EXTREME UNPROFESSIONAL MAKEOVER -or- PIMP MY UNPROFESSIONALISM

I’m taking a break from my usual silence (I think i’ve flogged the welfare crackwhore/dumbshit patient enough) to comment on a few important points.  Social sites and you.

Thats right, Facebook, Twitter, etc and the drama/flak they cause (as well as the laughs).

I want to start with a story.  When I was a lowly intern, I was at a very large hospital being the beating-boy for the medical team comprised of a few residents, an attending, myself (go pharmacy!) and a dietitian (wtf?).  We were examining a scrotal hydrocele case that was admitted.  The attending flings back the curtain, and the guy is laying there with his legs spread, and what looked like 2 large grapefruit between his legs.  The attending said “HOLY SHIT THOSE ARE THE BIGGEST BALLS I HAVE EVER SEEN”.  I laughed, the other residents were stone-faced.  The patient looked at me and the attending laughing, got a sense of pride in his crotch-fruit, and laughed.  He completed the exam (including one of the residents who really wanted to stick a needle in them) and left.  The most senior resident said as we were walking the halls “THAT WAS THE MOST UNPROFESSIONAL EXAM I HAVE EVER SEEN”.  The attending, in true Dr Cox style, said “Listen, you need to laugh or you’ll go crazy, sure it was off-color, but thats what makes us relate to the patient in a way that makes them feel not like they are some rat on an exam table”.  The patient, after his nuts drained and looked like prunes again, personally gave his thanks to the attending to making him feel like ‘one of the gang’.  Word got around the hospital about the nut-of-the-year award, and although no names were dropped and not personal information was given out, it was something that pharmacy and medicine could open dialog about.

Thats one of those lessons that you can’t be taught in a classroom.

The second part of this rant is some Twitter drama involving @mommy_doctor and (although a valid point) a bullshit article written by DrV.  Realize that I follow a lot of MD’s, mostly from the ER who say some pretty damn funny things regarding their profession. Much like myself, they give an insiders look at really goes on in the world of medicine.  In fact, I view these angry doctors with a ton of respect, mostly because they make us in pharmacy realize that we’re not alone in dealing with idiots; and their sense of humor/rants about their job makes them (in my eyes) someone who you can hang out and have a beer with.

Before I go further, let me explain about @mommy_doctor (herein known as m_d).  I’ve been following her for a few years now. Shes an anesthesiologist (obviously she is a female, hence mommy).  Her job is rough.  She puts her ass on the line day in and day out to save people.  She deals with surgeons, scared patients, and is a really really stand-up woman.  Her tweets are funny, usually clean, and show how much she cares.  She gives us an inside look at the crazy mixed up hybrid of pharmacy and medicine.  I view her with a huge heaping of respect and admiration for doing what she does on a daily basis.

Anyways, I got a major case of blue-balls when I saw that link, because I immediately thought that ole @BurbDoc was under fire for one of his many hilarious (and totally true) tirades about the unwashed masses.  However reading the holier-than-thou rant just got me pissed off.  I really wasn’t pissed off at the whole concept, but at the bullshit cliquish high-school drama that took place in the realm of Doctors.

First off, DrV, in an article about the lack of ethics, decided to copy/paste screen-captures of the tweets of @mommy_doctor treating a priapism case, one that she obviously felt empathy and sorrow for.  The tweets weren’t crass, funny, or even note-worthy.  However the MD fanboy population decided to textually masturbate themselves about how unprofessional this was.  Mind you these seem like the MD types who will DAW-1 everything, not give you the benefit of a clarification, and refuse to speak with pharmacists.  You know, the MD’s that us as pharmacists HATE dealing with.

Rather than using the text as an example (and blurring out the name), he unethically decided to just drive the bus over her and publish the tweets unedited.  Ironic that in an article about unprofessional behavior, he commits an unprofessional act by doing something that she obviously had the moral-high ground to not do.  Pin something to an individual vs a concept/idea.  In the comments he stated “ Regarding outreach, I don’t engage anonymous people.”  So wait, you dont engage anonymous behavior except when it benefits your argument?  How does that work?

Second: This whole clusterfuck over something absolutely stupid makes me realize how much MD’s are gunning at each other.  How quick and petty they are to nail someone on the cross over something that (in the grand scope of whats out there) a non-issue.  Yes, she made a joke about pripiasm, but I’m sorry, dicks are funny, and a 36 hour boner (although a medical emergency) is going to get SOME reaction.  If I had a boner for 36 hours, after the 10 tubes of KY jelly and the absolute destruction of my wifes vagina, I’d painfully tweet about it on my way to the ER.  If she were a male would this be an issue? Of course not.  @BurbDoc doesn’t get thrown under the bus for the outrageous things he says, but her being a female the rules were obviously changed.  How unprofessional.

