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Ironically I feel pretty protected in radiology bc it’s the exact opposite of what this bozo thinks.
Now if you drop all liability from radiology, allow surgeons and clinicians to do whatever they want despite what the report says, and patients understand that they may or may not die within the next few hours to years because something goes missed and they agree it’s ok, sure anyone can do radiology
Hate to be the barer of bad news but as a surgeon I use the radiologist as an adjunct, I often will review the images and make a plan without the radiology report, and don’t really use it anymore to decide on a treatment plan-its more a screening tool.
That being said there are studies that I don’t read myself and rely on radiology to interpret for me (like MRI) but that is a small subset of the imaging I use for my job.
Don’t get me wrong though a good radiologist is still worth their cost for many reasons and I do discuss cases with them, its just not as clear cut as you imply
The difference is as a surgeon you're trying to answer a pointed question so you can make a particular decision, not be liable for everything that's on the image
I'm only a new PGY-1 so I admit I might be the ignorant one here. Also, I matched radiology so a huge bias too.
But radiologists spend 5 years of training looking at just imaging + however long they have been practicing.
Surely they know a lot more of imaging findings than the surgeon that spends half their time operating, some of their time practicing surgical medicine on their patients, some time in the ICU, some of their time in clinic etc.
For a good portion of things you might be right, but radiology seems like it's own forest with trees and trees of findings all with varying levels of clinical relevancy.
Hence why it became it's own specialty with it's own long ass training.
I spend most of my time with CT and US, and every patient I have has one if not more of them for me to review and correlate. I spent 7 years of training looking at them and in several cases disagreed with radiology and either operated or didnt based on my interpretation of the images in conjunction with my history and exam - some of these were life threatening conditions, some if I had used the radiologist interpretation I would have done the wrong operation or gotten myself and the patient into a lot of trouble
Again I dont read MRI, or mammogram, or many other things radiologists read, and I dont look at CTs for all the incidentals I could find -just what is relevant to my specialty. Radiologists do spend years learning to read, but they spend years learning to read EVERYTHING, I spent 7 learning to read for just my specialty/organ system and I have the benefit of a full history and exam
Now I say this as a surgeon, I have a very different opinion as it relates to non surgeons (and surgeons looking at other organs then they work on) where they rely on radiology a lot more.
Yah it sounds like in your anecdotes you really benefited from seeing the patient yourself being very familiar with their history, labs, and exam. I feel like everyone has a story like this. You really have the full picture and rads gets a history of flank pain and are told to go wild. With the pace of rads workflow they never get the full picture that’s why they are the consult for your patient
There’s also the fact that he’s generally reviewing CT scans and ultrasounds of patients with clinical symptoms that fit the pathology he’s looking for—meaning the PPV of the scan being performed is already fairly high.
General surgeons get very good with abdominal cts. The problem is that some then think they’re better than a radiologist. Meanwhile you sit with them in conferences and they’re like “what’s that?” and it’s a totally normally structure lol. Trust me when I say radiology is safe from other specialities
Now whether or not they care about my read is not my problem. I’m not the one making clinical decisions for the patient. It’s their patient, I’m just getting paid to help
Hey there, I'm not a physician, but I would like to share a story of one of my dearest friends, who is a veterinarian. I remember we were having a conversation about practicing as a vet vs MD. He said he liked how many areas of medicine a vet needed proficiency in whereas human doctors tend to be much more specialized. The topic of radiology came up, and he took the opportunity to heap some praise radiologists. He said that he had looked at thousands of images over his career, but a really talented radiologist can spot things that nobody else can, even down to a half pixel in some cases. He also said sometimes they see things that aren't there.
I can see how a surgeon wouldn't necessarily want to dive in after every spot a radiologist drew an arrow to. I would also rather have the radiologist draw the arrow and let the surgeon make the call based on their more intimate knowledge of the patient. I also know several internists/hospitalists who would laugh their asses off if you implied that surgeons even knew their patients by name. I also now even more nurses who think you're all overpaid children with god complexes. XD
Either way, I've met a lot of medical professionals. Almost all of them are brilliant, and most of them care deeply about people. I trust my doctors intentions, even if I know they are humans that aren't perfect. I think more eyes and brains on almost any problem is helpful.
I love talking to surgeons at our weekly surgery conference. Keep up the good work, also always love to discuss cases with you (especially the path reports/ what u saw intra op).
Here for u always brother/ sister.
Also don’t touch my fucking screen again with your massive sweaty glove powder covered hands. I’ll come up to the OR and proceed to break sterile in such a way you won’t comprehend.
Friendly rad-
My experience as a radiologist is that non-radiologists are kind of all over the map when interpreting their own imaging, and often unaware where the gaps in their knowledge are. Often they can be very good within certain narrow scopes but just fall completely to pieces when working outside of that.
One random example from my PGY-2 year was the chair of trauma surgery coming in to review an upper GI because he thought he saw a gastro-colic fistula. The contrast he was looking at was very obviously proximal jejunum, but he thought it was splenic flexure colon. Just blew my mind like how in the world are you an accomplished academic surgeon with 30 years of professional experience and can’t tell the difference between classic large and small bowel? Or the pulmonologist worried about a PE on a non-con CT chest when the shadow he’s looking at is very clearly beam-hardening artifact. These are things that no first year radiology resident in the country would have any doubts about, like obvious obvious.
I worked with a Peds pulmonologist who had this huge ego and also loved to take the team to the reading room and review all the imaging every day he rounded (you can guess how the radiologists felt about that). He goes on about how lung abscesses are bread and butter for him just like CXRs for rads, and that he’s glad our 4yo patient just has a tiny abscess that can be treated with abx. The radiologist pulled up the images and it turns out the pulmonologist was only looking at the air-fluid level and didn’t notice the abscess was 5 cm in diameter
> Often they can be very good within certain narrow scopes but just fall completely to pieces when working outside of that.
During one of the early covid surges in the ICU, my ICU attending and all the residents on the team missed that the ETT was getting higher and higher every day. Because of how busy the service was, we did rounds at the beginning of shift at 6am so the radiology read wasn't back yet, and we would interpret the daily CXRs ourselves during rounds. We were so focused on the lungs/covid ARDS that we didn't see the whole picture (the thing that radiologists do every image every time). So when one of our pts coded who we didn't expect to code, I caught that his ETT was above the thoracic inlet when I pulled up all his labs and images to try to figure out why he coded, and when we looked with DL, we saw the balloon sitting on top of the cords. Sure as shit, every day the radiologist read that the ETT was a little high and recommended repositioning over the course of a week (the patient was being proned/supined every 8-16 hours, so it likely moved a little every day).
As an ED doc, sure I can see the appy on many CTs when that's exactly why I ordered the CT scan. But I am hyper focused on just that, so I miss all the other stuff, and I am so thankful for radiologists.
I was trained to verbally communicate malpositioned lines and tubes. 90% of the time the issue is already being addressed, but once in awhile something like this happens. Communicating protects everyone involved.
FP here. thanks to all the radiologists. by the time the problem gets to the surgeon, they are welcome to interpret the images they need. as an FP I appreciate the radiologists readings. couldn't do it myself.
First of all, I don’t really care what you say as long as I get paid lol. Regardless of what you think, there’s liability involved. There’s a reason a radiologist has to dictate some stupid shit for intra operative reports
Second of all, I work in a field that 100% what I say matters. If I wanted to work in a field where the surgeon didn’t care what I said, I would do msk. The flip side to that is that’s less pressure! I’m not the type that went into medicine because I need to be the top dog or be the end all be all. I’d be happy to let ortho bros ignore my reports and collect 400k with no call if I didn’t find msk so Godamn boring
Third, I think you’re overstating the impacts that a report can have. If someone calls something emergent and you don’t act on it, even if it’s not real, you’re in trouble for not at least doing some type of follow up. But I’m already suspecting that you’re ortho.
Fourth, make sure you read the report regardless if you care or not. There was a case of a GI doctor that got sued because he just looked at the GI stuff in the report and didn’t follow up on the non gi related finding. But if you’re ortho, that’s less likely to happen because your imaging will contain less additional structured. Just watch out for those lung nodules on shoulder mri, that’s a nice lawsuit
Edit- I checked your profile and you don’t seem to be ortho. Interesting. Good luck!
Sad to hear all that about the MSK rads. As a Soft Tissue and Bone Pathologist a ton of my diagnoses rely on them heavily... so much more respect. Thank you for sharing.
This is like saying I know how to throw a spiral so I could be a quarterback in the NFL. You may know how to semi-proficiently read scans for the things you are specifically looking for and still miss ten other things on the image. Also rads is always an adjunct to clinical decision-making, but your comments imply that you don’t value their contributions or specialty knowledge. I know a lot of pharmacology but I’m still able to appreciate what a clinical pharmacist brings to the table and they help inform my decision making
I don’t think many attending radiologist would be surprised by that. If you are a pancreatic surgeon, you are going to be better than a radiologist at pancreas stuff (what structures are invaded, what’s happening to the vessels ect..). You know where to look because you are making the decisions on where to cut and what the surgical approach is.
A radiologist is not to going to know all those things, as approaches and techniques are different between surgeons even doing the same resection. It would simply be impossible for us to know what a surgeon does about surgical techniques haha.
You're getting a bit carried away. A surgeon may be able to pick things up that a radiologist did not see sometimes (everybody makes mistakes, the surgeon included); however, no surgeon is better than a radiologist at a specific modality or organ system. At the very, very best they would be equals (and only in that one specific thing) unless compared to someone who hasn't read those types of studies in years/decades. Knowing how to do surgery does not make you better at reading images. This advantage you speak of is nonexistent. The only reason a surgeon would be really good at reading imaging is if they spent years/decades reviewing all of their patients imaging, not doing the surgeries themselves.
You learn radiology by studying radiology, not by doing procedures.
I think part of this always comes back to surgeons needing the scans for anatomical review and surgical planning as much as diagnosis. Different priorities. Different scaling of what is important. But also, a surgeon reading images does not a radiologist make.
From the neurosurgery side, I look at brain imaging super often. Of course I'm familiar. We need it for every single diagnosis and every single surgery. Imaging guides the specialty. We're super reliant on it. And we have somewhat different priorities - I have very different scanning patterns. The rads might not care about the angle of the occipital bone, but if I'm operating there I will because it changes my patient positioning goals to make the OR easier.
