Volatile Shadowing Experience

[GLaDOS]

So, I've been shadowing 2 MDs & a DO at an Immediate Care Clinic near my home. I've gotten along really well with 1 of the MDs & the DO, it's been a super interesting experience & I've put in close to 100 hours at this one clinic over this past year. I was really counting on a stellar LOR from this place...until today.

I came in to shadow today & the MD I usually work with called in because of a personal emergency, so they were busy, short-staffed & they had called in a PA to fill in. My instinct was to leave, but I ended up staying & I somehow I ended up paired with the PA because the other MD is a bit unfriendly.

So, this PA had an extremely poor attitude & things rapidly declined when, in my opinion, she acted completely unprofessional toward a patient. I know I cannot get into too many details, but basically this lady came in for a pre-health employment screening, is being treated for an endocrine condition, but had a lot of previous health problems before proper diagnosis & treatment. The patient was mildly overweight, but seemed otherwise able-bodied & generally healthy. The requirements for the job were something like being able to stand for an 8-hr shift, able to lift 40lbs unassisted & something about range-of-motion.

The PA did a super hasty exam on the patient, asked her if she could lift 50lbs off the ground (which she said she probably couldn't without some difficulty, but that 40lbs would be OK) & asked her to touch her toes (which she couldn't). Based on that & the prior complications with her condition, the PA marked her as unfit for duty, which essentially means she isn't going to get that job. She also told this patient that she was obese & probably couldn't stand for 8hrs. The young lady was a bit plus-sized, had thick legs, a booty, a little tummy & a large chest, but I would never have thought to call her obese!

This woman literally bursts into tears & the PA just walks out & tells the woman to pick up her paperwork at the front. I went to grab the patient some Kleenex & mentioned that she might be able to get a second opinion elsewhere because I felt incredibly awkward & just felt awful for this woman. Big. Effing. Mistake. The PA overheard, went off on me, then dragged me over to the MD & told him I had told a patient she was misdiagnosed (which really isn't true) & it just all spiraled out of control from there. After some heated words with the PA & MD, I elected to leave early & the MD said he'd be speaking with the other physicians regarding the incident.

I really have no clue how to handle this situation. I'm guessing I'll get the opportunity to explain myself sooner or later, but I'm still really concerned about how this could affect my relationship with the other 2 physicians & my ability to rely on being able to use this experience on my applications. Has anyone ever had an experience like this before?

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[karayaa]

What's there to explain?
Regardless, you can still say that you shadowed them on your app. The chances of an adcom actually contacting them are around 1%.

 

[No Limits]

Bummer, I understand where you are coming from but I'm afraid you may be in the wrong. If your shadowing gig was anything like mine or my hospital volunteer experience, you are not to discuss anything medically related with patients. You can ask them if they need a blanket all day but you can't recommend second opinions, medications, or other doctors as you are not qualified to do so.

 

[chillaxbro]

Sounds like you got yourself some nice secondary writing material!

 

[TreadLightly]

Yeah, try to explain your concerns to the other docs when they get back, but then get out of there and find somewhere else to shadow.

Probably best to not be mixed up in that whole situation. A single bad letter can destroy your app.

 

[TheWeeIceMan]

You should have stayed out of it.

 

[papi89]

I'd find somewhere else to shadow and just not mention that you were ever there... as the guy above said, a bad reference / comment could hurt your app but shadowing experience at a clinic isn't so amazing that you can't just go elsewhere.

Risk / reward...

 

[deleted407021]

Wow. The PA probably could have been more considerate of the patient, but in the end, I think you made a mistake (I think you understand that anyway). You aren't qualified to make such an assessment and, for all you know, the PA noticed something he/she was trained to discern that simply failed to occur to you. My FP gave me some good advice for shadowing doctors: "Keep your mouth shut."

 

[Akali]

If you've had so much experience with the 1 MD, do you really think he won't still write you a good LoR over this? When you talk to the MD about it, it would probably be best to act culpable, whether you truly believer you are or not. Bright side is that you will need to know how to avoid these situations and deal with them for third year so you can consider this early practice lol

 

[deleted480308]

In their office, with their patients.....you close your mouth. You don't know enough to second guess them.

