Dr Damania, I'm a gen surg intern at the University of Kentucky and have been following your podcasts and series on RUclips. You are an inspiration to the medical profession and the world at large. Thank you. Seriously, thank you for living up to the potential this profession can carry and changing the face of healthcare. The world would be a better place with more like you.
Some great insight. I always tell nurses and medical staff I am happy to take a call about a patient they are concerned about, I would rather get a call from them during the night, than the coroner in the morning.
Viktor Ko Im glad you are like that. I had a resident whos 02 dropped to 85% , SOB and febrile and i called the DR at 4am and he gave me crap for it. I was just like "Sorry doctor but you are on call and this person needs something to open the airway" he was new. I dont think he really realised what being on call would be like. I work in a nursing home.
Great show. I have been following you for about a year and you have gotten me to think about the difficulties of being in medicine. I think I am a better patient because of it. Thank you.
YESSSS im a ct tech who graduated in dec, PLEASE HAVE MRS ZDOGG ON AGAIN. ...sometimes its hard kniwing what patient history is important and whats not. ..when you ask a patient about things and they list every little problem theve ever had. ♡♡♡♡ Mrs ZDOGG
Bring back Mrs. ZDogg MD as she brought a sense of seriousness and intelligence to this show that is missing when you have your other 2 goofballs working. She is intelligent and actually has a helpful point of view. Like I said, bring her back. You did great Mrs. ZDogg, and no use to be nervous. Not all of us are as extroverted as your husband, but we value your opinion too. Thanks
Rude Dr's can harm patients . I'm a hospital pharmacist, and I have to examine physician orders for mistakes. There are physicians that do not accept criticism very well. They get defensive and yell at the pharmacist . For such Dr's the pharmacist may hesitate to call and clarify the order . My oncologist is a perfect example. He doesn't suffer fools gladly and he doesn't hesitate to yell. When I had to call him to suggest an improvement in an order I used to go into the conference room to meditate myself into calmness. But, when I got brain cancer and needed an oncologist, I didn't hesitate to choose him. Because he is super smart. And, get this, he is the best patient advocate, the most positive physician you can imagine. His patients adore him. I see him every month as a Condition of being on my chemo. Even if he does nothing Hands on, I always leave his clinic feeling much better.
I really didn't experience true rudeness until I went to work at a hospital in Florida. It's closed now but the Drs were terrible to the nurses! Yelling at us for others errors. They really didn't care who screwed up they just knew it was a nurse. Every nurse that worked there when I did left within a year. Including me.
Mrs Dogg is beautiful and brilliant what a refreshing change from Tom and Logan! I am in the administrative side of Healthcare and I happen to know that radiologists are some of the smartest and hard working portion of MD 's. Brilliant career choice
I love watching your posts! This one really hit home. I was a radiology technologist for 23 years and then went back to school and currently I am starting a new practice as an FNP in the emergency room. I have seen the rudeness on all sides. It is so important to try to understand the view points from all people within the system. One of the best pieces of advice I ever got from a preceptor was always make real friends with housekeeping, patient techs, and other modalities of medicine because these are the people who can save your rear when you are working. More times than I can mention this is true. At 3 am when you are exhausted and want to just finish the shift your kindness will be remembered by the RT who will show you subtle things they notice on a film, or the housekeeper when you need a room cleaned quickly, or you need something to complete a procedure
Radiology for dummies- YAAAAS!!! My friend is getting pimped right now as an intern. It made me so sad because he's the smartest person I've ever met. The docs totally broke him down and I had to talk him off the ledge. After that, he got totally pissed and is now kicking everyone's ass. I still think pimping's a messed up way to teach though.
This was a great discussion. Lots to think about while in the hospital and clinic and always trying to work and interact with equanimity. And I would definitely like to see Mrs. Dogg come back to do a session on "radiology for dummies!!"
ZDogg, could you please do a show about how, in a hospital admission, the ridiculous amounts of bogus admits and exorbitant amount of tests ordered, is bogging down the true care of the patient? Over the past 5 yrs or so we've seen so many patients be admitted for the most mundane things and scans ordered to excess. It is total overkill, seemingly to keep the hospital lights on while in the process raping the patients and their insurance. The doctors order scans to let the Radiologist make the diagnosis, we drag around patients for tests that aren't going to change the course of care, and all the while become burnt-out and calloused, maybe not delivering the level of patient care we ought to be. Can we have a show that delves into all sides of this, from us on the front line, to the doctors ordering, be it for the patients or for the administration, to the patients who have no clue what is really going on, and the pressure to treat, treat, treat, scan, scan, scan, all so the hospital can pay the bills at the patients expense.
Your reward for going to the SF College, was your wife. Enjoyed this segment on unconditional Love. A GOOD ATTITUDE IS THE KEY. You lost your wedding band in a River? My Jack lost his wedding band when he fell down a hill into a manzanita bush on a Deer hunting trip??Love from Grandma Carol.
Great podcast. Always true to form, talking about real issues and how to make HealthCare better. Sometimes the truth hurts, but system will never get better unless we recognize our deficiencies and attempt to fix them. Bring Mrs. ZDogg back. Great knowledge base and helpful point of view. Keep up the good work and the humor. WE need this more in medicine than ever!
Really enjoyed this show Dr. D, I hope you and Mrs. Dr. D will continue to make shows together! Best wishes to your family, especially ZDad and ZMom MDs
I am a new Registered Practical Nurse working in a nursing home and ive had a few very rude encounters with residents, doctors and a couple CNA/PSWs who are these rude high school like drama queen girls. One girl even is rude to the charge nurse. Shes almost been sent home multiple times. Most of my PSWs are amazing. Most encounters have been with residents who have dementia.
