Why is it so wrong to dislike dealing with sick patients?

[plasticsday1]

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Was having a conversation with a fellow plastics applicant the other day about what kind of practice we want to have down the road. He said that he likes "helping people in need" and wants to do the burn cases and other long surgeries that involve tons of inpatient care. I said that I'd quit medicine before doing that and mostly just want to do short, outpatient procedures. Not necessarily only cosmetics, but nothing that requires more than at most a single day of admission or that has a high chance of complications. I don't see anything wrong with this, but my fellow applicant seemed appalled. He basically said to me why I'm going into medicine if I don't like sick people. This is not the only time I've gotten this reaction when I've told people, but I don't understand it. Why would anyone voluntarily want to deal with all the garbage involved with inpatient care of the severely sick with multiple complications? It's not like I'm not helping people by only doing the more minor procedures.

 

[Money Moniker]

Was having a conversation with a fellow plastics applicant the other day about what kind of practice we want to have down the road. He said that he likes "helping people in need" and wants to do the burn cases and other long surgeries that involve tons of inpatient care. I said that I'd quit medicine before doing that and mostly just want to do short, outpatient procedures. Not necessarily only cosmetics, but nothing that requires more than at most a single day of admission or that has a high chance of complications. I don't see anything wrong with this, but my fellow applicant seemed appalled. He basically said to me why I'm going into medicine if I don't like sick people. This is not the only time I've gotten this reaction when I've told people, but I don't understand it. Why would anyone voluntarily want to deal with all the garbage involved with inpatient care of the severely sick with multiple complications? It's not like I'm not helping people by only doing the more minor procedures.

Why do you care what people think? Just do you, collect mad $$$ from simple outpatient procedures your patients appreciate if that's what you want to do, and laugh at the moral bloviators' hangups while you're poolside. You have the right to not want to deal with "sticky" procedures, your colleagues have the right to be appalled at your "selfishness," and you further have the right to not give a crap about your colleagues' stance. Not sure why you're even asking this question as it's a complete non-issue.

 

[Oso]

Plenty of people dislike working with acutely ill patients in the hospital and prefer to pursue other specialties or sub-specialties.

That's totally fine as long as you remember that regardless of specialty you will likely have to take care of very sick patients throughout your training.

I don't know, but perhaps it would be best to not mention this to many people in the field as it could be kinda taboo? Maybe it's kinda like applying to top fellowship programs knowing you want to do private practice afterwards...

 

[MSTPlease]

I’ve always wanted to know exactly what would happen if an applicant was interviewing for plastics residencies and was just like “I just want to do tits and ass all day every day - preferably in LA or Miami.”

 

[MSTPlease]

People who do rads/path don’t even really interact with not-sick patients, let alone sick ones.

 

[Gurby]

I shadowed a GI doc as a premed and at some point he sat me down and gave a little speech to the effect of, "I might not be doing flashy life-saving surgeries, but a lot of the time I can make my patients feel better, and that makes me happy."

 

[deleted103644]

Was having a conversation with a fellow plastics applicant the other day about what kind of practice we want to have down the road. He said that he likes "helping people in need" and wants to do the burn cases and other long surgeries that involve tons of inpatient care. I said that I'd quit medicine before doing that and mostly just want to do short, outpatient procedures. Not necessarily only cosmetics, but nothing that requires more than at most a single day of admission or that has a high chance of complications. I don't see anything wrong with this, but my fellow applicant seemed appalled. He basically said to me why I'm going into medicine if I don't like sick people. This is not the only time I've gotten this reaction when I've told people, but I don't understand it. Why would anyone voluntarily want to deal with all the garbage involved with inpatient care of the severely sick with multiple complications? It's not like I'm not helping people by only doing the more minor procedures.

I have to assume you’re just a troll, especially given your stupid thread about getting a full ride being the worst mistake of your life.

I’m reminded of the Scrubs episode, “My Sacrificial Clam”. Can’t find a good clip but JD says he’s a doctor afraid of sick people and then immediately loses the respect of the physicians in the room.

I’m sure there’s room for all types in medicine, but I hope for your potential patients’ sakes that you end up in a non-medical career.

 

[Iz_FtB]

What you'll lose in the respect and admiration of your peers you'll gain in cash.

Personally, I'm happier to surround myself with people who, despite all the ancillary nonsense of our profession, still retain some belief in the nobility of medicine.

 

[BigRedBeta]

Meh...

As a Pediatric ICU attending, a great many of my co-residents went on to become general pediatricians with nearly the exact same sort of "motivation" as you. The difference though is that general pediatrics claims a noble place in terms of preventative medicine in most people's mind, while plastics evokes a money grabbing focus on "fixing" manufactured problems. Your co-fellow likely has experienced this reaction in dealing with others, felt uncomfortable about the insinuation and is compensating by focusing on parts of plastics that seem more altruistic. If you don't care, then fine. If you're bothered by the response, do something about it.

