Some things, when I hear them, make me irrationally angry.
I recognize that the anger is irrational. But that usually doesn’t do much to still my pounding heart or force the blood from my cheeks.
However, I do try very hard to see things from the other person’s perspective. So today I would like to explore one aspect of medicine that drives me bonkers.
It’s the bias against medical students and medical residents.
I know one woman whose son is a physician. Yet this woman is adamantly opposed to allowing medical students or medical residents treat her or any of her family members.
I’ve heard her, time and again, mention how she won’t return to a certain emergency department because it’s populated with so many residents. Or how she would never let a medical student perform a physical exam. Or how she would not let a medical resident – especially not an intern – treat her.
I’ve heard her tell others that new interns start in July, so that’s the worst time to get admitted to the hospital or be seen in an ER.
And the other day, I heard the wife of a medical resident telling another wife that “You have the right to request a medical student or resident NOT provide care to you.”
Listen, I am going to say right up front that I find this offensive. Not to me, personally, but to physicians-in-training everywhere.
And especially when it comes from a family member of a physician. How can you expect your son or spouse to become a top-notch doctor if even you – you who know just how hard he’s worked, how much education he’s had, how smart and dedicated he is – won’t give people in his position the chance to gain experience?
Now I’m taking a breath.
You see, I understand where these women are coming from. To an extent. And maybe you share their reluctance. When it’s your health – or your life – on the line, you want the absolute best care possible. It’s natural to want the most experienced physician to treat you. And it’s natural to want these things for your loved ones as well.
If there’s even a chance that your doctor is too inexperienced to spot a tricky symptom… or to make a rare diagnosis… or to know of a specialized treatment… Well, you’d want her off the case, right?
I get it. When it comes to yourself or a loved one, you need to be selfish. I totally understand that impulse to get “the best.”
But on the other hand…
How do you expect a doctor to gain experience if he’s shut out of cases when he’s an intern?
How do you expect him to hone his diagnostic skills if he’s limited to the “easy” cases?
How do you expect him to think of all the latest technologies and drugs if he’s not been exposed to them?
It is reasonable to expect the best care from an experienced physician if you refuse to help a young physician gain that experience?
On the other hand…
Why should YOU – or your child or grandmother or husband – be the person on whom a young doctor practices?
Why not reserve that dubious privilege for the poor, the uninsured, the mentally disabled? *
Or why not leave it to “someone else” to say, “Sure, even though you’re just a third year med student/medical intern, you can operate on me/treat my diabetes/sew up my face/deliver my baby.”
Yes, I see that it’s distasteful to be someone’s “test case,” to have a physician “practice” on you. It can’t be fun to be the guinea pig when a med student is first learning how to do stitches or an intern is learning how to insert a chest tube.
On the other hand…
How else will they learn? I know there are tricks. His third year of med school, my husband had a weird contraption made up of a sponge glued to a piece of wood on which he practiced sewing. I’ve heard of practicing “drawing blood” on oranges.
But nothing can stand in for a real human, with real health issues.
Sometimes I think this is a side effect of the “American way.” Many of us feel entitled to the best of everything. And we want it without putting ourselves at risk.
But I think in this case, we are not only looking out for our own self interests… we are doing it to the detriment of future classes of physicians.
So is there a way to reconcile this problem? I believe so.
Now, I’m not saying that you have to swallow your fears and allow a med student to sew up your face… or have an intern perform heart surgery on you. If you are concerned, maybe ask that an attending oversee your case, or that your intern work in tandem with an upper-level resident. But I’d encourage you to be open to allowing med students examine you (they aren’t responsible for your care – they will discuss your case thoroughly with a more experienced physician) and even stitch up your arm. (My husband was excellent at making stitches – even as a med student.)
And no matter which doctor you have, ask questions. Be informed. Bring a friend or family member with you to listen in and ask questions you might not have considered.
Share your concerns with your physician. Ask her to explain everything she’s doing and why, so you know her thought processes and her reasoning behind the treatment she gives you. And if something doesn’t seem right to you… if something doesn’t feel right… if you feel like something is being overlooked – SPEAK UP.
If you take an active role in your healthcare, I firmly believe you can get the best care AND you can help a physician-in-training gain more experience.
* I have actually heard people suggest this as an alternative to having to deal with interns themselves.