Ist time watching this episode & i love it. Would like to to share as RN 1984. I worked on unit 3 & we had a great team. One day a witch RN was sent to help, from unit 2. She really rude all time. She asked how do you all Get along here. All I said "humility", Surprised her AND myself. Another hospital AIDS UNIT very sad but we laughed..1 top doc of AIDS research arrived & shouted "OK, WHO CALLED ME @2A.M. FOR MALOX??" WE LAUGHED Another pt was white and named James brown doc asked how he was was doing. we sang "He feels good!" More laugher. Kindness goes a very long way & gets paid forward. I am 64, seriously disabled and I am the WORST PATIENT 🙃 sorry However, I am my own best advocate. When things improve $$$ I promise to join. GOD BLESS YOU AND DR. MISSUS Thank you for all you & team do. P.s. As a Christian I Loved Jesus DNR XOXOXO ANN
Very cool meeting Mrs. Dogg, she had some excellent insights to share. I hope you talk her into doing another collaborative podcast together. This subject really struck home for me. I see a lot of rudeness on the street side of medicine, mostly not in front of patients, but back at the station. And I think most of it comes from compassion fatigue. I try to not give in to it myself, but I can admit to having to fight complacency and antagonism towards our frequent fliers. I try to remind myself, just because they "abuse" the system frequently, doesn't mean that they're not actually sick this time. Stress and rudeness from other care providers is also a thing sometimes, but fortunately, most of our first response agencies work pretty well together, onscene, but it's much easier when we've worked with the same crews and built a relationship prior to the incident.
I'm a nursing professor and I see this in medical education in collaborative rounds, on the flip side, I have students that push the envelope with me daily, they want the test questions, they only want us to give them the information, pour it in their head for the test and then they forget it by the time they get to capstone. I would never talk to my nursing professors the way my students talk to me at times. They feel entitled to passing the courses and when they can't pass the boards they don't understand why.
I have to conference doctors with each other as my daily work. When I have a rude doctor on one end of the phone, especially when it's one of "my" hospital docs, I am very embarrassed. I often end up staying on the phone longer with the doc receiving the abuse, and it IS abuse, to tell them they didn't do anything wrong, that this doc just has some issues. I had to tell one of the rude docs this week, that he needed to consider treating the patient who left AMA and ended up with worse disease process due to it, because we are here to help, even if people don't take that help all the time. And then he turned it on the ER physician trying to give him report. *sigh*. I wanted to reach thru the phone and smack him. I can see why the patient left AMA the first time if he talked down to her like that!
It takes a while to learn the ability to be compassionate at work and let the rest lie. I am incredibly compassionate. I truly care and want to help. I absolutely cannot internalize the things my patients are experiencing. It would destroy my ability to provide effective care. It definitely took me a while to develop an ability to be both compassionate and very deliberate in daily practice.
Finally Mrs. ZDOGGMD! Thanks for helping your husband. I am sure you have helped him behind the scene over the years without receiving much credit, and by the way I am sure you are always right! Good job and I hope you both can do more shows together. Stay strong and wish all the best for you and your family.
Most doctors on call at night are wonderful. There is the odd one though... that snap at you every time you call them past 5 pm, and seem to take glee in making you feel stupid for calling them. Whenever I am training a student nurse my first lesson is always 1. The doctor is your colleague not your boss. They cannot fire you and if they are rude to you they are out of line.” On the same line, I explain that there are ways to minimize the rudeness. 1. SBAR. Always. No exceptions. 2. Be to the point and professional. The doctor does not need to hear the life story and insignificant details. Get to the point tell them what you see tell them what you think needs to happen. Answer their questions. If they ask something you don’t know just say “I don’t know”. Also..it’s ok to say “Something is going on with this patient (After you have given them the pertinent details obviously)but something is different and my nursey senses are tingling”.
Kev Y your response was very accusatory and did not even address answering the question. I am quite thankful they have changed a lot of hospital cultures to remove the doctor as being the boss. The doctor may place the orders but in a court of law the one who actually administers or follows the orders is ultimately responsible for any outcome or error. If a doctor is being rude aggressive or a liability to patient outcome going up the chain of command is the best option. Doctors are actually not more in demand than nurses because they are expensive. In my experience and talking with all the travelers who come down this was hospitals are looking to hire more ARNP, pa's and nurses and have less doctors to save money.
Emma Hole are you in a hospital setting or office setting? If you are in a hospital setting does your facility have a system wide counsel that meets regularly to discuss problems and solutions? I have heard a nurse talk about one hospital she travels to that had a bad bullying problem from a few doctors and nurses towards the other staff so the system counsel decided to call all staff together to end the bullying and make a system or reporting abuse. What they would do is ask all staff who is nearby when the bullying aggressive behavior occurs to come stand behind the person being bullied or if the persons are alone to say a pre-arranged sentence aimed at diffusing he situation. The staff at orientation and the doctors when they receive the hospital privileges are giving a list of gentle but direct statements allowed to be said during times of bullying and aggression that are supposed to clue the person in that their behavior is perceived as bullying. After the incident staff document the behavior and outcome as well as what line was used (I.e. I'm feeling uncomfortable right now and going to get my charge nurse or supervisor to assist me in this matter thank you for your time.) In our system that includes 4 hospitals and several outpatient clinics we have a clinical practice counsel that has a representative from each and every unit including several administrators, pharmacy, maintenance, housekeeping etc... the counsel meets once a month and each unit keeps notes on disruptive behavior from physicians and brings it to the meeting where it is brought up as a whole and the administrators take backs to the meeting after to discuss how to handle it. We are also encouraged to go directly to each physicians supervisor in the group they are in or the systems physician director if anything life threatening.