This is the same sort of shit that Scrubs is made of.  Do the masses think doctors are “unprofessional” after watching Scrubs?  Do they think that House is unprofessional?  No!  If the doctor is anonymous, and writes a few crude humor lines on a medical condition that could happen to say, ANYONE, whats the harm?  The poor gal was probably on call, stressed out, and wanted to get some sort of outside reaction from a case that us, anonymous internet medical people, would get a chuckle about.  Do I feverishly check all of twitter about the patient with a horrible case of hemorrhoids the moment I leave the doctors office? Of course not!  The humor on twitter could happen ANYWHERE, yet the MD population thinks that it can be narrowed down to ONE office out of 10000000 in the United States (if she is from there) instantly.

I’ll be blunt here.  Voicing your frustration means you care. Your patients aren’t perfect, their conditions aren’t perfect, and sooner or later you are going to have to blow off some steam and vent to those who are in the trenches with you.  If you just saw patients, collected your paycheck, and went home without a care in the world, you dont care about your patients because they didn’t have a personal impact on your life.  The world is far from perfect, and yes, I bitch about crackwhores/welfare/shitty state of pharmacy because I do care.  I do care about those abusing the system or the crackwhore mother who obviously cares more about her early norco refill than her child who is ignored.  I can’t solve the worlds problems and that gives me frustrations.  I bleed the relief valve on twitter and on here to keep myself from going insane.  Burnout is huge in the medical world, and if we; the faceless medical community from all races, specialties, locations, etc, are unable to joke, laugh, and support each other then thats just going to separate US from our patients.  All of us have been the butt of jokes, all of us are patients in one form or another but as long as nobody is singled out and no harm is done (intentional or unintentional), whats the harm?

But what do I know, to these MD’s im just a fucking pill counter who gets yelled at because Solodyn is 500 bucks and the patient cant afford it.

Oh, and to close this off, heres an awesome twitter quote: If I had a 36hr priapism and Dr. V was attending, one thing’s for sure: There’d be two prominent dicks in the room.

Comments #

Comment by @JayWay76 on 2011-05-26 04:14:59 -0700 #

Once again, you hit the nail on the “head”. <– heh heh. It’s a dick joke. Get it?

Look, lay off, it’s early.

Comment by Dr Alice on 2011-05-26 10:01:45 -0700 #

Go you! I completely agree. I follow you and @BurbDoc on Twitter and your posts are the breath of life to me. Dr V is a self-righteous nincompoop. I posted on his website telling him that his take on @doctor_mommy is completely wrong (as are the whiners tut-tutting at her posts, BTW). Please carry on, I love your stuff.

Comment by Dr Marc on 2011-05-26 12:49:32 -0700 #

Probably your best written article, great job. If we lose our humor we are going to start blowing our brains out.

Comment by Carol on 2011-05-26 15:04:26 -0700 #

I’m a Mom, I belong to a message board where we vent. We are crass, disgusting, opinionated, educated and we love our children. We would go around the bend if we didn’t have a place to talk about all the crap that we deal with as parents so we post the stuff on this message board.

It’s not just the people in the medical field, it’s people who take care of other people, period.

Welcome to hell, there is the way to manage it. Vent, often.

Comment by The Highlander on 2011-05-26 17:35:42 -0700 #

Well said you bastard! It’s a shame we have all these douchegrundles who take their lives waaaaaaay to seriously!

http://www.apothecarytales.com

Comment by Mike W. on 2011-05-27 14:58:02 -0700 #

the last line or your post is priceless!

Comment by John Woolman on 2011-05-28 00:13:04 -0700 #

Interesting, My malpractice insurers in the UK sent me an e-circular yesterday warning about posting on social media. ““The two biggest mistakes doctors risk making when on social networking sites are breaching patient confidentiality and bringing the profession into disrepute”,
says Dr Anthea Martin, senior medical adviser with MDDUS. “Both could attract the attention of the GMC, which has the power to launch an investigation, suspend the doctor involved and – in the most extreme cases – remove them from the register.” MDDUS is the medical & Dental Defence Union of Scotland, the equivalent of malpractice insurers, and the GMC is the body that grants the licence to practice. No one is going to cavil about giving a good kicking to anyone who breaches patient confidentiality. “Bringing the profession into disrepute” is a subjective concept at best and when your career is at stake its not a good idea to assume that those who may be judging you share your sense of humour. I stopped blogging for that reason.

Comment by techie on 2011-05-28 15:18:03 -0700 #

Yea it wasnt til Dr. V went into details that i even knew wtf the tweets were about so how the hell is a breech of confidentiality. Secondly, i agree penises are damn funny, especially when they have been saluting a doc for 36 hours!!

Comment by michele on 2011-05-29 16:50:27 -0700 #

Could you recommend a laxtive to Dr. V? Sounds like he needs a good one.

Comment by Natalie on 2011-05-31 22:40:47 -0700 #

I started reading your blog as a pharmacy tech, and now am out of that field (with no regrets!) but can’t help but see the world through that lens from time to time. We joked about patients, privately, all the time. It helped us cope with the insanity that was around us all day.

