Recently I was asked if there were any downsides to being an attending in a teaching program. I came up with the following example of how being someone else’s teacher can be a detriment sometimes.
Mrs. WhiteCoat slipped on the stairs and injured her middle finger a few years back. I was working in the ED when it occurred, but was getting off of my shift. I told her to wait and I would come home and look at it, but she was in a lot of pain, so she went to the closest emergency department – at a hospital where I’m not on staff.
Once she got there, an x-ray was done and it showed that her finger was broken, not dislocated as I had suspected from her description.
The nurse practitioner who evaluated her in the fast track asked if she was my wife. When she told the nurse practitioner that she was, the nurse practitioner wouldn’t reduce her finger fracture because she worked with me at the teaching hospital.
Then the emergency physician came in. He wouldn’t reduce the finger either since I used to be one of his teaching attendings. He wanted my wife to see a hand specialist.
The other emergency physician working that day also didn’t feel comfortable reducing my wife’s finger. I used to be his medical director.
When I got to the hospital after the shift, everyone came up and said “hi” to me, then asked me what I wanted to do. I told that someone needed to reduce the finger. No one wanted to be the one that screwed up Dr. WhiteCoat’s wife’s finger, so they all said that she needed a hand surgeon to do it. Unfortunately, the hand surgeon wasn’t available until late that afternoon. I called the surgeon’s office and he had surgery scheduled all day.
So what did I do?
I asked the NP to go get a syringe and some lidocaine. Then I pulled the curtain, numbed my wife’s finger, and reduced it myself. Did a pretty damn good job at it, too – if I do say so myself. Good alignment, no scissoring. Now you can’t even tell it was broken.
The thing that sucked most about the whole experience was that about a month later, the hospital sent me a bill for reduction of the finger fracture … when I was the one who performed it.
At least my wife can still flip me off with a pretty normal looking finger.