Emma Hole best bet to check your hospitals policy and keep notes and dates and encourage other nurses to do the same or take notes on situations that do occur with other nurses for them with permission. Rude and hateful doctors only behave that way because they think they can since staff are to afraid to say anything. With the changes to how hospital get paid related directly to physician behavior hospital and clinics are stepping up to help physicians show more professional behavior.
Kev Y I'm certain your reply has already belittled far more nurses than myself. It takes a multitude of doctors in several specialties to care for one patient and it takes but one nurse who is well educated to see the trends or subtle changes the doctors miss to save the patients life. The doctor spends minutes with a patient and most of it glancing at screen clicking boxes and not actually doing a proper exam. If a nurse knows a doctor write the wrong order and the doctor won't listen to fix it there are plenty of recourses for us to go above that physicians head. I work in critical care and we have hospital approved automatic evidence based order sets for certain situations (I.e. Post Intubation orders (foley, og tube, X-rays, repeat X-ray, infection prevention medications and treatments), Electrolyte replacement protocols, basic wound care and pressure ulcers/skin tear) that allow nurses to place in the system due to doctors being negligent in following up and hospitals taking away the risk to ourselves. I know other units are utilizing their own order sets as well. Evidence based practices are adding more and more autonomous procedure sets including medications and treatment for hospitals to employ to make patient safety a priority. Also, it's cheaper for a hospital to fire and ban a physician than it is to be sued out of millions or have medical funding reduced due to ignorant and or careless physicians who are a liability. The doctor is not my boss and is not above me in the "chain of command". That is health 1.0. The doctor is a member of the care team. If he/she is wrong and/or being medically negligent he/she is easily replaceable when I go up my chain of command. I have seen several 1.0 doctors fired for said culpability and 1 put on performance plan by the board in my 10 years in the hospital. Yes nurses can also be replaced but it's also expensive to train a nurse and the need for nurses is only growing. It's a competitive market and hospitals want to keep good nurses and continue educating them. The new trend is for hospitals to stand behind the person who is following policy and protecting the system. I am also lucky not he fact that most of the intensivists and ARNP as well as PA's we have will absolutely step in to help wipe a butt, start an iv, ej, midline or central line or help administer care when they come into a room or if we call them. There are far more nurses than doctors so of course by numbers more will be fired or replaced but in my opinion the percentages are equaling out as more hospitals are realizing they can and should stand up to doctors to make them aware that even though they make more money and had more years of training they are still an equal in the care team and must be equally as professional and courteous.
What I don't hear you talking about is rudeness of medical professionals to patients and families and how that affects patients complying with treatment. Frankly, if a medical person does not engage me, then they have not done their job. They just wasted their time and mine and my money and insurance company's money. I will either seek out other medical advice or simply go untreated. This is because I don't think they listened to me and so may have made a mistake with their advice. Or it is because I don't feel like following their advice because every time I take the pill they prescribed it reminds me of their rudeness and I want to avoid that. There is logic behind this as the pain about remembering their rudeness may be greater than the pain of my medical problem.
That's a typical shut down phrase that means you're not listening to a problem that affects many people. Why would you even say such a thing? Use your own words if you want to have a real conversation. If you just want to be rude then I can just say back, "If you have nothing nice to say, don't say anything." Being rude to people online seems to be your choice. So how does that help anyone?
There is a huge knowledge difference between most patients and doctors. Patients have to trust doctors to do right by them and rudeness destroys that trust. Who wrote take a drug from someone they didn't trust? If you can, though, telling your provider what they are doing wrong might help them improve. It's not your job to fix their attitude but it's also hard for a doctor to do better if they don't realize that there's a problem. Either way, I hope you don't have to keep seeing a doctor you don't trust.
@@TheYipYee Doctors should never assume that a patient is completely ignorant about medical matters, even though many are. As for being dismissive and downright rude, there is at least one doctor for whom I would have to be at death's door before I saw him again. I also know enough about mddicine to tell when a doctor's advice is based on one size fits all statistics or PPO policies rather than insights into me. Usually because they hadn't the time or the inclination to treat me as an individual.
I also agree how we eat our young. Every RN was terrified of being assigned to MRS. McCafferty. OMG there was my Name. WELL...she was doing an i v 1 on 1..I just phased out & tears rolled down my face. Very sternly ASKED ANN, WHY ARE YOU CRYING 😢? my response i don't know, like a mouse. She stated Ann you are overwhelmed. I felt so good & understood. She had French twist hair Cat frame glasses, tight wrinkled skin, Lol( like me now) would you believe the next week a man freaking coded! Wrote his vitals on my pants what a day, SHE JUST STOOD THERE. Pt. Did fine. Well at end of clinic she announced to Our group about the experience and the great job I did AND made me tell the group, the whole story. That's when I was a mouse 🐁. To this day I think I have PTSD 🤪 THANK YOU FOR SPREADING THE NEWS, CHANGE IS HERE AND EMPATHY , Kindness Will continue to improve with your Platform. When this virus goes away like the flu lol I hope to see you in Las Vegas. A woman RN in my town said she met you & you were so genuine and kind. In ICU June my RN, , Tom loves your teachings. Thank you very much 😊 Ann Salaun Rondou RN 🤪🤪🤪🤪
I actually didn't mind "pimping" at all. After my first year on wards I saw it as a great learning opportunity. Here is another elephant of mine, so correct me if I'm wrong: The fact that a medical or nursing student cried after being corrected does not necessarily mean that the other person is at fault. Misunderstandings and hypersensitivity in the recipient can be the real problem. We live in a matriarchal society that always seeks to blame someone (usually a male) when "on the job crying" occurs.