Just forget they existed and never mention them.....that would poison a letter from most people

 

[kyamh]

In their office, with their patients.....you close your mouth. You don't know enough to second guess them.

Just forget they existed and never mention them.....that would poison a letter from most people

Agreed, that LOR is lost, don't gamble thousands of dollars in application fees by hoping that this incident won't come up. By your actions, you come off as arrogant and disrespectful - regardless of your previous relationship these are not qualities that you want anywhere near your LOR.

 

[organdonor]

I think it's probably worth a talk with the doctor you've been with the majority of the time. For all you know he could be like "yeah I disagree with what the PA and other MD did." But realize that PROBABLY won't be the case and you can forget the LOR.

For future reference and for all those other pre meds reading, has your own shadow ever talked? There's a reason it's called that!

 

[NickNaylor]

Why on earth would you second guess a PA/physician's judgment IN FRONT OF A PATIENT?!?!?!

Good God, man. Lesson learned - do not ever do that again. Not as a M1. Not as a M2. Not as a M3. Not as a M4. No, not even as an intern or a resident. MAYBE as an attending. Even then, that is horrendously unprofessional behavior. Unless someone is about to seriously harm a patient, it's not your place to question ANYTHING done by a healthcare provider. The patients are their responsibility, not yours. Your role is to learn and get a feel for what being a physician is like, not counseling patients and providing medical advice.

It should go without saying that getting a LOR from these physicians would be another terrible decision. I would chalk this is up as a learning experience in how the medical hierarchy works and perform better at your next experience.

 

[BioBeaver]

Wait a second, the woman COULD NOT pick up 50 pounds, touch her toes, and didn't look healthy enough to stand around for 8 hours? Why did you think she would get a different diagnosis somewhere else? She clearly can't qualify for the job and its probably for her better good that she didn't get cleared.

But like everyone has said, it's over now and you made a mistake. Find somewhere else to shadow and move on with life a little wiser.

 

[SN12357]

Wait a second, the woman COULD NOT pick up 50 pounds, touch her toes, and didn't look healthy enough to stand around for 8 hours? Why did you think she would get a different diagnosis somewhere else? She clearly can't qualify for the job and its probably for her better good that she didn't get cleared.

But like everyone has said, it's over now and you made a mistake. Find somewhere else to shadow and move on with life a little wiser.

If touching your toes is a requirement for general fitness, I know several crossfit nuts who apparently are SOL. None of us can accurately say whether or not the woman was fit. I know enough terrible doctors and PAs to think it's as likely as not that the OP did see bad medicine being practiced. Your internet diagnosis agreement with the PA isn't particularly impressive.

OP learned the hard way about the medical hierarchy. A LOR is out of the question, listing the experience as shadowing is probably ok but if he/she wants to be truly paranoid might be better to leave it off and no one will be the wiser.

 

[SouthernSurgeon]

The PA did a super hasty exam on the patient, asked her if she could lift 50lbs off the ground (which she said she probably couldn't without some difficulty, but that 40lbs would be OK) & asked her to touch her toes (which she couldn't). Based on that & the prior complications with her condition, the PA marked her as unfit for duty, which essentially means she isn't going to get that job. She also told this patient that she was obese & probably couldn't stand for 8hrs.

So setting aside what sounds like some pretty gruff bedside manner, from the limited description you gave us it sounds like the PA made an appropriate determination that the woman didn't meet the basic criteria for the job (which apparently involves at least some physical labor and heavy lifting). So he may have done a "super hasty" exam - but anything more than that is unnecessary if she has already failed to meet the requirements for the job.

It's not fun to cost someone a job...it's also not fun to falsify records or put your name down endorsing something you don't agree with. So I think the PA did the necessary thing in this case.

The young lady was a bit plus-sized, had thick legs, a booty, a little tummy & a large chest, but I would never have thought to call her obese!

This just shows that you have a warped perception of what obese means. It's ok, so does 99% of our society.

When you look at someone like you are describing and think they are "a bit plus-sized" - in all likelihood they meet the legal definition of obesity.

When you look at someone and think they are obese - in all likelihood they are morbidly obese. Etc.

 

[BioBeaver]

If touching your toes is a requirement for general fitness, I know several crossfit nuts who apparently are SOL. None of us can accurately say whether or not the woman was fit. I know enough terrible doctors and PAs to think it's as likely as not that the OP did see bad medicine being practiced. Your internet diagnosis agreement with the PA isn't particularly impressive.

