The "Hidden Curriculum"

[Bacchus]

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Can I quote that for my sig?

Makes me sound like an *******, doesn't it?

 

[Bacchus]

What do you think allows some people to stay above the "hidden curriculum"? What are you doing to try to prevent yourself from going down that road (assuming you think its a road you would rather not travel)?

Here's my serious answer, not an anecdote of how a "free-loader" was mooching the system and not being appreciative.

I think this is all about balance. I have found a majority of my patients are genuinely intrigued by me and want to know why I decided to do what I'm doing and how I go about it. However, there will always be a few out of the many who 1) Don't care you're trying to make them better 2) Would rather listen to the TV than have a conversation with you 3) Will lie to your face during your history. But, as frustrating as this is, you still have to provide them the care they need.

For me, the reward for getting past these few patients is the rest of the people I need to see. That alone isn't getting me through the day though. I'd say in general I'm an altruistic person and often put others before myself both in my "profession" and social and personal life. I believe it's an inherent characteristic and all of us start medical school with it in us. No one's sole reason (I hope) for going into medicine is to have a well-paid, secure job. If that's all you're looking for you will be miserable because of all the associated factors tied to money and employment. Genuinely, we all start out wanting to "help people." I wish this reason was more acceptable at interviews and we didn't have to *****-foot around it creating some abstract painting to prove we want to be there.

But, as time goes on you do get the happy-go-lucky feeling of wanting to do this beaten out of you continuously, just to pick it up and have it slapped out again. A lot of the problem is the hierarchy established at so many hospitals. Respect to elders rings true, but you shouldn't be fearful of your intern, resident, or attending. A lot of people do not enforce a tyranny, but there are quite a few that do. I don't think medical hazing will stop. I'd love to have it stop with me but that's impractical. Knowing ahead of time what the next several years will be like really can be a downer. I've survived so far but I may just be lucky I've had a good set of preceptors from intern up to attending.

The people that stay above the curve in terms of altruism are happy. They have bad patients, but can shrug them off and not let them get them down. You complain about them to a colleague and move on, provide the care they need, and hope for their discharge to occur soon 😉. The physicians get joy out of helping people and are able to roll with the punches.

I get through my day knowing a few things:
1) For every unappreciative patient you have, you will have many more that say thank-you, wish you luck, and tell you how good a person you are.
2) I have a great team behind me that is supporting me for the month. I can't predict what the following month will be like, but I can hope (to keep myself sane) it will be as good as past months.
3) This is what I want to do. I don't want to do another job, nor do I have the means unless I go back to school. I can't return to my laboratory degree unless I'm heavily medicated to stay happy.
4) Not only are you forming a bond with your patient, but you also are getting to know their family. You need to do everything you can (within reason) for the patient and indirectly the patient's family.

 

[Jack is Back]

When these arguments arise, I always tend to agree with some of each side. I don't think this debate has to be so polarized.

 

[Rocher]

No, I'm saying sending someone a bill and having them not pay it is not charity. That's called being stolen from. It's not exactly a subtle difference. And no, the extension is not that physicians should do more work for free. At no point did I argue that physicians have an obligation to do charitable work. I'm just laughing at trying to pass off running a profitable business as an act of charity.

Your list of tools and opportunities needed to get into medical school is pretty telling. You can't even imagine a world where mommy and daddy aren't pushing you into AP courses and violin practice. You can't even imagine a life where going to college isn't in the game plan. All you can imagine is having to find away around funding it. And then you try to pass off work ethic as some non-issue you magically chose and other's passed up on.

"Work ethic? Na, no thanks. I'd rather not be driven. Struggling through life sounds better than living comfortably."

I know you're done with the thread. You need to go back to convincing yourself the world is fair and just. You have what you have because you deserve it. Otherwise you'll have no justification in b--ching and whining about the 0.1% of the population doing better than you while ignoring the 99% doing worse...

For the most part I agree with everything you've said. It's not as easy to get out of the vicious cycle of poverty as some people think. They think this way because they've most likely never known true poverty.

 

[Gut Shot]

Can I quote that for my sig?

Knock yourself out.