Nice to see Mrs. Dogg MD! Awesome podcast, love the thoughtful discussions. FYI, I was told "PIMP" stands for "Put In My Place". I also vote for "Radiology for dummies".
I think the problem is that negativity harms everyone's self esteem and their desire to reach out for help or reassurances when under stress. I have literally had nurses who didn't want to call a doctor because they always yell at them. On the flip side I have seen doctors not want to talk to certain nurses who either act like they don't understand or who get argumentative with them.
No offense to Mrs Dogg but I work in the MRI dept of a Level 2 trauma center and while there are a very small amount if Radiologists that can act like humans, the majority have no interpersonal skills at all. They snap, growl, bark, and are flat out rude to the staff as well as the hospitalists. It seems they would rather sit in the dark room, or as we call it, The dragon's den, and read the exams with no interruption. While I understand that they have work to do, at out hospital they must interact and be human doctors. We all deal with it because they are so valuable to our hospital but they are considered the most rude of the bunch. I think it's because they must retain so much info that their brain has no room for social skills. Mrs Dogg MD seems very kind though. Wish there were more like her.
Cost or not, the fact you are married to a Radiologist, Tungsten seems more personal!!!! BTW, I like Mrs. ZDogg, I would help her place a Powerport any day!!!
top war- ICU vs ER nurses. OCD vs ADD. ANAL retentive vs oppositional defiance disorder. Im a former ER nurse turned PULM/CC ARNP, revenge is sweet jk!
I know that it can be demoralizing to be constantly the brunt of verbal abuse .Is there a difference between patients just making rude comments and if patients verbally threaten you and call you names . I wonder if these occur often enough - staff might "pull in " cognitively in order to protect themselves .
I only like you somewhat more bc of the mrs dogg and your adorable kids. See how that works when you see someone as a human being not an ideal or belief
I disagree to a point. I have seen too many times a health care provider purposely work against a patient because they did not like a suggestion from a nurse and not change their original plan just because of ego
Me again..... I feel you are confusing sympathy with empathy. Empathy is crucial; we can feel and understand another's situation, but don't take it personal. Sympathy is where we feel bad for the person and make it personal (Merriam-Webster, n.d.). Being in 17 years in Radiology ( working both level one and less, IR as well), and slowly blooming into an addiction and mental health therapist, empathy and compassion are the most important parts of healthcare. Sympathy, however, is where we fail ourselves, our patients and our coworkers. Because we bend our boundaries and destroy our own health. I have confronted several physician's after witnessing or experiencing a rude moment, for example, I sat and let a Urologist vent after he had a meltdown, only to find he had been working 16+ hours, wanted to treat a patient immediately, only to be met with lack of communication and still had many on call hours and more patients to see. Fortunately, he felt better after our discussion and knowing that we all want the best for the patient. However, as leadership, I have also learned that physicians or anyone in higher responsibility rarely get asked how THEY are doing and get the feeling they are important in the fact they have the ultimate responsibility for the outcome, and as people, they have feelings and stress as well. Sit with a man in your office for eight+ hours (while still trying to discharge others and maintain order on the milieu) coming off Meth with underlying schizo-effective disorder while he is hallucinating, scaring other patients and employees, being called everything abusive one can think of, hearing traumatic event after event, but be able to meet them with empathy and compassion, and eventually meet them in a healing method... THAT is when you learn the difference between empathy and sympathy. I have to move a patient with an obviously broken hip to my imaging table... Empathy and compassion says I know you are hurting, let's be gentle and get this done; sympathy would be crying on the foot of the bed because I don't want to hurt the patient, regardless of the necessity.... Curious on your input... Reference: Sympathy vs. Empathy: What's the Difference? (n.d.). Retrieved July 28, 2019, from www.merriam-webster.com/words-at-play/sympathy-empathy-difference You can contact me personally at nemrtr@yahoo.com
I keep hearing about lazy millennials, but honestly all of my friend group are so terrified of having to job hunt in this economy that we work our asses off to avoid letting anyone even THINK of letting us go. Where the heck do these punks live that they have enough job prospects to take one for granted
I would put Orthopods high on the list of rudeness. Much higher than Rads. However, Orthopods take the crap back without crying. You must be good in bed Dr Z because Mrs. Dr Z is beautiful and smart.
Dr Damania, I'm a gen surg intern at the University of Kentucky and have been following your podcasts and series on RUclips. You are an inspiration to the medical profession and the world at large. Thank you. Seriously, thank you for living up to the potential this profession can carry and changing the face of healthcare. The world would be a better place with more like you.
Some great insight. I always tell nurses and medical staff I am happy to take a call about a patient they are concerned about, I would rather get a call from them during the night, than the coroner in the morning.
Viktor Ko Im glad you are like that. I had a resident whos 02 dropped to 85% , SOB and febrile and i called the DR at 4am and he gave me crap for it. I was just like "Sorry doctor but you are on call and this person needs something to open the airway" he was new. I dont think he really realised what being on call would be like. I work in a nursing home.
@@emilyexorcismzombie probably that.
Cutest duo ever! You guys should do more shows together!!!!!! Love this!!!!
Great show. I have been following you for about a year and you have gotten me to think about the difficulties of being in medicine. I think I am a better patient because of it. Thank you.
