why do surgeons hate on obgyn?

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swoopyswoop

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I've heard so many derisive remarks from surgeons about how obgyns aren't really surgeons. Seems strange considering they operate... and the lack of similar remarks regarding urologists makes me just feel like it's the old boys club being sexist.
 
Not sure...but the OBs I've rotated with have 2 days a week +/- 1/2 day set aside to do OR stuff. Not as much as gen surgery, but a decent chunk of time is spent operating. I agree though, I don't understand that either
 
Why do surgeons hate on medicine?

Why does medicine hate on surgery?

Why does medicine hate on the ER?

Why does surgery hate on the ER?

Why does the ER hate on surgery?

Why does the ER hate on medicine?

Why does ortho hate on gen surg?

Why does gen surg hate on ortho?

Why does neurosurgery hate on neurology?

Why does neurology hate on neurosurgery?

Why does surgery hate on anesthesia?

Why does anesthesia hate on surgery?

Why does medicine hate on psychiatry?

Why does psychiatry hate on medicine?

Why can't we all just get along??
 
southernIM said:
Why do surgeons hate on medicine?

Why does medicine hate on surgery?

Why does medicine hate on the ER?

Why does surgery hate on the ER?

Why does the ER hate on surgery?

Why does the ER hate on medicine?

Why does ortho hate on gen surg?

Why does gen surg hate on ortho?

Why does neurosurgery hate on neurology?

Why does neurology hate on neurosurgery?

Why does surgery hate on anesthesia?

Why does anesthesia hate on surgery?

Why does medicine hate on psychiatry?

Why does psychiatry hate on medicine?

Why can't we all just get along??
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Let the record show that dermatology doesn't hate on anyone.
 
southernIM said:
Heh @DermViser hates on pretty much everyone...
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I wouldn't classify it as hate. Annoyed, unable to understand why they are the way they are, but hate is strong word. I very much like when we are consulted and our opinion is valued.
 
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swoopyswoop said:
I've heard so many derisive remarks from surgeons about how obgyns aren't really surgeons. Seems strange considering they operate... and the lack of similar remarks regarding urologists makes me just feel like it's the old boys club being sexist.
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I don't think surgeons hate OB-Gyn. They don't consider them to be "real surgeons" (which they're not). Urology is a surgical subspecialty.
Don't try to make this a sexist argument, bc it's not.
 
southernIM said:
Why do surgeons hate on medicine?

Why does medicine hate on surgery?
Why does medicine hate on the ER?
Why does surgery hate on the ER?
Why does the ER hate on surgery?
Why does the ER hate on medicine?
Why does ortho hate on gen surg?
Why does gen surg hate on ortho?
Why does neurosurgery hate on neurology?
Why does neurology hate on neurosurgery?
Why does surgery hate on anesthesia?
Why does anesthesia hate on surgery?
Why does medicine hate on psychiatry?
Why does psychiatry hate on medicine?
Why can't we all just get along??
Click to expand...
Bc we're all different specialties. Our environment and mores are different. I don't know what you classify as "getting along".
 
southernIM said:
I was just trying to shut down the annoying thread by the OP by pointing out you could ask the same question of nearly any two specialties that regularly interact.
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Which is weird, bc I haven't really noticed OB-Gyn or General Surgery interact in the hospital as far as between those 2 specialties. I don't know what OB-Gyn would consult General Surgery for or vice versa. I guess the title of the thread doesn't really match the OP. General Surgeons saying that OB-Gyns aren't really surgeons, isn't really hate. It's more a comment on the extent of their surgical training experience - which isn't extensive like in General Surgery. There's a reason they do Gyn Onc fellowships.

I especially like that he trotted out the gender card as the go to card.
 
southernIM said:
We get consulted by them for:
-uncontrollable intraop hemorrhage
-inability to close abdomen
-nec fasc post c-section
-damage to bowel intraop
-bowel obstruction in pt with history of gyn surgery
-any general surgery issue arising during pregnancy (appy, chole, and...sigh...hemorrhoids)
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So in other words, pretty much only when they **** up. Your examples support the point that OB-Gyns, aren't real surgeons. lol. 😆
 
southernIM said:
We get consulted by them for:
-uncontrollable intraop hemorrhage
-inability to close abdomen
-nec fasc post c-section
-damage to bowel intraop
-bowel obstruction in pt with history of gyn surgery
-any general surgery issue arising during pregnancy (appy, chole, and...sigh...hemorrhoids)
Click to expand...

