Why are surgeons held with higher esteem than are physicians?

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Is that true? My dad is an oncologist and he has a great deal of respect for surgeons, he tells me that surgeons are the most respected and in the tumor board he does their cases first so they can leave. Definitely surgeons get the most respect, followed by oncologists.
U should be banned for bumping trash

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Is that true? My dad is an oncologist and he has a great deal of respect for surgeons, he tells me that surgeons are the most respected and in the tumor board he does their cases first so they can leave. Definitely surgeons get the most respect, followed by oncologists.
lol@the necrobump. Also lol@respecting oncologists- they're generally joked about a good deal in medicine as the sort of people that are always looking to push one more round of drugs before a patient dies so they can buy their wife a new pair of shoes. They're pretty meh in how other physicians regard them, due to the controversual nature of their payment model.
 
When the average person thinks of a doctor, they often think of a surgeon cutting someone open on an operating table more than someone sitting at a computer clicking checkboxes on a note template. One is "cool" and "dangerous", the other is pretty boring. I say this as a current Internal medicine resident.
 
When the average person thinks of a doctor, they often think of a surgeon cutting someone open on an operating table more than someone sitting at a computer clicking checkboxes on a note template. One is "cool" and "dangerous", the other is pretty boring. I say this as a current Internal medicine resident.

Respect for surgeons dates back to world war 2. They were the ones saving lives, and such held higher military rank, better pay, more authority etc.

Today, surgeons get respect because they generate more money for the hospital. Also, we have longer and more difficult training than many other specialties. Finally, I have yet to see any specialty take as much ownership of patients as we do (maybe heme/onc, but not really). We get things done. Our attendings treat every patient as if it's their only one. Many attendings give out their cell numbers. We see patients with their families and expose them to a ton of risk (i.e. cutting them open), and as such, feel very responsible for them and to see them get through their ordeal better than when they started.
 
Also lol@respecting oncologists- they're generally joked about a good deal in medicine as the sort of people that are always looking to push one more round of drugs before a patient dies so they can buy their wife a new pair of shoes

You know why they put nails in coffins, right?

So the oncologist can't give another round of chemo.
 
Because they're the ones who actually get stuff done, unlike some other medical specialties.

"oh my goodness the patients potassium is 3.4" let's debate the 22 possible etiologies of that."

No thanks
 
Is that true? My dad is an oncologist and he has a great deal of respect for surgeons, he tells me that surgeons are the most respected and in the tumor board he does their cases first so they can leave. Definitely surgeons get the most respect, followed by oncologists.

definitely says the premed based on daddy's cases?

sorry, it's just, putting your foot into the medicine vs surgical debate, is never a good. It's stepping in horsehit. Your shoe is not coming out better for it.

 
Respect for surgeons dates back to world war 2. They were the ones saving lives, and such held higher military rank, better pay, more authority etc.

Today, surgeons get respect because they generate more money for the hospital. Also, we have longer and more difficult training than many other specialties. Finally, I have yet to see any specialty take as much ownership of patients as we do (maybe heme/onc, but not really). We get things done. Our attendings treat every patient as if it's their only one. Many attendings give out their cell numbers. We see patients with their families and expose them to a ton of risk (i.e. cutting them open), and as such, feel very responsible for them and to see them get through their ordeal better than when they started.
I would suggest that its because y'all can actually fix things on occasion. My keeping that guy's diabetes and blood pressure in check is important and all, but I'm not likely to ever actually fix him. Taking out his inflamed appendix, on the other hand, will fix that problem forever.
 
Because they're the ones who actually get stuff done, unlike some other medical specialties.

"oh my goodness the patients potassium is 3.4" let's debate the 22 possible etiologies of that."

No thanks
God forbid you spend your days thinking 😉 And all IM is not academic IM...
 
Respect for surgeons dates back to world war 2. They were the ones saving lives, and such held higher military rank, better pay, more authority etc.

Today, surgeons get respect because they generate more money for the hospital. Also, we have longer and more difficult training than many other specialties. Finally, I have yet to see any specialty take as much ownership of patients as we do (maybe heme/onc, but not really). We get things done. Our attendings treat every patient as if it's their only one. Many attendings give out their cell numbers. We see patients with their families and expose them to a ton of risk (i.e. cutting them open), and as such, feel very responsible for them and to see them get through their ordeal better than when they started.

