GetMeOuttaThisMess Posted June 1, 2017 Share Posted June 1, 2017 Two phrases that have stuck with me from years past from separate physicians:1. "Don't tell the patients what they don't have. Just treat them for what they DO have.". Quote from "Tricky Ricky", ED physician. (Don't argue with patients about their perceived dx.)2. "Healthy hearts don't have unhealthy heart rhythms." Quote from "Brother Bill", EP specialist (before anyone knew what an EP specialist was).Sent from my KFFOWI using Tapatalk Link to comment Share on other sites More sharing options...
Arthropathy Posted June 2, 2017 Share Posted June 2, 2017 I would argue that there are times when you should tell a patient what they don't have. For example when you have no idea what is causing their symptoms but you can rule out life threatening or surgical pathologies. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted June 2, 2017 Author Share Posted June 2, 2017 I would argue that there are times when you should tell a patient what they don't have. For example when you have no idea what is causing their symptoms but you can rule out life threatening or surgical pathologies. The intent of the statement was more akin to "I know I have a sinus infection" and instead of telling them why they don't, just treat them for what they have and let them go. Link to comment Share on other sites More sharing options...
karebear12892 Posted June 2, 2017 Share Posted June 2, 2017 As a medical scribe in the ED, I've heard several effective ways of communicating with patients in terms they can understand. Now that I'm in PA school, I've incorporated some of these into my patient interactions as well: Asking young children to take a deep breath and "blow it out like you're blowing out birthday candles" while examining their lungs. Explaining the nature of muscular pain to adults (especially males, s/p MVA) as "If you remember Friday night football, it wasn't Friday night that hurt, it was Saturday morning. And we're not 18 anymore." Makes them laugh and seems to get the point across. Another sports analogy - explaining why you're choosing one antibiotic over another by comparing this decision to choosing to play your first string quarterback vs. your third string quarterback. You wouldn't use your "last resort" option against a tough opponent if you're strongest quarterback knows the other team's weakest link and is able to play - same goes for fighting off an infection. And one of my all-time favorites, "My job in the ER is to be Chicken Little. The sky is falling! Now I have to prove it isn't falling on you." Link to comment Share on other sites More sharing options...
DizzyJ Posted June 2, 2017 Share Posted June 2, 2017 Derm - "If it's wet, dry it; If it's dry, wet it; If you don't want it, don't touch it". Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted June 2, 2017 Moderator Share Posted June 2, 2017 Derm - "If it's wet, dry it; If it's dry, wet it; If you don't want it, don't touch it". if they are not on steroids, start steroids. if they are on steroids, stop them. all of derm in a few sentences...:) "treat the patient, not the diagnosis." Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted June 2, 2017 Author Share Posted June 2, 2017 I need some uniqueness here with personalized, one on one insights. Another one from "Daddy Dan", former ED director: " You can't assess what you can't see.". In other words, get 'em naked. Sent from my KFFOWI using Tapatalk Link to comment Share on other sites More sharing options...
BruceBanner Posted June 2, 2017 Share Posted June 2, 2017 "Never order a test if you don't know what to do with the result." -Dr. Dunn, country doc and my FM mentor. Another way of saying that is never order a test if you don't know what you're looking for! Always have a direction, don't cast nets in the dark. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted June 2, 2017 Author Share Posted June 2, 2017 Late "Father Ron", master cardiologist. "Ma'am, when you have a headache it doesn't always mean that you have a brain tumor, it just means that you have a headache. Just because you're having chest discomfort (never used the world pain) doesn't mean that you're having a heart attack, it just means that you're having chest discomfort". Sent from my KFFOWI using Tapatalk Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted June 2, 2017 Author Share Posted June 2, 2017 My take on this has always been "Don't order a test if you don't care what the answer is". Ex.-you already know how youre going to treat the patient. Sent from my KFFOWI using Tapatalk Link to comment Share on other sites More sharing options...
Moderator ventana Posted June 2, 2017 Moderator Share Posted June 2, 2017 "How many times did you punch the wall" If > once - highly unlikely you have a boxers fracture this is proved true so many times from one of the best ER doc's I ever had the pleasure of working with The late and great Dr Richard Dodge..... Link to comment Share on other sites More sharing options...
sas5814 Posted June 2, 2017 Share Posted June 2, 2017 "Don't ever tell me someone is stable. Dead people are stable." Col. (Dr) Sonny Archangel, Ft Bragg NC Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted June 2, 2017 Author Share Posted June 2, 2017 Now THIS is what I'm talking about! Link to comment Share on other sites More sharing options...
