Session 71

Ryan and Allison bust some myths and point out several inaccuracies in many TV doctor shows. They also paint some pictures of what real life is really like for a physician during residency and as an attending physician.

ER

• The closest to portraying medical life as accurately as it could
• Allison thinks it’s a fantastic show
• Creator Michael Crichton was a physician himself before being a writer
• Shows real people, doctors, nurses, medical assistants, medical students and portraying pain, patient cases and problems, and what it can look like when patients are treated for those problems.

Scrubs

• Good at mimicking real life even as a comedy
• Also close to what life is like as a physician
• Based off the place where Allison did her internship

Busting the Myths and All the Medical Inaccuracies:

Grey’s Anatomy

• Sex – Everybody is having sex.
• Relationships with patients – Big No-No
• Relaxing in the middle of the day – There is never a time for sunbathing. You are either rushing to a cafeteria or a conference
• Fighting over the operating room – This is too cutthroat.
• General surgery makes you do all different sub-specialties – Not true.
• Too much drama and tragedies

House

• The same physician is doing everything – This is a huge pet peeve.
• Breaking into people’s house – Physicians don’t have that authority.
• House as the head of diagnostic medicine – All physicians are diagnosticians.
• Treatment as diagnosis – You don’t throw treatments at people and decide that’s the diagnosis.
• House’s addiction problems – Paints a physician in a bad light
• House’s bedside manner – Totally not a role model; he completely demeans people

So here’s what a TRUE day in the life of a physician would be:

Allison’s day:

• Primarily outpatient-based with inpatient consultation work at a local hospital
• Seeing patients for whom a neurology consult has been requested (ex. stroke, migraine, seizure) in the ER, wards, ICU
• Inpatient time gives her the opportunity to interact with residents and medical students, and the team she works with.
• In the outpatient world, she also works with a team made up by a receptionist, office manager, and medical assistants. She sees an average of 10-12 patients a day. It basically depends on the day; sometimes she sees 4 patients in a day, sometimes 18 where she encounters new patients and follow ups.

Administrative stuff can take a lot of your time.

• Patient phone calls
• Responding to primary care physicians
• Signing orders and prescriptions
• Arguing with insurance companies
• Responding to requests from pharmacies

*Statistics shows interns spend only 11% of the time on direct one-on-one patient care while the big chunk of time is spent on administrative stuff.

Understand what you’re getting yourself into.

Patient care + everything else involved such as:

• Computer-based training
• Re-certifications
• Maintaining your medical education units (if you’re board certified)
• Updating insurance companies every 90 days of your practice and all your numbers so you get reimbursed

What is a scribe?

A position where a person can come in and be hired to run around with a physician to document for the physician what’s going on during the patient visit.

Ryan’s day:

• Primary care (Dealing with patients, questions, and labs; Calling in for medication refills)
• Ryan refers patients to specialists (like Allison)

More TV show inaccuracies:

• Patient in a coma  – In the real world, patients in a coma need breathing tubes and need to be incubated
• Shocking people who are flat-lining
• How to put on a stethoscope

Links and Other Resources:

If you need any help with the medical school interview, go to medschoolinterviewbook.com. Sign up and you will receive parts of the book so you can help shape the future of the book. This book will include over 500 questions that may be asked during interview day as well as real-life questions, answers, and feedback from all of the mock interviews Ryan has been doing with students.

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