 

[Donald Juan]

This altruistic friend of yours is sounds pretty naive just like Johnnydrama above. Lots of people enter med school thinking they want to take on the sickest, poorest, most difficult patients. They don't realize the reality is a lot of losing battles, scrutiny over your management because you will have high mortality rates, getting trainwrecks from every other physician who is trying to dump their patients, and oftentimes patients or families that will just blame you because you didn't make everything better with your magic doctor wand. A lot of the people who start off on the high pedestal come back down to earth after residency.

Now, your friend may or may not keep his promise to work with those with the highest needs and biggest complications; obviously, some people do enjoy these things. Not understanding why someone wouldn't want to deal with trainwrecks all day long and would prefer a primarily outpatient based practice is what is so naive.

 

[operaman]

I see nothing wrong with it at all. Personally I think an outpatient cash only practice doing little ditsel cases would bore me to death, but some people love it. Nothing wrong with that. Some of the simplest procedures can make patients feel much better and be very rewarding.

 

[meister]

People who do rads/path don’t even really interact with not-sick patients, let alone sick ones.

I guess if you don’t count placing ports, dialysis catheters, IVC filters, TACE, TIPS, etc. Radiologists pretty much exclusively interact with sick patients if they happen to interact with a patient at all. Luckily, we don’t have to manage them!

 

[CyrusHabs7695]

I’ve always wanted to know exactly what would happen if an applicant was interviewing for plastics residencies and was just like “I just want to do tits and ass all day every day - preferably in LA or Miami.”

Its had to have happened at least once

 

[Lexdiamondz]

Was having a conversation with a fellow plastics applicant the other day about what kind of practice we want to have down the road. He said that he likes "helping people in need" and wants to do the burn cases and other long surgeries that involve tons of inpatient care. I said that I'd quit medicine before doing that and mostly just want to do short, outpatient procedures. Not necessarily only cosmetics, but nothing that requires more than at most a single day of admission or that has a high chance of complications. I don't see anything wrong with this, but my fellow applicant seemed appalled. He basically said to me why I'm going into medicine if I don't like sick people. This is not the only time I've gotten this reaction when I've told people, but I don't understand it. Why would anyone voluntarily want to deal with all the garbage involved with inpatient care of the severely sick with multiple complications? It's not like I'm not helping people by only doing the more minor procedures.

Because all of the patients you operate on have the potential to become very sick and have terrible complications and nobody wants a lazy surgeon who can't handle a sh*tstorm when things really get messy. If you can't handle the worst case scenario for each of your cases you have no business being their doctor.

There's nothing wrong at all with wanting a good lifestyle and most of us strive for it. But not wanting to deal with the sickness that comes with practicing medicine is a piss-poor attitude to have.

 

[MSTPlease]

I guess if you don’t count placing ports, dialysis catheters, IVC filters, TACE, TIPS, etc. Radiologists pretty much exclusively interact with sick patients if they happen to interact with a patient at all. Luckily, we don’t have to manage them!

I don’t count that because I was obviously talking about bread and butter DR.

 

[ParallelLines]

Because all of the patients you operate on have the potential to become very sick and have terrible complications and nobody wants a lazy surgeon who can't handle a sh*tstorm when things really get messy. If you can't handle the worst case scenario for each of your cases you have no business being their doctor.

There's nothing wrong at all with wanting a good lifestyle and most of us strive for it. But not wanting to deal with the sickness that comes with practicing medicine is a piss-poor attitude to have.

lol reading this made me think of that meme that girls post: "If you can't handle me at my worst, you don't deserve me at my best"

While I agree with you, I'm pretty sure OP means that he wants to cater his future practice around simple outpatient office stuff rather than slog through the 10 hour high intensity flaps and reconstructions you see at major medical centers. That being said, he should expect to do his fair share of those big operations in residency (obviously) and perhaps while he's getting established and building his outpatient referral base.

Just my 2 cents as someone who recently became interested in plastics

 

[LoGo]

I think the bigger question is would you be happy in plastics if your dreams of running an exclusively outpatient private practice with a good cosmetic component don’t materialize. It’s not as easy as it’s made out to be, so if you get “stuck” doing the big cases in sick people are you going to hate your job?

We were always told that in choosing a specialty, not only do you have to be ok with the bread and butter, but you also have to tolerate the crap. It sounds like you can’t tolerate the bad stuff in plastics, and it also sounds like you also don’t really love the bread and butter and instead are banking on being one of the few plastic surgeons who gets to cherry pick the easy outpatient and cosmetic stuff that pays well.

 

[Chillbo Baggins]

I don't really see an issue. It seems like you're still out to help people in the end. I quickly discovered that I don't like managing things like blood pressure and diabetes and don't especially like treating acutely ill patients. That's why I loved OB clinic because there was never any past medical history. That's why I'm doing ortho because, in general, patients aren't sick, but they are hurting and I can make a tangible improvement in their quality of life. Not everyone needs to be doing live-saving procedures in the middle of the night to be a good doctor helping someone.

 

[CharlieBillings]

.

 

[raiderette]

Huh never thought about OB or ortho this way thanks

OB/GYN is great if you want a relatively healthy patient. Patients can start in their teens so you get a patient during their healthiest years. OB patients tend to be compliant. Of course there can be chronic conditions, cancer, etc. but those are referred over to specialists.