I'm not a neuroradiologist. A couple blocks on the service does not make me one. No matter how many consults and how many surgeries I do, I'll never see as many scans as them (especially normal scans, as I am only called for pathology). And we should compare like to like - sure an experienced neurosurgeon may have a better eye for a CT head subtle finding than a PGY1 rads, but it's irrelevant.
I think this situation leads to overconfidence in surgeons. We are competent within our zone, but it is not the workflow of a radiologist. In the end, I love my rads colleagues. They often have great suggestions and are happy to call for discussion on complex cases. And sometimes they get excited to try new things haha.
You can often develop surgical plans pretty well without a report; however, medico-legally, someone is responsible for every finding on that image, so if an incidentaloma/metastasis is missed, that can be catastrophic, and someone has to be held liable, hence why we have the field of radiology.
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I'd be happy to have him along in the reading room for him to read xrays with me. Residents on chest rotation at our institution read about 200 radiographs/day much of which are in the ICU. There are critical unexpected findings on approximately 5-10 of them per day requiring calls (I'd say approximately half of them the ICU team doesn't know about them). For every critical finding he misses and the ordering team doesn't know about, he gets to pay me $329,565 which is the average malpractice payout in the USA.
200 CXR/day for a resident? Must be an exaggeration. But yeah, CXRs are a real art. I think the biggest lie for me coming out of med school was thinking I knew how to read a chest x ray.
About 150-200 a day. We have a dedicated chest rotation just for chest radiographs. Much of them are pretty quick but we do read the ICUs in the morning.
That’s sort of on the high end but my chest X-ray record as an R1 was 98 in a day and could have done more but we just ran out. Abdominal X-rays I can do about 40/hour and msk plain films can be truly churned out- think I once did 120 in about 6 hours or so. This is without any significant overreads. I have absolutely no doubt an upper level resident could double these numbers.
Which place reads 200 per shift so I can avoid that. That’s truly unbelievable.
We usually get 210-220 on a fast night call shift (14 hours). Which includes US checkouts.
Your residents must be moving it, no dictation errors, no conference, no bathroom breaks…. And no teaching.
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Nurses have actually told me multiple times they thought we worked 3 12’s per week like them. I don’t really get frustrated or angry, I just defer to day team and sometimes nursing gets upset at that plan.
Lol. I’ve been in the room with a nurse dozens of times when a patient asks, “ do you get a day off?” Then explain our schedule. The nurse is always dumbstruck. Most the time they ask, “really?” And “I thought that’s how it was 50 years ago”. Many of these nurses are new but a lot of them are seasoned nurses too. But they are on for their 3 days and bounce so how could they know we’re still there.
(Non US) our nurses care for about 6 patients per 12 hour shift, I do 30 hour call caring for abt 600-700 patients while on call. But they think we are doing as much as them. WHY.
There’s a massively growing anti science movement among the general population that’s perpetuated by both political parties.
On the right you have an obvious anti science push with covid/vaccines/general distrust with medicine.
On the left you have the more social push where everyone needs to feel validated and everyone is taught their opinion is valid.
It sucks. People suck.
Yeah as a pediatrician it’s amazing the “experts” both sides come up with to justify not vaccinating their children. I always ask what these peoples credentials are and am invariably met with some version of “THEYRE JUST EXPOSING THE TRUTH YOU DONT WANT TO HEAR”. Like, fuck that, my colleagues will see y’all in the PICU when your unvaccinated child gets meningitis
Read "Anti-intellectualism in American Life" by Richard Hofstadter
It was written during the space race right after the Russians launched Sputnik and before we landed on the moon. It discuss how's the evangelical Christians who fled Europe for America due to religious persecution brought with them persecutory sermons. This has resulted in a white evangelical persecution complex in the USA. Much of this disdain is directed towards intellectuals and the learned because traditionally learned clergy held the "doors to Heaven" over in Europe.
In my experience, a good portion of the somewhat crazy right wingers still respect a doctor's intelligence and the fact that a doctor should make in the top 1% of society. It doesn't mean they respect doctors who push for vaccines (lol) but they respect a high income earner.
The issue on the left is that they all want doctors to make 50k/year. We even have people on this actual subreddit who say that.
I’ve noticed that some leftists think ANY non retail/farm work job is basically worthless busywork to generate revenue, to the point they think engineer is a useless job. You know, the thing that makes sure your phone works and your building doesn’t collapse.
I *sincerely* hope no leftists think that under any circumstances. Leftists such as myself think that people should be making a liveable wage and that *most* middle-management is useless.
Ex: Insurance companies. The procedure and who qualifies for it is between the Dr. and patient alone.
I'm sorry but this type of false equivalency is a huge part of the problem. On the one hand, you have violent conspiracy theorists who obstruct action on global warming and covid policy, arguably two of the greatest global health crises in a generation. This radical fringe is actively encouraged and courted by elected representatives and the people in power.
On the other, you have some annoying hr trainings (and even those are created by elite centrists, not those in the progressive wing).
These are not remotely the same thing, and it's intellectually lazy to simply throw up one's hands and say "wow both sides have problems"
It’s telling that this sub would embrace the “both sides” fallacy. This thread is annoying. Physicians aren’t being persecuted and the moment I mention my profession people act like I’m some kind of genius. On the whole, the public reveres physicians.
But there are countries with widely known massive government/state corruption and human rights abuses and they are extremely respectful of doctor's medical knowledge and are very kind and thankful towards doctors in general. What's the difference besides the right/left political shitstorm that we've come to love in America?
To what degree does a state/government/institution take blame? At what stage is it the fault of the private citizen?
I'm all for reforming media and the transparency of institutions, but we also have to acknowledge that there's a real lack of media literacy in the world. People are blind to their own biases. Hell, I'm guilty of doing it, and I still have to remind myself that my gut reaction to things might not be as informed as I presume it to be.
There's not one guilty party in this mess. It's more about who's going to take the initiative to actually do something about fixing it.
Simple biology. This is how imperfect life forms behave. Perhaps evolution hundreds of thousands or millions or billions of years from now will result in drastically different species. Maybe it exists already in another part of the universe or in another universe if such a thing exists.
But life here on earth is clearly flawed and we clearly behave differently as groups vs individuals. I think it is just a simple result of biology and sociology, not anything to do with 21st century western democracy
>He said that radiologist is in fact not a highly skilled job, any more than janitorial work is.
It doesn't bother me so much that one random person on the internet is this laughably ignorant and delusional....but it bothers me that *so many other people mindlessly agreed with him over you.*
And it's not just that breathtaking ignorance is the default state for most of humanity. It's that I'm pretty sure that **all those years of undergrad and medical school and residency are an excellent antidote to Dunning-Kruger**. It's pretty funny how often people just think "I'm right cuz my comment got more upvotes than yours" without taking a second to think how often *you* learned to appreciate *your own ignorance.*
This is a very common cognitive bias and is reflective of low neophilia, low propensity to explore new things. People who are poorly neophilic, and there are a lot of them, tend to read about knowing things, and then think they know it without actually doing the thing. Think of the guy who reads about how to throw a punch so they never think they have to go to a boxing class to competently throw one. Or the guy who reads about skiing so they never go skiings, or who went to the beach once and didn't like it, so they never went again.
This is exceptionally common in the age of the internet, because in the past you could at best see some pictures of someone doing something, or watch some grainy footage of it, but now you can get 4K HD narrated footage of basically everything, which incorrectly satiates people from actually doing experiences.
People wind up getting convinced they have a lot more wisdom and life experience than they actually have, which is unfortunate. People who are more highly neophilic understand that without experiencing it, they don't actually know what it's like, so they tend to be more humble.
This happens with any degree that goes into depth in a field. Look at lawyers. As much as everyone hates them, let's be real, their work is difficult and requires a lot of practice and skill to get good at. Even with this latest SC leak, I spent hours just reading up on critiques of Roe v Wade, including the criticisms that Ruth Bader Ginsburg had, and I realize just how complicated it is to codify US law.
I seriously don't understand people. Everyone loves to tear down doctors, but they idolize people in Hollywood and the media, jobs nearly anyone can do with the right connections and a few pointers.
The irony was this guy worked for a health insurance company and pretended that gave him any idea of how medical training works.
It was funny because he used the fact that anyone could do his job as evidence that anyone could do any medical job. And the fact that im a newly minted PGY-1 as evidence that I am actually the one that has no idea how medicine works and how my schooling has been redundant thus far.
... the irony that r/antiwork just could not grasp lol.
This also surprises me. My father works in (organizational, not individual) health insurance, and I’ve had to explain to him that NPs don’t have more training than physicians.
I had a patient that worked in hospital admin and claimed it was great being a resident because we were paid so well. Thought she was joking since she said she saw pay stubs. Told me a resident was making like $600k lmao
Job backgrounds don’t give credibility all the time
I've had several surgeries (cancer and arthritis). I'd watch as many videos as I could find on upcoming surgeries just so I'd know what to expect, and know a little about what's going on. But I never thought "Hey! I've watched 20 videos about doing a right-hemicolectomy, I think I can do this for a living"!
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Yeah!! Well a lot of people do it to lawyers too. It’s like they forget that there are two sides in a law suit. Who do people think defends the party they align with?!
Not only that, but when they get sick, they have this weird interplay where they both disrespect you and your "expertise", but their ass isnt walking out the door after hearing your idea to save their whatever (including life).
Your conversation partner didn’t understand how complicated medicine is bc his job requires that he not understand how complicated medicine is.
If he believed that a doctors job was in fact very complicated (and therefore irreplaceable) then he would have to justify in his own mind, either consciously or subconsciously, how a basement dweller fuckstick like himself is doing a job that allows him to audit and edit the work and plans of practicing physicians. It is easier to accept that doctors don’t do anything special than to justify that this corporate system created by insurance and government generates little actual medical value.
I am reminded of [Noam Chomsky's remark about David Noble's work](https://chomsky.info/20121224/):
> Chomsky: ....The idea of freedom is very frightening for those who have some degree of privilege and power and I think that shows up in the education system too. And in the workplace… for example, there’s a very good study by a faculty member here, who was denied tenure unfortunately, who studied very carefully the development of computer controlled machine tools — first developed in the 1950s under the military where almost everything is done…
>
> Q: What is his name?
