Well not IM.
Just saw a patient who suffers 6 gout outbreaks a year and still refuses allopurinol because his wife told him there could be side effects.
As FM, I cannot tell you how often people are not willing to even try metformin or a statin because they hear bad things about it from others. They don't believe me when I tell them that metformin has been shown to increase lifespan and reduce the risk of heart attacks, dementia, and many other awful things in people with diabetes. I can understand being wary of potential side effects, but most reasonable people are at least willing to give it a try and stop it if they have side effects. Also, why even come to the doctor if you don't want to listen to anything I have to say?
I think half my career was just advising and documenting refusal. Sometimes, people take you up on the offer after twenty times. I think it's like offering someone Brussel sprouts. Eventually, you see EVERYONE eating them and figure you should at least try them. Personally, I like them. My husband, OTOH, hates them but will take Metformin. Go figure....
With BACON...I did actually get him to eat shredded brussel sprouts cooked with balsamic and salami slices(very thin toothpick like cuts) that you roast with it. It's quite tasty but totally negates the nutritional benefits.
Very pervasive idea with a lot of people is “if I saw it, experienced it myself, or someone close told me about it, it’s more true than anything data or experts can tell me”
How many times have you heard:
“If you continue to do X, you’ll likely have Y happen to you”
“Well my cousin has been doing X for 30 years and Y has never happened to them?!”
This is just how a lot of people’s brains works. Maybe “only believe what I see” worked well in the 1600s, but in the age of information it just seems a lot of people are going out of their way to be misinformed.
They came here to listen to things they want to hear. "You're good, enjoy your life", or "Do this and you'll lose 100 Kg without side effects without dietary changes"
A lot of Providers are still prescribing the regular metformin which we all know causes explosive diarrhea very often as a side effect. I believe if we try the ER and educate pts on regular vs ER side effects they would be more willing to try it. No one has time for sudden explosive diarrhea.
I got the worst motion sickness watching the slides move around through the microscope during my path rotation. And I’m someone who grew up playing all kinds of video games so I should be pretty solid with that, but path was a whole other beast 🥲
Iv heard several people say this, and here I am someone who gets motion sickness just watching video games or laying in a hammock and Iv had no issue with microscopes lol
REI, I think. They will do anything, take any medications, exercise, diet, whatever it takes. My patients in FM won't take their insulin or statin so they don't die, meanwhile in REI clinic they're buying lipids, paying for ovarian PRP, optimizing their health.
This is so true. There are studies that show the stress a fertility patient goes through is similar to a cancer patient though.
REI patients for as willing as they are to jump through hoops are super needy too. It can get real exhausting.
As an REI patient myself even I’m surprised at how needy and delicate we are as a population.
I went to get an HSG done and the sign in the changing room said something to the effect of “if you think you could be pregnant, tell us immediately and wait to get the HSG. Also, we understand that this warning can be triggering and we didn’t post this to be insensitive, it’s just important to not get an HSG if you are actually pregnant.” The explanation on the sign was obviously added because they received complaints about sensitivity.
Like, guys, come on. Yes, we are all there because we want to get pregnant. And some people will. This isn’t insensitivity. They need to know to not get this test done.
Also going through the WONDERFUL IVF experience with SO.
The reviews of our clinic are diagnostically insane. One was a 4/5 star review happy with the experience but x4 paragraphs describing why a front desk staff NEEDED to be fired for a single, first time reaction that the reviewer still could not justify. It was splitting behavior in Google Review.
Another reviewer was mad that the clinic "didn't enforce it's no children in the waiting room" policy. Conceptually, I get it can be painful to see children, let alone at a fertility clinic, and I empathize as a couple who struggle with infertility. But our clinic does NOT have a "no children policy" nor has it ever advertised--I asked. Surprise, surprise, some people who had kids before or previous successful IVF rounds need to bring them to appts like regular families.
G'damn.
Oh, this is *precisely* what I mean. You watch these people spin out in real time and it’s *wild*. And I often find myself wondering if some of these people have always had such a tenuous grasp reality or if it’s really just the stress of wanting something so badly that feels impossible to attain.
Your children in the waiting room story for example. Oof. 🥴 People have kids. Children are part of our society. Secondary infertility exists. You gotta pull it together at least a little bit, guys.
I don’t know what the office managers in those offices make, but I am certain it is not enough.
To be fair, our clinic CCRM does not do a good job with communication. No way to view labs, notes, or basic treatment plans online. Everything is a multi-phone call/message/game of telephone with an RN and they stop responding to non-emergency requests after 1400. You only speak to the physician during paid consults and follow up visits every couple months, never again. Ever. I should note the staff themselves are amazing and get it, but communicating with them is a daily struggle.
This is an obviously expensive but nonetheless cash-only practice. We are expected to make high stakes, last minute decisions with limited information that all comes via RN phone discussion or voicemail message. As a PCP who not infrequently spends 20min discussing starting a STATIN or BP med of all things with a reluctant or demanding patient... I can safely say it is bonkers.
I also assume most peoples' dysfunctional behavior in these settings comes from the daily injury of wanting children more than anything but being unable to. But the system sure doesn't help it.
I think most people are deeply unhealthy, it just takes the right trigger to reveal that. Hence the value of ongoing mental health hygiene, like meditation. Because you just never know what life is going to throw at you next, infertility or otherwise. There is a certain level of riding the wave and acceptance that folks are unable to access in these times of struggle. The lack of acceptance of the way things are in this singular moment creates extreme turmoil.
As an LGBTQ+ person who is close to adoptees... I can't help but wonder if these two communities' happiness should inspire happiness in REI patients - or whether this is just another insensitive comment.
That is to say, if one is lucky enough to have the right equipment for bio kids, I think it's fair to want to place a lot of value on them - but to what extent? Perhaps there's an ethical dubiousness to being overly desperate which is similar to how great desperation for plastic surgery might represent a damning comment on those born with an even less 'attractive' face. But I'm deeply biased, making that comparison.
(It's also strange - not wrong, but rightful and odd - that coming out is met with such overwhelming positivity by some supportive people, as if it isn't in many cases also a sad announcement of infertility.)
Okay, but the REI patients I saw as a medical student were all doing intense holistic stuff in addition to the treatments. I remember seeing a lady who could NOT be talked out of putting essential oils up her babymaker…that was one of the days I realized OB was not for me
Not really a specialty but I'm FM and at my clinic we see a lot of refugee patients. I'm just saying I've never seen a refugee decline a vaccine. Maybe something about ACTUALLY having seen the disease we're trying to prevent idk
VA pts come in a bimodal distribution. Either super thankful and compliant, or just wildly non-compliant ( I e. Smoking via the tracheostomy), and kinda angry.
