White Coat Underground

PalCast 11—the kitchen edition

It’s now up. It’s a good one. One link in particular that was discussed is here. Go and read, then go and listen.

Comments

  1. #1 khan
    May 25, 2009

    My aunt was/is a nurse practitioner.

    I must say that I did get get into some medical woo, but it never occurred to me to be against vaccinations.

  2. #2 A. willow
    May 26, 2009

    I’ve been thinking about asking this for a while,and I’ll just go ahead now,though I’m afraid it might be off-topic.(I haven’t listened to the podcast yet.)
    I live in China,and I often see people here with drips attached to their arms,usually hung off sticks and held by a friend or by the person who has the needle in their arm themselves.One of my friends was also counselled to “get IV” for his (mild) cold.
    So my question is this:I was under the impression that IV was used only in real emergencies,when it was the best/fastest way to get whatever somebody needed into their body.Was I wrong? Are there any studies that show what happens to a basically fairly healthy person when they get IV? Oh,and I don’t know what they are using in the bags.
    I’m afraid I’m rambling a bit,so I guess my main question is:Is this harmless,and can I stop wincing when I see children so young they can’t walk yet with these needles and tubes attached to their wrists?

  3. #3 Suzanne
    May 26, 2009

    Thanks for the information you’ve shared in the podcast. As you have pointed out, trust is an important component of the physician/patient relationship. This happens over time and requires the physician to be respectful of the patient and their needs. I’ll have to say that in my experience orthopedes (sp?) are the worst communicators. I hate to admit that patients and nurses support stereotypes but it’s true, we do! Orthopedic surgeons are known for having little or no people skills.

    On one visit to the orthopedic surgeon’s office he entered the examining room and spent the entire 20 minutes talking into a small recording device! Never once did he address either my daughter (the patient) or myself, in fact, he never even looked at us. He garbled medical jargon into the recorder and left! The nurse came in and translated his diagnosis for us. It was an amazing display of insensitivity.

    In the course of my protracted health issues I’ve been forced into the realization that I am a consumer of the physician’s services. As such I have a responsibility to speak up and voice my opinion on the care I’m receiving and that extends to the office staff.

    Anyone who forgoes vaccination for their children should read first person accounts of life before vaccines. “This Cruel War” (the Civil War letters between Grant and Malinda Taylor) would be a good start. It includes sobering realizations concerning childhood mortality and people’s frantic efforts to stave off death.

  4. #4 Dacks
    May 27, 2009

    The condescending doctor moment came for me when I was around 30, going to a new doctor for the first time. The history form asked for my eye color – the doctor took my chin and tilted my head back to see my eyes, rather than asking me or bending slightly to look at my eyes. That one gesture told me not to return.

  5. #5 jc
    May 28, 2009

    I think you beat the watermelon. It got silent there after a while. Work can be a rind:)

    The point about full spread obgyn exams being an American thing was raised at Z’s house. Are doctors here being trained to do exams with women in less horrifying positions?

  6. #6 DrugMonkey
    May 28, 2009

    That snide little slap at PAs is going to need some expansion and defense my friend. The ones that I am familiar with came out of EMT and or military corpsman type backgrounds which seriously questions your attempt to paint nurses as more experienced.

    what’s your damage with PAs anyway?

  7. #7 PalMD
    May 28, 2009

    Wow. I was making a casual hypothesis about the differential backgrounds of NPs and PAs (both of which I work with extensively).

    I do wonder if NPs might have a unique set of skills viz PAs given their nursing experience. It wasn’t meant as a dis on PAs (except for the one in question).

  8. #8 DrugMonkey
    May 29, 2009

    You certainly came across as dissing on PAs in general. Plus you pointed specifically to “experience” as a difference between PAs and NPs. And in any case, the motivating problem was with a rude response to patient discomfort which I’m not so sure comes from experience anyway. As you said repeatedly on the Palcast, it is common sense.

    All that aside, I really am interested in your take on the evolving balance of health care as the mid-level providers gain marketshare, so to speak. I understand why you object to those outside of real medicine becoming primary care providers and all. But what about those within real medicine who are not doctors?

    Me, I’m all about specific skill sets. In the area that touches my interests, I’ve never understood why some general practice doc is approved to prescribe and manage mental health pharmacology where someone who is a dedicated mental health clinician, albeit nonMD, is not. Horses for courses kind of thing…

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