranging from anatomy to physiology and neuroscience I had crammed in my head, even with me knowing the histology of the skin and being able to talk about the molecular architecture of things like basal lamina and tight junctions, I was drawing a complete and total blank on even the most fundamental concepts of first aid. Naturally, even if I could remember, the appropriate resonse would probably be something like "if you have any question about this being a significant burn, you should get it checked out by a doctor". In actuality, I think I shouted out something funny like "I don't know, we don't do fingers until next year". But it was quite eye-opening to me none-the-less. Yep, for all my fancy book learning, I still don't know squat.

Haha, exactly what I'm talking about. Nice to know I'm not the only one who feels this way.

However, a lot of you are kind of taking this out of context. I am not afraid of being sued by my friend, especially since I didn't even give him any advice, but telling him to go to the ER seems like quite an exaggeration. Haven't you ever shut your finger in a door? Would you seriously go to the ER and waste your (and more importantly, a doctors) time over it?

Anyways, thanks for the replies and the, "outs," guys. Good luck.

 

[Depakote]

The summer before I started school, my dad accidentally splashed himself in the face with some (really small quantity) antifreeze... nothing in the eyes, but he thought a drop or two might have gotten in his mouth.

He looks at the bottle... "It says here that I should talk see a doctor if I get any of this in my mouth. You're my doctor now... what should I do?"

"I haven't even started school yet. I won't be a doctor for a couple of years."

"Well you're still a doctor to me"

"That's great, but that doesnt mean I know how to treat you."

Plus, Good Samaritan laws exist in most states that legally protects well intentioned individuals that come to the aid of their fellow citizens in need. Performing CPR and using an AED if necessary comes to mind. Telling someone to rinse their eyes with water when they splash some chemical in them or perhaps to stop drop and roll if they catch on fire are other common sense things. See what i mean?

They mentioned this in my BLS class. You are protected as long as you act within the scope of your training. You can perform First Aid/CPR, but unless you're qualified/licensed, hold of on the emergency tracheotomy.

 

[neuroprotector]

I'm not really in disagreement with anything said here, but for the sake of argument:

Suppose you get a parking ticket, and so you ask a lawyer friend about your options because you're not that familiar with traffic law. He or she, having covered this in lawyer class (hell, I don't know), knows more about traffic law than you do, and does therefore have the opportunity to offer a broader insight into your problem than you can.

Now suppose you're talking to a friend with hypertension, and he wants to know about the statin he's been put on. Having taken pharmacology, you've covered statins in class. Doesn't it stand to reason then that you can tell your friend about statins without paralyzing yourself into worrying about your ethical situation?

It seems to me that the difference between this scenario and the friend with the finger problem is that this one is just about provision of information, while the owner of the jammed finger wants to know specifically what he should do. But on some level, especially in medicine, there is a very fine line between providing information to someone and offering a suggestion, and I'm not convinced we always have to be so journalistic about it. After all, don't we have an obligation to help people?