I told my sister not to go to medical school. She didn’t listen to me. The funny thing is, my mom told me not to go to medical school either. I didn’t listen to her. In our youth, we want to do good. Somewhere in medical training though, I’m afraid that do-good spark gets snuffed. Everywhere near you, hospitals are being run by twenty and thirty-year-olds. These individuals are just starting out and already they are questioning why they went to medical school.
The patients are sicker, more complex, and less funded it seems than before. It’s not the patient’s fault. Our system has failed us. Here’s how the system has failed me, a resident, and I guarantee you, other residents have had similar experiences.
It’s not even noon yet and you’ve replaced five patients’ potassium and magnesium instead of having them eat better hospital food. You’ve fielded twenty phone calls from nursing staff regarding patient care questions ranging from blood pressure to insulin management. You’ve had two phone calls from case management telling you that your newly declared dialysis patient has not been accepted to an outpatient dialysis chair. Somewhere in the recesses of your brain, you remember hearing that Medicare should cover dialysis patients. They didn’t teach you this in medical school and you’re not about to tell case management how to do their job, so you leave that conversation for tomorrow. You’ve also had quite a few calls from hospital administrators asking you to change your observation patients to inpatient status as it’s already been two days that they’ve been in the hospital and they clearly aren’t being discharged today.
You’ve already told one patient that if they don’t get their diabetes under control they’re going to lose their right foot, just as they had their left. You told another patient that you don’t feel comfortable giving them intravenous opioid medication for their twenty-year history of back pain because you think to yourself that you’re finally going to be the doctor that is going to stop the cycle of abuse. You’re also scared that this might be the time that they stop breathing from all the opioids.
You’ve gone through hundreds of computer clicks this morning as you slog through admission orders, medication reconciliations, prescribing medications, ordering labs and imaging, and discharging patients. You have not even written your notes yet for all of your patients. You’ve spent hours today staring in front of a computer screen and maybe spent a total of forty-five minutes with patients. You went to medical school to spend time with patients, not stare at a computer screen. You are not even done with all of your training and you have this to look forward to for the next thirty or forty-year career? For the sake of our patients and for the sake of the new young doctors starting out who are taking care of patients, something has to change. We didn’t go to medical school for this.