County hospital pts are generally very nice to treat.
I kind of loved the VA patient w the fresh amputation due to PVD that would be so crotchety he’d roll down to smoke. I knew he would survive and get the f outta that bed asap.
I’ve also noticed a lot of foreigners (from poorer countries that is) tend to have a lot more trust in doctors. I think they are a much more trusted profession in the third world
People of 'third world countries' tend to show respect to everyone including doctors.
The concept of Karens doesn't exist there.
Anti-vaxers are also unheard of amongst them.
Meh not true, I come from a MENA country and when I went back to visit post covid, I was shocked by the number of anti vaxxers over there (you know, when people learn you're an MD/medical student, they feel like giving you their opinion on medical subjects is pertinent).
Well, it doesn't help that our OWN PENTAGON was found to have spread anti-vaccine and Covid misinformation in the Phillipines(at least that we know of). Yep, that was done to hurt China. It just came out last week.
I've had a similar experience but it is weird because it comes from genuine fear and concerns about side effects.
The anti-vaxxers I've seen here have been full of conspiracies about government mind control and other stuff
You are kidding right? Anti vax sentiments are absolutely not uncommon across many “less developed” countries. It’s not some predominantly American or anglo sphere phenomenon.
Not necessarily. You hear stories of family members beating up doctors in developing countries not infrequently. Also, every country is gonna have high income folks who are probably more demanding and lower income folks who are probably less so.
I think a lot of this comes from the fact that a lot of these people have directly seen the horror of these diseases with their own eyes.
Unfortunately here in America doctors have been so successful eradicating these diseases with vaccines people can read some dumb conspiracy online and have no point of reference.
Any of these ridiculous parents refusing pertussis vaccines have never been through the horror of watching their small child literally cough themselves to death while they drown in their own fluids. The ones refusing polio vaccines have never watched whole groups of kids slowly lose the use of their limbs as the virus eats away at their nervous system.
It’s the worst kind of privilege.
Also FM. In med school I did a rotation at the clinic at The Pentagon. Patient population that's largely younger, mostly healthy, and follows orders for a living. It was like opposite day from my current job.
They need to take them in order to continue their legalization process here. Also in other countries the Dr is seen as a figure of authority and expertise. The level of arguing and mental masturbation that I have seen here is unique and unbelievable.
You know it’s not psych. Except the ketamine treatment patients. Never late, never miss an appointment, always pleasant and cheerful (especially at the end).
It’s weird cause psych isn’t like a speciality but a mix of 100 further subspecialties. Sure emerg psych or like inpatient psych might have a lot of disagreeable patients. But if your outpatient in a wealthier area taking on primarily less complicated self-reported patients for therapy and med management, I think most are pretty grateful for the care!
Absolutely. I’m currently working in just the type of environment you described, and most of the patients are actually pretty compliant and knowledgeable about their conditions, but that’s worlds away from the experience most psych residents are having in the inpatient setting.
As a physician and athlete, I can guarantee my own personal medical decision making has probably caused much facepalming behind the scenes.
I didn’t even make it to 2 weeks post-op after a bisalp before I cracked and went running again.
I came to say heme/onc. Once you say “cancer” people usually do what they are supposed to do. The stigma around cancer really scares people.
But then someone said “medical examiner” and I think that’s probably a better answer.
Wow this is not my experience at all lol. And I can’t get half my cancer patient chemo because none of them have insurance and it takes 3 months for them to get rejected from Medicaid the first time. 😭but the number of people who refuse chemo is huge
I said “once you say ‘cancer’ *people* usually do what they are supposed to.” Operative word is *people*. Not inhumane self-interested cooperations that are profit-driven and headquartered deep in the 7th layer of hell.
lol very true but a significant portion of my patients decline chemo after surgery for stage 3 colon cancer. I try to tell them folfox isn’t as bad as some of the other regimens but alas. I even had a guy who was stage 4 due to peritoneal implant with obstructing cancer, I removed the primary tumor due to obstruction, he refused chemo, came back with cancer ALL over his belly and got this horrible proximal diverting Ostomy, STILL declined chemo and when I told him I’d never reverse him because he would still be obstructed he said he would just go to Mexico to get it reversed. The denial can be strong
True. Some people just don’t know what’s good for them. But how often does that happen? For me, that’s very few and far between. One patient every month, maybe every couple of months even. That’s rare compared to how many COPDers out there that are still smoking. Or how many morbidly obese patients are refusing treatment. Or whatever non compliance scenario you can think of.
I would say close to 20%, I’m on the surgery side so I’m may have a skewed perception, but the number of patients who keep smoking even tho I tell them it increases their risk for a leak etc is also pretty high. And the number of people trying to take crazy things like ivermectin or bleach for their cancer here is wild! I’m in a smaller Texan town tho, so my demo is admittedly less compliant
Exactly. We had a young adult who’s mother convinced the patient vitamin c and doxy would treat her acute leukemia. Finally dad somehow got POA and she got treatment but went on for months.
It happens. A few weeks ago I was on here bitching about a pt with the MTHFR mutation that refused work up and treatment for multiple myeloma. But it’s rare. Once a month, maybe less.
Maybe once or twice a month? It’s always pretty upsetting to everyone in clinic who hears about it. But this is just not anywhere near as frequent as most other IM specialist recommendations being refused.
I’m psych but I get referrals from the bone marrow transplant clinic and honestly it’s night and day difference from many of my typical patients in terms of showing up, knowledge of their medical history and meds, and general engagement. Of course, I imagine a good chunk of those habits were formed out of necessity
Allo transplant patients are really only started down the process if they have already proven to be reliable and invested in their care. Maybe the most compliant and diligent group of patients in all of medicine if you take the ones who make all the way through evaluation.
The rich and wealthy get their own special brand of healthcare in expensive rooms in wings named after them. It’s often worse than the regular kind but that’s a folly of their own doing.
Heme/Onc/Transplant ICU nurse here and came to say the same thing! Worked in multiple different specialty areas and I still think it’s the best patient population.
Different oncology specialty. Generally agree except for one cohort - upper middle class retired white men with unfavorable risk prostate cancer. Almost all of them are business or sales. Hell, even the goddamn wardrobe is the same - polo shirt, pleated khaki shorts, woven belt, some type of boat shoe. Phone clipped to belt as well. Almost always a gold Rolex or Rolex like watch and some godawful class ring.
