dr-fizzy

Dr. Fizzy

Freida McFadden is a midwestern physician who has finally finally finally come to the end of her grueling medical training, and at last she has enough time to publish the wealth of cartoons she's created over the years. If you enjoy them, please comment. If you don't enjoy them, then you can just keep your fool mouth shut. Read the rest at Doccartoon.blogspot.com, and make sure to check out her books, A Cartoon Guide To Becoming A Doctor, and The Devil You Know, on Amazon!

https://www.amazon.com/Cartoon-Guide-Becoming-Doctor/dp/1105091023

Why I Didn’t Do Primary Care

My first residency was actually in a primary care program so this was obviously a field I was very interested in. But I aborted it. Why? 1) Partially it was a problem with my residency and probably a lot of residencies. Most internists who do primary care spend much of their residencies doing inpatient medicine, out of necessity. My “primary care residency” only different from general IM in that we got one month of primary care per year, which was a mix of clinic and urgent care. Enough to feel comfortable being a PCP? I felt it wasn’t. 2) I didn’t like the idea of having to know everything about everything, especially in a field where things are constantly changing and patients were getting more and more complicated. I felt like I’d have to be reading constantly just to stay current. 3) People would keep coming up with random complaints that I had no idea how to address, like, “My belly button feels cold.” 4) It felt like there was a push to see patients as quickly as possible, yet many of the patients were incredibly complicated. When an elderly patient hands you a bag of 30 bottles of medications and four of them are half-filled bottles of atenolol, just sorting through that alone takes like twenty minutes. I felt like I was being pushed to short-change my patients....

My Thoughts on Late-Term Abortions

I was recently talking to a friend of mine named Joe who works in health care and is an intelligent, well-educated person.  The subject of abortion came up and Joe told me he was pro-choice, but… Joe: “I just don’t think women should be allowed to have abortions at 37 or 38 weeks pregnant.  That’s just wrong.” I think I gasped audibly and said, “Oh no!”  I didn’t understand how a smart guy in healthcare could believe women were having abortions two weeks before delivery.  Or putting it another way, that there are doctors out there who are effectively willing to murder full term fetuses. Donald Trump said it during a debate though.  And while people did point out that this ridiculous, I always felt like a big enough deal wasn’t made out of this.  Our presidential candidate believed women are allowed to have abortions at full term.  How can we brush that off? I calmly tried to explain to Joe why this logic made no sense, and he quickly said, “I don’t want to talk about it anymore.”  And… that was the end of the discussion. Now I am someone who sympathizes with people who are genuinely pro-life.  I have female friends who believe life starts at conception, and can talk intelligently on the subject. I am willing to listen to anyone who does not just want to ban abortion...

Being a Doctor is Like Working in Customer Service

I feel like as a doctor, part of my job is customer service.  Because when I see inpatients, a lot of the time when I ask at the end of seeing them if there’s anything else I can do for them, they have a complaint about their call button taking too long to be answered, the food being bad, their roommate being too loud, etc.I try to handle the complaints best I can.  I never ignore them.  I say something like, “I’m so sorry that happened.  Let me see what I can do to fix it.” Then I tell them my plan, which involves anything from talking to the nursing supervisor about nursing issues or to the unit coordinator to get them a room change.  I can’t personally fix the problem, but at least I try to show I’m taking it seriously and addressing it. It’s made me a lot less tolerant of bad customer service. Recently, I got an email at 6PM from our leasing office, saying that tomorrow (a holiday when kids were off from school), they were doing repairs and our water would be shut off intermittently “after 8AM.”  I was horrified.  We didn’t even have a day’s notice of this!  I was going to be home with the kids all day and how can you do anything at home when you don’t know if you’re...

