Thursday Thoughts From The Throne #6

Interior chandelier Grand Central Terminal

I spent a few free hours this morning doing some CME (Continuing Medical Education). Part of the requirement was listening to real physicians have “difficult” simulated conversations with “difficult” simulated patients. 

It was awful.

The only redeeming factor is that at least I get to claim two hours of CME credit. Otherwise I would feel I had utterly wasted my time. 


Real life “difficult” patients are not that calm and polite when you are telling them you will no longer give them prescriptions for their controlled substances….


75 thoughts on “Thursday Thoughts From The Throne #6

  1. Perhaps you could set up your own CME course, a Master’s version. I volunteer to be the disgruntled patient. I’m really good at faking freaking out (your choice as to whether that is in sarcasm font or not) and I can swear with the best of them! I’m a giver…

    Liked by 5 people

  2. How do you know when a person is just taking the controlled substances for pleasure versus real issues? I guess I am defensive since I have a couple of chronic illnesses that could use some pain meds tho I choose not to take anything and just live with the pain but would be heartbroken if my physician thought I was abusing them when if fact, I was taking them just to make it day by day. I also have a panic disorder that is highly controlled by a small dose of Paxil daily and I would be so scared if for some reason my doc decided I did not need it anymore. I am sure (from what I know about you from your blog) you are a super caring doctor and would not cut-off a person unless you felt it necessary!

    Liked by 2 people

    • Typically patients are cut off when the state drug registry shows RXs from multiple physicians and they have been caught lying about it or they are behaving belligerently to the staff. That being said, the move is away from narcotics to other, more effective, treatments for chronic pain. Paxil is not a controlled substance, you have nothing to worry about! πŸ™‚

      Liked by 4 people

  3. Classes never simulate reality, at least not in my experience.
    How about those patients that see an ad and demand the drug so they too can have unlimited sex in a paradisiacal setting? It still boggles my mind that they let drug companies advertise…(K)

    Liked by 3 people

    • I wish they would outlaw direct to consumer advertising, though, it is not as effective as it used to be. Patients are bearing the brunt of the cost now more than ever and once they get over the sticker shock they all want generic. πŸ™‚

      Liked by 3 people

      • I don’t know why anyone would “want” to take any of these drugs. My mother had so many pills they had to be interacting with each other in ways that were not good for her health…(and that’s not counting the herbal remedies she added on)

        Liked by 2 people

  4. My GP told me recently that when he turned an addict down, the patient threatened to come back with a gun and shoot people. It was very evident that my GP was still very shaken even just recalling it.
    It sounds so scary. How do you weed those out who truly need the medications.

    Liked by 3 people

  5. Hey Victo πŸ™‚

    This the first ‘thought’ caught by my eye πŸ˜‰ Just wanted to say, I like the style of these hip-fired punchy plops of prevalent passing passages of pressing thoughts being aired for the very first time lol πŸ˜€

    In addition to being cheeky, a question: what is the overall success rate in permanently moving Class A addicts from substance abuse to prescribed medicated treatments?

    Thanks Victo. Hopiong all is well.

    God Bless. Namaste πŸ™‚


    Liked by 2 people

    • To your question about the rate: I honestly have no idea. The important thing to remember is that addiction makes good people do very bad things. Withdrawal is very physical, punishing and awful, and addiction is not rational. I have had some very motivated patients, though, get off of all opiates and benzodiazepines and they have done very well for years now.

      Liked by 3 people

  6. My husband’s CME has its positives for me when he goes to a conference in a cool place (and I get to go, with us paying for my flight and meals), but that is the very occasional exception. I think he does a fair amount of CME online. Your experience today doesn’t sound fun.

    Liked by 2 people

  7. Wouldn’t it be great if they had something like “choose your own adventure” where you are presented with the situation then you can choose how the patient reacts then watch the passenger handle that? You could choose every single option and learn from those. Of course, this would only work if they gave you real options and responses.

    Liked by 2 people

  8. What a pain. I’ve done all of mine. It’s like they don’t account for you learning on your job. We have to do 40 hours each year. I went over every year but not much as if they see we do more they might increase the threshold. Ours is due end of this month. The only thing I haven’t done is my learning plan for the next year. They make us do one now to say what we are going to try and improve on. Load of crap. If you don’t work in that field why would you want to improve on topics that has nothing to do with your work?

    Liked by 2 people

  9. You gotta be kidding me. Simulated difficult patients? I lose more and more faith in the medical profession just about every time I read a post from you. The fact that you see through the bullshit and just do what you have to do is the only thing that leaves me with hope. My hope is that my own physician has the same attitude.

    Liked by 2 people

  10. Not my favorite form of “training” either.
    I recently acquired a new family doctor, and before even scheduling, was told that this doctor does not prescribe long-term (insert a bunch of names for pills.) THAT says a lot about the level of misuse/ addiction/ pain in our society. I could just about hear the woman on the phone blush that she had to tell me that. Obviously there have been incidents. :/

    Liked by 1 person

  11. There should be a pill you can give to those weird and so over confident people who run professional “refresher” courses. But what ever you might think about going to a CME course at least be thankful you don’t have to put up with a recently graduated teacher telling you that from now on we will all be teaching ‘well being’. Because believe me, we who were teachers recognise the fact that we are worse than you doctors..

    Liked by 1 person

  12. Ha! Ha! Not to mention – self-appointed – “privileged” relatives of patients who think they have priority above and over everyone else…
    “How come you’re not giving my mother a room immediately?! I know the Secretary of HEW!”
    “Sir, I already have 4 patients in the corridor on stretchers when they really should be in ER. Come with me. I’ll show you, if you don’t believe me… Now if you do know the Secretary maybe you can put in a word?”

    Liked by 1 person

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