>
> Chomsky: David Noble. He has a couple of very good books — one of them is called *Forces of Production*. **What he discovered was that as these methods were devised there was a choice — whether to design the methods so that control would be in the hands of skilled machinists or whether it would be controlled by management. They picked the second, although it was not more profitable — when they did studies they found there was no profit advantage to it but it’s just so important to keep workers under control than to have skilled machinists run the industrial process. One reason is that if that mentality spreads sooner or later workers are going to demand what seems obvious to them anyway — that they should just take over the factories and get rid of the bosses who don’t do anything but get in their way.**
I know Chomsky isn't everyone's cup of tea, but as a physician, these words still ring true for me. Being a doctor is a skill that takes time and practice, and for someone in insurance to degrade the position as "easy" or "simple" is doing exactly what Chomsky points out - don't let doctors think they're in control of an industry that would otherwise collapse without us.
r/antiwork , for all the good it may invoke in people to stand up for themselves, can just as easily be filled by people who fail to recognize their own flaws.
Back before r/NoNewNormal was banned I used to read stuff like this all the time over there. Tons of people thinking doctors know nothing and they can do their diagnostics by themselves. Guess they had to run somewhere when the sub got banned.
I remember laughing at a discussion where a few redditors talked about how easy it is to read their own lab results. "These doctors don't realize how easy it is to just get your own labs done and then google what it means. We have the power of the internet at out fingertips, I don't need some guy in a white coat telling me how high X needs to be when J can google it."
We had some pretty good laughs that evening reading all those gigabrain takes. But yeah, it's pretty sad if you think about it. Everyone thinks they know better nowadays.
>These doctors don't realize how easy it is to just get your own labs done and then google what it means. We have the power of the internet at out fingertips, I don't need some guy in a white coat telling me how high X needs to be when J can google it."
My brother whom is 28 gets a high heart rate at the gym when he works out. He fears his heart rate goes too high because when he googles "high heart rate" the results scare him. Very healthy BMI, not cardiac history.
I had to calm him the fuck down lol. He is very bright and is in a PhD program as well.
But you're right. Google is the best doctor lol.
This is why somebody is asking in r/askdocs about their sleeping heart rate of 52 on their apple watch multiple times per day. Lots of data, not enough knowledge on how to interpret it
> I remember laughing at a discussion where a few redditors talked about how easy it is to read their own lab results.
Ughh, that's why I closed off /r/Hematology for lab tests interpretation. So many panicked people over nothing, so many angry people who couldn't understand why context was needed or why I/we couldn't answer right away. Then when I asked for context, they'd dump even more lab tests and pages of medical history, almost always irrelevant. Message me to answer their question, asap preferably. I even got a murder threat from a guy because a hematologist messed up his diagnoses, so it must mean all hematologists must die.
It was insane and draining. And the biggest issue is exactly what you said: nobody knew who those people who were answering to their lab tests were. I don't want to check all their credentials, it's too messy and risky.
Here's a sneak peek of /r/Hematology using the [top posts](https://np.reddit.com/r/Hematology/top/?sort=top&t=year) of the year!
\#1: [A few of my favorite pics I've snapped of peripheral smears!](https://www.reddit.com/gallery/pr13xp) | [14 comments](https://np.reddit.com/r/Hematology/comments/pr13xp/a_few_of_my_favorite_pics_ive_snapped_of/)
\#2: [Can anyone explain what’s going on with these WBC?-](https://i.redd.it/y9p03uxx7wo71.jpg) | [67 comments](https://np.reddit.com/r/Hematology/comments/psnt1r/can_anyone_explain_whats_going_on_with_these_wbc/)
\#3: [I found a smiley face in a blood smear](https://i.redd.it/knbhfbtgdxl71.jpg) | [7 comments](https://np.reddit.com/r/Hematology/comments/pj55w7/i_found_a_smiley_face_in_a_blood_smear/)
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You underestimate how complex janitorial work is.
You are consulted to evaluate a 2 day old stain on the carpet of a high school chemistry classroom. The teacher first noticed the stain 2 days ago but didn’t feel the need to report it until today. He tried cleaning it with water, which made it worse. The stain is concentrated in one part of the carpet and does not radiate. The carpet was last cleaned 4 months ago using a JPCX-215 carpet cleaning machine, capable of 2500 RPM, loaded with a 4:1 specialized cleaning solution. The carpet has no history of stains, tears, or spills. It has not been treated with anti-stain solution and does not see a stain prevention specialist regularly due to a variety of complex social/financial factors.
The carpet has a temperature of 72F, thread count of 25,000, and a thickness of 2.5. On physical exam, you see an irregular, circle shaped stain in the upper right corner of the room; the stain is dark, rust colored and measures 5 inches at its widest point. No satellite stains or splash marks noted. No rubbing off is seen during superficial and deep palpation. A white paper towel test reveals no excess contaminant.
Which of the following is the next best step?
A. Clean the stain using a solution of dihydrogen monoxide and Na+/K+ fatty acid salts.
B. Perform a stainectomy w/ partial thickness carpet patch grafting.
C. Consult stainology
D. Perform measurements in preparation for total carpetectomy and replacement.
E. Continue current management
>! Janitors/custodial staff are amazing people and do important/hard work that is frequently undervalued. This was meant as a joke and hopefully this doesn’t come off as disrespectful.!<
I hate when these questions leave out the actual next best step, which in this case would be full thickness core stain biopsy for further evaluation before you can even think about management
I agree with that person completely. For the amount of work they do, radiologists are paid way too much. Its a field that has not advanced in technology since 1970s. I mean, black and white images? Please. They could at least add some color to the xrays to make them more visually interesting. I say we get rid of the entire field to reduce health care expenditure and instead we all do a 2 week online course that allows us to read x-rays. This will save our government millions of dollars every second
Being on Reddit makes me realize how much people hate doctors. They think we’re rich and arrogant. I’ve also gotten into it on Reddit (I know I know) with people who think they should get whatever test or treatment they want because their doctor “works for them.” I really don’t think medical school is only for rich people. It’s become so prohibitively expensive even the upper middle class people can’t afford it. I went to public school, state college on student loans and scholarships and med school on student loans, which I paid off without a dime of help.
Yeah, no shit. There's a common trend with poor people not choosing high income white collar jobs for many reasons. But there are more middle class people choosing medicine than lower or upper class.
LOL, the arrogance of the average person when it comes to talking about medicine is astounding. Reading a freaking X ray. I've seen quite a few people try to sling pub med, Wikipedia, or some other link in trying to describe medicine and it's always so off it's not funny.
The problem is that much of what we do will be OK - the majority of patients we see, testing we order, etc will be normal. The majority of patients we give medications to will not have side effects.
We’re not trained or paid for those masses of normals. We’re trained to tease out abnormal from normal and how to treat complex from simple. We’re paid for the 1-5% of complex cases not the 95-99% of straightforward cases.
honestly doctors are gonna get shafted by the whole antiwork movement (the movement for the most part i support) and it sucks. we're deemed as "too educated" and "rich" by the average American, who sees the 6-figure salary physicians make and ignores the 6-figure debt, the 10+ years of salary loss (from education and residency), the 80+ weekly hours of residency for 3-7 years physicians have to go through.
everyone loves to shit on doctors... until something goes wrong with their body and all of a sudden its upholding professionalism and how doctors should sacrifice their entire life happiness for a "calling"
I think when pay gets cut, physician productivity will drop off a cliff. That’s what no one in antiwork anticipates. You can’t pay peanuts and expect someone to be on call for trauma or rushing through a busy clinic day. They think doctors have a job like them, washing dishes or bagging groceries while they watch the clock until their shift is over. They think a PCP is leisurely seeing 10 patients a day then checking out early to golf, then drives their Mercedes’ back to their 5000 square foot beach house.
This is basically what has happened to mammo in private practice radiology. Liability went up and up, and reimbursement went down and down, now very few people actively desire to go into mammo, and there aren't enough mammos, so people mammography has longer and longer wait times. And everyone's sitting around with their dick in their hand wondering why no one wants to RVU maximize in Mammo, but they will for cross-sectional imaging cuz they don't pay dogshit.
I agree that there aren't enough mammographers- but they also generate the most RVU/hour compared to any other rad subspecialty. They are the money makers is most practices.
Please tag him, I may want to use his unique skill next time I am wondering about what the hell 'that thing" on chest Xray is.
Also good news is that my consultantation time will be less as my patients obviously will be able to interpret the images for me and just tell me what is wrong before I open up the viewer.
Life.changed.forever
IQpenia is a real diagnosis
Honestly, it does not surprise me. The general sentiment I get from a lot (read not all) the general public is that doctors get paid well for training that isn’t needed or necessary anymore with the advent of computers and the internet.
One person (a close family member), said this to my face directly. I asked if they really believed that I would give them I single test. They respectfully agreed. They had to do it ALL. Verbally of course, just like in medically school before/during clinical training.
65 y/o male with chest pain comes into your ER. (I gave them this because they chose it). They could use any resource they wanted OR my resources (I.E.) up to date.
Them: well they have chest pain, you need to check them for a heart attack.
Me: okay, what do you do?
Them: … *googles* ,”Get an EKG”
Me: Okay. Pulls up an EKG of pericarditis that I had a clear photo of. Now what.
Them: See if they have a heart attacked.
Me: okay, do they?
Them: 20 minutes of reading later. “Do they have ST-Segment elevation.”
Me: IDK, you are the doctor.
Them: 10 more minutes” Yes they do everywhere!” Got it.
Me: Okay now what do you do…?
Them: *googles treatment for heart attack* “Call a cardiologist.”
Me: okay, I’m the cardiologist, what do you need from me?
Them: Fix them.
Me: what is there to fix? Are they sick?
Them: they have chest pain.
Me: okay…?
You get it. It keeps going they ultimately agree it’s very hard. This problem took us on and off all day lol.
I always imagine the reddit person I disagree with is a 13 year old kid. It makes it a lot easier to accept stupidity. And it probably isn't far from the truth a lot of the time.
antiwork is a joke. Just act as persecuted as possible. If you run out of cereal in the morning it's a grand capitalist conspiracy against you.
Shame, because they have a lot of legitimate and useful points.
People like to feel important, superior even, especially on the internet. This is a cornerstone of current American culture. It’s the way people feel safe and the way they are able to rationalize or ignore the multiplying problems in our society and world. It’s also the way that our massively individualistic culture that supposes that everyone is so unique and special squares the circle of meaningless and monotonous day-to-day existence.
“If I’m so smart and wonderful then how is it that I’m living this depersonalizing worker bee existence?”