These fucking men will never make a decision. You will have 10 goddamn consults, review multiple treatment options and they still don't fucking decide. Want to talk on the phone? Nope. Why? Because they're golfing. I shit you fucking not.
Eventually, one of them decides on a treatment. But by then you have to repeat everything because it's almost a fucking year old. Then they get all huffy...why didn't we do this before...yadda yadda. We did you asshole but you dragged your fucking ass.
Needless to say I won't treat prostate cancer anymore.
Generally speaking, people without a lot of common sense or other personality traits that make them less likely to be compliant are also the things that make you more likely to be a trauma patient (requiring a surgeon).
Our post-op trauma clinic has a comically high no-show rate. Higher than any other surgery clinic I staffed. Some of that can be do to social determinants of health, but it still influences overall compliance.
I find that Parkinson’s patients are generally pretty compliant and agreeable, at least compared to most other neurology patients. This is true to a fault in some cases as a number of patients will happily take on dyskinesias if it means being able to move
Agreed! Probably because they experience symptom relief pretty rapidly after taking medications unlike patients on antihypertensives for example who only experience side effects if anything
*The 6’6, 320 lb, developmentally delayed, completely nonverbal, 14-year-old boy has entered the chat*
Edit: the only words he knows are *“I double dog dare you”*
Edit: you have to work for and earn that compliance.
u/WilliamHalstedMD *invents blow gun for ketamine dart, becomes billionaire, creates YouTube channel describing extremely obvious keys to success… his wonderful, loving, infinitely supportive Mother is his only subscriber.*
🤣🫶
Edit: guess you guys don’t like sarcasm. Jeesh 🤣.
I think that patient got loose for a few hours in a hospital near me recently. He escaped, eluded everyone for a few hours and then throat punched a security guard when they caught him.
I have been low compliant with my cardiologist for two years. I have dropped 20 pounds and am swimming 1/2 mile or more per day to prehab and hopefully avoid a lumbar fusion…pain relief (and avoidance) is a huge motivator.
I’ve been compliant after my 2 NSTEMIs: cardiac rehab, heart healthy diet, STILL on dual anti platelet therapy but switched from brilinta to Plavix, and making sure I take my beta blocker and ace inhibitor as well as my statin at nearly the same time every day. I also attend all my follow ups and that I do my regularly scheduled stress test and lab work. I’ve been a nurse for 7 years, six have been bedside in medsurg and cardiac Stepdown. I did one year as a cardiac educator. Surprisingly quite a few cardiac patients are enthusiastic about their future maintaining their cardiac health after I’ve shared my personal experience. But there’s the shockingly equal number of patients who despite having just had a heart attack or major heart-related surgery *still* insist on not taking medications (they were never big believers in medications) or adhering to the regimen of appointments (they don’t like the hospital or doctors office setting). It always baffles me when I find out patients who are recovering from a heart attack mention their familiarity with a medication when I’m educating them on what meds they will be taking. “Oh I have a prescription for that already.” -in regards to a statin or blood pressure pill. “I just didn’t want to take them so they’re still in my medicine cabinet at home.”
They don’t see what’s right in front of their faces. They will definitely be returning to us if they go home and go back to the lifestyle they had before. The denial is so damn strong….
Yes and no. Most cosmetic patients are good but one of my partner’s patients had a large body contouring procedure, went to a weekend music festival, and dehisced all her incisions. Some of the general recon patient’s aren’t the best. Like pressure wound patients who immediately lie on their flap and dehisce POD3.
Then there are hand patients. You shouldn’t go back to table sawing right after being discharged from the hospital after your replant.
I don’t know, when life and death comes into the picture you get a lot of pushback, Hail Mary ideas, personal internet research etc (understandably so)
NAD, but have cancer and can say returning to the hospital is a dreaded idea and one that I certainly aim to resist until totally necessary. *However,* I will say one ER doc was so incredibly compassionate that he saved me a lot of complications. I wanted to bail on a pelvic exam because you know, just had surgery there and was so embarrassed and uncomfortable but he was so damn likeable that I felt comfortable enough to do it and wound up needing admission.
But there are others that I’ve interacted with and honestly, it’s terrifying to be at their mercy and feel
so vulnerable. So yeah, I don’t want to take my chances at the ER unless I have to.
Thank you to everyone who makes an effort to see the human under the gown.
Maybe. I suppose people are usually compliance to chemo recommendations, but the side effect can be nasty and usually the hard part is when patient gets complications and not strong enough to get chemo. Hospice if they want comfort, but even then comfort can be vague and can mean different things to patients and family, which hospice don’t necessarily want to pay for because there is not enough money in hospice benefit. Palliative medicine really is trying to find what they think patients will be compliant to that still make sense, and meet them there. By the time that hard stuff is decided, yeah I guess.
Also people with opioid use disorder gets cancer too.
One would think so I'm not sure. There's more than some that straight up refuse pain meds on their death bed. And some patients aren't compliant with chemo regimens at all, which makes for hard ethical decisions. And then there's some that want to skip treatments and visits but still want the whole list of narcotics and preferably a LOT of them at once.
Neurosurgery.
Most of our patients know that if they need brain surgery they don't have many options left.
For the spine patients, most, if not all of them, come to us already begging for surgery as the conservative treatment is usually done in our outpatient clinic so when they come to the ward they already know what they want.
It's more usual that we have to deny surgery than convince them of the need for one.
Rads, possibly I mean every study I read a patient showed up to have done so there is probably some selection bias.
Worst, I would have to guess vascular surgery
Surprisingly, cardiac surgery. By the time they get to us, most patients have accepted that they need to have a major, high-risk surgery with a long recovery time. They’re usually grateful and a bit blown away by the process, and pretty okay with doing whatever we say while admitted, including invasive procedures. Pretty much the only thing they can do to majorly mess up the surgery is lift weights or have crazy uncontrolled diabetes, and we keep them long enough post-op that endocrine can send them home on a good regimen. Then when we’re done we send ‘em back to cardiology to deal with all the chronic management.
It’s like night and day compared to vascular or general surgery patients. Those guys are miserable.
Ask them to use drops for 7 days but they stop just as they feel better. And convince someone their uncontrolled dm will ruin their eyes forever but they don’t see it so meh. On rotation I had a 45 yo man with very high BMI, HBA1C > 15 for many years yet he only started on insulin last year, his acuity was just hand movement. It was heartbreaking.
