Beware The Resident!

As we walked into the doctors' lounge heads turned to meet us. I recognized faces which just a few minutes earlier had been staring (or perhaps glaring) at me from the back of the hospital's conference room. One of the young residents walked over to greet us.

"Great talk. Very interesting topic," he said to me. "But, let me ask you: Say I am concerned that a patient of mine has skin cancer. If I do not order screening tests can I be held liable?"

"Of course," I replied firmly.

"Absolutely," answered the experienced physician next to me. "You must order proper testing if you suspect your patient has cancer!"

Even after years of suing bad doctors for horrible screw-ups I was not quite prepared for the utter stupidity of this young doctor's question. I had just spent about 45 minutes talking to residents about how to avoid committing medical errors in the primary care setting. At the end of my seminar, during which all those present stoically seemed to listen to what I was saying, no one had any questions; not, that is, until I ran into the young resident in the doctor's lounge. What, I wondered, does this young man think about when he sees patients? Is he contemplating providing the least care possible to avoid getting sued? Does he lack the knowledge of what tests are appropriate to assist in diagnosing various diseases and ailments? Is he thinking at all?

Hopefully, the resident that questioned me was an aberrant example of a young physician in training. However, residents tend to be responsible for a large share of medical errors made each year. My advice: avoid residents like the plague. I appreciate that they have to learn. All good physicians were green residents early in their careers. Fine. It is reasonable to allow a resident to see you, take your history and examine you. Just make sure that everything he or she does is repeated by an experienced attending physician. The physicians who are residents will be (or should be) identified on their name badges. If you are unsure whether the doctor treating you is a resident, ask.

Of course, there are good residents out there, but by definition they are always going to be inexperienced. Several years ago I went to the hospital with a dislocated elbow. An experienced emergency department doctor appeared along with a young resident to set it. Thankfully I was sedated, but my wife who was present told me later what happened as my elbow was twisted, pushed and pulled back into place. The young resident became queasy during the process and the attending had to take over.

Be kind and tolerate to young doctors, just make sure an experienced, guiding hand is nearby.