YESSSS im a ct tech who graduated in dec, PLEASE HAVE MRS ZDOGG ON AGAIN. ...sometimes its hard kniwing what patient history is important and whats not. ..when you ask a patient about things and they list every little problem theve ever had. ♡♡♡♡ Mrs ZDOGG
Bring back Mrs. ZDogg MD as she brought a sense of seriousness and intelligence to this show that is missing when you have your other 2 goofballs working. She is intelligent and actually has a helpful point of view. Like I said, bring her back. You did great Mrs. ZDogg, and no use to be nervous. Not all of us are as extroverted as your husband, but we value your opinion too.
Thanks
SD Williams Have a sense of humor! ZDogg's humor adds to the conversation!
Rude Dr's can harm patients . I'm a hospital pharmacist, and I have to examine physician orders for mistakes. There are physicians that do not accept criticism very well. They get defensive and yell at the pharmacist . For such Dr's the pharmacist may hesitate to call and clarify the order . My oncologist is a perfect example. He doesn't suffer fools gladly and he doesn't hesitate to yell. When I had to call him to suggest an improvement in an order I used to go into the conference room to meditate myself into calmness. But, when I got brain cancer and needed an oncologist, I didn't hesitate to choose him. Because he is super smart. And, get this, he is the best patient advocate, the most positive physician you can imagine. His patients adore him. I see him every month as a Condition of being on my chemo. Even if he does nothing Hands on, I always leave his clinic feeling much better.
I really didn't experience true rudeness until I went to work at a hospital in Florida. It's closed now but the Drs were terrible to the nurses! Yelling at us for others errors. They really didn't care who screwed up they just knew it was a nurse. Every nurse that worked there when I did left within a year. Including me.
Mrs Dogg is beautiful and brilliant what a refreshing change from Tom and Logan! I am in the administrative side of Healthcare and I happen to know that radiologists are some of the smartest and hard working portion of MD 's. Brilliant career choice
I love watching your posts! This one really hit home. I was a radiology technologist for 23 years and then went back to school and currently I am starting a new practice as an FNP in the emergency room. I have seen the rudeness on all sides. It is so important to try to understand the view points from all people within the system. One of the best pieces of advice I ever got from a preceptor was always make real friends with housekeeping, patient techs, and other modalities of medicine because these are the people who can save your rear when you are working. More times than I can mention this is true. At 3 am when you are exhausted and want to just finish the shift your kindness will be remembered by the RT who will show you subtle things they notice on a film, or the housekeeper when you need a room cleaned quickly, or you need something to complete a procedure
Radiology for dummies- YAAAAS!!! My friend is getting pimped right now as an intern. It made me so sad because he's the smartest person I've ever met. The docs totally broke him down and I had to talk him off the ledge. After that, he got totally pissed and is now kicking everyone's ass. I still think pimping's a messed up way to teach though.
This was a great discussion. Lots to think about while in the hospital and clinic and always trying to work and interact with equanimity.
And I would definitely like to see Mrs. Dogg come back to do a session on "radiology for dummies!!"
Glad that you continue to explain the need in medical care.
ZDogg, could you please do a show about how, in a hospital admission, the ridiculous amounts of bogus admits and exorbitant amount of tests ordered, is bogging down the true care of the patient? Over the past 5 yrs or so we've seen so many patients be admitted for the most mundane things and scans ordered to excess. It is total overkill, seemingly to keep the hospital lights on while in the process raping the patients and their insurance. The doctors order scans to let the Radiologist make the diagnosis, we drag around patients for tests that aren't going to change the course of care, and all the while become burnt-out and calloused, maybe not delivering the level of patient care we ought to be. Can we have a show that delves into all sides of this, from us on the front line, to the doctors ordering, be it for the patients or for the administration, to the patients who have no clue what is really going on, and the pressure to treat, treat, treat, scan, scan, scan, all so the hospital can pay the bills at the patients expense.
Your reward for going to the SF College, was your wife. Enjoyed this segment on unconditional Love. A GOOD ATTITUDE IS THE KEY. You lost your wedding band in a River? My Jack lost his wedding band when he fell down a hill into a manzanita bush on a Deer hunting trip??Love from Grandma Carol.
Great podcast. Always true to form, talking about real issues and how to make HealthCare better. Sometimes the truth hurts, but system will never get better unless we recognize our deficiencies and attempt to fix them. Bring Mrs. ZDogg back. Great knowledge base and helpful point of view. Keep up the good work and the humor. WE need this more in medicine than ever!
Really enjoyed this show Dr. D, I hope you and Mrs. Dr. D will continue to make shows together! Best wishes to your family, especially ZDad and ZMom MDs
my mamma used to say , "there is never any reason to be rude, when you can be very ,very polite ."
I am a new Registered Practical Nurse working in a nursing home and ive had a few very rude encounters with residents, doctors and a couple CNA/PSWs who are these rude high school like drama queen girls. One girl even is rude to the charge nurse. Shes almost been sent home multiple times. Most of my PSWs are amazing. Most encounters have been with residents who have dementia.
Nice to see you Mrs Dogg. Loved the program this week.
I 💜 Dr Mrs Dogg.
Ist time watching this episode & i love it.
Would like to to share as RN 1984.
I worked on unit 3 & we had a great team. One day a witch RN was sent to
help, from unit 2. She really rude all
time. She asked how do you all
Get along here. All I said "humility",
Surprised her AND myself.
Another hospital AIDS UNIT very sad but we laughed..1 top doc of AIDS research
arrived & shouted "OK, WHO CALLED ME @2A.M. FOR MALOX??" WE LAUGHED
Another pt was white and named James brown doc asked how he was was doing.
we sang "He feels good!" More laugher.
Kindness goes a very long way & gets paid forward. I am 64, seriously disabled and I am the WORST PATIENT 🙃 sorry
However, I am my own best advocate.
When things improve $$$ I promise to join. GOD BLESS YOU AND DR. MISSUS
Thank you for all you & team do.
