How are residents supposed to learn?

Dominic Carone writes about the “secret” that the attendings don’t perform all the surgical procedures in teaching hospitals. Not uncommonly, they supervise residents who are performing the actual procedure.

But if every patient were to opt for an attending, how are doctors supposed to learn?

Comments

AMedici
I find it interesting that when VIPs, doctors and their families become patients they can opt out of providing their bodies for the noble cause of training future suregons.
I wonder how an “unconnected” patient would be received if they tried to get the same privilege.
Anonymous
There would be more sympathy for the new surgeon’s need to have a body to practice on if he/she or their family, on becoming patients themselves, would set the example and offer their own bodies for training purposes.
But who in their right mind would do that when they have the option of an experience surgeon. Only the best for them, thank you very much. The unsuspecting regular patient can be the guinea pig.
Anonymous
Those are just the perks of the job I guess. If you work for an NFL team you are probably going to get NFL tickets. If you are a physician you are probably going to get your experinced friend to do your surgery. This is the way the world works.
Heidi
Sorry, but where in the article does it state only VIPs, doctors and families can opt out of residents practicing on them?
I don’t know how medicine is practiced in USA, but here in Oz, even if your a doctor etc. we will treat you the same as everyone else. I’m a student in Radiography and have x-rayed doctors etc. The patient is still placed in the queue with everyone else. He/She is still x-rayed by me (who is STILL) studying. I’ve never had a doctor tell me they’d like someone else to handle the examination (even when I had to perform a examination that I had never done before and this was on a radiologist). I have however been “snubbed” so to speak by non-medically related patients. When this first happened I tried not to take it personally, but really, its hard not to feel hurt. Then again, some patients have also remarked that if there were no one to practice on, students would never learn.
The point is, there will be jerks from both sides of the fence (medical and non-medical). It is unfair to think of only one group as such.
People who like to persecute medical personnel make me wonder why I chose the medical field in the first place. I remember first year of clinical, I was still “fresh” wanting to do my best for the benefit of others. Now I’m in my final year and my attitude is: I don’t care. It is because of those like amedici and anonymous 3:27 and even the original blogger, that I’ve come into a new mindset where I am now only in it for the money. That’s all I repeat to myself when I meet people like the above.
Anonymous
Almost all the docs I know were treated by residents when they were ill.
AS for me, I’d rather have an upper level resident who is interested in me getter better. This beats a a scientist anxious to get back to his lab any day.
Anonymous
Sorry to say this, but in many cases you are in better hands with the resident or fellow than the attending at academic teaching institutions. Ever hear the old saw “if you cannot do, teach”? Well, it holds more than a kernel of truth.
Moderate to high volume private practitioners are your best bet for most surgeries. Only go to the academic teaching hospital if you have a very uncommon or difficult problem requiring a multidisciplinary approach.
Anonymous
I don’t understand why everyone’s claiming that doctors’ families don’t let residents provide their care. It is very untrue. Doctors’ family members, unlike anyone else, are well aware of the importance of letting residents have their practice. I am a doctor’s wife, and I always welcome residents, and during my elective surgery a few years ago, I had a resident probably perform majority of it (but I did ask the attending to watch him like a hawk!). My sister always kicks students and residents out, but one of these days thought about my husband, and now she lets them stay. We don’t mind being the guinea pigs (with adequate supervision, of course).
Anonymous
The issue here isn’t that hospital personnel get perks. What does that have to do with the fact that the patient pays thousands of dollars thinking he’s getting an experienced surgeon to perform an operation only to be handed over (secretely in most cases)to an unlicensed novice who gets minimum wage. In the real world this would be fraud.
amedici
anon 7:28,
You mean because the patient doesn’t have hospital connections, they don’t get the “perk” of receiving what they paid for?
emily tse
Heidi said…
>>>>Sorry, but where in the article does it state only VIPs, doctors and families can opt out of residents practicing on them?>>>
Heidi, people are referring to poster comments on the article…
http://medfriendly.com/2007/11/tonsillectomy-tales-part-2-resident-vs.html
…that give reference to the book “Complications” written by Dr. Atul Gawande that reveals his experiences during residence training at Johns Hopkins Hospital in Baltimore. In it the doctor states:
“learning is stolen from the patient, their bodies taken as eminent domain, hidden behind drapes and anesthesia”
“Given a choice, people wriggle out (of care by doctors in training), and those choices are not offered equally. They belong to the connected and the knowledgable, to insiders over outsiders, to the doctor’s child but not the truck driver’s.”
He goes on to say medical students are “encouraged” not to “volunteer” the truth about their training status to patients. You might say this is one doctor’s opinion, but in all the serious reviews of this book, no one disputes the veracity of what he reveals, not even the many doctors who reveiwed the book.

How are residents supposed to learn?

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