Tuesday, June 17, 2008

We Need Young, Fresh Doctors

There is a lot to be said for the seasoned clinician. The gray haired physician with years of experience and wisdom and a noble demeanor. But I am here to say...I want to see some young doctors in my medical community who love practicing medicine.

Here is what young physicians bring to Medicine:
  • Availability (I am tired of referring my favorite patients to the ortho, or rheumatologist or neurologist and being told there is a 6 week wait)
  • Availability (I am tired of having to beg a consultant to see a patient)
  • Follow up consult note (When I take the time to send my work up notes, call ahead and arrange the appointment...I would like a follow up note from the consultant)
  • Curiosity and interest ( I am a comprehensive internist and I only send patients who are a medical challenge. I want a doctor who is curious and interested in figuring things out. After the tests are done, I would like the consultant to work with me and the patient and come up with a solution, not just tell the patient to phone me to interpret the tests that he ordered.)
  • Eagerness (I want a consultant who is happy to see my patients. Not someone who is burned out!)
  • Humbleness (this may not be age related but I've sure seen my share of egocentric specialists)
I understand the concept of being burned out. I know how brutal the practice of medicine can be in a regulated, managed care world. I just wish there were some fresh, eager, well trained Doctors in my community. The older ones are a bit jaded and overworked. I admire the new generation of Doctor who protects their time and values family. Maybe they will love Medicine throughout their entire careers.


Healthnut said...

I agree. There is not enough good doctors serving the public.

But it will be TOUGH to see fresh faces partially because of the insurance "squeezing" out the doctors and partially because of the rise in tuition costs.

From a patient's point of view, it's harder and harder to see a good doctor. A physical exam these days is a BIG JOKE. Instead of having the screening portion of the physical done at the doctor's office, my insurance sends me to an internist who does not know how to use his stethoscope properly.

Would you believe this internist lay the diaphragm side of his stethoscope on top of two layers of clothing I had on to listen to my lungs? And would you believe he only spent one second at each intercostal space and did not wait for me to complete a full breathe before moving onto the next intercostal space?

James said...

Speaking as one such new doctor - I hope you're right!

Toni Brayer MD said...

healthnut: Oh my! I had a similar experience with an "employment physical" 30 years ago so I hope that is specific for that kind of screening. I think they are mostly interested in the drug screen, not the lungs.

James: Protect yourself. Enjoy your profession.

Anonymous said...

Thanks so much for your comments. I'm a mid level provider in a rural community and my experience with referrals is actually painful. Today's post hit home as I have a young lady (in her 30's) with unexplained weight loss, a questionable diagnosis of Crohns, polyclonal IgG gammopathy with family history of lymphoma and now with joint pain with evidence of ill-defined bone demineralization in her ankle suggestive of malignancy. Nobody seems to be taking this seriously and I'm ready to refer to a university medical center for further evaluation. It makes me want to scream when symptoms are minimized and when specialists just don't seem to listen to the patient. Am I being unreasonable I ask? The bottom line is that I keep going until I have an answer that makes sense...isn't that what we're trained to do? Thanks for letting me get that off my chest. And keep up with the blog please!

Toni Brayer MD said...

anon: Hang in there. Yes, this post was a result of my own frustration that day as I tried to refer a complicated and fascinating patient with a potentially serious problem. Old doctors are often "winding down". I understand it, but without the vibrancy of youth a medical community gets very dull and it is not the best for patient care.

Anonymous said...

To Anon: Has anyone checked your patient for ovarian cancer with a sonogram, CT or Ca.125??
A close friend and also a cousin of mine were sent to the wrong specialist and missdiagnosed at first. Ovariann cancer is often not thought of at first since the symptons can look like other things. Unexplained weigth loss can be a symptom. It is very frustrating for the patient and family as you said to not be taken seriously and sent to the wrong specialists. Your patient is lucky that you keep fighting for her. Like everyone else doctors don't always know and do make mistakes. Keep trying, good luck.

Anonymous said...

Thank you for being a real kind of doctor and person that recognizes this is how it should be and has high quality medical values!!!

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I was in the Doctor yesterday, the old Doc , he is may be 75 years old , he need to retire right know because he cannot hear the people, his knowledge is discontinued!! "We Need Young, Fresh Doctors" is the solution!22dd

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