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Loading ...You may have missed it. It was kind of buried in all the news about the start of the NBA season, but there was an election last week. Yes, an election in the good ol’ United States.
Obama Won. He ran for president.
Interestingly, on Wednesday I got the following email:
Dear Dr. Rob:
I have been gunning for this job for over four years and just landed it this week. I am real excited about it, but need some advice on how to do it best.
What advice can you give me?
Anonymous (my name rhymes with “no llama”)
I am always excited to answer this kind of question. It is clear that he is real excited but a little nervous. Instead of a traditional Grand Rounds, I am going to use this time to give him some timely advice.
Thanks for sending it, Mr. “No Llama!”
First, let me congratulate you on landing the job. I remember when I landed my first job at Wendy’s. I was excited at the opportunity, but nervous that I might dry out burgers by overcooking them. That was stressful, but my guess is that your job will be a tiny bit more stressful.
So, Mr. “No Llama,” here is my advice for you:
1. Show Professionalism.
Professionalism can be defined as: setting expectations, providing experiences, and evaluating outcomes. Laurie Edwards at Chronic Dose has some thoughts on the issue. I am sure she knows much more about the subject than I do.
Is it professional to trick people? Walter at Highlight Health discusses an article that reveals a high percentage of physicians prescribing real drugs as placebos. I think it is getting caught between the “art” and the science of medicine. I am sure nobody in your profession is ever dishonest.
Sometimes, even if you have been very tolerant of frustration, even the most cool customer snaps (Med Valley High). This may not seem professional, but it is human. At Wendy’s, professionalism meant that you didn’t put the burger back on the grill after you dropped it on the floor.
2. Don’t be overly sensitive
Getting a hypoalergenic dog is a good start to those who are sensitive to dog dander (from Everything Health). Hot dogs don’t shed much.
If you do develop itchy and scratchy skin, Doc Gurley has some good advice as to how you could feel much better. Be careful, however, because she mentions cutting back on bathing.
3. Don’t tell jokes that involve monkeys, Andy Rooney yogurt, and plastic explosives.
Trust me on this one. People just don’t like them like they used to.
4. Get good advice.
If people around you are a pain in the neck, Dean gives great advice on how to get rid of your pain (Rebuild Your Back). He doesn’t give advice on how to get rid of the people.
If those people punch you in the nose, Ramona Bates gives great advice on bloody noses (Suture for a Living). Perhaps she can even quilt you a hankie if you ask her nicely.
If you want to look up your advice on the web, UpToDate seems to be more helpful than PubMed (although the author of Clinical Cases and Images suggests using more than one – just to be safe). However, the fact that you asked me for advice casts a huge cloud on your choice of advisors.
5. Listen to podcasts.
I do this one myself. If the stress of your job causes intestinal problems, you can listen to a podcast on the pain from irritable bowel syndrome (How to cope with pain blog).
If you want to do something useful (fixing healthcare) you can listen to an interview of the head of the Institute for Health Improvement as he discusses the ways in which healthcare can be improved through good use of information (Healthblawg).
Personally, I think the Sheep Guarding Llama podcast is especially inspiring.
6. Watch what you eat.
For instance, don’t eat pancakes with mites in them - you could have a bad allergic reaction (Allergy Notes). When you go to IHOP make sure you ask them to “hold the mites.”
If you do eat something that disagrees with you (like burgers that sat out too long), then just do what Paul Aurbach recommends: use oral rehydration fluid along with Ondansetron. Works like a charm.
But if you aren’t perfect in your eating, don’t be too ashamed. Even Amy, the queen of diabetes isn’t perfect (although her version of imperfection involves yogurt and rice cakes; mine involves donuts and Little Debbie’s).
7. Befriend nice Canadians
One of the nicest ones I know is Dr. Val. She has never called anyone a hoser or sneered because I didn’t drink enough beer. She did, however, ask a bunch of nurses if they would be willing to fill the gaps of the primary care shortage. Their answer? We’re not suckers, you hoser!
Another very noble Canadian is James Orbinski, the founder of Physicians Without Borders The Canadian Medicine blog has a very interesting interview with him that is well worth the read.
8. Every Friday, throw a big party for people named “Doug.”
They would really benefit from the encouragement.
9. Never forget that despite all the good there is in life, there are still things to gripe about.
Dr. Cris does this when she rants about people who try to take advantage of the fact that she is a doctor.
Andreas, who is a German orthopedist, laments the education system in Germany for orthopedics. It appears we are doing something right here in America. At least they can drink German beer to compensate for this inequity.
Dr. Shock is not happy that the American Journal of Psychiatry recommended that suicidal behavior have its own DSM V axis. Perhaps he should do one of those Vulcan neck-pinch thingies on them. No wait…sorry, wrong guy.
10. Get out every once in a while.
The Sterile Eye, a blog by a medical photographer, discusses a visit to the Medical Museum in Glasgow, Scotland. This city has quite a medical legacy. Don’t do it before dinner, though, because there are lots of jars with body parts floating in them.
Another thing you can do is to go to the AHA conference in New Orleans. The ACP Internist blog discusses the rapid emergence of personal genomics and how it will soon impact all fo us.
Don’t forget to get a beignet while you are there (with a Lipitor chaser).
