Doctors reveal the best (and worst) parts of their specialties. Can you relate?
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Best is discovering lethal but fixable pathology in young healthy patients.
—@justaphaze04, via Reddit
Least Favorite: Cold and flu season, low back pain, paperwork.
—@Bobblehead_steve, via Reddit
Every specialty has its highs and lows—the moments that remind physicians why they chose medicine, and the tasks that make them wonder whether someone else couldn’t possibly handle this part.
That was the question at the heart of a recent post in r/medicine: What are your specialty’s favorite and least favorite duties?
For an emergency physician, the thrill may be identifying the urgent problem, making a rapid decision, and fixing what can be fixed. But ask them to spend hours rounding? They’d rather not. A surgeon may love the operating room but dread the paperwork surrounding it. A primary care physician may value long-term relationships with patients while wishing prior authorizations would disappear forever.
Every specialty seems to have its own version of this trade-off. So what’s your specialty’s theme?
Related: 9 residents on what inspired them to choose their residency specialtyPsychiatry
Reddit user and psychiatrist @PokeTheVeil’s likes and dislikes:
“I like ‘clean‘ psychopathology. I can treat those things. I even like messy psychopathology. I can try to figure it out and treat it. I like getting called in early, or just curbsided to see if I can be called in helpfully.”
“I do not like when I am treated as auxiliary social work, like a special dispo service, or when someone else has wrecked psych treatment and belatedly wants me to make it okay. All psych meds held for no real reason, I’m looking at you. Again. And it’s clozapine.”
Cardiology
Cardiologist @justaphaze04’s likes and dislikes:
“Best is discovering lethal but fixable pathology in young healthy patients. Like severe AS or an aortic aneurysm.”
“Worst is seeing geriatric patients with fatigue to rule out a cardiac cause. Because their symptoms could be due to anything, we are likely to find something wrong with their heart that may or may not be the cause, and the fix is high risk. The end result is they might feel better but they also might die. It’s such an uncomfortable conversation to have.”
Related: Here's a skill you might have missed in cardiology trainingNeurology
Neurologist @iamchoti’s likes and dislikes:
“Favorites: TNK + thrombectomy, finding a medication that works for migraines, PLEXing a myasthenic crisis and seeing them get better, giving a butt load of steroids and getting vision back in optic neuritis and obviously - localizing the lesion.”
“Least favorites: generalized weakness, unspecified tingling, AMS in a febrile 95 year old with dementia, stroke codes for vision loss in patients who are blind, and when people don’t even bother doing a cursory neuro exam (please, at least tell me where they’re tingling!).”
Related: Neurologists love these 5 hobbies—here’s why they may benefit any physicianFamily medicine
Family medicine physician @Bobblehead_steve’s likes and dislikes:
“Most Favorite: Helping someone turn their diabetes/HTN/HLD/Depression/Pain around and spacing those follow up visits out.”
“Least Favorite: Cold and flu season, low back pain, paperwork.”
Emergency medicine
Emergency medicine physician @DrPrintsALot’s likes and dislikes:
“Favorite: being at the head of the bed with my formula 1 pit crew of highly trained nurses doing a big and fast resusc. I trust them, they trust me, we all flow together and get shit done.”
“Least: calling yet another specialist who does everything they can to get out of taking any responsibility for helping a patient in need. Having to back them into a corner until they’re forced to just do their job.”
Related: Is AI sending too many people to the ER? Docs debate the new wave of algorithm-driven anxietyGastroenterology
Gastroenterologist @FAx32’s likes and dislikes:
“Best: Satisfying intervention like banding varices or removing a large high grade polyp that you know will make a difference in this patient’s outcome.”
“Worst: Decompression of unprepped colonic pseudo obstruction in a tie with dealing with the exponentially increasing group of EDS/POTS/Mast Cell dysfunction trifecta (with no known objective evidence for any), who probably just have IBS and vagal stimulation from that who call regularly but won’t come in and won’t do anything you recommend.”
Related: A rheumatologist’s formula for dealing with patients who self-diagnose via AI and social mediaPediatric emergency medicine
Pediatric emergency medicine physician @E5D5’s likes and dislikes:
“Favorite: Cute babies even if they have temps of 101.”
“Least Favorite: Convincing the angry parents of that baby that an unmedicated temp of 101 for 4 hours doesn’t require a $5k work up and isn’t ER appropriate.”
Related: Can you tell a surgeon’s specialty by their OR stance? The hilarious responses speak for themselves