WOMENS-HEALTH Messages for February, 2000: Re: A favor from our readers

Re: A favor from our readers

From: Luanne (anonymous@obgyn.net)
Sun, 13 Feb 2000 13:38:08 -0500

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Dr. Hill,

I've been a patient in both military and civilian centers that are teaching hospitals.

At Georgetown's Breast Center, they handle it the best. First the nurse comes in and explains that a resident is present. I am asked if the resident may particpate. They're so nice when they ask it is impossible to say no.

On the other hand, if an OB-GYN clinic is running late, and I have to start by giving my history (again and again, at weekly appts!) I tend to get crabby. As a G8P2, the history is complicated!

With my most recent pregnancy and loss, I was completely comfortable with the 3rd year who oversaw my OB care and with the 2nd year who did my D&C. OTOH, in a prior pregnancy, I was furious with a Intern (or maybe 2nd year) who did loooong a cervix check at about 30 weeks --I had cramps for the next 24 hours. I called the Chief Resident on that one. That doc just spent too much time with the geography and seemed to need a bit more supervision/training!

It works best if the residents communicate when they come in the room. I am Dr. ____, I am a ___ year resident, Dr. SoAndSo is also here today...We're going to check ___ in this appt.

I understand the importance of their training, but I need them to be confident and communicative when they enter the room. I've also been fortunate to know the nurse who has overseen hundreds of OB-GYNs passing through their residencies. She can be an excellent buffer/communicator/resource.

Luanne

>
>Date: Sun, 13 Feb 2000 08:10:16 -0600 (CST)
>From: anonymous@obgyn.net (D. Ashley Hill, MD)
>To: anonymous@obgyn.net
>Subject: A favor from our readers
>Message-ID: <anonymous@obgyn.net>
>
>Ladies-
>
>I hesitate to use the forum for a nonmedical post, but I need a hand
>with this. In addition to a busy private ob/gyn practice, my partners
>and I also serve as full-time faculty for a Family Practice residency
>program. We teach our residents how to perform Pap smears, bimanual
>exams, breast exams, and how to deliver babies. Although many patients
>enjoy interacting with our residents (all of whom are doctors already),
>many decline to participate. At first glance it seems obvious- why
>would someone want another doctor participating in a genital exam?
>However, medicine is an apprentice system. There is no other way to
>learn physical exam skills, and someday younger doctors will be in
>offices, hospitals and emergency rooms. Without adequate skills they
>will be unable to provide quality care. My theory has been that the
>majority of patients, once they understand this, will allow a resident
>to participate.
>
>Any insight into this from our readers? Thank you very much in advance!
>
>--

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