TiredMD

I'm trying to mislead people by telling you what I took in medical school? Amusing. Believe it or not, we do have a few prereqs we do before we go to med school. And the fact that a few courses have titles that sound similar to traditional undergraduate topics does not mean that these subjects are taught at a basic level, or that we haven't seen the basic material as undergraduates. I took biochemistry in med school, yet it still was a required pre-req. If you think new med students come in fresh, having never taken stats, ethics, etc, you're kind of deluding yourself. It's also funny that you take statements of my own experience as some kind of attack on the nursing profession. I sense a touch of insecurity about your degree program.

Thank you. There's a definite undertone here that anyone who doesn't buy into the new-age "everybody should just hug and be happy" mindset is either trolling or some kind of hideous person. The real kicker for me in this thread was the notion that you shouldn't even yell at your kids. After all, little Johnny might need a lifetime of therapy if you yell at him as he tries to run into the street . . . Anyway, I've said my piece, and have nothing left to add. It's a simple disagreement. Shame so many have to take it personally.

Don't do it too often, but off the top of my head: 1) Patient acutely decompensating, I asked for critical piece of equipment (pericardiocentesis needle, ET tube, etc) that is not in the room. The quality nurses and techs are busting their behinds to get done what needs to be done and can hardly drop it to run to the supply room. The 5 "lookie-loos" standing by the door just stand there staring and chatting. 2) Fellow physician begins performing OR procedure . . . incorrectly 3) Intern/medical student makes potentially dangerous error (I've been on both the giving and receiving end of this one) or, my favorite 4) Walk on to a neuro ward one night, and CNA is announcing in a loud voice at nurses station that he is "sick and tired of cleaning up these old people's " and that he wishes "someone would just take them out back and shoot them like dogs". The first 3 are patient safety issues requiring strong and rapid intervention. The last one was just cathartic.

Again, let me encourage you to take this cop mentality to the hospitals, and attempt to get one of your physicians arrested for raising their voice. You'd be famous in the hospital for years to come, even if your employment was short-lived . . .

I absolutely do.

Don't worry, bronchitis isn't real anyway.

Never even opened the stupid thing. When I need administration information, I use Davis' Drug Guide for Nurses. When I need info on adverse effects, dosing, and interactions, I prefer to use sources not published by the manufacturer. I really don't think you're missing out on much.

How can you tell the difference when everyone wears a long white coat and no one wears a nametag? But I digress . . . Under LCME, ethics training is mandatory for medical schools. The actual form and structure of the courseis left to the discretion of individual schools. Mine, and most of my colleagues I have discussed this with, was a stripped-down bare minimum "seminar" which basically outlined important topics like, "Don't have sex with your patients, even if they're attractive" and "Get a patient to sign a release form before you let them go AMA." In general, our curriculum is already packed to the gills with actual medical topics, so the goal of ethics education tends more towards a 'check the box' mentality than any real attempt to address the topic comprehensively. No, we didn't learn biostats and epidemiology. That's an undergraduate topic. It was discussed, but not formally taught, because the presumption was that you had already covered it as a component of your bachelors degree. Kind of like Newtonian physics and basic cell biology. All that is covered in the licensing exams, so if you are weak in it, it's a good idea to relearn it on your own. The business/financial/management side of health care is generally not addressed, because an MD is a clinical degree, not an administrative degree.

Actually, they're not. I had one seminar on ethics, once a week for four weeks. Everyone is presumed to have learned statistics as an undergraduate, along with the other basics like biochemistry, cellular biology, and basic writing. Management isn't even discussed.

Whoa, don't think I'm equating yelling with threatening. Threatening is clearly out of order and obviously criminal.

That's kind of interesting, and I meant to ask you about it. I would have thought it would be opposite; that men would get yelled more than women, given the sensitivity to sexual harassment lawsuits. FWIW, I work in an all-male environment, so there's no opportunity for gender preference when it comes to yelling . . .

Once the OP clarified that this physician was on-call, obviously the yelling was inappropriate. Hell, the anger at being called was inappropriate. But I continue to insist that not only is yelling not a particularly big deal, but it can also be incredibly effective if used infrequently and only when absolutely necessary. Seriously, if you haven't yelled at someone lately, give it a try. You might be shocked how well it works.

I love it!

Not too sure why so many of these narcs are available as stand-alone products. There is that "synergy" theory that NSAIDs/tylenol in combination with narcs complement each other to provide superior pain relief. And certainly, other than the overdose factor, acetaminophen is a far safer drug overall. The NSAIDs have the gastric problems, potential renal failure, potentially contribute to heart disease, and at least theoretically can exacerbate bleeding issues. But yeah, not a clue why no hydrocodone on it's own. If given the option, I would probably utilize that before oxycodone, given the addiction/abuse profiles.

I'm with you 100%. In fact, I'll go a step further and say that many, if not most, chronic back pain patients should see Pain before they get sent to a surgeon. We are doing so many questionable lumbar lamis and decompressions, and so many recent papers have suggested that the outcomes w/ & w/o surgery are very very close . . . we could probably save a lot of people a surgery that really won't make them better in the long run.