Friday, April 27, 2007

A Tradition of Pfffft

WARNING: Negative, Crappy, Very emotional Post Ahead. Skipping this junk is good for your health.

Also, i intended not to use the exact names for several reasons: 1. once someone googles the keywords, this blog might be discovered 2. for security reasons - i didnt name names here. Someone has to use his or her neurons in order to figure out who im referring to. In short, if you'll react to this crap then you're guilty.


I have yet to see a hospital where the "captain of the ship" in every surgical procedure is the "pain-free department". This crap hospital however where i am in is truly one of a kind. The supposed to be captain of the ship who are the "cut-me-up" quacks are the kind who cant stand up for themselves. As for the risks of the operations, the last word always comes from the pain-free department. Oooops, i'm mistaken. I would like to correct myself. The last word comes from us. Our cp evaluations are the ones that determine the success or morbidity of the surgical procedure.

I shall lay down my premises to support such claim:
1. Cardio-pulmonary evaluations is not automatic for an above 40 years old patient with no medical problem. Why is it that we still accept referrals for evaluation once the patient is >40 years old? Should there be any electrolyte problem, then it's not a CP evaluation anymore. Take note too that the bible of the "cut-me-up" quacks has a chapter on fluids and electrolytes. They're supposed to be capable of managing any electrolyte problem of their patients.

What happens here is that the pain-free department shall suggest cp evaluation prior to a proposed procedure. What the hell are we going to evaluate in the pulmonary and cardiac aspects? The only laboratories that we request are CBC, ECG and CXRAY for a CP evaluation. Can you find any electrolyte examination there?

The supposed to be captains however are unfortunately chickens. Once the pain-free department would hold the or first for a cp evaluation prior to it, the cut-me-up quacks recede and follow blindly. They cant stand for themselves or for their patients. Speaking of lack of confidence to one's self. If the patient needs an immediate operation, why the hell wait for an evaluation from us? Will our evaluation change the prognosis of your patients? Should i give a high risk evaluation, will you defer the procedure? What i would like to emphasize here is that the success of your procedure doesnt lie in our cp evaluations. If you arent skilled enough to pull your patients out of the hell that they are in, then dont use our cp evaluations as your scape goat once you screw up.

2. If you're going to deny the truthfulness of the one mentioned above, then why the hell are you looking for all reasons just so to refer your patient for evaluation? A patient without any medical problem so long as he or she is more than 40 years old suddenly has hypertension or pneumonia. A normal ecg suddenly becomes abnormal.

Why am i ranting about this? It's not because i hate to accept referrals. Heck! Been toxic all my life and i'm used to receiving a lot of referrals. What i just can accept is the fact on how the supposed to be egoistic, thinking-they're-all-knowing cut-me-up quacks chicken out. Is it just to avoid conflicts with the pain-free department? Sheesh! If this is the reason then let me define it as rather plain and simply apathy topped with a cream of insecurity.

So long as noone moves to stop this tradition, so shall the pain-free department continue to rule over them. A lot of referrals become unnecessary. I hate to say this but i am tempted to think that we are the best residents in this crap institution. Why will our evaluations matter much if we arent? Why cant a procedure push through without a word from us? I just hope we'll stop all these craps. We all are under training. We too arent as good as you think we are. What separates us though from the rest is that we know how to stand on our ground for our patients' sake. We know how to mask our lack of confidence and we too know how to make up for it. In short we dont let it obvious how stupid we could get sometimes just like what you guys are doing.

Now, just so you'll feel better before i end this blog, ive got a secret to reveal here. When you call us for an intraop referral, you guys feel so confident that we are around. Without your knowing, we too almost goes into cardiac dysrrhythmia with the patient. So the next time around that ill be asking for diazepam, ask me first on who's going to have it first. The patient or Me?


snglguy said...

Hmmm, there seem to be a lack of command responsibility in the place. They're probably covering their behinds in case something happens. Sort of "passing the buck", so to speak...

AngelMD said...

more likely it is. it's so sad to realize that this happens wen they're already in private practice.