Got a medical question? Let me stretch my brain.

11-15-2009, 02:39 AM

As many of you probably know....I am a physician type. Family medicine more specifically. Military to be even more specific.

Well, I am involved in a constant effort to keep my clinical knowledge up to date, and less rusty. I read/listen to many sources, developing/maintaining my skills to stay at the level of a "competent generalist". In the military its a bit tough though because my patient base is just too healthy until they get blown up, then its mostly meat and bone carpentry and then shuttle quickly to the surgeon.

So, I help my friends (thats all of you) alot (probably more than most other physicians). A) it helps my skills, B) it hopefully helps out my friends, C) because of my situation (doc starving for the challenge in the face of healthy patients) it helps me feel better about myself. D) I am an attention whore.

Thus, I thought it might be good to open up a thread where you, my BOTLs/SOTLs, can throw out some concerns and I can see what I can do.

Disclaimers:
1) I can't promise you specialist knowledge. Depending on the question I may throw down what I already know and leave it at that. Or, maybe I will research it to a level I am happy with and then throw down what I have learned. Or, maybe I won't have much to put down about it and that is what you will have to settling with.

2) Anything I throw down here is to be taken for what it is....someone you don't really know (for all many of you know I am a 12 year old pretending to be a doc), fielding questions I may not be qualified to answer. NEVER take what you read here as gospel. If its serious, if its important, you should still see your doctor.

3) I am not always available. I get shipped around alot, spend long times without internet access. I am also orchestrating a big career change in the next 7-8 months (releasing from military, developing a civi practice, renovating a house, parenting children, being a good spouse, selling/buying a house, moving, prepping for the new practice). If I am not responding, maybe I never will.

4) This thread is an experiment. If life gets out of hand or things get too crazy in this thread I may abandon it. I will probably make that known though before it happens.

5) Once again...this thread should not count as your only medical consultation. I cannot refer you to specialists, I cannot determine the "all important" aspects of the situtation without actually being present with you. You probably don't realize how much of medicine is about the intuitive aspects of this situation. Body language, physical traits, they way things get said in a face-to-face encounter have HUGE importance in the evaluation of the situation. I could easily miss major important elements simply by not being in the same room with you, watching you as you describe your issue. Certainly physical exam is impossible, as would diagnostic testing. Finally, I can't start treatments, or even guarantee I will discribe the treatments best suited; once again, intuitive reasoning goes a long way here.

6) This is an advice column. Most advice columns are full of BS. Don't expect more. While I try to stay current and "evidence based", medicine is too big for everything to be based on well-worked out science. As a generalist I try to keep up, but its all too much, so my evidence based knowledge is going to be pathetic in orthopedics compared to an orthopedic surgeon. Its always possible that I may spout out "establish wisdom" in a sub-field of medicine that has already been proven wrong 10 years ago.

Scared you away yet?

And, with that, shoot out your questions and I will see what I can do. Ultimately this is probably going to take the form of a banter thread (in certain ways).

Cheers

Cy

PS: three out or every two people don't know how to handle statistics. Even worse, five out of four people misquote their statistics. I am no different. But, I take stats with a grain of salt. Telling you that condoms are 97-99% effective means that I don't really have the number memorized and that I don't really see the need to more accurate than that anyway....it means condoms are good (unless you are trying to stop herpes, which case they are only 30% effective)

11-15-2009, 02:39 AM	#1
Cyanide Guest Posts: n/a	Got a medical question? Let me stretch my brain. As many of you probably know....I am a physician type. Family medicine more specifically. Military to be even more specific. Well, I am involved in a constant effort to keep my clinical knowledge up to date, and less rusty. I read/listen to many sources, developing/maintaining my skills to stay at the level of a "competent generalist". In the military its a bit tough though because my patient base is just too healthy until they get blown up, then its mostly meat and bone carpentry and then shuttle quickly to the surgeon. So, I help my friends (thats all of you) alot (probably more than most other physicians). A) it helps my skills, B) it hopefully helps out my friends, C) because of my situation (doc starving for the challenge in the face of healthy patients) it helps me feel better about myself. D) I am an attention whore. Thus, I thought it might be good to open up a thread where you, my BOTLs/SOTLs, can throw out some concerns and I can see what I can do. Disclaimers: 1) I can't promise you specialist knowledge. Depending on the question I may throw down what I already know and leave it at that. Or, maybe I will research it to a level I am happy with and then throw down what I have learned. Or, maybe I won't have much to put down about it and that is what you will have to settling with. 2) Anything I throw down here is to be taken for what it is....someone you don't really know (for all many of you know I am a 12 year old pretending to be a doc), fielding questions I may not be qualified to answer. NEVER take what you read here as gospel. If its serious, if its important, you should still see your doctor. 3) I am not always available. I get shipped around alot, spend long times without internet access. I am also orchestrating a big career change in the next 7-8 months (releasing from military, developing a civi practice, renovating a house, parenting children, being a good spouse, selling/buying a house, moving, prepping for the new practice). If I am not responding, maybe I never will. 4) This thread is an experiment. If life gets out of hand or things get too crazy in this thread I may abandon it. I will probably make that known though before it happens. 5) Once again...this thread should not count as your only medical consultation. I cannot refer you to specialists, I cannot determine the "all important" aspects of the situtation without actually being present with you. You probably don't realize how much of medicine is about the intuitive aspects of this situation. Body language, physical traits, they way things get said in a face-to-face encounter have HUGE importance in the evaluation of the situation. I could easily miss major important elements simply by not being in the same room with you, watching you as you describe your issue. Certainly physical exam is impossible, as would diagnostic testing. Finally, I can't start treatments, or even guarantee I will discribe the treatments best suited; once again, intuitive reasoning goes a long way here. 6) This is an advice column. Most advice columns are full of BS. Don't expect more. While I try to stay current and "evidence based", medicine is too big for everything to be based on well-worked out science. As a generalist I try to keep up, but its all too much, so my evidence based knowledge is going to be pathetic in orthopedics compared to an orthopedic surgeon. Its always possible that I may spout out "establish wisdom" in a sub-field of medicine that has already been proven wrong 10 years ago. Scared you away yet? And, with that, shoot out your questions and I will see what I can do. Ultimately this is probably going to take the form of a banter thread (in certain ways). Cheers Cy PS: three out or every two people don't know how to handle statistics. Even worse, five out of four people misquote their statistics. I am no different. But, I take stats with a grain of salt. Telling you that condoms are 97-99% effective means that I don't really have the number memorized and that I don't really see the need to more accurate than that anyway....it means condoms are good (unless you are trying to stop herpes, which case they are only 30% effective)