A few months ago I wrote a post about psychiatrists’ being fake doctors. I stated that their inability to manage diabetes and hypertension disqualifies them from using the term “physician.” Today, I would like to extend that similar reasoning to the obstetrician/gynecologist: the ob/gyns are fake surgeons.
All throughout medical school ob/gyns promote their specialty by saying, “We practice both medicine and surgery. We see patients from across the lifespan. Praise us because of our vast repertoire of knowledge.” Things simply don’t work like that.
One immediate example is the multitude of second-year and third-year residents who are unable to tie suture knots. The ability to properly place sutures (“stitches,” as they’re called outside of medicine) is a skill that every doctor needs to acquire before graduating medical school. Certainly, I would expect all surgeons to be able to tie knots and appropriately perform simple surgical techniques. However, I have seen residents who time and time again must be re-taught methods of one-hand and two-hand knot tying. During many of these operations once the attending leaves, the third-year medical student takes over and finishes closing the patient. That perfect line on your belly from your C-section? That was me.
I’ve seen simple surgery such as laparoscopic hysterectomies take many hours solely because the attending in charge does not know how to use the equipment. If you’ve ever seen the bariatric surgeries on television, you’ve noticed that the surgeons hold one instrument in each hand to perform the operation. They then control the movement of the instruments using only fine finger motions. My own attendings are so inexperienced that they grasp the entire instrument with one hand to prop it up, and then use the other hand to manipulate its movement. The result is a need for additional hands (additional surgeons), wasted effort leading to fatigue, and an almost doubling in the amount of time necessary to complete the operation. In one particular case I was extremely annoyed when the attending tried to teach me anatomy by turning around the camera within the patient’s abdomen so that she could point out the liver and gallbladder. Well holy shit, lady! I would’ve never been able to figure out where the liver and gallbladder are. Thank you for halting the operation, singling me out as a medical student, and then showing me such basic anatomy as far as where the liver and gallbladder are. All of that time on my general surgery rotation I had imagined that those organs were within the legs. Thanks for correcting my ignorance.
Due to the need for additional hands (more residents), these cases get so overcrowded that the students take no part. When I did surgery, students typically held retractors and a conversation flowed with the attendings. Now, I don’t touch anything, I can’t see anything, and on several occasions I have had to completely step away from the surgical field because of all of the bodies pressing around the patient.
Perhaps the most annoying comment is the one about treating patients from across the lifespan. Given that they only see women who are of either childbearing age or postmenopausal, I would say that they have a very small subset of the population. Further, their lack of medical knowledge is astounding. For a specialty that promotes itself as performing both medicine and surgery, I would expect them to better able to manage hospitalized patients. When asked on rounds how to work up a patient with tachycardia (a fast heartbeat), my resident replied, “Consult with internal medicine.” His name was instantly added to the growing list of physicians that I would never let my family visit.