I've also gotten consulted to insert lap trocars when they struggle to insert them (i.e. place the trocar preperitoneal as they think they are looking at adhesions everywhere), have adhesions to the adnexa (would rather get called BEFORE the injury happens anyhow), and my personal favorite, when the appendix "looks funny".

Ob/Gyn is my #1 source of intra-op consults. Going to kindly help them out has resulted in a significant number of legit referrals to me.
 
VisionaryTics said:
You want to see hate, ask a urologist what he thinks of ob/gyns.

Three most common gynecologic operations:

1. Hysterectomy
2. Transection of the right ureter
3. Transection of the left ureter
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On my 2nd scrub-in on OB/Gyn, the attending nicked the left ureter, so this post made me laugh.
 
From an EM perspective, there are plenty of times when someone has an acute abdomen and it's unclear if it's from a gynecologic or surgical source, you need to get both involved. ovarian torsion, PID, appy do not always show up on imaging and can be unclear from exam at times (there is not always cervicitis or a TOA w/ PID, and you see arterial flow 25-40% of the time in torsion cases, CT misses ~5% of appendicitis cases). Gen surg won't touch ovaries, and ob/gyn won't touch bowel, so you won't know who the correct person is until they're in the OR.
 
And as has been said, you have surgical disease plenty of times in pregnant patients. Any appy r/o's in prengnant patients get admitted to ob/gyn w/ gen surg consult evaluating with serial exams normally at my community location (it is cheaper than an MRI overall the way things are billed here).
 
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.....
 
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southernIM said:
The contrasting example of Urology given by the OP is actually humorous, as I would say Urology has maintained the closest relationship with general surgery of any of the subspecialties - their interns do a full year with us, unrestricted; some programs their residents do two years of general surgery before starting urology; they were one of the last subspecialties to break off from general surgery (*I'm not counting fields that I still consider a part of general surgery and not truly distinct subspecialties - vascular, CT, and plastics).
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Why did other specialties start breaking off?
 
DermViser said:
Why did other specialties start breaking off?
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There's really not much similarity between neurosurgery, otolaryngology, and orthopaedics to general surgery. 70 years ago, there was probably enough similarity and a small enough set of things to know that it was OK for subspecialists to spend years in gen surg prior. There's some fundamentals that are shared (which is why we all do internship together). However, if you tried to teach all of modern orthopaedics or otolaryngology in a 2-3 fellowship period, it would be impossible. Simply too much to learn, and much of it is a completely different skill and knowledge base.

I'm not sure when neurosurgery or orthopaedics broke off, but I know of some old professor emeritus-types who did residency in the 1960s that did a general surgery residency prior to an ENT fellowship.
 
swoopyswoop said:
I've heard so many derisive remarks from surgeons about how obgyns aren't really surgeons. Seems strange considering they operate... and the lack of similar remarks regarding urologists makes me just feel like it's the old boys club being sexist.
Click to expand...

Because OBGYNs get really, really riled up?
 
DermViser said:
I very much like when we are consulted and our opinion is valued.
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Yea but that never happens... at least the part about the opinion being valued :smuggrin:



I kid, I kid. The different services should fight... in much the same way that siblings or branches of the armed forces fight with each other. In a good-natured way, but cognizant that sometimes we need each other.
 
Doctor Bob said:
Yea but that never happens... at least the part about the opinion being valued :smuggrin:

I kid, I kid. The different services should fight... in much the same way that siblings or branches of the armed forces fight with each other. In a good-natured way, but cognizant that sometimes we need each other.
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No, I understand. In the world of Internal Medicine, the more "valued" specialties in terms of valuing their opinion will naturally be GI, Cards, Heme/Onc, Pulm/Critical Care, maybe Nephro (as that can be quite complicated) as those are direct fellowships out of IM. With Derm, I believe it's more depending on the case - i.e. a very severe skin reaction (usually due to a certain drug, but not always) that no one can figure out which drug is doing it.