P.s. As a Christian I Loved Jesus DNR
XOXOXO ANN
Very cool meeting Mrs. Dogg, she had some excellent insights to share. I hope you talk her into doing another collaborative podcast together.
This subject really struck home for me. I see a lot of rudeness on the street side of medicine, mostly not in front of patients, but back at the station. And I think most of it comes from compassion fatigue. I try to not give in to it myself, but I can admit to having to fight complacency and antagonism towards our frequent fliers. I try to remind myself, just because they "abuse" the system frequently, doesn't mean that they're not actually sick this time.
Stress and rudeness from other care providers is also a thing sometimes, but fortunately, most of our first response agencies work pretty well together, onscene, but it's much easier when we've worked with the same crews and built a relationship prior to the incident.
I'm a nursing professor and I see this in medical education in collaborative rounds, on the flip side, I have students that push the envelope with me daily, they want the test questions, they only want us to give them the information, pour it in their head for the test and then they forget it by the time they get to capstone. I would never talk to my nursing professors the way my students talk to me at times. They feel entitled to passing the courses and when they can't pass the boards they don't understand why.
I have to conference doctors with each other as my daily work. When I have a rude doctor on one end of the phone, especially when it's one of "my" hospital docs, I am very embarrassed. I often end up staying on the phone longer with the doc receiving the abuse, and it IS abuse, to tell them they didn't do anything wrong, that this doc just has some issues. I had to tell one of the rude docs this week, that he needed to consider treating the patient who left AMA and ended up with worse disease process due to it, because we are here to help, even if people don't take that help all the time. And then he turned it on the ER physician trying to give him report. *sigh*. I wanted to reach thru the phone and smack him. I can see why the patient left AMA the first time if he talked down to her like that!
It takes a while to learn the ability to be compassionate at work and let the rest lie. I am incredibly compassionate. I truly care and want to help. I absolutely cannot internalize the things my patients are experiencing. It would destroy my ability to provide effective care.
It definitely took me a while to develop an ability to be both compassionate and very deliberate in daily practice.
thank you so much for addressing this!
Yes.. bring back Mrs Dogg !!!
Finally Mrs. ZDOGGMD! Thanks for helping your husband. I am sure you have helped him behind the scene over the years without receiving much credit, and by the way I am sure you are always right! Good job and I hope you both can do more shows together. Stay strong and wish all the best for you and your family.
Mrs Dogg MD is beautiful !!!
The ZPups are adorable. You must have known they got it from somewhere (not ZDMD mind you).
Dr W Sumner Davi
Radiology for dummies, please!
Great work, thank you for the dedication.
Excellent - thank you for this!!
Mrs Dogg please do radiology for dummies!
--from an M3
Most doctors on call at night are wonderful. There is the odd one though... that snap at you every time you call them past 5 pm, and seem to take glee in making you feel stupid for calling them. Whenever I am training a student nurse my first lesson is always 1. The doctor is your colleague not your boss. They cannot fire you and if they are rude to you they are out of line.” On the same line, I explain that there are ways to minimize the rudeness. 1. SBAR. Always. No exceptions. 2. Be to the point and professional. The doctor does not need to hear the life story and insignificant details. Get to the point tell them what you see tell them what you think needs to happen. Answer their questions. If they ask something you don’t know just say “I don’t know”. Also..it’s ok to say “Something is going on with this patient (After you have given them the pertinent details obviously)but something is different and my nursey senses are tingling”.
Can you address nurse doctor relationships and how nurses should address rude and hateful doctors.
Kev Y your response was very accusatory and did not even address answering the question. I am quite thankful they have changed a lot of hospital cultures to remove the doctor as being the boss. The doctor may place the orders but in a court of law the one who actually administers or follows the orders is ultimately responsible for any outcome or error. If a doctor is being rude aggressive or a liability to patient outcome going up the chain of command is the best option. Doctors are actually not more in demand than nurses because they are expensive. In my experience and talking with all the travelers who come down this was hospitals are looking to hire more ARNP, pa's and nurses and have less doctors to save money.
Emma Hole are you in a hospital setting or office setting? If you are in a hospital setting does your facility have a system wide counsel that meets regularly to discuss problems and solutions?
I have heard a nurse talk about one hospital she travels to that had a bad bullying problem from a few doctors and nurses towards the other staff so the system counsel decided to call all staff together to end the bullying and make a system or reporting abuse. What they would do is ask all staff who is nearby when the bullying aggressive behavior occurs to come stand behind the person being bullied or if the persons are alone to say a pre-arranged sentence aimed at diffusing he situation. The staff at orientation and the doctors when they receive the hospital privileges are giving a list of gentle but direct statements allowed to be said during times of bullying and aggression that are supposed to clue the person in that their behavior is perceived as bullying. After the incident
staff document the behavior and outcome as well as what line was used (I.e. I'm feeling uncomfortable right now and going to get my charge nurse or supervisor to assist me in this matter thank you for your time.)
In our system that includes 4 hospitals and several outpatient clinics we have a clinical practice counsel that has a representative from each and every unit including several administrators, pharmacy, maintenance, housekeeping etc... the counsel meets once a month and each unit keeps notes on disruptive behavior from physicians and brings it to the meeting where it is brought up as a whole and the administrators take backs to the meeting after to discuss how to handle it.
We are also encouraged to go directly to each physicians supervisor in the group they are in or the systems physician director if anything life threatening.
Mamaci I don't have the problem, but I notice 1 particular Dr that is just rude and hateful to new nurses.