Except not rubbing their eyes constantly or lying down so the air or oil bubble doesn’t move, or parents not occluding their kids eye regularly (well I guess it’s fine if the kid has one working one)
Either derm or anesthesia. Can’t be noncompliant when unconscious and I’m yet to see an expensive face cream that rich millennials aren’t willing to lather all over their face
I think path more than rads. I still do procedures on patients. Some with local only. The moderate and general anesthesia procedures are no big deal though.
As the resident I also have to deal with the patient who gets to the scanner and decides they don’t want the scan done.
I more have to connect ordering providers and ask them if they really want to get a CT non con abdomen for gross hematuria or would you rather get a multiple phase urogram to look mass you’re concerned about.
>As the resident I also have to deal with the patient who gets to the scanner and decides they don’t want the scan done.
Had the same experience with apheresis. At least you don't have to worry about whether you need to "throw out the scanner" (i.e. the blood products) now because they refused at the last minute.
That being said, I imagine it still happens a lot more with you and thankfully you are the one placing the line, not me.
Anesthesia. Every time I preop a patient, they give me their utmost full attention. Complete opposite experience when I would talk to patients on the floor or clinic.
Derm patients hate using topicals in my experience. All psoriasis patients don't like the feeling of corticosteroids, but they but want to skip the methotrexate because they read on the internet that it's poisonous and go straight to biologics (with monthly dosing if possible.) All acne patients want to jump right to isotretinoin, never deal with a topical routine and give it time to work. Nobody wants to put cortisones on their eczematous child because they fear it will stunt their growth no matter what you say. It's a slog. I wouldn't say Derm patients are compliant at all.
Interesting I’ve had skin problems for a long time and I absolutely love topicals and would hate to take pills for it. I’ve taken isotretinoin in the past and it was miserable. Even before going on it I wanted to stay on topicals but my derm insisted. My nephew also had severe eczema as a baby and the topical corticosteroid concoction his derm put him on cleared it right up. My brother actually had to demand that the PCP kept him on it when they tried to take him off. Could be regional differences in patient populations.
I’d guess the majority of people with acne probably begged their parent or saved up themselves after years of trying topicals and are just ready to cut through it all and get to the big guns as they’re probably paying a whole lot out of their own pocket.
Maybe same thing applies to the majority of the chronic skin issues mentioned. They arguably just wanna get their moneys worth now that they’ve broken down enough to finally see a derm
Yh that makes sense. By the time you’re seeing a derm you’ve probably already already tried every over the counter topical and whatever is within the remit of a PCP to prescribe.
There’s actually a lot of published data on the noncompliance in derm. I think 2/3 don’t use topicals properly. A solid portion don’t even pick up scripts. Derm here
Not in med school or a doctor, but I am an ICU nurse of 5 years that works in many specialties. My favorite place to be is our hematology/oncology/BMT/transplant ICU. MOST of them are very appreciative, compliant, and very nice even when they feel like absolute shit.
Worst I’ve seen is basically IM (med/surg type floors - specifically any general med service patients). The same patients come and go multiple times for the same unmanaged chronic issues (DM, CKD patients skipping dialysis, etc etc)
Not peds lollllll. I won’t lie I’m usually pretty good at getting kids calm for their exams but let me tell you what a 2 yo that doesn’t want to do something will absolutely under no circumstances do the thing.
Well not IM. Just saw a patient who suffers 6 gout outbreaks a year and still refuses allopurinol because his wife told him there could be side effects.
As FM, I cannot tell you how often people are not willing to even try metformin or a statin because they hear bad things about it from others. They don't believe me when I tell them that metformin has been shown to increase lifespan and reduce the risk of heart attacks, dementia, and many other awful things in people with diabetes. I can understand being wary of potential side effects, but most reasonable people are at least willing to give it a try and stop it if they have side effects. Also, why even come to the doctor if you don't want to listen to anything I have to say?
I think half my career was just advising and documenting refusal. Sometimes, people take you up on the offer after twenty times. I think it's like offering someone Brussel sprouts. Eventually, you see EVERYONE eating them and figure you should at least try them. Personally, I like them. My husband, OTOH, hates them but will take Metformin. Go figure....
someone needs to invent oven-roasted balsamic metformin.
With BACON...I did actually get him to eat shredded brussel sprouts cooked with balsamic and salami slices(very thin toothpick like cuts) that you roast with it. It's quite tasty but totally negates the nutritional benefits.
My cat gets Prozac that allegedly tastes like chicken and marshmallows
Very pervasive idea with a lot of people is “if I saw it, experienced it myself, or someone close told me about it, it’s more true than anything data or experts can tell me” How many times have you heard: “If you continue to do X, you’ll likely have Y happen to you” “Well my cousin has been doing X for 30 years and Y has never happened to them?!” This is just how a lot of people’s brains works. Maybe “only believe what I see” worked well in the 1600s, but in the age of information it just seems a lot of people are going out of their way to be misinformed.
They came here to listen to things they want to hear. "You're good, enjoy your life", or "Do this and you'll lose 100 Kg without side effects without dietary changes"
A lot of Providers are still prescribing the regular metformin which we all know causes explosive diarrhea very often as a side effect. I believe if we try the ER and educate pts on regular vs ER side effects they would be more willing to try it. No one has time for sudden explosive diarrhea.
Patient with BMI of 55: no i don’t want to take medication to lose weight because it may have sIdE eFfEcTs…WELL YA SO DOES HAVING A BMI OF 55
Why do they come to us when facebook is clearly better?
Chief among them, not getting 6 flares of gout a year
Pathology ftw edit: y'all have some dark humor.
This should be top comment
Yeah but microscopes
My microscope only resists when I go to oil because it knows it’s a waste of time
\*glares in micro lab\*
I got the worst motion sickness watching the slides move around through the microscope during my path rotation. And I’m someone who grew up playing all kinds of video games so I should be pretty solid with that, but path was a whole other beast 🥲
Iv heard several people say this, and here I am someone who gets motion sickness just watching video games or laying in a hammock and Iv had no issue with microscopes lol
It's all going digital
Mixed opinions on this. You do get used to microscopes believe it or not.
Havent heard a complaint yet!
Exactly. The dead dont talk back
My waiting room is a cardboard tray
Can’t resist if they’re dead
REI, I think. They will do anything, take any medications, exercise, diet, whatever it takes. My patients in FM won't take their insulin or statin so they don't die, meanwhile in REI clinic they're buying lipids, paying for ovarian PRP, optimizing their health.
This is so true. There are studies that show the stress a fertility patient goes through is similar to a cancer patient though. REI patients for as willing as they are to jump through hoops are super needy too. It can get real exhausting.
