Your "feel good" case(s)?

[Andros84]

I'm wondering if anyone would like to share a case that really stands out to them in their memory where they really made a difference in someone's life? I know you can love what you do everyday, but is there a case that you can remember that can make you feel great about yourself and what you do?

If not, are there cases that you see frequently that give you this same or similar feeling? (i.e. your feel good cases?)

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[Feli]

I don't have as much exp as a lot of other posters here, but so far:

The most rewarding stuff we do is probably the elective peds cases like flatfoot, coalitions, intoe, etc. Whether the treatments are conservative or surgical, if they get a good result, you feel like you've improved the kid's ability to fit in with peers, play sports, etc. Maybe it's because kids are innocent and all, but that feels good.

In adults, you might be suprised, but for those whose ego allows them to actually admit they like our chosen path of PO-diatry, the most rewarding cases are often conservative care - even RFC (nail care) patients. They are often older folks or persons with many health problems who are somewhat lonely and appreciate the podiatry office as much for the doc/staff socialization as they do for the medical exam + care they get. Those are honestly the patients you tend to get holiday cards/gifts, relative referrals, etc from. Surgically, arthrodesis procedures in severe OA or RA patients can work out well and improve day-to-day functionality. The complex elective recon like cavus, flatfoot, post traumatic angular deformities, Charcot, etc make for challenging cases with multi-plane deformity correction, etc... but those are honestly very tough to get optimal outomes with (a lot of things look great on the OR table or post-op XR, but follow them awhile).

...The least rewarding (for me) seems to be the trauma patients. Trauma pts are usually fairly young, active people like athletes or MVA victims who didn't expect the injury and are bitter and frustrated that they now have a temporary (or permanent if it's a severe injury) disability. A lot of trauma pts you see in teaching hospitals are also less than upstanding individuals who directly or indirectly tend to repeatedly put themselves in harm's way: substance abusers/addicts/dealers, gang members, mentally ill, criminals, general leeches of social services, etc. When you factor in those typical trauma patients' younger age (read: low income) and frequent unsavory lifestyles, you get an awful lot of noncomplaint, ungrateful, and litigious patients out of the ER... and, as you'd probably guess, a lot of them don't pay their hospital, surgeon, etc bills either.

You do get the occasional employed, grateful everyday Joe construction worker or high school athlete with a minor injury like a central met fx, ankle sprain, or a laceration that has a good outcome and the case ends up being rewarding to treat, but the majority of trauma cases reward the surgeon with little more than lint in the pocket, a huge pile of workers comp or disability forms, lost sleep, and gray hair... maybe even a certified mail attorney letter a couple years later. It's no small wonder that it's often said "trauma surgery's a young man's game."

 

[Andros84]

Thanks Feli! I appreciate the forthcomingness. I was thinking children would probably make it into someone's list. Kids are great! It pains us, at least it does me, when we see children in pain, or impaired by such ailments. I agree about "ungrateful" patients. I work in a clinic in the summers, and my least favorite are the ungrateful people. Ironic I don't usually remember them as well when they would come back, IF they came back. Good stuff. Anyone else want to add your "feel good" cases, or not so good ones?

 

[PADPM]

As Feli stated (for a young guy, I agree with him a LOT), it's not always the big surgical cases that are the most rewarding. Sometimes it's the simple things we do daily.

It can be as simple as helping an elderly patient with a painful keratotic lesion that is preventing her from having the ability to go shopping for her elderly husband. It can be the patient who always worries about EVERYTHING and has a ganglion cyst who thinks he/she has some horrible tumor, and you alleviate the patient's fear/concerns by simply aspirating the cyst, sending the contents away for cytology analysis and confirming the fact that it was simply a cyst with benign cells.

It can be the young 24 year old mother who is a non-smoker and is not on birth control pills and is in great physical shape who was referred by her PCP with a lingering "ankle sprain"/Achilles tendinitis. During my exam something just "wasn't right" and I had the gut feeling there may be a DVT, despite the fact she had ZERO risk factors.

I called her PCP who I know well (he referred the patient) and discussed the case. He thought I was crazy, but respects me enough that he wouldn't tell me not to send her for the proper tests. I informed her of my concerns, wrote her an RX for a Duplex Doppler U/S and called the local hospital to see if they could squeeze her in ASAP. She went over and was seen within one hour and had TWO significantly large DVT's that could have literally killed her by dislodging and causing a PE.

In my mind, these are at least as rewarding as any major reconstructive surgical procedures I've ever performed. Surgery is great for you ego and machismo, but I've been there, done that and realize that there's a LOT more than surgery that's great about our profession.

