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30 April 2012

A Little Rant from the Bottom of the Totem Pole

Some people you will succeed because of, and other people in spite of.
I have had yet another encounter with a consultant who sees students a bothersome and burdensome or bug-like, not worthy of talking to. I started by introducing myself, and she stared coldly and snipped "we're not starting yet."  OOoookay. So the other student and I sat and waited half an hour until she called me in and assigned the other student to another Dr. She then proceeded to see several patients, not once explaining to me or the patient what she was doing, or why. No teaching moments happened in an hour and a half.  Since I have much more interesting ways of wasting my time, I left halfway through clinic.
This is not an isolated incident. Last year in Internal Med, I was assigned to a consultant for 8 weeks. After 3 weeks of daily scribing and ward jobs, he looked up and said, "Yes, can I help you?" with no remembrance of me. Way to make me feel like part of the team.  This same guy then YELLED at a patient for not knowing she had the atrial fibrillation which caused her stroke. The poor woman was aphasic from the stroke (lost her ability to speak), and could do nothing but shake her head as tears rolled down her cheeks. I spent most of the morning after rounds comforting her and explaining what was going on with her treatment.  I have seen registrars just not show up with no explanation, or not prepare anything to teach for sessions because they "don't like students" (yes, she said this. At least she's honest.) I have seen more senior staff rip strips off junior staff, or like my experience today, just ignore them.  Just about everyone I know has been reduced to tears at one point or another in their training.

Why does everyone think this acceptable behaviour??? I think there is no level of education at which being a jerk of a human is OK.  I understand that the consultants are not paid to take us on at teaching hospitals (Even though the school of med still thinks it's OK to charge us full tuition for the free service they're getting). I also realize that not everyone is Chatty Cathy or uber-teacher.  But why can't there be competence AND kindness, or at least civility? ARRRRRRGH!
OKAY, getting off the soapbox. I have to say in all honesty that I have had more GOOD teachers than bad ones. I just had to get the grump off my chest.

Thanks, Dr. Douche, for at least teaching me how I don't want to practice (WHICH INCLUDES TEACHING). I'll remember it. And thanks, Drs. Decent and Still-Cares: I'll remember your lessons too.

"Dr. D" at Ask An MD addresses the Jerk Factor:

Why are so many doctors jerks?
Excellent question! As any nurse will tell you, doctors are notoriously difficult to work with. We doctors have a much higher percentage of jerks among us than the general population. Even Doctor D (on very rare occasions) has been known to be downright ornery towards patients. There is a epidemic of condescending, difficult, foul-tempered doctors, and you the patient are the one who suffers!

Some doctors have been jerks their whole lives. Maybe they weren't hugged enough as babies. These docs just love having a position of power so they can make others feel small. Such natural-born jerks can be found in any profession, and just one of them (especially as a customer service representative) can make anyone's day miserable. Such doctors will never change. It is best to avoid them whenever possible (unless you need surgery).

But the relatively few natural-born jerks in the world just aren't enough to explain the over-abundance of jerk doctors. This only leaves one explanation: many doctors become jerks by becoming doctors.

The number one reason everyone says they want to go to medical school is "to help people." Believe it or not, we were all once innocent wide-eyed young medical students who really cared about you.

Then they fed us through the decade long meat-grinder of training involving sleep deprivation, endless memorization, calling patients by their diseases, and getting yelled at regularly by our jerk-doctor teachers. At first we hated those other jerk-doctors, then we felt sorry for them. We worked till we were dead tired, and then got told heathcare is cutting back so we had to do the same work twice as fast next time. Patients expect us to work miracles after watching too much TV, and don't see any reason for dieting or quitting smoking since our purpose in life is to cure everything. Despite our good intentions people keep destroying themselves with bad habits, and nice people keep dying, and everyone is angry we can't turn them back into twenty-year-olds. Add to that lawyers promising irritated patients that they can hit the jackpot, if they just sue jerk doctors--It is enough to turn even the nicest medical students into misanthropic bastards.

As a patient that just wants to get your check-up none of this is your fault, but you are going to bear the brunt of this. Your best bet is to look at your doctor, and try to imagine him/her as the kindly, altruistic, and terrified student that showed up on that first day of medical school. Somewhere in your doctor lurks that annoying humanitarian impulse that doesn't die easy.

1 comment:

  1. very well said Barb, I have know some great caring doctors ... and some that should disappear somewhere forever .. At least in my experience the caring doctors have far outweighed the jerks. Hang in there my friend .. you will be one of the caring ones