When I mean by valued is the inpatient team (not just IM either) isn't able to figure out on their own up to that point with their specific knowledge base (It's usually an area that is outside the realm of general primary care Derm), so they consult us. Same if they were consulting Ophtho who are the experts in the eye.
 
DermViser said:
Which is weird, bc I haven't really noticed OB-Gyn or General Surgery interact in the hospital as far as between those 2 specialties. I don't know what OB-Gyn would consult General Surgery for or vice versa. I guess the title of the thread doesn't really match the OP. General Surgeons saying that OB-Gyns aren't really surgeons, isn't really hate. It's more a comment on the extent of their surgical training experience - which isn't extensive like in General Surgery. There's a reason they do Gyn Onc fellowships.
I especially like that he trotted out the gender card as the go to card.
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We joke here that the divide is so bad the two have their own floors for ORs. The only ones that use our OR are the GynOncs (which you mentioned).

southernIM said:
We get consulted by them for:
-uncontrollable intraop hemorrhage
-inability to close abdomen
-nec fasc post c-section
-damage to bowel intraop
-bowel obstruction in pt with history of gyn surgery
-any general surgery issue arising during pregnancy (appy, chole, and...sigh...hemorrhoids)
Click to expand...

Yeah... gen surg subI we were consulted by OB during a C-section because they "accidentally" perforated bowel. We went in, fixed the problem and left. The question "How it happened" was banned from being asked. Banned because there's a serious amount of "oops" to make a 2cm accident during a c-section. I wanted to leave the OR because I thought my attending was going to just spontaneously combust in fire and kill us all.

The other one is OB pre-consulting us 2 weeks before a woman is giving birth via c-section because of the fear of adhesions when they do her c-section. Granted, she's a Crohn's patient who's been operated on a couple times in the past by us, but come on....
 
Kaustikos said:
We joke here that the divide is so bad the two have their own floors for ORs. The only ones that use our OR are the GynOncs (which you mentioned).

Yeah... gen surg subI we were consulted by OB during a C-section because they "accidentally" perforated bowel. We went in, fixed the problem and left. The question "How it happened" was banned from being asked. Banned because there's a serious amount of "oops" to make a 2cm accident during a c-section. I wanted to leave the OR because I thought my attending was going to just spontaneously combust in fire and kill us all.

The other one is OB pre-consulting us 2 weeks before a woman is giving birth via c-section because of the fear of adhesions when they do her c-section. Granted, she's a Crohn's patient who's been operated on a couple times in the past by us, but come on....
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Yes. It's quite funny. I wonder if it has something to do with gender where males on Surgery get an automatic pass, while females on OB-Gyn don't. Mainly bc females, in general, are expected to be kinder, nicer, even tempered, etc.

The reason you probably can't ask why it happened is bc the OB-Gyn harpies would probably get angry bc then it looks like you're blaming someone when you've been called as a consult. So then when they think they're getting blamed, they're less likely to consult you, which in the end can be worse for the patient in terms of outcomes. I believe it's bc hospitals have adopted a "no-blame" hospital culture: http://www.todayshospitalist.com/index.php?b=articles_read&cnt=933

It's funny bc that culture is antithetical to the culture of a surgeon who demands things like personal accountability and responsibility.
 
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DermViser said:
Yes. It's quite funny. I wonder if it has something to do with gender where males on Surgery get an automatic pass, while females on OB-Gyn don't. Mainly bc females, in general, are expected to be kinder, nicer, even tempered, etc.

The reason you probably can't ask why it happened is bc the OB-Gyn harpies would probably get angry bc then it looks like you're blaming someone when you've been called as a consult. So then when they think they're getting blamed, they're less likely to consult you, which in the end can be worse for the patient in terms of outcomes. I believe it's bc hospitals have adopted a "no-blame" hospital culture: http://www.todayshospitalist.com/index.php?b=articles_read&cnt=933

It's funny bc that culture is antithetical to the culture of a surgeon who demands things like personal accountability and responsibility.
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Yeah, I definitely understand that. I didn't make an attempt - I just read their faces and kept quiet. But we were all thinking it lol
 
DermViser said:
Yes. It's quite funny. I wonder if it has something to do with gender where males on Surgery get an automatic pass, while females on OB-Gyn don't. Mainly bc females, in general, are expected to be kinder, nicer, even tempered, etc.

