Re: 3rd year Resident assisting w/ myo...

[Guest guest]

My newest Doc was assisted by a resident and there

were other residents and medical students in the

operating room. I was not aware how many people would

be present until some of them stopped in to check on

me post surgery. The med student was bright eyed an

naive. He gave me an interesting view of my surgery

which I appreciated.

The first Doc was assist by another RE. Together they

made a nine inch incision, removed a 1 cm tumor, left

in agrapefruit sized tumor and managed to do all this

while getting adhesions to completely engulf the front

wall of my uterus and adhere my bladder to my uterus.

So I guess I'd take the well watched resident to two

people who cannot find a tumor the size of a

grapefruit

but that is only my opinion

e

[Guest guest]

I had my surgery at a teaching hospital with a Dr. that had residents

with him. I too was concerned about this. When I asked my Dr. Will

you or ONLY Board Certified surgeons be working on me he said yes,

and then re-iterated very strongly " I AM YOUR SURGEON " . Ok..then! It

turned out that I really liked his primary resident as his bedside

manner was so much better than my Dr's. and he would take the time to

actually talk to me! All of the staff in Pre-Op, and Recovery were

great and there were so many of them...I felt I was in very capable

hands.

Best luck to you!

> Hi all,

>

> I just interviewed two MD's in San Francisco for my myo surgery,

Alison

> y and Fung Lam. I kinda preferred Dr. y a bit more BUT,

she is

> with a teaching hospital, UCSF [the other MD is not at a teaching

> hospital].. I asked about her surgical team, and she said she

always has a

> wonderful 3rd year OB-GYN resident assisting. She offered that she

is very

> controlling and a micro-manager and would tell them " Cut exactly

from here

> to here " . Funny thing is, I stopped by her office again today,

voice my

> mild concern to y's assistant, who said, " Oh, residents don't

actually

> do any surgery, they just hold the instruments " . She looked

suprised when I

> quoted the doctor!

>

> Am I crazy, or has anyone else been nervous about having a resident

do

> some/part/whatever of your surgery [who knows what goes on once you

are

> unconcious]? Does anyone know if this is a needless worry, if

highly

> monitored residents are just fine? If anyone has had to grapple

with this,

> or has some statistical info or learned opinion, I'd greatly

appreciate.

> I'd especially love to hear from any MD's out there.

>

> I appreciate your feedback and opinions!

>

> ***** Look for the good and praise it! *****

> R.--SF

>

> |

> = O =

> |

>

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[Guest guest]

Hi ,

The hospital I go to is a teaching hospital, so there are almost

always 3rd year residents involved in surgeries. I've had both an

emergency c/s as well as an abdominal myo and 3rd year residents

assisted with both. I find their perspective both before and after

the surgery very interesting - they may tell you things in a

different way than your regular Dr. and it's just interesting to

have a different perspective from another person who has seen your

insides.

For me, I trust my Dr. who was the lead on both surgeries - I am not

sure how much the 3rd year residents actually do to assist (probably

cutting or closing the incisions but maybe more depending on the

complexity of the surgery) but I completely trust my Dr. that she

will closely supervise them while teaching them. After all, she is

responsible for them. These residents have to learn somewhere and

the more hands on practice they get before they are 'let loose' the

better.

I wouldn't worry too much about it - it's not like the Dr. is just

going to hand the scalpel to the resident, go out for a coffee &

come back when it's done!

Good luck to you!

~Cindy

[Guest guest]

Hi & all,

wrote: > Am I crazy, or has anyone else been nervous about

having a resident do

> some/part/whatever of your surgery [who knows what goes on once you

are

> unconcious]? Does anyone know if this is a needless worry, if

highly

> monitored residents are just fine? If anyone has had to grapple

with this,

> or has some statistical info or learned opinion, I'd greatly

appreciate.

I knew, of course, that I was having surgery in a teaching hospital.

I didn't talk to my surgeon about this beforehand but had an

excellent experience with his resident team. He is a very practiced

and excellent RE and surgeon with a calm and reassuring manner. I was

pleased to find that his entire resident team, that assisted with the

surgery and then did just about all of my follow-up in the hospital

(changing meds when needed, monitoring a slight fever the night after

surgery, deciding when I could start eating), was young female

doctors-in-training. I was happy to know that young women doctors are

learning how to do excellent myomectomies. They were all highly

competent, knowledgable and warm. Even if they seemed like kids to me

(sorry all you 20-somethings).

I figure one of them stitched up the incision, at least, because when

the team came and removed the dressing the day after the surgery, I

said, " Oh, it's beautiful! " (which it was), and one of the residents

said, " Well, thank you! "

So -- make clear to your surgeon what your preferences are, as you

have, but as a VERY general statement I think you are in BETTER hands

when you are in a large teaching hospital because they keep up with

research and new approaches/techniques.

Sunny

[Guest guest]

Hi,

Just a work of caution about assistants. My surgery was pre-approved by my

insurance. The assisstant billed me. She happened to be out of network. Our

insurance said this often happens to regain part of the money they lose dealing

with insurance companies. I protested the bill and after review, didn't have to

pay. It took months and I was threatened.