 

[VA Hopeful Dr]

OB/GYN is great if you want a relatively healthy patient. Patients can start in their teens so you get a patient during their healthiest years. OB patients tend to be compliant. Of course there can be chronic conditions, cancer, etc. but those are referred over to specialists.

The only thing a lot of people don't realize about OB is just how quickly things can go bad.

If you have a baby in significant distress, it is exceptionally sphincter tightening. It's not a common event, but it's common enough that you can never quite let your guard down at deliveries.

 

[DrRiker]

I don't really see an issue. It seems like you're still out to help people in the end. I quickly discovered that I don't like managing things like blood pressure and diabetes and don't especially like treating acutely ill patients. That's why I loved OB clinic because there was never any past medical history. That's why I'm doing ortho because, in general, patients aren't sick, but they are hurting and I can make a tangible improvement in their quality of life. Not everyone needs to be doing live-saving procedures in the middle of the night to be a good doctor helping someone.

Really? I imagined OB would see the most complicated of deliveries with high-risk mothers.

 

[Chillbo Baggins]

Really? I imagined OB would see the most complicated of deliveries with high-risk mothers.

Oh, no doubt; when **** gets bad, it gets bad. But thankfully that's the exception and most things go off without a hitch. Even still, it's a different sort of animal then being in MICU or SICU and running vents and pressors and all that.

 

[Donald Juan]

Really? I imagined OB would see the most complicated of deliveries with high-risk mothers.

OB sees all deliveries....not just high risk ones. Unless you're in a really small town where the family doc is doing the delivery, or you have the person that hates doctors and only wants a midwife or natural birth at home by themself. There are plenty of ob/gyns that are taking care of routine pregnancies and if there is evidence prenatally of some intense complications will be sending their patient to MFM. It doesn't mean they are lousy docs because they like the nice routine cases.

 

[DrRiker]

OB sees all deliveries....not just high risk ones. Unless you're in a really small town where the family doc is doing the delivery, or you have the person that hates doctors and only wants a midwife or natural birth at home by themself. There are plenty of ob/gyns that are taking care of routine pregnancies and if there is evidence prenatally of some intense complications will be sending their patient to MFM. It doesn't mean they are lousy docs because they like the nice routine cases.

I hope I made no such implication. Thanks for filling me in!

 

[Donald Juan]

I hope I made no such implication. Thanks for filling me in!

Lol not at all, just bringing the point back around the to the original topic.

 

[raiderette]

The only thing a lot of people don't realize about OB is just how quickly things can go bad.

If you have a baby in significant distress, it is exceptionally sphincter tightening. It's not a common event, but it's common enough that you can never quite let your guard down at deliveries.

I didn't mean to imply that OB didn't see serious issues. I only meant that the patient population is healthier, compared to IM due to age. It was more about a preference for your patient panel.

 

[deleted103644]

This altruistic friend of yours is sounds pretty naive just like Johnnydrama above. Lots of people enter med school thinking they want to take on the sickest, poorest, most difficult patients. They don't realize the reality is a lot of losing battles, scrutiny over your management because you will have high mortality rates, getting trainwrecks from every other physician who is trying to dump their patients, and oftentimes patients or families that will just blame you because you didn't make everything better with your magic doctor wand. A lot of the people who start off on the high pedestal come back down to earth after residency.

Now, your friend may or may not keep his promise to work with those with the highest needs and biggest complications; obviously, some people do enjoy these things. Not understanding why someone wouldn't want to deal with trainwrecks all day long and would prefer a primarily outpatient based practice is what is so naive.

😆

Me a naive altruist.

Just because I think the OP is a useless troll doesn’t mean I want us to slave away for free.

We just happen to work with a fairly vulnerable population (eg sick people) and are given a fair amount of leeway to do what we want by society, so those who are simply out to make a buck without consideration for actually helping people are in my mind more despicable than financial folks who are truly only motivated by money.

So yeah. Don’t think he’ll make even a good plastic surgeon with that attitude.

 

[aafisahar]

I guess if you don’t count placing ports, dialysis catheters, IVC filters, TACE, TIPS, etc. Radiologists pretty much exclusively interact with sick patients if they happen to interact with a patient at all. Luckily, we don’t have to manage them!

IR is essentially a bunch of technicians. They don't have a role in the active management of patients save for their intervention. The primary doc is the one actually doing the leg work getting them onto IR`s table.

 

[meister]

IR is essentially a bunch of technicians. They don't have a role in the active management of patients save for their intervention. The primary doc is the one actually doing the leg work getting them onto IR`s table.

Oh word?

 

[deleted103644]

IR is essentially a bunch of technicians. They don't have a role in the active management of patients save for their intervention. The primary doc is the one actually doing the leg work getting them onto IR`s table.

You could say that about ANY procedural specialty.

You could also say primary docs do nothing but follow guidelines and refer to specialists.

 

[guytakingboards]

IR is essentially a bunch of technicians. They don't have a role in the active management of patients save for their intervention. The primary doc is the one actually doing the leg work getting them onto IR`s table.

Lol you either don't know the scope of IR particularly well or are just plain dismissive proceduralists/consultants/specialists.