 

[347932]

Saw a 12 yo Down's female patient who had severe equinus and couldn't put her heel on the ground. Her parents never saw her walk normally. I did a Tendo achilles advancement (Murphy Procedure for all of you taking your boards) and a gastroc recession one foot at a time. Once both were done, she had as normal of a gait she will ever have with heel to toe gait. The parents cried when they saw her walk somewhat normally for the first time after all was said and done. It was very emotional and something I will never forget. Those are the cases I think about often. It's rare that you can so profoundly affect someone like that.

 

[NurWollen]

I really like the tone of this thread. I've never really posted in the Podiatry forum before, but I read it regularly. I go to an undergrad that sends a lot of students to Podiatry school, and I hear a lot of anecdotes that lead me to think that podiatrists often have a lot higher job satisfaction than MD/DO's. I am just wondering what your takes on this are. I mean, the schooling is just as intense and just as long as and is very similar to that of MD/DO students. Why does it seem then that Podiatrists/Podiatry students are so happy compared to a lot of other health care professionals? Or is it just my imagination?

 

[347932]

I really like the tone of this thread. I've never really posted in the Podiatry forum before, but I read it regularly. I go to an undergrad that sends a lot of students to Podiatry school, and I hear a lot of anecdotes that lead me to think that podiatrists often have a lot higher job satisfaction than MD/DO's. I am just wondering what your takes on this are. I mean, the schooling is just as intense and just as long as and is very similar to that of MD/DO students. Why does it seem then that Podiatrists/Podiatry students are so happy compared to a lot of other health care professionals? Or is it just my imagination?

I love what I do. There is no questions about it. I think podiatry is really the perfect combination of a technically demanding surgical specialty as well as the satisfaction of interacting with people to help them to feel better on a daily basis. Cutting the aged's toenails, talking to the younger crowd, learning from people of all walks of life, surgical skill, you name it. I love every aspect of what I do and see everyday. The bright spot too, is that you never really know what's going to walk in the door next. Is it grandma for toenail cutting, or is it trauma that was inadequately managed and will require a complex surgical intervention? You just never know, which keeps it interesting and even exciting at times. I can't imagine doing anything else. I really can't.

 

[Andros84]

Thanks to everyone for the excellent comments and stories! I think this is, or can be, a sobering perspective on how much podiatrists provide to people's quality of life, including saving lives on occasion! I tell my premed friends at my school that I'm thinking seriously about Podiatry, and all they can think about is the "nasty feet" one might see. My dad is an MD. So, I have a pretty good perspective on that path. I like to remind my friends that if they think feet can be "nasty," then they've got another thing coming in , as I like to call it, MD school.

 

[NurWollen]

I love what I do. There is no questions about it. I think podiatry is really the perfect combination of a technically demanding surgical specialty as well as the satisfaction of interacting with people to help them to feel better on a daily basis. Cutting the aged's toenails, talking to the younger crowd, learning from people of all walks of life, surgical skill, you name it. I love every aspect of what I do and see everyday. The bright spot too, is that you never really know what's going to walk in the door next. Is it grandma for toenail cutting, or is it trauma that was inadequately managed and will require a complex surgical intervention? You just never know, which keeps it interesting and even exciting at times. I can't imagine doing anything else. I really can't.

Thanks for your response. Why do you think a lot of MD/DO's aren't as happy?

 

[347932]

Thanks for your response. Why do you think a lot of MD/DO's aren't as happy?

I think many MDs/DOs ARE happy. The ones that aren't tend to be the ones that verbalize it though. You rarely hear about how happy people are. Complaining is easier.

My brother is an MD and I know why he is somewhat lukewarm about being an Anesthesiologist. His dream was to be a Plastic Surgeon. He did VERY well in Med School, was published, and visited and spoke to all the "right" people. He didn't match with a Plastics program and was devastated. He thought all his hard work was for nothing and almost gave up. Anesthesia was his NINTH choice. He then realized that maybe he was better off in Anesthesia as he isn't so much of a people person, and also realized he may not be as "handy" as he thought he was. He is now "happy" doing what he does, but that thought always lingers in the back of his mind..."what if"? That thought quickly drifts away while he's cruising in his TT convertible though. His license plate is "IN2B8". His other car, a Mercedes SVU, is "EX2B8". He loves those damn cars.

I, very merrily, drive my Mazda 3 Hatchback to work everyday, and I have no idea what my license plate says.

 

[Andros84]

Thanks for your response. Why do you think a lot of MD/DO's aren't as happy?