I agree with your post except where bolded.

People in medicine will tell you this is total horse****.

I see surgeons treating their patients like bags of meat, and when they happen to be awake, bags of meat they can't wait to put to sleep and start cutting on, as fast as possible I might add.

As far as ownership, please, what a joke. Always foisting them off on medicine to be primary because apparently you guys can't manage simple stress hyperglycemia post-op. I've been privy to a case where medicine was consulting for a patient that was post op from a very big deal surgery, and after MULTIPLE calls surgery wouldn't come see their own patient, and the patient DIED. How was that for ownership?

Others, feel free to chime in. If you wanted to point to one reason alone there is so much bad blood between surgery and medicine, it would be the OPPOSITE of what you're saying, you guys don't own your patient. You cut them up and then try to hand them off elsewhere ASAP.

I've never read a bigger lie on SDN in my life.
 
I agree with your post except where bolded.

People in medicine will tell you this is total horse****.

I see surgeons treating their patients like bags of meat, and when they happen to be awake, bags of meat they can't wait to put to sleep and start cutting on, as fast as possible I might add.

As far as ownership, please, what a joke. Always foisting them off on medicine to be primary because apparently you guys can't manage simple stress hyperglycemia post-op. I've been privy to a case where medicine was consulting for a patient that was post op from a very big deal surgery, and after MULTIPLE calls surgery wouldn't come see their own patient, and the patient DIED. How was that for ownership?

Others, feel free to chime in. If you wanted to point to one reason alone there is so much bad blood between surgery and medicine, it would be the OPPOSITE of what you're saying, you guys don't own your patient. You cut them up and then try to hand them off elsewhere ASAP.

I've never read a bigger lie on SDN in my life.

Maybe I work somewhere very special then. Or maybe you work somewhere very not. Who knows.

Surgeons aren't shift-work based, and as such, our patient is our patient. I'm sure exceptions apply. Might be different in the community where some surgeons are pure technicians. Some residents might not feel ownership the way attendings do. Clearly you had a bad experience, I promise it's not generalizable.
 
Maybe I work somewhere very special then. Or maybe you work somewhere very not. Who knows.

Surgeons aren't shift-work based, and as such, our patient is our patient. I'm sure exceptions apply. Might be different in the community where some surgeons are pure technicians. Some residents might not feel ownership the way attendings do. Clearly you had a bad experience, I promise it's not generalizable.
Eh, it might not be but her story is not unique. When I was a 3rd year medical student on the family medicine service we consulted the resident service for a patient who needed an appendectomy. The resident called back and said "You guys never give us any interesting cases, so I'm refusing this consult". The IM service had just quit using the residents altogether and 100% of their consults went to private groups.

Now I'm not saying that all surgery residents are like this - I'm sure there are great programs out there. But I'm not sure this is as isolated as you seem think it is.
 
lol@the necrobump. Also lol@respecting oncologists- they're generally joked about a good deal in medicine as the sort of people that are always looking to push one more round of drugs before a patient dies so they can buy their wife a new pair of shoes. They're pretty meh in how other physicians regard them, due to the controversual nature of their payment model.

My dad used to work in private practice and this was a big problem. He was honestly disgusted by what he saw. When a 19 YO patient, clearly terminal w/ no hope, was being pumped with chemo by the group, he quit private for good and moved into academic at a hospital where they get relatively fixed salary and bonus is based on call and floor, as I understand. Its very easy to get a patient to take another round without fear of malpractice ("It probably won't work but their is always a small chance..you came this far...")

Radiation oncology is also another one. Lots of unnecessary treatment. We have a radiation oncologist friend and the stories he tells will shock you....
 
My dad used to work in private practice and this was a big problem. He was honestly disgusted by what he saw. When a 19 YO patient, clearly terminal w/ no hope, was being pumped with chemo by the group, he quit private for good and moved into academic at a hospital where they get relatively fixed salary and bonus is based on call and floor, as I understand. Its very easy to get a patient to take another round without fear of malpractice ("It probably won't work but their is always a small chance..you came this far...")

