Saturday, November 19, 2005

Touchy-feely medical course?

A kind medical student colleague, who is currently still stuck in the 'old' medical course with lectures, lectures and more lectures, considers the Problem-based Learning medical course as 'touchy-feely'. What does that mean?

The problem with the old course was that doctors know their stuff, but they treat their patients with condescension and superiority (not unlike how the 'old course' medical student commented on PBL students :P). Little emphasis is placed on research and continuing self-education.

The new course attempted to address this by being more clinically relevant, introduction of communication classes and earlier exposure to patients for the purpose of communication studies rather than disease-studies. Of course, with significant reduction in formal teaching time, it is almost impossible to cover in as much depth the many different disciplines that make up Medicine.

Some say that the new medical course produce doctors who know little anatomy. I say it produces doctors who can communicate well with patients and learn things as they practice medicine. Sometimes patients don't really care if doctors know about that tiny little vestigial ligament, what they really want is some help - To cure sometimes, to relieve often, to comfort always.

Thursday, November 17, 2005

All walks of life from behind a pane of plastic

Sitting behind the triage nurse gives a really colourful insight to the people that present to the emergency department. Many of which of course aren't really emergencies per se. You'll be surprised (or maybe not) that so many people go to the emergency department for no better reason than to take their blood pressure or to ask for some prescriptions for the gastric problems. Or come after the emergency period has ended - an example would be presenting to the ED 10 hours after the initial anaphylactic event.

Many a times I wondered if emergency departments have degenerated into a 24-hour GP clinic with some expertise in trauma and some Holter monitors. Staffing problems of course makes it difficult for everyone to be seen as promptly as what everyone expects - within minutes of being triage and registration. After one hour, two hours, 4 hours - people start getting restless and feel that they are being ignored. The fact is all beds are full and yes, there are more critical patients. People deal with this in all kinds of ways -- some sit quietly, looking at the door occasionally hoping that the big mechanical sliding glass door opens and someone behind it calls their name. Others make noise, lots of it.

I remember last night (or was it the night before?) that someone asked me if I was a GP. Now I'm not complaining here, really, but this same person is also waiting to be triaged by the psych nurse (and I suspect it was her who was complaining of an evil spirit in the toilet to the clerk, but don't quote me on that).

It's a small place really, the emergency department, but my, the people you see there...

Saturday, November 12, 2005

My week in ED

ED is really not the best place to do research, or rather the easiest place to do research. I know - I've been there this whole week - mostly from 3 to 11pm. Some nurses are really nice, others become a terror (or look and sound like one) when it becomes really busy. Quite a few are allergic to research questionnaires that takes up their time.

Life...feels like just all work with this kind of hours - is this all medicine is about?