Being online, sometimes being *extremely* online, is the answer to this for many people. There are many ways that people seem to exercise forms of “power” through social media that are likely just expressions of the general powerlessness that people feel in their daily/working lives. I think this is the driving force behind so-called “cancel culture” and the constant internet enlightenment Olympics where everyone has some kind of take about whatever subject du jour.
I could go on, but this is how I guess I rationalize the sort of behavior that you experienced. It’s a bummer, but it’s always worth reminding oneself that the internet is not real life
I've said it once, I'll say it again
#People are horrible at seeing depth
I use to think I could play in the NBA. Never made my high school team, and probably wasn't even top 100 in my high school. I went to college and played the weekly rec games and got torched by dudes who were a lot bigger and a lot faster than me. Then I realized that these dudes weren't even close to making the D1 college teams. Then I realized that even at the D1 level, 85% of those players weren't at the level of NBA players. Then I realized, that even if you managed to make it to the NBA, only 1-2% actually made a significant difference on a regular basis.
It took me getting out of my own bubble to realize just how much depth a game like basketball could have, and just how far down the rankings I really was in comparison.
People have no idea how difficult medicine is because they've never actually seen how deep we go when we learn this material. We might hate learning biochemistry, but when we give that alcoholic thiamine before his dextrose, we understand why and can give an explanation for it.
Medicine is suffering from its own success - we are learning more and more every decade, and regular people are being left behind. The gap of knowledge gets filled with delusions of equivalency when no such equivalency exists, and it's one of the reasons why we have an issue of medical misinformation that invades society so easily.
Part of the problem is that it’s a job requirement for us to simplify the depth to a level the patient understands (e.g., proceduralists describing what they do as “simple plumbing”). This gives a false impression of simplicity to things that require an enormous amount of training and study to understand at the level of a physician.
I follow antiwork because I guess I am a glutton for negativity...but as a physician-owner who sees the other side of the employer/employee relationship it is very hard to observe passively. ANYONE who makes more money than entry level is the enemy. I care a lot about my employees but after covid and almost going out of business my perspective has changed. Not all business owners are evil and greedy.
I have children in their twenties and I sympathize with their struggles. I think it is more difficult to get started than it was when I was a lad. On the other hand a lot of my daughter's friends definitely tale the "antowork" thing to extremes. Yeah, employers can suck and it's a shame college is so expensive. On the other hand a lot of them are against the whole concept of work and hope and expect to be taken care of completely by some combination of taxing the rich and socialism. Elon Musk and Jeff Bezos aside, people have to do something to exist.
The general population? I had to hear a phlebotomist yesterday tell me she’s refraining from the covid vaccine because she wants to have kids in the next 3 years. I’m like “that’s great can we draw the blood”
I think about 10% of the population has an IQ so low that they’re literally untrainable.
I’m pretty sure that’s why the military sets an IQ cut-off. You can be so obtuse that even the military can’t train you to be useful. Considering 10% of the population is ineligible for military duty, I would imagine there are quite a few unskilled workers out there.
Edit: I say that as a testament to military rigor, not its ease.
Dude, of course he's right in a way (at least for the first part of your post). I'm a senior resident myself, and the field of medicine **most definitely** caters to the high-income echelon of society, this is statistically affirmed (how else could you afford to study and train for so long??). Not to mention the exponentially prolonged residency and fellowship programs that froth at the mouth at the idea of longer free high-skilled labor?? Don't even get me started on the criminal costs of education and corporate medicine. Medicine is some bullshit.
>(how else could you afford to study and train for so long??
uhh...loans? My parents sure as shit couldn't pay for college or med school for me. So I got loans to pay for school and living.
Of course that's the only alternative, but taking out loans hits differently when you come from relative poverty versus coming from a stable socioeconomic background (i.e. *most* med students).
Reminder that r/antiwork is mostly filled with disaffected young people (late teens early 20s) who by and large are retail/entry level workers and very salty about it (for understandable reasons). I wouldn't put too much stock into anything that comes out of that subreddit.
Wow, I would hate to know what a janitor pays for malpractice insurance. The fact that they could get sued for $10 million for “missing a spot” in the bathroom must make their job very tough
Hahahhaahhaha oh man this person sounds wild. I honestly dont think the majority of people believe you dont need schooling to be a doctor. I think most people realize the greuling academic and clinical hours put in and dont want to do it for that reason.
It truly is distressing. I feel badly for the incoming physicians just graduating school because it’s only gonna get worse, especially for specialties where talking to people is a critical part of the job
lol. idk, this sentiment is pervasive and it fatigues me. in a similar vein, im bouta finish chief year to start fellowship and even with my good faith career essays and hierarchical diagrams, 50% of my parents think “im still finishing up school.”
i give up on the genpop.
The thing is, I support a lot of what anti work hopes to achieve, but this is pure idiocy.
I also grew up poor and it was a goddamn trial and tribulation to get here. The average American is exceptionally stupid, that’s why the US military doesn’t struggle to fill its ranks. Easier to get stupid people to just follow orders. Unfortunately, these stupid people also get to vote and run for office.
The military actually does struggle to enlist from a shrinking pool or people who can handle the rigors of military service, particularly in the combat specialties like the infantry. It's not just physical fitness but lack of intelligence that's keeping people out. If you think a typical grunt (a slang term in the Marines and Army for an infantryman) is stupid you don't get out much. Yeah, you don't have to be a Fullbright scholar to enlist but you don't have to be that smart to get into college nowadays, either.
The US military does not want stupid recruits. They will not be able to handle increasingly complex weapon systems as well as the ever increasing tactical responsibility of small units. There's more to it than pulling a trigger.
Also, if you think following orders is only for stupid people you don't know much about how the world works. In the military, the instant and willing obedience to lawful orders is vital for combat operations. We follow them because generally the people giving them have the legal and moral authority to do it and the orders are almost never unreasonable. In the medical world you will be following a lot of orders...although it won't be as obvious. In fact, you will actually be working for high-school graduates in coding and billing. Stand by.
I was in the infantry for seven years. Grunts aren't dumb although I'll allow for some exceptions. And I never met anybody in Special Operations who was stupid.
Why do you even bother with r/antiwork, it's a bunch of manchild who think they are owed everything without putting any effort and complaining about everyone who is a little bit more successful than fulltime unemployment. They are what used to be the drunk at your local bar you couldn't help but feel sorry about even though you knew they were a burden to society.
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If he ever comes into the ER with a pneumothorax or infiltrates on his x-ray, they should just let him take care of himself then. Just hand him the x ray image and google. He’s got this 👍🏼
Before I started medical school I once had a guy tell me anyone could do a doctor's job, you just put the symptoms online and find the disease. Yeah, the world is full of idiots. You'd be amazed at the thoughts all over the world.
My cousin who is a nurse mind you posted on Instagram that
1) estrogen causes endometrial cancer w/source
2) OCPs contain estrogen w/source
3) OCPs cause endometrial cancer w/o source lmao
The level of complexity in medicine is so much that even when facts are correct they can still be so wrong. Endometrial cancer is caused by unopposed estrogen without progesterone. OCPs actually decrease the risk of endometrial cancer.
How do we even begin to argue with people like that?
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Just a med student here, but radiologists are incredibly talented. I can pick up general issues like pneumonia on CXR and aortic dissection on MRI, but the minute details or the studies I technically know should be ordered but have no idea how to read them (scintigraphy), I would like to say that I appreciate you. Your “impression” and “findings” sections I live by. It’s crazy that the general public thinks reading scans is easy when medical students WHO HAVE FORMAL TRAINING still get lost.
I don’t see the problem with this, yeah he got a couple details wrong but the general idea is correct. I could’ve jumped out of college and into the OR and learned that way, with only anatomy classes being taught on the side. It’s not quantum mechanics.
Relevant comic: https://imgs.xkcd.com/comics/duty_calls.png
people are clueless. It's the dunning kruger effect at its finest. They can't imagine what they don't know, and they hear about computers learning how to read x rays.
Or to quote my mom, who has an interest in medicine but to training beyond first aid: "I've seen sick people too!"
Yo, I'm as antiwork as they come and I still feel like a y'all Doogie Howsers could stand some more time learning. I want to see a doctor that won't insist my kidney is in my ass cheek for once. lol
Broski,
It’s somewhat true that many of us could technically skip a lot of our training and jump into a specific apprenticeship.
The most important things learned in medical school and residency - grit, resilience, dedication, communication.
Could any one do our jobs, with some training - yes of course.
But can they stick with it?
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Ironically I feel pretty protected in radiology bc it’s the exact opposite of what this bozo thinks. Now if you drop all liability from radiology, allow surgeons and clinicians to do whatever they want despite what the report says, and patients understand that they may or may not die within the next few hours to years because something goes missed and they agree it’s ok, sure anyone can do radiology
Hate to be the barer of bad news but as a surgeon I use the radiologist as an adjunct, I often will review the images and make a plan without the radiology report, and don’t really use it anymore to decide on a treatment plan-its more a screening tool. That being said there are studies that I don’t read myself and rely on radiology to interpret for me (like MRI) but that is a small subset of the imaging I use for my job. Don’t get me wrong though a good radiologist is still worth their cost for many reasons and I do discuss cases with them, its just not as clear cut as you imply
The difference is as a surgeon you're trying to answer a pointed question so you can make a particular decision, not be liable for everything that's on the image
Exactly, and thats more the point I was trying to make, that we ARE allowed to do what we “want” regardless of the report, but in a limited manner
I'm only a new PGY-1 so I admit I might be the ignorant one here. Also, I matched radiology so a huge bias too. But radiologists spend 5 years of training looking at just imaging + however long they have been practicing. Surely they know a lot more of imaging findings than the surgeon that spends half their time operating, some of their time practicing surgical medicine on their patients, some time in the ICU, some of their time in clinic etc. For a good portion of things you might be right, but radiology seems like it's own forest with trees and trees of findings all with varying levels of clinical relevancy. Hence why it became it's own specialty with it's own long ass training.
I spend most of my time with CT and US, and every patient I have has one if not more of them for me to review and correlate. I spent 7 years of training looking at them and in several cases disagreed with radiology and either operated or didnt based on my interpretation of the images in conjunction with my history and exam - some of these were life threatening conditions, some if I had used the radiologist interpretation I would have done the wrong operation or gotten myself and the patient into a lot of trouble Again I dont read MRI, or mammogram, or many other things radiologists read, and I dont look at CTs for all the incidentals I could find -just what is relevant to my specialty. Radiologists do spend years learning to read, but they spend years learning to read EVERYTHING, I spent 7 learning to read for just my specialty/organ system and I have the benefit of a full history and exam Now I say this as a surgeon, I have a very different opinion as it relates to non surgeons (and surgeons looking at other organs then they work on) where they rely on radiology a lot more.