Radiation oncology is also another one. Lots of unnecessary treatment. We have a radiation oncologist friend and the stories he tells will shock you....
I could never go into oncology, because I know the temptation to overtreat or to treat with more expensive drugs when less expensive ones are equally effective would be too great. I mean, not to say that other fields don't have their own issues- many spine surgeons, for instance, use laminectomies, spinal fusions, and discectomies their bread and butter, despite the outcomes of such procedures often being minimal to nonexistent. But you know, it *might* be the only thing that'll work, so like, why not, amirite?
 
I agree with your post except where bolded.

People in medicine will tell you this is total horse****.

I see surgeons treating their patients like bags of meat, and when they happen to be awake, bags of meat they can't wait to put to sleep and start cutting on, as fast as possible I might add.

As far as ownership, please, what a joke. Always foisting them off on medicine to be primary because apparently you guys can't manage simple stress hyperglycemia post-op. I've been privy to a case where medicine was consulting for a patient that was post op from a very big deal surgery, and after MULTIPLE calls surgery wouldn't come see their own patient, and the patient DIED. How was that for ownership?

Others, feel free to chime in. If you wanted to point to one reason alone there is so much bad blood between surgery and medicine, it would be the OPPOSITE of what you're saying, you guys don't own your patient. You cut them up and then try to hand them off elsewhere ASAP.

I've never read a bigger lie on SDN in my life.

Oh god this is so true. I'm biased but seriously seen some stuff. Patient comes in for infected knee when they just had a knee replacement. Ortho refused to take on their service AND they refused to come see the patient (wtf?) Gen surg sees different patient in ed, omg htn dm send them to medicine we will be the consult for their ascending cholangitis ???
 
Maybe I work somewhere very special then. Or maybe you work somewhere very not. Who knows.

Surgeons aren't shift-work based, and as such, our patient is our patient. I'm sure exceptions apply. Might be different in the community where some surgeons are pure technicians. Some residents might not feel ownership the way attendings do. Clearly you had a bad experience, I promise it's not generalizable.
It's also possible that you're oblivious. Surgery was often like that at my hospital- their patients, if out of sight, were often out of mind. Getting ahold of a surgeon after they bumped someone to medicine could take quite some time during operating hours, and bumping people to stepdown, medicine, or the floors that should have maintained a higher level of surgical care was common (because they needed SICU beds- without them, many surgeries were postponed or canceled), and once bumped out of SICU (or the PACU) they dropped so far down the priority list that they surgeon seemed as if they were getting a call about the patient post-discharge.

The wanted their patient while they can do stuff with them, the second they were bored, they tried to bounce them off to another service or area where they'd have to deal with them as little as possible. The good ones were great, but many of the residents... They just didn't give a **** because they were too tired to care and you really had to draw any sense of giving a damn out of them, as if pulling teeth.
 
Because they're the ones who actually get stuff done, unlike some other medical specialties.

"oh my goodness the patients potassium is 3.4" let's debate the 22 possible etiologies of that."

No thanks

Any internal medicine worth their salt would have already put in orders for a big helping of k-dur before rounds anyways.
 
At one point in time, in surgical residency it was frowned upon to consult medicine for anything. It was a disaster in those days, but at least some of the older surgeons could actually manage some fairly basic medical problems. Nowadays they do not hesitate nearly as much in asking for help.
 
I could never go into oncology, because I know the temptation to overtreat or to treat with more expensive drugs when less expensive ones are equally effective would be too great. I mean, not to say that other fields don't have their own issues- many spine surgeons, for instance, use laminectomies, spinal fusions, and discectomies their bread and butter, despite the outcomes of such procedures often being minimal to nonexistent. But you know, it *might* be the only thing that'll work, so like, why not, amirite?

I was once shadowing an osteophatic doctor (DO). He was very nice, honestly I believe him to be extremely sincere. But oh my, the things he used to do, pseudoscience is not the word. Like, he would do the stupidest massages and spine alignment. Apparently his patients--almost all women suffering from "pain"--got better. Makes you wonder...
 
