Comments on: Asking: Or Is It Pimping?

By: The Art of Pimping « The Blood Doctor

The Art of Pimping « The Blood Doctor — Mon, 22 Dec 2008 06:50:45 +0000

[...] From Doc Gurley’s Blog [...]

By: Doc Gurley

Doc Gurley — Thu, 18 Dec 2008 03:01:57 +0000

Yeah! Sooo glad you found someone. Be well,
Doc Gurley

By: Amy Hengst

Amy Hengst — Wed, 17 Dec 2008 23:59:00 +0000

From a patient’s perspective, thanks for your explanation of one reason doctors might be averse to just admitting when they don’t know something, or asking the right follow-up questions. It took me years coping with asthma, repetitive stress injuries and strange foot pain to learn that I had to give the doc as much info as possible if I wanted treatment. And I learned that only *maybe* would they have an answer, diagnosis or appropriate treatment. I finally found a great doctor–one who was attentive and knew when to send me to a PT or specialist! Now I am healthy again at last.

By: Atticus Osler

Atticus Osler — Fri, 05 Dec 2008 06:28:22 +0000

While the tone of Snogger’s comment indicates what can happen to your attitude in law school [after three or four years of actually being expected to show up for class and being prepared to answer in front of a large classroom as well as take your own notes as opposed to a "lecture note service," and taking all essay questions on exams rather than multiple choice and multiple multiple choice] law school is still being asked to do the humanly impossible or develop all kinds of strategies on how to appear to be doing it until you can. Sleep is not that abundant to the earnest law student, either.
We have used the term “pimping” indiscriminately, and many times it is not intended to humiliate, it is just taken that way by fatigued, overwrought, sensitive, or new-to-the-exercise medical students. Sometimes it is taken that way by the calloused and the cynical-about-everything student or resident. There is usually a touch of that before many enter medical school, you can’t blame it all on the training. (You may more rightly blame it on years of playing the game of dollar-dollar-who’s-got-the-dollar “managed care” or “third party payor,” and the use of the term “provider” and other devaluation of the physician).
Having seen some of the other side, I find that a defensive or cynical attitude is rather unjustly blamed on the law profession and the fear that it engenders in many doctors. Comparing the two professions, I note that law has a built-in respect for its history because it evolves gradually, even with the legislatures passing new laws all the time, as opposed to becoming medical knowledge and techniques 50% obsolete every 5-10 years. Medicine denigrates its own spiritual heirs, considering their methods ignorant and antiquated (because duh many occurred in antiquity).
As opposed to a doctor not wanting to admit not knowing, many specialists with personality, as well as I, a primary care “provider” bouncing from room to room before everybody starts coming out of the rooms and staring as I rush up and down the hallway, have many times put on an intended-to-be-obvious dumbfounded or exasperated body language and said, “I don’t know”! when asked what is wrong or what are we to do. It often immediately disarms the patient into a relaxed and chuckling partner. If it does not, I then say, determinedly, “but we’re gonna find out.”
In my Spartan medical school, it was actually stated as a principle: “You can’t not know.” I took that to mean: “Be as sharp a clinician as soon as you can, because you’re going to need it out there.”
Having sat in on many trials before I started law school, I saw many attorneys putting their arm around their client, in a show of support and caring. Many doctors don’t even touch their patients anymore. In spite of the mean, steely, greedy stereotypes in both professions, do not judge the law profession until you have known a competent but kind lawyer. Their insisting that they get $250 an hour is a fair warning for involvement in your unfortunate life and is no worse than your office staff’s second question being, “well, what kind of insurance do you have?”

By: PinchingAbe

PinchingAbe — Thu, 02 Oct 2008 19:47:56 +0000

This is an interesting subject. In today’s age, patients wait an un-Godly amount of time to see a doc and then you feel like you just drove through McDonalds when you are finished. Having been told at one appt. that “you get one complaint” I became incensed. Really, just one? How then does the doc figure out what is wrong with me then? I think coaching the patients to hold back information is a bad plan. Many times symptoms are related or more obscure symptoms to a condition.

Then you have the docs who get upset with patients asking questions on their way out the door. Very rare do you get a doctor who asks you if there’s anything else you’re concerned about.

As for patients cyber diagnosing themselves… I recently asked my obgyn if I had a hernia… symptoms fit. But turns out it is a cyst that may need removed. Yeah, I was wrong, but my ego isn’t hurting (just something else!) but it was a great way to open a discussion about what was going on with me and that it was serious enough that I wanted a yes/no answer to be able to quit wondering about it.

By: From The Malebag: Man Up, Dude! | Doc Gurley

From The Malebag: Man Up, Dude! | Doc Gurley — Mon, 08 Sep 2008 12:38:26 +0000

[...] Response: The recent Doc Gurley post, Asking: Or Is It Pimping? provoked interesting and very insightful comments from our readers – and also revealed a profound [...]

By: Long Term Impacts of Pimping « Medliorate

Long Term Impacts of Pimping « Medliorate — Mon, 08 Sep 2008 08:09:36 +0000

[...] Asking: Or Is It Pimping? [Doc Gurley] [...]

By: John Paul

John Paul — Sun, 07 Sep 2008 14:47:57 +0000

Having been a program director for years and seeing how the pimping “whiners” perform in real life, I must say that it is reasonable way of testing “situtational medical knowledge”. The whiners are usually folks who do great at tests but have a hard time applying that knowledge to the care of their patients. But I admit that the pimping needs to be done in a profesional manner and not what is often seen on some surgical services.

By: Okey

Okey — Sat, 06 Sep 2008 15:02:15 +0000

Sounds like whinning to me, Gurley.

Med school should be tough. Practicing medicine is not for wimps. Law school (which, like most of academia, is restricted to the classroom) cannot compare to the rigors of med school. MS is a fatigue-inducing gauntlet in the 3rd and 4th year… an apprenticeship that is subject to a lot of personal style of the supervising doc. Then to residency, a new level of mental, physical, emotional marathon running. It’s all Navy Seal training of the mind.

Man up, dude.

By: Adrienne Zurub

Adrienne Zurub — Thu, 04 Sep 2008 01:42:38 +0000

My Gawd! You are so wonderfully human and funny!
I love your definitions and examples.

For a brief shining moment…albeit brief…I think I understood that perhaps a doctor(s) could have PPSD (post-pimp stress disorder) as a result of these experiences thus affecting dealings with patients.

Great post-pimp advice.

Adrienne Zurub
http://adriennezurub.typepad.com