* * Anonymous Doc

Friday, December 18, 2009

I'm talking to a patient in his room when his cell phone rings. He puts his hand up for me to stop talking and takes the call. "Hello?" he says. "Yeah, yeah, what do you want? I'm talking to the male nurse." He has a thirty-second conversation and then hangs up.

"Sir, I'm actually a doctor, not a nurse."

"I thought the other guy was the doctor."

"Yeah, we're both doctors."

"It seems like you do all the nurse stuff."

Four years of medical school, for this? I'm wearing a white coat. I have a stethoscope. What more can I do to look like the doctor?

My attending got a little annoyed at me today. A patient's brother asked why we'd stopped doing a certain treatment on the patient, and I said the attending decided it wasn't necessary. The brother wanted to know why, and saw the attending standing right outside the door-- so he went over and asked him.

The attending pulls me aside afterwards-- "why did you send that family member after me?"

"I didn't-- he was just asking--"

"Don't tell these people any more than you have to. They don't need to know our decision-making process. All they need to know is we're doing everything we can for the patient. I don't want anyone questioning what we're doing--"

"He asked specifically about that treatment--"

"And you tell him it's no longer the right treatment and you leave it at that. You don't say I decided something, or anyone decided anything. It's no longer the treatment. That's it. No questions. It's not our job to explain ourselves."

I mean, this guy is a good attending, and I think he's sort of right-- we don't want to explain every decision to every family member-- but when asked a real question I think they're entitled to a real answer, and to know what's going on. Even if it takes thirty seconds out of our day.

But I'm sure I will soon be jaded and sick of talking to family members and want to do everything I can to brush them off, like a real doctor.


  1. That's a scary one, actually. Values clash: our culture insists that we (as patients) "take charge" of our medical care, so this guy was doing just that. Then there's the "culture of medicine" which still holds on to the idea that the "doctor knows best", and the attending was promulgating that. And there you are, in the liminal state, caught between both worlds. --Miss__Tina (on Twitter)

  2. That is exactly why I don't trust those in the medical field! That is exactly why I think those in the medical field are overworked!

  3. Your the next doctor oz

  4. Our hospital system is pushing toward an environment where the patients and family members are actively involved in the care of the patient. This includes knowing when and why decisions are being made, or being able to make some of the decisions! Hope other hospitals are moving towards that, too!

  5. I'm a PGY4, in my last year of IM residency. I haven't read many of your entries, but just have to stop and say "Do everything you can to maintain your humanity." If you have to hold a patient's hand in the middle of night do it. If you have to explain why a particular treatment isn't being done, do it. You have remain a human being otherwise you just another a-hole doctor and there are already enough of them in the world.

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