That said, as a PATIENT, I would MUCH rather have a doctor like Mommy_doctor or those like her (and for that matter, a pharmacist like you) intead of one like DrV, who clearly got a professionalism stick shoved up his ass in med school. There are, as you said in your more recent post, two types of doctors. From my perspective, there are the type like DrV, who seems to be that think the MD after his name puts him in a class atop the rest of the world. They are the kind that don’t speak to pharmacies, but also don’t LISTEN to their patients. (Hey doctors: your patients can tell when you have your mind made up before you even examine us. Being an arrogant asshole is a good way to end up with no loyal patients.)

Then there are the other doctors who haven’t forgotten what it’s like to be the one being cared for. She was clearly empathetic, but it’s not just that – she was REAL. Pretending that you are unaffected by your patients makes you a robot, not a “professional.” Trying to pretend like anonymous stories about patients are somehow ruining the image of physicians is ridiculous.

(The fact that you can hardly get one to turn away from the laptop and look you in the eye during an exam, or return a call with a question, is what’s ruining their precious image – just for the record.)

If that patient had been my husband, I probably would have gotten a chuckle out of her tweets. Hell, if it were my OB joking about something stupid I said or did during labor, I’d laugh. There was no way that the patient could have been identified, and that’s pretty much where it ends for me.

It’s sad that she got chased off of Twitter by people that think they have the right to police the internet.

Comment by Liz Ditz on 2011-06-04 19:21:47 -0700 #

If anyone wants to read more about the story, I’ve been keeping a list..and comments, including from @Doctor_V (but sadly, none from @mommy_doctor) at

http://lizditz.typepad.com/i_speak_of_dreams/2011/05/anonymity-pseudonymity-privacy-online-discussions-deleting-posted-material-storm-in-the-twittercup.html

I’m still mulling over the sexism aspect of the attack on @mommy_doctor. I think it is significant but just don’t have the words yet.

Comment by Terri on 2011-07-23 14:28:36 -0700 #

Hey,
Had to stop & comment on “wtf” in regards do “dietician”. Kudos to the hosp for including a dietician(registered).

Terri

Comment by GOP Twentytwelve on 2011-08-22 03:33:45 -0700 #

You people are a perfect example of why the ‘unwashed masses’ voted for Obama. You are so blind to your effect on people. All the adages apply; ‘you think your shit doesn’t stink’, ‘born with a silver spoon in your mouth and your thumb up your ass’, etc. Also, your staff takes on this attitude, treating patients like turds from the get-go. Then he gets ‘treated’ by a Doc who projects a superior attitude, and then gets handed a bill for a small fortune. You stupid shits contribute to the class warfare struggle that is\has developed in our society and you are a big part of the reason why we are all getting screwed. Think about it while you’re exchanging tweets and chatting on facebook like a bunch of irresponsible adolescents.

Comment by Bill on 2011-10-20 08:58:42 -0700 #

I thought the tweets were funny and in no way directed towards an individual.

What I thought was DOUBLY funny was just how many responses others (as well as the original author) were able to log in less than 2 days. perhaps THIS is why we have such a tough time getting prescriptions clarified. Maybe Doc V should spend more time with patients and pharmacists and less time on twitter

Comment by Bill Walker RPh. M.S. on 2011-10-25 20:41:46 -0700 #

I may be easily confused (OK , I didn’t read the whole post) but when you say I “bitch about crackwhores/welfare/shitty state of pharmacy because I care” I don’t see the logic. Its like “I’m hitting you for your own good” or “this is going to hurt me more than it is you.” Perhaps the hitter really has intermittent explosive disorder but rationalizes its really in the child’s welfare. Not an exact analogy but most analogies are not exact. And do your expressions of anger help you because I find them rather whinny. I sense and can relate to your frustration, and anger is a more (sort of) “empowering” emotion than frustration but if your expressions of anger could be channeled into real, constructive efforts at initiating some helpful change I think you and the “profession” would all be better off. I relate to your use of sarcasm and irony (and even condescention) because I use them myself–probably too often. No job, professional or otherwise, is perfect, but a “virtual” expression of anger isn’t nearly as effective as one expressed to those who cause your wrath (I’m not suggesting yelling at “crackwhores” who were beaten and molested by their fathers). I mean the real culprits: pharmacy schools, organizations, insurance companies and anyone else who has assisted pharmcists down the path of semi-professionalism. BTW, I think nurses finished ahead of pharmacists in the most recent poll of “most respected.” Pharmacists did finish first in the “I wonder what the fuck he’s doing back there” poll and the “most educated but underutilized quasi-professional” poll. Food for thought? Maybe not, I’m just spit-balling here.
Bill Walker RPh. M.S. if your going to have an opinion, I think tagging your name to it is a good idea. I could be wrong.

Comment by jagg on 2013-03-12 08:31:15 -0700 #

So what do you do when a patient can’t afford their insulin?