Showing posts with label Awkward moments. Show all posts
Showing posts with label Awkward moments. Show all posts

Wednesday, January 26, 2011

Prescribing For Friends

It's inevitable. As a doctor, you'll be sitting there minding your own business when a hospital staff, friend, or family will sheepishly approach you and ask, "Do you mind if you fill out a prescription for me?" It's always an awkward moment for me. Since I have a medical license number, I can easily make a prescription without much fuss. But should I?

Now I would never fill a prescription for any narcotics, something that would immediately send up a red flag to the DEA and the state medical board. However people have asked me to prescribe drugs as diverse as antibiotics, NSAIDs, and antireflux medications. Should I be doing this? Hard to say. The meds I have prescribed are pretty benign. And the requester is usually somebody I already know and not just some stranger walking into the hospital. Still, I feel a twinge of guilt every time I put my signature down on a prescription pad for somebody who isn't a formal patient. But if I don't, I feel guilty for turning down a seemingly simple and innocuous request from a family or acquaintance. How can I refuse somebody who maybe coming to me with an ear infection and asking for some antibiotics? Isn't that an act of compassion? Is my trepidation of writing a prescription due to real concerns about the possible side effects the antibiotics may cause or is it just fear of the possible consequences from the medicolegal system? Should I just flat out refuse everybody a prescription request and risk their ire and disappointment? There doesn't appear to be any good answers for this common dilemma.

Thursday, March 11, 2010

Anesthesiologists and Pelvic Exams

Thanks to the Anesthesioboist, the talk amongst anesthesia blogs is about--pelvic exams. I kid you not. Anesthesiologists are reminiscing about the first time they had to perform a pelvic exam as a medical student. (Notice I didn't use "romanticizing".) Over at I Used To Be Disgusted, Bleeding Heart describes how students and residents are invited into the operating room to practice pelvic exams while the patient is asleep under anesthesia, WITHOUT THE PATIENT'S CONSENT. Wow, they do things differently in Canada.

I figure I'll put in my two cents worth on this topic. That plus I've kind of dried up on printable subjects to discuss lately (personal issues that have preoccupied most of my awake, nonworking time keep me from thinking through on ideas lately). At my medical school in the Midwest, one of the GYN faculty was paid bonus money for allowing medical students to practice pelvics on her. You talk about A-W-K-W-A-R-D. I remember very clearly how she'd hitch herself up onto the exam table and plant her feet into the stirrups. Then she'd guide your trembling hands on the proper placement of a speculum. The worst part was how she'd verbally instruct you on a proper bimanual exam.

"Put your fingers right THERE. Feel that? That's my cervix. Feel how firm that is? Like the tip of your nose. Now move your hands over to the right. Squeeze your hands together. Ooh yeah. Not too hard. That is my right ovary you're squeezing."

None of us could really look her in the face after that. I heard she made enough extra money every year to jet off to Europe.