I was once shadowing an osteophatic doctor (DO). He was very nice, honestly I believe him to be extremely sincere. But oh my, the things he used to do, pseudoscience is not the word. Like, he would do the stupidest massages and spine alignment. Apparently his patients--almost all women suffering from "pain"--got better. Makes you wonder...
Difference between that and a lot of spine surgeons is that their patients don't even get subjectively better, let alone objectively. And a spinal surgery is a whole lot more of an ordeal than OMM- It's a five to six figure procedure that can never be undone.
 
I think part of this is the tendency to lump "surgery" into one homogeneous field. Obviously there are vast differences in the ways that general surgery and ortho approach patient care and ownership.

That said, we (general) surgeons are not saints nor saviors. I generally hate the unique combination of hero/martyr complex that many general surgeons (residents in particular) seem to adopt - that we are "saving" patients from all the other incompetent services in the hospital and we are the only ones who really care and take the time to own our patients.

I do pride myself on my own patient ownership, but I know many physicians in many fields who do the same.

I'm with you on disliking the hero/martyr complex, but I would hardly say it is unique to general surgery. Probably 90% of the residents in any inpatient field I rotated through hard varying degrees of the above. It's a comforting delusion, to be sure and I'm sure it helps people cope with the intense demands that residency places on them (this job sucks but at least I'm the one saving these patients) and villifying the other services probably helps ease the constant insecurity that comes with medical training (am I competent enough? Of course I am look at how bad these other guys are). Unfortunately I usually found that it impaired communication between services. Instead of really listening to each other, each side seemed to be trying to walk the awkward tightrope of doing less work all while offering better care (at least in their head) and preemptively accusing the other side of doing the opposite instead of trying to understand the fundamental problem and fix it.

Fortunately, from what I've seen attendings are much better at appreciating other fields than residents. I don't know why (the better pay and more respect? More job security? They're actually faking it but it greases the wheels and they do it to function?), but I'm glad it happens regardless.
 
I was once shadowing an osteophatic doctor (DO). He was very nice, honestly I believe him to be extremely sincere. But oh my, the things he used to do, pseudoscience is not the word. Like, he would do the stupidest massages and spine alignment. Apparently his patients--almost all women suffering from "pain"--got better. Makes you wonder...

oooooh yeah, I hold the DOs in high esteem

I could use a little manual manipulation right about now

no joke, if you're a dude and a DO, I will find you 😏
 
I'm with you on disliking the hero/martyr complex, but I would hardly say it is unique to general surgery. Probably 90% of the residents in any inpatient field I rotated through hard varying degrees of the above. It's a comforting delusion, to be sure and I'm sure it helps people cope with the intense demands that residency places on them (this job sucks but at least I'm the one saving these patients) and villifying the other services probably helps ease the constant insecurity that comes with medical training (am I competent enough? Of course I am look at how bad these other guys are). Unfortunately I usually found that it impaired communication between services. Instead of really listening to each other, each side seemed to be trying to walk the awkward tightrope of doing less work all while offering better care (at least in their head) and preemptively accusing the other side of doing the opposite instead of trying to understand the fundamental problem and fix it.

Fortunately, from what I've seen attendings are much better at appreciating other fields than residents. I don't know why (the better pay and more respect? More job security? They're actually faking it but it greases the wheels and they do it to function?), but I'm glad it happens regardless.
I feel like everyone in the hospital has a hero/martyr complex. Nurses do the same thing.
 
Difference between that and a lot of spine surgeons is that their patients don't even get subjectively better, let alone objectively. And a spinal surgery is a whole lot more of an ordeal than OMM- It's a five to six figure procedure that can never be undone.
OMM is basically a sophisticated massage, which a lot of people feel better after, that's why the massage industry is so big lol
 
OMM is basically a sophisticated massage, which a lot of people feel better after, that's why the massage industry is so big lol

it's a little more with the high velocity manuveurs, although admittedly chiropractors would be the masters of that

it's a nice set of skills I wish I had in my toolbox as a generalist MD

MSK pain if I'm not wrong is like the #3 CC at the outpt PCP level

****, my neck was KILLING me for like 3 months in intern year and I turned to one of my fellow DOs and in like 5 seconds he showed me some strain/counterstraing technique that changed my life

I wish the DOs appreciated it more.
 
