An interesting event happened couple of days ago.
One colleague of mine paged me on my on call day, seeking for opinion on the management of a patient with unstable angina who had developed one episode of transient bleeding while he was on LMWH. From what I’d gathered over the phone it occurred to me that the patient was rather stable with minimal chest pain. I suggested him to switch to conventional unfractionated heparin instead, with careful monitoring, keeping in view of potential rebleeding. He thought the half-life of UFH was 6 hours. I corrected him by telling him that it was only 90mins (hence easier reversal and less prolonged bleeding should the patient bled again). Probably, this was what tickled him off ;P
I have always wanted to know (and get acquainted to) as many as possible of my medical colleagues elsewhere in the vicinity. Basically it’s for the sake of easier understanding among one another, as well as mutual sharing of clinical experience and knowledge.
As a friendly gesture, I had enquired him regarding the year of graduation and the university that he had graduated from, for I wanted to quote some names of my close friends of his batch. (We lead a rather small community in the medical line in our country, and eventually we tend to meet back one another rather soon!)
I was totally taken by aback when he accused me of being arrogant and that I had tried to insult him by asking his year of graduation. I eventually ended up half-apologising-half-pacifying him over the phone. Tough job indeed!
From this little untoward incidence, I could gather a few points of thoughts:
One colleague of mine paged me on my on call day, seeking for opinion on the management of a patient with unstable angina who had developed one episode of transient bleeding while he was on LMWH. From what I’d gathered over the phone it occurred to me that the patient was rather stable with minimal chest pain. I suggested him to switch to conventional unfractionated heparin instead, with careful monitoring, keeping in view of potential rebleeding. He thought the half-life of UFH was 6 hours. I corrected him by telling him that it was only 90mins (hence easier reversal and less prolonged bleeding should the patient bled again). Probably, this was what tickled him off ;P
I have always wanted to know (and get acquainted to) as many as possible of my medical colleagues elsewhere in the vicinity. Basically it’s for the sake of easier understanding among one another, as well as mutual sharing of clinical experience and knowledge.
As a friendly gesture, I had enquired him regarding the year of graduation and the university that he had graduated from, for I wanted to quote some names of my close friends of his batch. (We lead a rather small community in the medical line in our country, and eventually we tend to meet back one another rather soon!)
I was totally taken by aback when he accused me of being arrogant and that I had tried to insult him by asking his year of graduation. I eventually ended up half-apologising-half-pacifying him over the phone. Tough job indeed!
From this little untoward incidence, I could gather a few points of thoughts:
- Asking the year of graduation (and hence implies his seniority) would not be a good idea after a ‘skewed’ consultation. The other party would think that you’re trying to patronize him
- Over-the-phone consultation is both not specific and not sensitive (at least, the other party wouldn’t be able to pick up some visual cues that could have saved the misunderstanding)
- The referred party needs to be extremely cautious, as the referring party is easily sensitized by some unintentional audio cues, which is strongly influenced by the often imbalanced senior-junior relationship and is relentlessly driven by a hidden sense of inferiority complex among the juniors. Things could be quite different, if he were the senior :)
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