During my training days, one of my finest memories of roundsmanship was watching two esteemed senior physicians in the same specialty duke it out for the better treatment regimen of a patient.
After spending hours in the library tediously searching the indexes of every major American journal and textbook for references to the disease in question, one physician said: “Well, a review of the entire American literature on this topic revealed that…”
The other physician countered: “Well, I have reviewed those as well as the international literature, and my conclusion is…”
He had trumped the first statement by spending even more hours — and perhaps days — writing to international colleagues and translating from other learned international journals.
I was looking for a recipe the other day, something my mother made occasionally, and instead of picking up the phone, I used a search engine, and found a recipe that sounded right. The next time I saw my mother, I mentioned what I had done, describing the recipe.
Feeling offended, she said: “That’s not how I make it. My mother didn’t make it that way. You should have called me.”
The current and all future generations of physicians no longer have to rely on a senior physician’s research and experience, nor hours of time in the medical library, nor phone calls to other colleagues with more experience.
They can just do an Internet search.
Physicians with a publishing or educational bent are all out there, whether for dissemination of knowledge through publication or self promotion through blogs or “expert” websites. Medical knowledge and all the journals in the world, even many textbooks, are now online, with every bit of minutiae searchable in some database.
The proliferation of online and downloadable databases of medical information makes my memories of stuffed pockets in my white coat dinosaur-like, as everything now is obtainable with a few clicks on my smartphone. Can’t remember the preferred treatment for that condition you see once every two years? Search for it.
We docs, those of us not publishing, nor self-promoting on some website, have lost a voice. Our experience, hard-earned skills and lessons learned are being trumped by the ease of an Internet search and the musings of those with a bent to writing stuff and posting it where it can be found.
Ignoring all the junk science and bloviating becomes the new science. I wonder if anyone will call me? I think actually they have already stopped.
The students and residents I taught in the past don’t reach out to me, because they have something better, faster and easier.
Conundrum: Should I turn to the Internet and write to share my wisdom, or should I add my voice to the anonymity of physician-only websites, where colleagues share their problems and issues and discuss or share their tough patients?
What do you do when you have a tough medical problem?