Dr LC asked, “Do doctors study even while in practice and how do you go about it?
Fantastic question. Any doctor worth his salt, knows he doesn’t know everything. I mean the stuff we spill out in front of interns and med students, is the stuff we memorized last night or material that has been hammered into us when we were clerks. Things like what’s minimum K levels for hypokalemia, indications for epinephrine, Glasgow coma scale, how to treat hypokalemia, signs and causes of hypokalemia. By now, you realize, I know all things hypokalemia! Because it was drilled into me.
We spew it out as if we’re some all knowing being, while the clerks stand in awe.
But with all the advances in medicine and the daily evolution of research in the field, I’m afraid if you don’t study your field, whichever it may be, you’re losing out.
My approach to continual learning is threefold.
Annual, Monthly & Daily Goals
1.For my annual goals, I review the year behind me and decide what is it that I don’t know and need to work on. Last year I knew I was starting to see lot’s of psych patients, I realized I didn’t know how to deal with these patients when they first approached me. And the answer is not, ‘refer to specialist.’ So I took a course on Psychological First Aid by John’s Hopkins, to help me triage these patients. Not because I wanted an extra credential, but because it would benefit my patients. You could also include conferences here.
Conferences are a great way of keeping updated with current trends in the field. I remember when I was a clerk, our OB HOD, Dr. Pantig made this statement in the delivery room, “I go to conferences to enjoy myself and learn. It’s a lot of fun.”
And all the residents, interns and clerks, rolled our eyes. My idea of fun is jiving, eating out, bowling, a good book or karaoke among other things. But conferences, nada. Now that I’m in practice, i realize that they are fun. Some are in really exotic places, but usually they’re all in nice hotels, the food’s good, the company is great, you’re seated with the heavyweights of the field, stimulating conversation, with people who understand you and the information is top-notch. You really come home with knowledge and cutting edge research. You also get to meet the rest of the community, in case you’re under the false impression that you’re the “only special one” in you’re field.
2.My monthly study goals are books, journals, podcasts and papers. The protocols are ten years behind the research and I believe that a successful practice is a healthy mix of evidence based medicine and clinical experience. This month I had a chance to read the research on Psychopathy Checklist by Dr. Hare and a few papers on hand hygiene compliance in preventing (HAI’s). I love the cases presented on Emergency medical minute.
3. Daily learning pertains to my everyday caseload. Doc’s gotta learn! Despite everything, there are still some things that won’t stick in my brain, like Rinne and Weber’s test. It’s so simple, yet, it just won’t stay in my grey cells.
If I’m on a tele-medicine call and I can’t figure out what’s going on, because of lack of vision, I use the Isabel online symptom checker, which is the most up-to-date. In fact I’ve exchanged emails with Isabel’s owner and father of Isabel Maude. They provide special discounts for group practices, its a very handy tool. In 2016, Isabel and Merck Manual announced an integration. Read his story of why he created it in the fantastic book by Yale Dr. Lisa Sander, “Every patient tells a story.”
Dr Lisa Sanders, discusses a few cases and Isabel’s case of necrotizing fascitis is among them. It’s a must read, in case you like to test yourself on differential diagnosis.
So that’s about it. How do you keep track of what’s happening in your field? Any tips?
Image: Pixabay/Cameonaton/CC0 Public Domain/ Free for commercial use