We have several days of outpatient electives during our rotation blocks for the year. This week I’ve been bouncing around various private ophthalmology offices in the area basically shadowing the attending. For the most part, it’s like being a medical student, because the private offices are usually swamped, and there is little time to discuss cases with the attending while the patient is in the room.

Today I was at a busy retinal office pretty much observing intravitreal injections for diabetic retinopathy and wet AMD. By noontime, we had fallen about 8 patients behind schedule (that’s about 1-1.5hrs). Both the attending and I had realized that I was not getting much education out of this. Thankfully, she dismissed me to go back to the hospital, knowing that keeping me around would delay her schedule even further.

I thanked the attending and walked around the corner (marked on the diagram above).  As I was blowing my nose (I have a lingering cold), the following dialogue took place:

[I blew my nose on a tissue]

Nurse: Ha. You must be picking up at cold going around the office!

Me: Yea, I guess so. (I had never been to this office before)

[Office coordinator, with BMI around 35, storms in]

Coordinator: (Yells at me) No chatting at the nursing station! You are supposed to be with Dr. [attending's name] at all times!

Me: Is there a problem? I am blowing my nose, and I’m about to head out.

Coordinator: Where is Dr. [attending's name]?

Me: She is next door with a patient.

Coordinator: Residents are assigned to be with the doctors at all times!

At that point, I walked out and left.

I have no idea why the office worker was so furious. Firstly, residents are also “doctors”. Secondly, even if she is responsible for arranging resident schedules, she has no right to enforce arbitrary rules upon the residents. How does she benefit from making me sit through another Lucentis injection? Does she get a salary bonus if she’s able to make me follow the attending like a puppy? If I sneezed in the patient exam room, how would that reflect upon the office hygiene practices? Maybe it’s some stupid office wager they have going on…

Otherwise, the only other reason I have for her domineering attitude is that she just got high off this power trip at my expense. L-O-S-E-R.

medicine rant

This video says it all:

Ironically, “Outside Hospitals” usually have higher resident salaries, more benefits, a working nursing and phlebotomy staff, and nicer facilities. Must be those caths…

medicine humor, medicine

While it is bad enough that medical residents are mistaken for students, I’ve come to realize that there are many other misinformed people in the community that do not realize what medical training entails. Yesterday I spent the afternoon at a private ophthalmologist’s office, and I chatted with his senior technician for a while (she has been working as an ophthalmic technician for 14yrs):

Technician: So, do you want to be a doctor?

Me: (wearing long white coat with my name embroidered on it): Yes, but I’ve finished medical school already. I am training to become an ophthalmologist.

Technician: So will you be doing surgeries as well?

Me: (getting agitated) Yeah, I chose to become an ophthalmologist because I wanted to perform surgeries.

Technician: How do you even learn to do a cataract surgery? Do you have to go through special training?

[Thought: she needs to be educated.]

At that point, a new patient arrived, and I walked off to examine him.

Later in the afternoon, I had another conversation with her that started with her asking me whether I had applied for ophthalmology training. While I assume that there are people who are bold enough to advertise themselves as future doctors when they were 10, 15, 20, or even 25 years old, it would have been pretentious of me to state that, “I am training to become an ophthalmologist” without having matched for a spot in residency.  This is frustrating indeed. Read more…

medicine medicine

Stumped about what to do for residency? Here’s the ultimate guide for career choice. Alfred Padilla, one of the endocrinologists up at Greenwich, graciously sent me his Venn diagram. It doesn’t include all the specialties, but you can extrapolate from the data:

medicine euphemisms, medicine

I saw this electronic billboard at the Philadelphia Airport:

The demise of E. coli

We will never learn. E. coli will always get the last laugh. And for the record, E. coli is also a “native” of our colon. He makes Vitamin K for us. His nemesis C. diff is just waiting for him to die so that we can be blessed with foul-smelling, runny stools 10+ times a day (pseudomembranous colitis).

medicine euphemisms, life