Emma Hole best bet to check your hospitals policy and keep notes and dates and encourage other nurses to do the same or take notes on situations that do occur with other nurses for them with permission. Rude and hateful doctors only behave that way because they think they can since staff are to afraid to say anything. With the changes to how hospital get paid related directly to physician behavior hospital and clinics are stepping up to help physicians show more professional behavior.
Kev Y I'm certain your reply has already belittled far more nurses than myself. It takes a multitude of doctors in several specialties to care for one patient and it takes but one nurse who is well educated to see the trends or subtle changes the doctors miss to save the patients life. The doctor spends minutes with a patient and most of it glancing at screen clicking boxes and not actually doing a proper exam. If a nurse knows a doctor write the wrong order and the doctor won't listen to fix it there are plenty of recourses for us to go above that physicians head.
I work in critical care and we have hospital approved automatic evidence based order sets for certain situations (I.e. Post Intubation orders (foley, og tube, X-rays, repeat X-ray, infection prevention medications and treatments), Electrolyte replacement protocols, basic wound care and pressure ulcers/skin tear) that allow nurses to place in the system due to doctors being negligent in following up and hospitals taking away the risk to ourselves. I know other units are utilizing their own order sets as well. Evidence based practices are adding more and more autonomous procedure sets including medications and treatment for hospitals to employ to make patient safety a priority.
Also, it's cheaper for a hospital to fire and ban a physician than it is to be sued out of millions or have medical funding reduced due to ignorant and or careless physicians who are a liability.
The doctor is not my boss and is not above me in the "chain of command". That is health 1.0. The doctor is a member of the care team. If he/she is wrong and/or being medically negligent he/she is easily replaceable when I go up my chain of command. I have seen several 1.0 doctors fired for said culpability and 1 put on performance plan by the board in my 10 years in the hospital.
Yes nurses can also be replaced but it's also expensive to train a nurse and the need for nurses is only growing. It's a competitive market and hospitals want to keep good nurses and continue educating them. The new trend is for hospitals to stand behind the person who is following policy and protecting the system.
I am also lucky not he fact that most of the intensivists and ARNP as well as PA's we have will absolutely step in to help wipe a butt, start an iv, ej, midline or central line or help administer care when they come into a room or if we call them.
There are far more nurses than doctors so of course by numbers more will be fired or replaced but in my opinion the percentages are equaling out as more hospitals are realizing they can and should stand up to doctors to make them aware that even though they make more money and had more years of training they are still an equal in the care team and must be equally as professional and courteous.
Yay for Mrs. DoggMD going on camera!!!
Mrs. ZDogg! I just found this site, and am so glad to meet you! (So what, a year or so late!)
What I don't hear you talking about is rudeness of medical professionals to patients and families and how that affects patients complying with treatment. Frankly, if a medical person does not engage me, then they have not done their job. They just wasted their time and mine and my money and insurance company's money. I will either seek out other medical advice or simply go untreated. This is because I don't think they listened to me and so may have made a mistake with their advice. Or it is because I don't feel like following their advice because every time I take the pill they prescribed it reminds me of their rudeness and I want to avoid that. There is logic behind this as the pain about remembering their rudeness may be greater than the pain of my medical problem.
Martha-Lisa Flinsch Don't cut off your nose to spite your face. Taking care of your health is up to YOU and no one else.
That's a typical shut down phrase that means you're not listening to a problem that affects many people. Why would you even say such a thing? Use your own words if you want to have a real conversation. If you just want to be rude then I can just say back, "If you have nothing nice to say, don't say anything." Being rude to people online seems to be your choice. So how does that help anyone?
There is a huge knowledge difference between most patients and doctors. Patients have to trust doctors to do right by them and rudeness destroys that trust. Who wrote take a drug from someone they didn't trust? If you can, though, telling your provider what they are doing wrong might help them improve. It's not your job to fix their attitude but it's also hard for a doctor to do better if they don't realize that there's a problem. Either way, I hope you don't have to keep seeing a doctor you don't trust.
@@TheYipYee Doctors should never assume that a patient is completely ignorant about medical matters, even though many are. As for being dismissive and downright rude, there is at least one doctor for whom I would have to be at death's door before I saw him again. I also know enough about mddicine to tell when a doctor's advice is based on one size fits all statistics or PPO policies rather than insights into me. Usually because they hadn't the time or the inclination to treat me as an individual.
I also agree how we eat our young. Every
RN was terrified of being assigned to MRS. McCafferty. OMG there was my
Name. WELL...she was doing an i v
1 on 1..I just phased out & tears rolled down my face. Very sternly ASKED ANN, WHY ARE YOU CRYING 😢? my response i don't know, like a mouse. She stated Ann you are overwhelmed. I felt so good & understood. She had French twist hair
Cat frame glasses, tight wrinkled skin,
Lol( like me now) would you believe the next week a man freaking coded!
Wrote his vitals on my pants what a day,
SHE JUST STOOD THERE. Pt. Did fine.
Well at end of clinic she announced to
Our group about the experience and the great job I did AND made me tell the
group, the whole story. That's when
I was a mouse 🐁. To this day I think I have PTSD 🤪 THANK YOU FOR SPREADING THE NEWS, CHANGE
IS HERE AND EMPATHY , Kindness
Will continue to improve with your
Platform. When this virus goes away like the flu lol I hope to see you in Las Vegas.
A woman RN in my town said she met you & you were so genuine and kind.
In ICU June my RN, , Tom loves your
teachings. Thank you very much 😊
Ann Salaun Rondou RN 🤪🤪🤪🤪
LOOOOL MRS. DOGG DUCKED DOWN LOLOLOL
YES, MORE MRS. DOGG !!!!! :0P Awesome show! thx!
