Archive for March 13th, 2006

A little while back this email hit the inbox:

…I am looking for advice from experienced Doctors. I am hoping you can answer a quick question for me. In your opinion, is it impossible to successfully get through Medical school, residency, etc. with children? I am hoping to become an RN, and then continue my education to become a Physician. I admit that I don’t know much about what it takes other than the basics, and that is why I am reaching out for advice from Doctors who have already been there. Any help you can offer would be much appreciated.

It is certainly NOT impossible. I had classmates with kids, and they made it through (anecdotal but real information). As I recall they were a touch older than the ’straight-through’ students, and their kids were in the ‘can take care of themselves’ age bracket. Everyone you ask will give a different answer (I hope!), and I asked my wife what she thought. In only the second topic here she’s weighed in on, this is her input as to what the life is like:

Med Student Spouse…. 3′rd year medical student has a day off. It’s close to Christmas, mid-school year, and the 3′rd grade son has a holiday program at school. The entire family loads up in Dad’s car to attend the program: Dad is tired but game. He backs out of the garage, stops, and says, " I don’t know where [sons] school is". [Son] has been at the same school for about five months and Dad has no clue where the school is located.

He has been away from home so long that just to see him walk in the door is a bittersweet treat. I know he’s hungry, tired, and yet wants to inter-act with the family. What a struggle it has become, trying to balance it all.

As the spouse of a med student you must be able to function as a single parent. Pay the bills, shop for food, prepare the food, clean up the mess and most likely work a 9 to 5 job and WHEN the spouse is off work (and not sleeping) included them in the family functions. It is a very odd lifestyle, Spouse is working extremely hard, but not earning one dime to contribute to the budget. The reward will come much, much later (note to self, check insurance reimbursement rates). They are remotely connected but so immersed in school and medicine, that the study takes over their life.

I also remember on one occasion I actually called the hospital [ed: this was during my internship], asked for the chief resident on surgery, and told him I would pay the ransom, if I could just see my husband again. At that stretch, I think he had been at the hospital for 4 and 1/2 days.

Some habits die hard, I will always shop the clearance rack first, only call spouse at work when absolute needed, be thankful for days off work. See, I can rant also. Mrs. Grunt Doc

I was able to do it with a family only because I have been blessed with a very strong and independent spouse who can handle things in my absence (for instance). If I had to tell you the One Thing you’d need, it’s a supportive and committed family behind you.

As an aside, I think the RN first is going to be a deterrent to going to medical school. I’m not saying that it’s either a mistake or that people cannot go to med school after obtaining their RN, but I have seen people take that route and stop at RN (same for PA). Why? Being a nurse is a full-time occupation, it is its own profession with a real knowledge base, and frankly once you go from student to making RN money another 7+ years of being financially upside down isn’t terrifically attractive. Nurses are becoming more scarce, and thus more of a commodity, and that trend will only continue.

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…"I take the Fifth" now joins "recommend clinical correllation" in the radiology lexicon…

The rant-muse has abandoned me, hopefully temporarily.

However, I read this in today’s WSJ (subscription required):

The silicosis lawsuit scandal rolled into Congress last week, and it was quite the spectacle. The highlight was the sight of three doctors raising their right hands to swear to tell the truth, the whole truth, and then taking nothing but the Fifth Amendment.

Ray Harron, Andrew Harron and James Ballard were three of the dozen doctors singled out last summer by federal Judge Janis Graham Jack for supporting 10,000 phony silicosis claims that she said had been "manufactured for money." Her opinion piqued the interest of House Oversight and Investigations Subcommittee Chairman Ed Whitfield, who invited the doctors to testify as part of a probe into public health and legal fraud.

The doctors declined to appear voluntarily, so they were subpoenaed. They still haven’t provided documents to the committee, and in the hearing last week all three were lawyered up and hunkered down. You can decide what this says about their honesty, or their potential vulnerability before the federal grand jury now probing sham diagnoses.

The dumbstruck docs were a lot more energetic when it came to their assembly-line diagnosis of both asbestosis and silicosis, a disease caused by exposure to silica particles found in construction materials. For their effort, they were paid millions of dollars by X-ray screening companies hired by plaintiff lawyers. The Manville Trust — one of the largest asbestos funds — recently disclosed new statistics about the doctors who have sent the most such business its way.

…

Innocent until proven guilty, remember that.

And now some disconnected thoughts: when the system of setting up a very select few radiologists to be asbestos screeners was set up, was there no oversight provision? Talk about a potentially abusable situation! Send 2% of the films to another screener, blinded, and look for discordances. In retrospect, I’m sure nobody thought it would be necessary. I suspect they were wrong.

Why is ‘assembly line’ always pejorative in news articles? I know it’s supposed to bring up all sorts of 20’s and 30’s black and white images of laborers being abused by The Man, but have a brief scan around your room and ask how much of what you have came from a dread ‘assembly line’. (I’d be willing to bet the WSJ is, itself, printed out on an assembly line).

What’s the role of the Radiology professional societies here? Will they investigate? Now that the defendant doctors are all ‘lawyered-up’ I doubt they’d participate meaningfully in any investigation that could cost them their Board Certification.

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