I was at a teaching hospital and this assisstant was learning but I don't know

if she did any cutting. Teaching hospitals are considered very good. I'd ask

lots of questions if it worries you. Watch your billing.

Ku

[Guest guest]

Hi -

One of the first things I asked the doctor (since my surgery was at a

teaching hospital) was whether he would be doing ALL the surgery. I

made it clear I came from out of state specifically for his special

expertise. He assured me he always does all his own surgery. If I'd

wanted someone less experienced, I could have found a surgeon just

down the road.

-Mindy

> Am I crazy, or has anyone else been nervous about having a resident

do

> some/part/whatever of your surgery [who knows what goes on once you

are

> unconcious]? Does anyone know if this is a needless worry, if

highly

> monitored residents are just fine?

[Guest guest]

When I was contemplating myo surgery last summer I mentioned it to a

friend of mine. I told him that I wanted someone fully vested in the

outcome of the surgery since I wanted to have babies post-myo. I told

him I wanted a highly experienced surgeon and not just anyone -- and

a resident sounded like a bad idea.

My friend replied that from a social justice perspective it wasn't

fair for educated people with good incomes and health insurance to

only have the top surgeons. Poorer people don't have that luxury. And

those doctors in training need to learn somehow. He thought that it

was important to share that burden across socio-economic groups.

I didn't have the myo but it did open my mind a little to the broader

context of my decision.

Just food for thought.

Ann

[Guest guest]

When I was contemplating myo surgery last summer I mentioned it to a

friend of mine. I told him that I wanted someone fully vested in the

outcome of the surgery since I wanted to have babies post-myo. I told

him I wanted a highly experienced surgeon and not just anyone -- and

a resident sounded like a bad idea.

My friend replied that from a social justice perspective it wasn't

fair for educated people with good incomes and health insurance to

only have the top surgeons. Poorer people don't have that luxury. And

those doctors in training need to learn somehow. He thought that it

was important to share that burden across socio-economic groups.

I didn't have the myo but it did open my mind a little to the broader

context of my decision.

Just food for thought.

Ann

[Guest guest]

When I was contemplating myo surgery last summer I mentioned it to a

friend of mine. I told him that I wanted someone fully vested in the

outcome of the surgery since I wanted to have babies post-myo. I told

him I wanted a highly experienced surgeon and not just anyone -- and

a resident sounded like a bad idea.

My friend replied that from a social justice perspective it wasn't

fair for educated people with good incomes and health insurance to

only have the top surgeons. Poorer people don't have that luxury. And

those doctors in training need to learn somehow. He thought that it

was important to share that burden across socio-economic groups.

I didn't have the myo but it did open my mind a little to the broader

context of my decision.

Just food for thought.

Ann

[Guest guest]

Hello, Ann

Your friend's perspective is not unfamiliar to me. I've not had

insurance through a job in about a decade. I was in college and

worked in temp jobs that provided no benefits. Fibroids and iron

anemia hit me hard as I was coming to the end of my graduate school

training. My best option looks like the public health system. I have

no doubt that the experienced doctors in the gynecology department

can help me, it's dealing with the system and the lower level

bureaucrats you have to talk to first who get me down.

I also have no doubt that I do not want a student touching my uterus

or anything growing in it. Yes, the residents have to learn somehow

to treat fibroids. But when it's your body and you want to spare the

uterus, you have to be picky. No, it's not fair that residents in the

public health system are " practicing " on those who have no

insurance...and in my city, where the employment rate among even the

college educated has been high, the local system is more burdened

than ever to treat more people, not just the very poor. In all

fairness, the other hospitals have residents themselves so it's not

just the poor or uninsured who sometimes cross paths with doctors-in-

training though I suppose when you have insurance you have more

freedom to turn down a resident. What's the point of having money and

insurance except that you have better choices and more control? Yet,

when I talk to friends of mine about their health insurance plans, I

am finding that they don't always have great plans through their jobs

and they feel their choices are limited unfairly, also.

In all fairness, the very best gynecologist I know in this city was a

third year resident when I first met her. She is terrific! She is

someone who keeps up with new technology, new procedures and I am

thinking seriously of contacting her about what it would take to have

to look at my fibroids. At least one of them might be a candidate for

re-section and she's probably able to do that. I've paid out of

pocket for her help in the past and it was worth it.

Sincerely,

Gloria

> When I was contemplating myo surgery last summer I mentioned it to

a

> friend of mine. I told him that I wanted someone fully vested in

the

> outcome of the surgery since I wanted to have babies post-myo. I

told

> him I wanted a highly experienced surgeon and not just anyone --

and

> a resident sounded like a bad idea.

>

> My friend replied that from a social justice perspective it wasn't

> fair for educated people with good incomes and health insurance to

> only have the top surgeons. Poorer people don't have that luxury.

And

> those doctors in training need to learn somehow. He thought that it

> was important to share that burden across socio-economic groups.

>

> I didn't have the myo but it did open my mind a little to the

broader

> context of my decision.

>

> Just food for thought.

>

> Ann