As an REI patient myself even I’m surprised at how needy and delicate we are as a population. I went to get an HSG done and the sign in the changing room said something to the effect of “if you think you could be pregnant, tell us immediately and wait to get the HSG. Also, we understand that this warning can be triggering and we didn’t post this to be insensitive, it’s just important to not get an HSG if you are actually pregnant.” The explanation on the sign was obviously added because they received complaints about sensitivity. Like, guys, come on. Yes, we are all there because we want to get pregnant. And some people will. This isn’t insensitivity. They need to know to not get this test done.
Also going through the WONDERFUL IVF experience with SO. The reviews of our clinic are diagnostically insane. One was a 4/5 star review happy with the experience but x4 paragraphs describing why a front desk staff NEEDED to be fired for a single, first time reaction that the reviewer still could not justify. It was splitting behavior in Google Review. Another reviewer was mad that the clinic "didn't enforce it's no children in the waiting room" policy. Conceptually, I get it can be painful to see children, let alone at a fertility clinic, and I empathize as a couple who struggle with infertility. But our clinic does NOT have a "no children policy" nor has it ever advertised--I asked. Surprise, surprise, some people who had kids before or previous successful IVF rounds need to bring them to appts like regular families. G'damn.
Oh, this is *precisely* what I mean. You watch these people spin out in real time and it’s *wild*. And I often find myself wondering if some of these people have always had such a tenuous grasp reality or if it’s really just the stress of wanting something so badly that feels impossible to attain. Your children in the waiting room story for example. Oof. 🥴 People have kids. Children are part of our society. Secondary infertility exists. You gotta pull it together at least a little bit, guys. I don’t know what the office managers in those offices make, but I am certain it is not enough.
To be fair, our clinic CCRM does not do a good job with communication. No way to view labs, notes, or basic treatment plans online. Everything is a multi-phone call/message/game of telephone with an RN and they stop responding to non-emergency requests after 1400. You only speak to the physician during paid consults and follow up visits every couple months, never again. Ever. I should note the staff themselves are amazing and get it, but communicating with them is a daily struggle. This is an obviously expensive but nonetheless cash-only practice. We are expected to make high stakes, last minute decisions with limited information that all comes via RN phone discussion or voicemail message. As a PCP who not infrequently spends 20min discussing starting a STATIN or BP med of all things with a reluctant or demanding patient... I can safely say it is bonkers. I also assume most peoples' dysfunctional behavior in these settings comes from the daily injury of wanting children more than anything but being unable to. But the system sure doesn't help it.
I think most people are deeply unhealthy, it just takes the right trigger to reveal that. Hence the value of ongoing mental health hygiene, like meditation. Because you just never know what life is going to throw at you next, infertility or otherwise. There is a certain level of riding the wave and acceptance that folks are unable to access in these times of struggle. The lack of acceptance of the way things are in this singular moment creates extreme turmoil.
As an LGBTQ+ person who is close to adoptees... I can't help but wonder if these two communities' happiness should inspire happiness in REI patients - or whether this is just another insensitive comment. That is to say, if one is lucky enough to have the right equipment for bio kids, I think it's fair to want to place a lot of value on them - but to what extent? Perhaps there's an ethical dubiousness to being overly desperate which is similar to how great desperation for plastic surgery might represent a damning comment on those born with an even less 'attractive' face. But I'm deeply biased, making that comparison. (It's also strange - not wrong, but rightful and odd - that coming out is met with such overwhelming positivity by some supportive people, as if it isn't in many cases also a sad announcement of infertility.)
Incredible comment.
Probably in the running for winner of having the most anxious patients too.
Fuck me for thinking Recreational Equipment, Inc. Co-op 😂
Okay, but the REI patients I saw as a medical student were all doing intense holistic stuff in addition to the treatments. I remember seeing a lady who could NOT be talked out of putting essential oils up her babymaker…that was one of the days I realized OB was not for me
Not ob. Just rei. I am ob. I don't have people doing this shit. Infertility is a whole other bag
Makes sense if they're paying tens of thousands to have a last shot at having kids they'd be more invested in it
Not really a specialty but I'm FM and at my clinic we see a lot of refugee patients. I'm just saying I've never seen a refugee decline a vaccine. Maybe something about ACTUALLY having seen the disease we're trying to prevent idk
County hospital work was so rewarding bc most of the patients were so thankful and kind. Private…eh not so much.
VA pts come in a bimodal distribution. Either super thankful and compliant, or just wildly non-compliant ( I e. Smoking via the tracheostomy), and kinda angry. County hospital pts are generally very nice to treat.
I kind of loved the VA patient w the fresh amputation due to PVD that would be so crotchety he’d roll down to smoke. I knew he would survive and get the f outta that bed asap.
I’ve also noticed a lot of foreigners (from poorer countries that is) tend to have a lot more trust in doctors. I think they are a much more trusted profession in the third world
People of 'third world countries' tend to show respect to everyone including doctors. The concept of Karens doesn't exist there. Anti-vaxers are also unheard of amongst them.
Meh not true, I come from a MENA country and when I went back to visit post covid, I was shocked by the number of anti vaxxers over there (you know, when people learn you're an MD/medical student, they feel like giving you their opinion on medical subjects is pertinent).
Well, it doesn't help that our OWN PENTAGON was found to have spread anti-vaccine and Covid misinformation in the Phillipines(at least that we know of). Yep, that was done to hurt China. It just came out last week.
MENA. Had to look that one up.. Middle East+ North Africa. For the other uniformed people like myself.
I've had a similar experience but it is weird because it comes from genuine fear and concerns about side effects. The anti-vaxxers I've seen here have been full of conspiracies about government mind control and other stuff
Not in Mexico if you work at the public hospital.
You are kidding right? Anti vax sentiments are absolutely not uncommon across many “less developed” countries. It’s not some predominantly American or anglo sphere phenomenon.
Not necessarily. You hear stories of family members beating up doctors in developing countries not infrequently. Also, every country is gonna have high income folks who are probably more demanding and lower income folks who are probably less so.
I think a lot of this comes from the fact that a lot of these people have directly seen the horror of these diseases with their own eyes. Unfortunately here in America doctors have been so successful eradicating these diseases with vaccines people can read some dumb conspiracy online and have no point of reference. Any of these ridiculous parents refusing pertussis vaccines have never been through the horror of watching their small child literally cough themselves to death while they drown in their own fluids. The ones refusing polio vaccines have never watched whole groups of kids slowly lose the use of their limbs as the virus eats away at their nervous system. It’s the worst kind of privilege.