OP learned the hard way about the medical hierarchy. A LOR is out of the question, listing the experience as shadowing is probably ok but if he/she wants to be truly paranoid might be better to leave it off and no one will be the wiser.

All I know is that I've worked at some of these lifting/standing all day long jobs. If the woman was overweight and couldn't lift the required amount, she was gonna have a tough time. And possibly be a hazard to herself and others.

You're right though, I wasn't there and can't diagnosis it. But neither can the OP

 

[SN12357]

All I know is that I've worked at some of these lifting/standing all day long jobs. If the woman was overweight and couldn't lift the required amount, she was gonna have a tough time. And possibly be a hazard to herself and others.

You're right though, I wasn't there and can't diagnosis it. But neither can the OP

Every job I've ever held has had a 'must be able to independently lift 40 lbs' requirement. I don't know why because most of them were office jobs. It's actually written into my job description for my current paper-pushing research position.

(This next part not specifically directed at you, @BioBeaver)--I can't believe the number of people in this thread expressing the opinion that because someone appears overweight they must not be physically fit according to a set of boilerplate physical requirements to be able to lift 40 lbs and stand for 8 hours. Do you not actually see the guts on a lot of people who do extremely heavy physical work? Obese by the technical medical definition does not at all mean that you can't lift 40 lbs and stand for 8 hours and independent of this woman's actual medical history you can't possibly say if the PA was right or wrong.

 

[TheWeeIceMan]

If touching your toes is a requirement for general fitness, I know several crossfit nuts who apparently are SOL. None of us can accurately say whether or not the woman was fit. I know enough terrible doctors and PAs to think it's as likely as not that the OP did see bad medicine being practiced. Your internet diagnosis agreement with the PA isn't particularly impressive.

OP learned the hard way about the medical hierarchy. A LOR is out of the question, listing the experience as shadowing is probably ok but if he/she wants to be truly paranoid might be better to leave it off and no one will be the wiser.

Thank god there was a pre-med shadower there to right this injustice.

Obviously, none of us were there to see this woman, but OP thinking that he/she can determine what is or is not bad medicine is hilarious. I also love how the OP brushed off the womans numerous medical conditions and instead bases his/her "diagnosis" on whether or not OP thinks the woman is obese.

 

[SN12357]

Thank god there was a pre-med shadower there to right this injustice.

Obviously, none of us were there to see this woman, but OP thinking that he/she can determine what is or is not bad medicine is hilarious. I also love how the OP brushed off the womans numerous medical conditions and instead bases his/her "diagnosis" on whether or not OP thinks the woman is obese.

Having sympathy for someone who is clearly upset and suggesting that they can get a second opinion is not making a diagnosis. It is in fact a very appropriately human reaction, even though the exact context means that voicing it to the patient was overall a mistake. Have you really never told one of your friends to get a second opinion from a doctor? I commend you for having such a healthy cohort around you that you've never had the displeasure of encountering a medical professional with their head up their ass.

OP made a mistake, yes. I'm not disagreeing with that. But I would hope empathy would not be viewed as the fatal flaw here.

 

[mcloaf]

Your only job is to stand in the corner and not say anything. How do you mess that up?

 

[TheWeeIceMan]

Having sympathy for someone who is clearly upset and suggesting that they can get a second opinion is not making a diagnosis. It is in fact a very appropriately human reaction, even though the exact context means that voicing it to the patient was overall a mistake. Have you really never told one of your friends to get a second opinion from a doctor? I commend you for having such a healthy cohort around you that you've never had the displeasure of encountering a medical professional with their head up their ass.

OP made a mistake, yes. I'm not disagreeing with that.

Really? It sure sounded to me like OP was insinuating that the PA made the incorrect diagnosis. As to your second point, it is not at all an accurate comparison. OP, as a shadower, is seen as an extension of the PA he or she was shadowing. As such, telling a patient to get a second opinion undermines the PAs diagnosis in a way that some rando off the street telling her to get a second opinion wouldn't.

 

[487806]

Your only job is to stand in the corner and not say anything. How do you mess that up?

