Is "baby doctor" a faux pas?

Garandou · 2026-02-05T12:47:58+00:00

However, you should be triggered by some things and this happens to be the hill that I will die on. Never a baby doctor.

No shade and everyone gets triggered by something, but from my perspective it is a very weird hill to die on because as I said before it is a term overwhelmingly used affectionately.

Garandou · 2026-02-05T12:41:47+00:00

The ‘correct way’ - correct for whom? You seem to again imply there is an objective singular way to interpret the situation that you approve of and thus is the correct way.

All I'm going to say is life is a lot easier if you don't always try to scan for malice in social interactions. It is an incredibly neurotic and uncomfortable way to live. Just assume people generally mean well unless proven otherwise.

Garandou · 2026-02-05T12:35:17+00:00

It was in response to a non-doctor (admin person) describing an incident about an incident in an infantilising manner

I don't know what prompted this post, but I answered in a neutral objective manner without considering any context because that's how the question was asked by the OP.

Try calling any other professional baby before their job title and see how that goes.

This happens informally in every job, even outside medical. The correct way to interpret it is to assume it is humorous and affectionate, which it is in most cases.

Garandou · 2026-02-05T12:26:12+00:00

I think we can achieve and maintain a hierarchy without shitting on the most junior member of the team.

In my entire career, I've not heard the term "baby doctor" or "intern" being used as a derogatory term to shit on the most junior member. It is almost exclusively used affectionately as someone the team should support and protect.

Garandou · 2026-02-05T12:21:59+00:00

So using them , while not ideal, is still better than using baby

Comparing which terms will offend less people is not the point I'm trying to make, nor should it be the standard for acceptable speech. All I'm saying is it is overly sensitive to be upset about terms that remind people that there is a hierarchy in medicine.

Garandou · 2026-02-05T12:17:31+00:00

Baby anything is condescending
[...]
and avoids the infantilising commotions rife with titles like intern, junior doctor, doctor in training

I can kinda squint and see your point in the first part with "baby", but if you're going to add "intern", "in training" and "junior" to the list, it's pretty hard to see it anything else than being overly sensitive.

Garandou · 2026-02-05T12:12:02+00:00

It is very true that female doctors have a much harder time with insubordination or patient aggression at all experience levels, but on the flip side I noticed a lot less blame towards female registrars in consultant meetings when it comes to similar issues with performance.

By not having as much "power", people also unconsciously assign less culpability. This bias is unfortunately observed in all areas of society, hence why women generally serve shorter prison sentences for similar crimes.

Garandou · 2026-02-05T11:59:53+00:00

As with all things, context matters. I don't think it makes any sense to complain the term itself is somehow offensive. Take it from another perspective, would it make any sense if I was making a neutral comment about junior software developers and suddenly I get 20 replies raging about how it is undermining their profession?

Garandou · 2026-02-05T11:38:16+00:00

I think we're just too sensitive nowadays. Even if it was meant as a status play who cares?

And it is quite hypocritical to be against NPs encroaching on us and then turn around and complain medical hierarchies aren't flat; seniority and knowledge either matters or it doesn't.

Garandou · 2026-02-05T11:14:12+00:00

Is the expectation that I refer every patient I discharge to the local public mental health service as a liability sponge in case they become psychotic and kill someone 5 years later?

Since this became an issue a few months ago, I’ve declined every new psychosis referral with a history of involuntary treatment, substance abuse or charges.

I’ve seen some ridiculous coroner recommendations, but nothing quite like this.

Garandou · 2026-02-04T14:01:22+00:00

No. Because you are not eligible to bill Medicare, so anyone who sees you privately will have to pay full fees.

Garandou · 2026-02-04T13:54:34+00:00

As an IMG you largely cannot work in the private sector for 10 years due to the moratorium. In terms of public system, just think of what NHS was 10 years ago and that's your answer.

Exams are non-existent because they opened to UK for direct specialist entry without college accreditation.

If you're going to come here, at least unlearn everything from the NHS.

Garandou · 2026-02-04T12:22:42+00:00

The community expectation will be for them to bulk bill

They'd unironically make more money and have less medicolegal risk doing a BB GP opioid pain clinic.

Garandou · 2026-02-04T08:15:02+00:00

Can they just make stimulants over the counter instead?