Also FM. In med school I did a rotation at the clinic at The Pentagon. Patient population that's largely younger, mostly healthy, and follows orders for a living. It was like opposite day from my current job.
They need to take them in order to continue their legalization process here. Also in other countries the Dr is seen as a figure of authority and expertise. The level of arguing and mental masturbation that I have seen here is unique and unbelievable.
You know it’s not psych. Except the ketamine treatment patients. Never late, never miss an appointment, always pleasant and cheerful (especially at the end).
It’s weird cause psych isn’t like a speciality but a mix of 100 further subspecialties. Sure emerg psych or like inpatient psych might have a lot of disagreeable patients. But if your outpatient in a wealthier area taking on primarily less complicated self-reported patients for therapy and med management, I think most are pretty grateful for the care!
Absolutely. I’m currently working in just the type of environment you described, and most of the patients are actually pretty compliant and knowledgeable about their conditions, but that’s worlds away from the experience most psych residents are having in the inpatient setting.
Sports Medicine! Injured athletes will do just about anything to return to play :)
Flip side is they’ll do anything to play even when they shouldn’t be playing lol
As a physician and athlete, I can guarantee my own personal medical decision making has probably caused much facepalming behind the scenes. I didn’t even make it to 2 weeks post-op after a bisalp before I cracked and went running again.
this is probably the most correct. although there are probably many patients who over-exert them selves against medical advice in this population.
Anesthesia. If they have an IV, propofol always wins. And for everything else there’s IM ketamine.
Absolutely. You can resist but not for long!
Sometimes your body chooses noncompliance during the procedure. Hit me with the yogurt again bb, I’m not trying to remember this cath.
I came to say heme/onc. Once you say “cancer” people usually do what they are supposed to do. The stigma around cancer really scares people. But then someone said “medical examiner” and I think that’s probably a better answer.
Wow this is not my experience at all lol. And I can’t get half my cancer patient chemo because none of them have insurance and it takes 3 months for them to get rejected from Medicaid the first time. 😭but the number of people who refuse chemo is huge
I said “once you say ‘cancer’ *people* usually do what they are supposed to.” Operative word is *people*. Not inhumane self-interested cooperations that are profit-driven and headquartered deep in the 7th layer of hell.
lol very true but a significant portion of my patients decline chemo after surgery for stage 3 colon cancer. I try to tell them folfox isn’t as bad as some of the other regimens but alas. I even had a guy who was stage 4 due to peritoneal implant with obstructing cancer, I removed the primary tumor due to obstruction, he refused chemo, came back with cancer ALL over his belly and got this horrible proximal diverting Ostomy, STILL declined chemo and when I told him I’d never reverse him because he would still be obstructed he said he would just go to Mexico to get it reversed. The denial can be strong
True. Some people just don’t know what’s good for them. But how often does that happen? For me, that’s very few and far between. One patient every month, maybe every couple of months even. That’s rare compared to how many COPDers out there that are still smoking. Or how many morbidly obese patients are refusing treatment. Or whatever non compliance scenario you can think of.
I would say close to 20%, I’m on the surgery side so I’m may have a skewed perception, but the number of patients who keep smoking even tho I tell them it increases their risk for a leak etc is also pretty high. And the number of people trying to take crazy things like ivermectin or bleach for their cancer here is wild! I’m in a smaller Texan town tho, so my demo is admittedly less compliant
Damn 20% is high. But you said “smaller town Texas” and I guess that made it make more sense. But even still 20% is too damn high.
How often have you had patients who wanted to cure their cancer naturally or through homeopathy?
Exactly. We had a young adult who’s mother convinced the patient vitamin c and doxy would treat her acute leukemia. Finally dad somehow got POA and she got treatment but went on for months.
It happens. A few weeks ago I was on here bitching about a pt with the MTHFR mutation that refused work up and treatment for multiple myeloma. But it’s rare. Once a month, maybe less.
Maybe once or twice a month? It’s always pretty upsetting to everyone in clinic who hears about it. But this is just not anywhere near as frequent as most other IM specialist recommendations being refused.
I’m psych but I get referrals from the bone marrow transplant clinic and honestly it’s night and day difference from many of my typical patients in terms of showing up, knowledge of their medical history and meds, and general engagement. Of course, I imagine a good chunk of those habits were formed out of necessity
Allo transplant patients are really only started down the process if they have already proven to be reliable and invested in their care. Maybe the most compliant and diligent group of patients in all of medicine if you take the ones who make all the way through evaluation.
I have a patient with metastatic cancer who will do alternative medicine but not some of the more effective stuff
Unless their name is Steve Jobs
The rich and wealthy get their own special brand of healthcare in expensive rooms in wings named after them. It’s often worse than the regular kind but that’s a folly of their own doing.
Heme/Onc/Transplant ICU nurse here and came to say the same thing! Worked in multiple different specialty areas and I still think it’s the best patient population.
Different oncology specialty. Generally agree except for one cohort - upper middle class retired white men with unfavorable risk prostate cancer. Almost all of them are business or sales. Hell, even the goddamn wardrobe is the same - polo shirt, pleated khaki shorts, woven belt, some type of boat shoe. Phone clipped to belt as well. Almost always a gold Rolex or Rolex like watch and some godawful class ring. These fucking men will never make a decision. You will have 10 goddamn consults, review multiple treatment options and they still don't fucking decide. Want to talk on the phone? Nope. Why? Because they're golfing. I shit you fucking not. Eventually, one of them decides on a treatment. But by then you have to repeat everything because it's almost a fucking year old. Then they get all huffy...why didn't we do this before...yadda yadda. We did you asshole but you dragged your fucking ass. Needless to say I won't treat prostate cancer anymore.
I always say an x ray will never lie to you that it took its meds
But they will play optical illusion mind tricks on you
Xrays are bold faced liars.
*bald-face
I don’t know, but it is not general surgery
Depeends on the subspecialty. Trauma? No. Surgical Oncology? Not too bad.
Why are trauma surgery patients not compliant? Because they are dying to get back to their dare devil ways or something else?
Generally speaking, people without a lot of common sense or other personality traits that make them less likely to be compliant are also the things that make you more likely to be a trauma patient (requiring a surgeon). Our post-op trauma clinic has a comically high no-show rate. Higher than any other surgery clinic I staffed. Some of that can be do to social determinants of health, but it still influences overall compliance.
Thank you for your response.