Well, on the bright side for OP, he did manage to display "altruism" and "showing concern" about the "mistreatment" of the patient and provided some "rational", "evidence-based" arguments against the PA. That's definitely a plus by the Premed Way.

Why on earth would you second guess a PA/physician's judgment IN FRONT OF A PATIENT?!?!?!

Good God, man. Lesson learned - do not ever do that again. Not as a M1. Not as a M2. Not as a M3. Not as a M4. No, not even as an intern or a resident. MAYBE as an attending. Even then, that is horrendously unprofessional behavior. Unless someone is about to seriously harm a patient, it's not your place to question ANYTHING done by a healthcare provider. The patients are their responsibility, not yours. Your role is to learn and get a feel for what being a physician is like, not counseling patients and providing medical advice.

It should go without saying that getting a LOR from these physicians would be another terrible decision. I would chalk this is up as a learning experience in how the medical hierarchy works and perform better at your next experience.

Yeah agreed. Sorry OP, you got the short end of the stick. Don't screw up next time.

 

[jetsfan1234]

Man, that sucks. I feel so bad for you, OP. I can see you were trying to do the right thing, and suggesting a "second opinion" doesn't really fall under the category of "diagnosis," but it's a VERY fine line, especially when you are shadowing and not yet a clinician yourself.

I've had a lot of jobs in the medical field, and yes, I have had this kind of thing happen to me (not exactly, but similar misunderstanding-type issues). I hate to tell you this, but the PA is probably going to be talking about this incident for the next 10 years, lol. When things like this happen at my office, they NEVER die. Your best bet is probably to apologize profusely, find a a new shadowing gig, and do not ask these people for a LOR.

 

[Mad Jack]

If you've had so much experience with the 1 MD, do you really think he won't still write you a good LoR over this? When you talk to the MD about it, it would probably be best to act culpable, whether you truly believer you are or not. Bright side is that you will need to know how to avoid these situations and deal with them for third year so you can consider this early practice lol

I wouldn't risk it. Yeah, there's a good chance he will be fine with writing you a letter, but there's also a good chance he'll take the word of his partners over that of some guy that happens to be shadowing. Find a new doctor to shadow rather than risk having a red flag in your file.

And you can't very well pursue shadowing at the same facility again anyway, one of the docs and one of the PAs pretty much have it out for you. That is just way too hostile of an environment to foster a positive experience.

 

[deleted407021]

And here I thought setting off the burglar alarm at the clinic where I work was bad.

 

[GLaDOS]

I appreciate all the insight. I do realize I made a mistake & I probably should've waited to start this thread (or not have made a thread at all) until after I had calmed down. Just a couple of points I left out, that I'd like to address:

- The physicians there generally don't mind me talking to patients, but obviously I've never been in the situation of having a having a patient sit in a room crying for 10+ minutes on a busy day. They usually send me back in the room to check on patients who have been waiting, see if they have any questions for the doctor before he/she moves on to the next patient or let them know they're done & can go up front. Sometimes if they're really busy, sometimes I'll even call the patient back & do their weight/height, which was the case with this particular patient.

- The PA isn't a regular there, she was called in from a staffing agency, I believe. One of the MAs was actually surprised when this PA showed up because she said they've had problems with her before & had thought she wasn't going to be coming back.

- I can say with pretty decent certainty that this woman was NOT obese. If Sofia Vergara shrunk an inch & gained 10 pounds, I don't think anyone would be calling her obese. I calculated her BMI & she falls at 25.

- This woman had been gushing how she'd been unemployed for most of the year after she was unable to find work after being a laid off, how her unemployment benefits were about to run out & how excited she was about this job. When the PA & I exited the room so the paperwork could be filled out, the PA made rude comments about this & called the woman "fat & lazy".

- When we came back, the PA told the patient she wasn't passing her & the patient broke down. She peeked out after a bit & asked one of the MAs if the PA could come back & explain why the PA wouldn't pass her & the PA essentially refused to go back in & told the MA to tell her something like "based on exam findings". When I asked the PA what she meant by that, she just rolled her eyes.

- After the woman hadn't come out for ~10 minutes, the PA actually told me to go into the room "to get her to leave". I realize now that I probably should've just refused because I was already feeling incredibly awkward about this situation. What happened was I had brought her some Kleenex & asked her if she needed any help getting out to her car. She just kept crying & saying over & over again "I don't know what I'm going to do" & my exact words were something like "Maybe you can talk to your HR department & see about getting another one done".