it's a little more with the high velocity manuveurs, although admittedly chiropractors would be the masters of that

it's a nice set of skills I wish I had in my toolbox as a generalist MD

MSK pain if I'm not wrong is like the #3 CC at the outpt PCP level

****, my neck was KILLING me for like 3 months in intern year and I turned to one of my fellow DOs and in like 5 seconds he showed me some strain/counterstraing technique that changed my life

I wish the DOs appreciated it more.
Chiros are often actually kind of hacks in regard to a lot of HVLA stuff, watching them do things like cervical HVLA frequently makes me cringe like you wouldn't believe. But counterstrain can help quickly and effectively for some people- hell, I used to have chronic tension headaches that were borderline unbearable, but five minutes after some CS and suboccipital tension release and they're gone, often for weeks or months. It's literally the only thing I've ever found that works, and it's a pity people around here knock it so hard.
 
it's a little more with the high velocity manuveurs, although admittedly chiropractors would be the masters of that

it's a nice set of skills I wish I had in my toolbox as a generalist MD

MSK pain if I'm not wrong is like the #3 CC at the outpt PCP level

****, my neck was KILLING me for like 3 months in intern year and I turned to one of my fellow DOs and in like 5 seconds he showed me some strain/counterstraing technique that changed my life

I wish the DOs appreciated it more.

meanwhile the people who actually trained to do it, like 95 + % of them completely ignore it. so clearly you're overstating its efficacy

if OMM was so great allo medicine would pick it up in a heartbeat
 
meanwhile the people who actually trained to do it, like 95 + % of them completely ignore it. so clearly you're overstating its efficacy

if OMM was so great allo medicine would pick it up in a heartbeat

um, no, that's not really the issue

musculoskeletal health is like mental health when it comes to how it's dealt with

you act like allo medicine is the pinnacle of what should be done to help patients - it's all big business and that's what drives what is and is not done, not efficacy lol
 
um, no, that's not really the issue

musculoskeletal health is like mental health when it comes to how it's dealt with

you act like allo medicine is the pinnacle of what should be done to help patients - it's all big business and that's what drives what is and is not done, not efficacy lol

msk health is mental health. hence why chronic pain is nearly 100 % middle aged women
 
meanwhile the people who actually trained to do it, like 95 + % of them completely ignore it. so clearly you're overstating its efficacy

if OMM was so great allo medicine would pick it up in a heartbeat
Physical therapists do a lot of the same stuff we do in regard to CS and ME, and yet no one gives them **** for it. The real problem with these techniques isn't that they don't work, it's that they don't cure anything, they merely provide differing degrees of temporary relief. Like, I can fix someone's neck, but if it's screwed up because of the way they sit at work, it'll be ****ed up again in a couple days unless they change their ergonomic setup. That isn't efficient so far as medicine goes- you can't be going to your doctor every other day to ease your neck pain-, and isn't the sort of thing that mainstream medicine is looking to jump all over. It just isn't an effective use of time in most practices, and often addresses minor complaints physicians view to be "beneath them."

I use it all the time in my personal life, but will I use it in my career? Probably not, aside from very particular cases I think I can help quickly and easily.
 
msk health is mental health. hence why chronic pain is nearly 100 % middle aged women
Literally the most ignorant thing I've ever read on SDN. I can't wait until you get a little bit older, so you can realize what a "middle aged woman" you are. Chronic pain is a common part of aging for a lot of people, and a common result of many injuries.
 
msk health is mental health. hence why chronic pain is nearly 100 % middle aged women

I dunno bro I had pretty bad lower back pain for a few months out of nowhere and it disappeared just as suddenly as it came. Mentally was in a good place at the time too
 
msk health is mental health. hence why chronic pain is nearly 100 % middle aged women

Please... oh please do a rotation at a legitimate pain clinic. You know... the ones that will do things like RF ablations and injections under fluoroscopy. Tell me that it's just in their head when you read the MRI reports.
 
Literally the most ignorant thing I've ever read on SDN. I can't wait until you get a little bit older, so you can realize what a "middle aged woman" you are. Chronic pain is a common part of aging for a lot of people, and a common result of many injuries.
come to my ER and see my chronic pain patients that fail at pain clinics etc. almost all middle age women. yes its ancedote. although, his comment is a gross exergeration, a decent percent of chronic pain is compounded by psych and/or poor coping skills.