I think this is just a personal perspective. I think someone's level of happiness depends on the person. I don't think one can say with confidence that MD/DOs are any less happy than DPMs. I think the APMA advertises that DPMs have a "normal" work week on average, and that may be associated with less stress. But I think there's not too much of a difference in hours worked on average between DPMs and MDs/DOs. MD/DO may have longer hours worked on average because of specialties that are more demanding like general surgeons and its subspecialties. These guys are constantly working I think. But, again it depends on the physician and their level of practice.

Some bitterness of MDs/DOs comes from new regulations, medicare/medicaid reimbursement cuts, but this is mirrored with DPMs whom share these same regulations.

IF MD/DOs are more unhappy than DPMs on average, one point that has come to mind when thinking about my dad, who is an MD (Ophthalmologist) is that his specialty isn't usually dealing with life and death issues. If he is, say when he finds TIA (transient ischemic attack) in a patient, the patient is triaged. He doesn't manage the TIA, just the eye pathology. I think I can comfortably say that this is similar in Podiatry?

My point is that MD/DOs carry the burden of dealing with life and death scenarios, such as an internist, or an Oncologist. So there is a higher incidence of depression. This may be one reason. But again, it depends on the person. The reasons for why someone is unhappy in their profession probably has endless possibilities.

 

[NurWollen]

....IF MD/DOs are more unhappy than DPMs on average, one point that has come to mind when thinking about my dad, who is an MD (Ophthalmologist) is that his specialty isn't usually dealing with life and death issues. If he is, say when he finds TIA (transient ischemic attack) in a patient, the patient is triaged. He doesn't manage the TIA, just the eye pathology. I think I can comfortably say that this is similar in Podiatry?
....

I bet that if podiatry were a subspecialty of MD/DO it would be one of the most competitive fields, just like optho.

 

[UNVME2]

I bet that if podiatry were a subspecialty of MD/DO it would be one of the most competitive fields, just like optho.

This is a much needed thread, so let's not ruin it with this banter.

My most rewarding moment came from a man in his mid 30's with vericose veins and occasional leg numbness he thought was related to the veins, so he wanted them removed hoping that would resolve the symptoms. He traveled a lot for work and noticed that he only got the numbness when he drove or sat for a long time.

Just by the distribution of the numbness, I asked if he ever had an XR of his lower back. He said he did when he was younger, but couldn't remember the results. The first thing that came to mind was that this wasn't a vascular issue, but maybe stenosis causing nerve irritation. When I said that it like a big light went off in his head and he immediately called his father (who was an MD.) Evidently his father knew he had some arthritic changes in his back when he guy was younger, but the patient didn't mention these symptoms to him before.

I had left the room to get the attending to look at his legs and when we came back he was so happy he smiled and said "this podiatry student just solved a problem that 3 neurologists couldn't"..said thank you and left. Yeh, I felt pretty baller.

 

[NurWollen]

I bet that if podiatry were a subspecialty of MD/DO it would be one of the most competitive fields, just like optho.

Just trying to express my respect for podiatry as a profession... nothing more.

This is a much needed thread, so let's not ruin it with this banter.


My most rewarding moment came from a man in his mid 30's with vericose veins and occasional leg numbness he thought was related to the veins, so he wanted them removed hoping that would resolve the symptoms. He traveled a lot for work and noticed that he only got the numbness when he drove or sat for a long time.

Just by the distribution of the numbness, I asked if he ever had an XR of his lower back. He said he did when he was younger, but couldn't remember the results. The first thing that came to mind was that this wasn't a vascular issue, but maybe stenosis causing nerve irritation. When I said that it like a big light went off in his head and he immediately called his father (who was an MD.) Evidently his father knew he had some arthritic changes in his back when he guy was younger, but the patient didn't mention these symptoms to him before.

I had left the room to get the attending to look at his legs and when we came back he was so happy he smiled and said "this podiatry student just solved a problem that 3 neurologists couldn't"..said thank you and left. Yeh, I felt pretty baller.

 

[air bud]

I really like the tone of this thread. I've never really posted in the Podiatry forum before, but I read it regularly. I go to an undergrad that sends a lot of students to Podiatry school, and I hear a lot of anecdotes that lead me to think that podiatrists often have a lot higher job satisfaction than MD/DO's. I am just wondering what your takes on this are. I mean, the schooling is just as intense and just as long as and is very similar to that of MD/DO students. Why does it seem then that Podiatrists/Podiatry students are so happy compared to a lot of other health care professionals? Or is it just my imagination?

I don't have to do an OB/GYN rotation.