- The MD there didn't really say anything directly about this situation to me. He was definitely frustrated & asked why I was "making more work for him" & gave me the option of either following him & "keeping out of the way" or going home. I also got a text from the DO earlier today saying "I hope you're doing okay. Can you stop by tomorrow to talk? Happy New Year!".

I'm sure we're going to go over what happened & I've already decided I'm not going to ask any questions & just answer their questions & see how things play out. I guess I'll figure out what I am going to do based on our meeting. I mean, I definitely agree I shouldn't have said what I said to the patient, but I also think I had a completely human reaction to the situation.

 

[jetsfan1234]

Basically, to reiterate what many people have said: From a human perspective, you were in the right. From a purely professional perspective, you were in the wrong. Professional side wins. Go talk to the DO tomorrow. Word to the wise: I am fairly certain the DO is going to "side" with the PA when she talks to you. Don't be argumentative, just be apologetic and explain the situation from your perspective. I would not continue to shadow here. You can find another gig.

Another thing -- what's the point of getting a LOR from a doctor you shadow, anyway? It's not like they can attest to your work ethic, personal qualities, etc.

 

[KnuxNole]

Having sympathy for someone who is clearly upset and suggesting that they can get a second opinion is not making a diagnosis. It is in fact a very appropriately human reaction, even though the exact context means that voicing it to the patient was overall a mistake. Have you really never told one of your friends to get a second opinion from a doctor? I commend you for having such a healthy cohort around you that you've never had the displeasure of encountering a medical professional with their head up their ass.

OP made a mistake, yes. I'm not disagreeing with that. But I would hope empathy would not be viewed as the fatal flaw here.

Nobody tells their friends to get a second opinion WITHIN EARSHOT OF THE MEDICAL PROVIDER.

OP should have gave her some Kleenex and that's it! Maybe saying I'm sorry too if he genuinely feels bad. Otherwise, as a wee pre med, you can't say a word. Even if they are "wrong", shut that mouth. Unless they are doing something that is actively killing them. Telling Ms. Plus Size that she won't sign a job form isn't worth playing hero.

 

[SN12357]

Nobody tells their friends to get a second opinion WITHIN EARSHOT OF THE MEDICAL PROVIDER.

OP should have gave her some Kleenex and that's it! Maybe saying I'm sorry too if he genuinely feels bad. Otherwise, as a wee pre med, you can't say a word. Even if they are "wrong", shut that mouth. Unless they are doing something that is actively killing them. Telling Ms. Plus Size that she won't sign a job form isn't worth playing hero.

Amazingly poor reading comprehension. Did I say they should have actually SAID to get a second opinion as a shadower in that office? No. I have said several times that that was a mistake. But the impulse, and the thought, were not wrong, particularly given the extra information the OP has now provided. Which is exactly what I said in the post that you quoted, but apparently did not read.

 

[KnuxNole]

True. Remember, your job is to SAY NOTHING. AT ALL.

Still, for all we know, she could definitely be totally unfit! We don't know how big dem rolls are haha

But, for the OP, I can see how you had that feeling of empathy and feeling sorry for her. Unfortunately, it's just something you gotta observe. You can give tissues and say sympathetic stuff. Keep in mind that most people you'll meet in the medical profession will have LOTS of those thoughts to call that patient fat and lazy without hesitation...they are the majority.

 

[CarlosDanger]

That sucks...to be fair, the PA did specifically ask the OP to get the patient to leave, which is implying that they wanted him to have to have a conversation with the patient...which I think is a really bad call on their part. OP should never have been put in that situation. Honestly, I might have mistakenly said something similar to the patient - but I like to think I would have waited till we were out of the office or out of earshot. I guess I would have thought that just informing the patient that they have the right to obtain a second opinion would not be so terrible.

I would agree that in retrospect it was a mistake and should be used as a learning experience never to speak up like that. Just saying, it was putting an untrained person in a bad situation. Lesson learned.

 

[ThisCouldBeYou]

I went to grab the patient some Kleenex & mentioned that she might be able to get a second opinion elsewhere because I felt incredibly awkward & just felt awful for this woman.