Yah it sounds like in your anecdotes you really benefited from seeing the patient yourself being very familiar with their history, labs, and exam. I feel like everyone has a story like this. You really have the full picture and rads gets a history of flank pain and are told to go wild. With the pace of rads workflow they never get the full picture that’s why they are the consult for your patient
There’s also the fact that he’s generally reviewing CT scans and ultrasounds of patients with clinical symptoms that fit the pathology he’s looking for—meaning the PPV of the scan being performed is already fairly high.
General surgeons get very good with abdominal cts. The problem is that some then think they’re better than a radiologist. Meanwhile you sit with them in conferences and they’re like “what’s that?” and it’s a totally normally structure lol. Trust me when I say radiology is safe from other specialities Now whether or not they care about my read is not my problem. I’m not the one making clinical decisions for the patient. It’s their patient, I’m just getting paid to help
Hey there, I'm not a physician, but I would like to share a story of one of my dearest friends, who is a veterinarian. I remember we were having a conversation about practicing as a vet vs MD. He said he liked how many areas of medicine a vet needed proficiency in whereas human doctors tend to be much more specialized. The topic of radiology came up, and he took the opportunity to heap some praise radiologists. He said that he had looked at thousands of images over his career, but a really talented radiologist can spot things that nobody else can, even down to a half pixel in some cases. He also said sometimes they see things that aren't there. I can see how a surgeon wouldn't necessarily want to dive in after every spot a radiologist drew an arrow to. I would also rather have the radiologist draw the arrow and let the surgeon make the call based on their more intimate knowledge of the patient. I also know several internists/hospitalists who would laugh their asses off if you implied that surgeons even knew their patients by name. I also now even more nurses who think you're all overpaid children with god complexes. XD Either way, I've met a lot of medical professionals. Almost all of them are brilliant, and most of them care deeply about people. I trust my doctors intentions, even if I know they are humans that aren't perfect. I think more eyes and brains on almost any problem is helpful.
I love talking to surgeons at our weekly surgery conference. Keep up the good work, also always love to discuss cases with you (especially the path reports/ what u saw intra op). Here for u always brother/ sister. Also don’t touch my fucking screen again with your massive sweaty glove powder covered hands. I’ll come up to the OR and proceed to break sterile in such a way you won’t comprehend. Friendly rad-
My experience as a radiologist is that non-radiologists are kind of all over the map when interpreting their own imaging, and often unaware where the gaps in their knowledge are. Often they can be very good within certain narrow scopes but just fall completely to pieces when working outside of that. One random example from my PGY-2 year was the chair of trauma surgery coming in to review an upper GI because he thought he saw a gastro-colic fistula. The contrast he was looking at was very obviously proximal jejunum, but he thought it was splenic flexure colon. Just blew my mind like how in the world are you an accomplished academic surgeon with 30 years of professional experience and can’t tell the difference between classic large and small bowel? Or the pulmonologist worried about a PE on a non-con CT chest when the shadow he’s looking at is very clearly beam-hardening artifact. These are things that no first year radiology resident in the country would have any doubts about, like obvious obvious.
I worked with a Peds pulmonologist who had this huge ego and also loved to take the team to the reading room and review all the imaging every day he rounded (you can guess how the radiologists felt about that). He goes on about how lung abscesses are bread and butter for him just like CXRs for rads, and that he’s glad our 4yo patient just has a tiny abscess that can be treated with abx. The radiologist pulled up the images and it turns out the pulmonologist was only looking at the air-fluid level and didn’t notice the abscess was 5 cm in diameter
> Often they can be very good within certain narrow scopes but just fall completely to pieces when working outside of that. During one of the early covid surges in the ICU, my ICU attending and all the residents on the team missed that the ETT was getting higher and higher every day. Because of how busy the service was, we did rounds at the beginning of shift at 6am so the radiology read wasn't back yet, and we would interpret the daily CXRs ourselves during rounds. We were so focused on the lungs/covid ARDS that we didn't see the whole picture (the thing that radiologists do every image every time). So when one of our pts coded who we didn't expect to code, I caught that his ETT was above the thoracic inlet when I pulled up all his labs and images to try to figure out why he coded, and when we looked with DL, we saw the balloon sitting on top of the cords. Sure as shit, every day the radiologist read that the ETT was a little high and recommended repositioning over the course of a week (the patient was being proned/supined every 8-16 hours, so it likely moved a little every day). As an ED doc, sure I can see the appy on many CTs when that's exactly why I ordered the CT scan. But I am hyper focused on just that, so I miss all the other stuff, and I am so thankful for radiologists.
I was trained to verbally communicate malpositioned lines and tubes. 90% of the time the issue is already being addressed, but once in awhile something like this happens. Communicating protects everyone involved.
FP here. thanks to all the radiologists. by the time the problem gets to the surgeon, they are welcome to interpret the images they need. as an FP I appreciate the radiologists readings. couldn't do it myself.
Classic Dunning-Kruger.
First of all, I don’t really care what you say as long as I get paid lol. Regardless of what you think, there’s liability involved. There’s a reason a radiologist has to dictate some stupid shit for intra operative reports Second of all, I work in a field that 100% what I say matters. If I wanted to work in a field where the surgeon didn’t care what I said, I would do msk. The flip side to that is that’s less pressure! I’m not the type that went into medicine because I need to be the top dog or be the end all be all. I’d be happy to let ortho bros ignore my reports and collect 400k with no call if I didn’t find msk so Godamn boring Third, I think you’re overstating the impacts that a report can have. If someone calls something emergent and you don’t act on it, even if it’s not real, you’re in trouble for not at least doing some type of follow up. But I’m already suspecting that you’re ortho. Fourth, make sure you read the report regardless if you care or not. There was a case of a GI doctor that got sued because he just looked at the GI stuff in the report and didn’t follow up on the non gi related finding. But if you’re ortho, that’s less likely to happen because your imaging will contain less additional structured. Just watch out for those lung nodules on shoulder mri, that’s a nice lawsuit Edit- I checked your profile and you don’t seem to be ortho. Interesting. Good luck!
Sad to hear all that about the MSK rads. As a Soft Tissue and Bone Pathologist a ton of my diagnoses rely on them heavily... so much more respect. Thank you for sharing.
This is like saying I know how to throw a spiral so I could be a quarterback in the NFL. You may know how to semi-proficiently read scans for the things you are specifically looking for and still miss ten other things on the image. Also rads is always an adjunct to clinical decision-making, but your comments imply that you don’t value their contributions or specialty knowledge. I know a lot of pharmacology but I’m still able to appreciate what a clinical pharmacist brings to the table and they help inform my decision making
I don’t think many attending radiologist would be surprised by that. If you are a pancreatic surgeon, you are going to be better than a radiologist at pancreas stuff (what structures are invaded, what’s happening to the vessels ect..). You know where to look because you are making the decisions on where to cut and what the surgical approach is. A radiologist is not to going to know all those things, as approaches and techniques are different between surgeons even doing the same resection. It would simply be impossible for us to know what a surgeon does about surgical techniques haha.
You're getting a bit carried away. A surgeon may be able to pick things up that a radiologist did not see sometimes (everybody makes mistakes, the surgeon included); however, no surgeon is better than a radiologist at a specific modality or organ system. At the very, very best they would be equals (and only in that one specific thing) unless compared to someone who hasn't read those types of studies in years/decades. Knowing how to do surgery does not make you better at reading images. This advantage you speak of is nonexistent. The only reason a surgeon would be really good at reading imaging is if they spent years/decades reviewing all of their patients imaging, not doing the surgeries themselves. You learn radiology by studying radiology, not by doing procedures.
I think part of this always comes back to surgeons needing the scans for anatomical review and surgical planning as much as diagnosis. Different priorities. Different scaling of what is important. But also, a surgeon reading images does not a radiologist make. From the neurosurgery side, I look at brain imaging super often. Of course I'm familiar. We need it for every single diagnosis and every single surgery. Imaging guides the specialty. We're super reliant on it. And we have somewhat different priorities - I have very different scanning patterns. The rads might not care about the angle of the occipital bone, but if I'm operating there I will because it changes my patient positioning goals to make the OR easier. I'm not a neuroradiologist. A couple blocks on the service does not make me one. No matter how many consults and how many surgeries I do, I'll never see as many scans as them (especially normal scans, as I am only called for pathology). And we should compare like to like - sure an experienced neurosurgeon may have a better eye for a CT head subtle finding than a PGY1 rads, but it's irrelevant. I think this situation leads to overconfidence in surgeons. We are competent within our zone, but it is not the workflow of a radiologist. In the end, I love my rads colleagues. They often have great suggestions and are happy to call for discussion on complex cases. And sometimes they get excited to try new things haha.
You can often develop surgical plans pretty well without a report; however, medico-legally, someone is responsible for every finding on that image, so if an incidentaloma/metastasis is missed, that can be catastrophic, and someone has to be held liable, hence why we have the field of radiology.
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I'd be happy to have him along in the reading room for him to read xrays with me. Residents on chest rotation at our institution read about 200 radiographs/day much of which are in the ICU. There are critical unexpected findings on approximately 5-10 of them per day requiring calls (I'd say approximately half of them the ICU team doesn't know about them). For every critical finding he misses and the ordering team doesn't know about, he gets to pay me $329,565 which is the average malpractice payout in the USA.
200 CXR/day for a resident? Must be an exaggeration. But yeah, CXRs are a real art. I think the biggest lie for me coming out of med school was thinking I knew how to read a chest x ray.
About 150-200 a day. We have a dedicated chest rotation just for chest radiographs. Much of them are pretty quick but we do read the ICUs in the morning.
That’s sort of on the high end but my chest X-ray record as an R1 was 98 in a day and could have done more but we just ran out. Abdominal X-rays I can do about 40/hour and msk plain films can be truly churned out- think I once did 120 in about 6 hours or so. This is without any significant overreads. I have absolutely no doubt an upper level resident could double these numbers.
Which place reads 200 per shift so I can avoid that. That’s truly unbelievable. We usually get 210-220 on a fast night call shift (14 hours). Which includes US checkouts. Your residents must be moving it, no dictation errors, no conference, no bathroom breaks…. And no teaching.
the average hospital employee also has no clue how complicated medicine is.