11. Listen to people.
Robin raises her voice about the primary care crisis in the US – speaking as a patient and to patients. I hope her voice joined with ours finally gets heard.
Some things are difficult to hear. Code Blog tells about one of the hardest sounds to hear – the sound of heartbreak. We in medicine hear this sound more than most people; but we never get used to it.
12. Expect the unexpected.
How about “healthy” cigarettes? Somewhere someone got the idea for electric cigarettes (thanks to Patient Eye). No cancer risk, but you’ll be setting off the alarm in Home Depot for some time.
Duncan Cross found the unexpected when he got stuck in the hallway – an interesting tale of handcuffs and sign language. I hope they weren’t electric handcuffs.
Jordan over at In My Humble Opinion gives a nice story about an interaction with an Alzheimer’s patient. Patients can always be a source of surprises.
13. Support Zippy’s fight against brain cancer.
If each person who reads this gives $10 (or buys some fine Zippy merchandise), it would go a long way to help some needy kids.
14. Find a good doctor.
Despite the fact that your search lead to me, there are actually some good doctors out there. Theresa at Rural Doctoring tells about one such doctor who made a lasting impression.
Steve, over at Adventures of a Funky Heart, tells of the real impact of Dr.’s Blalock and Taussig. How real? Steve is literally living proof of that impact.
15. Don’t do Disco.
Ever since Disco came onto the scene, the rate of autism has gone up and the rate of global warming has become alarming. I am sure this is the cause, because they happened at the same time. Such logic is the discussion that Sandy at Junkfood Science takes up regarding the correlation between autism and rainfall.
Hmm…maybe disco causes increased rainfall. Maybe it’s some sort of rain dance.
If you do have trouble with compulsive disco behavior (otherwise known as dance fever), Daniel at Neuroanthropology discusses this behavior from multiple levels – from neuroreceptor (dopamine, fittingly) to anthropological approach. So if you are hooked on disco, don’t give up. There is hope.
16. Don’t get too stressed out.
This may seem to contradict the whole griping bit, but this is my grand rounds and I can contradict myself if I want to. Actually I can’t.
Kim at Emergiblog talks about a time she griped about hospital administrators, only to realize that their idea is exactly how she got into ER nursing. People do have the habit of criticising administrations, No Lllama. Don’t take it too personally.
Kerri gives perhaps the best advice at Six Until Me. Take each circumstance as it comes, and don’t let yourself get lost in the chaos of life.
17. Fix Healthcare.
If you happen to be getting a job that somehow has influence over the way that American healthcare is run, then I suggest you put some effort into fixing it. David Williams over at the Health Business Blog talks about how we seem to be heading for a single-payer system. Is this good or bad? The answer is clearly: “yes.”
Lawsuits are another big problem. Not only do they drive up cost, but they cause incredible emotional toll on the doctors – even if they are frivolous. Orthopod Online and Blogging gives good advice as to how to deal with this stress, but it would be nice if the threat wasn’t always looming so large.
The constant desire for new technology is also to blame, as is pointed out in the Colorado Health Insurance Insider. People always want the cutting-edge treatment and technology, but who is making sure we can afford it? Regular readers of this blog are not allowed to point out that I myself succumbed to such pressure in the recent purchase of a Macbook. I assure you, my need was real and my life unfulfilled without said gadget.
18. Know your Goat.
Good advice for anyone.
19. Don’t do (too many) drugs.
Prescription medication use is on the rise in teenage girls. The Poked and Prodded blog muses as to why this is the case. There may be good reasons, but there is probably a lot of unnecessary prescribing going on.
One way to avoid the use of medications is to use biofeedback. The Healthskills blog discusses the use of biofeedback on back pain. If it really works that well, then I ask all of you to only give me biofeedback on this session of grand rounds. My back could use it.
Getting fit can prevent the need for drugs as well. Jolie Bookspan discusses the development of an international academy to certify fitness trainers using her techniques. Congratulations Jolie! People have been telling me that I am certifiable for a long time. I just haven’t taken the time to get certified in whatever they are talking about.
20. Prepare for the Future.
After working at Wendy’s I knew that the sky was the limit. I am who I am today because of lessons learned over cooking french fries. So even if this new job only lasts you for, say, 4 or 8 years, you will learn valuable lessons that can lead to an even better job.
Job advice is plentiful at Vitum Medicinus. He has a whole series of posts on the decision to become a doctor, giving the wise advice: “know what you are getting into.” Interestingly, that is the advice my nurses give every one of my patients when they first start seeing me. Isn’t that nice?
Finally, Jeffrey at Monash Medical Student advises his readers on the choice of a medical specialty. Choosing to become a doctor may not be as big of a choice as chosing what kind of doctor you want to become.
So there you have it Mr. No Llama. That is my advice on your next job. I would suggest you pay close attention to the med blogosphere for further advice. We medical bloggers are not afraid to voice our opinions….and our opinions are usually right.
I sincerely wish you great success in what you do. I suspect great success for you would benefit a lot of people.
Here are two additional things everybody needs to do:
- Go next week to Grand Rounds at Dr. Deb’s Pad
- Go to Colin’s blog and wish him a happy birthday.
For the detailed list of the blogs, go to my Delicious list: http://delicious.com/rlamberts/grand_rounds
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