I'm totally in favor of Radiology for Dummies!
I prefer my docs be direct to me all the time.
I actually didn't mind "pimping" at all. After my first year on wards I saw it as a great learning opportunity. Here is another elephant of mine, so correct me if I'm wrong: The fact that a medical or nursing student cried after being corrected does not necessarily mean that the other person is at fault. Misunderstandings and hypersensitivity in the recipient can be the real problem. We live in a matriarchal society that always seeks to blame someone (usually a male) when "on the job crying" occurs.
Hey ZDogg
You may want to move the statue of Han Solo behind you. From this angle the pink tie looks like he has a giant...well, you know. Lol!
Ney! Props for pronouncing 'Anduin' correctly. Yeah, I'm a nerd.
Nice to see Mrs. Dogg MD! Awesome podcast, love the thoughtful discussions. FYI, I was told "PIMP" stands for "Put In My Place". I also vote for "Radiology for dummies".
I think the problem is that negativity harms everyone's self esteem and their desire to reach out for help or reassurances when under stress. I have literally had nurses who didn't want to call a doctor because they always yell at them. On the flip side I have seen doctors not want to talk to certain nurses who either act like they don't understand or who get argumentative with them.
No offense to Mrs Dogg but I work in the MRI dept of a Level 2 trauma center and while there are a very small amount if Radiologists that can act like humans, the majority have no interpersonal skills at all. They snap, growl, bark, and are flat out rude to the staff as well as the hospitalists. It seems they would rather sit in the dark room, or as we call it, The dragon's den, and read the exams with no interruption. While I understand that they have work to do, at out hospital they must interact and be human doctors. We all deal with it because they are so valuable to our hospital but they are considered the most rude of the bunch. I think it's because they must retain so much info that their brain has no room for social skills. Mrs Dogg MD seems very kind though. Wish there were more like her.
Do you have a podcast?
Awwww...love it!
We love MrsDoggMD!!!
your girls look just like Mom. they are beautiful,you arel
a lucky man 😉
can you link more elephant discussion please.
Cost or not, the fact you are married to a Radiologist, Tungsten seems more personal!!!! BTW, I like Mrs. ZDogg, I would help her place a Powerport any day!!!
As dr. Lecter famously said, rudeness is epidemic.
who is your barber ?
top war- ICU vs ER nurses. OCD vs ADD. ANAL retentive vs oppositional defiance disorder. Im a former ER nurse turned PULM/CC ARNP, revenge is sweet jk!
Yay for Mrs. Dogg!!
Radiology for Dummies?! Hell yeh!
I know that it can be demoralizing to be constantly the brunt of verbal abuse .Is there a difference between patients just making rude comments and if patients verbally threaten you and call you names . I wonder if these occur often enough - staff might "pull in " cognitively in order to protect themselves .
Your wife is smart and beautiful. You should keep her and get rid of the millennial.
I thought there was more than one millenial.
I only like you somewhat more bc of the mrs dogg and your adorable kids. See how that works when you see someone as a human being not an ideal or belief
I disagree to a point. I have seen too many times a health care provider purposely work against a patient because they did not like a suggestion from a nurse and not change their original plan just because of ego
Me again..... I feel you are confusing sympathy with empathy. Empathy is crucial; we can feel and understand another's situation, but don't take it personal. Sympathy is where we feel bad for the person and make it personal (Merriam-Webster, n.d.).
Being in 17 years in Radiology ( working both level one and less, IR as well), and slowly blooming into an addiction and mental health therapist, empathy and compassion are the most important parts of healthcare. Sympathy, however, is where we fail ourselves, our patients and our coworkers. Because we bend our boundaries and destroy our own health. I have confronted several physician's after witnessing or experiencing a rude moment, for example, I sat and let a Urologist vent after he had a meltdown, only to find he had been working 16+ hours, wanted to treat a patient immediately, only to be met with lack of communication and still had many on call hours and more patients to see. Fortunately, he felt better after our discussion and knowing that we all want the best for the patient. However, as leadership, I have also learned that physicians or anyone in higher responsibility rarely get asked how THEY are doing and get the feeling they are important in the fact they have the ultimate responsibility for the outcome, and as people, they have feelings and stress as well. Sit with a man in your office for eight+ hours (while still trying to discharge others and maintain order on the milieu) coming off Meth with underlying schizo-effective disorder while he is hallucinating, scaring other patients and employees, being called everything abusive one can think of, hearing traumatic event after event, but be able to meet them with empathy and compassion, and eventually meet them in a healing method... THAT is when you learn the difference between empathy and sympathy. I have to move a patient with an obviously broken hip to my imaging table... Empathy and compassion says I know you are hurting, let's be gentle and get this done; sympathy would be crying on the foot of the bed because I don't want to hurt the patient, regardless of the necessity.... Curious on your input...
Reference:
Sympathy vs. Empathy: What's the Difference? (n.d.). Retrieved July 28, 2019, from www.merriam-webster.com/words-at-play/sympathy-empathy-difference
You can contact me personally at nemrtr@yahoo.com
You really need to check out how medicine works in Canada. It doesn't sound anything like what you are describing.
I keep hearing about lazy millennials, but honestly all of my friend group are so terrified of having to job hunt in this economy that we work our asses off to avoid letting anyone even THINK of letting us go. Where the heck do these punks live that they have enough job prospects to take one for granted
I would put Orthopods high on the list of rudeness. Much higher than Rads. However, Orthopods take the crap back without crying. You must be good in bed Dr Z because Mrs. Dr Z is beautiful and smart.
Fee for service pie. Mmmmmm.....pie....
I'm a millenial and I'm not lazyish..I love you but I'm not in love with you.