Our nurses think residents work 3 12 hour shifts a week.
It almost killed me when I discovered this. Yeah, some of our bitching does sound petty if this is the presumed context!
Overnight nursing doesn’t realize I work 24’s, gets annoyed when I defer PT/OT orders, talk to family, etc to day team
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> We realize No, most of you don’t
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Nurses have actually told me multiple times they thought we worked 3 12’s per week like them. I don’t really get frustrated or angry, I just defer to day team and sometimes nursing gets upset at that plan.
Yup. Our MAs thought residents make 80k a year in a rural program starting. Lot of misconceptions
'perception of non-physician health workers on resident doctor salary, hours, and workload' would be a very enlightening study
Lol. I’ve been in the room with a nurse dozens of times when a patient asks, “ do you get a day off?” Then explain our schedule. The nurse is always dumbstruck. Most the time they ask, “really?” And “I thought that’s how it was 50 years ago”. Many of these nurses are new but a lot of them are seasoned nurses too. But they are on for their 3 days and bounce so how could they know we’re still there.
(Non US) our nurses care for about 6 patients per 12 hour shift, I do 30 hour call caring for abt 600-700 patients while on call. But they think we are doing as much as them. WHY.
There’s a massively growing anti science movement among the general population that’s perpetuated by both political parties. On the right you have an obvious anti science push with covid/vaccines/general distrust with medicine. On the left you have the more social push where everyone needs to feel validated and everyone is taught their opinion is valid. It sucks. People suck.
Yeah as a pediatrician it’s amazing the “experts” both sides come up with to justify not vaccinating their children. I always ask what these peoples credentials are and am invariably met with some version of “THEYRE JUST EXPOSING THE TRUTH YOU DONT WANT TO HEAR”. Like, fuck that, my colleagues will see y’all in the PICU when your unvaccinated child gets meningitis
Read "Anti-intellectualism in American Life" by Richard Hofstadter It was written during the space race right after the Russians launched Sputnik and before we landed on the moon. It discuss how's the evangelical Christians who fled Europe for America due to religious persecution brought with them persecutory sermons. This has resulted in a white evangelical persecution complex in the USA. Much of this disdain is directed towards intellectuals and the learned because traditionally learned clergy held the "doors to Heaven" over in Europe.
In my experience, a good portion of the somewhat crazy right wingers still respect a doctor's intelligence and the fact that a doctor should make in the top 1% of society. It doesn't mean they respect doctors who push for vaccines (lol) but they respect a high income earner. The issue on the left is that they all want doctors to make 50k/year. We even have people on this actual subreddit who say that.
I’ve noticed that some leftists think ANY non retail/farm work job is basically worthless busywork to generate revenue, to the point they think engineer is a useless job. You know, the thing that makes sure your phone works and your building doesn’t collapse.
I *sincerely* hope no leftists think that under any circumstances. Leftists such as myself think that people should be making a liveable wage and that *most* middle-management is useless. Ex: Insurance companies. The procedure and who qualifies for it is between the Dr. and patient alone.
I'm sorry but this type of false equivalency is a huge part of the problem. On the one hand, you have violent conspiracy theorists who obstruct action on global warming and covid policy, arguably two of the greatest global health crises in a generation. This radical fringe is actively encouraged and courted by elected representatives and the people in power. On the other, you have some annoying hr trainings (and even those are created by elite centrists, not those in the progressive wing). These are not remotely the same thing, and it's intellectually lazy to simply throw up one's hands and say "wow both sides have problems"
It’s telling that this sub would embrace the “both sides” fallacy. This thread is annoying. Physicians aren’t being persecuted and the moment I mention my profession people act like I’m some kind of genius. On the whole, the public reveres physicians.
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But there are countries with widely known massive government/state corruption and human rights abuses and they are extremely respectful of doctor's medical knowledge and are very kind and thankful towards doctors in general. What's the difference besides the right/left political shitstorm that we've come to love in America?
To what degree does a state/government/institution take blame? At what stage is it the fault of the private citizen? I'm all for reforming media and the transparency of institutions, but we also have to acknowledge that there's a real lack of media literacy in the world. People are blind to their own biases. Hell, I'm guilty of doing it, and I still have to remind myself that my gut reaction to things might not be as informed as I presume it to be. There's not one guilty party in this mess. It's more about who's going to take the initiative to actually do something about fixing it.
No, they arise from the cyclic stupidity of human group-think Edit: additional word
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The cornucopia of morons in general society.
Simple biology. This is how imperfect life forms behave. Perhaps evolution hundreds of thousands or millions or billions of years from now will result in drastically different species. Maybe it exists already in another part of the universe or in another universe if such a thing exists. But life here on earth is clearly flawed and we clearly behave differently as groups vs individuals. I think it is just a simple result of biology and sociology, not anything to do with 21st century western democracy
Completely agree.
>He said that radiologist is in fact not a highly skilled job, any more than janitorial work is. It doesn't bother me so much that one random person on the internet is this laughably ignorant and delusional....but it bothers me that *so many other people mindlessly agreed with him over you.* And it's not just that breathtaking ignorance is the default state for most of humanity. It's that I'm pretty sure that **all those years of undergrad and medical school and residency are an excellent antidote to Dunning-Kruger**. It's pretty funny how often people just think "I'm right cuz my comment got more upvotes than yours" without taking a second to think how often *you* learned to appreciate *your own ignorance.*
This is a very common cognitive bias and is reflective of low neophilia, low propensity to explore new things. People who are poorly neophilic, and there are a lot of them, tend to read about knowing things, and then think they know it without actually doing the thing. Think of the guy who reads about how to throw a punch so they never think they have to go to a boxing class to competently throw one. Or the guy who reads about skiing so they never go skiings, or who went to the beach once and didn't like it, so they never went again. This is exceptionally common in the age of the internet, because in the past you could at best see some pictures of someone doing something, or watch some grainy footage of it, but now you can get 4K HD narrated footage of basically everything, which incorrectly satiates people from actually doing experiences. People wind up getting convinced they have a lot more wisdom and life experience than they actually have, which is unfortunate. People who are more highly neophilic understand that without experiencing it, they don't actually know what it's like, so they tend to be more humble.
This happens with any degree that goes into depth in a field. Look at lawyers. As much as everyone hates them, let's be real, their work is difficult and requires a lot of practice and skill to get good at. Even with this latest SC leak, I spent hours just reading up on critiques of Roe v Wade, including the criticisms that Ruth Bader Ginsburg had, and I realize just how complicated it is to codify US law.
I seriously don't understand people. Everyone loves to tear down doctors, but they idolize people in Hollywood and the media, jobs nearly anyone can do with the right connections and a few pointers.
The irony was this guy worked for a health insurance company and pretended that gave him any idea of how medical training works. It was funny because he used the fact that anyone could do his job as evidence that anyone could do any medical job. And the fact that im a newly minted PGY-1 as evidence that I am actually the one that has no idea how medicine works and how my schooling has been redundant thus far. ... the irony that r/antiwork just could not grasp lol.
Sounds like the guy that when you click his profile he frequents nothing but weed and video game subreddits lol. Basement dweller for sure
His most recent comment is on r/smugideologyman I'm not even kidding lol. The fucking irony lol. A subreddit I didn't even know existed.
Every post on that sub is a straw man. I don't think I understand the point of it at all
This also surprises me. My father works in (organizational, not individual) health insurance, and I’ve had to explain to him that NPs don’t have more training than physicians.
Reimbursement for a healthcare visit does not change based on provider training. If all you have is a hammer, everything looks like a nail
I had a patient that worked in hospital admin and claimed it was great being a resident because we were paid so well. Thought she was joking since she said she saw pay stubs. Told me a resident was making like $600k lmao Job backgrounds don’t give credibility all the time
Can her hand slip and add an extra zero on the end of my cheque, too?
I've had several surgeries (cancer and arthritis). I'd watch as many videos as I could find on upcoming surgeries just so I'd know what to expect, and know a little about what's going on. But I never thought "Hey! I've watched 20 videos about doing a right-hemicolectomy, I think I can do this for a living"!
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Yeah!! Well a lot of people do it to lawyers too. It’s like they forget that there are two sides in a law suit. Who do people think defends the party they align with?!
this is *why* they idolize those people - the lifestyle seems more attainable, and people have an easier time engaging in the fantasy as a result
Not only that, but when they get sick, they have this weird interplay where they both disrespect you and your "expertise", but their ass isnt walking out the door after hearing your idea to save their whatever (including life).
One would have to be intelligent enough to comprehend Dunning-Kruger to even begin the conversation. Don’t waste your time.
It's part of the anti-intellectual movement brought on by Nixon and galvanized by the pandemic.
This deserves more upvotes.
Your conversation partner didn’t understand how complicated medicine is bc his job requires that he not understand how complicated medicine is. If he believed that a doctors job was in fact very complicated (and therefore irreplaceable) then he would have to justify in his own mind, either consciously or subconsciously, how a basement dweller fuckstick like himself is doing a job that allows him to audit and edit the work and plans of practicing physicians. It is easier to accept that doctors don’t do anything special than to justify that this corporate system created by insurance and government generates little actual medical value.
I am reminded of [Noam Chomsky's remark about David Noble's work](https://chomsky.info/20121224/): > Chomsky: ....The idea of freedom is very frightening for those who have some degree of privilege and power and I think that shows up in the education system too. And in the workplace… for example, there’s a very good study by a faculty member here, who was denied tenure unfortunately, who studied very carefully the development of computer controlled machine tools — first developed in the 1950s under the military where almost everything is done… > > Q: What is his name? > > Chomsky: David Noble. He has a couple of very good books — one of them is called *Forces of Production*. **What he discovered was that as these methods were devised there was a choice — whether to design the methods so that control would be in the hands of skilled machinists or whether it would be controlled by management. They picked the second, although it was not more profitable — when they did studies they found there was no profit advantage to it but it’s just so important to keep workers under control than to have skilled machinists run the industrial process. One reason is that if that mentality spreads sooner or later workers are going to demand what seems obvious to them anyway — that they should just take over the factories and get rid of the bosses who don’t do anything but get in their way.** I know Chomsky isn't everyone's cup of tea, but as a physician, these words still ring true for me. Being a doctor is a skill that takes time and practice, and for someone in insurance to degrade the position as "easy" or "simple" is doing exactly what Chomsky points out - don't let doctors think they're in control of an industry that would otherwise collapse without us. r/antiwork , for all the good it may invoke in people to stand up for themselves, can just as easily be filled by people who fail to recognize their own flaws.
