St Croix River Road Ramblings

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Sunday, June 17, 2012

Alpha Doctors leading packs through the halls

A generic group of doctors borrowed from the Mayo Clinic
Website  What should a group like this
who roam the halls in packs be called.  

At Mayo in the hospital halls, groups of doctors roam through in packs.  They sweep along briskly, pausing in circles to discuss before swooping into a patient room where the patient has been lying in bed for hours wondering if anything is going on at all.  For 5-15 minutes they talk to me and each other, plan what comes next and then swoop on to the next room on the long hallways.

  The pack is led by a Consultant (in wolf pack terminology, the alpha male or female).  This is the case in teaching hospitals where the main doctor who is a full fledged staff member with years of experience,  bringing along the trainees to have them learn on the job and under alpha supervision. 

Accompanying Dr. Alpha are a group of doctors in training, usually what are called first and second and third year residents.   The residents are students who have graduated from college, from an additional four years of medical school, and are in year one through three of on the job training.  Chief amongst the resident is a “chief resident” somewhere from one year or less from being turned out as a completed doctor ready for practice on her own. 

A resident is the primary person a patient deals with, the person who gathers the detailed information and makes the initial diagnosis.  This person presents the case to the others, often before they come with ipads, clipboards and such enmass to visit the patient.

The whole effort has two purposes, figure out what is wrong with the patient and train the residents in doing that.  They leader is not only key, but a showman or woman--somewhat in the Dr. House tradition.   One or two residents have already spent time visiting with the patient early in the morning and assessing things to present to the whole group including suggestions for treatment that are mulled over by the other trainees while Dr. Alpha presides, questions, prods both patient and residents.  At the end, the plan is explained, questions answered, presscriptions written and the computer entries made for the support staff to follow.  It is efficient, interesting, educational, and gives you the feeling that a group of highly educated doctors are all working together to fix you.  

My diagnosis of Myasthenia Gravis, is actually relatively rare.  Something like 60,000 people in the USA have the disease at any time.  This means that even at Mayo, a resident is quite eager to visit and test the fatigue-ability and reflexes of one of us rare folks--so they can get experience for the next one.  As such, I was relatively popular and got to do a lot of eyes following the finger, press against resistence, reflexes etc  both in medicated and unmedicated states to show the difference.  

So, watching these roving bands of doctors, one feels the need to give them a name.  Wolves run in packs, geese in gaggles, larks fly in exaltations, so these brilliant, dedicated, focused doctors surely deserve a name too.

The name should be indicative of:   a group; medicine, questions, analysis, diagnosis, treatment, and include the hierarchical nature (i.e there should be like in a chicken flock, a pecking order).  As far as I can find, there is no name for this group.  Team is not correct, as that implies equality.  

Some groups, like sharks have many names.  A group of sharks is called a gam, grind, school, herd, pod, collage, or shiver.  We might use one of these names for a group of lawyers.

My starting list. 
  Practice, order, diversity(my pack includes US, Asian, European doctors), consult, residency (most are residents 1-3) , ganglion (a gang of lions—appropriate for neurologists), school (taken for fish), solution, diagnosis,  think tank, infection and a pestilence, or plague.  The ganglion seems most popular amongst the neurologists I have polled so far!   

The head of my ganglion liked “pack,” as it has strict hierarchy and appealed to his nature.  He
recommended I watch a movie called "The Grey.” 

Scott thought "Death Panels" popularized by Sarah Palin might be the correct name in some cases.  My friend Walt wrote a wonderful story about the use of this term for the end of life decisions that are made that hopefully will show up in the Inter-County Leader in a week or two.