Why I Didn’t Do Family Medicine

Family Medicine might have been a better choice for me. I liked outpatient medicine much better than inpatient medicine. I like procedures, even pap smears. The hours are generally regular. Several people suggested family medicine as a good choice for me. Here’s why I decided against it: 1) Family medicine is very regional. In some parts of the country, many of the docs are family practitioners. In other parts of the country, there are few and they are not well respected. I trained in an area of the country where family medicine was not as common. Our family med sub-I was a disorganized joke. Almost all the people in my med school class who were interested in primary care did internal medicine or primary care residencies. Only a couple of people matched in Family Medicine. 2) I never wanted to deliver another baby for the rest of my life. 3) If I was overwhelmed by the idea of having to “know it all” in primary care, it’s even worse in family medicine, where you’re taking care of an even larger spectrum of patients. (Yes, you could restrict your practice, but you don’t always have that option.) 4) I worried that family med residency would be like a repeat of third year of med school, where you’re always in unfamiliar territory, always fumbling, and always the one who knows the...

Physician Suicide and Mental Health

I was talking to a medical student recently who said he didn’t want to do a residency in NYC because “everyone there kills themselves.”  I think that’s a little dramatic, although I do recall several years ago there was a rash of suicides in residents. I just read an excellent article on physician suicide. What’s sad is that if a physician really was feeling suicidal, I guarantee there’s no way they could seek counseling quickly that wouldn’t jeopardize their career and confidentiality–the only effective way would be to threaten suicide, which would take them to the ER and give them a record of suicidal behavior… a fate many proud physicians would consider worse than death. I’m going to take a step further and say mental health treatment in this country is really bad.  This is not a jab at mental health professionals, who are probably fine individually… just saying there aren’t enough of them. The system is bad. If someone is feeling depressed or suicidal, they can call their local behavioral health center and maybe get an appointment in a month or two.  Hopefully they’re alive by then. I had a few really down periods during my medical training, so I can speak to all this from experience. There were no mental health services available. At one point, when I was having a really hard time, I called some student health...

Why I Didn’t Do Neurology

Neurology was my last rotation of my third year of med school, and you guys, I Loved It. I found it so fascinating that for the first time ever, I didn’t mind staying long hours at the hospital. When I did the consult service, it was like solving little puzzles all day. And the residents and attendings were my favorites… I fit so well with them (being Nerdy McNerderson and all). So why didn’t I do neurology? I could list reasons, but there was one big reason that pretty much explained everything: In the area of the country where I wanted to live to be near my husband, there were a total of eight neurology spots. Four of them were at a highly malignant program. And I felt that I wasn’t competitive enough to win one of four spots in a very desirable region of the country where I had zero connections. So I didn’t bother to try. That said, here are the reasons I’m glad I didn’t do neurology: 1) The job market is tight right now in neurology. 2) Not much in the way of procedures if you don’t do a fellowship. 3) I think neurologists are much better at diagnosing than treating, especially in the area of stroke. I’m not impressed with the medications prescribed by neurologists. A neurologist friend of mine is convinced that neurontin...

My Thoughts on Fluoride

We live in one of the freak towns that doesn’t have fluoride in the water. My kids have both already had cavities, so I want to make sure to follow our pediatrician/dentist recommendation to get them fluoride pills, but it hasn’t been so easy. So we don’t have to wait in line at the pharmacy every month, we had been getting our pills from Express Scripts, but we changed insurance, so now we can only use Walgreens online pharmacy. This has proved to be quite the challenge. Walgreens would not allow me to add the kids to my pharmacy account until I placed an order with physical pharmacy, so I did this first. The local pharmacy would not fill the medication because they covered only drops but not pills unless they got “extra info” from our pediatrician. After a week, this was not received. Our giant peds practice did not know somehow that this info was being requested. Finally, we just paid $11 each out of pocket for the month’s worth of pills. I was still unable to add the kids online to the pharmacy and had to call to do it. I then asked the pediatrician to call in the pills to Walgreens online. They assumed that was the same as Express Scripts and called it in there. I assure you, they are not the same. I called...

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