Insufficient evidence
To my attention yesterday. Dr. Karen Sibert, a stridently proud full-time anesthesiologist, argues that women who choose to work as part-time physicians are short-changing their patients and the country. I’ve been meaning to write something about the changing relationship between physicians and their careers for some time, and so this may as well serve as my first post on the subject.Suffice it to say at the outset that the column makes all kinds of claims that it does not support, and that its author seems to me to be the kind of doctor who views her own experience as illustrative of how things ought to be for everyone. These are cut from the same cloth as doctors who had the tar ground out of them during residency, and so think that every new doctor should have a similarly grueling experience because that’s just what doctors go through in their training. This tendency to romanticize a negative runs strong in my profession. There’s usually some kind of bluster about how it instills a sense of commitment, an immersive dedication to the practice of medicine, which I happen to think is so much hooey.
Begins Dr. Sibert:
I’M a doctor and a mother of four, and I’ve always practiced medicine full time. When I took my board exams in 1987, female doctors were still uncommon, and we were determined to work as hard as any of the men.
Today, however, increasing numbers of doctors — mostly women — decide to work part time or leave the profession. Since 2005 the part-time physician workforce has expanded by 62 percent, according to recent survey data from the American Medical Group Association, with nearly 4 in 10 female doctors between the ages of 35 and 44 reporting in 2010 that they worked part time.
This may seem like a personal decision, but it has serious consequences for patients and the public.
Medical education is supported by federal and state tax money both at the university level — student tuition doesn’t come close to covering the schools’ costs — and at the teaching hospitals where residents are trained. So if doctors aren’t making full use of their training, taxpayers are losing their investment. With a growing shortage of doctors in America, we can no longer afford to continue training doctors who don’t spend their careers in the full-time practice of medicine.
Dr. Sibert does not actually support these assertions with any numbers. I don’t know many practice hours per provider per year are necessary for taxpayers to recoup their investment, and she doesn’t tell us. Who knows if a part-time career gives back enough to make the investment in the doctor’s career worthwhile. I suspect its hard to quantify, but am skeptical that part-time physicians are providing insufficient benefit to make their educations not worth the money.
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Since 2005 the part-time physician workforce has expanded by 62 percent, according to recent survey data from the American Medical Group Association, with nearly 4 in 10 female doctors between the ages of 35 and 44 reporting in 2010 that they worked
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Electronics in Car - Resuscitation today: How to defibrillate an ...
AED, like all defibrillators, are not designed to shock asystole (“flat line’) as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator.
The German dialogue on screen correctly critiques the CPR and defibrillation pointing out which parts are “Korrekt” and which parts wrong. In the English dialogue, the discussion about recharge times is simply wrong and the AED will not deliver a shock until after it has analysed AND found a shockable rhythm such as VF or VT. Even then it won’t shock without pressing the button. Basically what you see here is dramatic rubbish. Do a course and don’t waste time looking for a pulse!
@KPSKS AED can be used for asystole. But it is rarely successful once there is literally no heart rhythm. D-fib is designed to bring the heart back into a normal sinus rhythm, if the patient is in v-tac, v-fic, atrial flutter or has any other type of arrhythmia. Only on TV shows do you see people being shocked back into sinus, after having gone in asystole. I have only seen it done once in person and the patient was hypothermic, which increases their chances of survival.
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