Thursday, February 2, 2017

Yet another new medical TV drama

“'The Resident’ follows an idealistic young doctor who begins his first day under the supervision of a tough, brilliant senior resident who pulls the curtain back on all of the good and evil in modern day medicine.” So says the article announcing Fox’s pilot for a new medical TV show.

As opposed to all the other medical dramas, this one features an idealistic young doctor and a tough, brilliant supervisor. How original.

I tweeted the show's premise and got several humorous replies prompting me to write this post.

There is no such thing as an original medical show. Original would be a resident sitting in front of a computer 75 percent of the time and then leaving the hospital in the middle of a great case because of work hour restrictions. While at home he plays video games for five straight hours.

Someone wondered if “The Resident” would find romance—possibly in a convenient storage closet. I wouldn’t know about that because I trained at a Catholic hospital.

Another asked if there would be a tough staff with soft hearts, a hospital administrator who put profit before patients, a second-generation physician who cracks under pressure, and a renegade doctor who breaks all the rules but saves the day.

What about a show with overworked, stressed, but oh-so-average attending physicians and idealistic, but basically inept residents?

I’d like to pitch an idea. It’s called “The Administrator” and follows an idealistic young deputy assistant junior vice president who begins his first day under the supervision of a tough, brilliant hospital CEO who pulls the curtain back on all of the evil and none of the good in modern day medicine.

Think of all the dramatic meetings involving committees, ad hoc committees, lean, six sigma, budgets, root cause analyses, public relations, whether to buy a third robot, and so much more. True to life, the administrators never leave the C-suite*.

*C-suite (def): A widely-used slang term collectively referring to a corporation's most important senior executives. C-Suite gets its name because top senior executives' titles tend to start with the letter C, for chief, as in chief executive officer, chief operating officer and chief information officer. [From Investopedia]

Thanks to the Twitter folks who contributed: @smootholdfart, @DrDes1970, @geekpharm, @JessicaDeMost, @DrMikeSimpson, @jsekharan, @mjaeckel


Anonymous said...

Make sure said junior exec makes the pay of an ob/gyn after a year or two ...

{choking that down}

Skeptical Scalpel said...

Only what an OB/GYN makes? That wouldn't nearly be enough.

William Reichert said...

Make sure you have a recent 22 y.o.grad who majored in communications telling nurses with 15 years of ICU experience how to work more efficiently. They react understandably and are fired.\
Make a special effort to have a CEO complain to the hospital board that the physicians dont practice cost efficient medicine. Then show a doc asking the CEO for a list of what things cost and be told by the CEO, "I don't know what things cost at our hospital, sorry." Later, neither does the CFO for that at matter.Show the doc getting initially confused and then angry by these answers and be criticized for not being a "team player".

artiger said...

So much sarcasm, so little time..

How about following a resident around while he/she performs an abundance of scut work, while being intermittently chastised for poor In-Training exam scores and not being able to apply lessons learned from patient care?

Even better...a reality show that follows a high school educated clerk that works for a health insurance company, spending his/her days coming up with new and creative ways of denying authorizations for necessary tests and procedures, with particular focus on making the requesting physician or practitioner feel as stupid and guilty as possible for having the audacity to pretend to know what might be medically necessary? They could roll the closing credits showing the clerks gathering at a bar, drinking and laughing while sharing stories about all the anger they stirred up amongst the physicians they dealt with, as well as the bonuses they earned that day by saving the company money.

I could go on forever.

William Reichert said...

I almost forgot (how could I?). Have the CEO of the hospital have a meeting with a doc and ask the doc why he told a patient that the patient was too fat to be handled at the CEO's hospital and
had to be Xrayed at another hospital . It was because only the outside CT Scanner could support the patient's 456 pounds without crashing to the floor. After being chastised, the doc can
be seen asking other docs how to inform the patient of the reason for the transfer without hurting his feelings. Lots of interesting suggestions are offered ....

Skeptical Scalpel said...

William and Artiger, you've just about given me enough material for another blog post. Great stuff.

William Reichert said...

I've got more. Today I went to my MD for a check up. He said,"on the way out set up an appt. for 3 months." I went to the appt desk
and asked for a appt in "3 months". She said,"that is too far out.
I will give you an appt in March to come back and make an appt.
for May". The patient , a physician, leaves the office and begins
to question his sanity or his mind. "May be I am losing my mind",he thinks, "what I just think I heard must have been an
auditory seizure or paranoid delusion." He starts to sob. "It is all over for me", he decides.

