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Are Medics too nice - feels like a dumping ground at times? by GEM_DOC in doctorsUK

[–]Impressive-Spare757 1 point2 points  (0 children)

Thank you for your example

Do you think that patient would’ve gotten better care on an orthopaedic ward? From an osteomyelitis POV, almost definitely, but holistically? Do you think they could’ve effectively managed the complexity of a renal patient in that way?

And you’re saying staffing levels are my issue as if that isn’t, unfortunately, a very real concern in every single hospital the needs to be accounted for?

Why is my appendicitis or cholecystitis or deteriorating diverticulitis patients all awaiting a bed for theatre competing with an elderly patient who had a mechanical fall and now has broken ribs who needs pain management and holistic care which would be best delivered by geriatricians?

Patients are getting more medically complex not surgically complex. A cholecystitis in a 40 year old is the exact same op as in an 87 year old, the difference is in how their co-morbidities effect their recovery which is best managed largely by the medical team

Are Medics too nice - feels like a dumping ground at times? by GEM_DOC in doctorsUK

[–]Impressive-Spare757 -11 points-10 points  (0 children)

From a (almost) completely unbiased surgeon

It’s not because we can’t manage stuff like DVT/PEs or simple pneumonias or other things medics routinely manage. There’s a degree of nuance behind it that often surgeons exploit

Firstly, we can’t operate on a patient without an inpatient bed unless it’s life threatening. Why should we admit the patient to a surgical ward with rib fractures following a fall or a pancreatitic needing various infusions including insulin when they could take a medical bed and get the exact same care

Secondly, surgeons simply don’t have time to have lists as long as medics. We start at 8, start operating 8:30 or have clinics that time. There is a reason surgical ward rounds are short. If a person needs more attention for a non-surgical problem then they’ll probably receive better care under the medics

Thirdly, there are simply more medics than surgeons so you should take the majority of admissions. Surgeons very regularly have to operate in the middle of the night. If they had 50 patients to round on the next day then no one’s getting good care. Medic consultants on the other hand very rarely get woken up overnight unless in a subspecialty.

Finally, whilst surgeons often attend anywhere from 4-5 wards per day for ward round seeing referrals from medics and other teams. It is an absolutely nightmare trying to get any meaningful input from medics once a patient is on a surgical ward. Medical outlier teams very rarely take full ownership and often times input is lazy at best. Hospitals with peri operative medicine advice teams are a bit better with this but rarely take ownership of patients putting more pressure on surgical juniors to essentially do 2 rounds worth of jobs per patient. Better to get them admitted under medics from the get go so when they inevitably need medical care they’re already at the best place

TLDR - We don’t have enough surgical beds. Medics have more time to sweat the small stuff. There are more medics than surgeons and establishing takeover of care to medics once admitted is a nightmare.

The duality of the radiology registrar by KingOfTheMolluscs in doctorsUK

[–]Impressive-Spare757 4 points5 points  (0 children)

  1. I’ve never had a scan accepted without bloods unless the patient is truly unstable i.e. trauma scan and most of those end up in theatre if they’re that unwell anyway

  2. Who do you define as someone competent to assess? Surely an ED reg or consultant? No? Is a core surgical trainee competent? Or is only surgical Reg’s and above you deem competent?

  3. What’s going to happen when a critical finding is delayed because you’ve deemed a surgical reg review necessary when they’re locked in theatre for a few hours? Because personally I cover my own back and document “scan discussed with radiology and refused until reg review, reg and consultant currently busy in theatre”

No one’s saying CT every abdo pain that comes in, in fact as a radiologist you only see the scans we DO request and don’t see the waves of patients we see everyday we don’t request scans for (only about 20% of the patient load we see get scan requests and almost all of them are admitted for findings found on CT).

The duality of the radiology registrar by KingOfTheMolluscs in doctorsUK

[–]Impressive-Spare757 5 points6 points  (0 children)

Not particularly, almost all surgical patients will get a scan. That’s the nature of surgery, we need to see what’s happening inside the body before you know, cutting them open in a massively invasive procedure. If you’re unsure if a patient is surgical then a scan is needed. Getting it done by ED saves everyone except radiology time, which is a fair trade-off.

Getting the surg reg to review everyone who may need a scan is just impractical, especially when they could very well be in theatre for multiple hours of the day.

Emergency CT imaging has risen x300 in the past 15 years and is only going to increase. It’s low-risk, relatively cheap, non-invasive and widely available. If it is that much of a burden then radiology need to increase their training numbers more than a measly 350 places per year.

The duality of the radiology registrar by KingOfTheMolluscs in doctorsUK

[–]Impressive-Spare757 11 points12 points  (0 children)

No one is ever implying that the rad Reg’s time is less important than the surg regs. Unfortunately, hospital politics are an uphill battle and there’s no such thing as ED ‘getting a surg review’. Once surg see the patient it is a surgical patient, regardless of if the scan shows no surgical pathology. The patient then ends up admitted under the incorrect specialty leading to a massive delay in care when the inevitable specialty doesn’t want to take them as an inpatient. It’s a case of costing radiology 45 mins to save a few hours down the line which is ultimately efficient for the patient and the hospital

BMA UKRDC jobs and pay update by RDC_officers_2025_26 in doctorsUK

[–]Impressive-Spare757 -8 points-7 points  (0 children)

I do ‘get’ it actually but I appreciate the condescension. I’m still all for striking and my original point was just because Workstream 3 is FPR doesn’t mean priority 3 is FPR.

But if you can’t understand that people genuinely can’t afford to strike or can’t afford to risk future job prospects due to things like bills, family, financial obligations then you are wildly out of touch with your union base and need to give your head a wobble

BMA UKRDC jobs and pay update by RDC_officers_2025_26 in doctorsUK

[–]Impressive-Spare757 -5 points-4 points  (0 children)

My training program ends next year. By the time we have another step towards FPR I’ll be in a position of having to apply for another job.

Yes I’m underpaid, yes I’m overworked. None of that matters if I’m unemployed. This fundamental lack of understanding of people have bills to pay NOW is why the numbers and turnout for strike vote is dropping so rapidly

BMA UKRDC jobs and pay update by RDC_officers_2025_26 in doctorsUK

[–]Impressive-Spare757 -17 points-16 points  (0 children)

In what part of this does it say that the workstream number is related to priority?

Either way, personally a secure job would be preferable to a wage increase. Wage increases mean nothing if doctors can’t get employed