The reason you probably can't ask why it happened is bc the OB-Gyn harpies would probably get angry bc then it looks like you're blaming someone when you've been called as a consult. So then when they think they're getting blamed, they're less likely to consult you, which in the end can be worse for the patient in terms of outcomes. I believe it's bc hospitals have adopted a "no-blame" hospital culture: http://www.todayshospitalist.com/index.php?b=articles_read&cnt=933

It's funny bc that culture is antithetical to the culture of a surgeon who demands things like personal accountability and responsibility.
Click to expand...


As someone who has dealt with the emergency intraop consults for these "oops":

1. I can generally see or figure out what happened. I don't need to ask. But Usually I do get a brief explanation, which is more than enough for me to put two and two together. I will ask what procedure was being done, what portions of their procedure need to still be completed, the indication, and if concern for bowel injury, whether the patient had a bowel prep (which often the OB will tell me straight up when I enter the room).
2. There is NO POINT In pointing fingers. If I've been called, the OB/gyn is in trouble. This means a patient is in trouble. If the OB thinks they are in trouble but aren't, the patient is still in trouble, because the OB is unable to recognize what has or hasn't happened intraop and needs another person to evaluate; the last thing I want is for them to start "fixing" a problem that doesn't exist or fixing it wrong. This applies to other specialties as well.
3. In surgery, we do demand personal accountability, but we also respect that if someone needs help, you help. The patient comes first. Things can go bad very quickly, and dealing with the situation is what is needed. This is just understood. Next time it could be you who finds yourself in a bad case needing help. What students and residents often don't see is the discussion between the attendings after the fact about what happened, after there has been time to reflect on it. There is usually at least a brief conversation about it, which in my experience is usually meant to be supportive or helpful rather than accusatory (as often the person who needed help is beating themselves up about where they went wrong). If the case needs to be internally reviewed for whatever reason, that process can be initiated post op via the proper channels. That getting initiated is usually something that students (or residents, depending on situation) are not going to be privy to.
 
Still finding it odd that someone could think a C-section wasn't surgery, or that the person performing it wasn't a (part time) practitioner of surgery. I guess what they're getting at is that gen surg doesn't think ob/gyn are good enough at surgery, or perform a wide enough scope of surgery routinely, to be given the "honor" of being called "surgeon"? That might be a better way of putting it.

I'd be curious to see the outcomes and approaches of urogynecologists (fellowship out of ob/gyn) vs. female urologists (fellowship out of uro?). Does the training even out after the years of fellowship and do the outcomes support it?
 
mercaptovizadeh said:
Still finding it odd that someone could think a C-section wasn't surgery, or that the person performing it wasn't a (part time) practitioner of surgery. I guess what they're getting at is that gen surg doesn't think ob/gyn are good enough at surgery, or perform a wide enough scope of surgery routinely, to be given the "honor" of being called "surgeon"? That might be a better way of putting it.

I'd be curious to see the outcomes and approaches of urogynecologists (fellowship out of ob/gyn) vs. female urologists (fellowship out of uro?). Does the training even out after the years of fellowship and do the outcomes support it?
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What does being female have to do with it?
 
southernIM said:
Why do surgeons hate on medicine?

Why does medicine hate on surgery?

Why does medicine hate on the ER?

Why does surgery hate on the ER?

Why does the ER hate on surgery?

Why does the ER hate on medicine?

Why does ortho hate on gen surg?

Why does gen surg hate on ortho?

Why does neurosurgery hate on neurology?

Why does neurology hate on neurosurgery?

Why does surgery hate on anesthesia?

Why does anesthesia hate on surgery?

Why does medicine hate on psychiatry?

Why does psychiatry hate on medicine?

Why can't we all just get along??
Click to expand...