Skeptical Scalpel said...

William, that's a beauty.

Anonymous said...

Another student killed himself this week. Grats on furthering your mission of removing the weakness from our future residents.

Anonymous said...

I couldn't tell if the Anon post was kidding or not.

The fact remains, if someone figures out they are over their head in medical school, they should be of the character & maturity level to talk to someone about it and get help.

As a patient, I will say this frankly: a doctor who can't ask for help in this way very probably WON'T ask for help when they have a problem on their own as a doctor. That is a huge problem for us. You are going into medicine for US.

Medicine is known to be stressful. Very stressful. Medical school is. We see signs of drug overdoses, etc. and society as a whole is having more problems coping. Its not just limited to MD's in training.

Maybe the first thing we need is no more legacies and kids have to pass a maturity type of test before getting in. All the high scores and IQ's in the world do you no good if you can't realize there are those smarter than you out there and being mature is going to be dealing with a lot of different opinions, groups, etc. to be able to relate to. Communication skills have to be there. Maturity skills and a support system have to be there.

That's just the way it is. Some things will never change. There is simply no reason for any one not reaching out once they decide on medical school and get acceptance in planning how they are going to handle the reality jolt.

Skeptical Scalpel said...

I don't think 4:45 anon was kidding.

8:15 anon, it's hard to argue with you. You said it well. I'm not sure if legacies have more burnout than others. It would be an excellent topic to investigate.

Anonymous said...

Your Kevin MD post was a long, loving dump on the weak and stressed millennials whose emotional fragility is sullying the profession. When one puts a bullet through his head, or however this young man ended his career, it proves your point. Heck, you should be happy that he never made it into the match and took a spot away from someone who won't kill himself.

Why ask for help when this is what the administration and doctors think? Shitty, weak med students who are depressed and stressed make shitty, weak doctors. You don't want those. Every dead med student fixes the problem.

Skeptical Scalpel said...

When someone, med student or not, commits suicide, it is tragic.

Either I did not explain clearly or you missed the points of my KevinMD post. Almost weekly someone has written about burnout and depression in med students, residents and practicing physicians. My post was in response to a previous one on KevinMD. In that post, a med student was clearly despondent about his career choice. He said he had hidden his history of anxiety and depression from the med school admissions committee.

My point was that based on the rampant and rising incidence of burnout, maybe medicine is not a good career for someone who already has that problem. It's too late for that student, but maybe others can learn from his experience. I think that is one reason he told his story.

My second point was that despite the rampant burnout which has been known for several years, there are more applicants to med school than ever before. I find that puzzling. If you know that 50% of all doctors exhibit symptoms of burnout, shouldn't you at least pause to consider the impact of that for yourself.

I don't know how many med students who die by suicide have had histories of depression and anxiety. I think it's a topic worth investigating.

Yes, people with depression should ask for help. I am no longer in a position to directly deal with students and residents. Those who are should make it easier for trainees to do so.

x said...

Anon at 1230
I've got to agree with Skep. You were too emotional to see what is going on. Yes, it is tragic. What is more tragic is people who have gone to medical school in the last 10 years (and I'd venture to say 15) who didn't do serious soul searching and self examination before going to medical school.

This is an extremely tough career. You simply are not going to be prepared if you go from a protected environment to protected medical school to protected residency and at 30, in your first true job, welcome to the insanity of being an attending.

It is essential, nay required, to have a support system. If you have problems they have got to either be resolved or be working on solutions before you hit medical school. Its obvious more of these young people don't have the coping skills needed. That's a fact. If they did have them, you wouldn't see the suicide rate. It starts with colleges who should not be coddling young people and forces them to meet life head on. It starts with parents who make sure that their kids are able to cope.

These are facts. Rail against them no matter how you want, but young people have to be very prepared for the arduous life as doctors. Also remember more doctors are marrying doctors. You've got a massive debt load between 2 people, who also are going to try to have a family usually at the same time of residencies or early careers. It makes no sense to not have seen this coming and prepare.

Skeptical Scalpel said...

X, thanks for your support.

x said...

:) If you aren't honest you are NOT helping these people. Contributing to the blindness of the situation is just like helping them to commit suicide. It is tough, but it also means maybe saving someones' life. I seem to remember an episode of MASH where Hawkeye Pierce stopped someone from doing something that could potentially lead to their death. The person said they hated them. Hawkeye responded I hope it is a long and healthy hate.

That's how I feel. A teacher, mentor, and/or friend is going to teach important lessons. An enemy is going to set you up for failure.

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