tag:blogger.com,1999:blog-6760873683081651675.post4717610478304398559..comments2024-01-18T04:16:57.545-06:00Comments on Orthopaedic Residency: The attending perspective: It always starts with good intentions .... Not everyone will like you ...Anonymoushttp://www.blogger.com/profile/18071954032609414825noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-6760873683081651675.post-54933097242900561642008-01-07T19:21:00.000-06:002008-01-07T19:21:00.000-06:00Sitting down, eye to eye, is key.Sitting down, eye to eye, is key.Chrysalis https://www.blogger.com/profile/00757696627388704079noreply@blogger.comtag:blogger.com,1999:blog-6760873683081651675.post-89673329595189013452007-12-25T19:38:00.000-06:002007-12-25T19:38:00.000-06:00dokidok: i think that for most physicians, a diag...dokidok: i think that for most physicians, a diagnosis is made within the first minute of seeing a patient. the rest of the time we are confirming or disproving our hypothesis. the way each physician goes about showing empathy and giving the perception of spending time with the patient is different. for me, it is like a jedi mind trick. i see about 35 pts between 8am and 12pm (works out to 7 < min/pt). for the typical new patient, i walk in, introduce myself to everyone in the room (with handshakes), i sit down on the "doctor's stool" (if someone is sitting there, i explain it is my stool), i ask the patient the usual questions (regardless of what the resident has already told me), i examine the patient (actually place hands on the patient), explain the exam findings and radiographic findings to the patient and family, the proposed treatment and follow-up. at the conclusion, i ask if there are any questions and stay seated in the chair until they are all answered. then give the followup.<BR/><BR/>i think the mind trick comes with you own still. first sit down. second lay hands on the patient. third, give them an explanation in lay terms of what it is, proposed treatment and expected outcomes. finally, always ask if there are any more questions, and stay until they are all answered.<BR/><BR/>in my practice, for any "big surgery", i have preop conferences scheduled for 1/2 hr. this usually helps, especially if you see a patient once and can't answer all the questions. <BR/><BR/>another key is when you are in the room with the patient, you have to make the patient feel as if they are your only patient. everyone has their own way of approaching it. some are better than others.Someonecthttps://www.blogger.com/profile/01098940208758613514noreply@blogger.comtag:blogger.com,1999:blog-6760873683081651675.post-44721597986744413232007-12-25T11:57:00.000-06:002007-12-25T11:57:00.000-06:00I was seen by 3 ENT specialists. It took 45 second...I was seen by 3 ENT specialists. It took 45 seconds for the first one to do the check up, to made the diagnosis, to tell me what options I have, to prescribe me meds and to kick me out of the room. I wasn't sure that we were on the same page. I was just a name in his list. Not a person. The second one was faster than the first one. The third one used time a scope to see what is going on in my nose, and we spent more time talking about my case and the options I have. Actually all 3 of them came up with the same Dx:rhinitis, and prescribed me the same meds and gave me the same option for surgery, but I trust only the 3rd. one.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6760873683081651675.post-8497174658478391512007-12-24T16:01:00.000-06:002007-12-24T16:01:00.000-06:00MWWAK: thanks for the addition. that is an extre...MWWAK: thanks for the addition. that is an extremely important point.<BR/><BR/>md007: hope the intern year is treating you well. you bring up a very good point. i had a mentor who use to hate when we would hedge on questions in conference. he would say "answer it with conviction even if you are wrong." sounding confident takes practice. it is a fine line between sounding confident and arrogant. this is a practiced skill. the more often you are in the situations the better you will get. observe how your attendings and senior residents do it. you will develop this skill over time. i have no doubt that you are self-aware enough that this skill will develop.Someonecthttps://www.blogger.com/profile/01098940208758613514noreply@blogger.comtag:blogger.com,1999:blog-6760873683081651675.post-14427251538755947362007-12-23T16:28:00.000-06:002007-12-23T16:28:00.000-06:00As an intern - I have noticed something that bothe...As an intern - I have noticed something that bothers me. I feel like I am very aware of uncertainty (not only because of my lack of knowledge compared to my mentors, but also the uncertainty involved in medicine in general). I have noticed that the more honest I am with patients about uncertainty, the more likely I am to get a negative reaction from them. I believe this highlights the disconnect between the amount of uncertainty perceived by physicians vs the general public/society. Patients seem to react more favorably to confident physicians with more definitive-sounding answers.<BR/><BR/>I need to learn how to provide confident answers while still communicating the honest uncertainty I perceive in the situation. <BR/><BR/>How can I learn to be comfortable communicating less than the "brutal truth" of uncertainty while still managing to instill confidence in my patients?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6760873683081651675.post-40282743575200441232007-12-23T11:19:00.000-06:002007-12-23T11:19:00.000-06:00That is really great advice. The one thing I woul...That is really great advice. <BR/><BR/>The one thing I would add to it is that there is often an opportunity to "rescue" patient encounters, if you notice the patient is getting upset, or disengaged by asking something along the lines of, "What are your thoughts about what we're talking about?"Midwife with a Knifehttps://www.blogger.com/profile/04309579302399381913noreply@blogger.com