Doctor Office Visits

[Paul_R]

I am curious if many of the members of this board have experienced the following and how you handled the situation.

When being seen by a cardiologist at a teaching hospital have you had to deal with a parade of doctors in the examing room? By parade, I mean do they bring in the 1st year, 2nd year, 3rd year residents and so on ... and basicaly using you as a teaching prop?

As someone with CHD growing up this use to happen to me all the time. I grew to hate it. I felt like just a piece of meat. I hated it so much a stop going to the cardiologist for a long long time. Regrettably I am paying the price for this now.

I am having some anxiety about experiencing this again when I go to my appointment at UCLA.

 

[Creed3]

Hi!
I can definately understand what you mean. It only happened to me a couple of times at UVA. When I was seen in their clinic. I must have had three of four doctors come in and listen and poke around and then the students came in to listen to my heart. This was before they diagnosed me correctly and the proffessor kept saying this is what you normally hear with leaky aortic valve. This patient doesn't have that sound. This went on for about three or four different sounds they were searching for and they still didn't hear what they typically hear, so I guess maybe I wasn't a real good example. As it turned out, they had my diagnosis all wrong. I had an aortic dissection/anuerysm that caused the leaky valve. They only caught the leaky valve. That is why I didn't have the typical sounds of a leaky aortic valve. They were listening for certain clicks and booms etc....that they just weren't hearing because my case was not as simple as they thought. I would have thought that maybe one of the docs or proffessors would have listened to me but they didn't. I was finally diagnosed at a Philadelphia Hospital and then off to Cleveland Clinic.
After my surgery I chose a cardiologist that I see in his office, not the hospital clinic. I wanted no parts of the clinic anymore. I still am seen at UVA, just a private office now. You also have the option of telling them you do not want to be seen by the students. They usually ask first before bringing anyone else in.

Take Care!
Gail

 

[bvdr]

When I was being evaluated for a possible mitral valvoplasty there seemed like a parade of young doctors coming in to listen to my heart. They came in twos and threes. They must have all met in another room following the exam because the chief cardiologist came back in and asked permission to have a few come back for another listen. He said they had not "fully appreciated" what they were hearing. It didn't bother me. They have to learn and they need to take advantage of the opportunities available in tertiary care centers.

 

[Ross]

I've had that happen before. I don't mind if it's only an occasional thing, but if it becomes a habit, I let the attending know about it. What I really hate is when the teaching Doc sends a student (With no personality) in to talk to you. My last run in with one of these students just lowered the bar for their entrance into my room. He was a class A jerk.

 

[tobagotwo]

Most teaching hospitals will honor your request not to be viewed by students. While it is good to help them learn, sometimes enough is enough.

The only time I was approached by students at RWJUH was the evening after my surgery. My pain meds had run out, and I was trying to get the teaching doctor to arrange for a Fentanyl machine. He was adamant about doing his patients in painstaking order, and wasn't about to interrupt his routine to provide relief for a patient who, by that time, was literally shaking with pain. No one else at that hospital ever would have let a patient remain in pain like that. I agree: when teaching, doctors tend to be arrogant and ineffectual.

 

[Nancy]

Joe has his cardiology appts. at a teaching hospital now. Sometimes he's had a group come in, but they are pretty careful to keep the physical examination to the doctor or resident with the doctor doing the final check. On occasion they have asked permission to listen to his double valves and his operated on lungs.

Joe's a pretty funny guy, and the "little ones" will hardy escape without some sarcastic and funny comment. Most of the time they don't know how to respond to that. And I find it quite fun to ask them a question they should know and watch them tap dance, like, "what should his INR range be?". The last pharmacy student got it right on the nose, but he did some stammering. His teacher was with him.

We can have some fun too!

Seriously, they have to learn somehow, as long as it doesn't become a nuisance, or they're not doing something harmful, or they're not obnoxious.

 

[Harpoon]

I've ALWAYS had the med student visits and I've ALWAYS been asked for consent before they entered the room. I've always granted it too.


The way I figure things, my condition is "reasonably" rare and it's not often that a cardiologist is going to see someone my age in my condition. It's important for them to see such "cases" and I've never thought of it as being treated like a piece of meat.


On occassion, I've gotten a chance to grill the students regarding their findings. At Cleveland Clinic, the teaching physician told his charges what they were about to see and hear before they entered the room. That was no fun....

I've had experiences where a doctor has absolutely no f*%#&%@ clue what they were hearing/seeing and that bothers me. I know why it happens, but I'd rather not be treated by someone who doesn't have the foggiest idea what TGV means.

Oh, and you'll set off all KINDS of alarms if you ask me if I knew I had a heart murmor....


You'll be lucky if I didn't smack you upside the head for that kind of a question. =)


While I was in Cleveland a medical technician of some kind (or she may have been a nurse) paid me a visit one afternoon. One of my regular doctors had asked me if it was OK first. She had TGV, mustard repair and she was 27 at the time. She was physically fit, kept "fairly" active though not as much as she wanted to be, work and such. I told her to keep as active as she could for as long as she could and to take care of herself and her heart. I was doing everything right really when my tricuspid fell apart. I think one of the things that I had going for me was the shape I was in. If I hadn't been as active as I was when I got sick, I might not have had the same outcome...

 

[labguides]

Who is your doctor at UCLA? Our daughter's cardio at UCLA usually has one "associate" (a resident or fellow) who comes in to see her prior to the cardio seeing her. The associate always takes lots of time with her -- and then relays the info to her cardio. When she had surgery at UCLA, she had been warned about the parade of doctors who would come in. If I remember correctly, the cardio had a resident with her and so did the surgeon. But.. that was all.

 

[Paul_R]

My appointment is with Dr. Child and surgery will most likely be by Dr. Laks.

This will be the first time I will be seen there and any insight into how they do business is greatly appreciated.