sk732 Posted June 2, 2017 Share Posted June 2, 2017 "Medicine for Dummies" from Dave C, paramedic and colleague I used to teach with : "Air goes in, air goes out; blood goes round and round. Pink is good, blue is bad." Dr (Maj) Darryl Menard, my sports med teacher in school, former sports med advisor to the Chief of the Defense Staff and a Canadian Olympic marathoner: "Until 30, our bodies forgive and usually forget; up to 40, they'll often remind you but still forgive; after 40, our bodies never forget and rarely forgive." Another of his was "Always be an exercise thief"; in other words, walk instead of drive, stairs instead of elevators, etc...I used to use that a lot in family med when dealing with new and old diabetics, hyperlipidemics, etc who'd always say they didn't have time for exercise. Lastly, my own "There's a fine line between hard and stupid (or if talking to civilians - smart and silly/dumb)". I draw it for people - stupid is a long way from the line, as that's where you/they usually land on your/their face and have to try and crawl back home...comes in handy with folks that don't know when to slow down (usually guys) or those "hold my beer and watch this sh*t" types (again, usually guys). SK Link to comment Share on other sites More sharing options...
EMSGuy1982 Posted June 2, 2017 Share Posted June 2, 2017 "Medicine for Dummies" from Dave C, paramedic and colleague I used to teach with : "Air goes in, air goes out; blood goes round and round. Pink is good, blue is bad." SK One more line to add on the end of your first quote.... "eventually, all bleeding stops" :-) -"No matter what you do for your patients, no matter how hard you try, your bound to piss off at least 3% of the population... Get over it now and move on." So true in UC. Link to comment Share on other sites More sharing options...
sk732 Posted June 2, 2017 Share Posted June 2, 2017 One more line to add on the end of your first quote.... "eventually, all bleeding stops" :-) So true in UC. But then the blood don't go round and round :-D Mike O, my SP for three years in FM always said "The last doc that sees someone will always have the right diagnosis" - very true in folks these days in Gen Wuss that show up at the first sniffle of something that doesn't have time to evolve - the last person to see it in full bloom will likely get it right. SK Link to comment Share on other sites More sharing options...
EMSGuy1982 Posted June 2, 2017 Share Posted June 2, 2017 But then the blood don't go round and round :-D SK True! "Asystole is a stable rhythm" Link to comment Share on other sites More sharing options...
sk732 Posted June 2, 2017 Share Posted June 2, 2017 True! "Asystole is a stable rhythm" Probably the most stable of them. From Perry Cox, TV MD: SK Link to comment Share on other sites More sharing options...
dchampigny Posted June 2, 2017 Share Posted June 2, 2017 "Don't let the sun set on a pulmonary embolus" Link to comment Share on other sites More sharing options...
charlottew Posted June 2, 2017 Share Posted June 2, 2017 of course, "you're not dead until you're warm and dead" and "that patient there has got what we call a low tooth-to-tattoo ratio" Link to comment Share on other sites More sharing options...
Guest JMPA Posted June 2, 2017 Share Posted June 2, 2017 "its gotta make sense" "treat the patient, not the numbers" " it doesn't hurt till the bone shows" Link to comment Share on other sites More sharing options...
Reality Check 2 Posted June 2, 2017 Share Posted June 2, 2017 One rather jaded old doc used to ask us what the prescribed treatment was for some complicated cases - "High velocity, low caliber lead therapy".......... Favorite in the OR after a tough case of finding parts to put together - "THAT'S how you make a chicken salad" Crusty old Bethesda Navy chief Ortho attending - "Have you found the hole to put that screw in yet? Staff wants to go drink coffee." And - when asked how we were doing any given day in clinic - "Saving lives and stamping out disability" "Definition of a double blind study - 2 Orthopods reading an EKG" Link to comment Share on other sites More sharing options...
sk732 Posted June 3, 2017 Share Posted June 3, 2017 "Definition of a double blind study - 2 Orthopods reading an EKG" "There is a fracture...I must fix it....the patient has a condition I am not familiar with - aysistolee". Dr Sir William Osler - "There is no such thing as a poor historian, just a poor elicitor of the history." SK Link to comment Share on other sites More sharing options...
CVTSPA Posted June 3, 2017 Share Posted June 3, 2017 Many of the laws of the House of God that have been echoed to me multiple times by the cardiac surgeons. The one that resonates with me the most is: "At a cardiac arrest, the first procedure is to take your own pulse." Link to comment Share on other sites More sharing options...
PAMEDIC Posted June 3, 2017 Share Posted June 3, 2017 "80% of medicine is entertaining the patient while mother nature takes its course." Link to comment Share on other sites More sharing options...
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