2012 conventions 2012 election 2013 session arts arts and culture author ballot measures basketball bomb books boy scouts budget bullying business charlie hales children clackamas climate change coal college courts crime culture culture club democrats drugs economy education environment family film fluoride food gay rights guns handguns health health care health insurance high school history housing immigration internet kitzhaber law legislature lgbt literary arts living marijuana marriage media medicine mental health military minor parties mohamed mohamud movies music native americans news newspaper obama olympics oregon our town parenting pers photography police politcs politics port portland portland business journal president prevention public safety religion republicans rnc romney rural salem sam adams sandy hook schools science shooting sports suicide supreme court taxes technology terrorism theater third parties transportation union university of oregon washington wildfire women

My 2 cents as an MD:

1) I, to be honest, resent the implication that all us "docs" are interchangable.  I think NDs and DCs all bring in unique skills to patient care, but I also think the training (and pre-training) to become an MD far exceeds the other doctors.  I understand you sit in the same classes and have some of the same professors, but my hardest training years by far were the 3 clinical years in medical school and 3 clinical years in residency.  In addition to daily office hours, we worked on-call in the hospital on average 1:3 nights.  MDs bring to the outpatient setting a large skill set learned by taking care of acutely ill people at all hours of the day.  How many NDs have had to pronounce a death, or had a phone call from the ICU where your answers can have an immediate life or death consequence?  How many have spinal tapped a 6 month old in the ER or laid in a hospital call room going over your decisions of the day, wondering if you made any mistakes.  12 years into private practice I still take call 1:3.5 nights, being awakened at all hours to talk with and see sick adults and kids.  Do the NDs plan to be available 24 hours on call?  Because we MD primary call docs are. I think unless you've seen people at their worst, seen how a fever from yesterday turned into florrid sepsis today, or the neck pain turned into a cerebral dissection, that you are missing an important part of the clinical skill set that is needed even in the mundane world of outpatient medicine.  If you aren't familiar with and haven't had to manage the serious outcomes of "common" problems, you don't know the whole story, and your clinical skills are worse for it.  Those hours upon hours of clinic and hospital work in training teach you to recognize disease in its multi-varied presentations, and ensure that you see enough of the "exotic" presentations so that you don't miss them the next time they come up.  I don't want to harp on anecdotal experiences, but a recent young male patient of mine with facial swelling was told by a local ND he had "toxin build up" and sold $80 worth of vitamins.  He, in fact, had a lymphoma constricting his SVC which thankfully was diagnosed with conventional medicine.

(continued below if possible)

posted 3 years, 11 months ago
view in context