If you’re feeling disillusioned about medicine—and physicians—take a look at the Buck-Eye Surgeon’s musing on week-end rounds here.
I think you’ll enjoy it.
He also takes on the sticky question of specialists who are underpaid–and who might be overpaid–by dividing doctors into two groups: (1) The "Hit and Run Bandits" and (2) The "You Operate, You Own It Crew.”
Maggie:
The most interesting part of the post to me was the comment trail, where one can read the age-old and often acrimonious debate between surgeons and internists over who should be managing what. I have to say that, from my prospective, Buckeye Surgeon represents an example of the kind of problems I encounter every day. For those of us who work in the ICU, the irritation of dealing with surgeons who truly believe they know everything I know (as an intensivist), and they can do surgery, too. On the other hand, I do appreciate the kind of proceduralist, be it surgeon, cardiologist, gastroenterologist, or whatever, who stops by regularly after they have done whatever they needed to do to see how the patient is doing and if we need any more of their help. Patient families really appreciate this, too, since often they have questions the proceduralist is best suited to answer. In sum, it’s an old controversy, one not likely to end soon.
chris-
Thanks for a very interesting comment.
I can see why surgeons who really haven’t been trained in post-op care could be very irritating.
At the same time, I can imagine why patients and families are very happy to see them stop by.
I think it’s probably a matter of surgeons giving up “control” post-op, and leaving that to intensivists, palliaive care specialists, and others who have made a profession of caring for patients after surgery.
Maggie:
I think everyone agrees surgeons are the best folks to do general post-op care on the people they operate on. The controversy comes in when things get complicated. Buckeye’s complaint was that fewer and fewer surgeons really seem to want to do even routine post-op care, so, as Happy Hospitalist pointed out in the comment trail, somebody’s got to do it, often hospitalists or intensivists.
I tend to see a distinction in which general surgeons and those surgical subspecialists who are also fully-trained general surgeons (e.g. vascular, cardiothoracic, trauma, etc.) are willing and able to do much more general care than are those surgeons trained in a specialty in which they saw fewer general medical issues during their training (e.g. ENT, orthopedics, urology).