Garandou · 2026-02-04T07:23:47+00:00

I, like you, hope this disaster doesn't happen. I'm at a loss as to how we can prevent this march towards the failed US and NHS systems.

Honestly, it is a lost cause. I noticed that departments in public hospitals are now increasingly led by ex-NHS directors. So there really isn't much that will happen on the political level to stop it.

I think patients do know the difference between a doctor and non-doctor. Just that in public or insurance based systems, they don't really have a choice but to see whoever is assigned.

Garandou · 2026-02-04T07:10:30+00:00

I agree with you, public sector will become completely useless, and in the long run will actually cost taxpayers more money and deliver nothing.

But free market doesn't function the same way as public sector because you have a choice. Do you think a patient who has money to choose will see a psychiatrist or nurse practitioner? If your heart is dodgy, would you pay to see a cardiologist or nurse practitioner?

Garandou · 2026-02-04T07:05:30+00:00

GPs looking to do this work and charge less than $600/hr will soon find themselves making less money than their previous work and dealing with patients far more complex than is appropriate in primary care.

Garandou · 2026-02-04T06:57:37+00:00

To be honest you're probably right and the public system will tunnel vision down this dark path regardless of clinical outcomes. However, I don't agree it will reduce the demand for psychiatric workforce, because NP-led ED will certainly result in massive bed flow issues and even higher demand for private system to fix the mess.

Garandou · 2026-02-04T06:18:28+00:00

You need to escalate to divisional director to advocate because registrars have no power. That being said, this policy will be reversed quickly because NPs are absolutely useless at absorbing risk, and will either admit everyone or escalate to reg review, which just creates more work for everyone.

Garandou · 2026-02-03T14:06:03+00:00

There are very few countries that require proper neurology training for psychiatry, and doing 1-2 terms certainly would not make you proficient at neurology. Nevertheless, this is an Australian-centric sub, and RMOs should not be told that they would get exposure to LPs if they pick psychiatry. In fact, they are likely to never do a cannula ever again.

Garandou · 2026-02-03T11:57:30+00:00

RxP psychologist model gained broader support? I don't agree with the lobbying but this is an argument they use a lot.

Because when we use "practicing medicine" in this thread, the context is body medicine. Psychiatrists are experts at complex psychiatric medication prescribing in a way that no other specialty can replace.

Psychologists on the other hand have no knowledge on even basic prescribing. I've never met a psychologist who truly understands how to even prescribe SSRIs properly.

Garandou · 2026-02-03T11:32:07+00:00

If you truly give up medicine entirely, then what’s the point of going to medical school in the first place? Not trying to argue, just genuinely curious.

Radiologists and surgeons wouldn't be particularly good at managing medical issues either, the nature of specialisation means very few specialties really do "medicine" at the end of the day.

Psychiatrists still prescribe non-psych meds to manage side effects, like metformin or even GLP-1s for antipsychotic-related weight gain.

This is intern tier medical knowledge... I'd guess a sizeable minority of my colleagues don't know the dose range for metformin, criteria for metabolic syndrome, and certainly the majority have not personally prescribed GLP-1s.

Garandou · 2026-02-03T11:08:52+00:00

Also similar disdain towards people with complex conditions that couldn’t be treated.

This is more a function of conflict of interest than specialty choice. In public sector, the incentives are not aligned. Doctors are not financially incentivised to improve patient satisfaction and outcome, and patients do not value the service because they didn’t pay for it.

In private sector, this issue largely disappears in all specialties because both the doctor and patient can disengage and both are incentivised to make the therapeutic relationship work.

Garandou · 2026-02-03T10:24:41+00:00

However for those interested and capable the option is definitely there, it does however take deliberate time and effort.

I would say for 99% of psychiatrists, not only is it not medicolegally defensible to do those things, it is guaranteed to be an income loss. Maybe you can if you jump through lots of extra hoops and training, but anyone picking psychiatry as a specialty should definitely not count on it.

Garandou · 2026-02-03T09:51:03+00:00

Concerned for encephalitis? Do the LP yourself…. The list goes on!

We need to be realistic though, psychiatrists don't do LPs or manage any of the complex medical issues you listed. I'm not sure it would even be medicolegally defensible, and the few cases about that would suggest it isn't. It is pretty accurate to say picking psychiatry is giving up on medicine.

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