I dunno why but so far I've been only practicing defensive medicine. Ordering all the tests even though it doesn't seem to be clinically indicated. It's just the way here. I find it quite frustrating.
But then, there's always incidental findings eh.
Got an old man with on and off chest pain for the past 10 days. Did all sorts of blood tests to exclude heart attack and pulmonary embolus. He didn't have a heart attack or lung clot. So..hurmm.. what next. His chest was clear listening with stethoscope. He had no fever. No difficulty breathing. So not really a cause to get a chest Xray. But the nurse said do one anyway. Hurm okay.
Did a chest Xray and lo and behold, a HUGE MASS in that gentleman's left lung. Most likely aggressive lung cancer.
Since then I have only been thinking about possible litigations with every single patient that I see. It's sorta become catastrophic thinking.
Lacerations- what if the artery got nicked? What if the skin dies? What if the patient loses function of the limb?
Abdominal pain- what is it's gangrenous appendix? Appendicitis is hard to diagnose but does it mean we have to admit every single right side abdominal pain?
Chest pain- assume all kinds of chest pain are heart attacks until proven otherwise even though despite 6 years of medical training you've been taught that heart attack pain is dull, centre of chest and crushing.
I don't like this type of medicine. Sorta makes all your knowledge useless. Why not just do ALL the blood tests for certain symptoms. Do chest Xray for every patient who comes into hospital.
Doesn't help being anxious all the time either.
1 comment:
have you ever talked to the senior doctors particularly the one who have been in ER? surely they felt the same way as you do now. they must have the same fear. how did they overcome it.
In due time Insya Allah aliya, you will feel more confident for your decision and actions in this field.
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