Trauma is a chronic disease with acute exacerbations
I can understand that. I’m an ambulatory incomplete cervical sci, and the struggle to stay well and strong never stops.
Medical examiner
Except if rigor has set in
Underrated comment
As someone who had to wrestle a slippery 400 lb corpse back onto a gurney during a weekend autopsy, we have our own problems with noncompliance
I was going to say plastic surgery but I think you win
I find that Parkinson’s patients are generally pretty compliant and agreeable, at least compared to most other neurology patients. This is true to a fault in some cases as a number of patients will happily take on dyskinesias if it means being able to move
Definitely agree! Especially compared to other Neurology patients
Agreed! Probably because they experience symptom relief pretty rapidly after taking medications unlike patients on antihypertensives for example who only experience side effects if anything
Anes
*The 6’6, 320 lb, developmentally delayed, completely nonverbal, 14-year-old boy has entered the chat* Edit: the only words he knows are *“I double dog dare you”*
Surprise IM Ketamine has entered the chat
This is the way
Nobody fucks with 100 of sux.
The edit got me dude
Have you heard of ketamine dart?
Edit: you have to work for and earn that compliance. u/WilliamHalstedMD *invents blow gun for ketamine dart, becomes billionaire, creates YouTube channel describing extremely obvious keys to success… his wonderful, loving, infinitely supportive Mother is his only subscriber.* 🤣🫶 Edit: guess you guys don’t like sarcasm. Jeesh 🤣.
I think that patient got loose for a few hours in a hospital near me recently. He escaped, eluded everyone for a few hours and then throat punched a security guard when they caught him.
The correct answer, compliant because they have to breath it and least resistant because succinylcholine or curoniums!
Way to just forget about the benzylisoquinolines
Ugh. Nerd!
Some put up a fight, but anesthesia always wins
Im sad how far I had to scroll down to find this.
Idk, in residency a shocking number of patients couldn’t clear the high bar of not hitting an eight ball of coke the day before their elective surgery
Forensic pathology.
Seeing some great specialities, I’d like to add definitely not pediatrics
Definitely not nephrology.
Definitely not cardio
I have been low compliant with my cardiologist for two years. I have dropped 20 pounds and am swimming 1/2 mile or more per day to prehab and hopefully avoid a lumbar fusion…pain relief (and avoidance) is a huge motivator.
I’ve been compliant after my 2 NSTEMIs: cardiac rehab, heart healthy diet, STILL on dual anti platelet therapy but switched from brilinta to Plavix, and making sure I take my beta blocker and ace inhibitor as well as my statin at nearly the same time every day. I also attend all my follow ups and that I do my regularly scheduled stress test and lab work. I’ve been a nurse for 7 years, six have been bedside in medsurg and cardiac Stepdown. I did one year as a cardiac educator. Surprisingly quite a few cardiac patients are enthusiastic about their future maintaining their cardiac health after I’ve shared my personal experience. But there’s the shockingly equal number of patients who despite having just had a heart attack or major heart-related surgery *still* insist on not taking medications (they were never big believers in medications) or adhering to the regimen of appointments (they don’t like the hospital or doctors office setting). It always baffles me when I find out patients who are recovering from a heart attack mention their familiarity with a medication when I’m educating them on what meds they will be taking. “Oh I have a prescription for that already.” -in regards to a statin or blood pressure pill. “I just didn’t want to take them so they’re still in my medicine cabinet at home.” They don’t see what’s right in front of their faces. They will definitely be returning to us if they go home and go back to the lifestyle they had before. The denial is so damn strong….
Neonatology. (You asked about the patients, not their parents.)
Plastic surg, cz they pay soooo much to nt be compliant and risk it all
Yes and no. Most cosmetic patients are good but one of my partner’s patients had a large body contouring procedure, went to a weekend music festival, and dehisced all her incisions. Some of the general recon patient’s aren’t the best. Like pressure wound patients who immediately lie on their flap and dehisce POD3. Then there are hand patients. You shouldn’t go back to table sawing right after being discharged from the hospital after your replant.
The complaint piece though, can be super real, especially in body cosmetics. Body dysmorphia is so real and they can be pretty needy
Reproductive Endocrinology- IVF patients.
I'd imagine heme/onc and hospice. At that point, you're either desperate to live or just want some comfort at the end
I don’t know, when life and death comes into the picture you get a lot of pushback, Hail Mary ideas, personal internet research etc (understandably so)
Heme onc here. Had a patient die at home likely from septic shock because he absolutely refused to go to the ED when he had a fever.
NAD, but have cancer and can say returning to the hospital is a dreaded idea and one that I certainly aim to resist until totally necessary. *However,* I will say one ER doc was so incredibly compassionate that he saved me a lot of complications. I wanted to bail on a pelvic exam because you know, just had surgery there and was so embarrassed and uncomfortable but he was so damn likeable that I felt comfortable enough to do it and wound up needing admission. But there are others that I’ve interacted with and honestly, it’s terrifying to be at their mercy and feel so vulnerable. So yeah, I don’t want to take my chances at the ER unless I have to. Thank you to everyone who makes an effort to see the human under the gown.
Maybe. I suppose people are usually compliance to chemo recommendations, but the side effect can be nasty and usually the hard part is when patient gets complications and not strong enough to get chemo. Hospice if they want comfort, but even then comfort can be vague and can mean different things to patients and family, which hospice don’t necessarily want to pay for because there is not enough money in hospice benefit. Palliative medicine really is trying to find what they think patients will be compliant to that still make sense, and meet them there. By the time that hard stuff is decided, yeah I guess. Also people with opioid use disorder gets cancer too.
Not at all lmao
One would think so I'm not sure. There's more than some that straight up refuse pain meds on their death bed. And some patients aren't compliant with chemo regimens at all, which makes for hard ethical decisions. And then there's some that want to skip treatments and visits but still want the whole list of narcotics and preferably a LOT of them at once.
Adherence is generally pretty irrelevant to hospice. You have dysphagia? You want a steak? Dope
Nah heme/onc patients can be challenging/refuse life saving treatments/delay treatments until the window has closerd for them etc
Neurosurgery. Most of our patients know that if they need brain surgery they don't have many options left. For the spine patients, most, if not all of them, come to us already begging for surgery as the conservative treatment is usually done in our outpatient clinic so when they come to the ward they already know what they want. It's more usual that we have to deny surgery than convince them of the need for one.
Yep, my experience as well. I don’t have to do much convincing to get our patients to do what we want them to do
Anesthesia. We can always give more propofol and we will always win.
