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Rectal Exams

·432 words·3 mins

From Trust Me, I'm a Doctor:

I've quit doing screening rectal exams. Unfortunately, it takes more time to tell the patient why we don't need to do it than just getting it over with.

He's right.  The PSA conversation takes 20 minutes, but just ordering it takes about 20 seconds.  No wonder so many physicians just to the rectal and the PSA and .. treat bronchitis with antibiotics. 

My nurse complained to my wife yesterday that I take too much time with my patients.  She's right that I do.  But shouldn't I explain things?  She asks "what in the world are you doing in there for so long?" 

I'm mostly listening - but sometimes I'm explaining.

We physicians do a rotten job in general to explain things to people.  we use this secret language to communicate with eath other.  We learned it in medical school, and some of us forgot how to actually speak English when we graduated.

"Mrs Jones, you have microcytic anemia and your ferretin is decreased.  YOu need to take the feso4 tid.  We'll check a CBC in a month."    No kidding .. I've seen it this bad.  

Of course in my "other job"  (of which I rarely speak here, it seems) I see this even worse.   I work with computers in a hospital.  It's a bit more complicated than that -- but -- you get the idea , right? 

Computer people are worse at the translation from their secret language than physicians.   Interacting with humans was never a required component of their education like it is in medical school (albeit a small component).  So it is rare to find someone in technology who communicates well with "the other side."  Today was no different - and I felt bad reminding them again how speak English instead of TecnoSpeak.   

When I teach medical students how to un-learn the DoctorSpeak - they are appreciative and - yes - a bit ashamed.  I don't mean to make them feel silly - but sometimes when we have a student in the office and we're in a room together with a patient and the student says "do you have any dysuria?" and  I say to the patient "did you understand that?" and the patient says "no" and I ask the student to try again and they say "does it hurt when you pee?"  And we all wonder why the "dysuria" question would EVER be asked.  But it is .. very often.

Maybe the poor student has just finished surgery where some jerk told them that it's important to "be precise with your language."  ugh.