* * Anonymous Doc

Monday, February 28, 2011

I have a relative who likes to send me everything she reads that has the word doctor somewhere in the article, assuming that it's relevant to what I do.

Today she sent me an article from the New York Times (link here) about radiation and infants and asked me if I ever give x-rays to infants without protecting their gonads (and telling me if I do, I should stop).

I sent her back an e-mail asking her to please, finally, take me off of her e-mail list, and that, no, I don't do anything to infants because I only deal with adult patients, and I also don't administer x-rays because I actually went to medical school and have a degree in medicine, and I am not an x-ray technician.

I'd like to think the tone of my e-mail was more pleasant than the tone of my description of my e-mail, but it probably wasn't. I suppose lawyers and other folks have this problem too, but it's kind of frustrating to me that no matter how many times I explain to someone what internal medicine is, and what I do -- in a very general sense -- they still think that every doctor does everything, and that of course I'm not only an internist but I'm also a neurosurgeon and a gynecologist and a child psychiatrist and an insurance plan administrator and a podiatrist and a dentist and a pharmaceutical sales representative and a fitness instructor.

I don't know any more about the problem with your eye than Google does. Really, I don't. I don't know what you should and shouldn't do when you're pregnant, and I don't know what milestones your infant should be hitting at x number of months. There is enough that we have to learn and are expected to know that I don't read journal articles about veterinary nutrition in my spare time. I read about right bundle branch blocks and left bundle branch blocks (try saying bundle branch block ten times fast) and try to be a better doctor to the patients I do see, for the problems I am supposed to know something about.

(But I will say one thing about radiation. That article is fairly frightening. And, especially since no resident I know is paid per test ordered, I would hope that radiation on infants is only being used when necessary, and that the proper precautions are taken.)

(Editing to add after reading the first comment below-- nope, didn't mean to imply that. Not really sure what I meant, as I re-read it. I mean, I know what I was thinking-- residents especially have no incentive to order unnecessary tests. But, obviously, no one should be ordering unnecessary tests, on adults or on infants, involving radiation or not involving radiation, whether they're making money on them or not. Ever. Anybody. Period. I think my subconscious may have been expressing some doubt about whether every doctor puts all financial motivation aside when ordering tests on patients, but I didn't mean to imply anything. Watch your bills. Get second opinions.)


  1. "And, especially since no resident I know is paid per test ordered, I would hope that radiation on infants is only being used when necessary" <-- But it's OK for those physicians who *are* being paid per test ordered??? I *know* you did not mean to imply that!

  2. I hear you. My mom is still enraged at the "incompetent" doctors in the ED at our local community hospital for not diagnosing and fixing her AVM (which wasn't leaking at the time) when she presented with a headache 9 years ago. I've tried to explain why this isn't necessarily their fault, to no avail.

  3. That NYTimes article got me very angry. I know a few x-ray techs who are assholes (not saying all techs are assholes but...) they should know better than to send those babies unshielded. Assholes. Then the minute you do a Fellowship in their department they pimp you on bedside manners. Idiots.

  4. You mean you're not God??? I am SO glad to hear that! :-)
    Natalie ._c-

  5. My mother does the same thing. There are a couple things that she keys in on, med student or DO, that if she sees she automatically is e-mailing me & then calling me to see if I read it. I always end up saying yeah great one line in a four page article mom, can I get back to studying neuro now.