You felt badly for her. (empathetic) You felt awkward. (Sympathetic.) You told her she could get a second opinion. (Not a diagnosis, but clearly you didn't agree with the PA.) Not every interaction with patients will yield good news. Good lesson until you opened your mouth.

 

[sourdoughllama]

Thank god there was a pre-med shadower there to right this injustice.

Obviously, none of us were there to see this woman, but OP thinking that he/she can determine what is or is not bad medicine is hilarious. I also love how the OP brushed off the womans numerous medical conditions and instead bases his/her "diagnosis" on whether or not OP thinks the woman is obese.

1- I think OP was in the wrong purely because shadowing means shut your trap and look from the corner no matter what. It does sound like OP did disagree with the PA from his first and added posts even though he didn't technically voice it.
2- But even the most untrained person can tell whether basic human interactions are reasonable or unreasonable. As knowledgeable as health care providers are, many lack any sense of respect for others around them. PA sounds kinda mean

 

[GLaDOS]

I stopped in at the clinic for a bit earlier today. They were busy, as usual, but I was able to speak with the MD & DO separately & together. Someone did call in to discuss what happened with the patient's exam, so the physicians were mostly interested in what I observed in the exam room & my side of the story. A couple of other complaints were also called in, so I told them what I knew of those situations as well. They both mentioned that it probably would've been wise to have just left that day since neither of them were there, but not much was said regarding what I said to the patient other than asking me to rehash exactly what happened.

The MD said they're still working it out, but it doesn't really have much to do with me & has more to do with the exam itself & the potential employer. She said she'd catch up with me once they figure it out & that I'm welcome to stop by after-hours either today or tomorrow when everything is settled. Both of the doctors were a bit pressed for time, so I didn't get a really good feel of what's going to happen. Both of them were only focused on the facts, but from what I gathered, I think this isn't going to be as horrible as I had imagined. I apologized several times & all I got back was "we'll get to that later" & "don't worry".

Just to reiterate, I am, on occasion, allowed/encouraged to talk to the patients. In this particular case, I actually called this woman back to the exam area, took her height & weight & placed her in an exam room. I've been coming to this particular clinic for about a year now, so for the past couple of months, in addition to days where I just passively shadow, I sometimes do speak with patients. In this case, the PA requested I call the woman back & get her height/weight & requested I that I try to "get her to leave".

I'd also like to clarify, I had NO clue the PA was listening outside the door when I was trying to help get the patient to calm down & get herself together. After the PA had asked me to "get the patient to leave", I did say that I think the patient wanted to speak to her (the PA) directly & she replied something like "I'm busy, I should've been in room 3 a year ago" & then she walked away. I had assumed she was in that exam room when I was speaking with the patient.

I spoke with a couple of people from my classes & some of them said they've heard or have had receptionists say things to them like "if you're unhappy with/don't agree with the doctor's assessment, you're welcome to get a 2nd opinion elsewhere". I definitely acted on impulse with what I said when I was speaking with the patient, but since I clearly didn't offer my opinion on the PA's assessment to this patient, how does making her aware of her potential option to get a 2nd opinion translate into claiming misdiagnosis?

 

[deleted480308]

^you messed up long before any potential talk of "misdiagnosis". It's far more basic than that...you don't second guess the people who grant you a privilege in front of their customers. They allowed you into the place they use to feed their children and you implied they didn't know what they were doing to a customer. If one of our guys (different industry) told a customer to shop for another option, they would sooooo incredibly fired. You just don't get to...

 

[HelpPleaseMD]

like others have said you aren't qualified to make that assessment. I can certainly understand where you are coming from, as I was probably like that when I was in your position. I think its good that you learn this now so that this won't happen during the clinical rotations. If you have reservatios you speak with the person privately whether it be an attending or PA. IMO it is common courtesy. I personally think you had the best of intentions so just let this be one of those teaching moments.

 

[markmark]

Some people in the pre allo forum are really bizarre. The op already said countless times that he made a mistake, why is everyone pounding their chest telling the OP he made a mistake. He gets it. Wait and have a talk with the doctors. This is not going to turn out as badly as you think, and you may well get a glowing LOR from them or one of them. Humans make mistakes, especially humans in the process of learning.