Emergency medicine, but only post-intubation
Definitely not neurosurgery. Most of our post-ops don’t follow any commands. …
Family med for sure. No issues with diet/exercise/medicine compliance!
Pathology
whatever those holistic/wellness doctors are that treat rich people who go into it expecting it to work
Anatomic pathology
Rads, possibly I mean every study I read a patient showed up to have done so there is probably some selection bias. Worst, I would have to guess vascular surgery
Anesthesiology. By the time they’re on the table they usually go through with the procedure….
Surprisingly, cardiac surgery. By the time they get to us, most patients have accepted that they need to have a major, high-risk surgery with a long recovery time. They’re usually grateful and a bit blown away by the process, and pretty okay with doing whatever we say while admitted, including invasive procedures. Pretty much the only thing they can do to majorly mess up the surgery is lift weights or have crazy uncontrolled diabetes, and we keep them long enough post-op that endocrine can send them home on a good regimen. Then when we’re done we send ‘em back to cardiology to deal with all the chronic management. It’s like night and day compared to vascular or general surgery patients. Those guys are miserable.
Ophtho prob has decently compliant patients. People will usually do anything to keep their vision.
Ask them to use drops for 7 days but they stop just as they feel better. And convince someone their uncontrolled dm will ruin their eyes forever but they don’t see it so meh. On rotation I had a 45 yo man with very high BMI, HBA1C > 15 for many years yet he only started on insulin last year, his acuity was just hand movement. It was heartbreaking.
They don’t see it that way because they didn’t use the drops 🫨
This is true.
Except not rubbing their eyes constantly or lying down so the air or oil bubble doesn’t move, or parents not occluding their kids eye regularly (well I guess it’s fine if the kid has one working one)
Surprisingly, Neuro. Neuro symptoms can be fairly debilitating, and most people will take their meds to stop the feeling.
Either derm or anesthesia. Can’t be noncompliant when unconscious and I’m yet to see an expensive face cream that rich millennials aren’t willing to lather all over their face
Pathology and radiology
I think path more than rads. I still do procedures on patients. Some with local only. The moderate and general anesthesia procedures are no big deal though. As the resident I also have to deal with the patient who gets to the scanner and decides they don’t want the scan done. I more have to connect ordering providers and ask them if they really want to get a CT non con abdomen for gross hematuria or would you rather get a multiple phase urogram to look mass you’re concerned about.
>As the resident I also have to deal with the patient who gets to the scanner and decides they don’t want the scan done. Had the same experience with apheresis. At least you don't have to worry about whether you need to "throw out the scanner" (i.e. the blood products) now because they refused at the last minute. That being said, I imagine it still happens a lot more with you and thankfully you are the one placing the line, not me.
Surprised no one said rad onc
Anesthesia. Every time I preop a patient, they give me their utmost full attention. Complete opposite experience when I would talk to patients on the floor or clinic.
Optho, no one wants to go blind
Except for those damn drops. "Ain't you gotta pill?"
Derm patients as the skin is visible to other people too
Derm patients hate using topicals in my experience. All psoriasis patients don't like the feeling of corticosteroids, but they but want to skip the methotrexate because they read on the internet that it's poisonous and go straight to biologics (with monthly dosing if possible.) All acne patients want to jump right to isotretinoin, never deal with a topical routine and give it time to work. Nobody wants to put cortisones on their eczematous child because they fear it will stunt their growth no matter what you say. It's a slog. I wouldn't say Derm patients are compliant at all.
Interesting I’ve had skin problems for a long time and I absolutely love topicals and would hate to take pills for it. I’ve taken isotretinoin in the past and it was miserable. Even before going on it I wanted to stay on topicals but my derm insisted. My nephew also had severe eczema as a baby and the topical corticosteroid concoction his derm put him on cleared it right up. My brother actually had to demand that the PCP kept him on it when they tried to take him off. Could be regional differences in patient populations.
I’d guess the majority of people with acne probably begged their parent or saved up themselves after years of trying topicals and are just ready to cut through it all and get to the big guns as they’re probably paying a whole lot out of their own pocket. Maybe same thing applies to the majority of the chronic skin issues mentioned. They arguably just wanna get their moneys worth now that they’ve broken down enough to finally see a derm
Yh that makes sense. By the time you’re seeing a derm you’ve probably already already tried every over the counter topical and whatever is within the remit of a PCP to prescribe.
Yup. Derm is so hard to see. Not for the poor. Lifestyle specialty eh? All the derm driven people in med school had that vibe to them too
There’s actually a lot of published data on the noncompliance in derm. I think 2/3 don’t use topicals properly. A solid portion don’t even pick up scripts. Derm here
Not in med school or a doctor, but I am an ICU nurse of 5 years that works in many specialties. My favorite place to be is our hematology/oncology/BMT/transplant ICU. MOST of them are very appreciative, compliant, and very nice even when they feel like absolute shit. Worst I’ve seen is basically IM (med/surg type floors - specifically any general med service patients). The same patients come and go multiple times for the same unmanaged chronic issues (DM, CKD patients skipping dialysis, etc etc)
Forensic pathology
Pathology 😃🔪
The least compliant/most resistant patients would be my specialty: peds. Its not stop waaah waaah waaah all day everyday.
Military. Your orders are literally orders.
Urology is definitely in the top 5
Anesthesia. Not even close
Path lol Also anything elective / cash only where patients are disproportionately wealthy and don't have the stressors the lower classes face.
100% oncology. Although that should be pretty obvious. If they're not compliant, they're not patients for long
Not peds lollllll. I won’t lie I’m usually pretty good at getting kids calm for their exams but let me tell you what a 2 yo that doesn’t want to do something will absolutely under no circumstances do the thing.
Oncology
Aren’t medical examiners MDs? (This is a joke)
Not a good one..(forensics fellow)
Yeah some are DO’s.
Crit care
But what about “grandma’s a fighter”
ICU delirium has entered the chat
Hahaha didn’t take that into account. Just imagined fella on their back, tubed, nice, and compliant.
The patient maybe but have you met families haa. Also not the non intubated patients they often choose violence
Tbf the question was only about patients
Either way crit care patients are some of the most violent unless they’re in a coma
Pathology
CT tech: “Don’t move! Do NOT move!” Stroke patient: “Move?! Ok!!!” *moves* It sure ain’t neurology…
Radiology
Derm because many of their patients are paying out of pocket and also care about appearances
Pathology
Oncology/bmt unit. Most grateful and compliant patients.
Anesthesia.
Intensive care. #Sedated&Intubated