Surgery vs Medicine

[TexasHopeful]

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I was speaking with an cardiologist a little while ago and she started to crack some jokes about the surgical staff she worked with ("...that's why they're not real doctors! ha ha!"). I know that doctors like to joke about this kind of thing, and that the dichotomy is presented as being very prevalent in television shows, but in all honesty can anyone elaborate on this dynamic for me? So far I've been left with the impression that surgery and medicine each have their own distinct spheres of culture, and this is something that everyone in medicine acknowledges but doesn't really talk about openly.

 

[seelee]

I was speaking with an cardiologist a little while ago and she started to crack some jokes about the surgical staff she worked with ("...that's why they're not real doctors! ha ha!"). I know that doctors like to joke about this kind of thing, and that the dichotomy is presented as being very prevalent in television shows, but in all honesty can anyone elaborate on this dynamic for me? So far I've been left with the impression that surgery and medicine each have their own distinct spheres of culture, and this is something that everyone in medicine acknowledges but doesn't really talk about openly.

It's not just doctors, this is in pretty much every profession. Elitism is the way to self-justification. I have seen it all through the scientific community. Physicists rip on chemists, who rip on biologists, who rip on psychologists, who rip on sociologists. In health care industry, nurses rip on doctors and doctors rip on nurses, etc. In most cases it is good-natured ribbing, and in my opinion, it stems from the natural human's attempt to try and devalue skills and knowledge that you lack. Surgeons rip on internists because the internist knows more that they do about how to diagnose and treat disease. The internist rips on the surgeon because despite all their knowledge, the surgeon can walk in, cut the patient open, and achieve a result that the internist couldn't expect after months of pharmacotherapy. Both play an integral role in treating disease, and both groups know that.

 

[foofish]

I was speaking with an cardiologist a little while ago and she started to crack some jokes about the surgical staff she worked with ("...that's why they're not real doctors! ha ha!"). I know that doctors like to joke about this kind of thing, and that the dichotomy is presented as being very prevalent in television shows, but in all honesty can anyone elaborate on this dynamic for me? So far I've been left with the impression that surgery and medicine each have their own distinct spheres of culture, and this is something that everyone in medicine acknowledges but doesn't really talk about openly.

It's definitely very true, and in a way one of those things you need to experience to understand....but for most people, once you rotate through your third year clerkships it will be very obvious whether you're on the surgical or medical side of the divide. There are a lot of contributing factors, but I think part of it is that surgeons vs physicians have different foundations of their training and can have very different approaches to similar diseases. Some of the mockery, then, is from when someone tries to treat a disease not usually within their own field and then make choices that seem ridiculous to someone who is an expert in that field (this happens with the subspecialties within medicine, too). For instance, we had a patient admitted to the ICU for what, long story short, was the result of her orthopedic surgeon trying to tweak her blood pressure meds in a ridiculous way...ridiculous to us on the medicine side, but not so obvious to the orthopod who doesn't do this on a daily basis. The patient was fine, she was sent to us more for a rule out of PE because she was hypotensive and hypoxic, which was the correct first instinct...but in the end, essentially the patient went to the ICU to be put on her home meds. You can imagine the jokes that ensued. 😉 On the flip side, I'm sure the surgeons have tales of medicine docs doing things that seem totally idiotic when trying to approach a surgical disease.