 

[circulus vitios]

The PA sounds like a complete jerk but maybe the patient really was unfit to work. If she can't lift 50 pounds or stand on her feet for 8 hours, it's not going to work out.

 

[Beargryllz]

Another thing -- what's the point of getting a LOR from a doctor you shadow, anyway? It's not like they can attest to your work ethic, personal qualities, etc.

Is there such a thing as a medical school that *does not* require a LOR from a doctor? Caribbean maybe?

The point is busywork and boxes to check, just like the rest of it

 

[kyamh]

Is there such a thing as a medical school that *does not* require a LOR from a doctor? Caribbean maybe?

The point is busywork and boxes to check, just like the rest of it

None of the US MD programs I applied to needed a LOR from an MD, I don't have one. Almost no MD programs require one, mostly only DO programs require a DO shadowing/volunteering LOR.

 

[No Limits]

I just want to know why a college student, who was there to shadow, was given the responsibility to "get the patient to leave?" Don't they have nursing and support staff for that at your facility? Regardless if you were there for a year or whatever, you are there to observe real medicine and see that no one is indeed having sex in the elevator like on Greys Anatomy.

 

[kyamh]

... and see that no one is indeed having sex in the elevator like on Greys Anatomy.

Maybe hospital culture will change with the incoming generation of physicians

One can dream.....

 

[jetsfan1234]

Is there such a thing as a medical school that *does not* require a LOR from a doctor? Caribbean maybe?

The point is busywork and boxes to check, just like the rest of it

If you do actual work/volunteering for a doctor - like as a research/medical assistant, it makes sense.

I don't see the value of a shadowing LOR. What could they possibly write about you? That you are good at standing in the corner and observing?

 

[CharmanderMD]

I would assume that the MD who you generally like shadowing would refuse to write the letter instead of crushing your chances of getting into medical school. I'd hope he/she would remember what being a premed is like and wouldn't make one mistake (that is completely understandable at the very least) the end of your medical career. Talk to the physician and see their take on it before throwing out the whole experience.

 

[ThisCouldBeYou]

OP, you kept mentioning that it was "okay if I talk to the patients". And why not, especially if there isn't anyone else in the room? It's not like you're mute or you don't exist. It's just that, no matter if you're encouraged to talk to the patients or not, you don't talk about what just transpired in the exam room. Have you heard of the phrase, "Nod and grin and say nothing substantial"? The problem wasn't that you were polite and talking to the patient, it was simply that you gave the patient another solution not mentioned by the PA.

BTW, it should not matter that the PA was nearby and heard your conversation.

 

[UMU1030]

When I started reading this thread, I was in agreement with other SDN members, that the OP overstepped his role as a shadow. But having read further details, I'm much more troubled by the PA giving the shadow a task of dealing with an upset patient, while the she listned in. It's not like the PA was too busy to give the patient further explanation, because she clearly had the time to easedrop. I certainly can sympathize with the OP, because he or she was not trained to handle such a situation and the advice the OP gave resulted from a natural emotional reaction.
Given the amount of time the OP has shadowed these physicians, the OP has probably seen great examples of compassionate and appropriate behavior by a physician. In this case, the OP saw a patient get abandoned and they were given a task of providing the final kick out the door. In my opinion, it is not the PA's medical decision that the was truely put in question, but rather her professionalism. The OP walked right into an unfortunate trap, even though he or she only wanted to see the patient receive ample time and respect from the practitioner, albeit another practitioner.
Even though I and some others may sympathize with you,OP, there is no further reason to play the blame game. Have the personal satisfaction of acting compassionately, but also have the painful memory of poor judgment.Yes OP, some fault does fall on you. The lesson here is that you always have to be conscious of your role and your choice of words. I work as a nurse's aide and I constantly recieve orders which are outside of my scope of practice or questions outside of my expertise, and I simply have to redirect them. It's difficult and sometimes counterintuitive, but you have to protect yourself. You will fill many roles in your evolution of becoming an attending physician, but you cannot skip any of the steps. You mentioned that clerks often give the same advice that you gave, but you are still a shadow and not a clerk. If you encounter a similar situation in the future, just redirect it. Make the PA do her job instead of letting her throw you under the bus.
I don't think your prospects of a LOR are lost though. Show the physician that you have really thought about the experience and tell them what you have learned. After all, this is the kind of experience where you can show maturity and privide a memorable theme for the physicians to write about. If you are still worried, you can always elect for a disclosed LOR, where you will see what the physician wrote, but these letters do carry less weight than confidential ones. Good luck.