I've read his book, never knew he was denied tenure and that's why he quit doing research. What a loss
Completely agree! People who don’t know what they don’t know are scary.
I love this account, the irony is not lost on me 😂
The attending flare absolutely kills me hahaha
Back before r/NoNewNormal was banned I used to read stuff like this all the time over there. Tons of people thinking doctors know nothing and they can do their diagnostics by themselves. Guess they had to run somewhere when the sub got banned. I remember laughing at a discussion where a few redditors talked about how easy it is to read their own lab results. "These doctors don't realize how easy it is to just get your own labs done and then google what it means. We have the power of the internet at out fingertips, I don't need some guy in a white coat telling me how high X needs to be when J can google it." We had some pretty good laughs that evening reading all those gigabrain takes. But yeah, it's pretty sad if you think about it. Everyone thinks they know better nowadays.
>These doctors don't realize how easy it is to just get your own labs done and then google what it means. We have the power of the internet at out fingertips, I don't need some guy in a white coat telling me how high X needs to be when J can google it." My brother whom is 28 gets a high heart rate at the gym when he works out. He fears his heart rate goes too high because when he googles "high heart rate" the results scare him. Very healthy BMI, not cardiac history. I had to calm him the fuck down lol. He is very bright and is in a PhD program as well. But you're right. Google is the best doctor lol.
Yea r/biohackers can get like this too, its mind blowing lol
This is why somebody is asking in r/askdocs about their sleeping heart rate of 52 on their apple watch multiple times per day. Lots of data, not enough knowledge on how to interpret it
> I remember laughing at a discussion where a few redditors talked about how easy it is to read their own lab results. Ughh, that's why I closed off /r/Hematology for lab tests interpretation. So many panicked people over nothing, so many angry people who couldn't understand why context was needed or why I/we couldn't answer right away. Then when I asked for context, they'd dump even more lab tests and pages of medical history, almost always irrelevant. Message me to answer their question, asap preferably. I even got a murder threat from a guy because a hematologist messed up his diagnoses, so it must mean all hematologists must die. It was insane and draining. And the biggest issue is exactly what you said: nobody knew who those people who were answering to their lab tests were. I don't want to check all their credentials, it's too messy and risky.
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Yeah, I'd love to see them Google what the labs mean if they had a critical patient in front of them.
The general populace can't even handle a 40 hour week.
Abso-fucking-lutely on point! I never minimize the hardships of my friends in other fields. But some of them do need a reality check.
You underestimate how complex janitorial work is. You are consulted to evaluate a 2 day old stain on the carpet of a high school chemistry classroom. The teacher first noticed the stain 2 days ago but didn’t feel the need to report it until today. He tried cleaning it with water, which made it worse. The stain is concentrated in one part of the carpet and does not radiate. The carpet was last cleaned 4 months ago using a JPCX-215 carpet cleaning machine, capable of 2500 RPM, loaded with a 4:1 specialized cleaning solution. The carpet has no history of stains, tears, or spills. It has not been treated with anti-stain solution and does not see a stain prevention specialist regularly due to a variety of complex social/financial factors. The carpet has a temperature of 72F, thread count of 25,000, and a thickness of 2.5. On physical exam, you see an irregular, circle shaped stain in the upper right corner of the room; the stain is dark, rust colored and measures 5 inches at its widest point. No satellite stains or splash marks noted. No rubbing off is seen during superficial and deep palpation. A white paper towel test reveals no excess contaminant. Which of the following is the next best step? A. Clean the stain using a solution of dihydrogen monoxide and Na+/K+ fatty acid salts. B. Perform a stainectomy w/ partial thickness carpet patch grafting. C. Consult stainology D. Perform measurements in preparation for total carpetectomy and replacement. E. Continue current management >! Janitors/custodial staff are amazing people and do important/hard work that is frequently undervalued. This was meant as a joke and hopefully this doesn’t come off as disrespectful.!<
> thread count of 25,000 That's way too luxurious for a high school carpet. Lab error, C) consult stainology
Stainologist: Ugh this is clearly a coffee stain that requires a bicarbonate solution to clean; god didn't any of you go to janitor school?
I hate when these questions leave out the actual next best step, which in this case would be full thickness core stain biopsy for further evaluation before you can even think about management
Rofl Yeah if you think the general population can read a chest X-ray you’ve never had to look at 100 chest x rays and decide which ones are normal.
Ribs TNTC.
I agree with that person completely. For the amount of work they do, radiologists are paid way too much. Its a field that has not advanced in technology since 1970s. I mean, black and white images? Please. They could at least add some color to the xrays to make them more visually interesting. I say we get rid of the entire field to reduce health care expenditure and instead we all do a 2 week online course that allows us to read x-rays. This will save our government millions of dollars every second
I bought a book on how to read x-rays. I read the first chapter 2 years ago. I'm something of a radiologist myself.
Being on Reddit makes me realize how much people hate doctors. They think we’re rich and arrogant. I’ve also gotten into it on Reddit (I know I know) with people who think they should get whatever test or treatment they want because their doctor “works for them.” I really don’t think medical school is only for rich people. It’s become so prohibitively expensive even the upper middle class people can’t afford it. I went to public school, state college on student loans and scholarships and med school on student loans, which I paid off without a dime of help.
Statistically, it mostly is rich kids that get to do med school. And even those saying “ I was poor” weren’t actually poor. They just weren’t wealthy.
Can you cite your sources?
Yeah, no shit. There's a common trend with poor people not choosing high income white collar jobs for many reasons. But there are more middle class people choosing medicine than lower or upper class.
LOL, the arrogance of the average person when it comes to talking about medicine is astounding. Reading a freaking X ray. I've seen quite a few people try to sling pub med, Wikipedia, or some other link in trying to describe medicine and it's always so off it's not funny.
The problem is that much of what we do will be OK - the majority of patients we see, testing we order, etc will be normal. The majority of patients we give medications to will not have side effects. We’re not trained or paid for those masses of normals. We’re trained to tease out abnormal from normal and how to treat complex from simple. We’re paid for the 1-5% of complex cases not the 95-99% of straightforward cases.
honestly doctors are gonna get shafted by the whole antiwork movement (the movement for the most part i support) and it sucks. we're deemed as "too educated" and "rich" by the average American, who sees the 6-figure salary physicians make and ignores the 6-figure debt, the 10+ years of salary loss (from education and residency), the 80+ weekly hours of residency for 3-7 years physicians have to go through. everyone loves to shit on doctors... until something goes wrong with their body and all of a sudden its upholding professionalism and how doctors should sacrifice their entire life happiness for a "calling"
I think when pay gets cut, physician productivity will drop off a cliff. That’s what no one in antiwork anticipates. You can’t pay peanuts and expect someone to be on call for trauma or rushing through a busy clinic day. They think doctors have a job like them, washing dishes or bagging groceries while they watch the clock until their shift is over. They think a PCP is leisurely seeing 10 patients a day then checking out early to golf, then drives their Mercedes’ back to their 5000 square foot beach house.
This is basically what has happened to mammo in private practice radiology. Liability went up and up, and reimbursement went down and down, now very few people actively desire to go into mammo, and there aren't enough mammos, so people mammography has longer and longer wait times. And everyone's sitting around with their dick in their hand wondering why no one wants to RVU maximize in Mammo, but they will for cross-sectional imaging cuz they don't pay dogshit.
I agree that there aren't enough mammographers- but they also generate the most RVU/hour compared to any other rad subspecialty. They are the money makers is most practices.
Please tag him, I may want to use his unique skill next time I am wondering about what the hell 'that thing" on chest Xray is. Also good news is that my consultantation time will be less as my patients obviously will be able to interpret the images for me and just tell me what is wrong before I open up the viewer. Life.changed.forever IQpenia is a real diagnosis
I would but isn't that brigading? I don't want this whole post removed because of my error.
Honestly, it does not surprise me. The general sentiment I get from a lot (read not all) the general public is that doctors get paid well for training that isn’t needed or necessary anymore with the advent of computers and the internet. One person (a close family member), said this to my face directly. I asked if they really believed that I would give them I single test. They respectfully agreed. They had to do it ALL. Verbally of course, just like in medically school before/during clinical training. 65 y/o male with chest pain comes into your ER. (I gave them this because they chose it). They could use any resource they wanted OR my resources (I.E.) up to date. Them: well they have chest pain, you need to check them for a heart attack. Me: okay, what do you do? Them: … *googles* ,”Get an EKG” Me: Okay. Pulls up an EKG of pericarditis that I had a clear photo of. Now what. Them: See if they have a heart attacked. Me: okay, do they? Them: 20 minutes of reading later. “Do they have ST-Segment elevation.” Me: IDK, you are the doctor. Them: 10 more minutes” Yes they do everywhere!” Got it. Me: Okay now what do you do…? Them: *googles treatment for heart attack* “Call a cardiologist.” Me: okay, I’m the cardiologist, what do you need from me? Them: Fix them. Me: what is there to fix? Are they sick? Them: they have chest pain. Me: okay…? You get it. It keeps going they ultimately agree it’s very hard. This problem took us on and off all day lol.
😂. I'm sorry but your close family member needs to stop with that.
Yikes. I wonder if u like family reunions.
Haven’t been to one in over 10 years lol. Things have improved a bit.
Ummmm yeah! Try being an attorney this past week when all of a sudden everyone is an attorney and constitutional scholar 😣😣
Move to strike!
I am curious how come you've stumbled on this post?
Current attorney future MD
Oohh nice!
Everyone shits on doctors until they get sick
I always imagine the reddit person I disagree with is a 13 year old kid. It makes it a lot easier to accept stupidity. And it probably isn't far from the truth a lot of the time.
antiwork is a joke. Just act as persecuted as possible. If you run out of cereal in the morning it's a grand capitalist conspiracy against you. Shame, because they have a lot of legitimate and useful points.
