What do you do when an attending is wrong?

[zedpol]

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I have had a couple of experiences where teachers or attendings have said stuff that is just plain old wrong, normally some basic science factoid. i have obviously kept my mouth shut but how do you guys handle that stuff? Especially when it influences patient care.

peace

 

[Leukocyte]

Stay quite, and try to keep a straight face. If it will cause a DIRECT harm to a patient (very rare), then D/W your resident.

 

[ericdamiansean]

exactly...but it also depends on who you're dealing with. if it's some old foggy, then I guess keeping a straight face is the best. If it's a young resident, then I think you can tell him, but nicely. You should go like: "um, I read in a book that bla bla bla...what do you think about it?"

 

[Savasana]

Yeah, a friend advised me that if you think a resident has got something wrong, approach them with the "I read about this...." line, and ask as if you want them to clarify their approach, or you don't understand....make it look like an honest question, because they may have a reason behind what appears to be a mistake to you, and if it truly is a mistake, it allows them to save face.

 

[Pilot]

Generally, I would say keep your mouth shut. However, if you have been previously trained in another field (i.e. pharmacology, PT, etc.) I think it is OK to "counsel" correct information privately related to that field. Hopefully, the attending shoud be amenable to learning from you as much as you are learning from them (especially if you have additional training which is beneficial).

 

[scootad.]

Golden Rule #1 of MSIII: The attending is never wrong.

 

[Yosh]

I agree with the above posters...as it is NEVER advisable to come across as adversarial or contradicting your attending. Depending on your rapport with him/her, you can approach them alone, and privately as them to explain what it was they were talking about...which will show you as open minded and interested in learning, and afford you the opportunity to perhaps mention what you thought/know is correct.

 

[ericdamiansean]

I asked me attending, a surgeon who's about 35, if my patient is sexually active if she has coitus twice a month.
He told me "Dude, if you have sex once in your lifetime, you're sexually active" 😀 😀 😀

Is he right?

 

[lowbudget]

How do you know your attending is wrong? I mean, the moment you bust out something from First Aid/Blueprints/High Yield, they will THROW YOU DOWN with "After proving blah blah in multi-center, international, perfect clinical trial, I proposed it to XYZ National Academy and they notified me by EMAIL at 7:59 am before rounding that it was JUST approved." So... SHOW UP, SHUT UP, and LOOK IT UP.

But what I usually do (not because I'm trying to correct the guy, but instead because I'm a dumb ass) is ASK a question like, "What's your opinion about using a XYZ in this patient?" or "So do you usually do ABC in a patient like this?" I always couch my questions with "in a patient like this" because NOW you're deferring to their clinical experience/wisdom and not some crap that could be read out of a book... because if it can be, they will tell you to look it up AND give a presentation, putting a damper into your happy hour/work out time.

Also, don't forget what service you're on and who you're talking to. YOU have the benefit of rotating through different specialties every month... your attending doesn't. So DO NOT get into a long protracted discussion about the latest heart failure management or some crazy ass rheumatologic syndrome when you're on ortho or psych. I mean, seriously. Your attending will throw you down and make you do a presentation right after rounds. And your classmates and residents will just laugh at you. Remember, your attending has malpractice insurance... but you don't have I-just-got-clowned insurance.