Patience, grasshopper.

Yesterday I admitted a kid with pneumonia.  He looked pretty miserable, with a  high fever, working to breathe and needing oxygen by face mask.  I started him on treatment and told his parents it could take a few days.
Today, when I made rounds, his mother accosted me anxiously.  She wanted me to "run more tests" since, according to her, he wasn't getting any better (in less than 24 hours!).

When I went in to look at him, his fever was much lower.  He was breathing more easily.  He needed less oxygen, and was even hungry.  Needless to say, I did NOT order more tests.

I don't treat to order.

I am SO annoyed by parents who think they know everything.  We occasionally get parents who decide, at home, what treatment their child needs.  Since that treatment has to be provided by a doctor, they bring the kid in.  Not to have the doc evaluate the kid and recommend a treatment course.  Just to have the doc provide the treatment that the parents already decided they want.  The parents get so pissed when I insist on examining the child and offering only appropriate treatments.  Medicine has gotten so commercialized that people think they can just order whatever treatment they want.

Public Service Announcement

Parents of the world:  taking your child to the emergency room (or urgent care, or primary doctor) for a viral infection does not magically cure that infection.  Your child will likely still have symptoms, including fever, for several days.  There is no need to bring your child to the ER every day until they admit you.  Let your kid rest, give plenty of liquids and Tylenol as instructed.  Thanks.

Hospital floors

Every day, I see either someone letting their baby crawl around on the hospital floor or letting their kid run barefoot in the halls.  You can't say anything to these parents without eliciting an angry, defensive response.

This really grosses me out.  Hospital floors are covered in millions upon millions of disease-causing germs, tracked all over from various rooms.  These germs, while together on the floors, share mechanisms for resisting antibiotics and evading the immune system like suburban housewives trading recipes. ("You simply must tell me how you manage not to be killed by antibiotics!"  "Of course!  But only if you tell me how you manage to fool those immune cells so neatly!")  Hospital staff don't observe the 5-second rule.  If a piece of food falls below knee height, it's done.

If that weren't enough, hospital personnel clean those floors with very harsh chemicals in an attempt to keep the population down (yeah, right.  Hospital germs would survive a disaster that killed all the cockroaches.). No eco-friendly, non-toxic stuff here.  And it isn't rinsed off the floors, either.  The longer it stays there, the longer it takes the population of germs to rebound.

So, a baby who crawls on that floor (then puts her hand in her mouth!! Ewwwww!!) is likely to either catch a horrible disease or be poisoned by chemical residue.  Or both.  Keep your kids off the bare floor!

Bad days

Most doctors and nurses love what they do, and love the human interaction involved.  However, some days we are just not feeling warm and fuzzy.  Maybe there are problems at home.  Maybe the ER woke us up at 2 am to ask if we thought it was safe to discharge the asthmatic who cleared after one treatment (yes, it happened to me).  Maybe the weather is crappy.  Whatever the reason, some days we just aren't chipper.  We still do our best for the patients, we just are far more...businesslike about it. Oh well.

If you don't trust doctors...

I get that some parents don't trust the medical profession.  I get that they think medications are poison.  I get that they think doctors care about money more than patients.  I get that they think nature is better.  What I don't get is why they bring their kids to the hospital, then refuse to let us do anything!  Why?!?

The Not-So-Affordable Care Act

We were assured, when the ACA was passed, that all Americans would have affordable insurance that would cover their medical costs.  That, apparently, is not true:

http://www.nbcnews.com/health/some-say-obamacares-affordable-coverage-isnt-affordable-them-4B11241833

Not only will some people have to pay out of pocket and wait for the subsidies, there's another sneaky little problem.  When the government is calculating whether the insurance your employer offers is "affordable,"  they look at what it costs just to cover you-even if you have a family to cover.  They don't look at what it costs to cover your family.  You may be able to afford coverage for yourself-but not for your family.  Don't count on getting affordable coverage if you are in the middle class.

Some of you may be thinking, Doc Rugrat's in the medical field; I bet Doc has good insurance.  And you're right.  But not all of my family and friends are that lucky.  And if I have family and friends who are in trouble, they can't be alone.  Unfortunately, even if the ACA were reversed right now, it's too late.  Companies that raised their premiums aren't going to lower them again.  We must find a way out of this mess.