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Sat Sep 2 18:20:39 BST 2006

On Fri, 21 Jul 2006, Ronald Gross wrote:

> WHOA NOW, Ms. Burk!!!  I could say "Thanks for your truly insightful
> comments.  Why, I had NO idea how to treat my patients.  Never heard of
> followup calls.  And God forbid actually talking to my patients...".
> But I won't.  Instead, let me say the following.
>
> I get the distinct feeling that you are implying - no, that you are
> stating that surgeons, unlike anyone else in the medical profession,
> didn't know the correct way, the human way, the professional way to deal
> with our patients, that we are too busy to do the right thing and that
> we are above taking "a little time" to do the right thing.
>
> Let me be very clear - your post is condescending, and in fact downright
> insulting.  I know of far many more ED nurses who, because their
> staffing levels are sometimes 10-12:1 spend far less time and are far
> mor "brusk" with their patients that 99.9 of the surgeons I have had the
> pleasure of dealing with.  Quick and simple?  I DON'T THINK SO!  Our
> patient population is far more sophisticated these days, by and large,
> and they want to know everything in detail.  In fact, a pre-op
> consultation can and ofttimes will take the better part of an hour, if
> you want to truncate it.
>
> I wonder just how much contact you actually have with real
> physicians.........

I suspect she has quite abit actually.

Allow me,dear physicians of the list, to provide a patient's point of view
of the "average" surgical procedure.

I've had 1 elective lap, 4 emergency laps, a bone tumor resection, a
bilateral discectomy, and a few lesser encounters (kidney stones) which
loosely qualify as "surgical".  In addition, I have had close to a dozen
"shots" done deep in the body under flouro guidance (I believe these also
count as surgical encounters, but please let me know if I'm wrong).

On my first surgical encounter, elective laparotomy (which led to a
repair), I *never* saw the surgeon again until the 4 week followup.  Not
once.  Even though my 3-4 day stay ended up as a 14 day stay with numerous
specialist consults required for unexepected complications, my surgeon was
nowhere to be found - as I found out later, he left for his vacation
right in the OR, allowing a 3rd yr surgical resident to close and perform
all followup magangement.

My bone guy: never saw him afterwards, except for the office visit.

The third emergency lap surgeon was *great* (and has received several
referrals): lots of postop contact, answering of questions and close
following of progress.  The rest of these guys were vapor.

The discectomy surgeon was there, but only for a few seconds to glance at
the wound and ask if pain meds were adequate.  Unfortunately, even though
the meds were very inadequate, and even though he was asking, there was no
increase nor apparent interest in increasing them.  Makes you wonder why
he bothered, huh?

All of the 1on1 procedures, where you are conscious and in constant
communication with your doc (the deep steroid injections) were great -
closed loop feedback, with recover room followup being the never broken
exception.

In short, surgeons, like every professional, come in mixed flavors, and
with mixed levels of both caring and competence.  Neither the "Surgeons
are all cold uncaring creeps" nor the "Surgeons are the most caring and
attentive of physician" groups here have a leg to stand on.

It very, very unfortunate that the some of the docs Ive seen are allowed
to practice, but the fact is that they do not stand in the high majority
of surgeons - and, as a consolation prize, we have about half of the
surgical community that we can rely on through all phases of the surgical
experience.

--
Yours,

J.A. Terranson
sysadmin at mfn.org
0xBD4A95BF

"Surely the larger lesson learned from that day is that other men, all
over the world, took inspiration not from the heroism of the rescuers in
New York or the passengers flying over Pennsylvania, but from the 19
hijackers - the twisted brilliance of their scheme and their willingness
to sacrifice their lives to make a political and, as they saw it,
religious statement."

Richard Corliss/Time Magazine
11 Aug 2006

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