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Getting Pimped as a Professional


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I am a physician assistant working in otolaryngology for the past 2.5 years and I continue to be pimped over and over again by the supervising physicians. 

Is this typical? On one hand I understand how this is a good way for the supervising physical to gauge what I do and do not know. On the other hand I feel like I'm no longer a student and should not be subject to random on the spot questions. When I don't know the answer, I feel embarrassed because I am no longer a student and thus "should know the answer." 

Just looking to gain some perspective on this. Thanks! 

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Pimping is rude? 

I think if the Pimper is asking questions of deliberate obscurity that fall in the category of esoteric knowledge, and they seem to be asking those questions solely to get you to say 'I don't know' (because OF COURSE you don't know, it's a stupid question) - if that is the situation, then yes, pimping is rude. In that case, I deal with it like I deal with any rude person - water off a duck's back, it's their problem not mine, let's move on and take care of some patients.

If the Pimper is asking questions that are semi-obscure, but relevant - even if Pimpee is N years into their position - then well, maybe it's a teaching experience. A public one, to be sure, but a healthy ego does not bruise easily. Learn what you can, and move on.

There is always more to learn. Really!

*context: I work in an academic institution, 2.5 years in this position, I still get 'pimped' occasionally, if there is a learning point to it, then I take it to heart. If not, then not.

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I think pimping as a tool for teaching is not tremendously effective. A little stress and pressure is sometimes good for learning - we all remember patients and experiences we’ve dealt with under fire - but done on the regular it loses its impact.

 

I also work in an academic institution with residents and if I was constantly questioned in this manner by the attendings I work with, I would find it tiresome. If there’s a unique case or interesting factoid for me to know, we talk through it. My attendings gauge my level of knowledge pre-discussion by simply asking me what I already know about what we are seeing.

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It can be a dude Doc moment or a rude Doc moment. Depending on some factors: If one is being pimped by someone whom they have a great relationship with, it can be looked at as a teaching moment or a peer to peer 'FYI' moment. If there is no pre-existing relationship, or a less than good one, it may be a power move. If it's the former, consider yourself lucky and say "Thank you for the knowledge!"... If it's the latter, respond however you deem appropriate. 

pimpin.gif

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You can answer the question by saying, "Well, I know that in situation A would require approach X, but you are describing situation A prime, and I don't know how our approach to treatment would differ" 

Or something like that. Basically, state that you do know how to handle a related situation. IE, you do know what you are doing for more common situations. Or for situations you have seen before. Maybe this particular case is different from what you've seen before. Maybe the doc is trying to teach you a new detail about this situation. Maybe you have misread the situation in some way.

Or maybe the doc is trying to shore up their own ego by making you look small. Or maybe the doc is in a bad mood today. Or maybe the doc is misreading the situation, and you are actually right.

Personally my approach is to make it less about ego, and more about learning. If you are concerned that the doc thinks you 'don't know what you're doing', then try to demonstrate that, in other ways. Or, ask a followup or clarification question - then the doc knows you are listening and thinking, which is usually why pimping questions get asked, in the first place.

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Wait, so you actually graduated and are getting pimped?  Not weekly meetings with your special, where items of concern can be brought up?  Charts with recommendations and discussions, but actual pimping, with random esoteric facts?  

No, I don't get pimped.  Because everyone is too busy seeing patients.  A much more appropriate teaching post graduate is for, perhaps selected readings, cme, and a regularly scheduled time for both of you to sit down.  While you are- we all are- life long learner's, you have graduated and can sit at the grown up table and be treated like one.

Maybe answer like this:

" Quick, what's the third best way to drain a peritonsillar abcess in an afebrile 100 year old?"

You just say " Day um Dr dicktooshort, I would have figured a residency program might have prepared you to know this!" And walk away.

Pimping accomplishes one thing- it makes students feel both stupid and in awe.  

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I think it can be done well while you're training.  After you are done training, it's a bit difficult.  

This is a question I have actually - and I mean no disrespect at all.  Without residency/fellowship training, someone fresh out of school will obviously have a lot of holes in their knowledge.  That's expected for anyone.  I think just giving a lecture on every topic every time it comes up is pointless and unnecessary.   Asking if they are comfortable managing "xyz" is useful and I think is the way to go, but there's no way to really guage if that's true. I was on nephrology block just last month and if you had asked me if I was comfortable managing disease x, I would have said yes but when pressed, I realized I knew a lot less than I realized.  I guess if you're working with someone new, what is the best approach?  You want it to be a comfortable collegeial environment, but also want to make sure everyone is on the same page. 

 

Its easier with someone like me when I teach interns or when attendins pimp me because I'm still in training and it's not a big deal.  

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I had pediatrician pimping me on the phone while I was trying to get a kid out of my dept to the place with kid doctors...I started getting kind of impatient with trying to diagnose over the phone and kind of blurted out "You know, I'm not a student anymore - I'm calling you out of courtesy to let you know they're coming and a head's up of what is wrong.  I'm sure we're not going to solve this here as we don't have the appropriate imaging available for them and you do.  Thank you for the thoughts for my tool box though."

There is a time and place - school, education rounds, when you're giving a lecture, etc.  In front of a patient or learners to "put you in your place", yeah, not so much.  You could counter with a general medicine question a surgeon likely forgot as a tit for tat sort of thing, though that can backfire...or one of those "You didn't just do that??!!" looks.  I've stretched my extra ocular muscles so well I can almost see my cerebellum - eye roll followed by a Sgt Maj death stare, followed by an exasperated head shake might get the point across, especially if an inappropriate question or time.  A Dr Cox'ism from "Scrubs" might be fun to inject :-D.

Or you could also counter with "Couldn't you have asked me something that's actually hard?"; just make sure you can actually answer it first.

SK

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Hi lkth487,

I think you make a very good point. While I have been working for 2.5 years, I just recently started this new position. So while I am not a new graduate, I am new to this job. I want to continue to learn about my speciality, I just don't like feeling ashamed pressured. I think the best I can do is continue to look at it as a learning opportunity! 

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If you are new to the job, I would try to roll with it. Especially being in an academic institution; this is just part of the culture there. Unless you are an attending you are eligible for pimping. They should ease off once they get a sense of competency. 

This is really the only situation outside of training I think pimping is appropriate though.

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Talk to the doc.  Privately they might be trying to help you learn  

 

Explain you really do want to learn and appreciate their help, but that pimping you is not helpful nor educational

 

having just gone through a tough patch at work with non medical folks it is usually best to face it head on as a professional manor

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On 2/7/2018 at 9:20 AM, BruceBanner said:

Unless you are an attending you are eligible for pimping.

I'm not sure I would agree with that. I have a pretty good storehouse of esoteric (not necessarily useful) knowledge stored up. If someone wants to play medical trivial pursuit I can give it as well as I get it. 

Who first described tetralogy of Fallot? (Hint: it wasn't Fallot)

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13 minutes ago, CJAdmission said:

I'm not sure I would agree with that. I have a pretty good storehouse of esoteric (not necessarily useful) knowledge stored up. If someone wants to play medical trivial pursuit I can give it as well as I get it. 

Who first described tetralogy of Fallot? (Hint: it wasn't Fallot)

Was it tetrology? he was a pretty smart guy....

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