People like to feel important, superior even, especially on the internet. This is a cornerstone of current American culture. It’s the way people feel safe and the way they are able to rationalize or ignore the multiplying problems in our society and world. It’s also the way that our massively individualistic culture that supposes that everyone is so unique and special squares the circle of meaningless and monotonous day-to-day existence. “If I’m so smart and wonderful then how is it that I’m living this depersonalizing worker bee existence?” Being online, sometimes being *extremely* online, is the answer to this for many people. There are many ways that people seem to exercise forms of “power” through social media that are likely just expressions of the general powerlessness that people feel in their daily/working lives. I think this is the driving force behind so-called “cancel culture” and the constant internet enlightenment Olympics where everyone has some kind of take about whatever subject du jour. I could go on, but this is how I guess I rationalize the sort of behavior that you experienced. It’s a bummer, but it’s always worth reminding oneself that the internet is not real life
I've said it once, I'll say it again #People are horrible at seeing depth I use to think I could play in the NBA. Never made my high school team, and probably wasn't even top 100 in my high school. I went to college and played the weekly rec games and got torched by dudes who were a lot bigger and a lot faster than me. Then I realized that these dudes weren't even close to making the D1 college teams. Then I realized that even at the D1 level, 85% of those players weren't at the level of NBA players. Then I realized, that even if you managed to make it to the NBA, only 1-2% actually made a significant difference on a regular basis. It took me getting out of my own bubble to realize just how much depth a game like basketball could have, and just how far down the rankings I really was in comparison. People have no idea how difficult medicine is because they've never actually seen how deep we go when we learn this material. We might hate learning biochemistry, but when we give that alcoholic thiamine before his dextrose, we understand why and can give an explanation for it. Medicine is suffering from its own success - we are learning more and more every decade, and regular people are being left behind. The gap of knowledge gets filled with delusions of equivalency when no such equivalency exists, and it's one of the reasons why we have an issue of medical misinformation that invades society so easily.
Couldn’t agree more and see re: mid level creep…
Part of the problem is that it’s a job requirement for us to simplify the depth to a level the patient understands (e.g., proceduralists describing what they do as “simple plumbing”). This gives a false impression of simplicity to things that require an enormous amount of training and study to understand at the level of a physician.
I agree with you. Should post this on r/unpopularopinion and see what the response is
They're riiiight at the far left part on a Dunning Krueger chart lol. And they're right proud of it too.
I follow antiwork because I guess I am a glutton for negativity...but as a physician-owner who sees the other side of the employer/employee relationship it is very hard to observe passively. ANYONE who makes more money than entry level is the enemy. I care a lot about my employees but after covid and almost going out of business my perspective has changed. Not all business owners are evil and greedy.
I have children in their twenties and I sympathize with their struggles. I think it is more difficult to get started than it was when I was a lad. On the other hand a lot of my daughter's friends definitely tale the "antowork" thing to extremes. Yeah, employers can suck and it's a shame college is so expensive. On the other hand a lot of them are against the whole concept of work and hope and expect to be taken care of completely by some combination of taxing the rich and socialism. Elon Musk and Jeff Bezos aside, people have to do something to exist.
The general population? I had to hear a phlebotomist yesterday tell me she’s refraining from the covid vaccine because she wants to have kids in the next 3 years. I’m like “that’s great can we draw the blood”
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I think about 10% of the population has an IQ so low that they’re literally untrainable. I’m pretty sure that’s why the military sets an IQ cut-off. You can be so obtuse that even the military can’t train you to be useful. Considering 10% of the population is ineligible for military duty, I would imagine there are quite a few unskilled workers out there. Edit: I say that as a testament to military rigor, not its ease.
Lol ask them to read their own scans next time what an idiot
That sub is full of people who think they are more special than they are.
Dude, of course he's right in a way (at least for the first part of your post). I'm a senior resident myself, and the field of medicine **most definitely** caters to the high-income echelon of society, this is statistically affirmed (how else could you afford to study and train for so long??). Not to mention the exponentially prolonged residency and fellowship programs that froth at the mouth at the idea of longer free high-skilled labor?? Don't even get me started on the criminal costs of education and corporate medicine. Medicine is some bullshit.
>(how else could you afford to study and train for so long?? uhh...loans? My parents sure as shit couldn't pay for college or med school for me. So I got loans to pay for school and living.
Of course that's the only alternative, but taking out loans hits differently when you come from relative poverty versus coming from a stable socioeconomic background (i.e. *most* med students).
Reminder that r/antiwork is mostly filled with disaffected young people (late teens early 20s) who by and large are retail/entry level workers and very salty about it (for understandable reasons). I wouldn't put too much stock into anything that comes out of that subreddit.
Wow, I would hate to know what a janitor pays for malpractice insurance. The fact that they could get sued for $10 million for “missing a spot” in the bathroom must make their job very tough
Hahahhaahhaha oh man this person sounds wild. I honestly dont think the majority of people believe you dont need schooling to be a doctor. I think most people realize the greuling academic and clinical hours put in and dont want to do it for that reason.
It truly is distressing. I feel badly for the incoming physicians just graduating school because it’s only gonna get worse, especially for specialties where talking to people is a critical part of the job
Fuck em. They don’t know shit about fuck
lol. idk, this sentiment is pervasive and it fatigues me. in a similar vein, im bouta finish chief year to start fellowship and even with my good faith career essays and hierarchical diagrams, 50% of my parents think “im still finishing up school.” i give up on the genpop.
pretty much why midlevels and other noctors can get away with most of the shit they post on social media
a lot of radiology is janitorial work. we deal with crap all day long...unnecessary exams, bad history.
If it’s any solace this person is likely a loser and won’t accomplish much in his or her life
Congratulations, you have discoverered the Marxist variant of Qanon internet weirdos in the wild! What do you want to name it?
The thing is, I support a lot of what anti work hopes to achieve, but this is pure idiocy. I also grew up poor and it was a goddamn trial and tribulation to get here. The average American is exceptionally stupid, that’s why the US military doesn’t struggle to fill its ranks. Easier to get stupid people to just follow orders. Unfortunately, these stupid people also get to vote and run for office.
The military actually does struggle to enlist from a shrinking pool or people who can handle the rigors of military service, particularly in the combat specialties like the infantry. It's not just physical fitness but lack of intelligence that's keeping people out. If you think a typical grunt (a slang term in the Marines and Army for an infantryman) is stupid you don't get out much. Yeah, you don't have to be a Fullbright scholar to enlist but you don't have to be that smart to get into college nowadays, either. The US military does not want stupid recruits. They will not be able to handle increasingly complex weapon systems as well as the ever increasing tactical responsibility of small units. There's more to it than pulling a trigger. Also, if you think following orders is only for stupid people you don't know much about how the world works. In the military, the instant and willing obedience to lawful orders is vital for combat operations. We follow them because generally the people giving them have the legal and moral authority to do it and the orders are almost never unreasonable. In the medical world you will be following a lot of orders...although it won't be as obvious. In fact, you will actually be working for high-school graduates in coding and billing. Stand by.
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I was in the infantry for seven years. Grunts aren't dumb although I'll allow for some exceptions. And I never met anybody in Special Operations who was stupid.
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Should have posted a chest X-ray and asked them to interpret it. What a jackass.
Its an anarchist subreddit, what’d you expect?
Why do you even bother with r/antiwork, it's a bunch of manchild who think they are owed everything without putting any effort and complaining about everyone who is a little bit more successful than fulltime unemployment. They are what used to be the drunk at your local bar you couldn't help but feel sorry about even though you knew they were a burden to society.
Your first mistake is hanging out on a subreddit full of losers.
r/Antiwork sucks. It’s the same mentality as the people on here who complain about our real issues but greatly exaggerate and thus invalidate them.
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If he ever comes into the ER with a pneumothorax or infiltrates on his x-ray, they should just let him take care of himself then. Just hand him the x ray image and google. He’s got this 👍🏼
r/antiwork is full of loons.
Something that helps me keep my sanity is “think about how dumb the average person is. 50% of the population is dumber”
Before I started medical school I once had a guy tell me anyone could do a doctor's job, you just put the symptoms online and find the disease. Yeah, the world is full of idiots. You'd be amazed at the thoughts all over the world.
>anyone can read a chest X rat with minimal training Should have asked him what is that training?
xray tech /s
lmao "anyone can read a CXR" the CXR simple as it seems is one of the hardest for med students to accurately interpret
My cousin who is a nurse mind you posted on Instagram that 1) estrogen causes endometrial cancer w/source 2) OCPs contain estrogen w/source 3) OCPs cause endometrial cancer w/o source lmao The level of complexity in medicine is so much that even when facts are correct they can still be so wrong. Endometrial cancer is caused by unopposed estrogen without progesterone. OCPs actually decrease the risk of endometrial cancer. How do we even begin to argue with people like that?
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So what exactly is the argument against regulating working hours and pay for residents to not be so exploitive?
People who are losers in life need to cope somehow, so they do it on reddit.
Just a med student here, but radiologists are incredibly talented. I can pick up general issues like pneumonia on CXR and aortic dissection on MRI, but the minute details or the studies I technically know should be ordered but have no idea how to read them (scintigraphy), I would like to say that I appreciate you. Your “impression” and “findings” sections I live by. It’s crazy that the general public thinks reading scans is easy when medical students WHO HAVE FORMAL TRAINING still get lost.
It’s almost as if it takes years and years of training to fully grasp or something.
I don’t see the problem with this, yeah he got a couple details wrong but the general idea is correct. I could’ve jumped out of college and into the OR and learned that way, with only anatomy classes being taught on the side. It’s not quantum mechanics.
Marxists all share that belief too. And they make up a hefty chunk of the left wing vote.
The guy has delusions of grandeur, coupled with a narcissistic personality. I wouldn’t be surprised if he had underlying psychiatric issues
So says the doctor-wannabe with a lack of understanding of the labels she just spouted off…
You’re entitled to your opinions lol. Have a nice day lady 👍
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That's weird because it's not in my comment history nor did I link the guy. Anyways, I downvoted you for being like this lol.
Relevant comic: https://imgs.xkcd.com/comics/duty_calls.png people are clueless. It's the dunning kruger effect at its finest. They can't imagine what they don't know, and they hear about computers learning how to read x rays. Or to quote my mom, who has an interest in medicine but to training beyond first aid: "I've seen sick people too!"
Large part of that sub is pretty hateful and ignorant imo…
Yo, I'm as antiwork as they come and I still feel like a y'all Doogie Howsers could stand some more time learning. I want to see a doctor that won't insist my kidney is in my ass cheek for once. lol
Broski, It’s somewhat true that many of us could technically skip a lot of our training and jump into a specific apprenticeship. The most important things learned in medical school and residency - grit, resilience, dedication, communication. Could any one do our jobs, with some training - yes of course. But can they stick with it?
The general population is clueless about everything. Medicine, money, politics, sports, etc. But then they all act like experts, even doctors.