Saturday, August 18, 2007

I Should Have Gone Into Surgery

Title says it all. But in case you want additional details, here are a few:

They focus on just one problem
While medicine doctors focus on the acute problem during patient hospitalizations and clinic visits, they also have to address ALL other problems (hypertension, diabetes, lower back pain, anemia, etc.) Surgeons, on the other hand, address only their body part of expertise and that’s it. No more optimizing a cardiac patient's complex problems ... and then having to deal with their random bowel incontinence they get once a year.

Their history and physical are focused.
This is the best part. Based on your specialty, you can focus your questions and exam to just that one organ system. Examining the body head to toe gets to be quite tedious and rarely do you uncover a hidden physical finding that changes your management plan. I would love to just examine the abdomen and then be done.

If not altogether unnecessary.
Given how dependent the medical field has become on imaging these days, who cares what the patient complains about. You don’t care as much about chest pain when the echo shows aortic stenosis, and you definitely don’t care if a patient can’t move their arm when an x-ray shows a huge spiral fracture.

They know how long their patients will be hospitalized.
OK, THIS is the best part. Surgical patients fall into one of three categories: pre-op, intra-op, or post-op, and each period usually lasts several days. This is great for morale -- the physician’s morale, that is -- and patient turnover. No more rocks on your service!

They wear scrubs everyday.
I am not as passionate about this reason, but if I could bring my dressing time in the mornings from 15 minutes down to 1, that would be great. Although, I do look pretty good in shirt and tie ... .

Their notes are brief.
No, THIS is the best part, and it's a by-product of the “they focus on just one problem” reason. I would love not to be bogged down by writing notes, which often takes close to an hour with a full load of patients. Surgeon notes are often overly terse, but they convey their message well; on the other hand, medicine notes document every piece of information ever tied to the patient, whether they’re lab values, antibiotic histories, or elementary school grades.

I know some of this might be overly simplified, but it does capture the essence of how I presently see things.

1 comment:

keagirl said...

Amen to that.
In addition to my short H&P and short progress notes, I also relish my short discharge summaries.