 

[GLaDOS]

OP, you kept mentioning that it was "okay if I talk to the patients". And why not, especially if there isn't anyone else in the room? It's not like you're mute or you don't exist. It's just that, no matter if you're encouraged to talk to the patients or not, you don't talk about what just transpired in the exam room. Have you heard of the phrase, "Nod and grin and say nothing substantial"? The problem wasn't that you were polite and talking to the patient, it was simply that you gave the patient another solution not mentioned by the PA.

BTW, it should not matter that the PA was nearby and heard your conversation.

I've been trying to not feel the need to defend myself on this thread, because it seems like a lot of people are only skimming my posts & not absorbing the full details before giving their opinion. I keep mentioning the fact that I'm encouraged to speak with the patients because people keep repeating that shadowing entails "keeping your mouth shut" & not speaking to the patients. I also mentioned that I didn't know that the PA overheard because more than one person has mistakenly made reference to me either saying this directly in front of the PA or knowingly within her earshot.

I spoke with the DO tonight briefly on his way home & we plan to have me stop by after closing tomorrow to fully hash this out with him & the other MD. I got a little more detail from him & it looks like the patient will be coming back tomorrow for another exam. She apparently was part of a sponsored vocational training program, so a few weeks before the exam for which I was present, she went to another location under this particular immediate care chain for a pre-training exam & was given a pass. The most recent exam was part of her pre-hire requirements & based on the results of her pre-training exam (which apparently was far more rigorous), neither she nor the HR department were expecting any problems.

 

[SN12357]

I've been trying to not feel the need to defend myself on this thread, because it seems like a lot of people are only skimming my posts & not absorbing the full details before giving their opinion. I keep mentioning the fact that I'm encouraged to speak with the patients because people keep repeating that shadowing entails "keeping your mouth shut" & not speaking to the patients. I also mentioned that I didn't know that the PA overheard because more than one person has mistakenly made reference to me either saying this directly in front of the PA or knowingly within her earshot.

I spoke with the DO tonight briefly on his way home & we plan to have me stop by after closing tomorrow to fully hash this out with him & the other MD. I got a little more detail from him & it looks like the patient will be coming back tomorrow for another exam. She apparently was part of a sponsored vocational training program, so a few weeks before the exam for which I was present, she went to another location under this particular immediate care chain for a pre-training exam & was given a pass. The most recent exam was part of her pre-hire requirements & based on the results of her pre-training exam (which apparently was far more rigorous), neither she nor the HR department were expecting any problems.

Don't feel the need to keep defending yourself from people with poor reading comprehension skills on the internet. You'll lock yourself into an endless cycle of posting...

 

[TheWeeIceMan]

I've been trying to not feel the need to defend myself on this thread, because it seems like a lot of people are only skimming my posts & not absorbing the full details before giving their opinion. I keep mentioning the fact that I'm encouraged to speak with the patients because people keep repeating that shadowing entails "keeping your mouth shut" & not speaking to the patients. I also mentioned that I didn't know that the PA overheard because more than one person has mistakenly made reference to me either saying this directly in front of the PA or knowingly within her earshot.

I spoke with the DO tonight briefly on his way home & we plan to have me stop by after closing tomorrow to fully hash this out with him & the other MD. I got a little more detail from him & it looks like the patient will be coming back tomorrow for another exam. She apparently was part of a sponsored vocational training program, so a few weeks before the exam for which I was present, she went to another location under this particular immediate care chain for a pre-training exam & was given a pass. The most recent exam was part of her pre-hire requirements & based on the results of her pre-training exam (which apparently was far more rigorous), neither she nor the HR department were expecting any problems.

Just to be clear, you talking to the patient wasn't the issue here. No one is going to hold making small talk with patients against you. The issue was what you said. Also, it doesn't really matter where the PA was in the situation. It doesn't change anything (neither does the eventual fitness diagnosis).

Regardless, treat this as a learning experience and you'll be fine. Also, just realize that you don't need this physician's LOR, so don't take any chances if you get a hesitant vibe from him.