That's a lot of hate. I think medicine is filled with competitive people, who were programed to be competitive in order to have a chance to get into the field in the first place.
I have witnessed collegial relationships in medicine. It's like anything, though. People identify with a membership or team, but they forget to step back at times and just look at the big picture.
 
southernIM said:
(A) a c-section is an operation, not a surgery

(B) an appendectomy is also an operation, but no one ever mistook an old school family practitioner who did open appys a surgeon, and they didn't attempt to describe themselves as such

You can do operations and other procedures without being a surgeon
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Honestly, the prestige, or honor, or whatever you're investing in one term but not the other is kind of obsolete and internal to your club. I don't care whether it's an operation or a surgery. It involves a scalpel and cutting through lots of tissue to get out a gallbladder - or as the case may be, a baby. It's not lancing a superficial boil. And these distinctions to me - surgery or operation - are about as pedantic as the goofy internists who make a big deal about surgeons not being physicians.
 
jl lin said:
That's a lot of hate. I think medicine is filled with competitive people, who were programed to be competitive in order to have a chance to get into the field in the first place. I have witnessed collegial relationships in medicine. It's like anything, though. People identify with a membership or team, but they forget to step back at times and just look at the big picture.
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It has nothing to do with competitive people. Specialties are different, the culture of that specialty is different. We are respectful when we're in front of each other, it's when we're walking back to our respective places/departments in the hospital, which is when we talk and mainly it's to each other w/in our specialty. People consult or admit for stupid ****. That's just the nature of the beast.
 
mercaptovizadeh said:
Honestly, the prestige, or honor, or whatever you're investing in one term but not the other is kind of obsolete and internal to your club. I don't care whether it's an operation or a surgery. It involves a scalpel and cutting through lots of tissue to get out a gallbladder - or as the case may be, a baby. It's not lancing a superficial boil. And these distinctions to me - surgery or operation - are about as pedantic as the goofy internists who make a big deal about surgeons not being physicians.
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I don't think @southernIM is referring to prestige or honor. OB-Gyns are not surgeons, period. Their surgical training hours are very small in comparison to everything else.
 
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DermViser said:
It has nothing to do with competitive people. Specialties are different, the culture of that specialty is different. We are respectful when we're in front of each other, it's when we're walking back to our respective places/departments in the hospital, which is when we talk and mainly it's to each other w/in our specialty. People consult or admit for stupid ****. That's just the nature of the beast.
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IDK. It's just not cool. That's all I'm saying. It helps to keep the big picture in mind. . .and the golden rule. Right now, medicine is in a place where unity is more important than ever. That's my stupid opinion.

Nice pie pic.
 
southernIM said:
It's not a prestige thing. It's an accurate use of words. The surgery vs operation thing is a pet peeve of nearly every surgeon I know.

It's similar to misusing the term golf as a verb: "I played golf today" vs "I golfed today"
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Not trying to be snarky, just curious. Do you consider Ophthalmologists surgeons?
 
southernIM said:
I'm not trying to be snarky with any of my responses. As I said way back in this thread, my personal opinion is that I think the whole "surgeon or not a surgeon" thing is silly and simplistic. I've tried to clarify in this thread why the debate exists and why some/many label OBs "not a surgeon".
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So are ophthalmologists surgeons?
 
southernIM said:
(A) a c-section is an operation, not a surgery

(B) an appendectomy is also an operation, but no one ever mistook an old school family practitioner who did open appys a surgeon, and they didn't attempt to describe themselves as such

You can do operations and other procedures without being a surgeon
Click to expand...

So what makes a surgery a surgery?
 
Everyone knows the only true surgeons are general surgeons.

(there I said it)

(also neurosurgeons are considered superior to simple surgeons and therefore aren't surgeons either)
 
southernIM said:
It's not a prestige thing. It's an accurate use of words. The surgery vs operation thing is a pet peeve of nearly every surgeon I know.

It's similar to misusing the term golf as a verb: "I played golf today" vs "I golfed today"
Click to expand...

It's like a medicine doc saying "I internal medicined today." Surgery is a field of study. Operations are interventions, like medications.
 
southernIM said:
It's not a prestige thing. It's an accurate use of words. The surgery vs operation thing is a pet peeve of nearly every surgeon I know.

It's similar to misusing the term golf as a verb: "I played golf today" vs "I golfed today"
Click to expand...

...i say this all the time
 
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