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come to my ER and see my chronic pain patients that fail at pain clinics etc. almost all middle age women. yes its ancedote. although, his comment is a gross exergeration, a decent percent of chronic pain is compounded by psych and/or poor coping skills.

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yes, because the ED is a great representation of the wider population 🙄

right, and like I pointed out with the example of the VA, even if what you said was strictly true, and it's not, it's related to gender 🙄

nevermind that studies show in general women are more likely to express feeling and seek care, but sure, women just have poorer coping skills 🙄

nevermind that the fact that men are more likely to not seek care and sustain injuries, both of which can increase the risk of developing something and getting chronic pain

because not going to the ED is clearly a sign of better coping skills 🙄

because not talking about your feelings and just downing a 6 pack in the evening for your chronic back pain is a better coping mechanism 🙄

so yes, let's label chronic pain a problem of middle aged women with poor coping skills just because they might be more likely to end up in front of the physician 🙄

and in any case, whatever real sex differences exist in the development or experience of chronic pain, let's perpetuate negative stereotypes in any case and also express little empathy 🙄
 
come to my ER and see my chronic pain patients that fail at pain clinics etc. almost all middle age women. yes its ancedote. although, his comment is a gross exergeration, a decent percent of chronic pain is compounded by psych and/or poor coping skills.

Sent from my VS986 using Tapatalk
Middle age women keep spine surgeons rich.
 
Anecdotally, going through my PM&R residency my case log for outpatient emg, ncs, peripheral nerve clinic, pain management, headache, and interventional pain its at 65% female. There is a heavy interplay between chronic pain and psych in a good deal of these patients (men and women). I plan on doing interventional and on all of my electives in different cities, populations, etc the gender thing has come up. In defense of the XX men are more likely to be frankly misusing and seeking.

http://www.ncbi.nlm.nih.gov/pubmed/16290886
 
there's been some research that hormones may have a role in development of chronic pain

so what I resent here about the talk on chronic pain is acting like women are "hysterical" in the Freudian sense

I think there's more biology and less "mental whatever" at play here than docs give credit to

let's not make this a get down on chronic pain sufferers and on women thread

these attitudes do nothing to help these populations, only hurt

I really don't want to get banned going ape**** on you guys about this

not to mention this is way off topic from the thread
 
there's been some research that hormones may have a role in development of chronic pain

so what I resent here about the talk on chronic pain is acting like women are "hysterical" in the Freudian sense

I think there's more biology and less "mental whatever" at play here than docs give credit to

let's not make this a get down on chronic pain sufferers and on women thread

these attitudes do nothing to help these populations, only hurt

I really don't want to get banned going ape**** on you guys about this

not to mention this is way off topic from the thread

This and also a lot of "mental whatever" is legit medical illness as well.
 
I would suggest that its because y'all can actually fix things on occasion. My keeping that guy's diabetes and blood pressure in check is important and all, but I'm not likely to ever actually fix him. Taking out his inflamed appendix, on the other hand, will fix that problem forever.
cure that appendicitis with cefazolin?
 
I don't understand why though; for example, I think it takes more brain work to be a cardiologist than to be an orthopaedic surgeon. In short, "physicians use their brains; surgeons use their hands."

Orthopedics is incredibly tough and requires a great of intelligence as well. Just look at many who struggle on their aways. Surgery in general requires a lot of understanding of physiology and on the spot decisions. Also, if things go wrong, you don't have all morning before rounds to figure out why. Also, in order to match Ortho you have to publish which requires a seperate set of skills. There's I've heard there's also a whole visual-reasoning component to Orthopedics that I've seen fellow sdn'er actually struggle with. Just because something isn't taught in medical school, doesn't mean it's not a skill.

Also, Cardiology is highly respected. It's probably one of the most highly respected field by lay people for all the reasons you probably would think and seem to appreciate (physiology, problem solving, etc.) and for its procedures which lead to higher compensations.

Also, every field of medicine seems to be equally represented by physicians. Yeah, you'll always have some who's made it to competitive specialties with an ego but for the most part, surgeons rely on general practitioners and in fact in terms of decision making, primary is usually the executive in decision making.

Overall, all fields of medicine are truly (not even trying to be PC) respected among physicians.
 
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